Role of Case Management in Alternative Care &

Protection of Children, Monitoring & Follow-up

Udayan Care
 Contents of the Module
Poll questions
Part A: Overview, Defintion of Case
Management in Alternative Care
Part B: Framework for Case Management in
Alternative Care
Part C: Processes and Flow Chart on Case
Management
 Pre-assessment questions
Tick all statements that are true- The purpose of Case Management is:
Support to child and family
Documentation of assessments and records of a child
To develop care plans for children
To ensure children stay in institutional settings
To assess a child’s emergency needs only
The mitigation role of case management means:
Prevent separation of children from their families
To look for an alternative family
Reintegration of separated children with biological families
None of the above
State whether true or false:
Case Management system envisages to provide continuum of services for children.
Assessment of the risks, threats and vulnerabilities of a child is done at the stage of Secondary
Assessment.
Social Investigation Report is a tool for intervention plan.
Case Managers Intervention Register will be different from the Individual Care Plan
Which one of the following is not a tool for Case Management?
Legal representation
Intervention planning
Non-participation of a Child in Conflict with Law
Assessment of child and family

(Integrated in the Zoom poll

section)
Understanding Basics of Case Management
CASE MANAGEMENT is a systematic method of All Case Management must
organizing and carrying out work to address an be:
individual child’s (and their family’s) needs in an CHILD FRIENDLY: provide
appropriate and timely manner, through direct services in ways that are
support and/or referrals, and in accordance with a appropriate and accessible:
project or program’s objectives e.g. - by providing
Case management must be used as a strategy to information in formats /
reduce inter-connected risks and vulnerabilities language that can be
that cause protection violation (Preventive) or as understood by children of
a response to violations that children and young different ages
persons have already experienced CHILD CENTRED: organizing
(Rehabilitative) and delivering services, and
making decisions in a way
Case management procedures lead to quality in that centers on children’s
delivery of services, consistency and coordinated needs and best interests:
services in the best interest of children/ young e.g. consider holding
persons and their families reviews and meetings at
times that are convenient
for children and their
families, rather than those
which fit in with the
Case Management in the context of Alternative
Care
A professional system to serve Individual care: each
case is unique and
children living in Alternative Care – different and must be
children and young persons understood in its
uniqueness
WITHOUT parental care or at risk of Convergence and multi
being separated from their families sectoral Linkages and
Oriented towards understanding the support services are
crucial
unique circumstances and Focus on Prevention so
vulnerabilities of children and youth children stay in families
and their families and
living in Alternative Care - a rights communities are
based framework equipped to meet their
Committed to ensuring their needs needs, aspirations and
ensure their overall
with individual attention development
Following procedures and practices
based on child centric and child
friendly approach
 Understanding the Rights Based Framework
1. UNCRC and UN Alternative Care Guidelines
2. Constitutional Guarantee (Liberty, safety and development)
3. Juvenile Justice Act (procedures for CICL & CINCP), Model
Rules, ICPS,
(recap: the 3 points have been covered in Module 1 in details)
4. Various other rights and interconnectedness of rights
(survival, development, education, protection from child
labour, child marriage, child abuse and exploitation)

Purpose of Case Management

Consistent and on-going support to child and family through each step of the
process
Documentation of assessments and records to develop care plans and make
sound decisions regarding reintegration
Core Values:
Listen to Children and Young Persons in all decisions made for them
Do NO HARM principle
Best interest principle
Importance of Case Management in Alternative Care

A large number of children in Institutional Care (more than 3 lakhs) in India – 80%
have one or both parents alive as per MWCD report of 2018
- restorations in times of COVID – 19, Numbers have come down
In MP, prior to COVID there were around 2900 children in CCIs, during COVID
around 600 plus children have been restored to families.
(discussion on Restorations during COVID-19 and Case Management approach)
The negative impact on children spending longer time in Institutional care (recap
from module 1 and discuss the Necessity and Suitability - - covered in module 1
The Indian Laws, National Policy for Children and Juvenile Justice law and Policy
have all emphasized the importance of family based care approach … yet on the
ground implementation is a different scenario – care reform and hence case
management important

Food for thought – Case Management is always oriented towards family based
care of children and not the other way around – take opinion from participants
and encourage discussions
The principle of necessity: children should only be placed in
alternative care if it is really necessary. It must always be in the
child’s ‘best interest’

The principle of suitability: children should only be placed in

alternative care that suits their individual needs and situation and
are MOST appropriate to their individual circumstances
Goals of Case Management in Care & Protection of Children

Mitigate Prevent separation of children from their families.

Facilitate Reintegration of separated children with biological
Alternate families.
Locate Alternative family - If biological family not existing: non
Collaborat institutional and IC as last resort
e Family or family-like place
Safeguard Services and stakeholders on a larger scale to help the
Strengthen child
Create Children (in and out of institutions), their
rights/interests.
Families, communities, systems, services.
Family like environment for children not able to unite
with a family – small group home model
 How a Case Management in Alternative Care should be
Child focused Treats every case/client individually (child central
Needs Based in decision making
Non judgmental Interventions as per the specific requirements
Non-authoritarian Doesn't work on pre-conceived notions, biases,
Collaborative norms
Principled Follow laws and rules but beyond straight-jacket
Promotive and Multi-sectoral, multi-organizational, multi-services
Accountable Follows a child’s rights framework and interests
Holistic Takes stands and responsibility of ones actions
Participatory
Takes care of entire case-cycle and beyond
(continuum)
The client (child’s) views central in decision making

Case management is transparent, professional and

team work - it doesn't work in isolation.
 Activity – Identify the Approach
(Four Group work to discuss and present case studies in CM
approach)
Raju was rescued and sent to a CCI – 6 months later he still
wants to go back to his family

Meena has no parents and stays in a CCI – she is very friendly

with people coming to the CCI and wants to go out and visit
them
Aarif stays in the CCI as his father killed his mother and went
to jail – In the CCI, Aarif faces a lot of criticism from the
fellow children and staff and he does not like the food in the
CCI
Nidhi is 15 year old and lives in a CCI. She goes to a nearby
school where she made a lot of friends. Once she went to a
friend’s house and did not return for 2 days. The CWC has set
up an enquiry for this
 Case Presentation Template

Child What type What type of What type of What post-placement

Name of preparation preparation will supports will the child
placement will the child the family need and family need?
should be need prior to prior to
explored placement? placement?
first?

Who are Potential Key Part of Transition Key Points- Elevator

the Key Concerns Questions that Appeal to Pitch
Stakehol or Barriers About Stakeholder
ders Transition to
Family Care

         

 
 PART B
Framework for Case Management in
Alternative Care
Case Management Ecosystem - for Alternative Care

Screening Individua
System Laws and l level
policies &
Level Identifyin (child,
(statutory interface institutio
and other g needs of
Child the child Identify n&
stakehold welfare & family)
ers) family
protectio strengths
n systems and Risks
Case
Communi Management Quality
ty and
family System Interventi
ons

Continuu Participat
m of ion
Services (families
(Exo- & child)
system) Monitori
ng and Legal
Follow-up work &
document
ation
Universe of “Work” for Case Case Manager is a…
Managers Professional responsible for
The Child coordinating the overall care
The Family (and the delivered to children and
community) families following a
The Institution systematic case
The Child Care & management process
Protection System Work with family members,
The extended network of friends, educators,
stakeholders (schools, psychologists, health care
health, counselling, experts, and others involved
sponsors, etc.) in the child’s life to meet
the needs of each child
Must have:
Skill to develop relationship of
TRUST with the children and
families
Understanding of the
community, cultural customs,
local language
Tools for Case Management
A comprehensive care plan for
Identification a child in Alternative Care
Assessment (child Identifies child’s and family’s
and family) strengths, challenges, needs,
Care Planning and aspirations as
Legal Representation
(CWC, JJB, etc.) determined from the child
Case and family assessments
Planning/Interventio Plans for support and
n Planning interventions to be
(stakeholders, implemented
strategies and
monitoring)
Measurable goals, time
Follow-up and frames to achieve them, and
evaluation resources to be used
 PART C
PROCEDURES
Step 1: Identification (Intake and Admission)

- May include a child just entering a CCI or already living in a

CCI
- Case manager may reach out to the CWC/DCPU/CCIs/CBOs for
identifying cases or may be approached by such authorities
- key action may be to ascertain:
Whether the child has biological family or kin?
The location, linguistic linkage, etc.?
Whether the child has faced violence, abuse or
exploitation, etc.?
The child may need immediate escort back to the family;
or
May need a short stay at the institution
May need a slightly longer
May need a stay till an alternative family is located, or
May continue to stay at the institution (special
circumstances)
Step 2: Primary Assessment of the Child

Child’s present status, concerns and needs.

Child’s immediate needs
Information through – child interaction, case file at the CCI (having
details about the child, child report, ICP, SIR etc.), caregivers,
immediate persons in touch.

Assess the gravity of the case and related concerns.

Build a ground for secondary assessments and proper direction for
SIR & ICP in accordance with the intervention that will be
undertaken.

Assessment of the risks, threats, vulnerabilities, etc.

- In case of any risk to the child, a concerned stakeholder can be involved -
such as doctor, psychiatrist, teacher, caregiver, etc. for help in proper
assessment/future course of action.
Secondary Assessment of the Child

Aims at meeting the long-term goals – e.g. family

placement of the child, or other long term alternative care
arrangements
Assessment of child’s preparedness or vulnerabilities for
the next level of change in care options.
Assessment of child’s personal, behavioural,
developmental, aspirational and other such needs for a
change in care options
The tools – child interaction, caregiver interaction, exposure
and guidance to the child, etc.
Both the primary and secondary assessment are good
opportunity to repair the Individual Care Plan documents as
per the need/direction of the case.
Assessment of the Family
If the biological family has been traced / potential alternative family
has been identified
Important Tool - Social Investigation Report (SIR), Home Visit Report
Assessment of all Family members (numbers, relations, extended
family members, their situations etc.)
Background study - Reasons for separation, crises, conflicts, etc.
Family’s readiness, capability, safety audit (Risk Assessments)
Strengths & weaknesses of the family – as per the need of the child
Resources available around the family
Assessment of the community, (ascertain risk factors or strengths)
Step 3: Intervention Plan

Based on the assessments and best interest analysis of the child -

focused intervention plan
prepared in consultation with all the important and relevant
stakeholders
highlight the goal, time-bound actions and role of each
stakeholder
Is relevant and realistic and not very extravagant in its
approach/direction
Includes an alternative plan.
The Interventions will defer slightly in case of
- If the objective will be family-based placement/reintegration of
the child with family; or
- If the objective will be to place the child in an institutional
alternative care setting
Note – Case Managers Intervention Register will be different from
the Individual Care Plan
Step 4: Reintegration Plan Implementation
Ensure interventions as per the plan and within the set
timeframes
Pre-implementation training schedule to be prepared
involving all the stakeholders
The smoothness of intervention plan implementation must
not be compromised during the change of staff at any
level
(reference to Handout on the process in brief)
Step 5: Monitoring

The activities are happening as per the timeline of the

plan – mark any deviations
Targets are achievable and quantified – measured at
regular intervals
Plan is evaluated at monthly, quarterly and annual basis
as per set outcomes
Success indicators are enlisted at the time of plan
formulation and their achievement rates are studied at
given intervals.
Stakeholder contributions are weighted in the activities
and objectives in the Plan and part of the quarterly, mid
term and annual review of stakeholder contributions.
Step 6: Case Closure
Child & family are informed, consulted
and prepared When to close the case:
•Goals of the plan have been
All important files, documents, met and long-term care is
undertakings, are in place as per law assured
All stakeholders are consulted and in •Permanency goal has been
met
agreement •Child can successfully live
All formal agencies - child welfare independently at age 18 and
committee, etc. have issued proper beyond
sacntions •Care of child has been
transferred to another agency
A post closure support platform is or organization
available (helpline number or email ID, Even after closure, the child
etc.). and family should always
know who to reach out to
In case of any deviation at the child and for assistance in the future
family level – there are sources who can - family like means coming
reach out timely. back any tme
Post Assessment, closure and
planning the next session
1. Run the Poll again with an added question
What are the consequences of a bad
case management – Please explain
with examples
2. Discuss the difference in Pre and Post Polls
3. Run the Feedback form on Zoom
4. Plan Next session, schedule reminder and seek
suggestions
5. Closure with thanks for participation and contribution