4535. Placement - Intensive Resources

Original Date: September 27, 1995 

Revised Date: July 28, 2019

Sunset Review Date: July 30, 2023 

Approved by: Ross Hunter, Secretary


Purpose 

Intensive resources are used to stabilize children and youth in placement. These services can be emergent, crisis, or longer term depending on the need of the child or youth. This policy provides direction on:

  • When to request intensive resources.
  • How to refer children or youth to intensive resources.
  • When to request an in-state or out-of-state child specific contract.
  • How to access Emergent Placement Services (EPS).
  • What conditions must change for a child or youth to return home, and making active and reasonable efforts for timely reunification.
  • How to access specialized Child Placing Agency (CPA) - Group Receiving Care Services.

Scope 

This policy applies to Department of Children, Youth, and Families (DCYF) child welfare employees.

Laws 

RCW 13.34.020  Legislative declaration of family unit as resource to be nurtured—Rights of child.

RCW 13.34.030  Definitions

RCW 13.34.050  Court Order to take a child into custody, when – Hearing

Chapter 13.38 RCW   Washington State Indian Child Welfare Act

Chapter 26.44 RCW   Abuse of Children

RCW 74.13.283  Client Information

RCW 74.14A.020   Services for emotionally disturbed and mentally ill children, potentially dependent children, and families-in-conflict. 

RCW 74.15.020   Definitions

RCW 74.15.090   Licenses required for agencies.

Policy

  1. Intensive Resources
    1. If a child or youth has intensive service needs above the Foster Care Rate Assessment levels of care, including any exceptional cost plans or Behavior Rehabilitation Services (BRS), the caseworker must consult with the regional gatekeeper or program manager.
    2. Prior to referring for In-State or Out-of-State Intensive Residential Child Specific Contracts (IRCSC):
      1. Follow BRS or Medically Fragile Children policies and verify all less intensive services are unavailable or unable to meet the child or youth’s needs.
      2. The child or youth must be referred for a WISe screen and the results documented according to the WISe and BRS policies. If WISe is unable to meet child or youth’s needs, document the reasons why in the WISe section of the BRS referral DCYF 10-166A form.
    3. If services through BRS or medically fragile contracts cannot safely meet the child or youth’s needs or are unavailable, the regional BRS program manager will attempt to negotiate a Child Specific Contract with a Washington State service provider.
    4. If the child or youth’s placement changes to an IRCS contracted provider, verify the placement was documented within three business days in FamLink.
    5. Document the following information in FamLink:
      1. Use of shared planning to identify and develop a plan to meet the family and child or youth’s needs.
      2. Behavioral and permanency goals to be achieved through this placement.
      3. Determination of anticipated length of stay.
      4. The preliminary discharge plan with an identified date. This plan must include services and supports needed to stabilize and transition the child or youth to a less intensive service.
  2. In-State IRCSC
    1. Regional BRS program managers must only pursue an In-State IRCSC contract for a child or youth when all other less intensive contracted services are unavailable or unable to meet the needs of the child or youth.
    2. When the regional BRS program manager determines an In-State IRCSC is needed, they must complete all of the following:
      1. Inform the caseworker of the need to enter into an In-State IRCSC.
      2. Negotiate with prospective in-state agencies regarding an In-State IRCSC and obtain regional administrator (RA) or designee approval.
      3. Consult with the headquarter (HQ) intensive resource manager about the need to pursue an In-State IRCSC and explore other alternatives.
      4. Document the reason for the In-State IRCSC on the Regional Contract Request DCYF 15-470 form, and attach a completed Child Specific Contract Rate DSHS 10-490 form.
      5. Send the completed forms to the individuals listed on the Regional Contract Request DCYF 15-470 form for signature approval.
      6. Verify the WISe screen was completed and the results are documented according to the WISe policy.
      7. Once approved, inform the caseworker of the rate and placement information so that the caseworker can document this in FamLink
      8. Review the child or youth's service needs, level of care, target discharge date, and transition plan in collaboration with the caseworker and contracted service provider at least every three months.
  3. Out-of-State IRCSC
    1. DCYF must only pursue an out-of-state placement for a child or youth when in-state resources are unavailable or unable to meet the needs of the child or youth.
    2. Prior to looking for an Out-of-State IRCSC resource, the regional BRS manager must:
      1. Verify the caseworker has updated the BRS Referral 10-166A form and the BRS packet as needed.
      2. Verify the WISe screen was completed and results are documented according to the BRS policy;
      3. Exhaust all available in-state resources capable of safely meeting the identified needs of the child or youth, including Child Specific Contracts with Washington State providers. This includes a statewide search. Document these efforts, the in-state provider denials, and:
        1. Consult with the HQ intensive resource manager about the need to pursue an Out-of-State IRCSC to identify other resources available to the meet the family and child’s needs.
        2. Inform the caseworker of the need to search out-of-state.
        3. Search for out-of-state resources that meet the unique needs of the child or youth.
      4. Once an out-of-state resource is identified:
        1. Contact the Child Protective Services (CPS) and Licensing agency in the receiving state to learn if there are any violations, corrective actions, or serious concerns with the prospective contractor.
        2. Coordinate an in-person site visit by DCYF employees at any newly identified resource to determine suitability prior to requesting a contract for that placement.
        3. Based on the information gathered, determine if the out-of-state resource meets the Washington State minimum standards, including, but not limited to:
          1. No secure external, bedroom, or seclusion room doors.
          2. No secure perimeter fencing.
          3. No video monitoring in common areas or bedrooms unless prior approval and a court order has been obtained.
        4. Negotiate Out-of-State IRCSC with prospective contractors and obtain approval from the RA or their designee.
        5. Document the reason for the Out-of-State IRCSC, efforts to locate in-state resources, results of inquiries, and the site visit for newly identified resources on the Regional Contract Request DCYF 15-470 form, and attach a completed Child Specific Contract Rate DSHS 10-490 form.
        6. Send the completed forms to the individuals listed on the Contract Request DCYF 15-470 form for signature approval.
  4. Approved Out-of-State IRCSC Placement
    1. Assigned caseworkers must:
      1. Follow ICPC policy.
      2. Coordinate with the court and child or youth’s guardian ad-litem (GAL), Court Appointed Special Advocate (CASA) or attorney, and obtain court approval to place out-of-state.
      3. Complete a safety assessment at key points in the case according to the Safety Assessment policy.
      4. Update the Comprehensive Family Evaluation (CFE) in FamLink per the Family Assessment policy.
      5. Coordinate and verify that the receiving state ICPC or contracted out-of-state provider is conducting monthly in-person health and safety visits per the Health and Safety Visits with Children and Monthly Visits with Caregivers and Parents policy. If the provider does not conduct health and safety visits, consult with the regional contracts manager to identify contracted providers to conduct health and safety visits.
      6. Review the contractor’s monthly Health and Safety Visit Reports to monitor the child or youth’s well-being, and:
        1. Address any identified concerns or needs;
        2. Upload the report in FamLink; and
        3. Document the health and safety visits in FamLink case notes.
      7. Contact the child or youth monthly by phone or video conference, and document the interview in FamLink case notes.
      8. Conduct an in-person face-to-face visit with the child or youth each quarter. The time between visits must not exceed 120 calendar days.
        1. A DCYF employee other than the assigned caseworker may conduct the in-person face-to-face visits. DCYF employees conducting the visits must have:
          1. Current or prior child or youth interviewing experience.
          2. Knowledge and skills needed to assess the child or youth’s health and safety.
        2. Prior to the in-person visit, review available documentation regarding the child or youth which occurred in the last quarter, including but not limited to:
          1. Monthly health and safety visit reports.
          2. Incident reports involving any injury or restraints, if any.
          3. Case notes related from the out-of-state placement.
        3. During the in-person visit, follow up with the child or youth and facility employees about incidents that may have occurred during the last quarter.
        4. After the in-person visit, document the child or youth interviews in FamLink case notes and upload a completed Out-of-State Child Specific Contract Compliance Monitoring Youth Interview Questions DCYF 05-310 form in FamLink.
      9. Participate in quarterly Child and Family Team (CFT) meetings coordinated by the contractor. During the meeting, address youth safety, well-being, and transition planning. Participation may include phone, video conference, or in-person if the meeting occurs during a quarterly in-person visit.
      10. Coordinate visits between parents and siblings according to the Parent, Child, and Sibling Visits policy.
      11. Follow Outside Communication for Children in Out-of-Home Care policy.
      12. Make and document reasonable efforts to reunify the family and achieve timely permanency. If there is reason to believe the child is a member, or the biological child of a member and eligible for membership, in a federally recognized tribe, and document the active efforts made to reunify the family, including a description of the services that were offered or provided, pursuant to Chapter 7 Indian Child Welfare Policies and Procedures.
      13. Identify conditions for return home at the time of placement and when updating a CFE. Conditions to return home provide the parent or legal guardian with specific information on what changes need to occur in order to create a safe physical, psychological, and emotional environment for the child or youth. Conditions are not based solely on the completion of services in a case plan.
      14. Discuss with your supervisor, the child or youth’s progress and readiness for transition to less intensive services in Washington State per the Monthly Supervisor Case Reviews policy.
      15. Once plans to return a child or youth back to Washington begin, refer the child to a provider for a WISe screen to determine eligibility. Use the results to determine service needs.
        1. If the child or youth is eligible follow the service recommendations.
        2. If the child or youth is not eligible or the WISe provider is not able to meet their needs, document the reasons why in a case note or WISe section of the BRS Referral 10-166A form.
      16. Document the following information in FamLink case notes:
        1. Use of shared planning to identify and develop a plan to meet the family and the child or youth’s needs.
        2. Behavioral and permanency goals to be achieved through this placement.
        3. Determination of anticipated length of stay.
        4. The preliminary discharge plan with an identified date. This plan must include services and supports needed to stabilize and transition the child or youth to a less intensive service.
    2. Regional BRS managers must:
      1. Track out-of-state placements, the child or youth’s progress, and identified discharge dates.
      2. In consultation with the caseworker and out-of-state contractor, monitor and assess the child or youth’s readiness for transitioning back to Washington State.
      3. Review cases quarterly based on the out-of-state placement start date, transition plans, and discharge date. If a discharge date has not been identified, obtain it from the caseworker or the out-of-state contractor.
      4. Participate, as needed, in contract monitoring site visits based on identified concerns or monitoring assessments.
      5. Notify the HQ intensive resource manager within the calendar week of learning of any new CPS or other issues or concerns with the out-of-state contractor.
      6. Refer the child or youth to in-state resources when determined they can transition back to Washington State safely or when an emergent need arises due to health and safety concerns. If referring to BRS resources, follow BRS policy.
      7. If there is a placement disruption, make diligent efforts and document efforts to locate an in-state resource prior to searching for another out-of-state placement.
    3. When learning of any health and safety concerns for the child or youth, including but not limited to imminent risk of serious harm, allegations of physical abuse or neglect, inappropriate discipline, or use of restraints:
      1. Immediately contact CPS in the receiving state to make a referral and document the CPS referral number, date, and specific information in FamLink case notes;
      2. Within 24-hours contact the child or youth, unless they told you in-person.
      3. Within one calendar week, notify the:
        1. Health and safety visit contractor and request they conduct an in-person face-to-face visit the child or youth as soon as possible; and;
        2. Regional BRS manager of any CPS referrals made or if there are any other issues or concerns with the out-of-state contracted services.
      4. Follow up to determine the outcome of the investigation and take any actions necessary to address the youth’s safety and well-being.
  5. Emergent Placement Services (EPS) are contracted short-term (15 calendar days) crisis intensive resources that are used when there is an emergent need for a placement and no other placement options are available.
    1. Referrals
      1. If there is no placement available for a child or youth, the caseworker must contact the regional EPS gatekeeper to see if there is an EPS placement available. Regional EPS gatekeepers are identified by the RA or designee.
      2. The caseworker must update the CIPR DCYF 15-300 form if it is not already updated .
      3. Once a request is received, the regional EPS gatekeeper must contact the EPS provider for placement availability. If there is availability, the EPS gatekeeper will:
        1. Send the completed CIPR DCYF 15-300 form to the provider for consideration, and;
        2. Inform the caseworker of the provider’s decision.
      4. If the child or youth is accepted for an EPS placement, the caseworker will arrange the child or youth’s transportation to the provider’s address.
      5. If there is no placement available in the region, the EPS regional gatekeeper may contact the EPS gatekeeper in another region to request an EPS placement. Approval from the receiving regional EPS gatekeeper must be obtained before a child or youth is moved to that placement.
    2. Length of Service
      1. When the EPS placement begins, the caseworker must immediately begin discharge and transition planning for the child or youth, and communicate the discharge date and transition plan to the provider.
      2. If EPS placement is needed beyond 15 calendar days, the caseworker must obtain approval from the regional EPS gatekeeper where resource is located.
      3. If the EPS gatekeeper approves the extension, they must notify the EPS provider. EPS placements cannot be extended longer than 30 calendar days.
      4. When the child or youth transitions out of EPS, the contractor is required to provide the caseworker an EPS Transition Summary which must be uploaded into FamLink.
    3. EPS Contract Management
      1. The RA or their designee must identify one EPS regional lead to oversee the EPS program and compliance monitoring.
      2. The EPS regional lead must:
        1. Track a daily census of the contracted programs within their region.
        2. Track the provider’s monthly reports for:
          1. Percentage of referrals accepted.
          2. Utilization of contracted bed days per month.
          3. Reasons for denied referrals.
        3. Identify if a provider is in compliance with the referral acceptance rate percentage identified in the contract on a quarterly basis. If the provider fails to meet the required acceptance percentage, notify the regional contracts manager within two weeks and request a compliance plan from the provider.
        4. For providers who are not compliant with the required acceptance rate percentage in the EPS contract for the annual reporting period, the regional lead will inform the:
          1. Provider they will no longer receive the monthly per bed base rate and will move to a fee-for-service daily rate as stated in the EPS contract.
          2. Contracts and fiduciary employees of the payment structure change to a fee for service daily rate for the next contract cycle. This will continue until the next annual review and the provider achieves the required acceptance outcome.
  6. CPA Specialized Group Receiving Care are contracted short-term placement (14 calendar days) for children and youth who are in need of emergency housing. The rates cover all costs associated with placement and service delivery for the children and youth. There are two tiers available within these services. Both tier one and two provide children and youth a residence, food, clothing, and other essentials. Services must include a caregiver or contractor employee providing supervision for the children and youth. Tier two is a higher level of service and includes 30 hours of therapeutic case aide services per 30-day stay. The caseworker will also receive a Tier 2 Transition Summary within 24 hours of discharge to assist with service planning for the youth.
    1. Referrals
      Caseworkers, placement desk worker, or after-hours worker must:
      1. If Specialized Group Receiving Care is needed, send a written referral request to a contracted provider.
      2. Authorize the tier one or tier two service when entering the placement. The contracted rate for all tiers is all inclusive and no other payment authorization must be made for placement.
      3. Verify the CIPR DCYF 15-300 form is updated and send to the provider as soon as possible, but no later than three business days of the child or youth’s placement.
    2. Length of Service
      Caseworkers, placement desk worker, or after-hours worker must:
      1. Immediately begin discharge and transition planning for the child or youth when the placement is approved, and communicate the discharge date and transition plan to the provider.
      2. Meet weekly to coordinate timely discharge plans.
      3. Only authorize services as needed for no longer than 30 calendar days.
      4. Obtain signed authorization by the area administrator if the placement is beyond the initial calendar 30 days. Authorizations must be approved every seven calendar days for a maximum of 60 days. Send a copy of each signed authorization to the provider for their client file.

Forms

BRS Referral DCYF 10-166A

Out-of-State Child Specific Contract Compliance Monitoring Youth Interview Questions DCYF 06-310

Child Specific Contract Rate DSHS 10-490

Contract Approval Request DCYF 15-470

Contracted Health and Safety Visit Referral DCYF 10-566

Contracted Health and Safety Visit Report DCYF 10-567

Child Information and Placement Referral (CIPR) DCYF 15-300

Emergent Placement Services (EPS) Transition Summary

Specialized CPA - Group receiving care services Tier 2 Transition Summary