Section 4, Chapter 2 (Placements) – Overview

Effective Date: 9-30-21


This Chapter contains the following subsections

2.1 – Common Placement Types

2.1.1 – Placement with a Fit Parent

2.1.2 – Placement with Siblings

2.1.3 – Placement with Grandparents

2.1.4 – Placement with Adult Siblings or Parents of Siblings

2.1.5 – Placement with Relatives

2.1.6 – Placement with Former Foster Parents

2.1.7 – Placement with Foster Parents

2.1.8 – Residential Providers (Group Setting)

2.1.9 – Qualified Residential Treatment Program (QRTP)

2.1.10 – Psychiatric Residential Treatment Facility (PRTF)

2.1.11 – Sex Trafficking Program

2.1.12 – Transitional Living Provider

2.1.13 – Family Based Residential

2.1.14 – Maternity and Maternity with Infant Care

2.2 – Initial Placement Activities

2.3 – Residential Rehabilitative Services

2.3.1 – Residential Referral Process

2.3.2 – Residential Treatment Monitoring Process

2.3.3 – Department of Mental Health (DMH) Placement Referral Process

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

2.3.5 – Mandatory Placement Continuation Approval Process

2.4 –Levels of Care (Elevated Needs, Medical, and Treatment Foster Care) Placement

2.4.1 Level of Care Referral Process

2.4.2 Medical Foster Care

2.4.3 Elevated Needs Foster Care

2.4.4 Treatment Foster Care (TFC) Program

2.4.5 Relative Treatment Foster Care (R-TFC)

2.4.6 Level 2- Treatment Foster Care (TFC)/Relative TFC

2.4.8 Transition Treatment Foster Care (TFC) Services

2.5 – Mental Health Hospital Placements

2.6 — Qualified Residential Treatment Program (QRTP) Designation

2.7 – Requirements for Psychiatric Residential Treatment Programs (PRTF)

2.8 – Requirements for Family Based Residential Placements (FBR)

2.9 – Residential Care Screening Team Coordinator Responsibilities

2.10 –Independent Assessor Responsibilities

2.11 – ICPC

2.11.1 – Placement of a Missouri Child into Another State (Regulation 2)

2.11.2 – Placement of a Missouri Child with an Approved Resource

2.11.3 – Compact Termination/Placement Disruption or Closure

2.11.4 – Placement of Another State’s Child into Missouri

2.11.5 – ICPC Regulation 1

2.11.6 – ICPC Regulation 4 Residential Care Placements into another State

2.11.7 – ICPC Regulation 7 or Expedited Placements

2.11.8 – Border Agreement

2.11.9 – Other Interstate Compacts


Placement of Children

Each time a child is placed in out-of-home care the probability exists for the permanent loss of family relationships and trauma to occur. The first and greatest investment in time and resources should be made in the care and treatment of children in their own home.

When intervention becomes necessary it should begin with the Children’s Service Worker and family jointly developing a strengths-based assessment using the Signs of Safety approach, while seeing the family in the full frame of their life. A strengths-based assessment focuses on the family’s strengths through relabeling/reframing behavior rather than focusing on problems. Operating from this perspective inspires hope, reinforces the family’s own problem solving, and encourages family empowerment. The worker’s skill in engaging the family will set the stage for a continuing and productive relationship with the family. During the assessment process, the family and the worker will identify resources available (including safety networks) to ensure the safety of the child. If the provision of these services, the assistance of safety networks identified by the family, and other reasonable efforts made by the Division cannot ensure the child(ren)’s safety, the child must remain in out of home care.

Throughout the entire intervention with a family, it is imperative that the Children’s Service Worker explains to the child and parents, in an age appropriate and culturally sensitive manner, each step of the process and why each step is happening. It is also important to be sensitive to trauma issues that the parent or child may have.

All activities surrounding the placement of the child must be entered into FACES as soon as possible but no later than 24 hours after the change occurs.

Subsequent Placements within Children’s Division
The Children’s Service Worker shall attempt to retain the current placement, if possible. If that is not possible, the worker will find a new placement resource.

The Children’s Service Worker will give written notice to the resource family two (2) weeks in advance of any planned move, including a statement of the reasons for removal. Where there is no advance notice because of an emergency situation involving the foster child’s health or well-being, or upon court order, a written statement of the reasons justifying removal shall be provided to the resource family within five (5) days following the removal.

  • If a child is placed with an emergency resource family or a regular resource family where the placement is intended to be for less than two (2) weeks, the Children’s Service Worker will complete the CS-44.

When a move is requested by the resource family, the Children’s Service Worker shall receive written notice from the resource family two (2) weeks in advance of the requested removal of a child, unless there is an emergency. This notice must include an explanation of the reason why removal is requested.

The birth parents need to receive written notice two (2) weeks in advance of any planned move. Where there is no advance notice because of an emergency situation involving the foster child’s health or well-being, a written statement of the reasons justifying the removal shall be provided to the birth parents within five (5) days following replacement.

With any new placement a Placement Stability FST meeting or TDM should occur before the move. See later chapters for details on these meetings and when they must occur.

Educational stability should be a priority when assessing the child’s placement needs and making placement decisions. The Child and Family Services Improvement and Innovation Act (2011) requires state child welfare agencies to coordinate with schools to improve education stability for children in foster care at each placement change. This means prior to any placement decision staff should consider what impact the decision will have on the child’s educational stability.