(Effective 7/21/20)
Table of Contents
9.1 Immediate Safety Intervention
9.1.1 Components of the Immediate Safety Intervention Plan (CD-263)
9.2 Background Checks for Diversion Placements
9.4.1 Components of the Family Safety Planning Document (CD-267)
9.6 Responding to Youth Presenting Signs of Suicide
9.1 Immediate Safety Intervention
Safety interventions are actions or supports put in place to manage the safety threat to the child. Immediate safety interventions are used to manage the safety threat to the child when a child has been determined to be unsafe to allow for more thorough assessment and long term safety plan development.
The Immediate Safety Intervention Plan (CD-263) is to be used to document any necessary interventions to address immediate safety concerns. The CD-263 is utilized when there is not sufficient time to develop the Family Safety Planning Document (CD-267) due to the immediacy of the safety concerns.
The CD-263 should be used when there is identifiable and likely danger to the child(ren), there is insufficient existing safety to mitigate the danger, and some relatively immediate action is needed to keep the danger from actually occurring.
Development of a CD-263 should:
- Involve the caregiver and relevant safety network members in the development of the safety plan as much as possible;
- Utilize the family’s own resources first;
- Utilize the least intrusive interventions that will manage the safety concern;
- Involve the alleged perpetrator to the extent possible without compromising the safety of the child(ren). The nature of their relationship to the child(ren) and family should be taken into consideration in deciding how the alleged perpetrator involvement will happen;
- Assess the reliability of sources or providers of the action or supports. (Informal: friend, relative, neighbor or formal: school, agency, program…etc.). This may involve basic background checks to assess for past criminal or child protection allegations/convictions/determinations;
- Develop interventions to accommodate time elements (for example, weekends and holidays may require different actions than daytime hours during the week, etc.);
- Develop overlapping interventions to accommodate scheduling for the source or provider or to address times when the safety concern is active;
- Take into consideration the tradeoffs the family may have to make in order to implement the safety intervention;
- Be conscious to not create further trauma to the family.
Generally immediate safety interventions that address immediate danger should meet the following criteria:
- Immediately available – can be deployed right now and in sufficient quantity;
- Action oriented – steps/agreements that are active and focused with respect to safety concerns, not change or treatment related;
- Flexible access – safety resources that are located in acceptable proximity and can be called upon for immediate response;
- Immediate impact – actions or resources that do what they are supposed to do as they are delivered and achieve the objective…keep children safe;
- No promissory commitments – Immediate Safety Intervention Plans will never rely on parental promises to stop the threatening behavior, for example, will stop drinking, or will always supervise the child. Immediate Safety intervention Plans should provide an alternative action or a third party protective source to assist in preventing the actualization of the danger statement.
When developing an Immediate Safety Intervention Plan (CD-263) that involves either a parent who is an alleged perpetrator or a child leaving the home, staff must exercise extreme caution to balance the safety of children while respecting the parents’ constitutional rights. Parents and children have a well-established constitutional right to live together without governmental interference. The right is an essential liberty interest protected by the Fourteenth Amendment’s guarantee that parents and children will not be separated by the state without due process of law, except in an emergency. Therefore, a decision to develop a CD-263 without involving the court must be made with careful consideration.
If staff believe a child is in imminent danger or cannot be safely maintained in the care of their parent, a referral to the juvenile office should be made when it is unlikely that the threat of danger will be eliminated in a reasonable timeframe. It may be necessary to develop an Immediate Safety Intervention Plan placing the child outside the home while waiting for the court process to occur.
Any time a CD-263 is needed to manage a safety threat to the child, the Immediate Safety Intervention Plan may only be put in place for ten (10) days, but may be extended as described below. There are two general types of Immediate Safety Intervention Plans:
- When the child is maintained in the home with their parent/caregiver. In situations where the child has been maintained in the home, but a CD-263 has been developed and it is necessary to continue the CD-263 beyond ten (10) days, a supervisor consultation must be held to determine the most appropriate next steps with consideration being given to holding a Team Decision Making (TDM) meeting (where available) or a Master’s Level Consultation and/or opening a Family Centered Services (FCS) case.
- When the child and the parent/caregiver have been separated. In situations where the child and the parent have been separated through a CD-263, a TDM/Master’s Level Consultation must be held before the separation occurs, or in emergency situations by the next working day. If the parent fails to follow through with the plan developed in the TDM/Master’s Level Consultation within ten (10) days, a referral to the juvenile office should be made. If during the ten (10) days a new safety threat is identified, a TDM/Master’s Level Consultation should be re-convened to develop a new plan for the family.
Staff must carefully monitor all CD-263’s and these cases must be given high priority, especially when the child is particularly vulnerable due to age, developmental or medical needs, or concerns related to the parents ability and/or willingness to abide by the Immediate Safety Intervention Plan. Such monitoring actions include, but are not limited to, announced and unannounced home visits by the worker or trusted safety network member. Supervisors must staff cases with an open CD-263 at the time safety is re-assessed at the end of each ten day period. In most circumstances, a referral to the juvenile office should be made if there is no real likelihood the threat of danger can be mitigated within a reasonable time period.
Under no circumstances may a Child Abuse/Neglect report be closed with an open CD-263 unless the case has been referred to ongoing case management. However, the ten (10) day rules described above still apply even if a case is being opened and the CD-263 must continue to be monitored closely. To clarify, when there are concerns of abuse/neglect by the parent/caregiver, the Children’s Division shall not close out its involvement with the family while a child is placed outside of their parent/custodian’s physical custody as a result of a CD-263. Power of attorneys should not be used by the Children’s Division as a safety intervention. They may be used in limited situations to support the alternative caregiver while a CD-263 is in place.
Example: A parent has neglected their child and is not currently an appropriate caregiver due to their active drug use. The child is placed with a grandparent while the parent addresses their drug use. A power of attorney may be necessary for the grandparent to obtain medical care for the child while the parent is in inpatient treatment. However, the CD-263 remains in place while the Children’s Division works with the parent to address the safety threat related to the substance use concerns. Therefore the child abuse/neglect report may not be closed without either a referral being made to the juvenile office and/or a Family Centered Services (FCS) case being opened, dependent on the case specific circumstances.
Staff must clearly document in the case record when the CD-263 is terminated and the rationale for determining the child to be safe.
If at any time the juvenile office rejects a referral, staff must follow up with the juvenile officer to determine the reasons for the rejection and to ensure the Children’s Division’s worries have been clearly articulated. If the juvenile office continues to refuse to take action on a child who has been placed outside of the home on a CD-263, the case must be staffed with a supervisor or higher level manager to determine the most appropriate next steps.
9.1.1 Components of the Immediate Safety Intervention Plan (CD-263)
We are concerned about:
This section should describe the danger to the child. If developed, this would include the danger statement. This section may also explain how there is not sufficient existing safety to keep the child safe from the identified danger. Information from the safety scaling question may also be included.
Example: It has been reported to the Children’s Division that Susie has been sexually abused by her father, John, who is currently residing in the home with Susie. (Even though Mom rated safety for her children at a 9, Dad rated it at a 10, and the Children’s Division is only able to rate it at a 2 at this time because they haven’t had time to talk to all the family members and others who know the family best). CD is worried that Susie could be touched sexually and/or John could be accused of touching Susie sexually if they are alone together before everyone has a clearer understanding of what caused the recent allegations.
To prevent the worries from happening:
This section should describe the specific action steps that need to be taken to reduce the danger to the child(ren). If developed, this could include the safety goal. It is important that the action steps be developed with the input of the caregiver(s) and an initial safety network. All safety network members who are being relied on for an action step must be consulted and their agreement to participating in the safety intervention verified prior to implementing the CD-263.
Example: John agrees to leave the home and stay with his parents. The Children’s Division has spoken with John’s parents and they agree with this plan. The Children’s Division will schedule a forensic interview for Susie as soon as possible. Susie’s mom agrees to not allow Susie to have any contact with John.
If the worries DO start, we will respond by:
There are times in any safety plan that unforeseen circumstances may arise that place the child(ren) in danger. This section should describe the steps that will need to be taken in the event that the prevention plan does not work and the child(ren) becomes unsafe.
Example: Susie will call her maternal grandmother if John comes to the house or attempts to make any contact with her. Her grandmother will then notify Susie’s mother and the Children’s Division if this occurs. Susie’s mom will call John’s father if John comes to the home and refuses to leave. If John’s father is unable to get John to leave, Susie’s mom will call law enforcement.
These are our safety and support people:
Any safety network member actively involved in the immediate safety intervention should be listed along with their contact information. Other safety network members that may be a support to the family, or who could be involved in long-term safety planning may also be listed.
Monitoring / Timeframes:
This section should include a timeframe for how long the CD-263 will be in effect and how the plan will be monitored.
Example: The Children’s Division will meet with the family after Susie’s forensic interview to determine what will need to happen next, if this plan can be lifted, or if it needs to be adjusted.
A detailed plan for monitoring a safety intervention/plan is a critical piece of the safety planning process. It must be clear to everyone involved in the safety interventions what their responsibilities are in relation to the intervention, what the plan for monitoring is, and that monitoring includes a focus on:
- Successful use of the plan/intervention;
- Safety plan effectiveness and the need for adjustment and modifications;
- Ongoing assessment of the identified safety threats;
- The emergence of new threats or escalating threats; and
- Conditions are either resolved or no longer meet the safety threshold criteria.
In developing a plan for monitoring a safety plan, the worker must consider the following:
- As long as conditions are unsafe safety interventions must be in place;
- When there is no longer a safety threat, the need for a safety plan is resolved; and
- Understanding up front that Immediate Safety Intervention Plans must be monitored and may need to be adjusted or modified to assure the interventions are effectively controlling the threat of danger.
The plan for monitoring the safety plan must include:
- Who will be used in the monitoring plan?;
- If the worker uses another source to monitor the plan, how, and how often will it be communicated to the worker?
- Date/time of initial follow up? Protective actions are short term interventions that must be effective immediately until more information can be gathered and safety interventions can be developed. Initial follow up should be within a day or two.
- Frequency of monitoring action. Frequency should be made according to the situation; no active safety plan should go longer than ten (10) days before between monitoring actions.
- Monitoring Action – Direct contact with the caregiver, protective resource or child by the worker or a safety network member. If the worker is not the one monitoring the plan directly, the worker should be updated by the safety network member according to the specified plan.
Monitoring includes:
- Verification of implementation;
- Participation of participants;
- Effectiveness of intervention;
- Credibility, availability, and accessibility of the safety network;
- Flexibility, adjustability of safety interventions that are not controlling the safety threat;
- Understanding from the participants that plans must be modified if the Immediate Safety Intervention Plan is no longer effective in controlling the safety threat;
- Understanding that the Immediate Safety Intervention Plan is short term until the Family Safety Planning Document (CD-267) can be completed if the Children’s Division needs to continue to be involved through a Family Centered Services or Alternative Care case.
What steps should the family and/or safety network members take in the event this Immediate Safety Intervention Plan is violated?
A plan should be developed so that all those involved in the Immediate Safety Intervention Plan will know what to do in the event the plan is violated. This should include contact information for all those who must be immediately notified if the plan is violated or concerns arise regarding the safety of the child(ren).
Once the CD-263 is developed, the worker should make sure the family and any safety network members actively involved in the plan have a copy. The worker can take a picture of the plan for the record, and provide the family with the paper copy.
The CD-263 should be seen as a flexible agreement dependent on the effectiveness in controlling the danger to the child(ren). They should be evaluated, readjusted, or modified as needed. After the CD-263 is developed with the family, the worker may need to revise it until the Family Safety Planning Document (CD-267) can replace it, or there is no longer a need for an immediate safety intervention.
9.2 Background Checks for Diversion Placements
When a diversion placement is made outside of the family home, without the child being placed in protective custody, staff must take the following steps to complete a thorough background check of the diversion placement:
- FACES Prior History Search;
- www.Case.Net;
- Missouri State Highway Patrol Sex Offender Registry search; and
- Complete a walkthrough of the diversion placement home.
The parent/caretaker must be given a choice to participate in the safety planning process. There may be times when families refuse to enter into an Immediate Safety Intervention Plan. If so, they must be made aware of the potential consequences if staff feels the child’s safety cannot be assured. Staff may need to consult with their supervisor and/or make a referral to their law enforcement or juvenile office if a family refuses to enter into an Immediate Safety Intervention Plan.
Staff must refrain from the use of ultimatums or any other similar practices. The use of ultimatums is a direct contradiction to strength’s-based, family-centered practice, and may be construed as an oppressive act of coercion. Staff may inform families of possible actions, such as a report being filed with the local juvenile court, which may take place should children’s safety or wellbeing continue to be a concern beyond the Division’s ability to enter into a voluntary safety agreement with all suitable relatives or kin, including non-resident parents. However, staff may not tell a family that failure to enter into a specific safety plan, especially one that the family is not in agreement with, will result in their child(ren) being removed from their custody. Staff should consult their supervisory channels as needed when facing situations of unresolved children’s safety or wellbeing.
The Family Safety Planning Document (CD-267) is to be used to guide your conversations with the family and their network to develop the plan that will enable them to achieve and maintain the safety goal(s) for their children.
The CD-267 should be used once a safety goal has been developed with the family. The CD-267 creates the road map for how the safety goal will be achieved. Developing the Family Safety Plan will often take time and must be created primarily by the family and their network. If there is a need to address immediate safety concerns, staff should use the Immediate Safety Intervention Plan (CD-263).
The danger statement and safety goal must be developed prior to starting the CD-267. The danger statement is necessary so everyone is clear about the worries for the children and family. Having clearly established safety goals will ensure that everyone comes to the safety planning endeavor with a common vision of the desired outcome the plan is meant to achieve. The CD-267 should be developed with a focus on how people will be living differently to help keep the children safe now and in the future, even after the Children’s Division’s case is closed.
The CD-267 should NOT focus on services that will be provided to families. Instead, the CD-267 guides the development of a specific set of rules and arrangements that describe how the family and network will show everyone that the child(ren) will be safe in the future. As the case progresses, it is expected that the CD-267 will be modified and refined.
A safety network should always be involved in the creation, implementation and monitoring of the Family Safety Plan (CD-267).
9.4.1 Components of the Family Safety Planning Document (CD-267)
Signs Things are Going Well: What does it look like when things are going well related to the worries?
Triggers: Circumstances, conditions or situations that have caused or might cause the worries to start or be worse.
Preventative Plan: Steps people will take to keep the good things happening and/or to prevent the worrisome behaviors from starting (steps to manage the triggers).
Red Flags/Warning Signs: Things that tell everyone the response plan should be used right away.
Response Plan: Steps the family and/or the safety network will take to keep the kids safe when the warning signs are first noticed.
The details for each component of the Family Safety Plan are often captured during Three Column Conversations and then transferred to the Family Safety Planning Document (CD-267)
Monitoring the Family Safety Plan (CD-267)
As the CD-267 is utilized, it must be constantly evaluated, monitored, and adjusted as necessary. Families should be given opportunities to incrementally demonstrate how they are using their plan as the case progresses. As the use and effectiveness of the plan is demonstrated, contact with the children should gradually increase and become less restrictive.
Some ways the CD-267 can be monitored may include:
- Unannounced home visits by Children’s Division staff or safety network to observe how the CD-267 is being used;
- Have Three Columns Conversations with parents, children and network members to understand and compare their perspectives on how the plan is working;
- Have the family keep a safety journal where they can write their comments about how the CD-267 plan is working;
- Safety network meetings to review progress and assess the level of confidence in the safety plan based on how it is working;
- Rehearse, test, and/or practice different parts of the CD-267.As the CD-267 is developed, each revision should be shared with the family and the safety network. A child’s version of the CD-267 plan should be created so the child(ren) can understand what will be done by whom to keep them safe. Tools such as the Words and Pictures or the My Safety House (CD-216) are useful for turning the CD-267 plan into a child-friendly version. Any significant revisions of the CD-267 may indicate a need to update the child(ren)’s version of the safety plan.
Bottom lines are really less about the power differential and more about non-negotiable parts of the process. For example, involving a network and creating an age-appropriate explanation for the children are two of the most common process bottom lines. Occasionally, but not often, the agency will have bottom lines about the details of the safety plan. For example, in a child sexual abuse case, the agency will almost always set a bottom line that the alleged offender can never be alone with the children.
Total equality between the professionals and the family can never be achieved. Families often ask if their children are going to be taken away. That is because they view staff as having power and authority over them. Children’s Division staff should recognize that they are in positions of authority and should be sensitive to how this is managed. Due to the Children’s Division’s statutory obligation to protect children, decisions frequently have to be made that will have negative consequences for families. Staff should be open and honest about the agency’s bottom lines– the decisions the agency will have to make if the family is unable to make a plan that ensures the safety of their children. When families understand the bottom lines, they are better able to make fully informed decisions about how they are going to address the concerns of the professionals involved.
9.6 Responding to Youth Presenting Signs of Suicide
Assuring child safety extends beyond mitigating threats imposed by others, but also includes recognizing and responding to youth presenting suicidal behavior. When staff observe signs of suicide, or when a youth makes a plea for help, staff shall take steps to ensure the youth’s safety by immediately engaging appropriate mental health professionals. There should be a deliberate transfer of intervention from staff to the mental health professionals trained to assess and manage the crisis. This may include the youth’s therapist, if applicable and available, or it may involve contacting a crisis line for direction.
- Contact 9-1-1 if the youth has made a suicide attempt, or has verbalized suicide plans and has ready access to lethal means.
If this is not the case:
- If the youth is already working with a mental health professional – a therapist, or a community behavioral health center worker – staff should make contact with this individual first due to the existing professional relationship.
- If contact is made, staff shall follow the guidance provided by the mental health professional.
- If the youth does not have a current working relationship with a therapist or community behavioral health center worker – or they are unavailable at the point of attempted contact – staff shall contact:
- Access Crisis Intervention (ACI) Hotline, see Missouri Department of Mental Health’s Suicide Prevention page. A statewide, 24-hour crisis line that provides assistance or appropriate intervention, performing a mental health screening to render a clinical disposition for next steps, or
- Suicide Prevention Lifeline, 1-800-273-TALK (8255): A national 24-hour hotline for individuals experiencing a suicidal crisis or emotional distress.
The youth must not be left alone until contact is made with a mental health professional and guidance received for next steps. Until further guidance is received from a mental health professional, staff must ensure a plan for immediate and constant supervision. The discussion and plans made with the family to address safety issues must be clearly documented in a contact note within the FACES case record.