PA-DTX 11: Aftercare and Follow-Up
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The agency and the
service recipient work together to develop an
aftercare plan, and follow-up occurs when possible and appropriate.
Interpretation: While the decision to develop an aftercare plan is based on the wishes of the service recipient, unless aftercare is mandated, the ageny is expected to be strongly proactive with respect to aftercare
planning.
An aftercare plan is developed sufficiently in advance of
case closing to ensure an orderly transition.
An aftercare plan identifies services needed or desired by the person and specifies steps for obtaining these services.
The agency takes the initiative to explore suitable resources and contact service providers when appropriate and with the permission of the person,
family, or
legal guardian.
The agency follows up on the aftercare plan, as appropriate, when possible, and with the permission of the service recipient.
Interpretation: Reasons why follow-up may not be appropriate, include, but are not limited to,
cases where the person’s participation is involuntary, or where there may be a risk to the service recipient such as in cases of domestic violence.