Legal Authority/Introduction

LEGAL AUTHORITY:

• KRS 199.011 Definitions for chapter
• 922 KAR 1:360 Private child care placement, levels of care, and payment

Private child caring or private child placing agencies may provide care and services for a child for whom the Cabinet has legal responsibility.

Procedure

The SSW:

1. Seeks placement through a private child placing (PCP) or private child caring (PCC) agency when a DCBS foster and adoptive home is not available or appropriate for a child;
2. Obtains a level of care assignment for the child, if this has not already been done; 1 
3. Requests referral of the child to a private child care placement by:
1. Sending the level of care packet with the assigned level of care to the Regional Placement Coordinator (RPC) during business hours; or
2. Contacting the PCC directly, utilizing the After Hours Referral Contacts website;
4. Seeks and selects a placement for a child, in conjunction with the family team and RPC, based on the following criteria:
1. In the most family like, least restrictive setting;
2. That most closely meets the child's treatment needs;
3. With the child’s siblings;
4. That is in closest proximity to the family’s home; and
5. That promotes continued contact with the child’s family, friends, community, school and other primary connections;
6. That is the most culturally competent available, including religious beliefs.


5. Schedules an interview (if required) for the child with the PCP or PCC staff and makes arrangements for the child’s transportation to each interview;
6. Completes the DPP-114-Level of Care Schedule, and determines that the completed form is consistent with the child’s assigned level of care when placement is to be made;
7. Follows the form’s procedural instructions regarding the appropriate signatures, to indicate approval of the child’s placement;
8. Arranges transportation or transports the child and his/her belongings to the placement on the pre-arranged placement date;
9. Gives PCP or PCC staff the following information regarding the child upon admission in addition to the approved DPP-114-Level of Care Schedule:
1. Health insurance information;
2. Medical passport;
3. Copy of the DPP-106A Authorization for Health Care;
4. Educational passport;
5. Birth certificate (copy);
6. Social security card (copy); and
7. Commitment order (copy);
10. Notifies the agency if the child meets special circumstances for religious or cultural exemptions (i.e. cutting the child's hair may be a violation of his/her religious rights and cultural freedoms);
11. Sends written notification to the RPC that the child has been admitted to the program;
12. Provides the PCP or PCC staff the following information regarding the child, within seven (7) business days of admission:
1. DCBS child/youth action plan;
2. Visitation agreement; and
3. Transition plan, if the youth is over seventeen (17);
13. Provides the PCP or PCC staff the following information regarding the child, within ten (10) business days of admission: 
1. Reason for referral;
2. Statement of intended outcomes for placement (including the anticipated length of stay);
3. Complete placement history; and
4. Current social, psychological and mental health records;
14. Requests an out of state placement through the Interstate Compact on the Placement of Children (ICPC) if the SRA and Commissioner provide written approval of the request to place a child out of state (may be in the form of e-mail);3  4
15. Completes the following steps if there is a placement disruption that requires a move: 
1. Consults with the FSOS and keeps the family informed regarding placement options;
2. Determines whether the child’s level of care assignment is accurate based on the child’s current situation, and (if necessary) requests a redetermination after receiving regional approval to initiate a change in placement;
3. Notifies the regional placement coordinator (RPC) of the need for a new placement and forwards a revised level of care packet;
4. Notifies the medically complex liaison, Medical Support Section and the CCSHCN nurse of a medically complex child’s move;
16. Does not refer a child less than eight (8) years of age or with a level of care of three (3) or less, for placement in a PCC residential program, except under special circumstances, and with SRA approval;
17. Submits a special request through the SRA to the Director of the Division of Protection and Permanency, to request an exception, if it is determined that a child ages three (3) to six(6) is in need of PCC residential treatment.  The request includes:  
1. Documentation from the residential child-caring facility staff that there is no less restrictive placement available to meet the child’s mental health, physical, or behavioral needs; and
2. Verification that the residential child-caring facility:
1. Is also licensed to provide emergency shelter services;
2. Provides adequate space for the child that is protected from children who are age ten (10) and older;
3. Provides sight and sound segregation of the child from children who are age ten (10) and older while the child engages in:
1. Sleeping;
2. Personal hygiene; and
3. Toiletry; and
4. Provides staff supervision that supports the child’s individual treatment plan.
18. The RPC refers the child to appropriate PCP or PCC programs by sending the level of care packet and level of care assignment to the program, and provides the SSW with written notification of the referrals.

Contingencies and Clarifications

Practice Guidance

• The PCP or PCC program provides a response regarding possible placement of the child to the RPC within two (2) working days of receipt of a referral.
• Prior to private child caring facilities accepting a medically complex youth they are required to submit a written plan addressing how they will meet the medical needs of the youth. This plan is submitted to the medically complex liaison, who forwards it to the Medical Support Section.  A copy is also placed in the child’s case file.
• The RPC sends written information to the SSW about responses.
• Transferring a child between programs, facilities or foster homes is considered a placement move.  If a child's placement changes at any point, the SSW should always notify RPC to request a new placement.   
  
• Children under eighteen (18) years of age cannot be placed in a scattered site independent living program (ILP).  The SSW should contact the PCC/PCP liaison with questions regarding whether an ILP is considered scattered site.  This should occur prior to placing the youth.
  
• If an appropriate in state placement cannot be found and a PCP (PCC Listing) indicates a placement option in one of their out of state foster homes, the placement may be considered in limited situations. 
• Regional staff consults with the Medical Support Section and/or Out of Home Care Branch regarding medically complex children who are in need of specialized placement, which includes out of state placement.
• The placement must:
• Be in the best interest of the child;
• Meet the same requirements and the re-evaluation reviews as outlined in Chapter 12 Foster and Adoptive Family Recruitment, Certification and Reimbursement;
• Have the home study reviewed and approved by the SRA;
• Be within forty-five (45) miles of the Kentucky border;
• Agree to weekly visits by the PCP;
• Agree to monthly visits by the SSW;
• Comply with the Interstate Compact on the Placement of Children (ICPC).  5
• If the PCP agrees with these stipulations, the SSW seeks written approval through supervisory channels of the SRA and Commissioner prior to any placement.
• PCP/PCC agencies and any out of state facility submit the DPP-104C Medically Complex Monthly Report to the SSW, medically complex liaison and the Medical Support Section on medically complex children each month.

Footnotes

1. For a child entering a private child care emergency shelter, a level of care assignment is sought, but is not required in order to place the child.
2. Information is to be documented in TWIST.After best efforts to obtain responses from the child’s parent/guardian about parental objection, a no response may be an appropriate choice. (US District Court Western District of KY, Pedreira et.al. VS. CHFS et. al., Civil Action No. 3:00-CV-210-S).
3. Refer to guidelines found in SOP 10.5 Request to Place a Kentucky Child in Another State for Foster Care or Adoption.
4. Placement may not be made until approved by ICPC.
5. Guidelines for out of state placement requests are found in SOP 4.12 Out of State Placement as well as in Chapter 10 Interstate Compact on the Placement of Children.