CHILD WELFARE MANUAL

Section 4, Chapter 2 (Placements), Subsection 3 – Residential Rehabilitative Services

Effective Date:  10-1-2021

 

2.3 – Residential and Department of Mental Health Developmental Disabilities Placements

 

Placement in residential treatment or Department of Mental Health (DMH) Developmental Disabilities (DD) settings shall be the least restrictive placement settings to meet the specific needs of the child (an individual under twenty-one years of age, sometimes referred to as “youth”).  Group placement settings may also called “congregate care” or “institutional” settings.  It is important to explore and attempt lesser placement types prior to placement in a residential setting to the extent possible.

This sub-section describes the process of referring a child in out-of-home care to a residential treatment program or a DMH placement.  If residential treatment or a DMH placement is determined to be in the best interest of the child, as discussed below, all treatment planning shall be tied to the child’s permanency plan, and discharge planning shall begin at the time of admission.

Residential treatment may be appropriate for children with significant emotional and/or psychiatric needs, learning difficulties, behavioral disorders, trauma histories, and developmental disabilities or problems. Children suited for this type of placement are often unable to function adequately within the family, the school, or the community and are in need of additional support which cannot be reasonably met in a foster home setting.

Regardless of the reason a child is in need of residential placement, the goal of all levels of treatment must be focused on stabilizing the child’s behaviors so that he/she may be able to return to the community and least restrictive placement.

All children in the custody of the Children’s Division shall be placed in a facility that is licensed and contracted with the Division for residential treatment services, or licensed/certified by the DMH and contracted with on a case-by-case need.

Residential treatment or DMH placements for a child under the age of seven (7) years shall only be considered once other resources have been explored.  However, certain behavior and/or physical conditions can exist which would indicate a need for a structured treatment setting for such a child.  In most instances, a foster home setting is preferable to another setting.  Residential treatment for children under seven (7) years of age shall be indicated as necessary through professional evaluations and recommendations by qualified professionals such as a child psychologist. Residential treatment and/or a DMH placement for a child under the age of seven (7) must be recommended by the Family Support Team (FST) after evaluations and recommendations by qualified professionals are completed and reviewed.

2.3.1 – Residential Referral Process

Residential treatment shall only be considered if it best meets the child’s clinical needs.

The following placement settings are considered residential treatment settings.  These settings require review by the Residential Care Screening Team (RCST) Coordinator and an Independent Assessor as described further below:

  • Residential treatment (levels II, III, and IV) (as licensed in 13 CSR 35-71)
  • Qualified Residential Treatment Programs (QRTP) (residential treatment agencies at levels II, III, and IV who have a QRTP Designation issued by Children’s Division).
  • Psychiatric Residential Treatment Facilities (PRTF)

The following placement settings are not considered residential treatment.  These settings require review by the Residential Care Screening Team (RCST) but do not require review by the Independent Assessor*:

  • Emergency shelters (temporary placements not to exceed 30 calendar days**, as licensed in 13 CSR 35-71)
  • Maternity homes for pregnant or parenting youth (as licensed in 13 CSR 35-71)
  • Transitional living placements (transitional living group home (TLG), scattered site apartments)
  • Department of Mental Health (DHM) Division of Developmental Disability (DDD) licensed or certified placements

*If a child’s behaviors or presenting conditions may necessitate residential treatment, even though a youth may require an emergency placement immediately, the process for an Independent Assessor shall be followed.

**Emergency shelters are temporary placements, and shall not be used for placement after 30 calendar days, unless authorized as explained here.  In the event that another placement is not available after 30 calendar days, approval for any additional days, not to exceed an additional 30 calendar days, shall be made by the RCST Coordinator in writing, if determined necessary by the RCST Coordinator and Residential Service Manager.  The Case Manager shall be responsible for submitting written requests for approval for an extended emergency placement past 30 calendar days. Extension requests shall document all efforts made by the Division to locate appropriate placement for the child. The Case Manager shall continue to actively seek alternative placements regardless of a request for, or approval of, an extended emergency placement.

 

A referral to the RCST Coordinator for possible residential treatment may be triggered by the following events:

  1. The child has recently entered or re-entered CD custody and is currently placed in residential treatment;
  2. A court has ordered residential treatment or an independent assessment for residential treatment;
  3. A Youth with Elevated Needs Staffing (YWEN) Team has recommended residential treatment (information regarding YWEN can be found in Section 4, Chapter 4, Subsection 5);
  4. A Team Decision Making (TDM) meeting or Placement Stability Family Support Team meeting has recommended residential treatment;
  5. An emergency exists where the case manager and supervisor have staffed the child’s case, and the child was placed in emergency placement, either a shelter or residential facility; or
  6. A qualified clinician such as a primary care physician or psychologist has recommended residential treatment, or the child is being discharged from a hospital setting with a qualified clinician’s recommendation for residential treatment.

Note: In the event that the court orders residential treatment of a child prior to the completion of the Independent Assessment process, outlined below, a copy of the court order shall be sent to the RCST Coordinator immediately upon receipt of such an order for possible Division of Legal Services (DLS) action.  The RCST Coordinator shall refer the matter to DLS in the event that the independent assessment review process outlined in this policy was not followed.  In the event that the court orders residential treatment using a name of a specific facility, the same process of notification to the RCST Coordinator and DLS shall be followed.

Starting the Residential Referral Process

If one of the six triggering events occurs, the case manager and supervisor shall complete the following steps within three (3) calendar days of the decision to refer the child to a residential setting or within three (3) calendar days upon receipt of legal custody of a child already placed in a residential setting:

  1. The case manager for the child shall complete the Residential and Specialized Placement Referral (CS-9) Section A.
  2. In the event of a need for emergency residential placement, the CS-9 Section A, shall be completed and submitted to the RCST within three (3) calendar days of placement.  
  3. The CS-9, including all attachments shall be submitted for supervisory review.
  4. The supervisor shall review and if complete, shall approve the referral.
  5. The supervisor shall submit the CS-9 and the applicable attachments to the RCST Coordinator for the region. The Case Manager shall also be included on the communication.
  6. Upon submission of the CS-9 to the RCST, the Case Manager shall utilize the Residential Referral Tracking Sheet (CD-303) to monitor the referral.

Note: Failure to include all documents for the CS-9 may cause a delay in the screening process.  Case Managers shall include any specialized information as my required on the form, including Maternity and Parenting care (Section B) and Infant and Toddler Care (Section C).

The Childhood Severity of Psychiatric Illness scale (CSPI) is a required component of the CS-9.  The CSPI is an assessment tool developed to assist in the planning of appropriate services and is required to accompany the CS-9 for children age six (6) years and older.

The CSPI also serves as the eligibility determination process for child enrolled in the Medicaid Rehabilitation Option.  This program allows Children’s Division to access federal funding to purchase rehabilitative services to meet identified mental health service needs of children.

Note: Emergency residential shelter placement 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. For children entering an emergency residential placement, the CS-9 Section A shall be completed and submitted to the RCST within three (3) calendar days of placement.  

Reviewing the Referral

Upon submission of the Residential and Specialized Placement Referral (CS-9) to the RCST Coordinator, the RCST Coordinator shall:

  1. Screen the CS-9 and the attachments for appropriateness for residential treatment.
  2. Contact the case manager requesting additional information or clarification, as necessary.
  3. If the placement setting requires review by an Independent Assessor:

Forward the approved referral to the assigned Independent Assessor within three (3) calendar days of receipt of the completed CS-9.

  1. If the placement setting does not require review by an Independent Assessor, the RCST Coordinator shall determine and secure the most appropriate placement setting.
  • The child’s special needs shall take priority over placement to the parent(s) or guardian(s).
  • The case manager shall be available to answer questions from the potential facilities.
  • The RCST Coordinator will confirm the child’s admission with the case manager once placement has been identified and secured.

Note: If Above Level IV services and/or programming are recommended, the residential treatment facility shall send a request and certification for Above Level IV services and programming to the RCST Coordinator. The request shall include supporting documentation of the specific behaviors exhibited by the child and/or the specific treatment needs that require the Above Level IV services and/or programming; to include an explanation of the extra supervision and services that are requested based on the specific needs of the child. If the RCST Coordinator approves the request, the RCST Coordinator will forward the request to the Central Office for final approval. In the event there is a disagreement in the services requested by the placement and the Division’s determination, the determination of the Children’s Division shall govern.

 

Independent Assessor’s Review

Upon receipt of the CS-9 and supporting documentation from the RCST Coordinator, the Independent Assessor shall:

  1. Send the RCST a written response acknowledging receipt of the referral within three (3) calendar says of receipt of the referral.
  2. Work in conjunction with the family of, and FST for, the child while conducting and making the assessment.
  3. Complete the assessment within thirty (30) calendar days of the referral.

Send the completed assessment to the RCST Coordinator, Circuit Manager, Supervisor, and Case Manager using a secure mode of transmittal.

 

The purpose of the Independent Assessment will be to assess the strengths and needs of the child using an age-appropriate, evidence-based, validated, functional assessment tool.  The assessment will be in writing, and will determine whether the needs of the child can be met with family members or through placement in a foster family home or, if not, which setting would provide the most effective and appropriate level of care for the child in the least restrictive environment and be consistent with the short- and long-term goals for the child, as specified in the permanency plan for the child.

If the Independent Assessor determines the child should not be placed in a foster family home, he/she must specify in writing:

  1. The reasons why the child’s needs can’t be met by the family or in a foster family home (a shortage of foster family homes is not an acceptable reason for determining the child’s needs cannot be met in a foster family home); and
  2. Why the recommended placement in a residential treatment setting is the setting that will provide the child with the most effective and appropriate level of care in the least restrictive environment; and
  3. How the setting is consistent with the short- and long-term goals for the child, as specified in the permanency plan for the child.

Note: The assessment shall be in person or by telehealth using video communication. Transportation to the assessment is the responsibility of the foster parent, case manager, or residential provider.

For a full listing of Independent Assessor responsibilities see Section 4, Chapter 2, Subsection 10, Independent Assessor Responsibilities.

Review and Dissemination of the Independent Assessor Report

Immediate upon receipt of the report, the Case Manager shall:

  1. Distribute the Independent Assessor’s report to the parties to the juvenile proceeding, the members of the family support team and the court. Redactions may be necessary to protect information that is confidential as a matter of law, or may be harmful to the best interests, safety, and welfare of the child.
  2. Ask the court to assess the appropriateness for the child to be placed or remain in a residential treatment setting as described below. The Case Manager may need the assistance of DLS (such as preparing a motion) in order to trigger action by the court.
  3. In the event that after 15 calendar days after being sent the report, the court has not made a written finding to approve or disapprove the recommendations of the Independent Assessor’s report, the Case Manager shall complete a referral to DLS, attaching the Independent Assessor’s report.

 

When conducting an assessment of appropriateness for the child to be placed or remain in a residential treatment setting, the Division shall ask the court to make specific written findings of fact and:

  1. Consider the assessment, determination, and documentation made by the qualified individual conducting the assessment;
  2. Determine whether the needs of the child can be met through placement in a foster home or, if not, whether placement of the child in a residential treatment setting provides the most effective and appropriate level of care for the child, in the least restrictive environment;
  3. Determine whether that placement is consistent with the short-term and long term goals for the child, as specified in the permanency plan for the child; and
  4. Approve or disapprove the placement setting recommended by the Independent Assessor’s report. Such approval or disapproval must be documented in the case plan, and uploaded to OnBase.

In the event the court disapproves the placement, the Division shall seek placement in another setting, consistent with the findings of the Independent Assessor’s report.

Note: This written finding shall be made within 60 days of the child’s placement in the residential treatment setting.  It is important to immediately start this process so that the timeline is met.  A failure to follow this requirement may result in the Division’s inability to claim certain funds in accordance with the Family First Prevention Services Act (FFPSA) (Public Law 115-123).

 

Continued Review of the Placement

As long as a child remains placed in a residential treatment setting, the Children’s Division or contracted agency shall submit evidence at each review and each permanency hearing held for the child.  Evidence shall include:

  1. Demonstrating that ongoing assessment of the strengths and needs of the child continues to support the determination that the needs of the child cannot be met through placement in a foster family home, that the placement in a residential setting provides the most effective and appropriate level of care for the child in the least restrictive environment and that the placement is consistent with the short- and long-term goals for the child, as specified in the Social Service Plan;
  2. Documenting the specific treatment or service needs that will be met for the child in the placement and length of time the child is expected to need the treatment or services; and
  3. Documenting the efforts made by the agency to prepare the child to return home or to be placed with a fit and willing relative, a legal guardian, or an adoptive parent, or in a foster family home.

 

The Division shall ask the court at each review and each permanency hearing held to:

  1. Consider the assessment, determination, and documentation made by the qualified individual conducting the assessment;
  2. Determine whether placement of the child in a residential treatment setting continues to provide the most effective and appropriate level of care for the child, in the least restrictive environment;
  3. Determine whether that placement is consistent with the short-term and long term goals for the child, as specified in the permanency plan for the child; and
  4. Approve or disapprove the placement setting recommended by the Independent Assessor’s report. Such approval or disapproval must be documented in the case plan and uploaded to OnBase.

In the event the court disapproves the placement, the Division shall seek placement in another setting, consistent with the findings of the Independent Assessor’s report.

Note: DLS may provide support to the Division to accomplish these requirements.

 

New Placement Actions for All Residential Settings

As part of the residential placement process, the case manager shall proceed with placement by:

  1. Completing the residential admission packet and returning the information prior to admission;
  2. Arrange for adequate transportation of the child;
  3. Prepare the child and parent(s)/guardian(s) for placement, providing information about the facility, location, special programs, and visitation/contact arrangements, etc.;
  4. Inviting the parent(s)/guardian(s) to participate in the child’s admission process, if appropriate as determined by the case manager;
  5. Arriving at the placement with the child and participating in the intake process.
  6. Entering the child’s new placement information into FACES within 24 hours of placement.
  7. Entering a “Rehabilitation Service Begin Date” or an updated date on the Rehabilitation Services Tracking screen in FACES.  The Rehabilitation Service Begin Date must be the date the CSPI was completed or the date of placement, but may not be backdated to the date of placement unless the CSPI was completed on or before the placement date.

Move and Discharge Requirements for All Residential Settings

The residential facility shall begin planning the child’s discharge immediately upon entry into the residential facility.

The residential facility shall make every effort to reduce or eliminate the number of unplanned discharges, emergency discharges, and moves to more restrictive settings for children placed in residential settings.

If a child is being discharged on an unplanned/emergency basis or as the result of a 30-day notice for removal to another residential facility, the case manager shall follow the CS-9 referral process listed above.

New Placement to Another Residential Treatment Setting

If the child moves from a residential treatment placement to another residential treatment placement, the following steps shall be taken:

  1. The case manager shall begin the Starting the Residential Referral Process again, as outlined in this policy.
  2. A subsequent Independent Assessment shall be completed as outlined in the Independent Assessor’s Review section in the policy.
  3. All timeframes listed previously in this policy shall be followed.
  4. The case manager shall utilize the Residential Referral Tracking Sheet (CD-303).
  5. A transfer conference shall be held between the current provider and the next provider when a child moves from one residential treatment placement to another. The purpose of this conference is to share information about the child to aid in his/her transition to the next placement. This conference shall be arranged by the case manager and/or supervisor, with the current and subsequent placement provider, as well as the child (if developmentally appropriate). The RCST Coordinator may also attend the transfer conference, as necessary. The conference can be completed face-to-face or via conference call within the timeframes specified below:
    • For a planned discharge, a transfer conference shall be held prior to a child’s move, but not to exceed the first five (5) calendar days of a child’s placement move. 
    • For an emergency discharge, a transfer conference shall occur during the Placement Stability Family Support Team Meeting (FSTM) within 72 hour hours of placement, or separately from the FSTM within the first five (5) calendar days of the placement change.
  6. Transfer meeting notes shall be documented in the contact communication log in FACES.

 

Support from the Division of Legal Services

DLS can assist with any motions or hearings as may be required by the court in order for a ruling by the court regarding the approval or disapproval of the Independent Assessor’s report within the timeframes of this policy. 

2.3.2 – Residential Treatment Monitoring Process

Case Plan Requirements

For a child placed in a residential treatment setting the Children’s Division or contracted case management agency must document the following in the child’s case plan:

  1. The reasonable and good faith effort of the agency to identify and include all the individuals required to be on the child’s family support team (FST);
  2. All contact information for members of the FST, as well as contact information for other family members and fictive kin who are not part of the FST;
  3. Evidence that meetings of the FST, including meetings relating to the required 30-day assessment of the appropriateness of the residential treatment setting, are held at a time and place convenient for family;
  4. If reunification is the goal, evidence demonstrating that the parent from whom the child was removed provided input on the members of the FST;
  5. Evidence that the required 30-day assessment to determine the appropriateness of the residential treatment setting is determined in conjunction with the FST;
  6. The placement preferences of the FST relative to the required 30-day assessment that recognizes children should be placed with their siblings unless there is a finding by the court that such a placement is contrary to their best interest;
  7. If the placement preferences of the FST and child are not the placement setting recommended by the Independent Assessor conducting the required 30-day assessment, the reasons why the preferences of the team and of the child were not recommended; and
  8. The written recommendation by the Independent Assessor regarding the appropriateness of the residential placement and the court approval or disapproval of the placement.

 

Progress Reports from Licensed Residential Treatment Placement Providers

Facilities under contract with the Division for residential treatment services are required to complete treatment plan and progress reports for the child receiving residential treatment. Such reports shall be submitted to the child’s case manager and the RCST Coordinator at the following intervals:

  • Residential Treatment (Level II and III): Treatment plans must be developed within fifteen (15) days of placement. Treatment plans must be reviewed quarterly, every ninety (90) days. (See 13 CSR 35-71.060 and 13 CSR 35-71.130)
  • Intensive Residential Treatment (Level IV): Treatment plans must be developed within ten (10) days of placement. Treatment plans must be reviewed monthly, every thirty (30) days. (See 13 CSR 35-71.140)

The residential facility shall provide the case manager and the RCST Coordinator a monthly progress report of the child’s treatment within fifteen (15) calendar days of each calendar month following the month of service. The facility shall submit the monthly progress report to the RCST Coordinator at the same time as the invoice for payment for the service month. This report must be submitted using the Department’s online invoicing system as described in the residential treatment service’s contract.

This monthly report shall include, at a minimum:

  • An itemized statement describing the actual services provided to each child during the reporting period, including, duration of all individual, family, and group therapies actually provided during the reporting period; notations if the therapies and/or services are part of a specialized program such as chemical dependency/substance use treatments, child with problem sexual behaviors, etc.;
  • A summary of the child’s educational progress during the reporting period; and
  • A summary of the child’s health, behavioral health, and mental health care during the reporting period, including compliance with the requirements of the Settlement Agreement in M.B. vs Tidball which can be found at: https://dss.mo.gov/notice-of-proposed-class-action-settlement.htm.
  • All treatment sessions which were not provided in accordance with the child’s treatment plan, shall be disclosed to the case manager and RCST Coordinator in writing, by the following reporting month, and documented in the child’s record. A child’s refusal to participate in treatment sessions shall be documented in the treatment record.

Case Managers shall review the child’s progress reports to ensure that the services provided to the child remain consistent with the child’s ongoing treatment needs. The case manager shall address any discrepancies found in the progress reports with the residential provider in a timely manner.

Treatment plans and treatment reviews shall be completed by the facility in accordance with state regulation 13 CSR 35-71 Licensing Rules for Residential Treatment Agencies for Children and Youth. The full regulation can be accessed at: https://www.sos.mo.gov/cmsimages/adrules/csr/current/13csr/13c35-71.pdf

The facility shall complete the Monthly Medical Log utilizing form CD-265 Medical Log which may be found at http://dss.mo.gov/cd/info/forms and the providers Medication Administration Record (MAR) within five (5) calendar days of each calendar month following the month of service to the child’s case manager. The written documentation must contain all medication administered for the month, including the dosage, any adverse reactions, any new medications prescribed, including the dosage, prescriber notes from any medication monitoring appointments, and the dates/times of any upcoming appointments.

2.3.3 – Department of Mental Health (DMH) Division of Developmental Disabilities (DDD) Placement Referral Process

Department of Mental Health (DMH) Division of Developmental Disabilities (DDD) placements shall only be considered if such placements best meet the child’s treatment needs.  In order to be eligible for this type of setting, the child must be waiver eligible as determined by DMH-DDD.  A DMH placement, such as an Independent Supported Living (ISL) placement, shall be appropriate based on the capacity and/or needs of the child in order for placement to occur.   The DMH-DDD determines the assessment tools for the waiver eligible determination.  The Vineland Assessment is utilized for children under 18 and the MOCABI is utilized for children 18 and older. 

When a case manager identifies a possible need for a placement with DMH care placement, the following process shall be followed:

  1. The case manager shall ensure the child is waiver-eligible by contacting their local Regional Office for the Developmentally Disabled (DDD) and making a referral for services.
  2. The case manager shall ensure that a referral has been made for Supplemental Security Income (SSI) or SSI is currently issued for the child.
  3. Only after completing the prior steps shall the case manager complete the CS-9, including supporting document.
  4. The case manager shall send the completed CS-9 to the RCST Coordinator along with the information from the Regional Office, stating:
    • The child is eligible for waiver services, as verified in writing from the DMH Regional Office;
    • The child is approved for Social Security Income (SSI); and
    • A detailed explanation of why the placement with DMH is in the best interest of the child, including supporting documentation such as the Individual Support Plan and/or monthly treatment reports.
  1. The RCST Coordinator, if appropriate based on the information provided, will refer the child to the Children’s Division Medicaid Wavier Wait List.
  2. The RCST Coordinator will determine if the child is found to need a DMH-DDD provider placement. 
  3. RCST will contact the case manager to continue the process of placement.
  4. The Case Manager shall ask the court to sign an order to allow a DMH-DDD placement.

 

During the placement period, the RCST Coordinator shall:

  1. Ensure that protocol is followed between CD and DMH with utilization of a DMH placement provider
  2. Request and review child’s budget that is approved through DMH Regional Office for services and matches the child’s Individual Support Plan.
  3. Will complete the Child Specific Contract request packet and submit to Residential Services Manager for a decision of approval.
  4. Request information required for renewal when the contract prior to expiration of the contract.

 

New Placement Actions for DMH-DD Settings

As part of the DMH placement process, the case manager, after approval from the RCST Coordinator, shall proceed with placement by:

  1. Completing any admission information as may be required by the provider;
  2. Arrange for adequate transportation of the child;
  3. Prepare the child and parent(s)/guardian(s) for placement, providing information about the placement, location, special programs, and visitation/contact arrangements, etc.;
  4. Inviting the parent(s)/guardian(s) to participate in the child’s transition meeting, if appropriate as determined by the RCST Coordinator or the DMH-DDD Service Coordinator;
  5. Arriving at the placement with the child and participating in the transition process.
  6. Entering the child’s new placement information into FACES within 24 hours of placement.
  7. Entering a “Rehabilitation Service Begin Date” or an updated date on the Rehabilitation Services Tracking screen in FACES.  The Rehabilitation Service Begin Date must be the date the CSPI was completed or the date of placement, but may not be backdated to the date of placement unless the CSPI was completed on or before the placement date.

 

2.3.4 – Department of Mental Health (DMH) Placement Monitoring Process

DMH licensed or certified placements under contract with the Division for services, in conjunction with the DMH Service Coordinator, are required to complete Individual Support Plans and support monitoring reports for the child receiving care in accordance with all DMH requirements and in accordance with obligations outlined in Division contracts for such services. Such reports shall be requested by the child’s case manager and submitted to the RCST Coordinator quarterly.

Case Managers shall review the child’s support and service monitoring report to ensure that the services provided to the child remain consistent with the child’s ongoing treatment needs. The case manager shall address any discrepancies found in the Individual Support Plans with the provider in a timely manner.

 

2.3.5 – Mandatory Placement Continuation Approval Process

Review Process for Residential Treatment Placements Requiring an Independent Assessment

The Children’s Division Director or designee’s written approval is required for the continued placement in residential treatment settings that extend beyond the timeframes below:

  • Under 13 years old: When a child, not yet age 13, has been in a residential treatment facility for 6 months (consecutive OR non-consecutive);
  • Ages 13 and older: When a child age 13 or older has been in a residential treatment facility for 12 consecutive months OR 18 non-consecutive months of the placement.

When a child is 60 days away from the prescribed review point, the case manager must complete a Residential Extended Stay Review and the following steps must be taken:

  1. The worker and supervisor shall have a case consultation, within one week, to determine if child should remain in congregate care.
  2. The worker, no later than 14 calendar days from the 60 day review point, shall schedule a FST meeting to be held. The entire FST, made up of the youth’s family and permanency team, along with the RCST, shall be invited to participate.  During this meeting, the team is to discuss the current treatment plan, progress of this plan, discharge plan, and progress towards discharge.   The worker, along with the team, will discuss, and complete the Residential Extended Stay Review form (CD-304).
  3. The worker, within 7 calendar days of the Family Support Team meeting, shall provide the completed Residential Extended Stay Review form (CD-304), required documentation listed on the form, and with the most recent treatment plan from the placement provider, to the RCST.
  4. The RCST, no later than 14 calendar days from the date of receipt of the Residential Extended Stay Review form and attached documents, shall review the materials and provide the provided information to either the local Field Support Manager (for all residential treatment settings which do not have the Qualified Residential Treatment Program (QRTP) designation), or the Children’s Division Director (for residential treatment settings with the QRTP designation).
  5. Within 14 calendar days, the Children’s Division Director or local Field Support Manager will approve or disapprove extended placement in residential treatment.
  6. If Extended stay is not approved, the Case Manager must immediately begin process to obtain a new placement for the child.

This process shall be repeated every three months for a child aged 12 and younger, and every six months for a child aged 13 or older as long as the child remains in a residential treatment placement.

Review Process for DMH Placements

The RCST Coordinator, in consultation with the Case Manager, shall periodically review the child’s progress to determine if the continued placement in a DMH settings is meeting the unique needs of the child and the child’s permanency goals.