Inaccurate Medical Records Legal Cases - Excel

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					Adoption Services - Value Stream Map DRAFT Implementation Plan Recommendations

                           RECOMMENDATIONS
                                                                                  RESP    DUE    PERCEIVED   EST. GAINS /




                                                                     NFP
                                                                           KIN
                      (italics are those only from current




                                                                FP
     STEP #
                                                                                 PERSON   DATE   BARRIERS    OUTCOMES
                                state mappings)

1 - Pre-TPR
meetings/planning
activities (who will < Establish requirement that referral                 x
do what. Identify    be made to Adoptions at the time the
missing info)        decision is made to file TPR petition.
                     < Start process at least at case review
          1
                    & maybe at concurrent plan.
                    < Involve Ado. Unit at Dispo mtg. w/
         1
                    CPS/CS @ C2/jeopardy hearing.
                    < Identify Adoption Worker within 2
         1
                    weeks of referral.
                    < Assure that Relatives are already
         1
                    assessed
         1          < Start attending FTMs
         1          < Refer for Heart Gallery photo early            x
                    < Permit local/greater flexibility in
         1
                    photographers.
                    < Review Transfer Protocol
         1
                    (KAIZEN/RIE?)
                    < Explain adoption process to FP &
         1                                                      x
                    assess interest/commitment to adopt
                    < ADO assists in referral for home study
         1
                    update
         1          < Mine record for relatives/fictive kin                x
         1          < Start reviewing record.
                    < Set designated FAN meeting time/time
         1
                    frame for mtg. to be held.
                    < Set expectation that CS/CP workers will
         1          get child and family medical/health history
                    done prior to TPR.
                   < Require CS will provide updated list
        1          of providers to get inform for de-
                   identified packets? (w/contract info.)
                   < Assure that respite, after Cease
                   Reunification, is focussed toward
        1          permanency -- only with pure adoptive
                   families; families who have adopted; or
                   families open to/considering adoption.
                   < Refer Relative for Home Study &
        1                                                    x
                   training
        1          < Standardize transfer list statewide.
                   < Improve preparation of child for
        1          adoption and readiness of child for
                   recruitment.
                   Set expectation that FPs will be
        1          fingerprinted as soon as possible if
                   committing to adopt.
                   < Assure that Kin adoptions approvals
        1
                   are completed by time of TPR.
    2 Review
Records/Ongoing < Start ongoing assessment of child's
case assessment needs prior to TPR.
 of child needs.
        2        < IASC- Referrals early in process.
                 < Prepare for disclosure while reviewing
        2
                 record
        2        < Note where more info is needed
        2        < Tab portions for de-identified packet
        2        < Prepare notes for lifestory/lifebook
                 < Training for Lifebook/Lifestory process
        2
                 & product
        2        < Combine Lifebook & Lifestory
        2        < Relative search                           x
        2          < Does Timeline (summary) for Lifestory
                < "Fix" MACWIS Split: Carryover --
                Placements. --case plan. -- child
      2
                narratives. -- GAL. --Address Book
                window for case. -- Med hx. (KAIZEN?)
                < Keep cases that are under appeal in
      2         district. Currently, some are being
                transferred out of district.
                < Review case goal - locate non-foster
      2
                parent adiptive placement.
TPR (External   < Establish priority (within 45 days) for
KAIZEN/RIE?)    judges hearing appeal cases.
                < Improve timeframe/timeliness from
    TPR         filing TPR to hearing. TPR should be
                signed within 14 days.
                < AAG need to submit TPR order on a
    TPR
                more timely basis.
3 CS:Adoption
                < Review Transfer Protocol
  Transition
                (KAIZEN/RIE?)
   Activities
       3        < Clarify out-of-district transfer policy.
                < Require that cases/files be complete
      3         when sent to Adoption Unit -- cannot
                transfer unless complete and thorough.

                < Shorten transfer time between TPR
      3
                and transfer meeting.
                < Background & History Forms completed
      3
                in CS/CP - MACWIS
                < Assure that Child and Family Health Hx.
      3
                is completed by time of case transfer.
      3         < Hold FTM within 3 weeks.
                < Set expectation that all histories,
      3         legal packets, & adoption approvals for
                FPs/Kin are completed by transfer..
                   < Transfer CS child to more appropriate
        3          district to be closer to child and to
                   eliminate/ minimize travel.
                   < Identify ADO caseworker within 2
        3
                   weeks after referral.
                   < ADO Supervisor expects certain
        3          standards in relative resource. Medical
                   info or ? ? case
                   < Designate one specific day/week
                   statewide for transfer so that other
        3
                   conflicting mtgs/activities are not
                   scheduled on that day.
4 Legal Clearance
                  < Check out all current cases for Legal
     Review
                  Clearance
                  < Standardize protocol & set timeframes
        4         to have legal clearance signed by AAG
                  (EXTERNAL RIE?)
                  < Develop protocol to not accept case if
        4
                  all documents are not there.
                  < Assign one person to do legal
        4
                  clearance and set timeframe
                   < Designate one person in each office to
        4
                   do SWSS 015…..with time limits in place
                   < Develop paralegal position for each
        4
                   office & fill positions.
        4          < Revise the SWSS 014 form
                   < SWSS 014 done/approved by AAG
                   before transfer to CS - SWSS 015 done &
                   approved prior to transfer to adoption.
        4
                   Each program hold each other
                   accountable -- Case unable to be
                   transferred until complete.
                   < Request that AG's office develop a
        4          common, standard definition of what legal
                   clearance means.
        4          < Eliminate required religion form
                   < Ensure that all putative fathers have
        4
                   been served.
   5 Meet Child,
                   < Schedule and hold FTM that brings
Family, and Team
                   everyone together for transition purposes.
     Members
                   < Put into practice: Goodbye & Hello
         5         opportunity for the child with the CS &
                   ADO workers.
6 Assess & Select
 Type of Adoptive
 Placement Track: < Develop teen-specific recruitment
 Relatives, Foster efforts/commitment
Parent, Non-Foster
      Family
                   < Build "unconditional
         6         acceptance/commitment to child" into
                   recruitment study process
                   < MACWIS: Develop single resource
         6         module so don't have to recreate whole
                   case in Adoptions. (KAIZEN?)
                    < Establish waiver process for kids who
                    will be unable to reach permanency within
         6
                    12 months due to best interest,
                    readiness, and other factors.

                    < Have CS assess foster parents for
         6
                    adoption.
                    < Improve review of KIN before they
         6
                    come into the Adoption Unit.
    7 Foster
 Parent/Existing    < Establish in-house special position for
                                                                x   x
 Relative Home      Kinship study.
  Study Update
                    < Follow up with RFP for kinship studies
         7
                    in order to prevent delays.
                    < Have caseworkers do relative home
         7
                    studies.
                    < Include fingerprinting as part of the
         7
                    study.
                    < Improve working with Fire Marshalls,
                    timeframes, physical plant check, staff &
        7
                    Explore other options -- such as having
                    one worker do walk through? (RIE?)

                    < Upgrade licensing to caseworker:
        7           Staff to do physical plant walk-
                    through, not fire Marshall.
                    < Explore & implement more expeditious
        7
                    physical plant repair process.
8 Recruitment of
  NFP or New
                  < Re-design Web site.                          x   x
Relative Adoptive
   Placement
                  < Review vendor contract: getting new
        8         studies completed and completed in a           x
                  timely way is a problem.
                  < Assign worker to do Adoption family
        8
                  development and handle inquiries.
        8         < Prioritize kinship studies
                  < List all children under 14 with TPR on
        8
                  Adoptuskids -- Justify if not listed.
                  < Get # for Adoptuskids listing without
        8
                  having to do paper listing first.
                  < Follow up by supervisor with
        8         caseworkers on photo listing within 90
                  days of TPR.
                  < Change licensing rules for ADO in order
        8
                  to eliminate fire inspection.
                  < Kids needing ADO placement part of
        8
                  fundamental train
                  < Check within office for adoptive families
                  first, then no waiting time prior to listing
        8
                  on ADOPTUSKIDS to get more studies to
                  choose from.
                  < Build "unconditional
        8         acceptance/commitment to child" into
                  recruitment study process
                      < Develop teen-specific recruitment
                      efforts/commitment, inclduing
          8
                      informational meetings, trainings, etc.
                      specifically for families looking for teens.

9 Receive & Review < Send home study (30 or more) to be
                                                                     x
Home Studies-NFP reviewed by A Family For Me
                      < Provide ADO staff with information re:
          9           what AFFM can/is contracted to do -- not
                      currenty universally known.
          9           < Do without paper exchange.
    10 Identify
Adoptive Families
                      * none                                         x
 for Interviewing-
        NFP
                   < Modify disclosure requirements for
                   FPs/Kin -- not having to de-identify packet
11 Finalize & Send information for FPs/KIn. Only de-
  out Disclosure   identify for recruited families. FP/Kin
      packet       families still gets same information but
                      not take the time to black out last
                      names, etc. .
                      < Designate admin. Support staff as
         11           responsible for preparing disclosure
                      packet.
12 Meet & Interview
      "new"         * none                                           x   x
  family/families
                    < Explore and Modify current policy to
13 Select Family &
                    allow families to meet child prior to
      Secure
                    committing/AA agreement, especially with         x   x
   unconditional
                    older children to determine if it's a match (
   commitment
                    respite, pre-place visits, etc.).
                    < On ICPC, have less paperwork.
        13          Teamplayers. Standardized. Federal
                    Policy.
                      < Have fingerprint cards done by adoptive
         13
                      parents at time they are selected.
   14 Negotiate     < Develop consistency in what adoption
     Adoption       workers can provide funding for (e.g.
    Assistance      services, child care, bicycles, etc.)
15 Prepare & Send
                  < Require only Supervisor signature for
subsidy packet to
                  Adoption Assistance approval.
       CO
                  < Change process so that the subsidy
       15         packet and Commissioner packet are
                    sent together.
                    < Send AA & completion packets
        15
                    together.
                    < Have only one document for non-
        15
                    recurring adoption expenses.
        15          < Submit electronically.
                    < Establish/Develop capacity for
        15
                    electronic approval signatures.
                    < Explore having support staff in CO
        15          enter Adoption Assistance in
                    MACWIS.
16 Prepare child for
    transition to
                     * none                                      x   x
  placement with
  relative or NFP
17 Sign placement
                  < Sign medical & background information
agreement & place                                                x   x
                  by adoptive parents.
      child

     18 Prepare
 adjustment period < Get rid of placement waiver/ placement-
                                                             x
summary (period of adjustment summary
    supervision)
                    < Explore need for prbationary
        18          summary or waiver if case is being
                    discussed regularly.
                    < Bring the Child Plan & JR info
        18          together in MACWIS -- they are
                    redundant.
                   < Shorten completion of Adoption
        18         packet. Look at/evaluate submission
                   by Custodian & other requirements.
                   < Reduce requirements for JR (6 mos)
        18
                   for kids in ADO placements.
                   < When placement going well, start
        18
                   legalization paperwork at 4 months.
                   < Change policy to allow legal paperwork
        18
                   to start at 4 months. (KAIZEN?)
                   < Discuss standardizing placement
        18         summary (aka adjustment summary) --
                   shortening.
18a Prepare Waiver < Review need for Last Visit. (Has any
  of Adjustment
                   adoption not moved forward from Last         x
 Period (period of
   supervision)    Visit?)

                   < Evaluate purpose of waiver?
       18a
                   Adjustment period? Report?
        19
Caseworker/family
prepare (Probate)
court paperwork &
  Send to CO for  < Eliminate paper until court & then
     approval     print on court paper.
                   < Eliminate sending entire legal packet to
        19         C.O., only completion sheet & probate
                   work.
                   < Send complete packet to
        19         Commissioner & it then sent from CO
                   to Probate.
                   < Waive fingerprinting process for FP
        19
                   adoptions
        19         < Designate this as paralegal function.
                   < Assign paralegal to do all adoption
        19
                   attorney work.
        19         < Require fewer signatures.
                      < Eliminate C.O. signing off on legal
         19
                      packet -- have it approved in district.
                      < Adoption paperwork initial pickup by
         19           family - would eliminate 2 weeks of mail
                      time.
                      < Question whether or not adoption
                      attorney needed. Do away with private
         19           attorneys. Caseworker fills out with
                      family & AAG approves & assures legal
                      work.
                      < Address attorneys not making
         19
                      adoptions a priority.
                      < Send subsidy packet & A-5 same time
         19
                      for FP adoptions to C.O.
                     < Caseworker support family law change
20 File at (Probate)
                     and train caseworkers to do this in
       Court
                     response to length of time atty take to file.
                    < Have District Courts stay involved with
                    child (not Probate), able to legalize
                    adoptions just as they can order
        20          permanent guardianships. Would
                    eliminate need for adjustment
                    Summary/placment summary that
                    Probate requires.
21 Attend Hearing - < Explore Law Change: See above re:
   Legalization     District Court vs. Probate Court
    22 Post-          < Review why send legalization packet
   Legalization       down at completion of adoption if
    Activities
                      already seen by AAG for legalization?
                      < Review the post-adoptive work that
                      is being done by caseworkers, as it
        22            takes away from the time they are
                      actively working on their adoption
                      cases.
                      < Increase time to work with parents
         22
                      who are struggling post-adoptively.
System-1 Examine
Court Involvement
                     < Explore change of court jurisdiction so that
   System-1          case stays in District Court where the child is
                     already known. (External system KAIZEN?)

                     < Although Probate Court does work well in
   System-1          some Districts: Explore work for extra?
                     Adoption Specific court days?
                     < Explore increase in the time Probate
   System-1
                     Court is available for adoptions.
                     < Work with Probate Court to shorten the
   System-1          time in obtaining a court date for adoption
                     hearing.
System-2 Explore
 Different Service
      Models

                     < Explore different Service Models: One case:
                     one child: one worker all the way through
                     system --or-- another model, such as CS
   System-2
                     worker continuing to provide ongoing services
                     for child with adoption worker providing
                     specialized service. (KAIZEN?)

                     < Assure inclusion and consideration of
   System-2          ongoing case management functions and
                     their impact.
                     < Examine and provide for impact of
                     emergencies: Each and every emergency
   System-2
                     puts everything out of whack -- and
                     "emergencies" happen all the time.
                      < Look at impact of actual availability of
                      worker. (Up Time computation is
                      inaccurate --very-- it is not factored in
                      that the case worker may be available for
                      the consumer but each caseworker has
    System-2
                      around 14-16 consumers + they very well
                      may be having to work for a different
                      consumer. So....they are not really not
                      available. There are clusters of consumers.
                      (Also, travel, meetings, etc.)
                      < Consider "thinking time" needed. How to
    System-2
                      measure? How to allow for?
    System-3
     Change
  Administrative
  Support Staff
   Supervision
                      < Explore change in supervision of
                      administrative support staff back to program
    System-3
                      in order to unite goals and integrate functions
                      and tasks.

     System-4
Examine IT Problems

                      < Identify reasons and solutions (e.g. better
    System-4          quality equipment) for frequent electronic
                      equipment problems & malfunctions.

    System-5
 Improve MACWIS
   Functionality
                      < Improve MACWIS case/process
    System-5
                      functionality (KAIZEN?)

                      < Develop MACWIS ability to pull information
    System-5          over to forms. (i.e. placements on submission
                      of custody placements)

                      < Standardize training on MACWIS: CS, CPS,
    System-5
                      ADO & removal protocol
    System-5          < Health Hx. form done!
                     < More information/functions need to
                     carry over from the base case to the split
     System-5        case. "Fix" MACWIS Split: Carryover --
                     Placements. --case plan. -- child narratives. -
                     - GAL. --Address Book window for case. --
                     Med hx.
                     < Develop single resource module in
     System-5        MACWIS so don't have to recreate whole
                     case in Adoptions.

                     < Bring the Child Plan & JR info together in
     System-5
                     MACWIS -- they are redundant.

                     < Establish/Develop capacity for electronic
     System-5        submission and accompanying electronic
                     approval signatures.

                     < Develop and implement Special Needs
     System-5
                     Checklist on MACWIS - Event Tracking
                     < Submission of custodian form on
     System-5        MACWIS actually pulls last five years of
                     placements.
                     < Why is the Foster Parent Resource & the
                     Adoptive Parent Resource the same? The
     System-5
                     questions are different in MACWIS, but
                     the requirements are the same.
 System-6 Improve
and standardize ADO
      practice,
 documentation, and
    organization
      System-6
                      < Standardize practice standards,
     Standardize
                      documentation, & documents among the
Standards/Protocols/D
                      children's programs.
      ocuments
     System-6       < Develop better organization.
System-6 Streamline
                    < Decrease waiting time for signatures on
 Required Approval
                    Adoption documents throughout the process.
     Signatures:
  System-6 ICPC
                    < Make Adoption cases an ICPC high priority.
    Prioritization
System-6 Review /     < Review all forms and modify, streamline,
 Streamline Forms     or combine as indicated.
                      < Include format of forms (for example, 2-
    System-6
                      sided A-forms difficult to copy)
                      < Combine expense documents that families
                      have to sign. (Why do families have to sign
    System-6          so may documents for non-recurring
                      adoption expenses? Can we just have one
                      document?)
                      < Consider # of copies required: Doing only
                      1 copy when multiple copies are needed.
    System-6          Worker's statements, special needs
                      checklist, bio. Family info - medical >
                      subsidy.
System-6 Training &
                    < Enhance staff training.
  Best Practices
                    < Provide new Adoption workers and
    System-6          supervisors formal training for accurate
                      completion of paperwork.
                      < Increase time for assuring/supporting
    System-6
                      worker consistency.
                      < Develop clear understanding of process
    System-6          steps (by staff, parents, child & others
                      involved)
                      < Provide new Adoption workers and
    System-6          supervisors formal training for accurate
                      completion of paperwork.
                      < Increase time for assuring/supporting
    System-6
                      worker consistency.
                      < Develop clear understanding of process
    System-6          steps (by staff, parents, child & others
                      involved)
     System-7
Improve Fingerprint
     Process
                      < Work with police departments to improve
    System-7          fingerprinting process in relation to
                      adoption process.
           < Obtain fingerprints as early as possible in
System-7
           adoption process.
           < Work to standardize fingerprint process
           across police departments -- currently not
System-7
           consistent (some are even giving
           fingerprints to parents to mail in).

           < Work to improve wait time -- shorten
System-7
           time to process fingerprints.
           < Waive fingerprinting process for FP
System-7
           adoptions
           Adoption Services - Value Stream Map DRAFT Implementation Plan Recomm


                                      RECOMMENDATIONS
                                                                                             RESP




                                                                                NFP
                                                                                      KIN
                                 (italics are those only from current




                                                                           FP
Priority        STEP #
                                                                                            PERSON
                                           state mappings)

           1 - Pre-TPR
           meetings/planning < Establish requirement that referral
           activities (who will be made to Adoptions at the time the                  x
           do what. Identify
                                decision is made to file TPR petition.
           missing info)
                                < Start process at least at case review
                               & maybe at concurrent plan.
                               < Involve Ado. Unit at Dispo mtg. w/
                               CPS/CS @ C2/jeopardy hearing.
                               < Identify Adoption Worker within 2
                               weeks of referral.
                               < Assure that Relatives are already
                               assessed
                               < Start attending FTMs
                               < Refer for Heart Gallery photo early            x
                               < Permit local/greater flexibility in
                               photographers.
                               < Review Transfer Protocol
                               (KAIZEN/RIE?)
                               < Explain adoption process to FP &
                                                                           x
                               assess interest/commitment to adopt
                               < ADO assists in referral for home study
                               update
                               < Mine record for relatives/fictive kin                x
                               < Start reviewing record.
                               < Set designated FAN meeting time/time
                               frame for mtg. to be held.
                               < Set expectation that CS/CP workers will
                               get child and family medical/health history
                               done prior to TPR.
                               < Require CS will provide updated list
                               of providers to get inform for de-
                               identified packets? (w/contract info.)
                               < Assure that respite, after Cease
                               Reunification, is focussed toward
                               permanency -- only with pure adoptive
                               families; families who have adopted; or
                               families open to/considering adoption.
                               < Refer Relative for Home Study &
                                                                                      x
                               training
                  < Standardize transfer list statewide.
                  < Improve preparation of child for
                  adoption and readiness of child for
                  recruitment.
                  Set expectation that FPs will be
                  fingerprinted as soon as possible if
                  committing to adopt.
                  < Assure that Kin adoptions approvals
                  are completed by time of TPR.
2 Review
Records/Ongoing   < Start ongoing assessment of child's
case assessment   needs prior to TPR.
of child needs.
                  < IASC- Referrals early in process.
                  < Prepare for disclosure while reviewing
                  record where more info is needed
                  < Note
                  < Tab portions for de-identified packet
                  < Prepare notes for lifestory/lifebook
                  < Training for Lifebook/Lifestory process
                  & product
                  < Combine Lifebook & Lifestory
                  < Relative search                            x
                  < Does Timeline (summary) for Lifestory
                  < "Fix" MACWIS Split: Carryover --
                  Placements. --case plan. -- child
                  narratives. -- GAL. --Address Book
                  window for case. -- Med hx. (KAIZEN?)
                  < Keep cases that are under appeal in
                  district. Currently, some are being
                  transferred out of district.
                  < Review case goal - locate non-foster
                  parent adiptive placement.
TPR (External     < Establish priority (within 45 days) for
KAIZEN/RIE?)      judges hearing appeal cases.
                  < Improve timeframe/timeliness from
                  filing TPR to hearing. TPR should be
                  signed within 14 days.
                  < AAG need to submit TPR order on a
                  more timely basis.
3 CS:Adoption
                  < Review Transfer Protocol
Transition
                  (KAIZEN/RIE?)
Activities
                  < Clarify out-of-district transfer policy.
                  < Require that cases/files be complete
                  when sent to Adoption Unit -- cannot
                  transfer unless complete and thorough.
                    < Shorten transfer time between TPR
                    and transfer meeting.
                    < Background & History Forms completed
                    in CS/CP - MACWIS
                    < Assure that Child and Family Health Hx.
                    is completed by time of case transfer.
                    < Hold FTM within 3 weeks.
                    < Set expectation that all histories,
                    legal packets, & adoption approvals for
                    FPs/Kin are completed by transfer..

                    < Transfer CS child to more appropriate
                    district to be closer to child and to
                    eliminate/ minimize travel.
                    < Identify ADO caseworker within 2
                    weeks after referral.
                    < ADO Supervisor expects certain
                    standards in relative resource. Medical
                    info or ? ? case
                    < Designate one specific day/week
                    statewide for transfer so that other
                    conflicting mtgs/activities are not
                    scheduled on that day.
4 Legal Clearance
                    < Check out all current cases for Legal
Review
                    Clearance
                    < Standardize protocol & set timeframes
                    to have legal clearance signed by AAG
                    (EXTERNAL RIE?)
                    < Develop protocol to not accept case if
                    all documents are not there.
                    < Assign one person to do legal
                    clearance and set timeframe
                    < Designate one person in each office to
                    do SWSS 015…..with time limits in place
                    < Develop paralegal position for each
                    office & fill positions.
                    < Revise the SWSS 014 form
                    < SWSS 014 done/approved by AAG
                    before transfer to CS - SWSS 015 done &
                    approved prior to transfer to adoption.
                    Each program hold each other
                    accountable -- Case unable to be
                    transferred until complete.
                    < Request that AG's office develop a
                    common, standard definition of what legal
                    clearance means.
                    < Eliminate required religion form
                    < Ensure that all putative fathers have
                    been served.
5 Meet Child,
                    < Schedule and hold FTM that brings
Family, and Team
                    everyone together for transition purposes.
Members
                    < Put into practice: Goodbye & Hello
                    opportunity for the child with the CS &
                    ADO workers.
6 Assess & Select
Type of Adoptive
Placement Track: < Develop teen-specific recruitment
Relatives, Foster  efforts/commitment
Parent, Non-Foster
Family
                   < Build "unconditional
                   acceptance/commitment to child" into
                   recruitment study process
                   < MACWIS: Develop single resource
                   module so don't have to recreate whole
                   case in Adoptions. (KAIZEN?)
                    < Establish waiver process for kids who
                    will be unable to reach permanency within
                    12 months due to best interest,
                    readiness, and other factors.

                    < Have CS assess foster parents for
                    adoption.
                    < Improve review of KIN before they
                    come into the Adoption Unit.
7 Foster
Parent/Existing     < Establish in-house special position for
                                                                 x   x
Relative Home       Kinship study.
Study Update
                    < Follow up with RFP for kinship studies
                    in order to prevent delays.
                    < Have caseworkers do relative home
                    studies. fingerprinting as part of the
                    < Include
                    study.
                    < Improve working with Fire Marshalls,
                    timeframes, physical plant check, staff &
                    Explore other options -- such as having
                    one worker do walk through? (RIE?)

                    < Upgrade licensing to caseworker:
                    Staff to do physical plant walk-
                    through, not fire Marshall.
                    < Explore & implement more expeditious
                    physical plant repair process.
8 Recruitment of
NFP or New
                     < Re-design Web site.                          x   x
Relative Adoptive
Placement
                     < Review vendor contract: getting new
                     studies completed and completed in a           x
                     timely way is a problem.
                     < Assign worker to do Adoption family
                     development and handle inquiries.
                     < Prioritize kinship studies
                     < List all children under 14 with TPR on
                     Adoptuskids -- Justify if not listed.
                     < Get # for Adoptuskids listing without
                     having to do paper listing first.
                     < Follow up by supervisor with
                     caseworkers on photo listing within 90
                     days of TPR.
                     < Change licensing rules for ADO in order
                     to eliminate fire inspection.
                     < Kids needing ADO placement part of
                     fundamental train
                     < Check within office for adoptive families
                     first, then no waiting time prior to listing
                     on ADOPTUSKIDS to get more studies to
                     choose from.
                     < Build "unconditional
                     acceptance/commitment to child" into
                     recruitment study process
                     < Develop teen-specific recruitment
                     efforts/commitment, inclduing
                     informational meetings, trainings, etc.
                     specifically for families looking for teens.

9 Receive & Review < Send home study (30 or more) to be
                                                                    x
Home Studies-NFP reviewed by A Family For Me
                     < Provide ADO staff with information re:
                     what AFFM can/is contracted to do -- not
                     currenty universally known.
                     < Do without paper exchange.
10 Identify
Adoptive Families
                     * none                                         x
for Interviewing-
NFP
                   < Modify disclosure requirements for
                   FPs/Kin -- not having to de-identify packet
11 Finalize & Send information for FPs/KIn. Only de-
out Disclosure     identify for recruited families. FP/Kin
packet             families still gets same information but
                     not take the time to black out last
                     names, etc. .
                      < Designate admin. Support staff as
                      responsible for preparing disclosure
                      packet.
12 Meet & Interview
"new"               * none                                          x   x
family/families
                    < Explore and Modify current policy to
13 Select Family &
                    allow families to meet child prior to
Secure
                    committing/AA agreement, especially with        x   x
unconditional
                    older children to determine if it's a match (
commitment
                    respite, pre-place visits, etc.).
                    < On ICPC, have less paperwork.
                    Teamplayers. Standardized. Federal
                    Policy.
                      < Have fingerprint cards done by adoptive
                      parents at time they are selected.

14 Negotiate          < Develop consistency in what adoption
Adoption              workers can provide funding for (e.g.
Assistance            services, child care, bicycles, etc.)
15 Prepare & Send
                  < Require only Supervisor signature for
subsidy packet to
                  Adoption Assistance approval.
CO
                  < Change process so that the subsidy
                      packet and Commissioner packet are
                      sent together.
                      < Send AA & completion packets
                      together.
                      < Have only one document for non-
                      recurring adoption expenses.
                      < Submit electronically.
                      < Establish/Develop capacity for
                      electronic approval signatures.
                      < Explore having support staff in CO
                      enter Adoption Assistance in
                      MACWIS.
16 Prepare child for
transition to
                     * none                                         x   x
placement with
relative or NFP
17 Sign placement
                  < Sign medical & background information
agreement & place                                                   x   x
                  by adoptive parents.
child

18 Prepare
adjustment period < Get rid of placement waiver/ placement-
                                                            x
summary (period of adjustment summary
supervision)
                    < Explore need for prbationary
                    summary or waiver if case is being
                    discussed regularly.
                    < Bring the Child Plan & JR info
                    together in MACWIS -- they are
                    redundant.
                    < Shorten completion of Adoption
                    packet. Look at/evaluate submission
                    by Custodian & other requirements.
                    < Reduce requirements for JR (6 mos)
                    for kids in ADO placements.
                    < When placement going well, start
                    legalization paperwork at 4 months.
                    < Change policy to allow legal paperwork
                    to start at 4 months. (KAIZEN?)
                    < Discuss standardizing placement
                    summary (aka adjustment summary) --
                    shortening.
18a Prepare Waiver < Review need for Last Visit. (Has any
of Adjustment
                   adoption not moved forward from Last          x
Period (period of
supervision)       Visit?)

                    < Evaluate purpose of waiver?
                    Adjustment period? Report?
19
Caseworker/family
prepare (Probate)
court paperwork &
Send to CO for    < Eliminate paper until court & then
approval          print on court paper.
                    < Eliminate sending entire legal packet to
                    C.O., only completion sheet & probate
                    work.
                    < Send complete packet to
                    Commissioner & it then sent from CO
                    to Probate.
                    < Waive fingerprinting process for FP
                    adoptions
                    < Designate this as paralegal function.
                    < Assign paralegal to do all adoption
                    attorney work.
                    < Require fewer signatures.
                    < Eliminate C.O. signing off on legal
                    packet -- have it approved in district.
                      < Adoption paperwork initial pickup by
                      family - would eliminate 2 weeks of mail
                      time.
                      < Question whether or not adoption
                      attorney needed. Do away with private
                      attorneys. Caseworker fills out with
                      family & AAG approves & assures legal
                      work.
                      < Address attorneys not making
                      adoptions a priority.
                      < Send subsidy packet & A-5 same time
                      for FP adoptions to C.O.
                     < Caseworker support family law change
20 File at (Probate)
                     and train caseworkers to do this in
Court
                     response to length of time atty take to file.
                    < Have District Courts stay involved with
                    child (not Probate), able to legalize
                    adoptions just as they can order
                    permanent guardianships. Would
                    eliminate need for adjustment
                    Summary/placment summary that
                    Probate requires.
21 Attend Hearing - < Explore Law Change: See above re:
Legalization        District Court vs. Probate Court
22 Post-              < Review why send legalization packet
Legalization          down at completion of adoption if
Activities
                      already seen by AAG for legalization?
                      < Review the post-adoptive work that
                      is being done by caseworkers, as it
                      takes away from the time they are
                      actively working on their adoption
                      cases.
                      < Increase time to work with parents
                      who are struggling post-adoptively.

System-1 Examine
Court Involvement
                      < Explore change of court jurisdiction so that
                      case stays in District Court where the child is
                      already known. (External system KAIZEN?)

                      < Although Probate Court does work well in
                      some Districts: Explore work for extra?
                      Adoption Specific court days?
                      < Explore increase in the time Probate
                      Court is available for adoptions.
                      < Work with Probate Court to shorten the
                      time in obtaining a court date for adoption
                      hearing.
System-2 Explore
Different Service
Models

                      < Explore different Service Models: One case:
                      one child: one worker all the way through
                      system --or-- another model, such as CS
                      worker continuing to provide ongoing services
                      for child with adoption worker providing
                      specialized service. (KAIZEN?)

                      < Assure inclusion and consideration of
                      ongoing case management functions and
                      their impact.
                      < Examine and provide for impact of
                      emergencies: Each and every emergency
                      puts everything out of whack -- and
                      "emergencies" happen all the time.
                      < Look at impact of actual availability of
                      worker. (Up Time computation is
                      inaccurate --very-- it is not factored in
                      that the case worker may be available for
                      the consumer but each caseworker has
                      around 14-16 consumers + they very well
                      may be having to work for a different
                      consumer. So....they are not really not
                      available. There are clusters of consumers.
                      (Also, travel, meetings, etc.)
                      < Consider "thinking time" needed. How to
                      measure? How to allow for?
System-3
Change
Administrative
Support Staff
Supervision
                      < Explore change in supervision of
                      administrative support staff back to program
                      in order to unite goals and integrate functions
                      and tasks.

System-4
Examine IT Problems

                      < Identify reasons and solutions (e.g. better
                      quality equipment) for frequent electronic
                      equipment problems & malfunctions.
System-5
Improve MACWIS
Functionality
                       < Improve MACWIS case/process
                       functionality (KAIZEN?)
                       < Develop MACWIS ability to pull information
                       over to forms. (i.e. placements on submission
                       ofStandardize training on MACWIS: CS, CPS,
                       < custody placements)
                       ADO & removal protocol
                       < Health Hx. form done!
                       < More information/functions need to
                       carry over from the base case to the split
                       case. "Fix" MACWIS Split: Carryover --
                       Placements. --case plan. -- child narratives. -
                       - GAL. --Address Book window for case. --
                       Med hx.
                       < Develop single resource module in
                       MACWIS so don't have to recreate whole
                       case in Adoptions.

                       < Bring the Child Plan & JR info together in
                       MACWIS -- they are redundant.

                       < Establish/Develop capacity for electronic
                       submission and accompanying electronic
                       approval signatures.

                       < Develop and implement Special Needs
                       Checklist on MACWIS - Event Tracking
                       < Submission of custodian form on
                       MACWIS actually pulls last five years of
                       placements.
                       < Why is the Foster Parent Resource & the
                       Adoptive Parent Resource the same? The
                       questions are different in MACWIS, but
                       the requirements are the same.
System-6 Improve
and standardize ADO
practice,
documentation, and
organization
Standardize           < Standardize practice standards,
Standards/Protocols/D documentation, & documents among the
ocuments              children's programs.
                       < Develop better organization.

                       < Decrease waiting time for signatures on
Streamline Required
                       Adoption documents throughout the process.
Approval Signatures:

ICPC Prioritization    < Make Adoption cases an ICPC high priority.
Review / Streamline   < Review all forms and modify, streamline,
Forms                 or combine as indicated.
                      < Include format of forms (for example, 2-
                      sided A-forms difficult to copy)
                      < Combine expense documents that families
                      have to sign. (Why do families have to sign
                      so may documents for non-recurring
                      adoption expenses? Can we just have one
                      document?)
                      < Consider # of copies required: Doing only
                      1 copy when multiple copies are needed.
                      Worker's statements, special needs
                      checklist, bio. Family info - medical >
                      subsidy.
Training & Best
                      < Enhance staff training.
Practices
                      < Provide new Adoption workers and
                      supervisors formal training for accurate
                      completion of paperwork.
                      < Increase time for assuring/supporting
                      worker consistency.
                      < Develop clear understanding of process
                      steps (by staff, parents, child & others
                      involved)
                      < Provide new Adoption workers and
                      supervisors formal training for accurate
                      completion of paperwork.
                      < Increase time for assuring/supporting
                      worker consistency.
                      < Develop clear understanding of process
                      steps (by staff, parents, child & others
                      involved)
System-7
Improve Fingerprint
Process
                      < Work with police departments to improve
                      fingerprinting process in relation to
                      adoption process.
                      < Obtain fingerprints as early as possible in
                      adoption process.
                      < Work to standardize fingerprint process
                      across police departments -- currently not
                      consistent (some are even giving
                      fingerprints to parents to mail in).

                      < Work to improve wait time -- shorten
                      time to process fingerprints.
< Waive fingerprinting process for FP
adoptions
mentation Plan Recommendations


          DUE      PERCEIVED     EST. GAINS /     EST
          DATE     BARRIERS      OUTCOMES        DAYS    EST $     ACT.
                                                SVD/YR SAVED/YR   GAINS
                Adoption Services Implementation Plan                                                                                                                                                                                 12/12/06

           DHHS Adoption Services - Value Stream Map Implementation Plan
Priority




                                                                                                                  DATE                                                                                 STEPS TAKEN - 12/12/06              & New
                    CHANGE                      ACTION STEPS / ACTIVITIES                  RESP     PERSON                 DATE DONE PERCEIVED BARRIERS     EST. GAINS / OUTCOMES       STATUS
                                                                                                                PLANNED                                                                                Task Notations

                                                                                                                                     Need Legal input.     Reduce time to permanency.   To be
           Move Jurisdiction for                                                                                                     Legislative Issues.   Meet federal requirements.   addressed in
           Adoption Legalization to                                                         Virginia Marriner    9/30/06                                   Promote better consumer      next Leg.
           District Court                                                                                                                                  responses.                   Session


                                      < Ensure support by Commissioner and Director

                                      < Assemble Team
                                      < Talk with folks who submitted this legislation
                                      in the last session. See if they would co-
                                      sponsor.

                                      < Identify District and Probate Court judges who
                                      would agree to be involved.

                                                                                                                                     Concerns of Bar       Reduced Cost.                In Process
           Allow DHHS Staff to help
                                                                                                                                                           Reduced Time.
           families complete          (Comment: Item # 1 would eliminate need for this.)     Bob Glidden         9/30/06
           legalization paperwork

                                      < Engage AAG Office                                   Virginia Marriner
                                         -- Determine through AG's office (obtain                                                                                                       New            Will contact Matt.
                                      decision) if Adoption Wkrs. can clarify
                                                                                            Virginia Marriner    2/16/07
                                      questions/ statements on the forms to pros.
                                      parents. (12/12)
                                      < Paralegal Involvement
                                      < Involve Chris Lyng
                                      < Assign one person to do legal clearance and
                                      set timeframe
                                      Meet with Theresa, Lisa to determine what              Bob Glidden
                                      paperwork to provide to family, what checklist.       Theresa Nadeau      12/12/06
                                      (10/24)                                                 Lisa Valliere

                                      Check with Bangor Probate Court to see if they
                                      have a booklet/instructions already assembled.          Lisa Valliere     12/12/06
                                      (10/24 )

                                                                                                                                                                                                       Legalization paperwork process to reflect
                                                                                                                                                                                                       parent choice of A) Worker-Assisted
                                                                                                                                                                                                       paperwork completion (child is the
                                      Re-write legalization paperwork process to
                                                                                                                                                                                                       customer ) in which can use dept.notary or
                                      reflect parent choice for legalization paperwork        Bob Glidden        2/16/07                                                                New
                                                                                                                                                                                                       B) Lawyer-Assisted paperwork completion
                                      completion. (12/12 )
                                                                                                                                                                                                       (parent is the customer ) particularly re: child
                                                                                                                                                                                                       is non-US citizen, ICWA, or conflicted
                                                                                                                                                                                                       cases.

                                                                                                                                                                                                       Some of language/statements on the forms
                                      Develop standard, simple explanations of                                                                                                                         are complex. Simple, uniform explanatory
                                      language on the forms. Have this reviewed by                               2/16/07                                                                New            material will assure that all workers and
                                      AG's office.                                                                                                                                                     parents have the same basic explanations
                                                                                                                                                                                                       and language.


                                      Develop sample packet of legalization
                                                                                             Steve Conley        2/16/07                                                                New
                                      paperwork. (12/12)
                Adoption Services Implementation Plan                                                                                                                                                                                    12/12/06

           DHHS Adoption Services - Value Stream Map Implementation Plan
Priority




                                                                                                                    DATE                                                                                   STEPS TAKEN - 12/12/06            & New
                    CHANGE                         ACTION STEPS / ACTIVITIES                 RESP     PERSON                 DATE DONE PERCEIVED BARRIERS        EST. GAINS / OUTCOMES     STATUS
                                                                                                                  PLANNED                                                                                  Task Notations


                                        Develop specialized training for parents re:
                                                                                                                   2/16/07                                                                 New
                                        completing the legalization paperwork. (12/12)


                                        Explore standardizing/defining who (parent or
                                        dept.) picks up and/or pays for the forms and                              2/16/07                                                                 New             Including getting forms ahead of time.
                                        under what circumstances. (12/12)

                                                                                                                                       Need New State Lines.    Timeliness in adoptive
                                                                                                                                       Cost.                    placements.
                                                                                                                                                                Seamless record.
                                                                                                                                                                Accurate Legal records.
           Develop standardized legal
                                                                                                                                                                Standardized practice.
           clearance and legal record                                                          Pat Beaulieu        9/30/06
                                                                                                                                                                Free up CaseWorker time.
           processes
                                                                                                                                                                Improved Audit Results.




                                         < Develop paralegal position for each office &                                                                                                    Not in budget
                                        fill positions.



                                                                                                                                                                                           New             See discussion above re: color-coding. No
                                        Explore use of color-coded form/folders/record                                                                                                                     concensus in group.
                                                                                                                   2/16/07
                                        process. (12/12)

                                                                                                                                                                                           New             A) Checklist is "traveler" that moves with
                                                                                                                                                                                                           record. B) Add signature lines. C)
                                                                                                                                                                                                           Add/Identify "change" lines. D) Separate
                                        Re-design/format structured checklist to show                                                                                                                      into three sections to reflect points of
                                                                                               Pat Beaulieu        2/16/07                                                                                 responsibility. E) State purpose of checklist
                                        flow & responsibility. (12/12)
                                                                                                                                                                                                           at top of form. F) Add that relatives/foster
                                                                                                                                                                                                           parents don't need waiver.


                                                                                                                                                                                           New
                                        Enlist support of PAs in re-inforcing that this is
                                                                                              Virginia Marriner    2/16/07
                                        the responsibility of the worker. (12/12)

                                                                                                                                                                                           New
                                        Identify person in each unit who has final/overall
                                        responsibility for legal paperwork completeness.                           2/16/07
                                        (12/12)

                                                                                                                                                                                           New
                                        Explicate/Assure education of workers and
                                        supervisors in understanding this responsibility.                          2/16/07
                                        (12/12)

                                                                                                                                       Vendors' Values and      More adoptions of teens.                   Not present/No update
                                                                                                                                       Attitudes.               Hard to place.
           Increase committed                                                                                                          Treatment Foster Care.   Fewer Moves.
                                                                                             Becky Bolstridge     10/31/06
           resource families                                                                                                           Managed Care.



                                        E-mail list, Pat O'Brien article (10/24)              Becky Bolstridge      ???

                                        < Assemble a team                                                                                                                                  Completed
                                        < Work with CWTI
                Adoption Services Implementation Plan                                                                                                                                                                              12/12/06

           DHHS Adoption Services - Value Stream Map Implementation Plan
Priority




                                                                                                              DATE                                                                                    STEPS TAKEN - 12/12/06            & New
                    CHANGE                      ACTION STEPS / ACTIVITIES                  RESP    PERSON              DATE DONE PERCEIVED BARRIERS           EST. GAINS / OUTCOMES          STATUS
                                                                                                            PLANNED                                                                                   Task Notations

                                      < Work with AFFME
                                                                                                                                 Kin families resistant to   Caseworker going in the right
                                                                                                                                 going thru process.         direction.
                                                                                                                                 Requires cooperation with   Moving kids to Permanency
           Improved compliance with                                                                                              CS.                         faster.
                                                                                            Jayme Dennis    10/31/06
           current Kinship policy                                                                                                Cost of making changes in   Access IVE funds.
                                                                                                                                 kin homes.                  Program improvement plans.



                                      < Assure that Relatives are already explored,
                                      assessed/studied, and documented.

                                      Promote looking for kin immediately and on an                                                                                                          New      "We never stop looking."
                                      ongoing basis as an every day best practice.                           2/16/07
                                      (12/12)

                                      < Refer Relative for Home Study & training


                                      < Explore connecting with group looking into
                                      Kinship Services - Diane T.


                                      Identify methodology & dedicate time for review
                                      of chn's placements/ situation re: relative                            2/16/07                                                                         New
                                      search, permanency, licensing. (12/12)

                                                                                                                                                                                                      This was a special week-long event (similar
                                      Provide description of review process done in                                                                                                                   to a Lean Kaizen?). Will repeat in April but
                                                                                             Bob Glidden     2/16/07                                                                         New
                                      DO #8 to rest of team. (12/12)                                                                                                                                  have already noticed carryover into daily
                                                                                                                                                                                                      work.

                                      Start earlier to license if permanent. (12/12)                         2/16/07                                                                         New



                                      Support other Children Services workers to
                                                                                                             2/16/07                                                                         New
                                      identify/get relative resources early on. (12/12)

                                                                                                                                 IVE Audit - if incorrect,
                                                                                                                                 Federal fines.
           Simplify (signature)
                                                                                            Steve Conley    10/31/06
           approval process.


                                      < Require only Supervisor signature for
                                      Adoption Assistance approval.
                                      < Eliminate C.O. signing off on legal packet --
                                      have it approved in district.
                                      < Provide new Adoption workers and                                                                                     Reduce rework and errors
                                      supervisors formal training for accurate
                                      completion of paperwork.
                                      < Consider involving other CW programs -
                                      awareness.
                                      (Comment: Might want to bring in Diane Poulin, who
                                      has some expertise w/ this )
                                                                                                                                                                                                      Cover Checklist ready to go out

                                                                                             Steve Conley

                                      Distribute revised AA Checklist. (10/24)
                 Adoption Services Implementation Plan                                                                                                                                                                                          12/12/06

           DHHS Adoption Services - Value Stream Map Implementation Plan
Priority




                                                                                                                        DATE                                                                                     STEPS TAKEN - 12/12/06              & New
                    CHANGE                          ACTION STEPS / ACTIVITIES                   RESP     PERSON                   DATE DONE PERCEIVED BARRIERS           EST. GAINS / OUTCOMES         STATUS
                                                                                                                      PLANNED                                                                                    Task Notations

                                                                                                                     12/18/06                                                                                    Due Date changed from 11/15/2006 to
                                                                                                  Steve Conley                                                                                                   12/18.
                                          Begin using new checklist. (10/24)
                                                                                                                                                                                                       Delayed
                                          Monitor & track packets for errors/accuracy,
                                                                                                  Diane Poulin
                                          documentation. (10/24)

                                          Refer tested checklist/process for District                                                                                                                  New
                                                                                                 Virginia Marriner
                                          Approval. (12/12)
                                                                                                                                                                                                                 Special Service = service whose absence
                                                                                                                                                                                                                 would cause a significant barrier to adoption.
                                          Develop step in process for e-mail request for                                                                                                                         Examples: specialized/costly day care,
                                          special service approval in advance. (10/24)                                                                                                                           therapeutic horse-back riding, etc.


                                                                                                                                            Increase child's anxiety, Children moving to
                                                                                                                                            sense of rejection.       Permanency earlier.
           Enable families to meet                                                                                                          Treatment home policies. Improves the chance of
           child earlier, before having                                                                                                                               successful match.
                                                                                                 Julie McShane         11/30/06
           to make commitment/AA                                                                                                                                      More reflective of current
           agreement.                                                                                                                                                 practice.


                                                                                                                                                                                                                 Discussion: Represents a key philosophical
                                                                                                                                                                                                                 shift to allow families to meet child before
                                                                                                                                                                                                                 commitment/AA agreement. Strong support
                                                                                                                                                                                                                 within group for this. Has often been based
                                          < Explore and modify current policy to allow                                                                                                                           on child's picture which does not show
                                          families to meet child prior to committing/AA                                                                                                                          personality/etc. or special needs that the
                                          agreement, especially with older children to                                                                                                                           family may not be able to handle. Also has
                                          determine if it's a match ( respite, pre-place                                                                                                                         not allowed for potential siblings to "test" the
                                          visits, etc.).                                                                                                                                                         relationship. Blind visits discussed but some
                                                                                                                                                                                                                 disagreement re: these (perceived deceit?).




                                          Send out a memo for feedback & incorporate
                                                                                                  Julie McShane
                                          feedback. (10/24)
                                          Schedule meeting to formulate a plan/proposal.
                                                                                                  Julie McShane
                                          (10/24)
                                                                                                                                                                                                       New
                                          Hold "Kaizen" at 2/16 mtg. re: the policy to
                                                                                                                        2/16/07
                                          formulate recommendations for change. (12/12)

                                          Assure the development of solid practice                                                                                                                     New       Assure that older youth have a say in
                                          guidelines. (12/12)                                                                                                                                                    selection of family; ask for their opinion.
                                                                                                                                            Challenging group to work   Increased adoption of teens.             Not present/No update.
                                                                                                                                            with.                       Reduce residential
                                                                                                                                            Funding.                    placements.
           Improve teen-specific                                                                  Martin Smith                              10/24 - "It's not my job"   Empowerment of kids.
           recruitment efforts /                                                                Barbara Goossens.      10/31/06             attitude                    Increase resource base as a
           commitment                                                                                                                                                   'side effect.'
                                                                                                                                                                        More funds.



                                          < Develop teen-specific recruitment
                                          efforts/commitment, including informational
                                          meetings, trainings, etc. specifically for families
                                                                                                   Martin Smith
                                          looking for teens.
                                          (Comment: YLAT Media campaign )
                 Adoption Services Implementation Plan                                                                                                                                                                                   12/12/06

           DHHS Adoption Services - Value Stream Map Implementation Plan
Priority




                                                                                                                      DATE                                                                                   STEPS TAKEN - 12/12/06          & New
                     CHANGE                       ACTION STEPS / ACTIVITIES                  RESP      PERSON                  DATE DONE PERCEIVED BARRIERS          EST. GAINS / OUTCOMES          STATUS
                                                                                                                    PLANNED                                                                                  Task Notations

                                       Solicit ideas (for recruitment methods) via e-mail.
                                                                                                Martin Smith
                                       (10/24)

                                                                                                 Pam Cote.                               Cooperation with                                                    Update: Kristi Poole
           Improve Transfer Protocol
                                                                                                Kristi Poole        10/31/06             Children's Services.
           and adherence to it
                                                                                               Shannon Burns
                                       < Review/Evaluate Transfer Protocol
                                       (KAIZEN/RIE?)

                                       Combine/design new standard form after
                                       examining all 'what are you using now?'
                                       submissions. (10/24)
                                       Distribute new form for comment/feedback.                                                                                                                             Update: Team did not receive. Pam will re-
                                       (10/24)                                                                                                                                                               send.
                                                                                                                                                                                                    New
                                       Feedback provided by Team members. (12/12)                                    1/8/07

                                       Submit "final" version to PAs as                                                                                                                             New
                                                                                                                     1/31/07
                                       revised/recommended. (12/12)
                                       < Develop and conduct statewide training in the
                                       Protocol
                                       < Invite CS staff to be involved

                                       < Require that cases/files be complete when
                                       sent to Adoption Unit -- cannot transfer unless
                                       complete and thorough.



                                       Expand 'Lifebook' so all children have one -
                                       even if in Foster Care. (10/24)                         Shannon Burns


                                                                                                                                         FUNDS - Bigger the         Reduce Duplication.                      Met with Robin Bickford, Matt Galetta, Tom
            Improve MACWIS                                                                                                               change, higher the price   Better access to information.            (? - Programmer). Talked about how to
                                                                                                Bob Glidden.
           functionality to reflect                                                                                                      tag.                                                                change system to support 'Family Homes.'
                                                                                              Becky Bolstridge.
           seamless, integrated                                                                                     11/30/06                                                                                 Becky needs to be included.
                                                                                               Steve Conley.
           services & decrease
                                                                                             Robin Bickford (CO).
           redundancies.

                                       < Define requirements

                                       < Adapt MACWIS - 'Split' and Resource Module.
                                       (Comment: More information/functions need to carry
                                       over from the base case to the split case.)


                                       < "Fix" MACWIS Split: Carryover -- Placements. -
                                       -case plan. -- child narratives. -- GAL. --Address
                                       Book window for case. -- Med hx. (KAIZEN?)


                                       < Develop single resource module in MACWIS so
                                       don't have to recreate whole case in Adoptions.
                                       Define how 'Family Homes' IT structure will support
                                       current Business (AS/CS) Structure. (10/24)
                Adoption Services Implementation Plan                                                                                                                                                                                      12/12/06

           DHHS Adoption Services - Value Stream Map Implementation Plan
Priority




                                                                                                                          DATE                                                                                 STEPS TAKEN - 12/12/06          & New
                    CHANGE                          ACTION STEPS / ACTIVITIES                       RESP    PERSON                 DATE DONE PERCEIVED BARRIERS           EST. GAINS / OUTCOMES       STATUS
                                                                                                                        PLANNED                                                                                Task Notations

                                                                                                                                             Treatment Foster Care/      Improved timelines to
                                                                                                                                             Therapist not wanting the   Permanency
                                                                                                                                             child exposed               More eligible families
           Improve timeliness of photo                                                                                                       Case not being
                                                                                                    Virginia Marriner    8/31/06
           listings                                                                                                                          transferred in timely
                                                                                                                                             manner
                                                                                                                                             Scheduling the photo

                                         < Assure follow-up by supervisor with
                                         caseworkers on photo listing within, at most, 90
                                         days of TPR. (Comment: Discuss reducing to <
                                         90 days)

                                         < Improve preparation of child for adoption and
                                         readiness of child for recruitment.

                                         District Offices to Identify specific agencies.
                                         (10/24)
                                         Develop capacity and process for District Offices to
                                         take their own child photos to distribute within office.
                                         (10/24)


                                                                                                                                             Appeal process could be
                                                                                                                                             prolonged                                                         Update: This will be a decision made
                                                                                                                                                                                                               between the Commissioner and the
                                                                                                                                                                         Reduce anxiety - Adoptive
           Improve timeliness from                                                                                                                                                                             Governor. Aiming for:
                                                                                                    Virginia Marriner   10/31/06                                         Family.
           filing TPR to hearing.                                                                                                                                                                              Petition
                                                                                                                                                                         Reduce time to permanency.
                                                                                                                                                                                                               45 days to hearing
                                                                                                                                                                                                               30 days to signing

                                         < Improve timeframe/timeliness from filing TPR
                                         to hearing. TPR should be signed within 14
                                         days.

                                         (Comment: May be legislation about this. Grp might
                                         want to work with Karen Grossman, who is also
                                         exploring this.)
                                         < Establish priority (within 45 days) for judges
                                         hearing appeal cases.

           Review contractor(s)
           performance & act on
           findings

                                                                                                                                             Contract.                   Quicker adoptions.                    Update: Has contacted supervisors, families
                                                                                                     Pat Beaulieu.                           Locked in for a year w/     Customer satisfaction.                Suggestions:
                                         < Review vendor contract: getting new studies                                                       current contractor.                                                 Encourage people to make themselves
                                                                                                    Cynthia Lapointe.
           8                             completed and completed in a timely way is a                                   11/30/06             (Districts having                                                 available
                                                                                                       Pam Cote.
                                         problem.                                                                                            problems: 7, 8, 3, 5 )                                            Ideentified


                                         < New criterion has been added - ?Assess
                                         Contract performance

                                         < See if there are geographical differences

                                         < Include fingerprinting as part of the study.
           7
                                         (Comment: In process)
                Adoption Services Implementation Plan                                                                                                                                                                    12/12/06

           DHHS Adoption Services - Value Stream Map Implementation Plan
Priority




                                                                                                                  DATE                                                                          STEPS TAKEN - 12/12/06      & New
                    CHANGE                       ACTION STEPS / ACTIVITIES                 RESP      PERSON                 DATE DONE PERCEIVED BARRIERS       EST. GAINS / OUTCOMES   STATUS
                                                                                                                PLANNED                                                                         Task Notations



                                       Encourage people to make themselves
                                       available. (10/24)




                                       Identify Follow-up person in each office. (10/24)

                                       Explore tracking tool for barriers. (10/24)

                                                                                                                                      $$ for Cross-training.
                                                                                           Jay Economy Joy                            Not enough resources.
           Explore different Service                                                             Pottle.                              High worker turnover.
                                                                                                                11/30/06
           Delivery Models                                                                  Cynthia Lapointe.
                                                                                           Barbara Goossens.

                                       < Explore different Service Models: One case:
                                       one child: one worker all the way through
                                       system --or-- another model, such as CS worker
                                       continuing to provide ongoing services for child
                                       with adoption worker providing specialized
                                       service. (KAIZEN?)

                                       < Research different models:
                                        NACAC - Monitors states' policies.
                                        Nat'l Resource Centers.
                                        Ginny has contact info.
                                       < Identify Pros/Cons/Outcomes

           Establish & implement a
           management /follow-up                                                           Virginia Marriner
           process to implement plan

                                       < Distribute Implementation Plan                     Virginia Marriner    8/14/06

                                       < Review & Comment on Imp. Plan                       All participants    8/28/06


                                                                                           Team Leads (Resp.
                                       < Assemble Action teams                                                   8/24/06
                                                                                               Persons)


                                                                                                                Biweekly,
                                       < Report status of change actions/activities via    Team Leads (Resp.
                                                                                                                 starting
                                       conf. call                                              Persons)
                                                                                                                 8/28/06

                                       < Complete project plans for accomplishing          Team Leads (Resp.
                                                                                                                 9/11/06
                                       change actions/activities                               Persons)


                                       < Establish & hold regular Action Team              Team Leads (Resp.
                                                                                                                  ???
                                       meetings.                                               Persons)

                                       < Report status/progress of change
                                                                                             Sup's./ Team
                                       actions/activities at the monthly unit staff                              Monthly
                                                                                              Members
                                       meetings
                                       < Reconvene VSM team for VSM Plan
                                       Checkpoint (9 - Noon, 442 Civic Center Drive,        Virginia Marriner   10/24/06
                                       SETU Training Room )
                Adoption Services Implementation Plan                                                                                                                                                         12/12/06

           DHHS Adoption Services - Value Stream Map Implementation Plan
Priority




                                                                                                            DATE                                                                     STEPS TAKEN - 12/12/06      & New
                   CHANGE                      ACTION STEPS / ACTIVITIES             RESP     PERSON                 DATE DONE PERCEIVED BARRIERS   EST. GAINS / OUTCOMES   STATUS
                                                                                                          PLANNED                                                                    Task Notations


                                     < Reconvene VSM team for VSM Plan Review &
                                     re-Work of Actions/Activities: (9 - Noon, 442    Virginia Marriner   12/12/06
                                     Civic Center Drive, SETU Training Room )
      Adoption Services Implementation Plan                                        12/12/06



                           STEPS TAKEN - 10/24/06

Decision that this will be addressed in the following legislative session rather
than the current session.
      Adoption Services Implementation Plan                                          12/12/06



                            STEPS TAKEN - 10/24/06




Communications with Janice Stuver regarding the necessary papers needed
for an adoption clearance packet- attached list. Clarified when we can send for
ado clearance on non-consent cases - Janice says 42 days.
Lewiston created check list with necessary papers listed - check box and put
the form in a yellow file. that file (actually an accordion file) eventually comes
to the adoption unit after the TPR is granted. Use yellow file as easy to see
and discern from other files. We use a red one for the base case legal papers.




10/24 - Need a 'next step' Now that we have the 'yellow file' methodology.
 ? Solicit comments?
 ? Pilot?




Looking at PR, Awareness opportunities
Developing a plan with 'media'
Met w/ CWTI Trainer
Suggestion to include Pat O'Brien article with initial info packet.
Will be meeting with _____


10/24 - Becky will e-mail list, Pat O'Brien article
      Adoption Services Implementation Plan                                     12/12/06



                          STEPS TAKEN - 10/24/06



Identifying unlicensed placements - work going on.




AA Checklist distributed / Suggestion to attach checklist to each packet /
Training is needed. Steve has worked on discussion and follow up meeting
with Diane Poulin and Sue Harris of the AA Program. Will need more
commitment from supervisors to sign off on accuracy and completeness of
packet.




10/24 - AA Checklist revised.
 Steve will distribute for comment (please include comments on clarity). Also
will be distributed to workers
      Adoption Services Implementation Plan                                      12/12/06



                          STEPS TAKEN - 10/24/06


10/24 - Start using checklist by Mid-November.


10/24 - Diane will monitor packets for errors and document




10/24 - Will there be a standard process in place to ensure that people are on
the same page with this, and know how to handle 'special services', for
example? How/when will this be done? (I.e. e-mail Ginny in advance).



Forwarded an e-mail to supervisors with pros/cons to open up a dialogue.
Need to have group meet. Feeling is that certain children, like older and
special needs kids, need an early meeting. Question was raised about using
respite for this, and there were feelings on both sides.




No update. Have been trying different forums:
 Presentation at a local church
 Bangor - Forums @ the mall
 Informational meetings for DHHS staff
      Adoption Services Implementation Plan                                       12/12/06



                           STEPS TAKEN - 10/24/06

Ginny will provide distribution lists (Diane will produce a 'master')



Pam Cote has sent a draft protocol - have received no additional comments.
Next step to invite CS to review. Susan Hanson will be invited to next meeting.

Pam would like feedback in the form of 'what are you using now ?' within 1
week.




CS Supervisor is part of this team

10/24 - 'Flesh out'.
 What will the 'product' be? (Referral form, Transfer form - with summary
suggested)
 What are the steps to get there?


10/24 - 'Flesh out'.
 Need to work out the 'kinks'
  Mechanics - how will this be operationalized?

 Steve will schedule meeting to include Robin Bickford.




10/24 - In partnership with OIT.
 Will Business Processes change?
   Will model serve needs of
   Adoption Services,
   Children's Services,
   Protective Services, etc. ?
      Adoption Services Implementation Plan                                          12/12/06



                           STEPS TAKEN - 10/24/06

Question developed on TA re: Lifebooks.




10/24 - Suggestion for District Offices to take their own pix to distribute within
office. This should be developed into a task statement with a due date and
desired outcome (for example, a procedure and rules)




Pending Legislative proposals.




Emails were sent out and there did not appear to be as much of a problem with
timeframes as had been reported. Will be some follow up with families to
determine if they are going at speed they need. IASC report provided.
      Adoption Services Implementation Plan                                         12/12/06



                           STEPS TAKEN - 10/24/06

Note: What is the deliverable here? Will there be interoffice policy,
procedures? How will you know if it is being followed? (measures). A sample
task statement might read:
 Develop interoffice procedure for encouraging prospective families/contractor
cooperation with the process
 Develop checklist with timelines




Bangor has implemented a permanency unit with no adoption unit, but 3
adoption specfic specialists who work with the staff not individual children.
Research completed in different states (NH). Transitioned 10/2. All studies
are done in-house.




NEEDED !




Call in to:
1-800-394-6604
Passcode: 968014
Individual project plans with examples, tips will be distributed to team leaders.
Completion/monitoring of these plans is an expectation.
Adoption Services Implementation Plan   12/12/06



         STEPS TAKEN - 10/24/06

				
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