§4 ch24: Medical/Mental Health Planning
24.4 Identification of Children in the Custody of the Children’s Division Solely for the Purpose of Accessing Mental Health Services
Parents should not have to relinquish custody of their child due solely to a need to access clinically indicated mental health services. Children in custody for that reason and absent a probable cause or preponderance of evidence CA/N finding may be eligible for return to the custody of their parents through a protocol established by the passage of Senate Bill 1003 (SB 1003) during the 2004 legislative session:
Supervisory Review of Children Who Are in Division Custody Solely for Mental Health Services per Section 208.204.2 and 208.204.3 RSMo.
Children who have entered Children’s Division custody, absent a probable cause or preponderance of evidence CA/N finding, should be carefully reviewed to determine if they meet the criteria that were contained in SB 1003 signed into law in 2004.
The review of a child in CD custody and determination of meeting SB 1003 criteria must include the following:
- Is the child in the custody of the Division solely because the parents were unable to access or afford mental health needs of the child?
- Is the parent verbalizing a desire for the child’s return to his/her custody if the child could receive the necessary mental health services?
- Would the child’s safety or the safety of others in the home be compromised by such a return of custody?
Should the parent of a child not previously identified as potentially meeting the eligibility criteria contact the CD expressing a belief that his/her child indeed meets these criteria, CD staff will respond to the request and inform the parent that an FST meeting will be convened within two weeks of the parent’s request.
Convening the Family Support Team
Once the review is completed and it appears that the reason for the initial placement may be due solely to a need to access clinically indicated mental health services, a Family Support Team (FST) meeting is to be convened by the CD case manager upon agreement with the child’s parents. This FST meeting should be scheduled and held within 2 weeks in order to begin the process for further assessment and planning. Current policy for FST meetings is to be observed in keeping with the requirements of Section 4, Chapter 7 of the Child Welfare Manual. It is crucial that the child’s family be actively involved in the FST and planning process. The case record should clearly document if the family states they are not yet ready to regain custody.
Additional and crucial FST participants shall include:
- The local representatives of the Department of Mental Health’s (DMH) Administrative Agents and/or DMH Regional Center staff; and
- Representatives of current placement and treatment providers.
If the child has developmental issues that can best be served by MR/DD within DMH, this agency should be actively involved in the planning process.
The focus of the FST meeting is to jointly determine if the child’s placement in CD was due solely to a need for mental health services and was unrelated to parental abuse, neglect, or abandonment. In addition, the team should determine if the child can be returned safely to the custody of the parent even if he/she continues to need out-of-home care.
If consensus is not reached by the FST on whether the child meets the eligibility criteria, the child shall be considered inappropriate for the Senate Bill 1003 protocol. This, however, should not exclude other efforts toward reunification or further steps to obtain clinically indicated services or supports through DMH.
Development of an Individualized Plan to Return the Child to the Custody of the Parent and Request for a Court Hearing
If the FST agrees that the family meets the criteria for SB 1003 and the parent desires to have the child returned to his/her custody, an individualized plan shall be developed which outlines all services and supports needed by the child and family and identifies who shall be financially responsible for each.
The child, if appropriate and the family shall actively participate in the plan’s design. Identified services shall be provided in the least restrictive and most normalized environment. Treatment services and supports shall include but not be limited to those which are home and community based.
This plan shall be submitted to the court within sixty (60) days of the child having been identified through consensus of the FST. The judge may then return custody of the child to the parent.
Payment for Services Provided to the Child and Family Once Custody Has Been Returned to the Parent
208.204.4: When children are returned to their family’s custody and become the service responsibility of the Department of Mental Health, the appropriate moneys to provide for the care of each child in each particular situation shall be billed to the Department of Social Services by the Department of Mental Health pursuant to a comprehensive financing plan developed by the two departments.
The Children’s Division is committed to assuring that the child and family continue to have access to those services that help them meet the needs of the child. If the Division previously paid for such services, it will continue to do so. It is not necessary for the child to be returned to the home of the parent in order for custody to be transferred. To that end, the Division will continue to fund residential treatment if the child continues to need that service as identified through the individualized treatment plan.
Staff should contact the payment unit in Central Office (573-751-8946) for assistance in payment to placement providers for any youth in need of continued residential placement but no longer in the Division’s legal custody.
Ongoing Implementation of Sections 208.204
For youth who meet criteria under statute cited above and are not otherwise diverted from CD custody, staff should implement the above protocol as quickly as possible to help expedite the youth’s return to the custody of his/her parents. The issues relating to the child’s placement should be addressed as early as the initial 72-hour FST meeting. The representation of DMH and the current placement provider(s) should be brought into the FST process as soon as possible to assist in the service planning.
Within sixty (60) days of a child being identified as appropriate for the provisions of Section 208.204.2-3 RSMo. an individualized treatment plan shall be developed by the FST, and the Children’s Division shall submit the plan to the juvenile/family court judge for approval. The child may be returned by the judge to the custody of his/her family.
The instructions for Form CS-1 have been revised to better document the seeds of the child and family, see CS-1 in E-Forms Index. Issues relating to the child’s mental health needs and the services and supports that may be needed for his/her parents should be addressed in the ongoing FST meetings. Special emphasis should be placed on determining if the child can be safely returned to his/her parents custody if the necessary mental health services and supports were in place.