Department for Community Based Services

Standards of Practice Online Manual

12.11.1 Placement Exception Requests

Cabinet for Health and Family Services

Department for Community Based Services
Division of Protection and Permanency
Standards of Practice Online Manual
Chapter:
Chapter 12-Resource Family Recruitment, Certification and Reimbursement
Effective:
9/14/2018
Section:
12.11.1 Placement Exception Requests
Version:
5

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Legal Authority/Introduction

LEGAL AUTHORITY:

To ensure the needs of a child are met in a foster home, and to maximize safety, permanency, and well-being, it is essential that any exception has a specific therapeutic purpose (e.g. maintaining siblings' together or previous relationship with foster/adoptive parent).

The Placement Exception Request Tip Sheet is available to further assist staff in the decision making process.

Procedure

  1. The placing SSW requests approval for any exception listed below:
    1. Exceeding the number of children in a foster home;
    2. Exceeding more than two (2) children under the age of two (2) in a foster home, including children placed in out-of-home care by the Cabinet and the foster home parent's own children;
    3. A one (1) parent medically complex foster home caring for more than one (1) medically complex child;
    4. A two (2) parent medically complex foster home caring for more than two (2) medically complex children;
    5. Placing a medically complex child in a placement other than an approved medically complex home. (Director of the Division of Protection and Permanency or designee approval required); or
    6. Primary caregiver of a medically complex child, placed in a DCBS or PCP foster home, working outside of the home (Director of the Division of Protection and Permanency or designee approval required). 1

For children placed in a DCBS Foster home:

  1. Prior to the proposed placement, the placing FSOS completes and submits the DPP-112A DCBS Placement Exception Request documenting the reason the placement is in the best interest of a child and the specific support services that will be provided to the SRA or designee for approval.
  2. For medically complex children, the SSW forwards the exception request (DPP-112A) to the medically complex liaison, after it is approved by the SRA or designee, and in turn, the medically fragile liaison forwards the exception request to the Medical Support Section in central office. 2
  3. If an exception request crosses regional lines, the FSOSs and the SRAs, or their designees from both regions (sending and receiving), and the R&C worker from the receiving region are to consult in order to reach concurrence regarding the appropriateness of placement. 
  4. Each FSOS also discusses any additional services needed to maintain the placement if recommending approval. 3  
  5. If the child being placed is from another region, approval for exceptions must also be approved by the SRA or designee of the region supervising the case. 
  6. The SRA discusses concerns related to the child's therapeutic needs, the foster home, or other children already in the foster home, with the originating region's FSOS or SRA when making a decision to exceed the number of children in a DCBS foster home. 
  7. The SRA also considers the needs of the other children in the foster home.
  8. If an exception is necessary for a placement to occur outside of normal business hours, the FSOS or SSW shall verbally provide all information contained within the DPP-112A to the SRA or designee prior to the placement;
  9. A  verbal approval from designated cabinet staff shall be required prior to the placement occurring; and
  10. The completed DPP-112A shall be submitted on the first business day following placement.

For children placed in a private child placing (PCP) foster home: 4

  1. Prior to the proposed placement, PCP staff completes and submits the DPP-112B Private Child-Placing Agency Placement Exception Request documenting the reason the placement is in the best interest of a child and the specific support services that will be provided to the SRA or designee for approval.
  2. PCP staff, the SRA or designee contacts the FSOS who supervises the child's case to discuss the child's therapeutic needs and behaviors or problems that may prohibit placement in a home that exceeds the required number of children in a PCP home.
  3. The SRA or designee also discusses with the FSOS any additional services needed to maintain such a placement if it were to be approved. 
  4. If the child being placed is from another region, the SRA or designee discusses concerns related to the child's needs, the foster home, or other children already in the PCP Home, with the originating region's FSOS or SRA/designee when making the decision.
  5. The SRA, based on information obtained from the FSOS supervising the case, discusses the DCBS recommendations related to the exception request with the PCP, including what additional services would be expected to be able to maintain the placement.  5 
  6. If a placement occurs outside of normal business hours, the child-placing agency verbally provides all information contained within the DPP-112B Private Child-Placing Agency Placement Exception Request, to the SRA or designee prior to the placement.
  7. A verbal approval from designated cabinet staff is required prior to the placement occurring and the completed DPP-112B Private Child-Placing Agency Placement Exception Request, will be submitted on the first business day following placement.
  8. The signature of the Director of he signature of the Director of the Division of Protection and Permanency (DPP) or designee is required for medically complex children to be placed in a home not approved for a medically complex placement, or when the primary caregiver works outside the home.
  9. The SRA or designee approves, denies, or requests additional supportive services be added to the DPP-112B plan. 
  10. The DPP SSW files the completed DPP-112A or DPP-112B into the child's file.

Practice Guidance

  • If choosing a respite provider for a child that is an approved resource home, consideration should be given to the number of children already placed/residing in the home (refer to SOP 12.11 Number of Children in Resource Home).
  • When requesting an exception regarding a medically complex child, the R&C worker should describe, in detail, how the resource parents are prepared to meet the needs of the child.  This should include child specific training received, as well as when they will attend the next medically fragile training, if applicable.
  • The signature of the Director of DPP or designee is required for the primary caregiver of a medically  complex child to work outside of the home. 
  • Prior to submitting the exception request to the director, a detailed plan, with specific information about how the family will continue to meet the child’s needs, is provided.   
  • For children placed in a private child placing (PCP) foster home the PCP executive director makes the final decision if the placement exception is approved.  This excludes medically complex children placed in non-medically complex homes and the primary caregiver of a medically complex child working outside the home. In those cases, the Director of the Division of Protection and Permanency or designee has the final approval. 
  • The signature of the Director of the Division of Protection and Permanency (DPP) or designee is required for medically complex children to be placed in a home not approved for a medically complex placement.
  • A medically complex child may not be placed with a PCP agency that does not hold a medically complex license.  There is no exception to this requirement.    
  • The PCP executive director may approve an exception to the number of children in a PCP foster home upon consultation and discussion with the SRA or designee in the Region where the foster home is located to determine the best interest of the child.
  • If the PCP approves of the placement exception request, the DPP-112B Private Child-Placing Agency Placement Exception Request is submitted to the SRA with documentation for the therapeutic purpose and supporting documentation for the reason the placement is in the best interest of the child and specific additional support services to be provided to maintain stable placement.

 

 

Footnotes

 

  1. All information is provided with the DPP-112A.
  2. The regional CRP liaison should be notified at the time of an original referral if the placement will require a placement exception.  The CRP liaison, SSW, FSOS and/or other involved staff make every attempt to explore alternative placement opportunities that do not require exceptions.
  3. Placement exceptions are required for PCC/PCP foster homes that have more than four (4) children, including the foster parents’ own children and/or more than two (2) therapeutic foster children. 
  4. In order for a child to be classified as therapeutic, the child’s level must be a three (3), four (4) or five (5). 
  5. Prior to placement in an adoptive home, the SSW should consider:
    • The prospective adoptive parent's parental capacity and resources to meet the needs of all children in the home;
    • The impact of all children involved, including the potential adoptive child; and 
    • A prospective adoptive parent may request review of a denial through the SRA, based upon the number of  children.    

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