Form M-11F LTFC Case Manager Questionnaire

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OMB 0970-0564 [valid through MM/DD/2024]

(Revised date: July 6, 2020)

LTFC Staff Questionnaire – Case Manager/Lead Case Manager

Interview Details
Program Name:	Past and Current Position(s) at Program:
Full Name:	Date/Time of Interview:
	Interviewer:

*Note: Before beginning the interview and/or providing this questionnaire to staff, provide a brief introduction, including monitor role and purpose of monitoring visit, confidentiality of staff interview, and clarify any questions. See Introduction Prompt for Staff for additional guidance as needed.

*If the program does not have an educational coordinator, include the educational questions listed at the bottom.

	NOTES
Tell me about your role and main responsibilities as a case manager. How many cases do you typically cover? In the last year, what was the highest number of cases on your caseload? Lowest number? Is your current caseload manageable? Has your caseload been unmanageable in the past? If so, why?
What are the things that you love/enjoy about your job? What are the challenges you face in your job?
How do you keep up-to-date on current and new ORR policies and procedures? How many cases do you typically cover? How are you trained/notified when there is an update or a change to ORR policies and procedures? Cooperative Agreement? Flores Settlement Agreement? Do you know where to find the most up to date information? What is the last policy update you received? Tell me about a recent policy update you received and how it was implemented in case management service provision.
Do you feel that you receive adequate training to perform your case management duties? If not, please explain. (Lead Case Manager) Describe your system to assess ongoing staff training needs and opportunities for development? How is this working? Please describe any training needs that your staff currently has.
Tell me about your staff meetings. How do you communicate with staff? All staff? Case Managers and Lead Case Manager? Describe how your weekly case staffing works. Do you feel that your weekly staff meetings and case staffing meetings are helpful?
Please describe your relationship with your supervisor. How often do you have individual and/or group supervision? How often do you participate in other staff meetings? Do you feel that you have adequate support from you supervisor?
Describe your working relationship with stakeholders. GDIT Case Coordinators Legal Service Provider/Child Advocates Other Stakeholders – OSSI, ATIP, Immigration Court, etc. DHS/ICE Juvenile coordinators
(Lead CM) Please explain your internal referral review process. Who is in charge of reviewing and accepting referrals? How many cases are reviewed at a time? Are there any specific barriers/challenges (i.e. legal, special needs etc.) your program encounters when reviewing LTFC referrals?
How does the CM team address and respond to UAC needs, such as: Safety concerns Medical issues Mental health issues Victims of trafficking UAC with special needs
How do you encourage the participation of UAC in the case management and reunification process?
What does trauma-informed care mean to you? How do you deliver trauma-informed care as part of the case management team? Describe how the case management team ensures that services are culturally sensitive and age appropriate.
Do you have any recommendations, suggestions or concerns regarding the way your cases are reviewed/staffed?  Please elaborate. Are there any current challenges to ensuring safe and timely release of UACs?
How do you collaborate with other teams to ensure that UACs physical, mental health, developmental, social, and educational needs are being met? What recommendations do you have to strengthen the collaboration and communication with other departments?
How often are home visits conducted? What does a home visit entail?
Tell me about the behavior management system in the foster homes. How do you work with foster parents and UAC to implement the system? Who explains to UAC foster home rules and when is this completed? How does the program monitor each individual foster home behavior management system? How is the system differentiated to meet individual children’s needs (age, stage of development, previous experiences, etc.)?
How is risk of runaway evaluated? What happens once a UAC is identified as being at risk of running away? What procedures/safeguards are implemented?
How do you prepare youth who are at risk of aging out of the program? What local support/resources are available? Please describe your post-18 planning process.
Describe the procedures when there is an allegation of child abuse or maltreatment at school, in foster homes, etc. (Interviewer provide an example of child abuse or neglect and ask case management staff the procedures for reporting.)
Do you have any concerns about the treatment of the UAC? Do you have concerns about any particular staff members (any staff members or foster parents you think should NOT be working with UAC)?
What general recommendations do you have to strengthen the program? What improvements would you put in place? Have you shared these ideas with your supervisor or any other program staff?
What recommendations do you have for ORR that I can take back to share with our headquarter teams?

Supplemental Education Service Questions, if necessary:

Additional Notes

Enter Additional Notes.

THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to allow ORR Monitoring Team staff to interview and document responses from case managers and lead case managers during biennial site visits. Public reporting burden for this collection of information is estimated to average 1.0 hour per response (plus an additional 1.0 hour if the site visit is performed by a contractor monitor), including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a mandatory collection of information (Homeland Security Act, 6 U.S.C. 279). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. If you have any comments on this collection of information please contact UCPolicy@acf.hhs.gov.