– Our System–

 

CAFAS Driven Tiered Rate System

 

Connor Homes is committed to attaching services to children through a tiered rate system. We believe that children should be funded as opposed to programs. After reviewing the services we currently deliver to our children in the treatment foster care program, It made sense to base the different tiers of care on the factual information about the child through the use of their CAFAS assessments.

We have been using CAFAS since 2008 to evaluate the mental health needs of the children and have used CAFAS as a rationale for reducing special rate agreements for the past 2 years. As a result this is an evidence based proposal as opposed to “I hope” and “I think it might work”.

Rationale For CAFAS Driven Treatment Foster Care Program:

  1. CAFAS is a best practice tool.
  2. Connor Homes completes assessments as they were intended, every three Months
  3. Assessments are done by third party therapists working for Quinte Counselling.
  4. CAFAS results drive the plan of care.
  5. Because CAFAS results are shared every three months this provides an overview of whether the plan is having success, we are status quo or things are getting worse and a format for discussion on methods in the treatment plan.
  6. Results are timely allowing for removal or increase of supports.
  7. The rate is reflective of the child’s needs.
  8. Reduction of Special Rate Agreements.

How It Works?

When a child is admitted to Connor Homes the child will be automatically admitted into a Tier 1 program. Within 60 days the initial CAFAS assessment is completed the overall score will be reviewed by Connor Homes and the legal guardian (CAS). This score will drive the future supports and tier of care that are put in place. (See Scores for determining level of care), The CAFAS assessment will then be reviewed every 90 days therefore continuing to drive the level of care for the child.

What Is The Intake Process?

When a child is admitted to Connor Homes the child will automatically be admitted to Tier #1. During this time the child will receive the services as noted in Tier #1 which include the psychiatric consultation, psychological consultation and psychometric screening. The reason for the child to be admitted to Tier #1 is to allow for the proper assessment of the child’s needs during this 60 day period.

What Is Included In Each Tier

 

 

 

What Happens At The 60 Day Mark?

Once the child has been placed with Connor Homes for 60 days the child will have already had the following completed;

  1. Risk Screening
  2. CAFAS Assessment
  3. Initial Treatment and Planning Report
  4. Psychological Consultation
  5. Psychiatric Consultation
  6. Psychometric Testing

At the 60 day Plan of Care meeting all the relevant assessment data will be reviewed. The Treatment Plan of Care including goals section will be driven by the recommendations of the assessment materials. The Initial CAFAS assessment and treatment plan will be reviewed with the Area Supervisor, Foster Parent and child’s worker or legal guardian. The result of the CAFAS assessment will then determine the supports for the next 90 days. After which the child’s therapist will re-evaluate the child using a second CAFAS assessment to develop the treatment plan. This process will continue every 90 days while the child is in care of Connor Homes.

How Does A Child Change Tiers?

If the result of the CAFAS assessment remains at a score of 100 or more the child will remain receiving the Tier 1 services for the next 90 days which is when the 2nd CAFAS assessment is completed. If the CAFAS score drops the supports for the child will be decreased to meet the needs of the child.

 

In order for a child to change from one tier to a lower tier the following steps will take place:

  1. The most recent CAFAS assessment will be reviewed including the scores to determine the level of the tier based on the assessment scores
  2. The results of the assessment, the corresponding tier and supports will be discussed with the worker or legal guardian
  3. The changes will take effect once all parties are notified and are in agreement of the impending changes
  4. The child’s per diem rate and services will be changed effective of the date of agreement by all parties.

How Often Is The CAFAS Assessment Completed?

The CAFAS assessment is completed by the therapist every 90 days. The child’s Tier and level of support included in their placement can possibly change every 90 days depending on the progress of the child.

What Happens If The Child’s CAFAS Score Doesn’t Decrease Over Time?

If the child is on Tier 1 they will have a quarterly psychological consult which includes the involvement of the therapist and Area Supervisor assigned to the child’s case. During these psychological consultations behavioral and therapeutic strategies/ interventions will be discussed that should in time lower the child’s CAFAS score. If the child’s score doesn’t decrease by the 3rd assessment Connor Homes and the worker are responsible to call a case conference to discuss the lack of change. If there are impeding factors over the child’s placement that have caused of the lack of change, a plan will be put forth at that time to ensure that the child’s needs are being met. The program could be modified to affect change.

Can The CAFAS Scores Be Overridden?

Yes and No, If the CAFAS score drops to the amount of the next tier on a child that is receiving Tier 1 or 2 Supports the decrease in supports can be overridden by agreement with the child’s worker or guardian. However if the child’s scores increase to the next tier level they cannot be overridden. In most cases if the child’s score increases to the next

Tier they child is experiencing some level of issues within their placement. Once the score rises the increased supports will be put in place and a psychological consult with the Area Supervisor and Therapist will be completed in order to get the child back on track quickly and to determine the best course of action so the child doesn’t put their current placement at ris

When The Child Moves Between Tiers Do They Move Placements?

No, All of Connor Homes Treatment Foster Care programs have the ability to provide Tier’s 1 through 3 for each child. The child throughout their placement will remain in the same foster home and the supports will surround the child and their needs. This per diem enhances permanency

What Are The Benefits?

  • By using a tiered Treatment Foster Care System the clients placed with Connor Homes will:
  • Receive the supports they require to be successful in their placement.
  • Decrease the overall cost for CAS by reducing supports
  • Determine the level of care by using an assessment completed by a third party based on factual information
  • Be able to stay in the placement as they achieve success in their lives

What Are The Cost Savings To Placing Agencies?

Conventionally Agencies pay an operator a set per diem for the service they provide even though if the placement is successful the need for supports can decrease. With our new program the per diem rate will decrease over time if the client’s need for services diminished

What Is Tier #4 (Basic Care)?

Tier 4 was developed as a basic rate with no Child and Youth Worker Support or Therapeutic Supports included. This rate is for children under the age of 6 and or medically fragile children in which the CAFAS Assessment ratings would not be

applicable. The child will require additional supports and a Special Rate Agreement will be built around the child’s needs. No child will be admitted at the base rate.

Respite Care?

Connor Homes can accommodate respite placements in many of our treatment foster homes across Ontario. Children referred to Connor Homes for respite will fall under our Tier #4 for basic care. However if additional supports are required for the child during the respite period they will be negotiated in advance and a special rate agreement will be developed to provide the supports.

What Is Included In Our Clinical Supports Including Costs?

Below you will find some of the details regarding our clinical supports for each Tier including cost of the support which is included in the per diem rate and a cost of additional supports which can be purchased as an add on to the basic care rate. We realize that not all children referred to Connor Homes will benefit from Individual Psychotherapy sessions. However our aim is that every child be engaged in some type of therapy. If an alternative therapy (i.e. Family Therapy, Art Therapy, etc) would be more beneficial to the client these alternatives can be negotiated with Connor Homes in place of their individual psychotherapy sessions provided that:

a) The therapist qualifications are equivalent to an M.S.W. or greater

b) The therapist provides reports which integrate the results of the child’s CAFAS Assessment

c) The therapist can provide Connor Homes with evidence of supervision

Involvement Of The Child’s Family?

Connor Homes continues to find ways to involve the child’s natural family in the child’s individualized Plans of Care, addressing outcomes of the child and including family members in any other meetings pertaining to the child’s care. Mostly all children placed with Connor Homes have had some familial contact which we continue to support and encourage. However many familial members have difficulty attending these meetings due to distance, work and or personal schedules. Connor Homes has ensured all areas of our Treatment Foster Care system are equipped Skype, Microsoft Lync, Teleconference lines, etc. so we can ensure all familial members have an opportunity to participate in each child’s care.

How Will We Know This Programme Is Working?

Connor Homes is committed to transparency continual quality improvement within our programs. Connor Homes will provide each placing agency including the ministry with a quarterly report on how our Tiered Rate Foster Care System is meeting the needs of each child placed in our care. This report will include items such as:

  • Reductions of Special Rate Agreements
  • Changes in CAFAS Assessment Scores
  • Changes in level of Risk
  • Overall Achievements of the children in our care.

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    Connor Homes has been providing Residential Care and Treatment to Children and Youth for over 40 years throughout the province of Ontario.

     

    OUR MISSION . . .

    To provide high quality, effective residential services to children and youth that support helping each individual child to emerge and grow.