Juvenile Delinquency Permanency Roundtable Action Plan

Date of Roundtable:

Case Number:

Child’s Name:

Child’s Date of Birth:

Gender:

Race/Ethnicity:

County:

Region:

Current Placement:

Does Child currently have an open CHINS Case? If Yes, CHINS Case Number:

Permanency Roundtable Participants / Name / Signature
Probation Officer:
Probation Supervisor:
Facilitator:
Master Practitioner
Scribe:
DCS Representative:
Other:

Documentation of Clarifying and Exploring Questions

Examples of clarifying questions include:

When was the last time PO talked with the child about whom he/she would like to have permanency?

What do you believe to be the primary barriers to permanency for this youth?

Describe any factors that affect progress towards permanency for the youth?

What is the child’s vision for permanency?

What do you think is the best possible-but realistic-permanency outcome for this child in the next six months?

What supports would you need to help the child achieve that permanency?

Other.

Type questions/answers below.

Permanent Connections

Does youth have a permanent connection with at least one caring adult that both the youth and adult agree will be lifelong? Yes or No:

If yes, specify type and frequency of contact:

If yes, list below the name of each of the youth’s positive permanency connections, the email address and contact phone number, and the youth’s current or former relationship to them (do not include professionals): (e.g., “Mary Jones, older sister” or “James Tompkins, former football coach” or Juanita Valdez, former foster mother”)

Name of Permanent Connection / Email Address / Contact Phone Number / Current or Former Relationship to Youth

Child’s Current Permanency Status Rating

The Legal Permanency Status Rating is based on a snapshot of the legal status of the youth and the availability of committed life long connections “at the moment”. It is not an evaluation of what has happened in the past nor is it to reflect what is anticipated or hoped for in the future. The Legal Permanency Status Rating is not a measure of safety, stability, and well-being, although those are components. It focuses on measuring what progress has been made to date in establishing legal/committed caregiver relationships for this child/youth including reunification, adoption, guardianship, or a life long connection. For example, does the child/youth have an identified individual(s) that can make medical decision, and other legal decisions for him/her should the need arise?

The Legal Permanency Status Rating is to describe the current situation for this child/youth only and is to provide a base line for evaluating future progress toward achieving the best possible permanency status for each child/youth.

Please rate the child’s current permanency status based on the descriptions to the left of the rating (and/or reference chart).

Child is in a family setting that the child, caregivers and tam believe is long term and identified safety, risks have been eliminated (could include reunification not THV, pre-adoptive, guardianship, or fit and willing relative). May include youth with Permanency Goal of APPLA if youth is age 17.5 or older and has demonstrated ability to live independently by successfully completing or is on track to graduate from High School Diploma or GED program or has demonstrated ability to maintain consistent employment of at least 30 hours per week for period of more than 6 months, and has at least 3 identified and committed adult connections and is living in an environment that ;youth will be able to financially support themselves within the next 6 months or less. / Very Good Permanency Status
Child is in a family setting that the child, caregivers, and team believe is long term; a plan to ensure safety and stability has been achieved, caregivers are committed to the plan; and reunification/adoption/guardianship/fit & willing relative issues, if any, are near resolution. May include youth with Permanency Goal of APPLA if youth is age 17.5 or older and has demonstrated ability to live independently by being within 12 months of completing High School Diploma or GED; has at least 1 identified and committed adult connection, has demonstrated ability to obtain and maintain consistent employment and has a realistic plan to financially support themselves in the future. / Good Permanency Status
Child is in a family setting (includes any Child Caring Institution, Group Home, Foster Home, Relative Home and any other court approved placement under the direct supervision/care of at least one adult) that the child, caregivers and the team believe is stable and meets the child’s current needs, and the caregivers are committed to the plan; viable permanency options such as reunification/adoption/guardianship/fit & willing relative are likely and are being sought at this time. May include youth with Permanency Goal of APPLA if youth is age 17.5 or older and has demonstrated some ability to live independently by being within 12 months of completing High School Diploma or GED and demonstrated ability to obtain employment but has no identified and committed adult connections or does not have a realistic plan to live independently in the next 12 months. / Fair Permanency Status
Child is in a foster care setting and likelihood of reunification or permanent home is uncertain; reunification/adoption/guardianship/fit & willing relative issues are being assessed; and concurrent plan(s), if any are uncertain or problematic. May include a youth with a Permanency Goal of APPLA if the youth is 17.5 or older and has demonstrated some ability to live independently by being within 12 months of completing High School Diploma or GED and demonstrated ability to obtain employment but has no identified and committed adult connections or does not have a realistic plan to live independently in the next 12 months. / Uncertain Permanency Status
Child is living in a setting that is not likely to endure or is moving from home to home due to safety and stability problems, failures to resolve issues, or because the home is unacceptable to the child. Child remains in a temporary setting without a realistic or achievable permanency plan and concurrent plan(s), if any, have stalled or failed. May include a youth with a Permanency Goal of APPLA that is under the age of 17.5 regardless of any demonstrated abilities to live independently. / Poor Permanency Status

Documentation of Brainstorming Ideas

What will it take to achieve Permanency?

What can we try that HAS been tried before?

What can we try that has NEVER been tried before?

What can we do concurrently?

How can we engage the youth in planning for permanence?

Record brainstorming ideas below:

Permanency Action Plan

You are not limited to the spaces provided on this page and the next; for example, you may have more than four action steps for a particular strategy or need more room to document the plan actions or plans to overcome barriers; feel free to use additional lines and/or write on the back of the page.

CURRENTPermanency Goal: Reunification Adoption Guardianship Placement with fit/willing relative APPLA

NEW Permanency Goal Recommended by Team: Reunification Adoption Guardianship Placement with fit/willing relative APPLA

CONCURRENT Permanency Goal: Reunification Adoption Guardianship Placement with fit/willing Relative APPLA

Strategy/Goal (e.g. family engagement, youth involvement, individualized services) / Actions (the specific tasks planned, e.g., contact maternal aunt for current situation) / Anticipated barriers to Implementation (if any) / Plan to overcome Identified Barriers / Target Completion Date (month, yr) / Person Responsible
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Debrief

How can the Probation Officer/Supervisor best explain the action plan to the family and youth, court, provider and other stakeholders?

Are there unanswered questions or concerns? If so, how can we address them?

What did we learn that can be applied to other cases?

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