a) Introduction
In the delivery of casework intervention and social services, children and families face unexpected or accidental life events. These events may impact the child in placement or those with whom the child has a significant relationship.
The Department is responsible for attending to the acute grief and needs of DCFS wards and their families. These individuals include the foster parent, parent, relative caregiver as well as the caseworker. This protocol will address the various responsibilities of child welfare staff when crisis situations arise.
The Division of Clinical Services will insure delivery of services to Department involved families in the event of a crisis. Crisis events dictate an immediate response that is consistent with best practice.
Specific consideration shall be given to the needs of the direct service worker and supervisor who may be emotionally affected by the event. For Department staff, please refer to Administrative Procedures #16; Staff Safety pages 6, 7, and 8 to aid Department staff dealing with the effects of traumatic events such as the death of a client.
The Clinical Administrator shall assess the impact of crisis events on the worker(s) and supervisor(s) involved and determine whether there is a need for outside assistance such as but not limited to the Employee Assistance Program (E.A.P.) available to all Department employees and other programs available to Department employees through AFSCME, (800) 647-8776.
b) What is a crisis?
For the purposes of these procedures the term crisis will refer to:
1) Death of a ward.
2) Death of a ward's parent, foster parent, relative caregiver or sibling.
3) Life-threatening illness, victim of a serious crime (such as rape, shooting/stabbing), attempted suicide, onset of chronic illness, an accident or serious illness which results in disability (such as coma, amputation, paralysis, etc.) of a ward.
4) Disaster resulting in loss of property such as fire or vandalism.
c) Crisis Response Team
1) Who will serve as the Crisis Response Team Leader?
A) For cases in which the Department has primary responsibility, the Regional Clinical Manager shall serve as the Response Team Leader.
B) For private agency cases, a manager shall be designated to serve as the Crisis Response Team Leader.
2) Which staff members make up the Crisis Response Team?
A) Crisis Response Team Leader (Regional Clinical Manager/POS Manager)
B) Direct Service Supervisor
C) Direct Service Worker
D) Medical Director or designee
E) Guardianship Administrator or designee
F) Clinical specialists as determined by need such as grief counselors, psychiatrists, medical counselors, Child Welfare Nurse Specialists, and/or child and family therapists
3) What are the anticipated effects of the crisis?
A) Sense of shock and disbelief
B) Feelings of guilt and helplessness
C) Inability to make a decision
D) Extreme anger or depression
E) An inability to cope with normal, daily responsibilities
4) What services may be needed?
A) Crisis intervention counseling (in cases of catastrophic loss) or grief counseling (in death cases) for:
i) Wards
ii) Foster parent or guardian
iii) Parents
iv) Siblings
v) Involved extended family
vi) Caseworker and/or supervisor
vii) School classmates and teachers (provided by the State Board of Education)
B) Assistance in planning the funeral and burial
C) Referral to support groups and community resources
E) Respite or additional care for other children in the home
F) Arranging accommodations for out-of-town visitors
G) Direct Assistance services such as grocery or clothes shopping (clothing may be needed for the funeral), meal delivery, babysitting, etc.
H) Coordination of services with crisis response teams with the Board of Education and the American Red Cross
5) What is the focus of the Crisis Response Team?
A) Provide short-term intervention to address the immediate crisis.
B) Provide support to the parties involved.
C) Assess the need for specialty services from the community (the American Red Cross, for example).
6) What exactly will the Crisis Response Team do?
A) Gather sufficient facts to complete a chronology of events and to initiate the crisis intervention.
B) Assess the focus, specific roles, and duration of the intervention.
C) Determine which individuals need service.
D) Identify individuals appropriate to intervene.
7) What about confidentiality and consent?
The Regional Clinical Manager/POS Manager is responsible for insuring confidentiality. When communicating with schools, counselors, the media, etc., strict adherence to Department policy and the parameters of the law is mandatory. Workers, supervisors, and State Central Register (SCR) staff should be clear on the limits placed on them regarding discussion of information related to the child or family.
d) How does the process work in each specific crisis event?
1) Death of a Ward:
A) Communication Process
i) Deaths are to be reported to SCR and the SCR supervisor on duty generates a CFS119, Unusual Incident Report Form (UIR).
ii) SCR contacts DCFS Advocacy Office.
iii) Advocacy Office notifies the Director's Office, Office of Communications and the Division of Clinical Services.
iv) Direct service worker completes the morning report and chronology for the ward and forwards the report to the Advocacy Office, Office of Communications, the Director's Office and appropriate administrative staff within 24 hours of being notified.
B) Planning
i) The Crisis Response Team Leader assembles the team and assigns responsibilities within 24 hours.
ii) The Crisis Response Team Leader will work with the direct service worker and supervisor to plan an immediate response.
iii) The Response Team Leader shall identify specific needs and required services and will assist in coordinating services from these resources.
iv) The Crisis Response Team Leader will contact the Deputy Director of Clinical Services if assistance is needed for funeral expenses.
v) If indicated, the Crisis Response Team Leader will insure that proper documentation of costs is forwarded to the Deputy Director of Clinical Services.
C) Implementation
i) In most cases, the direct service worker will provide immediate contact and offers of help, services and support to the family during the crisis. However, the worker or supervisor shall not be expected to provide the crisis response intervention directly if he/she is affected significantly by the event.
ii) Grief counseling shall be made available to family members of the child.
iii) Crisis intervention counseling will be needed immediately; bereavement and grief counseling may be needed after the initial crisis subsides.
iv) The direct service worker should coordinate with the school to provide grief counseling to students if needed.
v) The direct service worker shall assure that normal services and casework support continue after the crisis.
vi) The direct service worker shall work with the family to determine if financial assistance is needed and will submit appropriate documentation to the Response Team Leader.
vii) The Deputy Director of the Division of Clinical Services shall conduct all the arrangements for funeral and burial services in accordance with Procedures 359.9 (D.21) Payments for Medical Care.
2) When a parent, foster parent, relative caregiver or sibling dies:
A) Communication Process
i) As soon as the direct service worker becomes aware of the death of a parent, foster parent, relative caregiver or sibling, he/she shall immediately notify the direct service supervisor.
ii) The direct service supervisor will notify the Clinical Administrator/POS Manager and the Deputy Director of Clinical Services, who will then notify other parties as deemed necessary.
iii) The Clinical Administrator/POS Manager notifies the Deputy Director of Clinical Services who will then notify other parties as deemed necessary.
B) Planning
i) The direct service supervisor works with the Clinical Administrator/POS Manager to determine needed response.
ii) If the need for a team is indicated, the team is assembled and responsibilities are assigned within 24 hours.
iii) The direct service worker shall determine the needs of the family and insure that the placement needs of the child are met.
i) The direct service worker insures that the immediate placement needs of the child(ren) are met.
ii) The direct service worker is responsible for determining the need for transportation to school, to necessary activities, and to the funeral service. If the child does not have appropriate clothing, the worker will assist to find the proper attire.
iii) Grief counseling shall be offered to the child(ren).
iv) Crisis intervention counseling shall be made available to the family immediately; bereavement and grief counseling may be needed after the initial crisis subsides.
v) The direct service worker remains in daily contact with the child(ren) in order to assess the level of need and provide appropriate intervention and services.
vi) The direct service worker and/or the worker's supervisor will make a determination to move child(ren) from one place to another and, if removal from placement is necessary, shall facilitate this transition. Refer to Procedures 301, Placement and Visitation Services.
3) When a child is critically ill or disabled:
A) Communication Process |
i) As soon as the direct service worker becomes aware that a ward in their caseload has become critically ill or disabled, the direct service worker shall immediately notify the supervisor, and generate a CFS119 Unusual Incident Report Form (UIR).
ii) The direct service supervisor shall notify the Clinical Administrator/POS Manager.
iii) The Clinical Administrator/POS Manager notifies the Deputy Director of Clinical Services and the Office of the DCFS Guardianship Administrator.
iv) The Office of the DCFS Guardianship Administrator and the Deputy Director of Clinical Services will notify the Medical Director if necessary and will contact the hospital for medical information and to arrange consents.
B) Planning
i) The direct service worker and supervisor will be responsible for developing a response plan in collaboration with the Office of the DCFS Guardianship Administrator.
ii) If a crisis response team is needed, the Regional Administrator will assemble the team and assign responsibilities within 24 hours.
iii) The Clinical Administrator/POS Manager will identify appropriate resources and will assist the direct service worker in designing a plan.
C) Implementation
i) In cases where a child is determined to be critically ill or disabled, the direct service worker will work with the Office of the DCFS Guardianship Administrator to insure that all necessary support and services are provided to the child.
ii) All requests for consent to the removal of life support, limiting medical treatment, foregoing life sustaining treatments and/or the entry of a Do Not Resuscitate (DNR) Order must immediately be referred by telephone or telefax to the Office of the DCFS Guardianship Administrator. Prior to providing consent, the Guardianship Administrator will consult with the Department's Medical Director about the request. Refer to Procedures 327.5 Medical Consents, and Policy Guide 2001.04 for additional information.
iii) Any action relating to the removal of life support, foregoing life sustaining treatment, limiting medical treatments, and/or the entry of a DNR order must be taken in accordance with the Health Care Surrogate Act (755 ILCS 40/1 et seq.)
iv) Grief counseling focusing on anticipatory grief shall be offered to family members of the child. Grief counseling may be provided directly by the Department or contracted.
v) The direct service supervisor will keep the members of the response team updated with relevant information and the current status of the crisis event.
4) Disaster resulting in loss of life or property:
A) Communication Process
i) As soon as the direct service worker becomes aware of a disaster, which results in the loss of life or property, he/she shall immediately notify the supervisor.
ii) The direct service supervisor notifies the Deputy Director of Clinical Services and the Office of the DCFS Guardianship Administrator.
iii) The Office of the DCFS Guardianship Administrator will notify the Medical Director and will contact the hospital for medical information and to provide necessary authorization for treatment.
i) If a crisis response team is needed, the Regional Administrator will assemble the team and assign responsibilities within 24 hours.
ii) The Regional Administrator serves as the Crisis Response Team Leader or assigns someone to serve.
iii) The direct service worker shall identify specific needs and required services. The direct service worker shall deliver these services directly and will determine the level of intervention and recommendations for further casework support and services.
iv) The Clinical Administrator will be responsible for identifying appropriate resources and will assist the direct service worker in implementing these services.
v) The direct service worker will insure proper documentation of all services.
i) The direct service worker assists the family in securing new housing and resources as deemed appropriate for the event.
ii) The direct service worker is responsible for insuring that the child has transportation to school, counseling, etc. in the event of a move.
iii) In the event of a placement change, the direct service worker shall assist the child with the transition to a new school and neighborhood, making sure that they have a chance to say goodbye to friends and neighbors.
iv) Grief counseling shall be offered to the child(ren) in cases where there is a loss of life, property, etc.
v) Crisis intervention counseling shall be provided immediately; bereavement and grief counseling may be needed after the initial crisis subsides.
vi) The direct service worker remains in daily contact with the child(ren) in order to assess level of need and provide appropriate intervention and services.
vii) The direct service supervisor will keep the response team members updated with relevant information and the current status of the crisis event.