4. Case Plan Documentation

Annual Case Plan Review and Documentation
The passage of SB 89 requires new information to be documented annually in the case plan for foster youth, ages ten or up, and for NMDs. These new requirements can be found by viewing the newly added subdivisions (g)(20) and (21) of W&IC section 16501.1.

Subdivision (g)(20) was added to section 16501.1 of the W&IC to require case management workers to review case plans of foster youth annually, and update them as necessary, to document that a youth has received comprehensive sexual health education which meets the requirements established in the California Healthy Youth Act (CHYA) (Education Code sections 51930-51939).
Specifically, case management workers are now required to document in the case plan the following:
A. For a youth in middle school or junior high, either that the youth has already received this instruction, OR how the county agency will ensure that the youth receives the instruction at least once during middle school or junior high.All County Letter No. 18-61 Page Three
B. For a youth or NMD in high school, either that the youth or NMD has already received this instruction during high school, OR how the county will ensure that the youth or NMD will receive the instruction at least once during high school.In order to verify that a foster youth/NMD has received or will receive instruction within the necessary time frame, it is recommended that the case management worker communicate with an official working at the youth/NMD’s school.

This will allow the case management worker to determine if the youth/NMD will be able to meet this requirement through school attendance, or if the case management worker will need to arrange an alternative way for the youth/NMD to receive the instruction. The California Department of Education (CDE) website provides information about comprehensive sexual health education, including the curriculum requirements and a list of Frequently Asked Questions. Although W&IC section 16501.1, subdivision (g)(20) does not dictate a specific year of middle school, junior high, or high school in which the curriculum must be delivered, it is recommended that case management workers connect a youth/NMD to comprehensive sexual health education as early as possible so that if it is determined that a youth/NMD will not receive this education through school attendance, there is sufficient time for the youth/NMD to receive it by some other means, prior to completing middle school, junior high, or high school.

Additionally, subdivision (g)(21) was added to section 16501.1 of the W&IC to require that, for a foster youth, ten years of age or older, or for an NMD, case management workers annually update the case plan to indicate that the case management worker has done all of the following:

A. Informed the youth or NMD that they may access age-appropriate, medically accurate information about reproductive and sexual health care, including, but not limited to, unplanned pregnancy prevention, abstinence, use of birth control, abortion, and the prevention and treatment of sexually transmitted infections,

B. Informed the youth or NMD, in a developmentally and age appropriate manner, of their right to consent to sexual and reproductive health services and their confidentiality rights regarding those services; and

C. Informed the youth or NMD how to access reproductive and sexual health care services and facilitated access to that care, including by assisting with any identified barriers to care, as needed.

As described in the Manual of Policies and Procedures Sections 31-210 and 31-230, case management workers are required to explain the purpose and content of the case plan including case plan updates to the parent(s)/guardian(s) of minors placed in foster care. When the case management worker explains the content of the case plan to the parent(s)/guardian(s) of a minor aged ten or older, included in that discussion shall be information about the newly required items in the case plan resulting from the passage of SB 89; that the minor must receive comprehensive sexual health education (once during junior high and once during high school in accordance with the requirements of the CHYA) and that the case management worker has informed the minor of theirsexual and reproductive health rights. If the parent(s)/guardian(s) is/are unwilling to sign the case plan document, the case management worker shall document the reason(s) for refusal to sign, but will still provide the case management services to the minor, including the new sexual and reproductive health components of the case plan.

Instructions for Documenting SB 89 Requirements in the Case Plan
The passage of SB 89 requires that county case management workers document these new activities in the case plan, including case plan updates, for a youth in foster care, ten years old or older, or a NMD. At this time, there are no existing fields in the Child Welfare Services/Case Management System (CWS/CMS) for this purpose. However, the CDSS is providing interim step-by-step instructions in Attachment A for documenting these activities on CWS/CMS, until new fields are created. The CDSS is aware that probation departments across the state use at least twelve different data systems for monitoring probation cases. Probation officers will need to meet the new mandates for case plans for their minors and NMDs placed in foster care, however they will need to determine at the local level how the new requirements of SB 89 may best be met within the particular system used by their department. Due to the number of different systems used by probation departments, it is not feasible for CDSS to provide step-by-step instructions for data entry. In addition to documenting these required activities in the case plan, the case management worker should document in the case record any contact with the youth or on behalf of the youth about sexual and reproductive health topics, and any actions the case management worker took to provide the youth/NMD with information, resources, and assistance to remove any barriers the youth/NMD may have in receiving sexual and reproductive health care. Information about collateral contacts made on the youth’s behalf or assistance provided to a youth in facilitating their access to reproductive health care and services does not belong in the case plan document due to the protected and sensitive nature of this information.Note: For instructions on entering pregnancy-related information in CWS/CMS and the practice of capturing this information as either an observed condition or a diagnosed condition, please refer to ACL 16-32.

A good time to inform a youth about these above three rights is when the case management worker is informing the youth of all their personal rights afforded to children in foster care. Case management workers are required to review personal rights with minors/NMDs in foster care:
• At entry into care,
• placement change, and
• every six months after the most recent of those events

Case management workers must indicate in the case plan when they have facilitated access to sexual and reproductive health care, including by assisting with any identified barriers to care, as needed.

Case management workers will produce a Delivered Service contact in the Contact Notebook and include in the Associated Services tab an ‘Associated Service of Assist Access to Sexual/Repro Care Srvcs’ to indicate when they have facilitated access. Doing so will populate the Delivered Services Related to Sexual Health and Reproductive Care/Rights section of the Case Plan.

Not all youth or NMDs will encounter barriers to access, and therefore the case management worker may not need to facilitate access and document this in the case plan. But if the case management worker does facilitate access, it must be indicated in the Delivered Services log and in the Case Plan.