6.1 Out-of-Home Placement Support Activities

The Children’s Service Worker should meet face-to-face, individually and jointly, with the child and the resource provider, at the placement, the next business day following placement. The worker should then meet face-to-face with the child and resource provider, a minimum of one time per month in the placement to monitor the placement and assess the safety of the child. Staff will likely visit with children more than once a month, however the state worker visit report will calculate compliance per calendar month based on the federal standard.

The Division has the authority to provide services to a child and parent when the child is not in custody but is under court ordered supervision by the Division. This includes visiting with the child. Face-to-face visits in the home should be done no less than once a month or more as needed to assure the safety of the child and to achieve the case goal. If the child remains in the custody of the parent, the Parental Home Visit Checklist, CD-83, should be utilized to document this contact. If the child is in a non-parental placement, the Worker/Child/Caregiver Visit Guide, CD-82, should be utilized. Safety of the resource home should be assessed:

1. Provide the necessary support to the resource family to involve them to meet the needs of the child and his/her parents, to include information, technical assistance, advice and counsel as follows:
   1. Assist the resource family in understanding the circumstances and behavior of the parent;
   2. Encourage the resource provider to be a model for good parenting. This will be beneficial to the foster youth and parents; and
   3. Encourage child care practices which promote and protect the psychological, physical, and emotional well-being of the child including the physical, developmental, and mental health screenings which are required every six months for children from birth to age 10 as long as the child remains in care.
2. Discipline deserves special mention since resource providers are vulnerable to the accusation of child abuse, and many children exhibit problematic and provocative behavior. Physical punishment of foster youth is not permitted. Resource providers shall use discipline methods which are consistent with Children’s Division policy, Section 210.566, RSMo. It is crucial for children to be exposed to alternative ways of problem solving aside from force or threat of force. Limit setting is necessary in a consistent and firm way. Resource providers must be offered training to manage the behavior of the child in ways other than spanking, slapping, or hitting. Briefly, depending on a child’s age and capacity to understand, these ways include:
   1. Distraction;
   2. Isolating a child in his room when he is out of control until he quiets down and can discuss things. "Time out" should be understood by both the resource provider and the child before it is used;
   3. Spontaneously rewarding a child for good behavior;
   4. Removing a child from dangerous situations;
   5. Removing dangerous objects;
   6. Explaining; and
   7. Specific natural or logical consequences ("If you fight with Jim, then you can't play with him today.").
3. Address the following issues with child and resource family or other care provider during regular placement support contacts and during Family Support Team (FST)/Permanency Planning Review Team (PPRT) meetings:
   1. Stabilization in child’s life so that development and learning can proceed at a normal rate. (Excessive anxiety and insecurity interfere with normal development and learning.)
   2. Help the child deal with the trauma of separation. Explore with him and reinforce the belief that he is not the cause of the family breakdown.
   3. Assure the healthy growth and development of the child by reviewing the child’s progress and response to care provided by the resource family, including integration of the Child Assessment and Service plan, CS-1, and any special evaluations, treatment and treatment recommendations.
   4. Give attention to the child’s special interests, talents, and vocational interests.
   5. Assist the child in rebuilding parental relationship, if the child does not want to visit.

      Authorization from the court must be obtained if visits with parents are to be restricted.

   6. Begin and maintain a "life book" with or for the child, to reinforce continuity in care and relationship to parents.
4. The Children’s Service Worker should consult with the residential care provider, at a minimum, once a month to assure safety, monitor the placement and assess the progress of the child. See Section 4 Chapter 18 if the child is placed in level II, III, or IV residential treatment services.

   Related Subject: Section 4 Chapter 18 Residential Rehabilitative Treatment Services

   These providers also include any facility in which a child in Division custody has been placed through special arrangements.

5. Secure the provision of needed and specialized services to compensate for any current learning or developmental deficits caused by previous life experiences.
6. Implement any treatment recommendations made by the physician, dentist, other professional, and the psychological examiner, including any recommendations for assisting the resource family to participate when needed.
7. Assist the resource family to cooperate with the parent/child visiting plan:
   1. Visitation should be scheduled at a time that meets the needs of the child, the biological family members, and the resource family whenever possible. Recognizing that visitation with family members is an important right of children in foster care, resource providers shall be flexible and cooperative with regard to family visits, RSMo 210.566.
   2. Child visits with parents and siblings should occur within the first week of placement, and then weekly thereafter, when possible. The Visitation Plan developed through the Family Support Team process should include the frequency of the visits. It is the worker’s responsibility to assure that the child is present for the visits and that a location is secured. Visits should not be canceled or rescheduled because of unexpected problems with the worker’s schedule, a backup plan should be in place.
   3. Visits should occur in the parental home or in a homelike environment unless determined by the FST that the safety of the child or staff is an issue. Office visits are discouraged.
   4. Seek progress reports after each visit, if the resource providers carry out the visitation plan. The Visitation Reaction Form, CD-85, should be used for all visits whether supervised or unsupervised. If visits are supervised, the Supervised Visitation Checklist should be completed by whoever supervises the visit.
   5. Resource families must be informed that visits should never occur in homes in which a known or suspected methamphetamine laboratory exists or has existed unless it has been professionally treated or decontaminated by a hazardous waste clean-up agency according to the guidelines of the Environmental Protection Agency (EPA).
8. Assist the resource family in providing necessary guidance and behavior management of the child:
   1. Assess the need for residential treatment services via the Residential Referral Treatment form, CS-9, if:
      1. A child’s behavior becomes such that resource family care can no longer meet the child’s needs; and,
      2. A more structured, treatment-oriented environment is needed.

         Related Subject: Section 4 Chapter 4 Subsection 2: Guidelines for Initial Placement Resource Selection, Criteria, and Selection; Section 4 Chapter 13 Placement of the Child with A Subsequent Provider; Section 4 Chapter 9 Permanent Outcomes for Children; and Section 4 Chapter 18 Residential rehabilitative Treatment Services if such placement planning becomes necessary.

9. Assist the resource family and child in terminating or maintaining the relationship to family and other significant persons as desired and as appropriate to the child’s needs when the child is reunified with parents or is placed with another resource family.
   1. The resource providers shall make every effort to support and encourage the child’s placement in a permanent home, including but not limited to providing information on the history and care needs of the child and accommodating transitional visitation, Section 210.566 RSMo.
10. Prepare the child for adoptive placement if this becomes the child’s permanency plan:

    This shall be done irrespective of whether the child will remain with the family currently caring for the child or will move to a new family.

    1. Secure a medical examination, and report for same, within six (6) months prior to the child’s adoptive placement, if adoption is the permanency plan for the child.
    2. Secure a dental examination beginning at age three (3) years, and report for same, within six (6) months prior to the child’s adoptive placement, if adoption is the permanency plan for the child.

       A Healthy Children and Youth assessment will meet the medical or dental examination requirement if one has been completed within the six (6) months prior to the adoptive placement. In those instances in which a report of abnormalities was received, a report of any treatment provided shall be secured.

       The medical and dental requirements can be met, if the child is involved in a current and regular treatment regimen, by securing a report of the child’s health status and continued need for treatment from the attending physician or dentist.

       Physical examinations through the Healthy Children and Youth (HCY) program may be authorized as often as necessary in order to provide completeness regarding the child’s physical condition.

    3. Secure a psychological evaluation and report beginning at age three (3) years and within six (6) months prior to adoptive placement if the child’s permanency plan is adoption.

       Developmental evaluations should be secured for any child from birth to age three (3) years, as indicated by the condition of the child.

       Related Subject: Section 2 Chapter 4.1.12.3 Referral to Early Childhood Intervention and Section 2 Chapter 4.1.14 Notification for Investigations Disposition

       A psychological examination may be waived for a child age three (3) to five (5) years if a resource competent to perform a psychological examination cannot be located. A report of any psychological services provided as a part of the case/treatment plan may be used if this service was provided within six (6) months prior to adoptive placement and is a comprehensive evaluation.

    4. Obtain reports of any specialized treatment (i.e., speech therapy, physical therapy, therapeutic child care, surgical procedures, etc.) currently being provided to the child if the child’s plan is for adoptive placement.

       A synopsis of any of the above reports shall be included in the written summary provided to adoptive parents at the time of placement.

    5. Maintain healthy growth and development through the provision of the usual community health, educational, religious (if appropriate) and socialization services.
11. Record all activities every 30 days.