Overview of Child Welfare for Medi-Cal Providers

What is Child Welfare Services (CWS)?

The Child Welfare Services is the major system of intervention of child abuse and neglect in California. Existing law provides for services to abused and neglected children and their families. CWS goal is to keep the child in his/her own home when it is safe, and when the child is at risk, to develop an alternate plan as quickly as possible.

Child Welfare agencies are required to ensure they follow the California Indian Child Welfare Act (Cal-ICWA) State Plan. For additional information please see: Office of Tribal Affairs.

Referral Process: Juvenile Dependency Flow Chart (ca.gov)

When a child abuse referral is received:

• The child welfare agency staff obtains facts from the individual making the referral to determine if there are victims of, or at risk of, abuse, neglect, exploitation, or parental absence.
• Whenever a report indicates the need for protection, child welfare will determine how immediate a response is needed and the referral is assigned to a social worker for investigation into the referral.
• If there are no immediate safety needs, then the emergency response staff may:
  • Refer to Differential Response
  • Refer to Family First Preservation Services

If there are immediate safety needs, a social worker will:

• Investigate the allegation of child abuse or neglect through interviews with collaterals
• Either close the referral because the allegations are unsubstantiated, or open a case because further intervention and services are necessary and/or a child/children need to be removed from their homes because it is unsafe to remain in the home

Once a case is opened, there are a number of different types of child welfare services and care that may be offered:

• Voluntary Family Maintenance/Family Maintenance
  • Voluntary Family Maintenance (VFM) is the provision of child welfare supervised, time-limited protective services to families whose children are in potential danger of abuse, neglect or exploitation when the child(ren) can safely remain in the home and the family is willing to accept services and engage in corrective action. The agreement for voluntary services may be initiated by the CSW or by the court, per WIC 301(a) or 360(b). Voluntary services are limited to six (6) months and may be extended for two three-month periods if it can be demonstrated that the case plan objectives can be achieved within the extended time period by the provision of appropriate services.
  • Family Maintenance (FM) can be offered to a family when their child(ren) are returned to their home in order to maintain support by child welfare to ensure the child(ren) can remain safely in the home.
  • Types of Placements:
    • Foster Family Agency Resource Home Placement (FFA): FFAs are organized and operated on a non-profit basis and are engaged in the following activities: recruiting, certifying, and training resource parents, providing professional support to resource parents, and finding homes or other temporary or permanent placements for children who require more intensive care.
    • County Resource Home Placement: County resource homes are overseen by county child welfare.
    • Kinship Placement: Kinship care in the foster care system refers to the care of children by relatives and includes nonrelative extended family members (NREFMs).
    • Crisis Nursery: A facility licensed to provide short-term, 24-hour non-medical residential care and supervision for children under six years of age, who are voluntarily placed by a parent or legal guardian due to a family crisis or a stressful situation, for no more than 30 days.
    • Short-Term Residential Therapeutic Program (STRTP): A residential facility licensed by CCLD and operated by a public agency or private organization that provides short-term, specialized, and intensive therapeutic and 24-hour care and supervision to children. The care and supervision provided by an STRTP shall be non-medical, except as otherwise permitted by law.
    • Group Home (GH): A GH provides 24-hour non-medical care and supervision to children, age 0 through 17, and non-minor dependents, age 18 through 21, in a structured environment, with services provided by persons employed by the licensee. Children in a GH are in treatment programs under court jurisdiction or as dependent children removed from their homes because of abuse, neglect, or abandonment.
    • Temporary Shelter Care Facility: A temporary shelter care facility is a facility owned and operated by the county or on behalf of a county by a private, nonprofit agency that provides for 24-hour non-medical care for up to 10 calendar days, for children under 18 years of age who have been removed from their homes as a result of abuse or neglect. During the child’s stay, the county is identifying and placing the child with a suitable family member or in an appropriate licensed or approved home or facility.
    • Transitional Housing Placement Program: A licensed provider who operates programs which include supportive housing and a wide range of supportive services to youth from 16 to 21years of age, who are in or were formally in foster care on their 18th birthday. Supportive services shall include counseling, educational guidance, employment counseling, job training and assistance reaching emancipation goals outlined in a participant’s Transitional Independent Living Plan, the emancipation readiness portion of a youths’ case plan.
  • Types of Caregivers:
    • Resource Parents: Temporary out-of-home care for foster youth while arrangements are made to return the foster youth to the home of their removal.
    • Relative Caregiver: A family member of the foster youth who provides care for the child while arrangements are made to return the foster youth to their home of removal. It is required that when a youth is removed from the home, relatives must be located, contacted and informed about the child’s removal within the first 30 days of the removal. The law allows for consideration of relatives as a placement resource for the youth.
    • Non-Related Extended Family Member: A friend or someone known to the family who provides care for the foster youth while arrangements are made to return the child to their home of removal.
    • Legal Guardianship: Legal guardianship is a court order that says someone who is not the youth’s parent is in charge of taking care of the child. Legal guardians have many of the same rights and responsibilities as parents.
    • Concurrent Resource Parents: Concurrent caregivers actively support reunification efforts and are also willing to provide a permanent home when it is not possible for children to return to their home of removal. If reunification with their family does not occur, the concurrent caregivers may then pursue adoption.
    • Adoptive Parent: These families provide a permanent, safe, stable and loving home for a youth when it has been determined that the youth cannot safely be returned to their birth parents. Adoptive parents can be relatives or non-relative families.
  • Post-Placement:
    • Child Welfare Agency Social Worker meets with the family/youth at least once a month
    • Child Welfare Agency Social Workers, foster youth, caregivers, parents and any support system to the foster youth/family attend the Child Family Team Meetings (CFTMs).
    • CFTMs occur every six months or every three months if the foster youth receive Specialty Mental Health Services until case closure.
      • Complete the final draft of the Child Adolescent Needs and Strengths Assessment Tool (CANS), which is a multi-purpose tool that supports decision-making, including level of care and service planning, which allows for the monitoring and outcome of services 
      • Plan and provide services, set goals, identify resources and timeframes
      • Link to community services
      • Link to health care options (FFS or MCPs)
      • Partner with Managed Care Plans(if applicable) for services such as Enhanced Care Management (ECM) and Community Supports (CS)
      • Plan for permanency for the foster youth:
        • Reunification: The foster youth is reunited with their family and returned to their home of removal.
        • Legal Guardianship: Legal guardianship is a court order that says someone who is not the youth’s parent is in charge of taking care of the child. Legal guardians have many of the same rights and responsibilities as parents.
        • Adoption: The foster youth is provided permanency from a relative or a non-relative family when a reunification fails.
        • Tribal Customary Adoption Indian children who are unable to reunify with their parents may now, at the option of their tribe, be eligible for adoption by and through the laws, traditions and customs of the child's tribe without requiring termination of the parental rights of the child's biological parents
        • Extended Foster Care (AB 12): Eligible youth in the child welfare and probation systems to remain in foster care until age 21. Youth may leave extended foster care and later choose to re-enter the program up to age 21.
    The follow occurs during a CFT:
    • Child Welfare Social Worker provides ongoing support, visitation and documentation of the case.
    • Court occurs every six months to access the status of the case and determine plan for permanency is appropriate