The Family, Children and Adult Services
Manual Transmittal Letter No. 108 regarding the Revisions to the Risk
Assessment and Forms was incomplete and reproduced incorrectly. This Manual
Transmittal Letter is being issued to provide the correct information and
forms.
The Ohio Department of Job and Family Services has worked closely with the Statewide Risk Assessment Committee to revise the "Family Risk Assessment Model". A primary recommendation of the committee was to change the name of the model to the "Family Decision Making Model". This was done to focus attention on the fact that the Risk Assessment Matrix is only one part of the model which also includes the Case Plan, the Semiannual Review and the Safety Plan. As a result, the name of the model listed on the forms had to be changed. There were no recommendations for changes in how the forms were to be completed or the information to be collected and documented on the forms.
The forms (JFS 01500, JFS 01444, JFS 01445, JFS 01510 and JFS 01520) became effective on January 1, 2001 (the previously stated date of January 1, 2000 was incorrect). The form, JFS 01414, will be effective on February 1, 2001. A brief explanation of the revisions appears on the following page.
For those PCSAs using the Family Assessment and Planning Tool (FAPT), modifications are underway to version the application for these forms with an effective date of April 2, 2001. Forms completed prior to April 2, 2001, will follow the prior format in FAPT. Therefore, until that time, PCSAs may use either the forms currently available in FAPT or the revised forms found as an attachment to this transmittal letter. All old forms will be obsolete as of April 2, 2001.
The following table consists of a brief explanation of the form revisions mentioned above.
| ODJFS Form Number | Form Title and Brief Explanation of Proposed Changes |
|---|
| JFS 01500 | Family Risk Assessment Matrix - multiple use version
Name of model was changed to Family Decision Making Model
Name and number of form was changed from ODHS 1500 to JFS 01500
Element a - Extent of Physical Injury was changed to Extent of Inflicted Physical Injury
Element b - Extent of Emotional Harm was changed to Extent of Emotional Maltreatment
Element l - Behavioral Problems of Children was changed to Emotional/Behavioral Problems of Child(ren)
Factor IV - Characteristics of all adults in the household was changed to Characteristics of all involved adults
Element u - Coping with Problems in Family Functioning was changed to Recognition of Problems in Family Functioning
Element w - Adult's response to Stress was changed to Family Stressors and Response
Element y - Attachment/Bonding-Nurturance was changed to Attachment/Bonding
|
| JFS 01444 | Case Plan
Name of model was changed to Family Decision Making Model
Name and number of form was changed from ODHS 1444 to JFS 01444
Certified Family Foster home was changed to Certified Foster Home
Long Term Foster Care (LTFC) was removed from the Child's Legal Status Codes
|
| JFS 01445 | Amended Case Plan Cover Sheet
Name of model was changed to Family Decision Making Model
Name and number of form was changed from ODHS 1445 to JFS 01445
|
| JFS 01414 | Semiannual Administrative Review (SAR)
Name of model was changed to Family Decision Making Model
Name and number of form was changed from ODHS 1414 to JFS 01414
Family Foster Home was been changed to Certified Foster Home
Long Term Foster Care (LTFC) was removed from the Child's Legal Status Codes
|
| JFS 01510 | Safety Plan for Children
Name of the model was changed to Family Decision Making Model
Name and number of form was changed from ODHS 1510 to JFS 01510
|
| JFS 01520 | Family Risk Assessment Matrix - single use version
Name of model was changed to Family Decision Making Model
Name and number of form was changed from ODHS 1520 to JFS 01520
|
INSTRUCTIONS:
The following chart depicts what materials are to be removed from the Family, Children and Adult Services Manual (FCASM) and what materials are to be inserted in the FCASM.
| LOCATION | REMOVE AND FILE AS OBSOLETE | INSERT/REPLACEMENT |
|---|
| FORMS | ODHS 1414 | JFS 01414 |
| | ODHS 1414 Instructions | JFS 01414 Instructions |
| | ODHS 1444 | JFS 01444 |
| | ODHS 1444 Instructions | JFS 01444 Instructions |
| | ODHS 1445 | JFS 01445 |
| | ODHS 1445 Instructions | JFS 01445 Instructions |
| | ODHS 1500 | JFS 01500 |
| | ODHS 1510 | JFS 01510 |
| | ODHS 1510 Instructions | JFS 01510 Instructions |
| | ODHS 1520 | JFS 01520 |
| | ODHS 1506 | |