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 (PCC) or private child placing (PCP) agencies may provide care and services for a child for whom the Cabinet has legal responsibility.

Practice Guidance

• The PCP or PCC program provides a response regarding possible placement of the child to the regional placement coordinator (RPC) within two (2) working days of receipt of a referral.
• Prior to a PCC facility 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 then 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 needs change at any point, the SSW should always exhaust Department for Community Based Services (DCBS) foster care, as appropriate, then complete an updated DPP-886A Application for Referral and Needs Assessment in TWIST and submit to Children's Review Program (CRP) for placement. 
• Children under age eighteen (18) 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; and
• Comply with the Interstate Compact on the Placement of Children (ICPC).  1
• 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.

Procedure

The SSW:

1. Seeks placement through a PCP or PCC agency when a DCBS foster and adoptive home is not available or appropriate for a child;
2. Obtains a level of care (LOC) assignment for the child, if this has not already been done; 2 
3. Follows procedures detailed in SOP 4.51.1 Placement in a Congregate Care (Residential Treatment) Setting when a youth is being considered or referred for residential treatment: 3​
4. Requests referral of the child to a PCC placement by:
1. Documenting on the DPP-886A and email the RPC to advise that the DPP-886A has been uploaded; 
2. Se​nding the referral packet via TWIST with the assigned LOC to the RPC during business hours;​4 or
3. Contacting the PCC directly, utilizing the After Hours Referral Contacts website;
5. 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;
5. That promotes continued contact with the child’s family, friends, community, school and other primary connections; and
6. That is the most cross-culturally informed and responsive available, including religious beliefs.
6. Schedules an interview (if required) for the child with the PCP/PCC staff and makes arrangements for the child’s transportation to each interview;
7. Completes the DPP-114-Level of Care Schedule and determines that the completed form is consistent with the child’s assigned LOC when placement is to be made;
8. Follows the form’s procedural instructions regarding the appropriate signatures, to indicate approval of the child’s placement;
9. Arranges transportation or transports the child and his/her belongings to the placement on the pre-arranged placement date;
10. Gives PCP/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);
11. 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);
12. Sends written notification to the RPC that the child has been admitted to the program;
13. Provides the PCP/PCC staff the following information regarding the child, within seven (7) working days of admission:
1. DCBS child/youth action plan;
2. Visitation agreement; and
3. Transition plan, if the youth is over age seventeen (17);
14. Provides the PCP/PCC staff the following information regarding the child, within ten (10) working 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;
15. Requests an out-of-state placement through the 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); 5 6
16. 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 LOC 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. Exhausts DCBS foster care per regional protocol, if foster care is appropriate;  
4. Notifies the RPC of the need for a new placement by completing a new DPP-886A in TWIST and submitting to CRP for placement if DCBS foster care is not appropriate or available; 
5. Notifies the medically complex liaison, medical support section, and the SKY MCO nurse of a medically complex child’s move;
17. Does not refer a child less than eight (8) years of age or with a LOC of three (3) or less, for placement in a PCC residential program, except under special circumstances, and with SRA approval;  
18. ​​Follows procedures detailed in SOP 4.51.1 Placement in a Congregate Care (Residential Treatment) Setting for any child placed in a PCC residential treatment setting.  
    

1. Refers the child to appropriate PCP/PCC programs by sending the ​referral packet and LOC assignment to the program, and provides the SSW with written notification of the referrals.

Footnotes

1. 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.
2. For a child entering a PCC emergency shelter, a LOC assignment is sought, but is not required in order to place the child.
3. SOP 4.51.1 Placement in a Congregate Care (Residential Treatment) Setting aligns practice with guidelines and requirements for the placement of youth in residential treatment facilities, in addition to their ongoing treatment, discharge, and aftercare planning, established under the Family First Prevention Services Act.​
4. In the event of an emergency referral, the SSW should contact CRP via email or phone to advise of an imminent placement need. Efforts to complete the DPP-886A should be made to ensure the most appropriate placement.  ​
5. Refer to guidelines found in SOP 10.5 Request to Place a Kentucky Child in Another State for Foster Care or Adoption.
6. Placement may not be made until approved by ICPC.