CHILD WELFARE MANUAL

Section 4, Chapter 2 (Placement), Subsection 1 – Common Placement Types

Effective Date: 10-1-21

 

Emergency Placements

Emergency placements require a determination to be made that serious danger exists for a child if the child remains in the care of his/her parent(s) and that the delivery of treatment services will not provide immediate protection for a child.

The report to the court will likely be made after the placement has occurred and should indicate the emergency conditions necessitating out-of-home placement.

The report shall include a request that the court, in its dispositional order, make a determination that such conditions exist and that reasonable efforts to prevent placement would not secure, for the present, a safe environment for a child.

Placement Options

Selection of the most appropriate placement resource is guided by the assessment of the child’s unique needs and personality, and the placement provider’s capacity and skills in meeting those needs that are in the best interest of the child.  All efforts to locate parents, relatives, and other least restrictive placements should be documented in FACES.

Placement shall be in the least restrictive that serves the child’s best interest and special needs. The preference for placement is as follows (in order from most to least desirable – see the Placement Hierarchy on e-forms for more detailed information):

2.1.1 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
  • Evidence indicates only one of the parents is the subject of an investigation of abuse or neglect
  • 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. 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
  • 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.

2.1.2 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).

The definition of sibling shall be: one of two or more individuals who have one or both parents in common through blood, marriage, or adoption, including siblings as defined by the child’s tribal code or custom.

2.1.3 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 6 of this manual.

The status of a grandparent shall not be affected by the death or the dissolution of the marriage of a son or daughter.

If the child is not placed with grandparents, the Children’s Service Worker must document in FACES 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 (including adult siblings and parents of siblings) 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 FACES. If more than one grandparent requests placement, the Family Support Team will make a recommendation to the court regarding placement.

These statutes allow staff to contact grandparents and other relatives without a signed release of information form or permission from the parents. However, no protected health information about the parents should be disclosed.

2.1.4 Placement with Adult Siblings or Parents of Siblings

According to state law, a child’s placement should be made with an adult sibling (a sibling of the child that is 18 years of age or older) of that child or the parent of a sibling of that child if at all possible.  The definition of sibling is any children that share at least one parent.

2.1.5 Placement with Relatives

If grandparents are not available or are not able to care for their grandchild, Section 210.565, RSMo states other relatives should be given first preference and first consideration over non-related 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 in FACES. 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 FACES 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 or has a close relationship with the child and/or the family.   Relatives within the 3rd degree have preference for placement over others who are not as closely related.

The age of the child’s relative shall not be the sole 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.

After identifying a potential relative care provider, the Children’s Division Worker should ask the family to describe the relationship with that individual/family, to include the following:

  • Provider’s relationship to the foster youth and length of involvement with the family
  • Description of the provider’s involvement with the family, i.e., provided care for the foster youth and/or parent, assisted the family through crisis, provided moral support, member of church or community organization, neighbor, etc.
  • Whether the provider ever resided in the home with the parent or foster youth and, if so, how long and when

The parent of the foster youth shall not live in the relative foster family home with the foster youth with the exception of those parents of foster youth who are also in the legal custody of the Children’s Division (CYAC), unless ordered by the court. If a court orders that a parent of the foster youth may remain in the resource home, the parent of the foster youth shall be in compliance with 211.038 RSMo background check results.

The resource home will not be eligible for maintenance payments if the foster youth’s parent(s) reside in the resource home. If the resource home was not previously licensed, they will not be eligible for licensure if the foster youth’s parent(s) resides in the resource home.

Steps for Placing a Child in a Relative Home – see Section 6.

2.1.6 Placement with Former 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.

2.1.7 Placement with Foster Parents

Any foster parent who is currently licensed and capable of accepting placement of the child. Preference is given to foster parents that have cared for the child in the past.

 

2.1.8 –Residential Providers (Group Setting)

There are several types of residential providers, including group settings and treatment settings.  The residential agencies licensed by the Children’s Division in accordance with 13 CSR 35-71 include the following facility types:

  • Emergency Shelter: This is a short-term resource for children requiring an immediate, temporary living arrangement in an open facility where their safety and supervision is ensured through an organized program of appropriate activities.
  • Moderate Need (Level II):  This is an extended placement resource for children requiring a planned program affording safety, structure, and supervision. This level is indicated for children who by reason of behavioral disorder, maladaptive behaviors, family situation, relationship problems with family, and level of development are unable to accept traditional family ties and/or successfully participate in traditional family settings. Residential treatment facilities, should provide reunification services, work with the family, community based services, schools, etc. as a part of therapeutic services provided.
  • Severe Need (Level III):  This is an extended placement resource for children requiring active, coordinated, and professional intervention on a residential basis. This level is indicated for children who cannot be effectively managed in a less restrictive setting. These children have a significant emotional and/or psychiatric need. These children have continued difficulty adjusting to an open public school setting. Residential Treatment agencies should provide reunification services, work with the family, community based services, schools, etc. as a part of therapeutic services provided.
  • Intensive Need (Level IV):  This is an extended placement resource for children requiring active, coordinated, and professional intervention in a highly structured and secure environment. Such children will have demonstrated an inability to function in any less restrictive setting. This level is indicated for children who have a significant emotional and/or psychiatric need. These children, present a chronic runaway risk, and typically present a history of impulsivity, intensify of behavioral problems, significant family issues, self-destructive behaviors, etc. Residential Treatment agencies should provide reunification services, work with the family, community based services, schools, etc. as a part of the therapeutic services provided. They present a chronic runaway risk. They also typically present a history of showing rage, including physical aggression.
  • Infant/Toddler Care: Residential care services provided to serve children under the age of seven, including those who are medically fragile or drug and alcohol-affected children and severely emotionally disturbed.

2.1.9 – Qualified Residential Treatment Program (QRTP)

A QRTP is a licensed residential treatment program that has met all program requirements for designation as a QRTP.  All QRTP programs shall be trauma-informed, accredited, and utilizing on-site nursing and clinical staff.  More information about the QRTP designation can be found in Section 4, Chapter 2 (Placements), Subsection 6 – Qualified Residential Treatment Program (QRTP) Designation. 

2.1.10 – Psychiatric Residential Treatment Facility (PRTF)

A PRTF is a program that provides inpatient psychiatric services furnished in a psychiatric residential treatment facility.  Approval for placement in this setting requires rigorous review by an independent team, which includes a physician.  These settings are not licensed by the Children’s Division.  The Department of Health and Senior Services (DHSS) is responsible for the certification of PRTF settings in Missouri.  More information about PRTF facilities can be found in Section 4, Chapter 2 (Placements), Subsection 7 – Requirements for Psychiatric Residential Treatment Facility (PRTF) Placements.

 

2.1.11 – Sex Trafficking Program

A licensed residential treatment program that incorporates trauma-informed standards and care providing high-quality residential services for the safety, permanency and well-being of children (under twenty-one years of age) who are sex trafficking victims.

 

2.1.12 –Transitional Living Provider

The Transitional Living Program (TLP) is intended for a youth, typically age 16 and over; whose permanency goal is not reunification, adoption or legal guardianship. The purpose of the transitional living program is to provide a living environment in the best interest of the youth that provides a path for the youth to transition from alternative care to self-sufficiency and achieves the outcome of preparing the youth to live independently.  More information about transitional living providers can be found in Section 4, Chapter 5 (Older Youth Program), Subsection 4 – Transitional Living Program

2.1.13 – Family Based Residential (FBR)
A Family Based Residential placement is used for a child in the legal care and custody of the Children’s Division to be placed with a parent in a licensed residential family-based treatment facility for substance abuse for up to 12 months. These settings are not licensed by Children’s Division, but are licensed and contracted with Department of Mental Health (DMH), Division of Behavioral Health (DBH). More information about FBR facilities can be found in Section 4, Chapter 2 (Placements), Subsection 8 – Requirements for Family Based Residential (FBR) Placements.

2.1.14- Maternity and Maternity with Infant Care
These are Residential care services provided to serve pregnant and parenting adolescents to help prepare them for parenthood and self-sufficiency.

Related Practice Alerts and Memos:

1-3-20 – PA20-RD-01 – Relative Resource Placement Consideration

1-15-19 – https://dssmanuals.mo.gov/wp-content/uploads/2019/01/cd19-01.pdf

6-11-20 – CD20-23 – Update on Placement Hierarchy and Diligent Searches