Each family participates in the development and ongoing review of a service plan that is the basis for delivery of appropriate services and support.
Interpretation: Generally children age six or over are to be included in service planning, unless there are clinical justifications for not doing so.
A family-centered service plan is developed within a timeframe that is responsive to family needs, with the full participation of family members.
Interpretation: Service planning is to be conducted so that family members retain as much personal responsibility and self-determination as possible and desired. Individuals with limited ability in making independent choices can receive help with making or learning to make decisions.
The service plan is based on the assessment and includes:
Interpretation: The agency should recognize the value of incorporating culturally-grounded interventions into the service plan, and include traditional practices or customs of the child’s culture, tribe, or faith-based community to the greatest extent possible and appropriate.
During service planning the agency explains:
Families are informed about:
Extended family members and significant others, as appropriate and with the consent of the family, are advised of ongoing progress and invited to participate in case conferences.
Interpretation: The agency can facilitate the participation of extended family and significant others by, for example, helping arrange transportation or including them in scheduling decisions.
The provider and family regularly review progress toward achievement of agreed upon goals and sign revisions to service goals and plans.
The provider and a supervisor, or a clinical, service, or peer team, regularly review the case to assess:
Interpretation: Experienced providers may conduct reviews of their own cases. In such cases, the provider’s supervisor reviews a sample of the provider’s evaluations as per the requirements of the standard.
Agencies providing intensive services should review cases monthly, and agencies providing less intensive services should review cases at least quarterly. Timeframes for service plan review should be adjusted depending upon issues and needs of persons receiving services, and the frequency and intensity of services provided.
Interpretation: When the case involves an Indian child, a representative from the tribe or a local Indian organization should receive timely notification of case reviews, be given an opportunity to participate, and be informed of any changes made to the plan. The case review should include an assessment for compliance with the Indian Child Welfare Act.