24.2.1 Initiation of Case

  1. Children’s Division shall ensure that children in the agency’s custody receive appropriate medical and mental health care.  Each child’s care must include:
    1. Emergency treatment, whenever necessary;;
    2. Timely examination and treatment of nonemergency injuries and illnesses;
    3. Provision of ongoing allied health services, like physical or occupational therapy, when recommended. Allied health professionals are not doctors, dentists or nurses, but others who aim to prevent, diagnose and treat a range of conditions and illnesses and often work within a multidisciplinary health team to provide the best patient outcomes;
    4. Proper assessment and care of any behavioral health issues; and
    5. Regular preventive care appropriate to the child’s age and condition, including immunizations
  2. In order to ensure that a child receives the best possible care, collection of a comprehensive medical history is important and required by law.  When a child is placed in alternative care, the Children’s Service Worker placing the child will request pertinent medical information from the parent(s) or other caregiver, to include information necessary to provide immediate care for the child, including present illnesses or other health concerns; allergies; pending appointments and current medications, if any.  That information shall be provided by the Children’s Service Worker to the resource provider at the time of placement and documented in the case record.
  3. The Children’s Service Worker shall specifically ask the parent(s) whether the child is currently taking any medication, prescribed or over the counter, including herbal remedies. The parent(s) response should be documented in the record and the medication, if any, shall be provided to the resource provider at the time of placement, along with written instructions for its use. If the parent(s) reports that the child is supposed to be on medication but is not, or has not been taking the medication regularly, then the Children’s Service Worker should also document that information, including the name of the medication, the prescriber, and the parent(s) explanation for the discrepancy, and follow up with a medical practitioner at the child’s first examination before making any decision about administering the medication.
  4. Collection of medical history and updating the child’s medical records is a continuing and shared responsibility.  The assigned case manager will obtain additional medical records and information from the parent and/or health care providers, using form CW-103 (Child/Family Health and Developmental Assessment) and CD-264 (Health Care Information Summary, and provide this information to the resource provider within 72 hours, if possible, but no later than 30 days following placement. Examples of additional information to be gathered include: immunizations; past hospitalizations; surgeries; dental records; nutritional history; prior medication history, including any allergic reactions or negative side effects; and the names and contact information for all of the child’s current and past mental health, dental, and medical providers. Sections 210.760 and 210.566, RSMo., emphasize the importance of information sharing with resource providers. The law requires the Children’s Division to provide resource providers with full disclosure of all medical, psychological, and psychiatric conditions of the child, including the provision of full and accurate medical information and medical history to the persons providing foster care at the time of placement.
  5. Initial Family Support Team (FST) Meeting:  At the first FST meeting following the child’s placement in alternative care, the assigned case manager shall inform parent(s) that the Children’s Division will expect them to take an active role in healthcare decisions about the child, unless the FST determines that would be contrary to the best interests of the child.  An active role would include, but is not limited to:
    1. Attending the child’s appointments;
    2. Demonstrating an understanding of the child’s health status and recommendations of any providers; and
    3. Providing necessary care and medication during visitation and trial home placement.
  6. The Children’s Division case manager shall keep the parent(s) informed of the child’s health and medical decisions.  The Children’s Division case manager is responsible for the child’s medical and mental health care while the child is in Children’s Division custody.  The case manager shall partner with the parent(s), the child (to the extent reasonable for the child’s age and understanding), resource providers, and primary health care providers and the case manager will attempt to contact these partners prior to the provision of any treatment.  The parent(s) will be asked to return the completed CD-103 within a week of the Initial FST if not returned at the time of the meeting.
  7. All information about the child’s medical care while in out-of-home care shall be shared with the parent/caregiver on an ongoing basis. A copy of the complete medical history should be furnished to the parent/guardian unless termination of parental rights (TPR) has occurred or the court has issued an order providing the parent/guardian should not have access to the information.

Chapter Memoranda History: (prior to 1/31/07)

Memoranda History: