Title: Section 361.9 - Comprehensive needs assessments; identifying goals, tasks and

361.9 Comprehensive needs assessments; identifying goals, tasks and providers; personal plans. (a) Timing. Within 90 calendar days from the date an eligible adolescent is referred to case management staff for case management activities, the case manager must provide the adolescent with the information and assistance necessary to ensure that the adolescent understands which services and assistance providers exist to help the adolescent to maintain and strengthen family life and to attain or retain the capability for maximum self-support and personal independence so the adolescent may make an informed choice regarding the services and assistance providers to which he or she would like to be referred. The case manager also must complete a comprehensive assessment of the adolescent's needs; identify the short- and long-range goals the adolescent needs to achieve and the tasks the adolescent needs to complete in order to maintain and strengthen family life and to attain or retain the capability for maximum self-support and personal independence, and the estimated time periods for achieving those goals and completing those tasks; identify and inform the adolescent about the services and assistance providers available to help the adolescent attain those goals and complete those tasks; and develop a personal plan for the adolescent to gain access to the services and assistance providers to which the adolescent chooses to be referred.

(b) Comprehensive needs assessment. (1) The case manager must complete a comprehensive assessment of the adolescent's strengths and short- and long-term needs in each of the primary assessment areas set out in paragraph (2) of this subdivision as they relate to the adolescent's ability to maintain and strengthen family life and to attain or retain the capability for maximum self-support and personal independence in order to ascertain what services and assistance providers are available in the community to help the adolescent meet his or her needs. The case manager must ask the adolescent to provide the information needed to complete the comprehensive needs assessment and, when and if appropriate considering the individual case circumstances, seek to obtain, with the adolescent's or his/her authorized representative's permission, needed information from other sources. The case manager may not deem an adolescent's refusal to provide information needed to complete any portion of the comprehensive needs assessment as a request by the adolescent to have the case closed. However, the case manager must indicate in the adolescent's case record the reasons such information was unavailable and must pursue whatever other areas of assessment and planning are possible based on the information provided by the adolescent or obtained from other sources. The findings of the comprehensive needs assessment must be documented in the adolescent's individual case record.

(2) Primary assessment areas. (i) Basic maintenance. The case manager must assess, at a minimum: the adolescent's progress in resolving the emergency needs identified in the initial needs assessment and the actions necessary to resolve the conditions which contributed to those emergency needs; the adolescent's understanding of basic public assistance, food stamp, medical assistance, child support, and housing assistance, as appropriate, and the actions necessary to obtain and maintain entitlement to such assistance; and any other factors relating to the adolescent's ability to obtain and maintain the basic necessities of daily living for himself or herself and his or her child(ren).

(ii) Basic educational competence. The case manager must determine the adolescent's current educational status, including the adolescent's current grade level or the last grade the adolescent completed and the extent to which the adolescent is performing at the expected grade level and if the adolescent has any special educational needs or problems. When necessary, the case manager must attempt to have the adolescent obtain, from appropriate educational professionals, a formal assessment of the adolescent's educational capacities and needs. Special emphasis must be placed on assessing how the adolescent's current educational status and attitudes may affect the adolescent's vocational aspirations.

(iii) Vocational orientation. The case manager must assess the adolescent's vocational aspirations and basic attitudes toward employment. Any special talents, capabilities and competencies which the adolescent still must achieve before his or her vocational aspirations can be fulfilled must be assessed. The case manager must determine the adolescent's employment history, past vocational experience, job-related training and vocational education.

(iv) Health maintenance. The case manager must assess the adolescent's knowledge of, and attitudes toward, family planning, parenting, sexual activities, and reproduction. The case manager also must determine if the adolescent and/or his or her child(ren) potentially are eligible for programs which may be needed to ensure the health of the adolescent and/or his or her child(ren). The case manager must attempt to have the adolescent obtain from a medical professional an assessment of the adolescent's and his or her child(ren)'s general health, medical history and any special health or medical needs relating to the adolescent's ability to accomplish his or her goals, including any need for specialized medical treatment of specific health problems. If the adolescent is pregnant, the case manager must assess the extent to which the adolescent has followed through on any initial referrals for needed medical services. The case manager also must explore the adolescent's knowledge of basic health maintenance, including personal health maintenance and nutrition; the prevention of sexually transmitted and other diseases; and the types and timing of professional preventive health care, such as immunizations and periodic checkups, needed to protect the adolescent's and his or her child(ren)'s health.

(v) Informal support network. The case manager must assess the extent to which the person with whom the adolescent has intimate and continuous social contact and/or the parent of the adolescent's child(ren) and the adolescent's family members and friends are capable of providing, or required to provide, assistance, guidance and emotional support to help the adolescent implement his or her personal plan. The case manager also must assess any needs or problems such other individuals have which may impede the adolescent's ability to attain his or her goals.

(vi) Personal capabilities. The case manager must assess the adolescent's knowledge, maturity, skills, abilities and weaknesses, and how these personal capabilities are likely to affect the adolescent's ability to establish realistic goals and to follow through on the tasks the adolescent needs to complete to maintain and strengthen family life and to attain or retain the capability for maximum self-support and personal independence. The case manager must determine the extent to which he or she needs to supervise and monitor the adolescent's personal plan activities, and determine if the adolescent needs any personal counseling services.

(c) Identifying goals, tasks and providers. Based on the adolescent's assessed needs, the case manager, in consultation with the adolescent and any other appropriate individual, must identify: the adolescent's short- and long-range goals within each of the primary assessment areas, the specific tasks which the adolescent and other appropriate individuals need to complete for the adolescent to attain those goals, and the estimated time periods necessary to attain those goals and complete those tasks. The case manager also must identify the service and assistance providers available to help the adolescent attain those goals and complete those tasks and provide the adolescent with information about those providers so the adolescent can make an informed choice regarding the providers to which the adolescent wants to be referred.

(d) Personal plan. The case manager, in consultation with the adolescent and any other appropriate individual, must develop a personal plan for the adolescent describing: the goals toward which the adolescent chooses to work, the tasks necessary to accomplish those goals, the service and assistance providers to which the adolescent chooses to be referred to receive help in attaining those goals, and the estimated time periods necessary to attain those goals. The personal plan does not have to include all the goals the adolescent needs to achieve in order to maintain and strengthen family life and to attain or retain the capa bility for maximum self-support and personal independence; however, the plan must include those goals toward which the adolescent chooses to work during the next six-month period and the services and assistance providers to which the adolescent chooses to be referred to receive help in attaining those goals. The personal plan should be written in such a manner that the adolescent will be able to understand the plan's provisions. The personal plan must include a statement explaining that the plan is flexible and that it can and will be revised if necessary. The adolescent must be given a copy of the personal plan, and a copy must be retained in the adolescent's individual case record.

(e) Failure to comply with the plan. The case manager may not deem the adolescent's failure to complete any portion of his or her personal plan as a request by the adolescent to have the case closed.

 

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VOLUME A-1 (Title 18)

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