Administering and Evaluating PCAP: Protocols and Forms

Hiring & Training

Supervisor

• Clinical Supervisor Job Description
• Training Requirements for Clinical Supervisor

Advocates

• Advocate Job Description
• Sample Advocate Interview Questions
• Training Requirements for Advocates

Office Assistant

• Office Assistant Job Description

Exit Interviewer

• Exit Interviewer Job Description
• Training Requirements for Exit Interviewers

Recruitment, Referrals

• PCAP Brochure
• Brochure Insert
• PCAP Eligibility Criteria
  • Community Referral Screening Questionnaire (CRSQ)
  • Alternate CRSQ for FASD Eligibility
• Referral Tracking and Decisions
• Waitlist Script

Instructions for Obtaining a Federal Certificate of Confidentiality

Consents, Permissions, Release of Information

Washington State Institutional Review Board (IRB) Consent Forms/Scripts

• For Use at Intake:
  • Recruitment Script
  • Main Study Consent
  • Main Study Consent for CPS Contracted Clients
  • Program Staff Script for Depression Screen Re-administration
  • Photography Consent
• For Use at Exit:
  • Program Staff Script for Exit Interview Client
  • Program Staff Script for Exit Interview ‐ Client Living Out of Area
  • Program Staff Script to Locate Missing Client for Exit Interview
  • Exit Interview Consent
  • Exit Interview Authorization for Contact
  • Exit Interview Consent for CPS Contracted Clients
  • Researcher Script ‐ Client Living Out of Area
  • Researcher Script for Social Worker at Exit
  • Exit Interview Social Worker Authorization
  • Researcher Script for TC Guardian at Exit

Program Permissions (Non‐IRB)

• Release of Information
• Client Service Agreement
• Permission to Transport Children

Advocacy: Getting Started

• Advocate Safety Guidelines
• Advocate Boundaries and Standards
• First Home Visit ‐ The Ground Rules

The Client File: 6 Sections

Client File Protocol

1. Inside Front Cover:
   • Client ID sheet
   • Tracing Information Update Log
   • Client Service Agreement (see “Program Permissions Non-IRB” above)
2. Service Coordination:
   • Service Coordination Form
   • Service Coordination Code Sheet
   • Release of Information (see above)
3. Medical Information:
   • Mother’s Medications Form
   • Target Child Medications Form
   • Immunization Schedule
4. Goals & Assessments:
   • Goals Assessment (see Evaluation Forms)
   • Difference Game (see Evaluation Forms)
   • Difficult Life Circumstances (see Evaluation Forms)
   • Family Strengths and Needs
   • ASI Last Page
5. Case Notes:
   • Case Notes Protocol
   • Case Notes Form
6. Correspondence:
   • Copies of letters, etc.

Advocate Tools

• Weekly Goals
• Circle and Fence Activity
• Pros and Cons Activity
• Baby Can Do and Weekly Activities
• Developmental Profiles 0-12 Ordering Information
• TIP #35 Ordering Information (Motivational Interviewing)
• Tracing Tips
• Tracing Tips–Spokane
• Native American Questionnaire

Supervision and Administration Tools

• Clinical Supervision Protocol
• Clinical Supervision Form
• Client File Review Protocols
• Client File Review Form
• Weekly Staff Meetings
• Weekly Staff Meeting Sign In Sheet
• Resolving Service Barriers
• Referral to CPS
• Client Flex Fund
• Flex Fund Log
• Client Status Definitions and Protocols
• Staff Emergency Contact Information

Client Exit

• Client Exit from PCAP

Legal Protocols

• Reporting Abuse and Neglect Protocol
• Duty to Warn
• PCAP Legal Policy

In‐House, Administrative Protocols

• Advocacy Training Time Guidelines
• PCAP Advocate Performance Evaluation
• PCAP Supervisor Performance Evaluation
• Client Public Presentations
• Courtesy Visits
• Consent for PCAP Staff Photos
• Protective Payee Policy
• PCAP Cell Phone Policy
• Paper Storage Protocol
• FADU/PCAP State Car Policy
• Telecommuting Protocol
• Confidentiality Agreement for Visitors
• Guidelines for Shadowing Advocates

• Manual
• Protocols and Forms
• Evaluation Forms