1005-6           GENERAL TIPS FOR COMPLETING A CONSULTATION REQUEST

A Work Services case manager is encouraged to discuss the Consultation Request process with a client. However, no guarantees of service delivery track transfers should ever be provided to a client prior to a final determination being made.

Complete client and case manager boxes with accurate information. Please check spelling and misplaced numbers before submitting. Date is the date case manager completed the CR Consultation Request.

• Request action: Transfer from to _________ (FFF Families First Facilitators will approve or deny on this line.)

• Check one: incorrect ITT Initial Tracking Tool (or) Change service delivery

• Check one:

• (to) FF Families First or (to) WF Work First

• (to) Discovery

• (to) SSI Supplemental Security Income

• (to) Urgent

Box #1:

Describe why you’re making this request. 

Do not use the second half of the box next to FFF Families First Facilitators recommends.  The date box is when FFF answered the CR Consultation Request.

• History of, describe _____. 

• Current situation, describe_____.

• Complexity, describe _______ .

Example:

Client has history of DV: see CLNO Client Notes dates (8/09) DV crisis,(10/09) 12 mo restraining order in place, (12/09) staying at DV shelter, (3/11) DV trial – convicted. All aiding her to have PTSD & need for MH counseling, especially around anniversary dates & life situations

Example:

Clients aged mother moved in with her from out of state & requires around the clock care. Mother is diagnosed stage 4 cancer & Alzheimer’s. See CLNO Client Notes (11/10/12) changes in HH – new TA10, Doctor states client needs to care for her mother since patient knows no one in town & is frightened of everyone. Client is the only one who can keep her calm so she does not injure herself. Mother doesn’t speak English.

Example:

Client is working with OCS Office of Children's Services, BH for self & newly diagnosed 10 yr old child with behavioral health issues, probation, parenting classes, DJJ Division of Juvenile Justice. See Family network & CLNO (11/15/12) employment assessment, multi agency. 

Review and reference any pertinent CANO Case Note’s to reflect your CLNO Client Notes’s.  If CANO and CLNO do not match, find out why they are different and correct the information, as appropriate. Notify DPA Division of Public Assistance eligibility staff and case management supervisor.

Box #2:

Summarize who this client is seeing and how they manage appointments with those agencies. Obtain ROI Release of Informations and follow up with the agency personnel for validation and learning of calendar scheduling requirements. Ask about referrals made to client and if the client followed up with additional referral’s, if no - why not. State the source of this information.

Summarize attendance and penalty history with Work Services agency(s).

Example:

Client states she has trouble meeting OCS Office of Children's Services’s expectations because she has no transportation & she has many weekly obligations. See CLNO (10/10/12) CM spoke to OCS worker for confirmation statement from OCS.

Example:

Client has had 4 SS penalties within the last 5 months. See CLNO Client Notes‘s dated (8-9-10-11/12) CM requesting SS penalty.

Box #3:

The last Family Progress Report information is entered as well as the date for the next Family Progress Report.

Example:

See CLNO Client Notes (9/5/12) Family Quarterly Progress Report. Family reports progress (sec A) in 3 of 5 areas. CM reports (sections B & C) some progress (always quantify) made from the initial employability assessment dated 8/29/12. See CLNO (8/29/12) initial assessment. 

Example:

See CLNO (8/29/12) next family progress report due: 12/10/12.

Enter client statements about their progress, or lack of progress, or relapse of progress. Case managers are to measure client against themselves, not others progress or case manager’s expectation for progress. 

Box #4:

This is the case manager’s outreach to other agency partners on behalf of the family. Partially to understand with whom is the family involved, to what extent (on the family calendar) and an agency worker the family is working with (the family network) and perhaps the Family Support Team. Case managers are expected as part of due diligence to engage partnership and cooperation with community agencies to support the family’s efforts. Explaining community supports using wrap around services to others is considered outreach. Building rapport is considered engagement. All contact with community agencies on behalf of the family must be documented in CMS Case Management System CLNO.

CLNO Client Notes Example:

CM contacted Mary Smith 907.123.4567, PI’s case worker at Good Samaritan Counseling to introduce Mary to Work Services and invite her to attend a FST Family Support Team meeting. CM requested Mary bring information about PI’s requirements and monthly schedule with Good Samaritan

Example:

CLNO (10/29/12) phone call to Mary at ABC Agency.

Box #5:

Countable and uncountable activities belong here. 

Examples:

Classroom time, work search, volunteer, activities during BA or TA10 exemptions.

Getting feedback from instructors or work site supervisors carries valuable information