Ambrose Place Family Support Services
Supervised Visitation Service Description
This service provides parents and children the opportunity to visit one another in a safe and supervised environment when children have been placed in out of home care due to abuse and/or neglect concerns. The family visit is constantly monitored by a neutral third-party provider assigned to observe, supervise and document the visit of one referred family at a time. The contracted visitation agency is required to provide all transportation necessary to facilitate the visitation services including, when needed, transportation of the child(ren) to and from the visit.
With the goal of maintaining relationships between parents and children or sibling groups, provider agencies arrange and provide for the transportation and supervision of children in an environment determined safe by CSSW. It is generally expected that parents arrange their own transportation to and from visits.
Visits occur in the provider agency’s office, the family’s home or a community location as approved by the CSSW Case Manager. Visits should not occur at CSSW sites (Summit Place, Next Door Foundation, Ascension Church, 76th Street, Children’s Hospital, etc.). Initial visitation schedules should match the schedule outlined in the referral whenever possible. Any changes to the visitation schedule including days, times, length, etc. should be passed by the CSSW Case Manager to ensure they are in agreement with the proposed changes.
Parents and caregivers must also be in agreement with any schedule changes. When the caregiver or provider cancels a visit for reasons other than the parent not confirming a visit, the missed visit time should be made up by adding an extra visit or adding time on to existing visits. In situations where the parent is required to confirm prior to a visit and does not or the parent does not show for a visit, a make-up visit should not be offered. If the parent cancels a visit with 4 or more hours of notice for acceptable reasons (court, written medical excuse, etc.), make-up time should also be offered. Visits should be made up within 7 days whenever possible.
As child safety and well-being are paramount during these monitored family interactions, the contact between family members must be supervised at all times. This includes supervising diaper changes, visits to the restroom, all conversations, etc. Providers must always have a clear view of all family members and the ability to hear their conversations. Parents and visitation workers should not discuss the child welfare case or possible outcomes with the children or in front of the children nor should they speak negatively about the children’s caregivers, parents, siblings, relatives, etc. Such conversations should be redirected during visits if they occur. Any concerns or questions the parent has about their child welfare case should be directed back to the CSSW Case Manager. Only non-physical behavior management techniques can be utilized during visits.
Children should not be roughly pulled, hit, slapped, spanked, pinched, threatened, called derogatory names, etc. A visit should not occur if the parent appears to be under the influence of alcohol or drugs. It is equally important visitation staff pay close attention to children’s responses during visits. Something in the child’s experience may cause them to be particularly sensitive to or scared by a person, place or thing. Adjustments should be made quickly in such situations where a strong response is noticed so the child is made comfortable again. If visitation staff at any time feel the safety or well-being of the children is in jeopardy, a reminder should be given to the parent about the applicable visitation rules and/or responsibilities. The observed behaviors as well as the conversation should be documented and the visit ended if necessary.
Additional visitation workers may be assigned to a visitation case with CSSW approval to assist with the supervision of larger or high-risk family groups to ensure safety.
As CSSW is committed to the health, safety and well-being of the children and families receiving direct service in the community, client homes and agency offices, we do not allow the use or practice of any restrictive behavior management techniques or interventions when working with clients. This includes, but is not limited to, any physical holds or manual restraint, mechanical restraint or use of isolation or locked seclusion techniques by the visiting adult or provider to manage a client’s behavior.
We recognize that at times clients may become extremely upset and challenging and may become a danger to self or others. In these circumstances, verbal defusing and de-escalation techniques should be utilized to resolve the situation if at all possible. If the client is determined to be out of control, a call for assistance should occur as appropriate to the situation, including the provider agency supervisor,
CSSW on-call supervisor, emergency crisis team, local law enforcement or other emergency phone numbers including 911. In an extremely rare situation where a client is an imminent danger to the health and safety of themselves or others, common sense must prevail. However, the least restrictive means of controlling the situation should be used to prevent serious injury until help arrives. A written summary of the event, what actions were taken and why must be completed in the form of an incident report within 72 hours submitted to the CSSW Lead Service Coordinator. Notification to the CSSW case manager and other relevant parties should occur as soon as the situation has been moderated.
Visits occurring between parent(s) and children need to focus on the observation and documentation of parenting skills. Concentrating, for example, on appropriate/inappropriate interactions, age expectations, behavior management techniques and visit planning/preparation. Sibling visits need to focus on establishing and/or maintaining sibling relationships. Documentation should describe the interactions of the involved family members. For example, describing what the family did during the initial greeting and how it was received. Activities that minimize interactions need to be noted. Actions providers or parents took to redirect inappropriate situations and/or prompt appropriate interactions also need to be documented. This service is intended to support parents and model appropriate parent/child interactions. Intervention is expected when needed to teach the parent appropriate behavioral management techniques and to ensure child safety/well-being.
Watching TV, videos or movies during the visit are not allowable or billable activities as these types of activities do not promote positive and active interaction between the parent and children. Likewise, the playing of video/phone games, texting, talking on the phone, etc. should be redirected during visits.
Computer/Internet use should also be minimal and limited to educational activities only (under 30 minutes). Similarly, active sport/exercise Wii games should be limited to 30 minutes or less and they should involve several family members playing at the same time. Other Wii usage should be redirected to more interactive family options.
Parents are permitted to record/photograph their children as long as other client families and community members are not in the area and are not in the recording/photo. Parents are not permitted to record or photograph CSSW staff.
This service is not intended to simply document parent/child interactions, but to also monitor, model and teach family interaction. Invoicing is based on the number of units (hours) of the visit and travel time, regardless of the number of family members attending the visit.
Only approved persons should be in attendance at visits. The CSSW Case Manager or their Supervisor must approve a person’s attendance prior to the actual visit. If an unapproved person presents at any point during a visit, the visitation worker should instruct the parent to ask the person to return after the visit. If the unapproved person does not depart promptly, the visit should be ended. Such exchanges should be documented in the progress notes as well.
A maximum of 15 minutes of wait time is allowed for no-shows. CSSW will not pay for more than 15 minutes of wait time, regardless of whether the parent eventually shows up. Actual travel time is billable.
Cancellations are non-billable when the provider or provider agency cancels the visit. Cancellations made by the visiting adult, caregiver, case manager or other party related to the visit are reimbursed at 15 minutes unless the provider is en route to visit related activities when the cancellation occurs.
Actual travel time can then be billed under these circumstances in addition to the 15 minutes of service time. Documentation related to circumstances surrounding the cancellation must be submitted in order for the 15 minutes of service time to be invoiced in the aforementioned circumstances.
Phone contact with CSSW staff or service recipients and any required documentation are considered indirect costs built into the service rate and therefore are non-billable activities.
Agencies must ensure that vehicle safety mechanisms are utilized according to Wisconsin State Law during transport (i.e. safety seats, seatbelts).
Documentation should be specific and objective describing what the worker saw and heard rather than what they think or feel about what they observed. The thorough and accurate documentation of visits, no shows and cancellations are critical. This information helps the Case Manager and Child Welfare system determine the appropriate visitation schedule/level, assists with case planning and contributes to the overall picture of case progress. Visit concerns should be documented in the progress note, reported to the case manager directly by phone or email and an incident report completed as appropriate.
As visitation staff are mandated reporters, a call to 220-SAFE may be additionally warranted in some situations. For child safety purposes, it is always better to document and report a situation. CSSW regards the submission of incident reports favorably.
Minimum Documentation Requirements:
- Date of service
- Time visit began, Time visit ended
- Start time and end time of transportation from the initial pickup location to the visit location
- Start time and end time of transportation from the visit location to the last drop off location
- Name of providing staff
- Name of the individuals in attendance during the service
- Name of the absent person(s) expected to participate in the service
- Focus/goals of the service
- Progress of the family during visits citing goals, objectives and specific examples
- A timeline of what transpired during the visit from beginning to end
- Descriptions of the individual family members participation in the service
- Interactions/Reactions/Behaviors of the visiting adult(s) toward the child(ren)
- Interactions/Reactions/Behaviors of the child(ren) towards the visiting adult(s)
- Interactions/Reactions/Behaviors of the siblings towards each other
- Descriptions of the activities that took place during the visit
- Descriptions of the efforts the visiting adult(s) made to care for the child(ren) during the visit
- Descriptions of how the visiting adult(s) exercised their “parental” role during the visit (setting limits, planning activities, meeting the needs of the child(ren), engaging with the child(ren), etc.)
- Descriptions of how the worker actively re-directed the visiting adult(s) when necessary and the response of the visiting adult(s)
- Descriptions of the initial greeting and departure
- Any additional information as appropriate