Placement –When to Place, Where to Place, When to Return Home

Course Description: This training was developed to support the June, 2018 rollout of the “Placement Out of Home and Conditions for Return Home” and “Dependency Petition Process” policies. These policies are “transformed” policies, combining and editing of several policies to make them clearer and succinct. A case scenario is utilized throughout the training to advance the key learning objectives. Some of this information may be new to some and a refresher for others. Topics covered in this training include what to do with information gathered, assessing for safety, parent engagement and communication, legal authority for placement, court process, reasonable and active efforts to prevent placement, reducing trauma, disproportionality at placement, placement process, and reunification.

Other Trainings Available:

Child Safety Framework: Analyzing and Planning for Child Safety (Coaching) Assessing Parents, Caregivers and Others in the Home for Child Safety Assessing Child Safety in the Context of Domestic Violence Decision to Place Critical Thinking Reunification CPS In-Service CFWS In-Service Permanency for Every Child Parent Child Visitation (eLearning)

Competencies: SW202-04 Understands how personal culture and life experiences impact views of others SW202-05 Ability to provide culturally relevant casework services SW205-01 Ability to elicit, analyze, and integrate relevant information to support decision

making at all phases of case involvement SW205-03 Ability to assess safety throughout the life of a case and evaluate conditions for

family reunification SW213-01 Ability to choose appropriate placements for children and prepare and support foster

families for placement SW221-02 Ability to interpret reports and other material received from treatment providers,

including DSM diagnoses for various mental health needs.

Policy/Laws:

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1120. Safety Assessment1140. Family Assessment 1150. Case Plan1710. Shared Planning Meetings1720. Family Team Decision Making Meetings4254. Parent, Child and Sibling Visits?????Placement Out-of-Home and Conditions for Return Home4304. Reasonable Efforts43051A. Trial Return Home4308. Dependency Petition Process43091. Court Report4313. Notification of Court Hearings to Out-of-Home Caregivers4420. Health and Safety Visits with Children and Monthly Visits with Caregivers and Parents4527. Kinship Care; Searching for, Placing with, and Supporting Relatives and Suitable Other Persons45274. Placements with Unlicensed Relatives or Suitable Persons4630. Periodic Case Review

Learning Objectives:1. Demonstrate ability to assess information gathered throughout the case to determine:

• risk and safety• when and where to place• when to return home.

2. Engage and communicate with parents the reasons for removal and conditions for return home. 3. Understand legal authority and legal requirements for placement.4. Implement reasonable and active efforts to prevent placement when appropriate.5. Implement tips for reducing trauma at placement.6. Apply safety assessment findings to parent-child-sibling visit and visit plan.

Handouts

Case Scenario (Part 1) (In-class-Hard Copy) Gathering Information Crosswalk and Worksheet (In-class-Hard Copy) Present Danger Guide Blank 17 Safety Threats (worksheet) (In-class-Hard Copy) Safety Plan Form (DSHS 15-259) Case Scenario (Part 2) (In-class-Hard Copy) Gathering Sufficient Information and Common Reasoning Errors in Child Welfare Child Custody Transfer form (DSHS 10-157) Case Scenario (Part 3) (In-class-Hard Copy) Trauma Informed Removals (from After Hours Training) Tips for Decreasing Trauma at Placement Understanding the Dependency Court Process (DSHS 22-1499) Keeping Brothers and Sisters Connected (DSHS 22-1455)

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Case Scenario (Part 4) (In-class-Hard Copy) Caseworker Tip Sheet–Successful Parent Child Visits (DSHS 22-1716) Case Scenario (Part 5) (In-class-Hard Copy) Shared Planning Guide (DSHS 22-1688) Case Scenario (Part 6) (In-class-Hard Copy) Case Scenario (Part 7) (In-class-Hard Copy) Case Scenario (Part 8) (In-class-Hard Copy)

Materials and Preparation LCD Projector with computer Poster paper and markers PowerPoint Slides Internet Connection

Session FlowTopic Method Time Begin Time

Welcome (Slide 1) Lecture 15 minutes 9:00Learning Objectives (Slides 2-3) Review Slide/Lecture 5 minutes 9:15Risk and Safety (Slide 4) Lecture/Group Discussion

Group Activity/Handouts20 minutes 9:20

Assessing for Safety (Slides 5-7) Lecture/Group DiscussionHandouts

30 minutes 9:40

What Do I Do With the Information? (Slide 8)

Lecture/Group DiscussionGroup Activity/Handouts

30 minutes 10:10

Break 10 minutes 10:40Reasonable Efforts/Active Efforts (Slides 9-10)

Lecture/Group Discussion 10 minutes 10:50

When to Place (Slide 11) Lecture/Group ActivityHandout

20 minutes 11:00

Legal Authority (Slide 12) Lecture/Group ActivityGroup Discussion

10 minutes 11:20

Formal/Informal Placements (Slides 13-14)

Lecture/Group Discussion 10 minutes 11:30

Parental Notification (Slide 15) Lecture 10 minutes 11:40Lunch 60 minutes 11:50Reducing Trauma for Children (Slide 16) Video/Group Activity

Group Discussion/Handouts20 minutes 12:50

Dependency/Court (Slides 17-18) Lecture/HandoutGroup Discussion

15 minutes 1:10

Disproportionality (Slide 19) Lecture/Group Discussion 10 minutes 1:20Placement (Slide 20) Lecture 5 minutes 1:25Placing with Kin (Slide 21) Lecture/Group Discussion 10 minutes 1:30Siblings (Slide 22) Lecture/Handout/Group

Activity10 minutes 1:40

Checklist (Slide 23) Lecture 10 minutes 1:50

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Parent-Child-Siblings Visits (Slide 24) Lecture/HandoutGroup Discussion

10 minutes 2:00

Child Well-Being (Slide 25) Handout/Group Activity 10 minutes 2:10Shared Planning (Slide 26) Handout/Group Activity 15 minutes 2:20Achieve an Understanding (Slide 27) Lecture/Group Activity

Group Discussion15 minutes 2:35

Conditions for Return Home (Slide 28) Handout/Group Activity 10 minutes 2:50Return Home (Slides 29-30) Handouts/Group Activity 25 minutes 3:00Break 10 minutes 3:25Considerations (Slides 31-36) Group Activity 15 minutes 3:35Risk for Reentry (Slide 37) Lecture/Group Discussion 5 minutes 3:50Supporting Reunification (Slide 38-39) Lecture/Group Discussion 5 minutes 3:55Thank you/End of the Day 4:00

Slide 1

Welcome.

This training was developed to support the June, 2018 rollout of the “Placement Out of Home and Conditions for Return Home” and “Dependency Petition Process” policies. These policies are “transformed” policies, combining and editing of several policies to make them clearer and succinct. We will utilize a case scenario throughout the training to advance the key learning objectives. Some of this information may be new to some of you and some information may be a refresher for others.

The decision to place a child in out of home care is based on child safety issues, not because you think that the parents are lousy parents or a child might be better off in another home. The child safety framework provides the model on which you build your safety assessments and a structure to analyze and explain why a child is unsafe and if placement is needed.

There are several trainings available to go more in-depth in using the safety framework and the topics we will cover today:

•Child Safety Framework: Analyzing and Planning for Child Safety (Coaching)•Assessing Parents, Caregivers and Others in the Home for Child Safety•Assessing Child Safety in the Context of Domestic Violence•Decision to Place•Critical Thinking

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•Reunification•CPS In-Service•CFWS In-Service•Permanency for Every Child•Teaming for Parent-Child Visits•Parent Child Visitation (eLearning)

Slide 2

Review the slide

Slide 3

Review the slide Slide 4

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Trainer’s Note: Participants should have read two of Dee Wilson’s Sounding Board articles prior to the training:

• Thinking Fast and Slow • Controlling Heuristic Bias

Risk vs. Safety:

Risk is not the same thing as a safety threat, or present or impending danger. Rather, risk is the chance, probability, or likelihood that an incident of either abuse or neglect will happen again in the future. In Washington, there are four levels of risk: low, moderate, moderately high and high.

Just because a household is high risk for a repeat incident of abuse or neglect does not mean that there will definitely be another incident. In addition, although high and moderately high risk families are more likely to have a safety threat, there are high risk families without a safety threat and low risk families where a safety threat is present.

In Washington, the risk level of a family is determined through an actuarial assessment called Structured Decision Making. Other states use this tool. SDM was developed by looking in case files and seeing what factors in households were associated with repeat maltreatment of children. Risk assessment helps determine if services will be provided to the family. When risk is determined to be high or moderately high, services are offered.

Risk: Factors that increase the likelihood of bad outcomes for children over time.

Group Discussion:What might be some common risk factors you see in families?(if no one contributes, you might suggest the following)Substance use by caregiversHousing instability or physically unsafe housingParental mental health issuesDVParents’ history of having been abused or neglected as a childPast history of Child Welfare system involvement, past incident of ca/n

Risk factors might be part of a safety threat, and children living in homes with lots of risk factors are often unsafe, but you need to know more about the situation than just that these things are present in order to determine whether a child is safe or unsafe.

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Safety: The situation or caregiving environment is such that we could expect (given what we know about how the household functions) an act with serious, severe consequences to the child to occur within the relatively near future, and we expect that no parent or caregiver in the home will be able or willing to stop it.

Many families are chronically referred/reported to Children’s Administration. It is important to understand those families as it relates to risk. Jonson-Reid, M., et al. (2010). Understanding chronically reported families. Child Maltreatment, 15 (4):271-281. Retrieved on January 4, 2015 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3628675/

Families receiving 4 or more re-referrals or re-report were more likely to have:•An emotionally disturbed, mentally ill, or developmentally disabled child•Lower social support•Headed by younger parents•Higher rates of domestic violence and parental mental illness•Caregiver with less than a high school education

A worker’s perception that the family was receptive to child welfare intervention was not significant in whether the family had re-referrals.

Group Discussion: What about those characteristics of chronically referred families of 4 or more reports?

Thoughts? How and what information do we gather to assess child safety and determine if a child can safely

remain in home or if placement is necessary? How do we assess the information we have gathered?

Handouts:Case Scenario (Part 1)Gathering Information Crosswalk and WorksheetPresent Danger GuideGroup Activity:Pair and Share or small group:Have participants pair up and review the intake portion (Part 1) of the case scenario. The pairs should discuss the following:

•Is there present danger?•What information would you gather?•What collateral contacts would you want to make?•What are the risk factors identified at intake?•Who would you talk to?

Re-convene the whole group and discuss their answers to the above questions.

Page | 7Trainer Note: Put 6 Flip Chart sheets on the walls with one of the six Gathering Questions on each

sheet. (Have extra sheets available) Have participants use the Gathering Information Crosswalk and Worksheet as reference. Divide class into 6 Gathering questions groups and have them write answers to the gathering questions based on the scenario on the appropriate sheet.

Slide 5

The Safety Framework uses multiple steps that guide placement decisions.

First, there is a determination if a safety threat exists. The handout lists the 17 safety threats that Washington uses.

Second, there needs to be a determination whether the threat actually presents danger to specific child in that family. This is called the safety threshold. It helps us check ourselves about whether a safety threat that might be present is actually ‘active’ – and possibly endangering the child.

Last, you assess if we can work together with the child’s parents to keep this child safe. Many unsafe children can actually be kept safely in their homes through a safety planning. The tool we use to figure this out is the safety plan analysis.

Group Discussion:What is the definition of an unsafe child?

•There are safety threats and the threshold is met•Child is vulnerable to the safety threat(s)•Caregivers unable or unwilling to protect the child

Handouts: Blank 17 Safety Threats (Worksheet) Safety Plan Form (DSHS 15-259)

Slide 6

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Information based safety assessment:Safety assessment in the Child Safety Framework is overtly interested in the totality of the situation, not just an understanding of the incident that brought CPS into the family’s life, and not just a list of risk factors the family has. Without gaining an understanding of the dynamics of the family – and how active risk factors are operating and impacting both parents/all household members and children, it’s difficult to accurately assess child safety.

As you complete the gathering questions and consider whether a child is safe or unsafe, your documentation should reflect what you know about both the family’s past and current functioning. If you believe that the family will be better able to protect the child in the future then they were at the time of the incident, or at other times in the past, then there should be reliable information that supports this belief.

Handouts:

Case Scenario (Part 2)

Group Activity:

Pair and Share or small group:

Have participants pair up with same pairs and review the case scenario Part 2. The pairs should discuss the following:

•What are the identified risk factors?•Are there any identified safety threats?•Would you want to consult with anyone?•What are your next steps?

Have each pair start filling in the safety threats worksheet.

Re-convene the group and discuss their answers to the above questions.

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Trainer Note: Use the same groups and have participants add additional information obtained in Case Scenario (Part 2) to the 6 Flip Chart sheets on the walls. (Have extra sheets available) Have participants use the Gathering Information Crosswalk and Worksheet as reference.

Slide 7

Prior to making a decision about safety in a parent’s home, it is important to have a conversation with the parent and child about who is in the household and their interactions with the child. This includes not only who resides in the home, but also who else will have unsupervised access to the child, such as family, friends, and roommates. Your assessment of the safety of the child will include information you will find out about those individuals through interviews, collateral contacts, FamLink checks and criminal history checks.

Children will often provide honest information about who lives in the home and how they feel about that person. Start by asking the child who lives in the home and who takes care of them. Conversation with children can include how much time they spend with that person and what type of activities they do together to gain an impression from the child of the relationship between the adult and child.

While the focus is on adults, it is also important to assess the safety of the child around other children and youth. You will want to find out about the behaviors of the other children in the home, if they have a history of aggression or sexual acting out, and what role they will play in helping with the care of the child.

Confirming with the parent who lives in the home is the next step. Be sure to ask the parent about any persons identified by the child.

Interview the adults identified by the child and parent when possible, to gather additional information about their role and contact with the child. In a non-threatening way, obtain the correct spelling of their name and date of birth. This will be essential to search background information in FamLink.

Group Discussion: Ask participants how each of the below questions help them identify safety threats, risk factors or protective factors that might exist in a family?

How do they discipline the child? What are their overall parenting practices? What are the developmental needs and behaviors of other children/youth in the home? How do they manage their own lives on a daily basis? Have they used illegal drugs or used prescription drugs outside of the directions of their

physician? What is their alcohol use now and historically?

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Have they ever had a mental illness or mental health problems? Have they been involved in a relationship with domestic violence?

You can use the Gathering Questions and Structured Decision Making tools to make sure you have covered the risk factors. It can also be helpful to complete the SDM including the individual as a caregiver to check and balance your own assessment of risk.

If any concerns arise throughout your assessment, staff the concern with your supervisor and consider holding a Family Team Decision Making meeting (FTDM) or a Shared Planning Meeting (SPM) to address the concerns and form a Safety and Supervision plan if appropriate.

Slide 8

First, let’s look at some practice vignettes to identify risk factors and protective factors.

Group Activity: Protective Factors in Practice Vignettes

https://www.childwelfare.gov/topics/preventing/preventionmonth/resources/protective-factors-in-practice/

First, review Scenario #1. Before having participants select the protective factors, ask participants to identify the risk factors first. This is a group discussion and could be done by shout out. Then have participants select the protective factors. Repeat this process with Scenario #5.

Reminder: Understanding only the incident that brought the child to our attention is not sufficient in understanding child safety. That is why you must gather sufficient, reliable information about the family, the child, each caregiver, and the family situation. Once we start getting this information we are ASSESSING whether we think the child might be unsafe. We’re comparing what we know to the safety threats, considering the threshold analysis, and also identifying what other information we might be able to gather to strengthen our assessment.

Start with who is in the child’s family – parents, household members, siblings, other important participants. Include first names and ages. Identify the family’s cultural identities that are important to them.

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What were the concerns that brought the child/family to our attention this time? As much as possible, this should stay focused on what the allegation was, how it played out in the family, and what the family and others have reported. This should also include a description of the prior history the family has had with our agency, and any additional information about their past functioning provided by them or collaterals.

What safety threats and/or significant risk factors have been identified so far? Do we understand their functioning or have we just identified present danger? If safety threats have been identified or are suspected, can they be described in detail beyond just what happened to bring the family to our attention? What else would you like to know but haven’t been able to unearth? Who has participated in providing information?

Once you as the CPS worker determine that a child is not safe, you no longer expect that caregivers will be the ones responsible to assure the child is protected. That is now your job. You can see how assuming that responsibility will result in you putting together in-home services that will assure protection rather than relying on parents to follow through by complying with directives, admonition or promises made. (© ACTION for Child Protection, Inc. Page 5 June 2009)

Handout: Gathering Sufficient Information and Common Reasoning Errors in Child Welfare

Group Activity:Have participants review the handout. Have participants shout out what resonated with them.

Ask participants to think about a case that they felt there was insufficient information. What did you do about it? Did you ever have a case where you changed your mind about your conclusions later on?

Slide 9

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What does that look like? Offering services is concrete evidence of reasonable efforts to prevent placement. Developing a written case plan with the family helps engage the family in investing in the plan and provides excellent documentation of reasonable efforts. Does the protective action plan or safety plan show reasonable efforts to prevent placement? There will cases in which no reasonable efforts were offered due to the emergent situation.

Family Voluntary Services provide opportunity for reasonable efforts. However, in cases that law enforcement has placed the child in protective custody and transferred the child to CA care, the FTDM provides the perfect opportunity to explore whether a safety plan/protective action plan can be implemented to return the child home and provide reasonable efforts to prevent the continued placement or re-entry into out of home care down the road.

Assess family resources/supports capable of carrying out protective actions. Address concrete and immediate needs that create the present danger, e.g., housing, food, supervision.

Refer participants to the following policies:•2440. CPS Service Delivery (policy outlines services to prevent placement)•3000. Family Voluntary Services•4519. Concrete Goods

Let’s review the Reasonable Efforts policy:4304. Reasonable Efforts

Placement Prevention - Unless the child is determined to be unsafe (See 1100 Child Safety) and an in-home Safety Plan cannot be used to keep the child safe, the CA worker must make the following reasonable efforts to prevent placement:

Complete the Comprehensive Family Evaluation with the family to determine what reasonably available remedial services and activities would remedy identified safety threats.

Develop a written Case Plan .

Services must:

Focus on the identified safety threats.

Be culturally appropriate

Be geographically accessible.

Consider whether a parent is developmentally delayed and eligible for developmental disability services. If so, services and their delivery must be tailored to the parent's needs and coordinated with Developmental Disabilities Administration (DDA).

Group Discussion:

In the scenario, you have in front of you and the information provided: can reasonable efforts be made to maintain the child in the home? Would the reasonable efforts be different for Sarah or Rick? What would that look like?

Slide 10

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Active efforts are legally required in cases involving children who are eligible for membership in federally recognized tribes. Active efforts implies “going the extra mile.”

• Have you identified and linked family members to services? Give referrals, contact information, and ensure that the services are accessible (financially and otherwise) for the client. Document your efforts.

• Additionally, are the services provided culturally appropriate? What have you done to connect the family to services? Document your efforts.

For example, in a non-ICWA case in which mental health treatment was needed, you will be asked if the parent was referred for services and how those services were made accessible to the client, Were the services paid for through Medicaid or was the parent able to afford the services? Was the parent able to get to the counseling office or were services offered in the home? Were the services provided in accord with the cultural beliefs of the family (i.e., sending a Jewish family to a Christian counseling agency that prescribed prayer as part of the treatment plan would not be reasonable).

In an ICWA case, you must document how you helped the parent make an appointment, arrange for transportation to the appointment, and how the services provided were culturally appropriate for the parent. You contact the child’s Tribe and include the Tribe in service planning.

Slide 11

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When to place?

When children are in present danger or unsafe and parents will not cooperate with a protective action plan or safety plan, safety cannot be ensured.

Once you have identified a safety threat is active and meets the threshold, you have assessed through the safety plan analysis, and an in-home safety plan is not possible, you have an unsafe child and you must place. Let’s review the safety plan analysis questions:

There is a parent/caregiver or adult in the home. The home is calm enough to allow safety providers to function in the home. The adults in the home agree to cooperate with and allow an in-home plan. Sufficient, appropriate, reliable resources are available and willing to provide safety activities and

tasks.

Children are considered unsafe when they are vulnerable to present or impending danger and caregivers are unable or unwilling to provide protection. You must ask yourself:

Are you making placement decisions based on these safety threats and utilizing the safety threshold and in-home safety planning guidelines?

Are you able to articulate what the safety threats are and why the child cannot be safe in his/her home?

Handout: Case scenario (Part 3)

Group Activity:Pair and Share or small group:

Have participants pair up and review the case scenario Part 3. The pairs should discuss the following: What services need to be in place to address the identified safety threats and/or risks? What would be the Conditions for Return Home that you would discuss with the parents? Think about a case where the family’s idea about what they needed differed from yours? How

did this get resolved?

Slide 12

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Despite what the public sometimes thinks, Children’s Administration (DCYF after 7/1/2018) employees have no legal authority to place a child in out of home care. Caseworkers must obtain legal authority to place. There are four ways a child may be placed in out of home care under the law.

Protective Custody:Under RCW 26.44.050, law enforcement (LE) may take a child into “protective custody” without a court order if there is probable cause to believe that the child is abused or neglected or if the child could not be taken into custody if it were necessary to first obtain a court order.

Sometimes LE removes children in the course of doing their regular work – then call us to assist with placement.

Sometimes we call LE and ask them to pick up a child because we believe they are in immediate danger and there is no other way to protect them.

We don’t file a dependency petition every time a child is removed.

Often if we placed a child after LE called us, we do further work with the family and find that the situation is actually safe, or can be kept safe with a safety plan.

We should coordinate with LE if considering returning a child home from a PC. They may have critical information about child safety that is needed to make a good decision.

Remember, LE doesn’t HAVE to PC a child just because we ask them to. They are entitled to make an independent decision.

Court Order (RCW 13.34.050):

Requires:1. A petition filed alleging the child is dependent and the child’s health, safety and welfare will

be seriously endangered if not taken into custody2. An affidavit or declaration is filed by the department in support of the petition that included

factual evidence of the danger and imminent harm.3. The court finds reasonable grounds to believe the child is endangered

A dependency petition was filed.

An affidavit requesting the pick-up was also filed and this order was signed by a judge or commissioner.

OR

At the shelter care hearing the commissioner/judge ordered the child be placed out of the home (with or without agreement of the parents).

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Social Worker typically goes to the child’s location with a copy of the court order and police and removes the child.

Voluntary Placement Agreement:

VPA may be signed if there is a safety threat or need for immediate care, but it’s expected to resolve or be managed by a parent/caregiver in the relatively near future. (Shouldn’t exceed 90 days)

Should not be signed if a safe situation for the child is unlikely in the near future, or if the parent is likely to revoke the VPA.

Remember, the timelines for dependency actions start from the placement of the child – so when a child spends 90 days in a VPA and then we file, the parent (and child) has lost 3 months off the timeline, but the situation hasn’t received court oversight and the parent (and child) have had no representation in court.

If a parent revokes a VPA, the child must be returned to the parent. We do have the option to call law enforcement and ask for protective custody, but this is no guarantee. This can create a situation in which protection of the child is very difficult.

Policy states:

4307. Voluntary Placement Agreement (Practices and Procedures Guide)

A VPA is valid when: Signed by both parents or legal guardians of the child unless:

The department is unable to locate the other parent or legal guardian; or Legal custody resides with one parent, which must be verified.

Signed by the DCFS caseworker and supervisor. Signed in front of a judicial officer of the Tribal Court or Juvenile Court when the child is an

Indian child as per ICW Chapter 6. Placed with a licensed caregiver or relative as defined in RCW 71.15.020 (2) and within the state

of Washington.

Hospital Hold: Hospital administrators or physicians have legal authority to detain children if they believe a child is in imminent danger if released to their parent. This may be done without consent of the parent or guardian and regardless of whether the child needs medical treatment. This hospital administrator or physician must make a report to law enforcement or child protective services. The DCFS/DCYF caseworker may receive the child into department custody. (use the Child Custody Transfer form - DSHS 10-157)

Child protective services shall detain the child until the court assumes custody or upon a documented and substantiated record that in the professional judgment of the child protective services the child's safety will not be endangered if the child is returned.

If the hospital administrator or physician first called Law Enforcement to place the child in protective custody and child protective services determines the child can safely return home, we must keep the case open for a six-month period to monitor and assure the continued safety of the child's life or health. “The monitoring period may be extended for good cause.” (RCW 26.44.056)

Handout: Child Custody Transfer form (DSHS 10-157)

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Group Activity:

Break into small groups and have them report out on definitions-referring to policy. Have them present to the large group. Make sure their definitions are correct, as Hospital Holds are the most confusing.

Group Discussion:When do you coordinate with Law Enforcement?

(Allow time for group response and if not the following answers can be offered) •When you are concerned about your safety based on history or allegations.•When you anticipate difficulty in removing a child with a pick up order.•When you conduct an initial face to face and determine the child is in present danger and can not safely be maintained in the home.

Slide 13

Reminder that once we knock on the door, we are responsible for assessing safety.

Formal placements are the only placements CA can support legally and financially to ensure the safety of the child. Formal placement occurs when a child has been determined to be unsafe in the parent/guardian’s care and custody and a safety plan cannot be created or implemented to keep the child in his or her home.

Legal authority has been obtained, as indicated on the previous slide.

CA is required to conduct home studies, criminal background checks and child abuse and neglect background checks on any unlicensed relatives or other suitable persons considered as placements for the child. This includes youth age 16 and above (or younger than 16 where it is warranted) who are residing in the caregiver home.

Why does CA support only using “Formal Placements?”

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Removal or placement of the child from their parent’s care should not be taken lightly. It can have serious impacts on the child’s emotional and physical well-being and permanency. Removal from the home may cause further trauma for the child. All reasonable efforts must be taken to provide services and supports to maintain the child within their own home, whenever possible.

Additionally, the parent has the right to due process, court involvement, legal representation, and services to remedy to safety threats or risks. Accountability for actions taken by CA and/or the parent can only be ensured with a formal placement.

Group Discussion:What type of placements are formal placements?

(Allow time for group response and if not the following answers can be offered)

Legal authority to place Relative or Suitable other (with approved background check and home study or at least with

referral for home study) Licensed foster home Group care

Slide 14

Parents have the right to place their child with a friend or relative if they choose to do so. However, when CA has made contact with a parent and “suggests” that the parent place their child in a friend’s or relative’s home because the child is unsafe in the parent’s care or the parent decides to do this to get CA out of their life, CA has influenced a placement without any legal authority. Whether intended or not, parents may feel coerced into the placement and CA has no way to ensure the child’s safety. This does not follow our Safety Framework.

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Trainer Note: This slide fades in for each bullet point. Fade in each bullet point after the group discussion.

Group Discussion:

Can you provide some reasons why an informal placement would be a cause of concern for a CA involved case? Have one participant write answers on flip chart.

Fade in each bullet point after the group discussion. Ask Participants: How does the slide line up with the reasons the group came up with?

Additionally there is little or no accountability on the part of with CA or the parent/guardian when an informal placement is done. The parents/guardians have none of the rights they get if a dependency case is filed and CA has not way to ensure that the child has a safe, healthy and nurturing out of home placement. When informal placements have occurred, child have been placed in unsafe situation. Bottom line: This is not a safe or good practice for children we serve.

Slide 15

If the child is placed in out of home care by law enforcement, the caseworker must obtain a signed copy of the Child Custody Transfer form (DSHS 10-157) and upload it into FamLink. Both the custodial and non-custodial parents must be notified as soon as possible and provided the completed Temporary Custody Notification form (DSHS 09-731) and a copy of the Parent’s Guide to Child Protective Services. Read slide. Provide the following overview of legal requirements for notification:

RCW 26.44.110

Information about rights—Custody without court order—Written statement required—Contents.If a child has been taken into custody by law enforcement pursuant to RCW 26.44.050, the law enforcement agency shall leave a written statement with a parent or in the residence of the parent if no parent is present. The statement shall give the reasons for the removal of the child from the home and the telephone number of the child protective services office in the parent's jurisdiction.

RCW 26.44.115

Child taken into custody under court order—Information to parents.If a child is taken into custody by child protective services pursuant to a court order issued under RCW 13.34.062, the child protective services worker shall take reasonable steps to advise the parents immediately, regardless of the time of day, that the child has been taken into custody, the reasons why

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the child was taken into custody, and general information about the child's placement. The department shall comply with RCW 13.34.060 when providing notice under this section.

RCW 26.44.120

Information about rights—Notice to noncustodial parent.Whenever the child protective services worker is required to notify parents and children of their basic rights and other specific information as set forth in RCW 26.44.105 through 26.44.115, the child protective services worker shall also make a reasonable effort to notify the noncustodial parent of the same information in a timely manner.

Placement of a child is out of home care is traumatic for both child and parent depending on the parent’s own experiences and trauma. Notifying parents of actions that are being taken is the first step in engaging them in the work ahead. While there may be anger and hostility, having the difficult conversation will go a long way in setting the tone for the relationship the parent has with the agency in working toward reunification. If it is not an emergent placement (i.e. protective custody) parents should have knowledge of the pending placement through participation in the FTDM.

Enlisting the parent to help reduce the trauma for the child further engages the parent in the process and helps the child. You are conveying that the parent still has a parental role and that you need their help. You are acknowledging that they are still the parent and important to the child.

Slide 16

Group Activity/Discussion:Show “Removed” video: https://www.youtube.com/watch?v=lOeQUwdAjE0

Ask participants: How do we reduce trauma when children are placed outside the home? Remember children likely have experienced trauma prior to our involvement. The removal process can also be very traumatic.

Ask participants to generate ideas or tips they have used to reduce the trauma for children. Use flip chart to record ideas.

Handout: Trauma Informed Removals (from After Hours Training)

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Tips for Decreasing Trauma at Placement

Ask group how their lists compared to the handouts?

Slide 17

Court intervention is required if it is expected that a child placed in out of home (not on a VPA) will remain in out of home care longer than 72 business hours. The caseworker must consult with his/her supervisor when court intervention is needed to manage or control child safety. If there is sufficiency to file a dependency petition, the caseworker must contact the Assistant Attorney General and file a dependency petition.

A shelter care hearing will be scheduled. Parents must be notified of the date, time and location of the initial shelter care hearing, provided a copy of the petition and the parent’s guide to CPS as mentioned earlier. The brochure on this slide should also be provided. The brochure also includes a dependency timeline.

You must follow ICWA policy and procedures when there is reason to know that child may be a member or the biological child or a member and eligible for membership in a federally recognized Tribe. Key things to remember are: the burden of proof in Court is higher for an ICWA case, the Tribe must be provided notice of hearings and opportunity to intervene and there are very specific placement priorities.

Handout- Understanding the Dependency Court Process (DSHS 22-1499)

Slide 18

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Group Discussion:

What if the court returns the child at shelter care against CA’s recommendations? How do you address this when policy and the safety framework leads us to the conclusion that

the child cannot be safely maintained in the home? When do you bring it back to court? What are the circumstances?

o Change is circumstanceso New informationo New intakes

What are your next steps?(ideas for the group if they can’t come up with anything)

• Immediately consult with the AAG. If the decision was made by a court commissioner, the decision can be taken to a Superior Court Judge for reconsideration. Some AAG’s do not like doing this because it may cause issues later on.

• Ask for court ordered services or conditions immediately • Put as many eyes on the child as possible….• Offer reasonable efforts.• In-home services.• Review the petition and evidence.• Make further collateral contacts, continue the investigation.• File another motion and further articulate the safety concerns. • Health and Safety Visits.

What if the court decides to return home on a trial return home when the department feels it is still unsafe?What are your next steps?

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Slide 19

When talking about placement in out of home care, we must talk about disproportionality. While CA cannot control reports of CA/N coming in, CA does a pretty good job of negating disproportionality in intake decision making. Where we see most disproportionality is at placement decision.

Review Chart

Group Discussion: Why do you think that there is disproportionality at placement decision?

What do you do to diminish bias?• Question your own assumptions• Ask questions and be curious• Ask others such as peers and supervisors

If the family is from a different culture, what steps do you take? • Use an interpreter (if needed) to ensure you and the family understand what is being relayed• Ask the family about their culture• Reach out to community leaders from that culture• Read about culture, race, religion, sexual orientation, etc. • Attend as many trainings about racial bias, cultural bias, and others available out there.

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Slide 20

Per policy and good practice: Siblings must be placed together unless there is an exception and placement separately is

approved by the supervisor and area administrator. Children must be placed in the least restrictive placement available, ideally with kin or someone

known to the child. CA caseworkers must document for the court efforts to place the child with a relative or other suitable person requested by the parent.

If the child is re-entering out of home care, law requires placement with a previous caregiver unless the caregiver is unavailable, unwilling or unable to meet the child’s needs. The placement with the previous caregiver must be in the child’s best interest.

The placement must be in the child’s best interest including special needs, safety, permanency and well-being needs. This may include cultural needs, religious needs and the needs of LBGTQ children and youth.

The placement must be in close proximity to the parent’s home and in the child’s current school district when possible. Court reports require information related to proximity to the parent home.

Children should be placed in homes that are likely to provide a stable placement. We know that children (all children) do better in all domains if they are in a stable environment. Moving from foster home to foster home further traumatizes children. It is important to identify relatives and potential permanent alternatives (in the event the child can’t return home) early on so children can be stable as quickly as possible. Placement stability allows children to connect or maintain relationships, receive consistent parenting, maintain a consistent environment, school connections and opportunity for improved academic performance, extracurricular activities—all of those things that build protective factors in children to overcome trauma.

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Remember: A Family Team Decision Making meeting will be conducted in accordance with 1710 Shared Planning policy when placement is being considered, after a child has been placed in out-of-home care or a change in placement occurs to discuss placement resources and options.

Refer participants to CFWS in-service training (2 days) and Permanency for Every Child in-service training (one day).

Slide 21

Federal law, state law and policy ask us to place with relatives whenever possible. It’s the right thing to do. The Indian Child Welfare Act also outlines placement preferences when placing Native American children in out of home care. Additional individual Tribes may have placement preferences that we need to honor to the extent possible when we are placing a Native American child.

Research shows that youth in kinship placement experience fewer out of home placements, have lower rates of juvenile justice involvement and exhibit less anti-social conduct than youth in traditional foster care or group home placements. Youth are “Better prepared for independence” when placed with a relative.” (Promoting Protective Factors for Victims of CA/N: A Guide for Practitioners. Child Welfare Information Gateway.)

“Federal and state laws give priority to placing with kinship caregivers absent child safety and welfare concerns”

Children are best cared for by a person they have has a relationship with, when the caregiver is assessed as safe and suitable. An unlicensed caregiver is a relative or suitable person as described in RCW 74.15.020(2)(a) or 13.34.130(1)(b) .” Refer to Practices and Procedures 45274 Placements with Unlicensed Relatives or Suitable Persons and Practices and Procedures 4527 Kinship Care: Searching for, Placing with, and Supporting Relatives and Suitable Other Persons

Permanency begins from our first contact. We must continue to search for relatives throughout the life of the case. We must always be looking for a permanency option in the event the child cannot return home. Additionally, children benefit from relative connections even if not placed with the relative.

Group DiscussionHow do you determine whether they are safe and suitable?

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What steps must you take?

See if participants can come up with answers first. If not: Before Placement

a walkthrough of the unlicensed caregiver’s home and property using the Household Safety Inspection for Unlicensed Placement and Adoptions Home Study Updates form DSHS 10-453. For courtesy supervision cases, follow requirements in Courtesy Supervision policy.

assessment of character, competence, and suitability to determine if the caregiver is a suitable placement per 6800. Background Checks . This includes obtaining results of the background check for all household members aged 16 and older.

Review the content in the completed home study in FamLink under the Provider icon to verify the caregiver has an approved home study for the child being placed.

In those limited instances where the unlicensed caregiver is being referred for a home study after the placement occurs,

submit the following information to DLR within 30 days of placement: Foster Home Study Application DSHS 10-354 completed by the caregiver.

Background check summary for all household members age 16 years and older indicating all members passed the required background check.

Slide 22

Siblings are defined in RCW 13.34.030. There may be reasons for children to be placed separately:

SAY/PAY special needs of one child step or half siblings relatives only want related child…..etc.

However, most children who enter care with a sibling are able to remain with at least one. This means children with larger sibling groups are the most likely to be split.

Sibling relationships are some of the longest lasting relationships a person has in life.

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When children don’t reside with all other siblings who are in care, we have to ensure they: have visits twice per month. have meaningful contact as is reasonable You CAN NOT limit sibling visitation or contact as a consequence of a youth’s behavior or for any

reason other than to protect the safety of one of the children.

Handout: Keeping Brothers and Sisters Connected (DSHS 22-1455) Review handout with participants.

Slide 23

When a child is removed from the home and placed in out of home care, there are many steps to complete in a short amount of time.

Refer participants to the Training “Assessing Parents, Caregivers, and Others in the Home for Child Safety”.

Placement packets include: (show participants where to find placement packets on the intranet)Caregiver authorization form

which gives the caregiver the authority to make medical and educational decisions, routine medical and dental care, dispensing medications, emergency care, mental health and substance abuse services and treatment etc (placement letter) (see Caregiver Authorization Voucher for Interim Pharmacy and Medical Services for Foster Children)

CHIPR (Child Health Information Placement Referral Form) (at time of placement or within 72 hours)

which gives information on the child’s history including where they’ve been enrolled in school, allergies, gender identification and sexual identity information for children over 12, prior school attendance, sibling information (see Child Information and Placement Referral)

Placement Agreement which provides information about assigned worker and expectations for first 30 days (see Placement Agreement)

Foster Care Initial Health Screen form

Must occur within the first 5 days—it’s basically a once over to be sure there’s nothing emergent

Supervision Plan (if there is one)

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for kids who’ve already been in care and have been identified as having specific supervision needs

Voucher for interim pharmacy and medical services OR medical card

If the child was not previously in care they will not have a medical card immediately

Caregiver monthly mileage form (see Caregiver Monthly Mileage)

School notification form (if child is school aged) (See School Notification)

Monthly health and safety visit checklist (see Monthly Health and Safety Visits – Caregiver Checklist)

For unlicensed caregivers, there will be additional information and forms; Unlicensed caregiver placement checklist (see Unlicensed Caregiver Placement Checklist) Household safety inspection (see Household Safety Inspection for Unlicensed Relatives/Suitable

Others) Application for benefits (see Application for Benefits) Information on support service funds (see Relative and Other Suitable Person Support Services

Funds)

It is critical to get the placement entered into FamLink. DCFS is required to make a referral to the Division of Child Support (DCS) whenever a child is placed in out of home care for more than 72 hours.

FamLink will automatically send a referral (if placement is entered) to DCS once the child is placed for 72 hours or more. The sent referral initiates the process for establishment and collection of support from the child's parents to reimburse DCFS for foster care expenditures.

In certain cases there may be Good Cause for not pursuing collection and for those situations DCS will not collect support to reimburse the FC expenditures.

6620. Good Cause for Non-Cooperation with Division of Child Support (Policy)

Slide 24

It is critical to get parents engaged in visits quickly. Setting up visits right away can help reduce trauma for children placed in out of home care and keep parents engaged.

Visits preserve the bond between the parents, child and siblings. Visits may provide an opportunity to create and build a bond. Visits can be the laboratory for parents to try out new parenting skills and the

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window for workers to observe motivation and behavior change in the parent. A written visit plan can reassure the parent that we value their role as the parent, that we want them to stay involved in their child’s life and that we believe they can do it.

On-going visits may motivate the parent to make positive changes and the parents’ participation in visits may be an indicator of their motivation. Parent allies have stated on several occasions that having one person believe they can do it was what helped them in achieving reunification. This may be the caseworker, their attorney, the CASA, the child’s case giver or another support person.

Policy requires that visits be in the least restrictive setting and unsupervised unless the presence of threats and danger to the child requires the constant presence of an adult to ensure the safety of the child. Decisions about whether visits are unsupervised, monitored or supervised are based on:

Risk factors Present danger Safety threats Protective factors demonstrated by the parent

On-going reassessment of risk and safety and review of visit plans should occur at: worker observations of visits at least quarterly, Shared Planning Meetings and monthly supervisor reviews until the child returns home or permanency is achieved. This on-going assessment should focus on whether safety concerns are mitigated or reduced, the quality of the parent-child interaction, communication patterns, roles, strengths, concerns and overall progress. Complete a safety assessment before recommending unsupervised or overnight visits.

Handouts:

Case scenario (Part 4)

Caseworker Tip Sheet (Parent-Child Visits) (DSHS 22-1716)

Group Discussion:Pair and Share or small group:

Have participants pair up and review the case scenario Part 4. The pairs should discuss the following:•What does the caseworker have to relay to the court to justify the request for supervised visits? (give participants a few minutes to come up with the answers and if not, provide the following examples):

Results of the safety assessment The recommended visit plan Results of the gathering questions:

o Sarah Boyfriend and lack of information but criminal history Drug use/DUI Criminal history Condition of the children (Bruise, diaper rash, urine, feces on

clothing) Inconsistent care of the children

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o Rick DUI Allegations of DV Lack of information Bruise and diaper rash Condition of the children (Bruise, diaper rash, urine, feces on

clothing) Substance use Criminal history

• What would it take for the visits to be unsupervised? Visit plans change as safety threats are mitigated.

Re-convene the group and discuss their answers to the above questions.

Slide 25

Handout: Case scenario (Part 5)

Group Activity:

Pair and Share or small group:

Have participants pair up with the same pairs and review the case scenario Part 5. The pairs should discuss the following:

•What are the reasons to include the parents in medical/assessment appointments? •How would you engage the caregiver in providing these opportunities for both parents?

Re-convene the group and discuss their answers to the above questions.

Summarize: Parents inclusion and participation in medical appointments, assessments, school meetings and other activities for their child are not only required by federal law but good for children and their parents. These normalized activities allow the parent to continue to be engaged in their child’s life but also helps reinforce the parent’s role in the child’s life. It may also provide the parent with opportunity to learn to engage in these normalized activities. This on-going participation in the child’s life helps ease transitions in reunification.

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As the assigned caseworker, you are acting as a co-parent of the child on your caseload, along with the out of home caregiver.

Slide 26

Don’t go it alone. Shared Planning Meetings provide the opportunity for shared decision making.

Handout: Shared Planning Guide

https://www.dshs.wa.gov/sites/default/files/SESA/publications/documents/22-1688.pdf

Group Activity: (This activity should only be done if you have sufficient time)

Take the case scenario, assign roles. Have participants identify what type of shared planning meeting should occur at this point in the case. Conduct a mini shared planning meeting. And address the key issues…..

Slide 27

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How often have we heard parents and their attorneys or even co-workers talk about the parent having to “jump through the hoops?” Case plans should be more than “jumping through the hoops”.

Case plans must reflect changes that need to happen to address the risks and safety threats that brought the child into care. Case plans developed with the parent help motivate and engage the parent in the process. Frequently we lose sight of this and layer service requirement upon service requirement that has little meaning to the parent and little contribution to mitigating the risk and safety concerns. Services that promote family reunification include many of the same services needed for prevention: family strengthening, parent education, substance abuse services for parents, and concrete supports such as housing and transportation.

Group Activity/Discussion: (Ask Participants each question, giving time between for answers). In looking at the case scenario information you have so far:

•Does this client recognize a need for our intervention? •Does this client believe her/his family will receive help through our intervention?•Is this client making an effort to benefit from the intervention? •Are this client and her/his worker able to communicate? •Does this client have an extreme lack of trust in our intention?•And most important: if the engagement of this client appears to be low, what might we do to

enhance it?

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Slide 28

To understand the conditions for return home, you must have completed a thorough family assessment and safety assessment. These assessments provide the foundation for understanding what needs to happen for a child to safely return home.

We must communicate the conditions to return home at key points in the case (removal, reunification efforts and return home) to the family, providers, and the court system.

Handout: Case scenario (Part 6)

Group Activity:Pair and Share or small group:

Have participants pair up with the same pairs or group and review the case scenario Part 6. The pairs should discuss the following:

•How are these services linked to the safety threats and risks? What safety threat? (#5)(Trainers should help participants discuss the following: psychological evaluations isn’t related to a safety threat; DV evaluation may or may not be appropriate as there isn’t enough information; should they do the DV screening and specialized DV assessment?)

•What progress would demonstrate the possibility of return home? (Discuss compliance vs. progress. Does attending visits demonstrate progress?)

•What information would you need to gather? And from whom?

Re-convene the group and discuss their answers to the above questions.

Slide 29

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Review slide.A safety assessment must be completed when considering reunification or trial return home.

It is also important to be mindful of disproportionality throughout the case. “In previous studies, longer stays in foster care and lower rates of reunification were reported for African American children as compared to white children (Becker et al., 2007; Fein & Maluccio , 1984 ; Finch & Fanshel, 1985; Wells & Guo , 1999 ). In this study, African American youth were reunified less often than other children, consistent with these findings. These findings suggest that intensified services, innovative service models, and advocacy may be needed to ensure that African American youth are reunified at the same rate as other youth.” (Predicting Family Reunification, Adoption, and Subsidized Guardianship Among Adolescents in Foster CareSonya J. Leathers, Lydia Falconnier , and Jill E. Spielfogel ; American Journal of Orthopsychiatry, July, 2011)

Group Discussion-What are some ways that you measure progress? Ask participants to provide examples. Write them on a flip chart. Compare their examples to the following list:

Check with providers to determine if the parents are able to demonstrate skills. Ask participants if they have ever had difficulty interpreting reports? What steps do they take to understand?

Ask parents, and those who know them well, what is different about their behavior when they are controlling their substance use, mental health issues, not engaging in domestic violence, etc.

Ask parents directly what differences they have noticed in their behavior and mood. Ask parents for their relapse prevention plan and how they have used it (ask for specific

examples). Look at behavior in other areas – getting to work on time, regular sleep patterns, participation in

activities with family or friends who have a healthier lifestyle, etc. Observe visits to see how parents’ behavior has changed with their children. Make unannounced contact.

Slide 30

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Review slide.

Handout:

Case scenario (Part 7)

Group Activity:

Pair and Share or small group:

Have participants pair up with the same pairs or groups and review the case scenario Part 7. Address Sarah first. The pairs should discuss the following:

•Do safety threats remain and if so can they be managed in the home?•Are there any conditions for return home that have not been met?•Is there any additional information that needs to be gathered?•What are the next steps?

Handout:

Case scenario (Part 8)

Group Activity:

Pair and Share or small group:

Have participants pair up with the same pairs or groups and review the case scenario Part 8. Address Rick now. The pairs should discuss the following:

•Do safety threats remain; and if so can they be managed in the home?•Are there any conditions for return home that have not been met?•Is there any additional information that needs to be gathered?•What are the next steps?•After completing a new safety assessment, reviewing Rick’s progress and his supports, it may be

time to request return home to Rick. What services, supports and plans would need to be made and happen in order to return the children to Rick within the next 4 to 6 weeks?

Re-convene the group and discuss their answers to the above questions.

Group Activity:

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Take safety assessment worksheet done at the beginning and then re-assess.

Slide 31

Review Slide

Group Discussion: In reviewing the scenario, answer these questions as a group.

Slide 32

Review Slide

Group Discussion: In reviewing the scenario, answer these questions as a group.

Slide 33

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Review Slide

Group Discussion: In reviewing the scenario, answer these questions as a group.

Slide 34

Review Slide

Group Discussion: In reviewing the scenario, answer these questions as a group.

Slide 35

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Review Slide

Group Activity: In reviewing the scenario, answer these questions as a group.

Slide 36

Review Slide

Group Activity: In reviewing the scenario, answer these questions as a group.

Slide 37

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When we return a child home to their parent’s care we are required by law to continue to work with the family for six months on a “trial return home” to support the reunification. We will have achieved permanency for the child when the dependency is dismissed. We also know that some children do re-enter care when their safety cannot be maintained in the family home with a safety plan after reunification. (It should be noted that the re-entry rate for Washington State is actually very low). This creates further trauma for the child. Risks that pose greater threat of re-entry are often the same risks and safety threats that brought the child into care. The family’s vulnerability and lack of protective factors also contribute to the risk of re-entry.

(Slide information from the Center for Advances Studies in Child Welfare, Practice Notes, March, 2006)

Group Discussion:

What preparations can be made at the time of reunification to address the risk of re-entry?

How do you mitigate these risk factors?

Slide 38

Services to support reunification are necessary to support safety, permanency and well-being of the child-to prevent recurrence and re-entry. It cannot be “out of sight”, “out of mind”. Parents are under pressure from two fronts: the agency expectations of compliance and sustained progress, and often challenging behaviors from their children who may be demonstrating anger and resentment in their

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separation and loss experience. Establishing support and ties to community networks are essential for success.

When possible, try to establish a working relationship between the birth and caregiver so that some stability and consistency follows the child when they return home. Encourage the birth parent to be open to ongoing support from the caregiver after the child returns home. The caregiver can help the parent increase their understanding of the child’s needs and further develop how to best respond to the child. Support the caregiver in becoming an advocate for the child.

Group Discussion:

Ask participants: How does mitigating risk of re-entry line up with supporting reunification? It requires transition planning. What would that look like?

Ask participants if they have any other ideas about supporting reunification.

Slide 39

Review Slide

Remember the services to support the family are aimed at building the parental capacity to parent their child after our involvement. Unlike what some people think, we do not drive around looking for children to remove from their parents’ home. We do not want to keep children in foster care throughout their childhoods. We do want parents and children to be successful in reunification.

(From the Center for Advances Studies in Child Welfare, Practice Notes, March, 2006)

Group Discussion:

In thinking about the case scenario and your ideas to support reunification with Rick, and in looking at this list, do you have additional thoughts on how Rick can be supported in reunification?

Slide 40

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Thank you all for you participation today. Are there any other remaining questions?

For additional assistance your HQ staff are: (read slide)

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