§4 ch5: Placement/Replacement of the Child
5.1 Placement in a Resource Family
When a child needs placement with a resource family, the Children’s Service Worker will obtain a court order for placement or an authorization to detain the child and then prepare the resource provider for placement, providing all available information about the child. The resource provider shall be provided with a copy of the court order. The Children’s Service Worker shall provide to resource providers and potential adoptive parents prior to placement, all pertinent information including but not limited to, full disclosure of all medical, psychological, and psychiatric conditions of the child, as well as information from previous placements that would indicate that the child or children may have a propensity to cause violence to any member of the resource family home. The resource providers shall be provided with any information regarding the child or child’s family, including but not limited to the case plan, any family history of mental or physical illness, sexual abuse of the child or sexual abuse perpetrated by the child, criminal background of the child or the child’s family, fire-setting or other destructive behavior by the child, substance abuse by the child or child’s family, or any other information which is pertinent to the care and needs of the child and to protect the resource or adoptive family. Knowingly providing false or misleading information to resource providers in order to secure placement shall be denoted in the worker’s personnel file and shall be kept on record by the division.
When a child is to be in care for less than two weeks prior to an adoptive placement, obtain a completed Emergency Waiver of Two Week Notice, CS-44 from the resource family.
To prepare the child for placement, the Children’s Service Worker will provide the child with information about the resource family. The worker will help with the trauma of separation, reinforcing the belief that the child is not the cause of the family breakdown. The child will also need help to understand the reasons the parents/caretakers cannot care for him/her. For youth, ages 14 – 21, assure the child they will be directly involved in long-term planning and will be expected to maintain personal responsibility for their actions.
- Youth, ages 14-21, shall receive a copy of "What’s It All About?" A Guidebook for Teens in Out-of-Home Care, and shall be referred to the Older Youth Program for Chafee Foster Care Independence Program (CFCIP) services. The book is intended to assist youth while in care and transitioning out of care. The last page of the guidebook contains an acknowledgement form for the youth to sign and a copy is to be placed in the file under the Older Youth Program Section. Documentation of a youth being provided the guidebook should also occur in the case narrative.
- Youth, ages 14-21, shall be referred to the Older Youth Program for Chafee Foster Care Independence Program (CFCIP) services.
The Children’s Service Worker shall arrange pre-placement visits, except in emergencies, per Section 210.566 RSMo, and arrange to obtain a medical examination and medical history. The medical examination should include an HIV screening (ELISA test) for children displaying symptoms of AIDS or AIDS Related Complex (ARC) or at high risk of HIV exposure.
Any pre-placement visit must be discussed and pre-approved by the Family Support Team and the pre-placement provider. The Family Support Team should review the Foster Family Profiles of potential resource providers in determining and selecting the most appropriate placement for the child. Decisions regarding the pre-placement visit plan are on a case-by-case basis and are unique to the needs of the child. Discussion and decisions regarding the pre-placement visit should include at a minimum:
- Does the foster youth require a pre-placement visit to facilitate a successful placement?
- Does the resource home require a pre-placement visit to facilitate a successful placement?
- What are the time frames for pre-placement visit(s); minimum number of visits, maximum number of visits, length of the visits, etc.?
The licensed resource home of the pre-placement visit is not eligible for any payment for the child while on the visit, except allowable mileage reimbursement if applicable. Any exception must be pre-approved through supervisory channels with final approval by Central Office.
The medical examination should include an HIV screening (ELISA test) for children displaying symptoms of AIDS or AIDS Related Complex (ARC) or at high risk of HIV exposure.
Children at risk of HIV infection include:
- Hemophiliacs or those children who received blood transfusions prior to 1985;
- Intravenous (IV) drug users;
- Infants born to a mother who tests HIV positive;
- Children with one or both parents who have tested HIV positive, have ARC, AIDS, or is at high risk for AIDS;
- Sexually active youth who have had a sexual contact with a high-risk individual or an HIV infected individual; and
- Subjects of sexual abuse where the perpetrator is at high risk of AIDS or is an HIV infected individual.
If the Children’s Service Worker is unable to obtain the initial medical exam prior to placement, the initial medical examination shall occur, if possible, within 24 hours of the child coming into care. This initial health examination does not need to be a full Healthy Children and Youth (HCY) assessment. The purpose of the initial health examination is to identify the need for immediate medical or mental health care and assess for infectious and communicable diseases. When possible, this initial health examination should be completed by the child’s current primary care physician as they know the child and have knowledge of the child’s medical history.
If a provider is not readily accessible, this exam must occur within 72 hours of the initial placement.
A full HCY examination including eye, hearing, and dental examinations should be completed no later than 30 days after the child is placed in Children’s Division (CD) custody. In addition, children should receive a developmental, mental health, and drug and alcohol screening within 30 days of the child’s entry into care. If needs are identified, these needs must be treated as soon as possible.
Per Section 210.110 RSMo, children from birth to age 10 in CD custody should also receive a physical, developmental, and mental health screening every six (6) months following the initial examination as long as the child remains in care. Prior to all Permanency Planning Review Team (PPRT) meetings, a full HCY assessment should be completed, thus staff should schedule appointments in a timely manner to ensure the appointment occurs prior to the PPRT meeting.
Children, 10 years and older, who enter CD custody should have continued follow up as needed following the initial examination. It is the Children’s Service Worker’s responsibility to ensure that children in CD custody receive the appropriate screening, assessment, and follow-up services as necessary.
The needs of the child should always be foremost in deciding how soon the exam must take place. If the child has obvious medical needs, or is coming from an environment where a physical exam is indicated, the exam must take place as soon as possible.
The Children’s Service Worker shall also arrange to meet the cost of care expenses.
The worker will utilize the team approach to determine the most appropriate resource family for a child who tests HIV positive. Team members should include:
- The child’s physician;
- Public health personnel;
- The child’s parent or caretaker;
- Case manager;
- The potential resource family provider, i.e., foster parent, adoptive parent, residential care provider;
- The child (age 13 or older); and,
- Residential licensing representative, if appropriate.
- The team may need to meet at regular intervals to assess the child’s health status and the appropriateness of the placement setting.
- A child placed in an out-of-home care setting has a right to privacy. This right is necessary to protect the child. Only those persons directly responsible for the child’s care or defined as a person with the need to know (see RSMo 191.650 - 191.695 and 210.566) should be informed of his/her condition.
- Report immediately any accidental injuries to a child in Children’s Division’s custody, and who is a MO HealthNet recipient, using procedures in the Income Maintenance Manual, Chapter VII.
After transporting the child to the resource family, the Children’s Service Worker will confirm or clarify any information previously shared. The worker will provide a copy of the court order placing the foster youth in CD custody. The resource provider shall be provided with a copy of subsequent court orders while the foster youth is placed in their home until the release of jurisdiction is signed by the judge. The worker will also provide full and accurate medical information (current condition and history) to the resource provider at the time of placement. Some of this information may be found on the Child/Family Health and Developmental Assessment (CW-103) and attachments A and B. If none or only part of the above is known, share what is available and continue obtaining needed medical history and updating the CW-103. The updated CW-103 should be shared with the resource provider as information about the child’s care and treatment becomes available. If the child has tested HIV positive, provide complete information for caring for the child's special medical needs and infection control.
If the resource family is a relative or kinship provider, the Children’s Service Worker should provide them with the following information at the time of placement:
- A copy of the Authorization to Provide Alternative Care form, CS-33;
- A MO HealthNet form and instructions for obtaining a complete health examination;
- Procedures for obtaining clothing for the child;
- The name and phone number of the child’s current school and instructions to enroll the child in a new school, if needed; and
- The name and 24-hour contact telephone numbers of the worker and supervisor.
The Children’s Service Worker will assist the resource family or other resource provider with the initial adjustment of the child. Follow the placement with a visit to the resource family home, the next business day to do an assessment of the initial adjustment. Determine if any assistance is needed.
The Children’s Service Worker must contact the parents to continue formulating a treatment plan. Set up a visit between the birth parent(s) and child within the first week of placement. Visitation shall not take place in a home where a known or suspected methamphetamine laboratory exists or has existed unless it has been professionally treated or decontaminated by a hazardous waste cleanup agency according to the guidelines of the Environmental Protection Agency (EPA). An alternate location for the visit must be decided upon.
The Children’s Service Worker will complete the necessary placement forms: AC Client Information screen in FACES (within two (2) business days of case opening), Placement Report for Resource Home Record, CD-104, Placement Report for Child’s Record, CD-105, and set up a section of the record for the child, separate from parent’s section of the record. Using information from Section 4 Chapter 11, the worker will also complete and submit all cost of care forms.
For youth age fourteen (14) and older, assessment for referral to the Chafee Foster Care Independence Program will begin. Initial work on the Adolescent Family Support Team Guide (CD94) and Individualized Action Plan Goals (CD94), will begin in the first thirty (30) days and be completed within 120 days of the youth coming into care. The Life Skills Strengths/Needs Reporting Form (CD-97) and the Casey Life Skills Assessment will be completed within the first sixty days of a youth coming into care. All youth fourteen and older will be referred for Chafee Foster Care Independence Program Services within the first 120 days of coming into care.
All placement activities must be entered into FACES as soon as possible but no later than 24 hours after the change occurs. The progress of the placement and treatment plan will be recorded every 30 days thereafter. The worker will also provide a written report to the court which will include the identification of the resource family or other resource provider and information regarding placement activities. Furthermore, the worker will participate in any court hearings.