The child’s social worker is directly responsible for delivery of... many of the services outlined in this section are provided... SECTION 6 SERVICES TO CHILDREN IN CARE

SECTION 6
SERVICES TO CHILDREN IN CARE
6.1
Social Worker Contact with the Child
The child’s social worker is directly responsible for delivery of services to the child. While
many of the services outlined in this section are provided by others under the direction of the
social worker, the social worker must provide direct social work service to both the child and
the child’s caregivers.
The social worker must maintain regular direct contact with each child in care for whom they
are responsible. Such contact should be purposeful and consistent with the comprehensive
plan of care. Where the child is of an age and developmental ability to understand, such
contact will be in private with the child and present the opportunity for the child’s input.
The amount of contact the social worker has with the child will vary depending upon the
child’s age, length of time the child has been in care, the circumstances under which the
child was placed, the child’s adjustment to care, special needs, and placement stability.
However, minimum standards are set to make sure that contact is maintained as part of
ongoing casework services.
Standard 6.1(a)
The child’s social worker must have face to face contact with the child in their placement
within the first 7 days of placement.
The social worker must make have contact, either phone or face to face, every 30 days
with the child.
The social worker must have face to face contact with the child at a minimum of every 90
days for children and youth in care of the agency. This contact must occur in the child’s
placement and may continue in the community.
All contact with the child, attempted or completed must be recorded and documented on
the case management system.
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Frequent contact should be maintained during the child’s initial placement period and
regular contact thereafter.
Services to Children in Care
• Contact should take place both in the placement setting and outside of it. This will let the
social worker observe the child in the placement setting and let the child have private
meetings with the social worker to discuss any concerns they may have concerning the
placement.
• Those children living in less stable placements, during periods of crisis, or after a re­
placement will require more frequent contact.
• Older adolescents living in independent living situations will also require more frequent
contact to make sure their goals for independence are being met.
Standard 6.1 (b)
Children and adolescents in care must have access to a telephone and a contact number
for their social worker or how to reach another worker or the supervisor in an
emergency
Purpose of Meeting with the Child
Frequent contact during the first part of placement is necessary to assess the child’s initial
adjustment to care, to help the child understand the reasons for coming into care, and to
begin the process of developing the child’s comprehensive plan of care. Ongoing contact is
essential in the development of a trusting relationship with the child, making sure the child’s
comprehensive plan of care is being followed, and making sure that the child is making
progress in the following areas:
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•
•
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6.2
health
education
identity
family and social relationships
social presentation
emotional and behavioural development
self care skills
Social Worker Contact with Caregivers
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Services to Children in Care
Standard 6.2
Social workers responsible for a child in care must have regular and meaningful contact
with the child’s care providers, this includes foster parents and/or residential providers.
The child’s social worker must have face to face contact with the care provider in the
placement within the first seven days of placement.
The social worker must make have contact with the care provider, either by phone or face
to face, every 30 days.
The social worker must have face to face contact with the care provider at a minimum of
every 90 days while children are placed in their care. This contact must occur in the
child’s placement.
All contact with the care giver, attempted or completed
documented on the case management system.
6.2.1
must
be recorded and
Frequency of Contact
The initial period of placement requires frequent contact. It is also essential that regular
contact with caregivers be maintained throughout the child’s time in care and is part of
the social worker’s responsibility in supervising the placement. This includes personal
contact with foster parents, group home staff, and residential staff that is separate from
contact with the child.
6.2.2
The Purpose of Maintaining Contact with Caregivers
The success of a placement depends in large part on the casework support that is
provided to the foster family. Continuous and ongoing contact between the social worker
and the foster family is essential in maintaining and supporting the foster family in
addition to providing continuity to the child.
For youth living in a group home or residential facility, contact, as outlined in Standard
6.2, is maintained to make sure lines of communication are clear and that comprehensive
plans of care are developed with input from the significant people in the child’s life.
The purpose of maintaining contact with caregivers is to:
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assess the initial adjustment period
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• develop plans to address the developmental dimensions for the child and identify
who will be responsible to make sure action plans are carries out to meet these needs
• provide information and seek input into the development of the child’s
comprehensive plan of care
• determine what supportive services are required
• provide information to caregivers on the status of the family situation, comprehensive
plan of care, and court update
• provide additional background information on the child as it becomes available
• review access arrangements, noting the caretakers’ observations of the child’s
reactions prior to and following visits
• make sure that the child’s religious, linguistic, racial, and cultural heritage is being
recognized
• make sure that caregivers are following through with medical and dental
appointments, maintaining life books, and any and all of their responsibilities as
outlined in the child’s comprehensive plan of care
6.2.3
Contact with Significant Others
The child’s social worker should also establish contacts with people who are significant
in the child’s life and whose input would be beneficial in the development of the
comprehensive plan of care. Such people include birth parents, grandparents, siblings,
or other extended family members as well as friends, teachers, and any other people
important in the child’s life.
Standard 6.2.3 (a)
Children over 12 must be consulted on whom they consider significant and who they
would like contacted (see Section 2.19: Access Services).
6.3
Transportation of Children in Care
6.3.1
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Transportation by Social Worker
Services to Children in Care
Standard 6.3(a)
When a social worker or other agency staff is transporting a child in care, the social
worker or agency staff must make sure that the children are properly restrained, either
by seatbelt or by child restraint system, as appropriate.
6.3.2
Transportation by Taxicab
According to the Nova Scotia Safety Council and the Nova Scotia Registry of Motor
Vehicles, seatbelt use by passengers (or child restraint systems, as appropriate) in
taxicabs is required by the Motor Vehicle Act. Taxicab drivers, however, are exempt from
both wearing seatbelts and for making sure that their passengers use them.
Standard 6.3(b)
A child in care must not be transported by taxicab unless they are properly secured by
either a child restraint system or a seatbelt, as appropriate, and as prescribed by the
Motor Vehicle Act.
Procedures
When the social worker deems that a child is of sufficient maturity to travel alone by
taxicab, the social worker should make sure that the child is aware of the necessity to
wear a seatbelt. The operator of the cab should also be advised of this expectation.
It is recommended that agencies develop their own agreements with taxicab
companies that their drivers will make sure that children in care are properly secured
when travelling by taxicab. It is also suggested that, when possible, children sit in the
middle position in the back seat of the taxicab, as they are less vulnerable to side
impact in this position.
6.4
Maintenance of Children in Care
Agencies must provide for children in their care as would any wise and conscientious parent.
This includes meeting the child’s needs for food, clothing and shelter but also the opportunity
to participate in activities that nurture their talents and skills to help them to grow up to be
healthy, well rounded adults. This may include the opportunity to participate in recreational
activities such as sports, creative outlets such as painting or music or group activities such
as Brownies or Scouts.
Planning for children in care includes an assessment of the financial capacity of the parent
to contribute toward the cost of their child’s maintenance, as set out in the Children and
Family Services Act and Regulations. In almost all cases, the assessment will be completed
by the family’s protection social worker, following the procedures outlined in Section 4 of
the Child Protective Services - Policy Manual. However, there may be circumstances where
this assessment falls to the child in care social worker if, for example, the original Section
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17 or Section 18 Agreement signed by the parents may need to be revised. In any situation
where the child in care social worker is required to review the financial capacity of the
parents’ ability to contribute toward maintenance, the Child Maintenance Guidelines in the
Regulations of the Maintenance and Custody Act will be applied. The Guidelines are a well
recognized, standardized tool, specifically developed to determine appropriate levels of
parental support for their children.
The Child Maintenance Guidelines can be found on the internet at the following website:
http://www.gov.ns.ca/just/regulations/regs/fmcmg.htm.
The Federal Child Support Guidelines which are referred to can be found at the following
website:
http://canada.justice.gc.ca/en/ps/sup/grl/glp.html
Standard 6.4(a)
Parents have an obligation to contribute financially to the care of their children. Agencies
are required to review the financial capacity of all parents who enter into a Section 17 or
Section 18 Agreement regarding their ability to contribute toward maintenance of their
children in care, using the Child Maintenance Guidelines.
Agencies or district offices provide board and clothing allowance to foster parents and
restricted homes for the children in their care, or for the youth who are living in approved
independent living situations along with covering other expenditures necessary to meet the
needs of children and youth in care. Funding for parent counsellor homes, small option
homes, group homes, and residential facilities is provided to meet the needs of the children
in their care. The agency or district office that is responsible for the child is required to
approve expenditures based on the rates and funding standards set by the Department of
Community Services (see Policy Statement 94 and Policy Statement 75 in reference material
for Section 6).
6.4.1
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Food
Services to Children in Care
Standard 6.4.1(a)
A child in care must be provided with sufficient nourishing food to meet their
individual needs for growth, development, and activity.
A child’s individual needs for growth, development, and activity must take the
following into account:
•
•
general nutritional requirements of children
the special nutritional requirements of the particular child, including any
requirements or limitations diagnosed or prescribed by a health care provider
the child’s views, including the child’s specific likes and dislikes
the child’s culture and diet customs, if applicable
any special requirements of the child relating to the manner in which food is
served or prepared, if the child is young or has special needs
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6.4.2
Clothing
Standard 6.4.2(a)
A child in care must be provided with clothes that are of comparable style, quality, and
condition as those of other children in their community.
The agency should assess the child’s clothing needs when:
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the child enters care
the child’s comprehensive plan of care is reviewed
a request to do so is made by the child or caregivers
the child leaves care.
The agency should discuss the child’s clothing needs with the following, as
appropriate:
•
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6.5
the child
caregivers
parents of the child
Medical Care
A child in care has the right to receive medical care when required to ensure their health,
safety, and well-being.
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Standard 6.5(a)
A medical must be completed within 30 days of a child entering care and annually
thereafter while in care. (See Appendix Section 3 for forms)
Standard 6.5(b)
A medical booklet must be provided and maintained for every child in care which must
include the child’s health card number.
Procedures
The child’s social worker:
• ascertains the medical status of the child when they come into care
• arranges for accurate records to be kept of the child’s medical care, and for these records
to be kept current; a child in care may consult a number of health care providers during
the time they are in care and accurate records are necessary to determine appropriate
health treatments and to provide an accurate medical history to the child when they reach
adulthood (Policy Statement #64)
• provides a medical booklet for each child in care including the child’s health card
number
• arranges for a child in care to receive medical care as required
• makes sure the child’s medical records are treated as confidential and that the contents
are not disclosed except to the extent necessary to ensure the child’s safety and well­
being and to protect others
• assists the child and the child’s family in assuming responsibility for the child’s health
when the child leaves care
It may be necessary for a child to visit a doctor more than once a year to meet their medical
needs. Any costs associated with a medical exam or routine prescriptions should be covered
by the agency under the maintenance budget. Extraordinary medical expenses must be
approved in advance by the executive director or district manager. In some cases, older youth
in care may refuse to go for a medical. The social worker should discuss with the youth the
importance of a medical; however, if they continue to refuse and there is no apparent risk to
the health, safety, or well-being of the youth, the reasons for the refusal and a summary of
the situation should be recorded.
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The medical booklet should be updated by caregivers and maintained in safekeeping for the
child. Where the child is living independently, the booklet should be kept by the youth or if
they wish, held in safekeeping in their file.
Refer to the Guidelines for Medical Treatment and Services, Section 10 of the Foster Care
Manual for further clarification (see appendix for this section).
6.5.1
Dental Care
Standard 6.5.1(a)
A child in care must receive dental care as required to maintain their oral health,
safety, and well-being. A dental checkup must be completed within 90 days of a child
entering care and annually thereafter while in care.
Procedures
The child’s social worker:
•
ascertains the dental health status of children when they come into care
•
arranges for accurate, current records to be kept of the child’s dental care
•
arranges for the child to receive the dental care required
If there is a dental problem, the child should be able to visit a dentist immediately. Any
costs associated with a routine dental checkup should be covered by the agency under the
maintenance budget. Extraordinary dental expenses such as orthodontic work must be
approved in advance by the executive director or district manager. The Nova Scotia
Children’s Oral Health Program provides coverage for routine dental care for children
up to 10.
6.5.2
Consents to Treatment
Parents may retain certain rights of guardianship including the right to consent to and
arrange health care for the child under a temporary care Section 17 agreement or by court
order. Where the child is in care by Section 17 agreement, Section 6 of the agreement
addresses whether the parent retains the responsibility to consent to treatment or the
parent consents to the agency assuming responsibility.
Under Subsection 44(2) of the Act:
Where an order for temporary care and custody is made, the court may impose
as a term or condition of the order that the parent or guardian shall retain any
right that the parent or guardian may have to give or refuse consent to medical
treatment for the child.
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In all other cases where the child is in temporary care or in care and custody by court
order, the agency or district office has the right to consent to health care for the child
including:
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routine medical and dental care
recommended routine health care or treatment
low-risk elective or emergency surgery
unusual or extraordinary medical procedures or treatment (see sample Medical
Consent form in the appendix for Section 7)
The agency or district office may authorize caregivers to consent to medical or dental
care. Consent is provided by completing the Letter of Medical Designation, Authority
to Consent for Medical Treatment, Authorization for the Sharing of Medical Information
about Children in Care (see Appendix for this section).
Refer to the Guidelines for Medical Treatment and Services, Section 10 of the Foster
Care Manual (also included in Appendix for this section) for further clarification.
Standard 6.5.2(a)
Where the child has the capacity to consent, the child’s consent to treatment must be
obtained.
6.5.3
Health Care Planning
In developing the health care component of a child’s comprehensive plan of care, the
child’s social worker consults with the child, the child’s parent, and caregivers, as
appropriate, and determines:
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the child’s current health status
the child’s current and future health care needs
how those needs will be met
the specific responsibilities of the child’s parents, caregivers, the social worker, and,
if appropriate, the child in meeting these needs
The following factors should be considered:
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the age of the child
the child’s views
the child’s capacity
the continuity and stability of the child’s relationships with health care providers
attitudes of the child and the child’s family to health care
the resources available to the agency to meet the child’s health care needs
involvement by caregivers or the child’s parents, taking into account whether or not
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the parents continue to assume the rights and responsibilities for consent to health
care
6.5.4
Medical and Dental Coverage
Standard 6.5.4(a)
A valid Nova Scotia health care number must be documented for each child in care on
the case management system and made available to those persons responsible for
overseeing the medical care of the child.
Under the Nova Scotia Children’s Oral Health Program, children under 10 are
provided routine dental care coverage.(Policy Statement #64)
6.5.5
Aboriginal Children Health Care Benefits
Where the child is registered as having Indian Status, the costs for medical care should
be covered by Indian and Northern Affairs Canada.
Standard 6.5.5(a)
Where the status of the child is not determined, the social worker must apply to Indian
and Northern Affairs Canada to determine if the child is eligible for Indian status. For
a child with Indian status, the social worker must clarify with Indian and Northern
Affairs Canada which health care benefits the child may be entitled to receive.
6.5.6
Hospitalization of Children in Care
When admitting a child in care to hospital, a family and health history, religion of the
child, and guardian's name must be given to the admitting officer. Caregivers should
request that their names be placed on the visible part of the chart rather than the agency's
so as not to stigmatize the child.
The responsibility for signing medical consents for medical treatment, X-rays or
emergency surgery for the child rests with the executive director or district manager or
social worker, or caregivers if delegated this authority by the district manager or
executive director or social worker. Where the child is in temporary care, the consent of
the parent is required (see Appendix 7).
The executive director or district manager or social worker may authorize caregivers to
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consent to medical care. Consent is provided by completing the Letter of Medical
Designation, Authority to Consent for Medical Treatment, Authorization for the Sharing
of Medical Information about Children in Care (see Appendix for this section).
The responsibility for signing medical consents for planned surgery rests with the
executive director or district manager or social worker delegated this authority by the
agency or district office.
When a child is admitted and discharged from hospital, it is necessary to complete an
entry on the child movement screen. Foster parents or child caring facilities are eligible
to receive board payments while the child is in hospital. While in hospital, the caregivers
are expected to visit the child and provide the necessary ongoing care and support of the
child.
Spending money may continue to be sent to the caregiver while the child is in hospital.
6.6
Maintenance Expenditures for Children in Care
In addition to the routine daily living requirements while in care, the child may have
additional special needs related to their physical or emotional well-being.
The comprehensive plan of care for the child should address the special needs of the child,
how and by whom these needs will be met, and time lines. Department-approved rates for
“Maintenance Expenditures for Children in Care” under Policy Statement 94 should be
followed (see the appendix for this section).
In addition to board*, clothing, and routine medical and dental care, the maintenance
expenditures for a child in care include:
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prescriptions
transportation
camps, club memberships
child care and/or babysitting*
diapers and/or formula*
driver’s education, driver’s license/insurance
equipment, furniture and replacement of bedding*
glasses and/or contact lenses
hair care
independent living
medical equipment
non-prescription items
orthodontics
school activities and items
telephone calls
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•
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•
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post-secondary education
vacation costs
school supplies
spending allowances for children
special occasion costs
*foster care only
6.6.1
Service Agreements
Service agreements are required where services are being provided by an independent
service provider. These services may include but are not limited to:
•
•
•
•
transportation
tutoring
counselling
child care
These agreements, including the service plan, should be completed in all cases where
Policy Statement 75 applies (see the appendix for this section).
6.7
Sexual Health
Sexuality is an integral part of the personality of everyone: man, woman and
child. It is a basic need and aspect of being human that cannot be separated from
other aspects of life. (World Health Organization 1994)
Sexuality includes an individual's gender, sexual orientation, body image and self-esteem,
feelings, values and beliefs, attitudes about touch and affection, decision-making,
relationships, and sexual behaviour. All people are sexual beings and learning about
sexuality is a life-long process.
Sexual health involves the life-enhancing aspects of sexuality (e.g. the capacity to love) and
the absence of negative outcomes (e.g. diseases, shame, or unplanned pregnancy). The
foundation for sexual health begins in early childhood and learning opportunities and support
for sexual health can occur throughout the life span.
Learning about sexuality issues is an important part of a child's overall well-being and
healthy development. Comprehensive sexuality education can help protect children and youth
from peer pressure, sexual abuse and exploitation, unhealthy relationships, unplanned
pregnancy, sexually transmitted infections, and shame and guilt (which act as obstacles to
sexually healthy behaviours). Youth who have been exposed to comprehensive sexuality
education are more likely to postpone sexual involvement and practise sexually healthy
behaviours when they become sexually active.
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Sexual health is an integral aspect of children's well-being and healthy development and all
children and youth have a right to comprehensive sexuality education. In addition, youth
have a right to access sexual health services and to choose among options that will help them
make responsible informed decisions about their sexual health. The agency will strive to
foster an environment that supports sexuality education and responsible sexual decisionmaking by youth.
Standard 6.7(a)
The child’s social worker must make sure that children and youth in care receive ongoing,
age-appropriate education about sexuality issues. In addition to healthy sexual
development the risks associated with and prevention of sexually transmitted diseases
must be reviewed. The date and summary of the discussions must be noted in the record.
The social worker should:
• provide children and youth in care with support, counselling, and other resources
regarding sexuality issues
• make sure that children and youth in care have access to inclusive sexual health services
that are responsive to the diversity of the children and youth, regardless of their gender,
age, sexual orientation, race, ethnicity, or ability
• promote awareness of the importance of regular sexually transmitted infection testing for
sexually active youth and annual pap smears for sexually active young women
• respect the right to confidentiality of the youth with regards to sexual health services
6.7.1
Sexuality Education
The goals of (sexuality education) are to help people achieve positive
outcomes (e.g. self-esteem, respect for self and others...rewarding human
relationships...) and to avoid negative outcomes (e.g. unwanted pregnancy,
sexually transmitted disease, sexual coercion). (Canadian Guidelines for
Sexual Health Education 1994)
Canadian Guidelines for Sexual Health Education provides the framework for the
provision of sexuality education to children and youth in care. Following these
guidelines, ongoing sexuality education for children and youth in care will include
developmentally appropriate information and resources, opportunities for skills
development (e.g. communication, decision-making, media literacy, values clarification,
critical thinking) and the promotion of positive self-esteem and other motivations for
sexually healthy practices. Information for youth in care will include both the positive
and negative components of sexual health outlined in the guidelines.
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Caseworkers, foster parents, and/or residential staff should work collaboratively to
provide sexuality education for children and youth in care. Members of this adult team
must communicate that they are available and approachable if children and youth in care
have any questions about sexuality and relationship issues. However, the adult team
members should initiate discussion and learning rather than waiting until children and
youth in care ask questions, as they may not ask out of fear or shame. There are many
opportunities for the provision of sexuality education. Adults can use naturally occurring
events as teachable moments. For example, a pregnant pet in a foster home is an
opportunity to talk to young children about pregnancy and birth. With adolescents, adults
could initiate a discussion by inquiring about what sexual health information they have
received at school. In addition, caseworkers and residential staff might set up information
sessions about sexual health topics for youth in care. There are also a number of books
available on a variety of sexuality issues written for children and youth of all ages.
Effective sexuality education is ongoing and comprehensive and the opportunities for its
provision are likewise extensive.
The child’s social worker needs to develop a basic comfort level with sexuality issues so
that they are able to communicate in a positive, non-judgmental, and sensitive manner,
affirming the importance of sexual health. Social workers, foster parents, and residential
staff should be sensitized to the importance of sexuality education for children and youth
in care. Social workers may be supported in their role as a sexuality education resource
for children and youth in care through access to sexuality information, training
opportunities, and the sharing of resources.
6.7.2
Access to Sexual Health Services
Effective sexual health education...(goes) hand-in-hand with access to clinical
services, counselling, and social services...and the physical resources that are
required to support individual efforts to enhance sexual health and avoid
sexual problems. (Canadian Guidelines for Sexual Health Education 1994)
Procedures
Sexual and reproductive health services are part of primary health care. The child’s
social worker should endeavour to make sure that the child or youth in care have access
to inclusive sexual health services. The social worker can facilitate access by keeping
up to date on community resources for the purposes of referral, developing a working
relationship with sexual health agencies, sharing sexual health resources with youth in
care, and perhaps arranging transportation to appointments for sexual health services.
The social worker should promote awareness of the importance of regular sexually
transmitted infection testing for sexually active youth and annual pap smears for sexually
active young women. The social worker can discuss this issue with the youth in care and
encourage the youth to talk to their health care provider. This encourages the youth to
assume responsibility for their sexual health and fosters independence. In addition, the
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social worker may consult with the physician to make sure that these issues are raised by
the health care provider during annual checkups.
It is imperative that the social worker, foster parents, and residential staff respect the right
to confidentiality of youth with regards to sexual health services. Medical records
pertaining to the provision of sexual health services should not be accessed without the
youth's consent. A violation of confidentiality, whether perceived or actual, may cause
youth to conceal their sexual activity and/or to avoid accessing sexual health information
and services, thereby placing them at risk of unhealthy outcomes.
Results of sexually transmitted infection testing do not need to be included in case files.
From a public health perspective, it is not necessary for residential facilities or foster
homes to be informed of positive test results. As long as these facilities are following
basic universal precautions, there is no risk of transmission of sexually transmitted
infections from household contact. A local public health department can provide
information on universal precautions.
6.7.3
Gay and Lesbian Youth
Legislation
In Canada there is legal protection from discrimination because of sexual orientation for
gay, lesbian, and bisexual people in the majority of provinces, including Nova Scotia.
It is important to make sure that gay, lesbian, and bisexual youth enjoy the same human
rights as the rest of society. Even though this protection is mandated by our human rights
legislation, prejudice and discrimination still exist.
For information, contact the provincial Human Rights Commission or the Federal Human
Rights Commission (see Resource Material for this section).
It is the social worker’s responsibility to provide information, support counselling, and
other resources to youth in care regarding sexuality and family planning.
Youth require accurate information regarding sexual development and this is best
provided by a caring parent or caregivers. In the case of children and youth in care, it is
necessary for the caseworker, foster parents, or residential staff to decide who should
provide this information.
In the case of gay or lesbian youth, it is the social worker’s responsibility to help
caregivers explore their own values and beliefs about sexuality and make sure that
accurate information and proper confidential support services are available.
It is the responsibility of the social worker to provide support for the youth who have
questions about their own sexuality. Information is available on activities, outreach
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programs, workshops, and referrals. These programs are available for youth in both urban
and rural areas.
6.8
Assessment and Therapy
Legislation
The Act provides for children in care to have access to “child care services,” which means
assessment, counselling, and referral services as stipulated under Clauses 3(1)(g)and (i) of
the Act.
The agency is responsible to assess and counsel the child in care the best they are able given
the resources that are available to them.
To assist a child in care with their future, an agency must have an understanding (as clear as
possible) of the child’s past. Therefore, the agency must attempt to understand the interaction
of family members: the relationships between adults, relationship between the adults and the
child or children, and the patterns of parenting that have occurred in the past. The goal is to
develop an understanding of the child that will result in a comprehensive report describing
the psychological, biological, and social history of the child.
6.8.1
Contracting Services Policy Statement #75
Standard 6.8.1(a)
Policy Statement #75 must be applied when contracting services for a child in care.
A complete copy of this policy (and the contract) must be reviewed by the social worker
before entering into any service agreement (see the appendix for this section). The
following is a brief summary:
Standard 6.8.1 (b)
When directed by the courts to complete psychological, psychiatric, or other
assessments, or where the child welfare agency requires an assessment/treatment of
a child, and the agency is unable to provide the assessment and/or treatment, the
agency must utilize existing mental health or other publically funded services when
possible and appropriate.
• When such services are not available, and the agency’s social workers are unable to
provide the service, or when a special assessment or counselling service is required, an
agency may use an approved practitioner. Any such service is subject to the availability
of funds.
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• There is an approved list of private practitioners that is made available to agency
offices on a quarterly basis.
• Any use of a private practitioner must be approved by a casework supervisor, agency
executive director, district manager, or special needs committee.
• A contract or agreement must be signed between the practitioner and agency that
outlines the maximum number of hours and must specify what services are being
offered.
• There is a set rate for assessments and counselling.
6.8.2
Psychological Assessment and Testing
It is important to distinguish between these two terms.
Assessment is a set of statements about an individual and his/her
circumstances in relation to some problem. Assessment, as a process, is the
bringing together of relevant information from a variety of sources, that is the
systematic collection, organization and interpretation of information about a
person (child) and his/her situation. Assessments are never undertaken in
isolation, they are investigated to solve a clinical problem which
predetermines the form and goals of assessment.(Berger 1985)
A psychological test is a device and/or a set of procedures for measuring
psychological phenomena. The term ‘psychological test’ is usually associated
with a narrow range of procedures to measure IQ, personality, educational
attainments, or to diagnose ‘brain damage,’ ‘thought disorder,’ or deficits in
language or perception. It is, however, more appropriate to regard a test as
any systematic procedure for obtaining information about psychological
functioning and describing it with the aid of a numerical scale or category
system.(Berger 1985)
Professionals:
Psychiatry is a speciality of medicine concerned with the treatment of mental illness and
emotional problems. There are many sub-specialties, e.g. child psychiatry.
The social worker should consider using a psychiatrist if seeking a diagnosis of a possible
mental disorder, or if there is an indication of an emotional condition that may require
psychiatric attention. If the child has already been diagnosed as suffering a mental
disorder, a psychiatrist will be able to comment on the probable outcomes of various
treatment methods, as well as the implications that mental disorders and their treatment
have for the lives of the youth as well as others involved.
Section 6
Services to Children in Care
Psychology is the study of mental processes, normal and abnormal. Many sub-specialties
exist, e.g. developmental psychology.
The social worker should consider using a psychologist if there is concern about the
child’s intellectual level, if there is need for information by various recognized tests
concerning developmental normalcy and learning functions, or if there is a need to
compare personality structure and coping skills to norms in a measured way through
projecture tests and personality tests.
Couselling:
Mental health professionals, e.g. psychiatrists, psychologists, social workers, nurses, all
practise counselling at varying levels of expertise. Those who are licensed and trained
in one or more of a variety of schools of thought in psychotherapy recognize the course
of treatment is generally several years long. There are many others who claim expertise
in counselling and are not licensed. There is no legal requirement to be licensed as a
therapist or counsellor.
Treatments include individual psychotherapy that assumes the need to gain insight into
intra-psychic processes. Other forms of counselling include behavioural techniques
which are based on learning principles, therapies that focus on the re-orientation of
conscious thought processes, interventions designed to alter patterns of family
interaction, methods that seek to improve a person’s skills to cope with social problems,
and approaches that aim to influence the broader social environment. Psychotherapy is
not generally appropriate for children in care.
6.8.3
Referral Criteria
Being successfully involved in counselling requires certain prerequisites as outlined
below:
• The child has demonstrated an ability to form and sustain at least one meaningful
relationship (must be capable of forging a relationship with a therapist).
• The child has shown some ability to internalize psychological tension within
themselves, rather than having to discharge it immediately via poorly controlled and
outwardly directed behavioural explosions, technically referred to as ‘acting out.’
• The child must not only have serious psychological problems, but must recognize at
least some of these as problems within themselves, rather than attributing them all
to an unsympathetic family or environmental situation (motivation to change).
• As a corollary to the above, a reasonable candidate for counselling should be able
to reflect upon the part they play in perpetuating their unsatisfactory relationships
(ability to reflect on personal contributions to the problems).
Section 6
Services to Children in Care
• The final and least negotiable criteria to be met before referring a child in care for
counselling concerns the stability of that child’s environment. (Steinhauer 1991)
In general, children in care are poor candidates for psychotherapy (Steinhauer 1991). The
average child in care is more likely to benefit from and find a relationship within the child
welfare system, e.g. specialized families, agency social worker, residential centre.
6.9
Education
Legislation
Education Act 5(2) Subject to this Act and the regulations and notwithstanding the
Age of Majority Act, every person over the age of five years and under the age of
twenty-one years has the right to attend a school serving the school district or school
region in which he/she resides, as assigned by the school board.
Standard 6.9(a)
A child in care is entitled to have access to education. In compliance with the Education
Act, a child in care over 5 and under 21 must be enrolled in public school in their local
community unless:
•
the child is 5 and it is in the child’s best interests that enrolment be deferred for one
year
•
the child is involved in an alternate education program offered or approved by the
Department of Education
•
the child is over 16 and refuses to attend any school or any alternate education
offered or approved by the Department of Education
Procedures
6.9.1
Enrolment
A child in care should be enrolled in school as soon as possible after placement in the
local school district. Previous school records should be transferred accordingly and any
steps necessary be put in place to make sure there is a smooth transition between schools.
Section 6
Services to Children in Care
6.9.2
Additional Services Within the School
Children in care with special needs have the entitlement under the Special Education
Policy to additional services within the school. The costs of these services are the
responsibility of the education authorities. (See Appendix 6)
6.9.3
Meetings: Parent/Teacher Consultations
The social worker or the child’s caregivers should attend meetings with the educational
authorities. Where the child’s caregivers attends these meetings, the child’s social worker
should be kept informed of what transpired at the meeting as part of the case planning
process.
6.9.4
Additional Services Outside of School
The child should be encouraged and assisted in their education including establishment
of regular study habits. Funding is provided by the agencies under Policy Statement 94
for the purchase of school supplies. If the services of a tutor after school are needed,
compliance with Policy Statement 75 is required (see the appendix for this section 6).
6.9.5
Enrolment in Private School
In exceptional circumstances, the executive director or district manager may approve a
child in care to attend a private school if the following circumstances exist:
• the public school system is unable to offer a suitable education program to the child
and the Department of Education has approved funding, and
• the child’s physical and emotional needs could best be met in the private school, and
• the child’s level of development will likely be enhanced by the child’s attendance at
the private school, and
• attendance at the private school would provide continuity of education for the child
6.9.6
Post-Secondary Education - Educational Bursary Program
Standard 6.9.6(a)
Educational goals must be developed as part of the Comprehensive Plan of Care.
Section 6
Services to Children in Care
Where youth are in the care and custody of the agency, their care and custody may be
extended to 21 if they are pursuing their education (see the appendix for Section 8).
All children and youth in care should be encouraged to continue their education. Preparation
for post-secondary education should begin several years in advance of the youth’s anticipated
graduation from high school. Efforts directed towards supporting and preparing the youth
for post-secondary education, including advising the youth in care about the Educational
Bursary Program, should be documented in the youth’s Comprehensive Plan of Care.
Under the Educational Bursary Program for Youth in Care, youth in permanent care and
custody will receive funds to cover the actual costs of tuition, books and related expenses,
in addition to regular maintenance.
The following conditions apply:
• the youth must be in permanent care and custody
• the youth in care must be enrolled in a program offered at an accredited educational
institution (university, community college or private vocational training) that is
designated by or registered with the Canada Student Loan Program or registered as a
Trade School under the Private Career Colleges Act (see www.ednet.ns.ca for complete
listing)
• the youth in care will attend an education institution within the Atlantic Provinces unless
the program they wish to pursue is not available within the Atlantic Provinces
• the youth in care must attend the program of study on a full-time basis and carry a full
course load for the year
• the youth must successfully complete a minimum of 80% of the courses per year. An
exception can be made with the approval of the Regional Administrator. The request for
an exception shall be forwarded in writing from the Executive Director/District Manager
to the Regional Administrator.
• the youth in care must provide an annual transcript to the youth’s social worker
• the youth in care must contribute $500 towards the cost of the first year of post-secondary
expenses and contribute $1000 in each year thereafter. These funds may be obtained
through summer employment, part-time employment or loans. A reduction of the $1000
contribution may be approved by the Executive Director/District Manager, if the post­
secondary program extends beyond eight months each year.
• the youth in care must apply for any available scholarships and bursaries, including the
Ken Dryden Scholarships
• this program will provide funding to support the completion of only one degree at
university, one community college program or one private vocational program.
• post-secondary programs whose tuition fees are greater than the most expensive Nova
Scotia university tuition fees will require the approval of the Regional Administrator.
The request shall be forwarded in writing from the Executive Director/District Manager
to the Regional Administrator.
• funds can be made available until the youth’s 21st birthday
Section 6
Services to Children in Care
Procedures
Youth who are planning to attend a post-secondary educational institution should make their
plans known to their social worker. The social worker will provide support and assistance
to the youth as they complete application requirements and apply for available scholarships
and bursaries.
Once the youth receives confirmation of acceptance at a post-secondary institution, the youth
and social worker will determine the costs of tuition, books and related expenses. The total
funds provided will be reduced by the value of any scholarships or bursaries the youth is able
to obtain and the $500 contribution from the youth.
Prior to the beginning of each subsequent school year, the youth and social worker will
determine the costs of tuition, books and related expenses for the upcoming year. The total
funds provided will be reduced by the value of any scholarships or bursaries the youth is able
to obtain and the $1000 contribution from the youth.
The anticipated budget for each school year should be determined and recorded by the social
worker, as completely as possible, in advance of any expenditures.
For each year of the program, the agency/district office will pay tuition and other fees directly
to the post-secondary institution. The youth will be provided with the funds to cover the
costs of books, supplies and related expenses for each term or session and will be expected
to provide receipts to the social worker. The social worker will be available to assist with
these purchases. Maintenance payments and expenses covered under Policy 94 will continue
to be paid by the agency/district office.
A youth in care who is unsuccessful in completing the first year of any post-secondary
program may, under exceptional circumstances, be considered for another program. The
youth will be required to write a letter to their Executive Director/District Manager, outlining
the reasons for not completing the first program, the reasons why the youth believes that he
or she will be successful in the second program and requesting permission to obtain funds
from the Education Bursary Program. The Executive Director/District Manager will forward
the request to the Regional Administrator with respect to the release of funds for a second
program.
6.9.6.1
Extension to the Educational Bursary Program
The Extension to the Educational Bursary Program is intended to assist former youth in
care who have begun post-secondary studies to continue their studies up to their 24th
birthday. It is anticipated that the Extension will make it possible for these former youth
in care to complete their post-secondary studies. With the approval of the Regional
Administrator, former youth in care who had not begun post-secondary studies prior to
exiting care and who wish to pursue their studies will also be eligible for this program.
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Services to Children in Care
The following conditions apply:
• the youth must have been in permanent care and custody and be between the ages of
19 and 24 years
• the youth must be enrolled in a program offered at an accredited educational
institution (university, community college or private vocational training) that is
designated by or registered with the Canada Student Loan Program or is registered
as a Trade School by the Private Career Colleges Act (see www.pcc.ednet.ns.ca for
complete listing)
• the youth must attend an education institution within the Atlantic Provinces unless
the program they wish to pursue is not available within the Atlantic Provinces
• the youth must attend the program of study on a full-time basis and carry a full course
load for the year
• the youth must successfully complete a minimum of 80% of the courses per year. An
exception can be made with the approval of the Regional Administrator. The request
for an exception shall be forwarded in writing from the Executive Director/District
Manager to the Regional Administrator.
• the youth must provide an annual transcript to the youth’s social worker
• the youth must contribute $1000 annually. These funds may be obtained through
summer employment, part-time employment or loans. A reduction of the $1000
contribution may be approved by the Regional Administrator if the post-secondary
program extends beyond eight months each year
• the youth must apply for any available scholarships and bursaries, including the Ken
Dryden Scholarships
• this program will provide funding to support only one degree at university, one
community college program or one private vocational program.
• post-secondary programs whose tuition fees are greater than the most expensive
Nova Scotia university tuition fees will require the approval of the Regional
Administrator. The request shall be forwarded in writing from the Executive
Director/District Manager to the Regional Administrator.
• funds may be made available until the youth’s 24th birthday
• in the event a young person’s 24th birthday falls during the course of the academic
year, funding will be extended to allow the youth to complete the academic year
• the youth must sign a Post Care and Custody Agreement (see Appendix for Section
6) which will outline the terms and conditions of the financial assistance
Procedures
Prior to their 21st birthday, youth in care who have attended post-secondary education
must notify their social worker of their intention to continue their education. The youth
will sign a Post Care and Custody Agreement (see Appendix for Section 6), indicating
that he/she understands and accepts the terms of the Agreement. The Agreement will be
signed by the youth’s social worker and the Executive Director/District Manager with the
approval of the Regional Administrator, and must be renewed annually.
Youth who were formerly in care and who received funds through the Educational
Section 6
Services to Children in Care
Bursary Program but who reached their 21st birthday prior to the introduction of the
Extension to the Educational Bursary Program are eligible for funds under the Extension.
They must apply in writing to the Executive Director/District Manager of the
agency/district office that had been responsible for their care. The youth will sign a Post
Care and Custody Agreement, indicating that he/she understands and accepts the terms
of the Agreement. The Agreement will be signed by the youth’s former social worker
(or another social worker assigned to provided support under the Extension) and the
Executive Director/District Manager with the approval of the Regional Administrator and
must be reviewed annually.
Youth who were formerly in care but exited care prior to their 21st birthday must apply
in writing to the Executive Director/District Manager of the agency/district office that
had been responsible for their care, outlining their wish to pursue post-secondary
education. If the Executive Director/District Manger agrees, the request will be
forwarded to the Regional Administrator for approval. If approved, the youth will sign
a Post Care and Custody Agreement, indicating that he/she understands and accepts the
terms of the Agreement. The Agreement will be signed by the youth’s former social
worker (or another social worker assigned to provide support under the Extension) and
the Executive Director/District Manager with the approval of the Regional
Administrator, and must be renewed annually.
Prior to the beginning of each school year, the youth and social worker will determine
the costs of tuition, books and related expenses for the upcoming year. The total funds
provided will be reduced by the value of any scholarships or bursaries the youth is able
to obtain and a $1000 contribution from the youth.
The anticipated budget for each school year should be determined and recorded by the
social worker, as completely as possible, in advance of any expenditures.
For each year of the program, up to the youth’s 24th birthday, so long as the terms of the
Post Care and Custody Agreement are met, the agency/district office will pay tuition and
other fees directly to the post-secondary institution. The youth will be provided with the
funds to cover the costs of books, supplies and related expenses for each term or session
and will be expected to provide receipts to the social worker. The social worker will be
available to assist with these purchases. Maintenance payments and expenses will
continue to be paid by the agency/district office.
The standards with respect to Children in Care do not apply to youth formerly in care but
the social worker will provide supportive services to the youth, as required. All
documentation concerning the Post Care and Custody Agreement is to filed in the
Children In Care file.
6.9.7
Education: Aboriginal Children
To determine source of funding for an aboriginal child’s education, the agency should
Section 6
Services to Children in Care
contact the individual band or First Nation for educational services.
Eligibility for educational services is as follows:
• jurisdiction at band levels
• preschool, elementary, and secondary services are provided to members and non­
members who are residing in First Nation communities (on reserves)
• post-secondary educational services or programs are provided to registered band
members who may reside in and away from First Nation communities (on and off
reserves)
• agency must contact individual bands for advice on funding for educational services
6.9.8
Residential Child-caring Facilities
Standard 3.3.2 of the Provincial Standards for Residential Child-caring Facilities should
be applied.
6.10
Employment
Any youth who is over 16 may apply for employment.
Procedures
A youth over 16 who wishes to apply for employment should do so in consultation with the
caseworker and caregiver in the context of the youth’s comprehensive plan of care.
Contributions to the youth’s maintenance from earnings should be determined in consultation
with the youth, social worker, and caregivers.
The social worker is responsible for making sure that the youth has the proper
documentation, such as a birth certificate and social insurance number.
For information on services and programs available under the Employment Support Services
program, contact the Department of Community Services, Employment Support Services.
6.11
Inheritance and/or Insurance Settlements
Section 6
Services to Children in Care
Standard 6.11(a)
Where a child is in the care and custody of an agency or district office by court order and
the child is entitled to money from an estate or insurance settlement, and no guardian has
been appointed in regard to that money, the agency or district office must consult with the
office of the public trustee.
Procedures
If a child in care is entitled to money under the Public Trustee Act and there is no trustee for
that sum of money established, either in the terms of the will or in the terms of the insurance
settlement or other document which bestows the money upon the child, then any person can
apply to the court under the Guardianship Act to become the guardian of the estate of the
child.
If the guardianship order is granted, the individual who is appointed by the order is entrusted
with the child’s money and has the obligations of a trustee as prescribed under the Trustee
Act and Guardianship Act.
6.12
Canada Pension Plan Benefits
Standard 6.12(a)
Where a child in care is entitled to Canada Pension Plan benefits, the agency or district
office must take the necessary steps to make sure an application is made for those benefits
and the benefits be used to contribute to the costs of maintaining the child. A child may
be eligible for pension benefits if either of their parents are disabled or deceased and the
contribution requirements have been met.
Procedures
The agency or district office should contact the nearest Human Resources Development
Canada (HRDC) office to advise them that the child is in the care and custody of the agency
or district office. HRDC will forward the appropriate application form for completion and
take action to suspend payment to the previous payee. The Canada Pension Plan benefits for
a child in care upon receipt should be placed in the maintenance budget to offset the costs
of maintaining the child (see Policy Statement 62 in the appendix for this section).
Section 6
Services to Children in Care
SECTION 6
APPENDIX
1.
Guidelines for Medical Treatment and Services
2.
Letter of Medical Designation, Authority to Consent for Medical Treatment, Authorization
for the Sharing of Medical Information about Children in Care
3.
Policy Statement #62
Surpluses in the Children’s Services Agencies’ Operating Accounts
4.
Policy Statement #64
i. Authority to sign Medical Consents for a Child Placed on Adoption Probation by a
Child Placement Agency
ii. Notification of Hospitals of Adoption Placement
iii. Notification of MSI of order of Care & Custody or Adoption Placement
5.
Policy Statement #75
A. Policy Statement regarding the process for contracting with private practitioners to
provide private assessments or counselling for matters under the Children & Family
Services Act; and
B. Provision of other Contracted Services
6.
Policy Statement #94
Maintenance Expenditures for Children in Care
7.
Special Education Policy: Go to
www.ednet.ns.ca/pdfdocs/studentsvcs/specialed/speceng.pdf
8.
Post Care and Custody Agreement
Section 6
Services to Children in Care - Appendix
Department of Community Services
GUIDELINES FOR MEDICAL TREATMENT AND SERVICES
FOSTER CARE SERVICES
POLICY DATE: March 2007
Children and Youth receive a variety of medical and mental health services as a result of
their individual needs and as documented in the Child’s Comprehensive Plan of Care or
within the Case Plan prepared for the courts.
Within each type of care status, the legal responsibilities for guardianship and legal care may
vary, and subsequently within the Health Care system, the roles and responsibilities for
information sharing and medical consent with the Department of Community Services and/or
the local Child Welfare agency may also vary depending upon the level of treatment, the type
of medical service ,or consultation required for the child or youth in care.
To enhance the process of information sharing and the determination of the level of medical
consent required, the following Guidelines for Medical Treatment and Services have been
developed for use with the IWK, and any other hospitals or medical services throughout the
province.
Medical Records Booklet
The Medical Records Booklet is required for all Children and Youth in Care.
•
The Medical Records Booklet is provided through the Department of Community
Services to assist social workers, foster parents, residential facilities and children and
youth to track and manage medical services and needs.
•
The Medical Records Booklet is to accompany the child/youth to all medical
appointments to ensure that the information regarding the medical services received
are documented and maintained as part of the child/youth’s personal record.
•
All care providers responsible for ensuring that the child/youth receives medical
services and treatment will be provided with the Medical Records Booklet
•
Responsibilities for maintaining the Medical Services Booklet and the subsequent
Section 6
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Services to Children in Care - Appendix
responsibilities for medical services is documented in the Child’s Comprehensive Plan
of Care or the Case plan.
Attendance for Medical Treatment and Services
•
Children should never attend clinics or any type of treatment facility without the
support of the social worker or a designated care giver. (Child care worker, foster
parent, or family member.)
•
Children require the support of their foster parent, their social worker, child care
worker, or a family member when attending medical visits. The access facilitator,
access driver, nor any other type of facilitator, do not have the authority to provide
information, to receive information, nor to consent to medical services.
Letter of Medical Designation and Care Giver Identification
•
A duly signed Letter of Medical Designation from the Child Welfare Agency/District
Office will also accompany the Medical Records Booklet clearly stating the
designation of authority to either receive and/or disclose information about the
child/youth in care and where necessary to consent to a specific level of medical care.
•
All care givers from Residential and Foster Care Services, all relatives caring for
children and youth on behalf of the Department of Community Services and/or local
Child Welfare Agency are to be provided with the Letter Of Medical Designation from
the social worker responsible for the child/youth in care (see form letter of medical
designation).
•
All care givers are required to provide picture identification to the IWK and all other
medical facilities and/or services when accompanying a child/youth for medical
services . A driver’s license or work identification is preferred.
•
All care givers are also required to present the Letter of Medical Designation for the
child or youth in care.
Types of Child/Youth in Care Status as Defined in the Children and Family Services Act,
1991
The medical designation or the responsibilities of the care giver may vary depending upon
the legal status of the child or youth in care. The following types of legal status may require
varying degrees of designation.
Children and Youth Taken Into Care - Section 33
Section 6
Page -30-
Services to Children in Care - Appendix
•
During the initial stages of the Child Protection Investigation when children are being
taken into care and the status of the child is before the courts, the children and youth
are the full responsibility of the Department of Community Services or local Child
Welfare agency. The social worker has the responsibility to advise the IWK, and any
other hospitals or medical services of the status of the child or youth and the authority
in which they are requesting services.
•
In circumstances where treatment is required, the Health Care system have consent
procedures in place that are determined by the level of treatment required.
•
It is the responsibility of the Child Welfare Social Worker to advise whether there are
safety or information sharing concerns that hospital personnel may be required to
discuss with the Child Welfare Social Worker as the Child Protection Investigation
proceeds and document it accordingly.
Children and Youth In Care through Agreement (CRV7, CRV8) - Section 17 and
Section 18
•
Children and Youth in Care by Agreement through Section 17 and 18 of the Children
and Family Services Act have entered into care through the parents and/or youths
consent and agreement. Parties to the Agreement do address the issue of medical care
and services as part of the Agreement documentation. Parental rights regarding
medical treatment usually continue to rest with the parents. In some cases the parent
may be unable to continue to maintain their parental rights and may wish to transfer
medical responsibilities to the local Child Welfare Agency/District Office.
•
In all cases the Temporary Care Agreement has a specific section dealing with Medical
Services and Consent. This section is to be photocopied and attached to the
designation document for the IWK and any other hospitals or medical services as part
of the notification of the designation process and documentation.
Child and Youth in Care through Adoption Agreement (CRV6) - Section 68
•
Children in Care through a Section 68 of the Children and Family Services Act have
entered care as a result of the birth mother and/or birth parents actively developing an
adoption plan for the child. Within the Section 68 Agreement, the responsibility and
p a r e n ta l a u th o r i t y f o r m e d ic a l s e r v ic e s re s ts s o le ly w ith t h e
Child Welfare Agency/District Office. However, once the Notice of Proposed
Adoption has been signed the local Child Welfare Agency/District Office is required
to designate legal control to the adopting parents.
Section 6
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Services to Children in Care - Appendix
Children in Temporary Care and Custody - Section 42 and 44
•
Children and Youth in Care through a Temporary Care and Custody Order have been
ordered into care through the court and full authority for parental responsibilities and
consent usually rests solely with the local Child Welfare Agency/District Office, unless
otherwise stated within the Temporary Care Order.
•
However, in many cases, the birth family may be actively involved with the child/youth
in care and the local Child Welfare Agency and/or District Office and is working
towards a plan for the child’s return home to parental care.
•
In these instances IWK, and any other hospitals or medical services require notification
within the Designation document from the local Child Welfare Agency/District Office
of the medical responsibilities of the birth family and care giver as stated within the
Case Plan or the child/youth’s Comprehensive Plan of Care to determine where their
responsibilities for information sharing is required.
Children and Youth in Permanent Care and Custody - Section 42 (f) and 47
•
Children and Youth in Care and Custody have been ordered into care by the courts and
are the full responsibility of the local Child Welfare Agency/District Office. All
parental responsibilities for parental care and custody and subsequent medical services
rest solely with the Child Welfare Agency/District Office.
Internal Medical Consent and Information Sharing Procedures and Policies within
local Hospitals, Mental Health Services and the IWK Health Centre
•
All medical facilities and services have protocols, policies and procedures for consent
to treatment and information sharing that are applied for all children and youth
receiving services. In order for doctors and medical personal to accurately determine
the level of consent, the type of information required for diagnosis, and the information
required for treatment, all parties require full understanding of the legal status and
subsequent responsibilities for gathering information ,as well as releasing information.
•
Internal Medical /Health Services Consent policies are developed and determined upon
the level of treatment or intervention required by the child or youth in care . The letter
of Medical Designation provides the Health profession with the information required
to accurately assess who receives information ,who provides information, and who has
the authority to determine the type or level of treatment required.
For example: The level of treatment and the level of consent required for a
bruised knee from a fall on a bicycle is different from the level of
treatment and the level of consent required for ongoing therapeutic
Section 6
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Services to Children in Care - Appendix
treatment at a day clinic which may include medication and
direction from a mental health or medical professional, versus
treatment for cancer, juvenile diabetes, congestive heart failure, etc.
The Letter of Medical Designation
•
Attached to the Guidelines for Medical Treatment and Services is the template that
social workers will use and provide for the care givers that have responsibilities in
ensuring that child and youth receive regular and ongoing medical check-ups, treatment
and ongoing medical services .
•
Medical services include regular visits with the family doctor, all clinics at the IWK
or any other medical or health centre, including Mental Health Services .
•
Medical designation may change as the child or youth’s health needs change ,or the
legal care status may change. The medical designation may subsequently change and
should be reviewed during the annual child in care comprehensive planning meeting
or during any case conference where a revised case/family plan may result.
Section 6
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Services to Children in Care - Appendix
Department of Community Services
LETTER OF MEDICAL DESIGNATION AUTHORITY TO CONSENT FOR MEDICAL TREATMENT
AUTHORIZATION FOR THE SHARING OF MEDICAL INFORMATION
ABOUT CHILDREN IN CARE
I _______________________________ of
(Name of Care Giver)
(Address)
have been designated by the Minister of Community Services of the Province of Nova Scotia, or his/her
delegate, under the authority of the Children & Family Services Act, and the Freedom of Information and
Protection of Privacy Act, as the Care Giver for:
(Child/Youth’s Name)
(HCN#)
(Date)
The type of care status of the said child/youth is the following (please check appropriate box):
Q
Q
Q
Q
In care through agreement
Taken into care (case before the courts)
Temporary care and custody
Permanent care and custody
As the designated Care Giver, I am authorized to consent to the following medical services:
Q
Q
Q
Q
Regular visits to family doctor
Appointments at the hospital
Routine dental work
Other (specify if necessary)
for tests or visits with specialists
I am also authorized to consent to the release of patient information from the child/youth health records to
another care provider.
The Social Worker responsible for this child/youth in care is:
______________________________________________
(Social Worker responsible for Child/Youth in Care)
_______________________
(Phone #)
The Social Worker shall be contacted when:
•
•
medical treatment or surgical interventions other than those identified above are required;
for the release of patient information from the child/youth health record to a third party.
Section 6
Page -34-
Services to Children in Care - Appendix
Page - 2 ­
This designation is valid for one year from date of signing or as determined by the Department of Community
Services or Child Welfare Agency. It is the responsibility of the social worker responsible for the child/youth
in care to ensure that a current Letter of Medical Designation is presented at the time of requesting medical
services.
(Care Giver)
(Witness)
(Date)
(Social Worker)
(Agency/District Office)
(Date)
(MARCH 2007)
Section 6
Page -35-
Services to Children in Care - Appendix
Policy # 62
Family & Children’s Services Division
Policy Statement/Protocol
NO: 62 DATE: May 1, 1997
RE: Surpluses in the Children’s Services Agencies’ Operating Accounts
Any funds received on behalf of children being maintained by the Department of Community
Services, e.g., parents’ contribution, Canada Pension benefits, shall be placed in the appropriate
maintenance budget subject to offset the cost of maintaining the child.
___________________________________
Jane E. Fitzgerald, MSW, RSW
Administrator
Family & Children’s Services
Page -36­
Policy # 64
DEPARTMENT OF COMMUNITY SERVICES
FAMILY AND CHILDREN’S SERVICES DIVISION
Policy Statement
DATE: July 21, 2003
No: 64 (revised)
TO: District Offices, Department of Community Services
Children’s Aid Societies
Family and Children’s Services
Child Placing Agencies
RE: i)Authority to sign Medical Consents for a Child Placed on Adoption Probation by a
Child Placement Agency
ii)Notification to Hospitals of Adoption Placement
iii)Notification of MSI of Order of Care and Custody or Adoption Placement
i)
At the time a child is placed with an adopting family and the Notice of Proposed Adoption is
signed, the agency and adopting parents shall also sign the attached form giving the adopting
parents authority to sign for any medical treatment the child may require. (Form A)
Form A shall be completed for:
•
•
all children now in adoption probation placements;
all children being placed on adoption probation after this date.
ii) In addition, the social worker’s responsibilities include:
•
•
•
checking to determine if the child was previously admitted to any hospitals; and if so,
advising the Hospital Medical Records Department of each hospital of the child’s new
status and new parent(s)’ name(s) and birth date(s). (Form B)
providing adopting parents with Form A.
..../2
Page -37­
Policy Statement No. 64 (revised)
July 21, 2003
Page Two
iii) When a child is placed in permanent care and custody, or placed for adoption, agencies must
notify MSI. Where a child in care is placed for adoption the adoptive parents must apply for
a new Health Card Number in the adoptive name.
Form C must be completed and submitted within five (5) working days of the order of care
and custody or placement of a child for the purposes of adoption.
Sincerely,
Jane E. Fitzgerald, M.S.W., R.S.W.
Executive Director
Family and Children’s Services
Att.
c
Regional Administrators
Regional Child Welfare Specialists
Page -38­
Form A
WHEREAS a female/male child, born on the ____ day of ____________________ , 2____
and known as
is under the legal control of the
(adoptive name)
by virtue of an Order of Care and Custody
or a Voluntary Care Agreement Section 68, under the Children and Family Services Act,
AND WHEREAS the agency, by virtue of its legal control of the child has been given all the
rights of the parents of the child,
AND WHEREAS the child known as
has been
(adoptive name)
placed on an adoption basis with
who are
adoptive parents’ name(s)
fully responsible for the care and maintenance of the child,
This document authorizes the above named adoptive parent(s) to obtain medical treatment,
surgery, anaesthetic, etc., necessary for the health of the above named child and to sign whatever
forms are necessary for admission of the child to hospital in furtherance of any such medical
treatment, surgery, anaesthetic, etc.
.......................................................
DATED
......................................................................
(Executive Director/District Manager)
Previous admission to hospital ................................................
New Health Card # .................................................................
We, Mr. and Mrs.
confirm the placement with us
on an adoption basis of the child, named
born on
day of
day of
,
, who was placed with us on the
,
.
....................................................
DATED
SIGNED ................................................................
SIGNED ................................................................
Page -39­
Form B
CHANGE OF NAME - ADOPTIVE CHILDREN
(In accordance with Policy #64)
FROM:
Children’s Services Agency:
(i.e.: Children’s Aid
Society, Family and
Children’s Services or
District Office, Child
Placing Agency)
TO:
Name of the hospital(s)
where the child was
previously a patient:
Complete the following cross reference information
Child’s Previous Health Card #
Child’s Date of Birth
day
month
year
first
second
surname
first
second
surname
Hospital Chart Number
if known
Child’s New Health Card #
Child’s Adoptive Name
Adoptive Parents’ Name
and mailing address
Send this completed form to the above named hospital(s).
Date
After the Medical Records Department at the Hospital has completed the cross-reference procedure,
this form will be destroyed. Note: This form must be forwarded to all hospitals in Nova Scotia who
have treated this child.
Page -40­
Form C
NOTIFICATION OF CANCELLATION
TO M. S. I.
TO:
M.S.I.
P.O. Box 500
Halifax, NS B3J 2S1
FROM:
or by fax:
481-3160
Name and Address of Agency
Reason for cancellation:
G
Placement for Adoption
Date of Placement
or
G
Order of Permanent Care and Custody
Date of Care and Custody
Old Health Card #
Child’s Date of Birth
Page -41­
Policy #75
Family & Children’s Services Division
Policy Statement/Protocol
NO:
75 (Revised)
DATE: April 1, 1999
RE:
Revised Policy Statement for:
(A) Persons Wishing to Provide Private Assessments or Counselling
Pursuant to the Children and Family Services Act and
(B) Provision of Other Contracted Services
(A) PersonsWishing
to Provide Private Assessments or Counselling
Pursuant to the Children and Family Services Act
Mandate
This directive provides for the preparation of court ordered psychological, psychiatric or other
assessments by private practitioners for children or families pursuant to Children and Family
Services Act. It also covers requests for private assessments or counselling services by child welfare.
The following is subject to the availability of funds designated for this purpose as referenced herein.
Background
Staff receiving a Court order for assessment or counselling of a client(s) under the Children and
Family Services Act shall utilize existing mental health or publicly funded services when possible
and appropriate.
In matters where existing mental health or publicly funded assessments or counselling services are
not available nor appropriate or in matters where special assessments or counselling services are
required that are not otherwise available except through private practitioners, then these services may
be provided by a person who has been approved pursuant to this directive. This directive is further
subject to the availability of funds for this purpose as noted herein.
. . . /2
Page -42­
Policy Statement 75, Effective
Page 2
April 1, 1999
Assessments and Counselling Arranged Through Private Practitioners
Assessments or counselling sessions by approved private practitioners under the Children and
Family Services Act may be approved by the Regional Administrator, District Manager, Agency
Executive Director or Casework Supervisor and charged to the agency or department office budget
approved for that purpose.
In either case, an agreement for assessment or counselling must be developed between the agency,
district office and the service provider which shall indicate the maximum number of hours being
agreed to by the agency, district office and the private assessment or counselling service. In addition,
the specific services being agreed to shall also be outlined. A standard agreement, Services
Agreement pursuant to Policy #75, is attached as Part A and Part B.
Approved List of Private Practitioners
Before a person is contacted to provide a counselling service or complete an assessment, pursuant
to this policy, the person must be included on the approved list of private practitioners. This list, to
be maintained by the Family and Children’s Services Division and updated on a regular basis, shall
include the qualifications of the practitioner and the type of service they are offering to provide. This
list shall be made available to departmental and agency offices on a quarterly basis.
Requirements
For a person to be considered for the list of private practitioners, the following must be provided:
(a)
A completed application (as provided in Appendix “A”) as well as a curriculum
vitae.
(b)
Proof of educational credentials (i.e., copy of diploma, certificate, etc.).
(c)
The person must be licensed or certified by their professional body and approved for private
practice. Documentation to this affect shall accompany the application and be updated and
submitted on an annual basis.
(d)
The person shall carry appropriate liability insurance while in private practice and shall
include a copy of their current liability insurance along with their application. This must be
updated on an annual basis.
(e)
A letter of security clearance from the municipal police force or RCMP shall also be provided.
The potential service provider shall report to their local municipal police detachment or
RCMP and request a criminal records check be completed on them and a copy included with
the application. Please note that there may be a charge for this criminal records check.
. . . /3
Page -43­
Policy Statement 75, Effective
Page 3
April 1, 1999
(f)
The person shall include a signed permission to check with the Child Abuse Register as
provided in Appendix “B” and returned with your application. Please complete the second
section on the form and be sure that it is sworn to before a Commissioner of Oaths and return
the form with your completed application.
(g)
An Oath of Confidentiality, signed by a Commissioner of Oaths, as provided in Appendix “C”.
(h) Three letters of references from professionals who have knowledge of the professional
qualifications and capabilities of the person requesting to be listedmust be submitted (see
Professional Reference Form - Appendix “D”).
(i)
In the application, related experience in the area of specialization, i.e,. assessment, counselling,
custody assessment, etc., must be highlighted.
All requested information must be received before a review of the application will be considered.
The completed application and supporting documentation should be forwarded to:
Director of Child Welfare
Family and Children’s Services
Department of Community Services
PO Box 696
Halifax, Nova Scotia B3J 2T7
Please note where private organizations or firms are asking to provide these services, the persons
who will be providing services for the purposes identified shall be listed and similar information as
noted above shall be provided with respect to these individuals.
Persons Not Eligible for Private Service Agreements
The following persons are not deemed eligible for private service agreements:
(a) former employees of the Department of Community Services within the first six months of
their separation from the Department cannot perform private practice for the Department of
Community Services.
(b) Current employees of Children’s Aid Societies or Family & Children’s Service Agencies if the
parties are residents within the territorial jurisdiction served by the agency.
(c) Current employees who may or may appear to be in a conflict of interest to prepare
assessments or conduct counselling for youth because of their performance of official duties.
. . . /4
Page -44­
Policy Statement 75, Effective
Page 4
April 1, 1999
(d) Individuals unwilling to comply with the information requirements or rate structure noted in
this directive.
(e) Individuals who are deemed to be unqualified to provide the services offered.
Rates - Assessments, Counselling
The maximum approved rate for assessments or counselling services pursuant to the Children and
Family Services Act for assessments and counselling is up to $65.00 per hour to a maximum total
amount agreed to when services were discussed with the assessor/counsellor and permissible within
budget allocations. (Please note - individuals may be contracted to provide services for less than that
amount).
Where services cannot be obtained for this rate, the Executive Director or District Manager, as
appropriate, may approve a rate up to $85.00 per hour to a maximum total amount agreed to by the
parties.
Executive Directors, District Managers, or Casework Supervisors will be able to enter into
agreements subject to the allocation of funds approved for this purpose in their budget.
Psychological Assessments/Counselling
Where psychological assessments or counselling services are required under the Children and
Family Services Act, the maximum approved rate shall be up to $85.00 per hour. (Please note parties
may charge less than the maximum rate).
Psychiatric Services
Where private psychiatric services or reports are ordered and/or approved payment should be in line
with the MSI fee scale for private practice and specified in the Agreement of Service.
Hourly Rate Charges
The hourly rate may be charged for:
(a) Interviews with agency, district office or court personnel making the assessment or counselling
referral
(b) Reviewing documentation related to the case
(c) Interviewing the parties
(d) Interviewing collateral contacts as necessary or appropriate
(e) Report/assessment preparation
(f) Attending court when ordered/or required for the purpose of giving evidence.
. . . /5
Page -45­
Policy Statement 75, Effective
Page 5
April 1, 1999
(g) Travel time in situations where the total amount of travel exceeds 100 km per session. In these
instances, the travel time for the period related to the travel in excess of 100 km will be paid
for at the rate of 50% of the agreed hourly contracted rate.
Expenses Included in the Rate
The following are deemed to be covered in the approved rate and shall not be charged for
additionally. These include:
(a)
(b)
(c)
(d)
(e)
(f)
(g)
the typing of the report;
providing the minimum number of copies of the report required, i.e., original and two copies;
long distance phone calls;
meals;
courier costs;
the first 100 km of travel related to each client session;
other costs related to the assessment not prior agreed to.
Billing
The Service Provider agrees to the terms set out in Part “C”, the Client Attendance Policy for
Payment to Service Providers.
As per the Service Agreement, a bill shall be forwarded to the designated staff person who contacted
the private practitioner to prepare the report outlining, in detail, the time spent, by date relating to
the service provided. Part “D” Client Confirmation of Service Provided Pursuant to an Established
Purchase of Service Agreement must be completed and accompany each billing presented.
(B) Provision of Other Contracted Services
A listing of the Other Contracted Services is outlined on the Service Agreement Form, Part A,
pursuant to Policy Statement #75.
Requirements
For a person to be considered to provide services listed on the Services Agreement Form other than
counselling and assessments, the following must be provided:
(a) A completed application for contracted services (as provided in Appendix “E”) as well as a
curriculum vitae.
(b) A letter of security clearance from the municipal police force or RCMP shall also be provided.
. . . /6
Page -46­
Policy Statement 75, Effective
Page 6
April 1, 1999
The potential service provider shall report to their local municipal police detachment or RCMP
and request a criminal records check be completed on them and a copy included with the
application. Please note that there may be a charge for this criminal records check.
(c) The person shall include a signed permission to check with the Child Abuse Register as
provided in Appendix “B” and returned with your application. Please complete the second
section on the form and be sure that it is sworn to before a Commissioner of Oaths and return
the form with your completed application.
(d) An Oath of Confidentiality, signed by a Commissioner of Oaths, as provided in Appendix “C”.
(e) Three letters of references from professionals who have knowledge of the professional
qualifications and capabilities of the person requesting to be listed must be submitted.
(f)
In the application, related experience in the area of the service to be provided etc., must be
highlighted.
(g) A valid driver’s licence, current vehicle inspection certificate and proof of current automobile
insurance.
All requested information must be received before a review of the application will be considered.
The completed application and supporting documentation should be forwarded to the Agency/
District Office the applicant is applying to provide a service.
Please note where private organizations or firms are asking to provide these services, the persons
who will be providing services for the purposes identified shall be listed and similar information as
noted above shall be provided with respect to these individuals.
Persons Not Eligible for Private Service Agreements
The following persons are not deemed eligible for private service agreements:
(a) former employees of the Department of Community Services within the first six months of
their separation from the Department cannot perform private practice for the Department of
Community Services.
(b) Current employees of Children’s Aid Societies or Family & Children’s Service Agencies if the
parties are residents within the territorial jurisdiction served by the agency.
. . . /7
Page -47­
Policy Statement 75, Effective
Page 7
April 1, 1999
(c) Current employees who may or may appear to be in a conflict of interest to conduct counselling
for youth because of their performance of official duties.
(d) Individuals unwilling to comply with the information requirements or rate structure set out by
Policy #75.
(e) Individuals who are deemed to be unqualified to provide the services offered.
Rates and Billing
The Service Provider agrees to the terms set out in Part “C”, the Client Attendance Policy for
Payment to Service Providers.
Rates will be paid as per the Service Agreement. A bill shall be forwarded to the designated staff
person who contacted the private practitioner to prepare the report outlining, in detail, the time spent,
by date relating to the service provided. Part “D” Client Confirmation of Service Provided Pursuant
to an Established Purchase of Service Agreement must be completed and accompany each billing
presented.
_____________________________
George R. Savoury, MSW , RSW
Acting Executive Director
ps’75.cw (Feb 1//99)
Page -48­
Revised July 1, 2011
Policy #94
MAINTENANCE EXPENDITURES FOR CHILDREN IN CARE
Babysitting
Prior Approval**
Up to a Max. $4.00 per hour***
Approvals are on a case-by-case basis and must be associated with
the child’s Plan of Care.
Board
Dept. Rate* (Appendix A)
Covers food, lodging and personal care items. Personal care items
includes items such as toothpaste, soap, shampoos, deodorant,
shaving supplies, etc.
Camps, Club Memberships
Prior Approval**
Up to a Max $500 per year.***
Includes fees for registration and membership, associated costs i.e.,
brownie uniform, camping gear along with travel expenses, i.e.,
hockey practices outside local community. Recreation and items
such as skates, bicycles.
Child Care
Children in Permanent Care and Custody: agency pays full costs.
Children Taken into Care who are with their parents under
supervision of the agency: subsidized child care costs are paid by
the parents.
Children Taken into Care and placed in foster care:
Agency pays full costs. The agency has the discretion to cover the
costs of the child care space for a period up to two weeks after the
child is removed to hold the space for the child.
Clothing
Dept. Rate* (Appendix A)
Guideline: Careful consideration of the parents views regarding
clothing should fully be discussed at the time of placement.
Evaluate with the family that there may be a possibility that their
child(ren) will return home with a higher level expectation of dress
than the parents can afford.
If the initial contract is for less than (4) four months, the clothing
subsidy shall be omitted. The only exception to this policy is in
special circumstances where there is a demonstrated seasonal/or
obvious need. In this case, workers have discretion up to $200 for
the purchase of immediate clothing needs when a child first enters
care.
*
**
***
Department rates are enclosed and must be adhered to.
Prior Approval - bases on decision of worker and/or supervisor and/or Executive Director or District Manager
upon review of the agencies maintenance budget.
W here maximum are indicated, consideration to exceed these limits must be reviewed at a case planning
meeting.
Page -50­
Damages
When a child in care damages property in a licensed child caring
facility outstanding costs not covered by the insurance shall be
paid from the facility’s maintenance and repair budget. In the case
of damage to a staff person’s personal property, outstanding costs
not covered by a staff person’s personal insurance, may be
submitted to the agency and any payments, with prior agency
approval, shall be issued from the appropriate agency budget
depending on the child’s care status.
When a child in care damages property in a foster home, costs
under $250. are to be submitted to the agency and may be
reimbursed from the appropriate agency budget. Foster parents
will first discuss property damages with agency staff and request
approval for reimbursement. All damages over $250. and up to
$25,000. are to be managed under the Foster Care Self-Funded
Program.
When appropriate, the child should make restitution for the
damage, ie. from their spending money or doing chores.
Dental
Costs paid to a dentist for routine examinations, cleaning and
preventative care including fillings not covered by provincial
health care.
Diapers/Infant formula
Up to a Max. $200 per month per child***
To be paid by agency. There will be a straight reimbursable for
items purchased upon receipt verification.
Driver’s Education
Requests to be reviewed at a case planning meeting.
Driver’s License/Insurance
Driver’s Ed. may be cost shared with child and agency. Any
license or insurance costs are responsibility of the youth.
Equipment, Furniture &
Replacement of Bedding
Crib, highchair, playpen, beds, dressers, etc.
These items are expected to be provided by the foster parent and
will only be covered in extraordinary circumstances with prior
approval. If foster parents(s) do not have access to a safety
approved car seat, the agency will provide one. If any items in this
category are purchased, then they are considered to be the property
of the agency. Foster parents will be required to complete an
equipment and furniture request form (Appendix B). Agencies will
be required to use the inventory system to track purchases and
subsequent retrievals of these items (Appendix C). Replacement
of bedding may be provided based on the special needs of the
child. The cost of furniture to establish a child in an independent
living situation requires prior approval. Consideration must be
given to obtaining these furnishing in a cost effective manner.
*
**
***
Department rates are enclosed and must be adhered to.
Prior Approval - bases on decision of worker and/or supervisor and/or Executive Director or District Manager
upon review of the agencies maintenance budget.
W here maximum are indicated, consideration to exceed these limits must be reviewed at a case planning
meeting.
Page -51­
Glasses/Contacts
Prior Approval**
Up to a Max. $300 every other year***
Eye examinations (10 yrs. - 21 yrs.)
Hair Care
Prior Approval**
Up to a Max. $150 per year***
Cuts, perms, straighteners, extensions, colouring and associated
items.
Independent Living
Under Review.
Medical Equipment
Prior Approval**
The cost of equipment not covered by MSI as recommended in
writing by the appropriate specialist i.e., wheelchair, prosthesis,
etc.
Non-Prescription Items
Prior Approval**
The cost of non-prescription remedies associated with ongoing
treatments as recommended by a doctor or required to treat
common ailments, (cold, flu, e.g., common cold remedies, acne
remedies, allergy medication or items such as menstrual discomfort
remedies and sanitary supplies).
Orthodontics
Prior Approval**
Only applies to long-term placements, children in permanent care
and custody or Section 18.
Post Secondary Education
See Section 6 - Children In Care and Custody Manual for
Department of Community Services Educational Bursary Policy
and Extension to the Educational Bursary Policy. Prescriptions
Prescriptions for children in care who are placed outside of their
parents’ home will be covered by Pharmacare. Pharmacare
provides prescription drug coverage for those drugs listed in the
Nova Scotia Formulary. Pharmacare generally covers generic
drugs. If there is a need for a drug that is not listed, the physician
may be able to obtain approval by contacting Pharmacare.
In extraordinary circumstances, and with supervisory approval,
Pharmacare benefits may be extended to children in care whose
placement is with a parent.
*
**
***
Department rates are enclosed and must be adhered to.
Prior Approval - bases on decision of worker and/or supervisor and/or Executive Director or District Manager
upon review of the agencies maintenance budget.
W here maximum are indicated, consideration to exceed these limits must be reviewed at a case planning
meeting.
Page -52­
School Activities & Items
Prior Approval**
Up to a Max $200 per year***
The cost of approved school related items such as class and school
trips, school pictures, additional supplies, etc.
School Supplies
Prior Approval**
Up to a Max $200 per year**
The cost of approved school related items such as class and school
trips, school pictures, additional supplies, etc.
Special Occasion Costs
Includes: Birthday, Christmas, Grading gifts, Graduation costs and
other ethnic/religious events.
Birthday:
Up to a Max. $125***
Worker and caregiver discretion.
Christmas:
Dept. Rate* (Appendix A)
Grading Gifts:
Up to a Max. $50***
Worker and caregiver discretion. Should not be awarded to set up
expectations of success or failure, however, should be provided if
birth child(ren) in the home receive gifts. The child’s age and
appropriateness of the gift must be considered.
Graduation Costs:
Prior Approval**
Up to max. (Senior - $400, Junior - $200)***
Graduation photos, school ring, Prom outfit, etc.
Clothing is cost shared from clothing allowance with certainty of
a successful school completion.
Other (Ethnic/Religious Events):
Up to a Max. $20***
Worker and caregiver discretion.
Spending Allowance for Children
Dept. Rate* (Appendix A)
Telephone Calls
Prior Approval**
Up to a Max. $30 per month***
May be used to maintain contact with birth family and significant
others determined by child’s worker and caregiver. Whenever
possible, use discount times.
*
**
***
Department rates are enclosed and must be adhered to.
Prior Approval - bases on decision of worker and/or supervisor and/or Executive Director or District Manager
upon review of the agencies maintenance budget.
W here maximum are indicated, consideration to exceed these limits must be reviewed at a case planning
meeting.
Page -53­
Transportation
Transportation shall be reimbursed for the following only:
•
•
•
• •
•
•
child’s medical appointments
child’s mental health appointments
child’s other counselling
legal
access visits
case conferences
recreational activities
at the current provincial government rate
Vacation
Prior Approval**
Up to a Max. $300 per year.***
Approvals are on a case-by-case basis and must be associated with
the child’s Plan of Care.
Procedure for Reimbursement
Foster parent must use the claim form for reimbursement of expenses incurred on behalf of a child in their
care (Appendix D). Receipts must be provided for purchased items. The form is forwarded to the child’s
worker for approval who then forwards the cheque requisition and receipts to Financial Services/Agency
Accounting Department for payment.
*
**
***
Department rates are enclosed and must be adhered to.
Prior Approval - bases on decision of worker and/or supervisor and/or Executive Director or District Manager
upon review of the agencies maintenance budget.
W here maximum are indicated, consideration to exceed these limits must be reviewed at a case planning
meeting.
Page 1
Appendix A
DEPARTMENT OF COMMUNITY SERVICES
Foster Care Maintenance Rates for Children in Care
Revised July 1, 2011
AGE
RATE PER DIEM
0-9
$17.50
10+
$25.43
CLOTHING ALLOWANCE
AGE
MONTHLY
QUARTERLY
3 TIMES/YEAR
YEARLY
0-4
$39.20
$118.00
$157.00
$471.00
5-9
$64.75
$194.00
$259.00
$777.00
10+
$90.60
$272.00
$362.00
$1,088.00
Note: Slight variance in clothing allowance may occur depending on frequency of payment.
SPENDING ALLOWANCE
Effective March 1, 1999
AGE
MONTHLY
0-5
$10.00
6 - 11
$15.00
12 - 15
$25.00 paid to child
16+
$40.00 paid to child
Page 2
SCHOOL SUPPLIES RATES
Effective March 1, 1999
AGE
ANNUALLY
Grades Primary to Six
$120.00
Grades 7+
$150.00
CHRISTMAS ALLOWANCE
Effective March 1, 1999
Revised July 1, 2011
AGE
ANNUALLY
0-5
$100.00
6 - 10
$145.00
$125 to caregiver to purchase child’s
gift and $20 for child to buy gifts)
11 - 20
$190.00
$150 to caregiver to purchase child’s
gift and $40 for child to buy gifts)
Appendix B
Family and Children Services Agencies
Furniture Request Form
Foster Parent Name
Request #
Child’s/(children’s) Name (s)
Care Status
CRCC G
CRTC G
Vol. Care G
Date of Placement
Initial Placement at this home ­
yes G
no G
Reason foster parent is unable to provide appropriate furnishings.
Date furniture is required:
Items Required
Description
Estimated/Actual Costs
Total
Foster Parent
In completing and signing this request, I confirm that I do not have access to the described furnishings above in any
other manner than direct purchase by the Agency. As well, I understand that these furnishings remain the property of
the Agency and as such I will ensure they are returned in reasonable condition following the termination of a related
foster care placement. Failure to return these furnishings may result in a garnishing of board payments.
Foster Parent signature:
Social Worker
I have reviewed the above request and based on this support the provision of furniture by the Agency. In advance of
approving a purchase of new equipment, I have reviewed the availability of existing furniture items not in use.
Social Worker signature:
Supervisor/District Office Manager Approval
Family and Children Service Agencies
Furniture Inventory Tracking
Appendix C
Item #
Request #
Description
Price
Purchase Date
Placed at (Foster Parent)
Date
Moved to (Foster Parent)
Date
Moved to (Foster Parent)
Date
Moved to (Foster Parent)
Date
Appendix D
Part 1
FOSTER HOM E TOTAL EXPENSE FORM
Please forward the completed form, including any receipt information, to your agency/district office on a monthly basis.
NOTE: Please attach all receipts when requesting reimbursement.
ONE EXPENSE FORM PER CHILD
Name of Foster Parent:
Address:
Name of Child:
Postal Code:
Telephone:
Date From:
DATE
TRAVEL
DESTINATION
(From/To)
M ILEAGE
# OF KM S
Date To:
DESCRIPTION
OTHER EXPENSES
AM OUNT
SUBTOTAL # OF KMS
TOTAL KMS REIMBURSEMENT FOR THIS CHILD
TOTAL OTHER EXPENSES
TOTAL EXPENSE REIMBURSEMENT
I hereby certify that the expenses claimed are correct and just in all respects and that the w hole expenditure w as incurred on behalf
of the child in care.
Signature of Foster Parent:
Appendix D
Part 2
FOSTER HOM E TRAVEL EXPENSE FORM
1.
2.
3.
4.
5.
6.
7.
8.
9.
Complete a FOSTER HOM E EXPENSE FORM (Appendix D) for each of the children in your home during the past
month.
Complete your name, address, telephone number and postal code.
Enter the appropriate dates, i.e., Date From: April 1, 2007 Date To: April 30, 2007.
Total the numbers of Kms driven for all children and enter this figure in the This M onth’s Kms block .
Add the figure in This M onth’s Kms block to the Year to Date Kms block and enter this figure in the Total Year to Date
Kms.
The figure in the Total Year to Date Kms. block will be the figure in the Year to Date Kms block next month.
As your total Kms driven for all children reaches 16,001 kms and then 27,001 kms, the rate will be reduced, as shown.
Place the number of Kms driven this month in the appropriate column, depending on the yearly total of Kms. driven.
Calculate the Amount and the Total Amount.
Foster Parent Name:
Address:
Telephone:
Postal Code:
Current Claim Summary
This M onth’s
Date Kms:
Date From:
Date To:
Year to
Date Kms.
First 16,000
Provincial Government Rate
16.001 - 27,000
Over 27,000
Total Year to
Date Kms:
No. of Kms
driven this month
@
Kms claimed
@
Kms Claimed
@
Kms Claimed
@
Rate
Amount
Amount for First Child
Amount for Second Child
Amount for Third Child
Amount for Fourth Child
Total Amount
I hereby certify that the expenses claimed are correct and just in all respects and that the w hole expenditure was incurred on behalf
of children in care.
Signature of Foster Parent:
Appendix E
DEPARTMENT OF COMMUNITY SERVICES
FAMILY AND CHILDREN’S SERVICES DIVISION
ASSESSMENT OF CHILDREN IN FOSTER HOME CARE
GUARDIAN AGENCY
DATE OF ASSESSMENT
NAME OF CHILD
BIRTH DATE
SIGNATURE OF FOSTER PARENT
SIGNATURE OF WORKER
INSTRUCTIONS:
Read through the following lists checking in the space beside each statement only if it applies to the child.
Go back over those statements you have checked off and make a further rating (1, 2 or 3) by putting a check mark
in the appropriate space to the right of the line.
(1)
requires NO MORE time, energy or skill than would be spent caring for a child of his/her age not having
this problem.
(2)
requires a MODERATE expenditure of time, energy and/or skill (quite a bit more than would be spent on
a child of his/her age not having this problem).
(3)
requires a GREAT expenditure of time, energy and/or skill (much more than would be spent caring for a
child of his/her age not having this problem).
EXAMPLE:
Mrs. Jones feels that Johnny is physically slow in getting around and a bit uncoordinated, that this does not require
any more time, energy or skill from a supervising point.
N/A
#2
Child needs supervision and/or some
help with mobility due to:
(1)
(2)
(3)
x
NOTE:
FOR RATING PURPOSES, THE CHILD ’S PHYSICAL AND /OR MENTAL AND /OR EMOTIONAL DISABILITIES - NOT AGE ,
ARE TO BE CONSIDERED AS THE DETERMINING FACTORS .
I.
PHYSICAL OR PERSONAL CARE
THIS SECTION , NORMAL CARE INCLUDES THOSE CHILDREN WHO ARE BASICALLY SELF-CARING FOR THEIR AGE ,
BUT WHO MAY NEED SOME HELP WITH PUTTING ON BRACES OR PROSTHESIS , HELP WITH BUTTONS, LACES.
N/A
1.
Child needs help with dressing, bathing and
general toilet (except infants).
2.
Child needs supervision and/or some help
with mobility due to:
3.
a)
being physically slow/uncoordinated
b)
being independent on a mechanical appliance
to move around, eg., uses wheelchair, or
braces, or walker.
c)
being unable to run and play as others do.
Child has feeding problems that require attention
and/or assistance due to:
a)
excessive intake of food, may require
frequent small meals rather than three.
b)
excessive messiness or slow eating due to
mental retardation, emotional or physical
disability.
c)
need for tube or gavage feeding.
4.
Child does not have complete bladder or bowel
control because of illness or organic defect
and requires attention.
5.
Child has a medical appliance that requires attention,
eg., for drainage or ileal conduit, colostomy.
6.
Child cannot be left alone at any time, eg., in the
yard, in a room watching T.V.
Page -61­
(1)
(2)
(3)
7.
Child requires continuous supervision by a mature
adult and cannot be left with a teenage babysitter.
8.
Child requires continuous supervision by a
skilled adult, eg., trained nurse.
II
THERAPEUTIC PHYSICAL CARE
9.
Child requires regular program of prescribed
medications requiring skill and training to administer.
10.
Child requires extra care to skin.
11.
Child requires special diets or supplements.
12.
Child requires attention due to need for
aspiration, suctioning, mist-tent.
13.
Child requires attention due to need for allergyfree atmosphere, eg., for asthma.
14.
Child requires assistance with:
(a)
physical therapy
(b)
speech therapy
(c)
occupational therapy
to be done at home.
15.
Child requires supervision of:
(a)
physical therapy
(b)
speech therapy
(c)
occupational therapy
to be done at home.
16.
Due to:
(a)
physical disability
(b)
mental disability
(c)
learning disability
child requires extra attention and play to
stimulate development.
17.
Other (Specify)
N/A
(1)
(2)
(3)
N/A
(1)
(2)
(3)
III
SUPERVISION OF MEDICAL CARE
18.
Child needs frequent hospitalization.
19.
Child needs unusual or exceptional medical
care at least monthly.
20.
Child needs unusual or exceptional dental
care at least monthly.
21.
Child needs regular visits to allied health
professionals.
IV
ANCILLARY CARE
22.
Child requires excessive laundry.
23.
Child is destructive to household goods, eg.,
tearing up sheets, chair covers, smearing
and soiling.
24.
Other (Specify)
N/A
(1)
(2)
(3)
N/A
(1)
(2)
(3)
THERAPEUTIC EMOTIONAL CARE:
IN THIS SECTION , NORMAL CARE INCLUDES CHILDREN WHOSE CARE IS ESSENTIALLY NORMAL ON A DAY -TO -DAY BASIS,
BUT WHERE IRREGULAR LAPSES COULD OCCUR , EG ., DUE TO PARTICULARLY DIFFICULT SESSIONS AFTER VISITS WITH
NATURAL FAMILY , OCCASIONAL PERIODS OF EXCESSIVE DEPENDENCY AND /OR CHILD IS PASSIVE , LACKING IN
RESPONSE AND ABILITY TO RELATE .
N/A
25.
Child needs emotional support, encouragement
and re-assurance because:
a)
is unusually withdrawn.
b)
has a low self-image, feels inferior/
rejected.
c)
is unusually dependent.
d)
is depressed.
e)
Other (Specify) (1)
(2)
(3)
N/A
26.
27.
Child needs extra attention from the foster parents,
eg., extra time for discussion, special play
periods, supervision of activities due to:
a)
attention seeking.
b)
night problems.
c)
need for constant repetition and followthrough on instructions.
d)
hyperactivity.
e)
encopresis (incontinence, not due to
illness or organic defect).
f)
lies.
g)
Other (Specify)
Child needs limit setting, firmness, some
discipline because:
a)
is angry/defiant
b)
is manipulative
c)
is destructive
d)
is aggressive
e)
is a runner
f)
steals
g)
is dependent on drugs/sniffing
h)
is dependent on alcohol
i)
acts out sexually
j)
Other (Specify)
(1)
(2)
(3)
N/A
28.
29.
Child’s behavior in the community requires that
foster parents have frequent contact with community
persons such as: neighbours, school authorities, law
enforcement authorities and the Courts, in order to
explain and deal with the child’s problems which are:
a)
academic/learning problems.
b)
regular truanting.
c)
inappropriate behaviour but non-delinquent.
d)
delinquent or deviant behavior.
e)
Other (Specify) Child needs help in finding and making use of
satisfying recreational opportunities.
TABULATION OF SCORE:
#2's x 2 =
#3's x 4 =
TOTAL POINTS
=
(1)
(2)
(3)
SPECIAL BOARD RATES
(Regular Rate Plus Point Rating)
Points
Rating
Points
Rating
10 - 19
$1.50
80 - 89
$8.50
20 - 29
2.50
90 - 99
9.50
30 - 39
3.50
100 - 109
10.50
40 - 49
4.50
110 - 119
11.50
50 - 59
5.50
120 - 129
12.50
60 - 69
6.50
130 - 139
13.50
70 - 79
7.50
140 - 149
14.50
Post Care and Custody Agreement
I, __________________________________________, wish to participate in the Extension to the
Educational Bursary Program. I understand that I will receive funds to cover the actual costs of
tuition, books and related expenses, in addition to regular maintenance, so long as I meet the
following conditions:
•
I enroll in a program offered at an accredited educational institution (university,
community college or private vocational training) that is designated by or
registered with the Canada Student Loan Program or that is licensed by the
Private Colleges Act
•
I attend an education institution within the Atlantic Provinces unless the
program I wish to pursue is not available within the Atlantic Provinces
•
I attend the program of study on a full-time basis and carry a full course load
for the year
•
I successfully complete a minimum of 80% of the courses per year. An
exception can be made with the approval of the Regional Adminsitrator. The
request for an exception shall be forwarded in writing from the Executive
Director/District Manager to the Regional Administrator.
•
I provide an annual transcript to my social worker
•
I contribute $1000 annually. These funds may be obtained through summer
employment, part-time employment or loans. I understand that a reduction of
the $1000 contribution may be approved by the Executive Director/District
Manager if the post-secondary program extends beyond eight months each year
•
I apply for any available scholarships and bursaries, including the Ken Dryden
Scholarship
•
I understand that this program will provide funding to support only one degree
at university, one community college program or one private vocational
program.
•
I understand that post-secondary programs whose tuition fees are greater than
the most expensive Nova Scotia university tuition fees will require the approval
of the Regional Administrator. The request shall be forwarded in writing from
the Executive Director/District Manager to the Regional Administrator.
•
I understand that funds can be made available until my 24th birthday
_______________________________
Date
______________________________________
Signature
I, _____________________________________________, Executive Director/District Manager of
____________________________________, agree to cover the costs of post-secondary tuition, books
and related expenses in addition to regular maintenance for _________________________________,
so long as the conditions of this agreement are met. This agreement is effective for one year but will
expire on ______________________________________’s 24th birthday.
______________________________
Date
____________________________________
Signature
SECTION 6
REFERENCE MATERIAL
SEXUALITY RESOURCES
Publications:
1.
Agnes, M. (1996). Nova Scotia Sexual Health Needs and Resources Assessment: Just
loosen up & start talking. Halifax, NS: The Nova Scotia Department of Supply & Services.
2.
Early Childhood Education Task Force (1995). Right from the start: Guidelines for
sexuality issues, birth to five years. USA: Sexuality Information and Education Council of
the United States.
3.
Health Canada (1994). Canadian Guidelines for Sexual Health Education. Ottawa: Health
Canada.
4.
McCullagh, J. & Simpson, B. (1995). “Accessible child welfare services for lesbian, gay and
bisexual youth”, OACAS Journal, 39(3).
5.
Planned Parenthood Federation of America (1986). How to talk with your child about
sexuality. New York: Doubleday & Company, Inc.
6.
Selverstone, R. (1996). Now what do I do? How to give your pre-teens your messages.
USA: Sexuality Information and Education Council of the United States.
Community Agencies with Sexual Health Information &/or Services:
1.
2.
3.
4.
5.
6.
AIDS service organizations
Gay, lesbian & bisexual youth groups
Planned Parenthood affiliates
Public health department
Teen health centres
Helpline
Websites:
1.
2.
3.
4.
5.
6.
American Social Health Association: www.ashastd.org
Planned Parenthood Federation of America: www.plannedparenthood.org
Planned Parenthood Federation of Canada: www.ppfc.ca
Rainbow Classroom Network: www.dezines.com/rainbow/
Sexuality Information & Education Council of the United States: www.siecus.org
Lesbian, Gay and Bisexual Youth Project: www.youthproject.ns.ca
Resources/Books:
Entitlement Books
Frog Hollow Books - Street, Halifax
One Teenager in Ten, Alyson Publications, Boston, 1983
Looking At Gay and Lesbian Life, Warren Blumfeld and Diane Raymond, Beacon Press, Boston,
1983
The New Loving Someone Gay, Don Clark, Celestial Arts, Berkeley, 1987
Young Gay and Proud, S. Alyson, ed, Alyson Publications, Boston, 1981
Reference Material:
Steinhauer, Paul D., The Least Detrimental Alternative, 1991
Psychiatry:
Provincial Medical Association
Psychology: St. Mary’s University, Department of Psychology
Dalhousie University, Department of Psychology
Provincial Psychological Association
SECTION 6
SERVICES TO CHILDREN IN CARE
Summary of Standards For Services To Children In Care
6.1(a)
The child’s social worker must have face to face contact with the child within the
first seven days of placement, this must occur in the child’s placement. The social
worker must have either phone or face to face contact at least every 30 days with
the child. Face to face contact with the child must be at a minimum of once every
90 days for children and youth in care of the agency, and this contact must occur
in the child’s placement. Each contact with the child must be recorded and
documented on the case management system. When contact was not possible, the
reasons why should also be documented.
6.1(b)
Children and adolescents in care must have access to a telephone and a contact
number for their social worker or how to reach another worker or the supervisor
in an emergency.
6.2(a)
Social workers responsible for a child in care must have regular and meaningful
contact with the child’s care providers. The child’s social worker must have face
to face contact with the caregiver within the first seven days of placement, this
must occur in the child’s placement. The social worker must have either phone or
face to face contact at least every 30 days with the caregiver. Face to face contact
with the caregiver must be at a minimum of once every 90 days, and this contact
must occur in the child’s placement.
6.2.3(a)
Children over 12 must be consulted on whom they consider significant and who
they would like contacted (see Section 2.19: Access Services).
6.3(a)
When a social worker or other agency staff is transporting a child in care, the social
worker or agency staff must make sure that the children are properly restrained,
either by seatbelt or by child restraint system, as appropriate.
6.3(b)
A child in care must not be transported by taxicab unless they are properly secured
by either a child restraint system or a seatbelt, as appropriate, and as prescribed
by the Motor Vehicle Act.
6.4(a)
Parents have an obligation to contribute financially to the care of their children.
Agencies are required to review the financial capacity of all parents who enter into
a Section 17 or Section 18 Agreement regarding their ability to contribute toward
maintenance of their children in care, using the Child Maintenance Guidelines.
6.4.1(a)
A child in care must be provided with sufficient nourishing food to meet their
individual needs for growth, development, and activity.
Section 6
Services to Children in Care
A child’s individual needs for growth, development, and activity must take the
following into account:
•
•
•
•
•
general nutritional requirements of children
the special nutritional requirements of the particular child, including
any requirements or limitations diagnosed or prescribed by a health care
provider
the child’s views, including the child’s specific likes and dislikes
the child’s culture and diet customs, if applicable
any special requirements of the child relating to the manner in which
food is served or prepared, if the child is young or has special needs
6.4.2(a) A child in care must be provided with clothes that are of comparable style, quality,
and condition as those of other children in their community.
6.5(a)
A medical must be completed within 30 days of a child entering care and annually
thereafter while in care. (See Appendix Section 3 for forms)
6.5(b)
A medical booklet must be provided and maintained for every child in care which
must include the child’s health card number.
6.5.1(a) A child in care must receive dental care as required to maintain their oral health,
safety, and well-being. A dental checkup must be completed within 90 days of a
child entering care and annually thereafter while in care.
6.5.2(a) Where the child has the capacity to consent, the child’s consent to treatment must
be obtained.
6.5.4(a) A valid Nova Scotia health care number must be documented for each child in care
on the case management system and made available to those persons responsible for
overseeing the medical care of the child.
6.5.5(a) Where the status of the child is not determined, the social worker must apply to
Indian and Northern Affairs Canada to determine if the child is eligible for Indian
status. For a child with Indian status, the social worker must clarify with Indian
and Northern Affairs Canada which health care benefits the child may be entitled
to receive.
6.7(a)
The child’s social worker must make sure that children and youth in care receive
ongoing, age-appropriate education about sexuality issues. In addition to healthy
sexual development the risks associated with and prevention of sexually
transmitted diseases must be reviewed. The date and summary of the discussions
must be noted in the the record.
6.8.1(a)
Policy Statement #75 must be applied when contracting services for a child in care.
Section 6
Services to Children in Care
6.8.1(b) When directed by the courts to complete psychological, psychiatric, or other
assessments, or where the child welfare agency requires an assessment/treatment
of a child, and the agency is unable to provide the assessment and/or treatment, the
agency must utilize existing mental health or other publically funded services when
possible and appropriate.
6.9(a)
A child in care is entitled to have access to education. In compliance with the
Education Act, a child in care over 5 and under 21 must be enrolled in public school
in their local community unless:
•
•
•
the child is 5 and it is in the child’s best interests that enrolment be
deferred for one year
the child is involved in an alternate education program offered or
approved by the Department of Education
the child is over 16 and refuses to attend any school or any alternate
education offered or approved by the Department of Education
6.9.6(a) Educational goals must be developed as part of the comprehensive plan of care.
6.11(a) Where a child is in the care and custody of an agency or district office by court
order and the child is entitled to money from an estate or insurance settlement, and
no guardian has been appointed in regard to that money, the agency or district
office must consult with the office of the public trustee.
6.12(a) Where a child in care is entitled to Canada Pension Plan benefits, the agency or
district office must take the necessary steps to make sure an application is made for
those benefits and the benefits be used to contribute to the costs of maintaining the
child. A child may be eligible for pension benefits if either of their parents are
disabled or deceased and the contribution requirements have been met.
Section 6
Services to Children in Care
`