§4 ch4: Selection of Placement Resource and Placement Options
4.2 Guidelines for Placement Resource Selection:
Placement shall be in the least restrictive setting needed that serves the child's best interest and special needs. -The general preference for placement is as follows:
- Placement with a Fit Parent - Section 211.037, RSMo, states children shall be promptly returned to the care and custody of a non-offending parent entitled to physical custody of the child if:
- The parents have continuously maintained joint domicile for a period of at least six months prior to the alleged incident or the parents are maintaining separate households, and
- Evidence indicates only one of the parents is the subject of an investigation of abuse or neglect, and
- The non-offending parent does not have a history of criminal behavior, drug or alcohol abuse, child abuse, or child neglect, domestic violence, stalking, or full orders of protection entered against them within the past five years, and
- The worker shall request that a local or state law enforcement agency or juvenile officer immediately conduct a name-based criminal history record check to include full orders of protection and outstanding warrants by using the Missouri Uniform Law Enforcement System (MULES) and the National Crime Information Center (NCIC) to initially assess whether the non-offending parent holds a criminal history.
- The parents are maintaining joint domicile and the offending parent is removed from the home voluntarily or involuntarily, or the parents live separately and the child is removed from the home of the custodial parent; and
- A non-offending parent requests custody of the child and agrees to cooperate with any orders of the court limiting contact or establishing visitation with the offending parent and the non-offending parent complies with such orders.
- Placement with Siblings- A priority should be made to place siblings together. In addition, a priority should be made to place a minor parent and child together, whenever possible. CD must make reasonable efforts to place siblings in the same placement unless doing so would be contrary to the safety or well-being of any of the siblings. If siblings are not placed together, the state must make reasonable efforts to provide frequent visitation or other ongoing interaction between the siblings, unless this interaction would be contrary to a sibling’s safety or well-being. (Section 210.565 RSMo.)
- Placement with Grandparents - Section 210.305, RSMo, requires the Division to give preference and first consideration for foster care placement to grandparents of a child. The Children’s Division must conduct an immediate diligent search to contact, locate, and place with grandparents once the decision has been made to take custody during the first three (3) hours after placement. The statute requires staff to place with grandparents unless the decision to place with grandparents is contrary to the welfare of the child. The statute also requires staff to continue to make diligent efforts, while the child is in care, to contact, locate, and place the child with a grandparent or another relative, with first consideration given to a grandparent for placement. To make emergency placements with relatives or kin, follow the Purpose Code “X”screening process outlined in Section 4 Chapter 12.3.
If the child is not placed with grandparents, the Children’s Service Worker must document in the case narrative and on the child’s CS-1 why the child was not placed with grandparents. If no grandparents can be found, preference for placement must go to other relatives.
- The law also requires the Children’s Division to identify and notify all adult grandparents and other adult relatives within 30 days when a child is removed from the custody of their parent(s). Some of these relatives may include: adult siblings, grandparents, aunts, uncles, great-grandparents, great aunts, great uncles, half-brother, half-sister, and first cousins. If relatives cannot be identified or found initially, the search for grandparents and other relatives should continue while the child is in care. These efforts should be documented in the case narrative and on the child’s CS-1.
- These two legislative changes allow staff to contact grandparents and other relatives without a signed release of information form or permission from the parents.
- Staff should utilize all available resources to meet the ongoing health and safety needs of the child, and to locate a grandparent or grandparents of the child after all of the child's physical needs have been attended to. A good faith attempt to locate grandparents should be documented in writing. At minimum staff must:
- Ask the parents, children, and other relatives for names, addresses, and/or other contact information for all of the grandparents, if unknown
- Utilize diligent search efforts to locate the grandparents, if their whereabouts are unknown
- Attempt to notify grandparents, and leave a message asking them to return the call, and
- Ask grandparents if they are interested in placement of the child
If more than one grandparent requests placement, the Family Support Team will make a recommendation to the court regarding placement.
- Placement with Relatives-If grandparents are not available or are not interested in caring for their grandchild, Section 210.565, RSMo states other relatives should be given first preference and first consideration over non-related kinship resource providers, if the court has determined relative placement is not contrary to the best interests of the child. Staff should also document their efforts to locate relatives in their case narrative and on the child’s CS-1. The court of jurisdiction must make specific findings on the record detailing why placement with a relative is not in the best interests of the child. If a child is not placed with a relative, staff must document in the case narrative and on the child’s CS-1 why placement with relatives was not in the best interest of the child.
- As used in this section, the term “relative” means a person related to another by blood or affinity within the third degree. The status of a grandparent shall not be affected by the death or the dissolution of the marriage of a son or daughter.
- The age of the child’s relative shall not be the only factor that Children’s Division takes into consideration when it makes placement decisions and recommendations to the court about placing the child with such relative.
- Placement with Kin-Kinship is a person who is non-related by blood, marriage or adoption who has a close relationship with the child or child's family (godparents, neighbors, teachers, close family friends, and fellow church members) or a person who has a close relationship with the child or child's family and is related to the child by blood or affinity beyond the third degree
- Placement with Foster Parents-Recognizing the critical nature of attachment for children, if a child re-enters the foster care system and is not placed in a relative home, the child’s former resource parents shall be given first consideration for placement of the child per Section 210.566 RSMo.
- Any foster parent who is currently licensed and capable of accepting placement of the child.
Guidelines to Establish Contrary to Best Interest of the Child:
- Child has no serious emotional, physical or behavioral problems that the non-custodial parent/relative/kinship relationship is unable to handle
- Careful evaluation indicates the non-custodial parent/relative/kin will be supportive of the goals of the placement
- It appears the child may be more accepting of separation from his parent(s) if he/she were to be placed with non-custodial parent/relative/kinship with whom he/she is more familiar
- Child has some positive relationships formed with the non-custodial; parent/relative/kinship and is already familiar with the life style and expectations of the family
- Child, by this association, feels that he/she is still maintaining some relationship with his/her parent(s)
- Evaluation of the non-custodial parent/relative/kinship home indicated that it would not perpetuate the same negative family patterns necessitating the need for placement
- Geographic proximity of the non-custodial parent/relative/kin's house allows for continued planned involvement with the child's parent(s), and
- No one in the home has been convicted of certain felony offenses in chapters 566 or 568 listed in the kinship licensing requirements.
Consideration of Child Needs
The following criteria should also be considered when making placement decisions:
- Placement shall be made with a family that can best preserve the cultural identity of the child.
- For any Native American child placed in protective custody, the Children’s Division shall comply with the placement requirements set forth in 25 U.S.C. Section 1915.
- Placement shall be in reasonable proximity to the child's parents while accommodating the child's special needs.
- Placement shall be made with a family that can best meet the needs of the child including the preservation of the child’s cultural identity.
- Placement shall be in a licensed home which has a contract with this Division to provide foster care, relative/kinship care, foster/adoptive care, residential treatment, and family group home services.
- The selection of an appropriate resource depends on the complexity of the child's treatment needs and case plan. Each of the following resources, generally, follows an ascending order in capacity to meet the child's level of treatment needs. In certain instances, a resource to meet the child's needs may not be available or cannot be developed.
The Children’s Service Worker shall explain to the family that possible placement resources for the child may include:
- Non-Custodial Parent - This placement is preferred if the parent can meet the child's needs and is supportive of the case plan.
- Relative or Kinship Placement - This placement is recommended if the resource is supportive of the case plan.
- Resource Family - This resource is recommended for a child of any age who can benefit by placement in a family setting and in a community where access is available to schools, friends and resources. Different foster families provide specialized levels of care, which are designed to meet the special needs of children.
- Large Family Resource Home - This resource is recommended for a child who is a member of a sibling group and/or for a child who can use peer support and needs to have easy access to school, friends, and community resources while remaining in a family setting.
- Emergency Residential Placement - This resource is recommended when the child's needs require an extensive evaluation and/or structure and supportive services. This is a placement until the needs of the child can be determined or until a placement in a residential treatment facility is available which can meet the child's specific needs.
- Residential Treatment Facility - This resource is recommended when the child needs a highly structured environment and extensive supportive services.
- Level "II" (moderate) residential treatment services: Child has mild to moderate social, behavioral, educational, and emotional problems, is in need of a diagnostic assessment, but can tolerate an "open" environment.
- Level "III" (severe) residential treatment services: Child's emotional disturbance is so severe as to require comprehensive, intensive treatment and services, and a structured, supervised environment.
- Level "IV" (intensive) residential treatment services: The child may have been in a psychiatric hospital and/or the child's emotional/behavioral disturbance is so severe as to require a level of care more intensive than that provided in level "III" residential treatment services.
- Therapeutic Foster Care (TFC) – This resource is recommended when the child needs highly intensive individual treatment in a family foster home setting and community environment. TFC should be utilized for children with significant emotional, or behavioral needs, who, with additional resources, can remain in a family setting and achieve positive growth and development.
- Psychiatric Hospital Placement - This resource is recommended when the child's emotional disturbance is so severe that the child is a danger to themselves or others. Psychiatric hospital placement should only be used when a less restrictive setting cannot better meet the child's needs. Psychiatric hospitalization is for evaluation only and is not considered a "permanent plan." Prior to psychiatric hospitalization, the Children’s Service Worker shall refer the child to the psychiatric diversion program according to local guidelines.
- Pre-Waiver Placement – placement in a DMH-DD licensed home prior to a waiver slot being available.
- Youth must be deemed Medicaid Waiver eligible and on CD’s waiver wait list;
- CD and DD case managers should work together to locate appropriate placement for youth based on individual needs;
- These youth must be placed with another DD waiver client in the home or the services coordinator must agree in writing to provide necessary licensing oversight as required by DMH-DD.
- Pacement is funded by CD; providers should invoice CD directly for the services and room and board for these youth.
- There is an Interdepartmental Agreement (IDA) between CD and the Division of Developmental Disabilities (DMH-DD) to provide assistance with locating placement for a Medicaid Waiver eligible child when all other appropriate placement resources have been explored and are not available.
- Prior to the placement and during the term of any residential placement, CD and DMH-DD case managers will work jointly on permanency planning for the child when appropriate
- Children will remain in CD custody until the child reaches the age of 21. Transition planning should start to occur on the child’s 20th birthday.
- The provider of these placements will invoice DMH-DD using the IDA and DMH-DD will invoice CD for services and room and board based on the IDA guidelines.
- CD will maintain case managerial responsibility for children referred to DMH for placement. Coordination for services, placement, and transitional planning with DMH-DD should occur monthly.
- Placement with a Fit Parent - Section 211.037, RSMo, states children shall be promptly returned to the care and custody of a non-offending parent entitled to physical custody of the child if:
- Adoptive family- The child's case plan goal is adoption.
- Adoption can become the permanency goal for any child in Children’s Division (CD) custody and in out-of-home care. Adoptive family placement or adoption by a foster, relative, or kinship family should be the placement of choice when this occurs. It may be necessary to place a child with an approved adoptive family who needs temporary financial assistance until the adoption is final or the adoption subsidy agreement is approved for an eligible child. In this situation, the family must meet the requirements for this placement.
- Subsidized Guardianshipv - The subsidized guardianship program provides eligible relatives or families with the same services that adoptive parents would receive under the Missouri adoption subsidy program. Relatives who qualify for this type of subsidy are defined by 453.072 RSMo and are any grandparent, aunt, uncle, adult sibling of the child or adult first cousin of the child, or any other person related to the child by blood or affinity; Close nonrelated person means any nonrelated person whose life is so intermingled with the child such that the relationship is similar to a family relationship. A qualified child is a child who is or has previously been in the custody of one of the following: Children’s Division (CD), DYS, DMH, or a licensed private child caring/placing agency and who meets the special needs requirements.
The Children’s Service Worker and family (all parents and child) discuss which of these options would be most appropriate for the child.
The Children’s Service Worker and family (all parents and child) select the most appropriate resource and proceed to implement the steps to place the child in the resource selected.
A Large Family Resource Home Could be Considered if Several of the Following Apply:
- No suitable non-custodial parent, relative, or kinship family resource can be developed;
- If a child reenters the foster care system and is not placed in a relative home, the child’s former foster parents shall be given first consideration for placement of the child, per Section 210.566 RSMo.
- The child is very young (under 6) and is normal or near normal in development
- The child is of school age and is normal or near normal in development and/or has limited personality, health, and physical handicaps
- The child of any age who can profit by placement in a family setting and in a community where access is available to schools, friends, and resources
- Immediate placement is necessary, and a diagnosis and treatment plan is needed
- The family's situation indicates that the child will be able to return to his/her own home within a short time, or time is needed to select an adoptive home or other permanent placement for the child
- The child has been in residential care and placement with a family will ease the transition from residential facility to the child's own home or other permanent placement
- The child is pregnant and unmarried, needs to work through related problems with own family, and
- A young child placed in Division custody is legally free, or almost legally free, for adoptive placement and an assessment of the child's physical and/or emotional condition is required.
Issues to be Considered in Selecting a Particular Resource Family:
- Proximity of the resource home to child's family in order to facilitate visitation and reunification
- Extent to which the resource family can accept the child's relationship with his/her family and can deal adequately with situations which may arise from that relationship
- Ability of resource family to preserve the child's cultural identity
- Extent to which interests, strengths, and abilities of the resource family enable them to relate to the child's needs, including his/her individual problems, age, interests, intelligence, moral and ethical development, family relationships, educational status, social adjustment, and plans for the future
- Extent to which the resource family can meet the needs of a sibling group, in order to avoid the separation of siblings, and
- There should be no more than six (6) children in a resource home. If, by placing a sibling group in the home, the allowable placement limit is exceeded, no other children shall be placed in the home until the home is again within allowable capacity.
- Proximity of resource family to specialized services or facilities which the child may need.
- Restrictions on placement, custody, visitation or reunification for minors who were determined to be either a victim or a perpetrator in an incident of abuse between minors. (Section 210.117 RSMo., Section 210.710 RSMo., Section 210.720 RSMo., and Section 211.038 RSMo.)
A Resource Family Group Home Should be Considered if Several of the Following Apply:
- The child is at least six (6) years of age or younger, if part of a sibling group, and needs can best be served by keeping the children together
- The child is mildly to moderately acting out and can benefit from peer support in a group setting
- The child can tolerate sharing adult attention with other children
- The child does not need intensive therapy or structured supervision
- The child can profit by placement in a family setting which provides access to school, friends, and resources available in a community
- The child has been in residential care and placement with a family will ease the transition from this care to the child's own home or other permanent placement, and
- The child is pregnant and unmarried and needs to maintain confidentiality or work through related problems with own family.
A Level "II" (Moderate Need) Residential Treatment Facility is for Children Generally Typified by Several of the Following:
- The child has mild to moderate social, behavioral, educational, and emotional problems
- The child is in need of a diagnostic assessment
- The child needs assistance in educational, religious, recreational and/or socialization experiences
- The child displays behaviors such as, running away, school truancy, incorrigibility, sexual misconduct, drug experimentation, physical display of intense anger, verbal or physical abuse toward authority figures
- The child is of average intelligence and exhibits adequate responses to reality testing, and can function in a regular or alternate community school or can benefit from on-site tutorial or educational services where available
- The child needs structure and supportive services not available in a resource family or large family resource home
- The child is emotionally disturbed and his/her past experience is such that he/she is unable to be supported in a resource family or adoptive home
- The child is in need of more structure, but still can be supported in an open environment, where he/she can be studied and observed by the child care staff, social workers, psychiatrist, and psychologists, and where a diagnosis can be made and treatment plan can be developed and implemented, and
- The child and family are in need of family and group counseling and/or social work services as part of the comprehensive case plan.
A Level "III" (Severe Need) Residential Treatment Facility is for Children Generally Typified by Several of the Following:
- The child's emotional disturbance is so severe as to require comprehensive, intensive treatment and services (i.e., psychotherapy, both individual and group; educational training, vocational training, social and cultural enhancement, after-care services) and structured supervision
- The child and family need "family therapy"
- The child is in need of psychological/psychiatric diagnostic assessment
- The child has serious behavior deviations (i.e., severely aggressive, chronic enuresis or soiling, chronic running away, fire setting, sexually acting out, bizarre sexual behavior, chronic truancy, incorrigibility, drug usage, suicidal gestures, chronic nightmares, extreme temper tantrums, severe relational problems)
- The child is depressed, has low frustration tolerance, neurotic and personality disorders, psychosomatic illnesses, delayed emotional development, mild or severe forms of anorexia and thought or affect disorders, i.e., jumbled speech pattern, inappropriate response
- The child is a danger to self or others, or is severely withdrawn
- The child cannot function in a public school setting because of his acting-out behavior and/or severe learning deficits
- The child needs extensive professional help in areas of social skills, learning skills, and/or motor skills, and
- The child exhibits behaviors that require a highly structured setting providing intensive treatment services.
- The degree of severity of these conditions may indicate that hospitalization may be more appropriate. The Children’s Service Worker should seek additional supervisory or consultation assistance when considering whether referral for hospital care is needed.
A Level "IV" (Intensive Need) Residential Treatment Facility is for Children Generally Typified by:
- Previously receiving care in an acute-care hospital, but who do not currently need in-patient psychiatric treatment, or
- Having treatment needs which cannot be met by any of the residential care facilities contracted with the state to provide level "III" (severe need) care, and
- Demonstrating treatment needs which require the following services:
- Psychiatric supervision and review of the child's individual treatment wherein the psychiatrist's physical contact with the child occurs no less than once every 30 days
- Treatment encompassing a coordinated plan using at a minimum, group and individual therapeutic modalities consistent with the needs of the child, and
- Classroom education (required by law) provided in a school located at the provider's facility.
Selection of an Adoptive Family Should be Considered if Several of the Following Apply:
- The child is healthy or the selected family can accept any risks
- The child is legally free or very likely to be legally free and the selected family accepts the minimum legal risks; i.e., the biological parents are making a voluntary decision to release the child for adoption
- The goal of adoption is established for the child at entry into CD custody, but termination of parental rights (TPR) is not complete
- The goal of adoption is established after the child enters CD custody, a TPR petition for either or both birth parents has been filed, subsequent placements for the child becomes necessary, and such placement would prevent future replacements and be beneficial for a specific child
- A child of an older age understands and accepts an adoptive placement, and
- An adoptive family is available or can be recruited to meet the needs of the child.
- Families selected and recruited for the child must be approved for adoption. In some instances, financial assistance may be needed for the child's care until the adoption is completed or the adoption subsidy agreement is approved for an eligible child. The family can be licensed for foster/adoptive care (FA). Licensed resource families who adopt a child who is in their care do not have to be licensed for foster/adoptive care (FA) to receive financial assistance.