Children's Administration, Department of Social and Health Services
Children's Administration, Department of Social and Health Services
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Practices and Procedures Guide

4540. Adoption Services

45401. Purpose

The department's adoption program is intended to meet the needs of children who have no legal parents and who are in the department's care and custody by providing opportunities for them to be adopted into stable, nurturing families.

45402. Eligibility

DCFS provides adoption services to any child in the department's custody whose permanency plan is adoption.

45403. Information Gathering and Sharing

This section provides guidelines for Children's Administration (CA) staff for the collection and disclosure of full information regarding adoptive children and their birth families to adoptive parents.

  1. The assigned social worker and private adoption agencies and entities must make reasonable efforts to locate records and information concerning the mental, physical, and sensory handicaps of the child and his/her birth parents, their family backgrounds, and social histories.
    1. The entities providing the information have no duty, beyond providing the information, to explain or interpret the records or information regarding the child's present or future health.
    2. The assigned social worker maintains the Health and Education record in accordance with guidelines contained in the CA Practices and Procedures Guide, chapter 4000, section 43092.
      1. For any child in placement after 90 days, or whose placement is expected to last longer than 90 days, the agency must gather medical, educational, and mental health background information concerning the birth parents and the child. The assigned social worker must ensure this occurs, but another employee or contractor of the department may complete the task.
        1. The social worker documents this information in the child's case file by maintaining all records gathered and by documenting information on the child's Health and Education Record or on the Health and Education Passport in FamLink. The worker also maintains copies of written requests for records from the child's and parents' physician, treating professionals, and the last school attended in the case file.
        2. The social worker reviews this information prior to the disposition and permanency planning hearings.
        3. Assigned staff must complete the Health and Education Passport and document efforts to obtain information about the child and birth parents prior to case transfer between social workers or units.
      2. The social worker will ask birth parents, for every child in placement or expected to be in placement longer than 90 days, to sign appropriate release of information forms so that the department can gather information concerning both the child and the birth parents from treating professionals, physicians, and schools.
        1. If parents are unwilling to sign appropriate release of information forms, the social worker must request the court to order authorization of release of confidential records so that background information may be obtained.
        2. The social worker consults the AAG so that the language in the court order meets federal requirements for release of confidential information from substance abuse and mental health treatment programs.
    3. The social worker includes on the DSHS 13-041 information about the efforts, including unsuccessful efforts, made by the department to obtain information about the child and his/her birth family. Efforts to obtain information about the child include interviews with relatives; interviews with parents; and requests for information from treatment agencies, schools, and other sources from whom the parents received professional examination, evaluation, or treatment.
  2. The adoption worker shares information about children and birth family for whom a family is being considered with that family by using the following guidelines:
    1. General information about a referral may be shared with a family each time a referral is made.
    2. For policy regarding disclosure of information, see the Case Services Policy Manual, chapter 5000, section 5840.
    3. Guidelines for information shared with the adoptive family can be found in 42 USC 675, section 475, RCW 26.33.350, 26.33.380, and RCW 70.24.105, as well as the Case Services Policy Manual, chapter 5000, section 5840. See the Case Services Policy Manual, chapter 4000, section 4120, paragraph A, for requirements to disclose information regarding HIV infection and sexually transmitted diseases to the residential care provider for the child who is less than 14 years of age.
  3. The child's assigned social worker must make available and provide copies to the prospective adopting parent prior to adoptive placement the Child's Medical and Family Background Report, DSHS 13-041, the child's Health and Education Passport, and other available social information.
    1. The social worker need not copy information in the Passport on the DSHS 13-041, but may incorporate it by attaching the Passport, and documenting the attachment, on the DSHS 13-041.
    2. The complete medical report must contain all known and available medical information concerning the mental, physical, and sensory handicaps of the child. The report must not reveal the identity of the birth parent of the child, except if already known by the adoptive parents. However, the report must include any known or available mental or physical health history of the birth parent that needs to be known by the adoptive parent to facilitate proper health care for the child or that will assist the adoptive parent in maximizing the developmental potential of the child.
    3. Where known or available, the information must include:
      1. A review of the birth family's and the child's previous medical history, including the child's x-rays, examinations, hospitalizations, and immunizations;
      2. A report of physical examination of the child conducted within the previous 12 months by a licensed physician with appropriate laboratory tests and x-rays;
      3. A referral to a specialist if indicated in reports released in the DSHS 13-041; and
      4. A written copy of all evaluations of the child with recommendations to the adoptive family receiving the report.
    4. Following reasonable efforts to locate the information, the placing social worker must give to the adoptive parents a family background and child and family social history report with a chronological history of the circumstances surrounding the adoptive placement and any available psychiatric, psychological, court, or school reports. Reports or information provided to the prospective adopting parent must not reveal the identity of the birth parents of the child but must include reasonably available non-identifying information. The form used for this report is the DSHS 13-041(X).
    5. The social worker must share with the prospective adoptive family all reasonably available information about the child and his/her birth parents, with receipt, including date of receipt, documented on the DSHS 13-041.
      1. If a prospective adoptive parent reads the child's file, the social worker must document that activity and have the adoptive parent sign and date an acknowledgment of having read and reviewed the file.
      2. In addition, the social worker must request that the adoptive parent initial each page of each document, including the Service Episode Record (SER), the adoptive parent has reviewed. The adoptive parents' signature on the form signifies their intent to adopt the child and acknowledges receipt of the information provided. The prospective adoptive parents' signature on the DSHS 13-041 does not signify the agency's approval of the adoptive placement.
    6. If CA staff withholds information from the adoptive parents, the adoption supervisor or a staffing in which adoption specialists are present (such as an adoption planning review) must approve the action. Following these approvals, the area manager must also approve withholding of information. The social worker must document the approval to withhold information in the child's archived file and needs to include the signatures of the adoption supervisor and/or adoption specialists authorizing the withholding of the information. Information may not be withheld if it could have any effect on the parenting of the child.
  4. The social worker must disclose to adoptive parents when a child being placed for adoption is receiving or has received mental health services, is or has been prescribed psychotropic medication, has a sexually transmitted disease, and/or is HIV positive. With respect to disclosure of HIV antibody testing or treatment of sexually transmitted diseases, department staff must comply with the following requirements:
    1. The following persons may receive such information:
      1. A department worker;
      2. A child placing agency worker;
      3. A guardian ad litem who is responsible for making or reviewing placement or case-planning decisions or recommendations to the court regarding a child, who is less than 14 years of age, has a sexually transmitted disease, and is in the custody of the department or a licensed child placing agency;
      4. A person responsible for providing residential care for such a child when the department or a licensed child placing agency determines that it is necessary for the provision of child care services.
    2. No person may release information concerning HIV status and sexually transmitted diseases to the adoptive parent of a child over the age of 14 without the consent of the child or an order from the court. No one may release mental health counseling and treatment information, including the prescription of psychotropic medications, to the adoptive parents of a child over the age of 13 without the child's consent to release of the information or court order.
      1. The social worker must not make a placement without full disclosure, either by consent of the child or court order, of diseases that the child may have or a condition that requires treatment.
      2. The social worker must inform the adoptive parents that information exists which cannot be released because of the failure of the child to sign a release of information:
        1. If the youth refuses to sign a release of information; or
        2. The social worker cannot obtain a court order authorizing release of information.
      3. The social worker must document in the case file that the child has refused the release of confidential information and that the social worker has informed the prospective adoptive parents of this fact.
      4. If the social worker cannot disclose HIV or mental health information because the worker does not have a court order or consent to release information, the social worker, the worker's supervisor, and the prospective adoptive parents will have to make a decision on an individual basis whether to proceed with the adoptive placement or finalization of the adoption.
    3. The social worker must follow an oral disclosure with written notice within 10 days.
    4. Whenever the social worker discloses information, the worker must accompany the disclosure with a written statement that includes the following or substantially similar language:
      “This information has been disclosed to you from records whose confidentiality is protected by state law. State law prohibits you from making any further disclosure of it without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. A general authorization for the release of medical or other information is NOT sufficient for this purpose.”
  5. In addition to the requirements regarding the adoption placement decision in, chapter 4000, section 45407, below, the following conditions apply:
    1. If a child is already placed with the prospective adoptive family as a foster child or in a relative placement, the social worker shares the DSHS 13-041 with the family prior to the child's placement being considered an adoptive placement.
    2. An adoptive placement requires prior provision of all reasonably available child and family medical, school, psychological, and social reports to the prospective adoptive parents. CA considers a placement, including one with the current foster parents or relative care providers, to be an adoptive placement when:
      1. The birth parents' rights have been terminated;
      2. The prospective adopting parent(s) have formally expressed an intent to adopt (e. g., submitted an application for an adoptive home study and/or applied for Adoption Support), usually in writing; and
      3. The department has acknowledged the prospective adopting parent(s)' interest in a particular child by formally acknowledging the eligibility of the adoptive parent(s) to adopt a particular child, usually in writing.
        1. Acknowledging the eligibility of a prospective adoptive parent for a child may be contained in an ISSP, approval of an adoptive home study, approval of an Adoption Support application, or other written communication.
        2. An approved home study/pre-placement report is not required prior to an individual attaining the status of “prospective adoptive parent.”
    3. The department regards approval of an Adoption Support application, even one that later lapses because the adoption was not timely finalized, or inclusion of a plan for a family to adopt in an ISSP as formal acceptance of the suitability of the parent, even if the social worker or private agency representative has not yet completed an adoptive home study/pre-placement investigation . This formal acceptance triggers the duty to disclose, meaning that the social worker must promptly disclose the medical, family, and social histories to the adopting parents.
    4. The prospective adoptive family may consult with a specialist prior to agreeing to adopt the child and signing the DSHS 13-041. The DCFS social worker must provide to the prospective adoptive family all documents requested (with identifying information of the birth family deleted) in order to facilitate a consultation with a specialist of the family's choosing. If a prospective adoptive parent reads the child's file, the social worker must document that activity and have the adoptive parent sign an acknowledgment of having read and reviewed the file.
  6. The family's receipt of information about a child, contact with a child's caseworker, contact with a child's foster family, etc., must be governed by procedures that do not violate the confidentiality requirements of case information. Thus, prospective adoptive parents must agree to keep information about the child, family of origin, and foster family confidential.
  7. For guidelines for archiving of records of legally free children, see the CA Operations Manual, chapter 13000, section 13930.

45404. Services to Parents

  1. Voluntary Adoption Plan-Under a voluntary adoption plan, the department must follow the wishes of the parent(s) and/or the alleged father in identifying the proposed adoptive placement of the child if the proposed family receives an approved home study and the court agrees that adoption by this family is in the best interests of the child. See the Case Services Policy Manual, chapter 5000, section 5762, for requirements of a voluntary adoption plan.
    1. The assigned department social worker must work with the parent to determine whether the parent will identify a preferred adoptive placement by name.
    2. If the parent identifies a preferred placement, the assigned social worker will advise the alleged father, the birth parent, and proposed adoptive parent(s) that either CA, a private agency, a qualified individual may do an adoptive home study.
    3. If the proposed adoptive parent chooses to have an adoptive home study completed by a private agency or qualified individual, CA retains the right to do its own home study if it has concerns regarding the recommendations contained in the non-departmental home study.
    4. If a private agency or qualified individual completes a home study and CA chooses to do its own adoptive home study, the CA social worker must prioritize scheduling this CA home study over pending studies of other proposed adoptive homes.
    5. Using approved procedures for determining suitability to be an adoptive home, the social worker must determine that:
      1. The family meets the criteria to be an adoptive placement as described in RCW 26.33.190; and
      2. The placement is in the best interests of the child.
    6. In the event that the social worker, the alleged father, birth parent, or current adoptive parent disagree about the suitability of the proposed adoptive placement, the court will determine whether the prospective adoptive resource is suitable and whether this placement is in the best interests of the child.
    7. If the Attorney General's office or the local prosecutor, as applicable, has filed a termination petition at the department's request and the parent agrees to relinquish parental rights, CA must consider the parent(s) or alleged father's adoption placement preferences for the child but is not required to accept it.
  2. The social worker gives consideration to requests of the parent(s) regarding religious or other general characteristics of the adoptive family for their child when those requests are in the best interest of the child.
  3. The social worker must inform Native American parents of the federal/state law requirements regarding the adoption of Native American children and of the department's goals and procedures regarding Native American children. Refer to the ICW Manual.

45405. Services to the Child

  1. The social worker provides ongoing casework and preparation of the child for adoption, which may include:
    1. Gathering information to prepare life story books.
    2. Counseling the child.
    3. Arranging referrals to various professionals.
  2. The social worker assesses the child's medical and social needs by completing:
    1. The life story book.
    2. The DSHS 13-041(X), Child's Medical and Family Background Report.
  3. The social worker gives a copy of the completed Child's Medical and Family Background Report to the adoptive family before or at the time the child is placed with the adoptive family. The worker must provide the form to the foster-adopt family and/or relative family planning to adopt the child, following the worker's decision that the family is the adoptive family of choice. The prospective adoptive parents need to read and sign the form. The social worker places the original copy of the form in the child's file for archiving with the child's record.
  4. The social worker refers the pre-adoptive child for an SSI application if not already screened by the SSI facilitator. Funding under Title IV-E for adoption support is available to children eligible for SSI prior to adoption.
  5. Adoption planning occurs before and immediately after termination of parental rights. See section 4330 on open adoption agreements and section 4690 on adoption planning reviews. The goal of review is to explore all possible permanency options available for the child and to choose the best permanency option for the individual child. The reviews are also an opportunity to initiate social and medical assessments if they have not been done, to explore available adoptive family resources, and to develop the recruiting and post-termination case plan for a particular child.
  6. The assigned social worker conducts monthly Health and Safety Visits with the child:
    1. See Section 4420- Social Worker Monthly Health and Safety Visit.

45406. Family Selection and Recruitment

  1. Family selection and/or family recruitment and matching may be completed through utilization of local and/or regional adoption consortia and state, regional, and national adoption exchanges.
  2. What children can be registered?
    1. Children who are legally free for adoption and who do not have an identified permanent family.
    2. Children who are not yet legally free can be registered with WARE under the following circumstances:
      1. Termination of parental (TPR) has been initiated or TPR date has been set; or
      2. The child's worker has obtained a court order to search for an adoptive family; or
      3. The child's social worker has obtained the parents written consent to recruitment for an adoptive home.
  3. The child's social worker shall refer all children with an identified plan of adoption with the Washington Adoption Resource Exchange (WARE) within 30 days of the court order ordering the termination of parental rights.
    1. The social worker sends the following documents to the WARE office:
      1. Adoption Exchange Child Registration; and
      2. A clear photograph of the child.
      3. Specific recruitment is desired because the child may be difficult to place; the social worker also sends the DSHS 9-6111, Release and Consent for Child Specific recruitment.
    2. The social worker maintains a copy of the Adoption Exchange Child Registration in the child's social service file.
    3. The contracted provider of the WARE will:
      1. Send the child's social worker information on potential families.
      2. Coordinate child specific recruitment activities.
      3. Upon certain conditions, refers the child to other regional and national adoption exchanges.

45407. Placement Decision

  1. The social worker evaluates families referred for a legally free child to determine which of the families can best meet the needs of the child using the following criteria:
    1. The family's ability to meet the physical, cultural, emotional, and mental needs of the child. A family need not be of the same ethnic background as the child in order to meet the ethnic or cultural needs of the child. In rare circumstances, the social worker may identify a compelling reason to attempt to place a child with a family of a particular racial or ethnic heritage. Otherwise, the department will not match children on the basis of race to families.
    2. The compatibility between the child's personal characteristics and the expectations of all members of the adoptive family.
    3. The specific experiences and/or training the family has had which prepares them to provide for the special needs of the child.
    4. The resources in the family's community which are available to meet the special needs of the child.
    5. The degree to which the family is willing to initiate and participate in medical and/or therapeutic treatment.
  2. The social work staff of the CA office with administrative responsibility for the child makes the final decision on placement of a child with an adoptive family. The child's worker makes the final placement selection for families referred from the WARE and other referral sources in conjunction with the CWS supervisor. The CA staff considers the following criteria:
    1. The child's attachment with the foster family and length of time in the foster care placement.
    2. The ability of the adoptive family to meet the special needs of the child.
    3. The ability of the adoptive family to meet the cultural and ethnic needs of the child. A family need not be of the same ethnic background as the child in order to meet these needs. Unless the CA staff identifies a compelling reason, CA staff will not match children on the basis of race to foster or adoptive families.
    4. Willingness to provide long-term contact with siblings who may be placed elsewhere, appropriate birth relatives, former foster families, or other individuals who may have prior relationships with the child.
    5. Whether or not the adoptive family is a birth relative. If a relative, the following factors shall also be evaluated:
      1. The relatives' previous relationship with the child.
      2. The relatives' ability to protect the child, if necessary, from the birth parents while avoiding portraying the birth parents in an unnecessarily negative manner.
  3. For foster-adoptive placements, the foster-adoptive family must sign a Permanency Planning Placement Agreement, DSHS 15-175. See section 45351.

45408. Visitation and Placement Planning

The child's foster parents may be involved in planning and implementing plans.

  1. The purposes of visitation include:
    1. To initiate contact between the family and the child and to observe the relationship as it develops.
    2. To allow the prospective adoptive parents and child(ren) an opportunity to begin to know each other.
    3. To allow the prospective adoptive family, the adoption worker, the child, and the child's caseworker an opportunity to make a continuing evaluation regarding suitability of the placement.
  2. The child's worker:
    1. Works with the adoptive family to select an appropriate location for the visitation(s).
    2. Accompanies the child on the initial visit.
    3. Discusses each visit with the child and family after they have occurred.
    4. Continues to assess with the adoptive family and the child, as appropriate, whether to proceed with visitation and/or placement.
  3. The length of visits and total amount of time between first meeting and placement will vary. The age and developmental level of the child(ren), their attachment to the foster family, and their emotional readiness to move are all factors to consider. A typical placement transition may include three to five pre-placement visits, with each visit increasing in length until child is actually placed. Open contact between the new family and the family the child is leaving should occur whenever possible and when in the child's best interest.

45409. Adoption Placement Services

  1. For Foster-Adoptive Placements, the social worker needs to refer to section 4535.
  2. For regular adoptive placements, the child's social worker completes the following upon placement of the child:
    1. Provides the adoptive family with a letter permitting them to obtain medical care for the child.
    2. Coordinates/arranges for moving all the child's possessions.
    3. For children registered with WARE, completes and submits DSHS 15-21, Change of Status, to the WARE program manager.
    4. Inclusion of the following in the child's case record:
      1. Certified copies of all legal documents terminating parental rights.
      2. Signed copy of the Permanency Planning Placement Agreement, DSHS 15-175
      3. A cover memo to the adoptive family worker stating the date of the next six month court review hearing and the address of the court holding jurisdiction.
    5. Transfers the child's record (all volumes) to the DCFS adoption worker who will be supervising the placement, except in the case of a placement into a private agency adoptive home or into an out-of-state adoptive home.
      1. For placements within the same local office service area, the child's social worker transfers the child's file for reassignment to the adoption worker.
      2. For placements into a DCFS home outside the catchment area, the child's social worker transfers the child's file to the receiving adoption worker and maintains a dummy legal file. Legal jurisdiction is retained and dependency reviews continue until the adoption is finalized.
      3. For placements into a private agency or out-of-state home, the child's file is retained and only copies of necessary documents are provided to the supervising agency adoption worker.
      4. For out-of-area placements, local protocols shall determine whether the local office adoption worker or child's worker maintains case responsibility pending finalization.

454010. Post-Placement Services to the Family and the Child

  1. The purpose of post-placement services is to support continuing placement of the child in the family by providing needed services or referrals.
  2. The assigned social worker provides on-going casework supervision of the adoptive placement and coordinates needed support services for the family and/or child. Post-placement support services may include the following:
    1. Casework services designed to assist the family and child during the initial adjustment period. Contacts shall be maintained, at a minimum, on a monthly basis and may be face-to-face or telephone. The social worker must document the contacts in the case SER.
    2. Information and referral to community resources.
    3. Formation of and leadership in adoption support groups for parents of adoptive children.
  3. The assigned social worker provides the family with a copy of the adoption support brochure and:
    1. Discusses the child's eligibility for medical and/or financial assistance. See chapter 4000, section 4517, for Medicaid eligibility, and chapter 5000, section 5700.
    2. Discusses the ability of the family to adopt without adoption support. In most instances, the worker shall encourage the family to apply for medical support.
    3. Completes applications for adoption support and non-recurring costs as described in section 5700.
    4. Tries to ensure that the family has a signed agreement(s) prior to finalization of the adoption.
  4. The assigned social worker is required to conduct monthly visits with the caregiver (See Section 4420 - Social Worker Monthly Health and Safety Visit)
  5. At the time when the family, the child, and the adoption worker mutually agree that finalization of the adoption is in the best interest of all persons involved, the adoption worker encourages the family to retain an attorney to file the petition for adoption. If the local court permits, an adoptive parent may petition to adopt without an attorney when there is no need for DCFS to release confidential information; for example, the adoption of an older child when the names of the birth parents are already known to the adopting parents.
  6. The attorney retained by the adoptive family files the petition for adoption. The adoption worker provides the attorney with the following documents and information when the worker is satisfied that finalization is in the best interest of the child and the family:
    1. A certified copy of the legal order of termination of parental rights.
    2. Release and Consent to Adoption signed by the Regional Administrator or designee or information indicating where to obtain consent if that responsibility does not lie with the Regional Administrator.
    3. Adoption consent from children 14 years of age and older.
    4. A completed Application for Adoption Re-Registration, DSHS 9-465, for issuance of the child's revised birth certificate.
    5. The date of filing of the pre-placement report or is intended to be filed with the court.
    6. A copy of the final signed Adoption Support Agreement and agreement for non-recurring costs reimbursement, if applicable.
    7. A written request for a copy of the certified decree of adoption after finalization.
  7. The assigned social worker completes court work that includes:
    1. Dependency reviews until adoption is finalized.
    2. Individual Service and Safety Plans.
    3. Post-placement report.
    4. Notification of GAL and juvenile court that adoption is finalized and obtain dismissal of dependency order.

454011. Post-Placement Report

  1. The court, accepting a petition for adoption, orders a post-placement report to advise the court as to the propriety of the adoption.
    1. The department shall be named to complete the post-placement report for a child for whom it provided post-placement services.
    2. The adoption worker completes the Adoption Data Card.
    3. If the adoption worker does not intend to appear at the hearing, he/she completes the Waiver of Notice of Further Hearing, DSHS 9-54, or the Acknowledgment of Notice and Declaration of Intent Not to Appear, DSHS 9-56, provided the departmental recommendation is positive and the parental rights of the child to be adopted have been terminated.
  2. If the post-placement report is negative, the department shall request representation by the Office of Attorney General (or local prosecutor, where applicable) at a hearing on the matter. In this case, the DSHS 9-54 and the DSHS 9-56 shall not be included with the report.

454012. Disruption Services

Disruption services are designed to develop a new placement plan for a child when it becomes evident, prior to finalization of an adoption, that the adoptive placement should not continue.

454013. Post-Adoption Finalization Services

Refer to section 4700, Case Resolution/Closure

4541. Psychotropic Medication Management

45411. Purpose and Scope

  1. This standard and procedure establishes guidelines for Children's Administration (CA) staff and CA-licensed or certified out-of-home care providers to follow when a child is in the custody of the department, placed in out-of-home care, and is or may be administered psychotropic medication.
  2. This standard applies to children placed in the department's custody, whether by voluntary placement agreement (VPA) or court order. It is prospective only. It applies only to children not receiving such medications on the effective date of this policy, June 1, 1997.

45412. Definitions

  1. For definitions of “Medical History,” “PRN,” and “Psychotropic Medication” as they pertain to this section, see Appendix A.
  2. “Informed consent” means consent given for administration of psychotropic medications by a person authorized by law or under this section following provision of information by a licensed medical professional regarding the purposes of the medication, the range of dosages, possible side effects, and expected results.

45413. Standard

  1. The CA social worker and the out-of-home care provider must comply with the provisions of RCW 13.34.060 regarding authorization of routine medical and dental care for the child in the custody of CA.
  2. For children who have been prescribed psychotropic medication, compliance with Chapter 71.34 RCW, Mental Health Services for Minors, is required.
  3. Neither the CA social worker nor the out-of-home care provider may authorize the administration of psychotropic medications to a child in the custody of CA, with the following exceptions:
    1. The CA social worker may authorize the administration of such medications if the child is legally free and in the permanent custody of the department.
    2. The CA social worker may authorize the administration of such medications when it is impossible to obtain informed parental consent after normal work hours, on weekends, or on holidays. In such instances, the social worker must obtain either informed parental consent or a court order within 72 hours, excluding weekends and holidays, of authorizing administration of the medication.
  4. The parent of the child in CA custody must provide informed consent for the administration of psychotropic medications to the child, unless the child is age 13 or older and competent to provide consent in his or her own behalf. If the parent is unavailable, unable, or unwilling to consent to the administration of medically necessary psychotropic medications, the social worker shall obtain a court order before the medications may be administered.
  5. Consent for treatment will vary according to the child's age.
    1. Children age 13 years and older must consent to the administration of their own medication. They also have the right to maintain confidentiality of the information.
      1. The CA social worker needs to encourage the adolescent to share information about the use of such medication with their parents, their out-of-home care provider, and their guardian ad litem. The care of the child is likely to be compromised if the out-of-home care provider does not have knowledge of the medication being used and access to the prescribing physician for consultation.
      2. If the child refuses to release information concerning medication to the out-of-home care provider, the CA social worker shall review the child's continued need for placement. If the child remains in out-of-home care and continues to refuse to release information about his/her medication, the social worker will request the court to order release of the information to the care provider and to the department.
      3. If the child refuses to release information to the parent, the parent, if wanting the information, needs to request a court order to obtain it.
    2. Children who are 13 years of age and older may not be able to provide knowledgeable consent to administration of psychotropic medication due to cognitive disabilities. In such an instance, the treating medical professional determines if the child is capable of giving consent. If the child is unable to provide consent, the parent must provide consent or the social worker must obtain a court order to authorize treatment.
  6. The informed parental consent or court order needs to be a general authorization for the administration of psychotropic medications at the direction of a qualified, licensed physician so that a change in the consent or court order is unnecessary when it is necessary for the physician to adjust the medication.
  7. The social worker may contact the statewide Child Abuse Consultation Network at 1-206-987-2194 or after hours at 1-206-987-2000 whenever medication management would be facilitated by expert medical consultation. For consultation with a pharmacist on prescribed or non-prescribed medications, the CA social worker, the foster parent, or other care provider may contact the Washington Poison Control Center at 1-800-222-1222. Department staff needs to identify himself or herself as a CA social worker, and ask to speak to the pharmacist on duty.

4542. Holding Therapy

45421. Purpose and Scope

  1. The Children's Administration (CA) Adoption Support Program Manager will consider a request for Holding Therapy only for a child who has been adopted and is served by the Adoption Support program.
  2. CA staff must not approve the use of Holding Therapy for any child other than one served by the Adoption Support program.
  3. The level of service is limited to that prescribed in chapter 388-25 WAC relating to the Adoption Support program.

45422. Definitions

  1. “Holding Therapy” is a therapeutic process designed to promote, develop, or enhance a reciprocal attachment relationship through therapist(s)-led holding and/or parent-child holding. Holding means to physically restrain a child or use an “arms in” position in the course of therapeutic treatment.
  2. “Physical Restraint” means to control the movement or curtail the freedom of a child in the course of therapeutic treatment.
  3. “Arms In” describes a method in which the child sits or lies in the arms of the therapist(s) or parent during the treatment session.

45423. Procedures

  1. Only the Adoption Support Program Manager may authorize department payment for Holding Therapy.
  2. In determining authorization for holding therapy, the Adoption Support Program Manager needs to see chapter 388-25 WAC for the Adoption Support program for specific department requirements that apply to outpatient counseling services not covered by Medicaid.

4543. Foster Care Assessment

45431. Service Definition

  1. The Foster Care Assessment Program is a multi-disciplinary contract between Children's Administration (CA) and Harborview Center for Sexual Assault and Traumatic Stress and its subcontractors to assess the needs of children who have been in out-of-home care for more than 90 days. Assessment services include a six-month follow-up period to assist the DCFS social worker in implementing a placement plan and to help meet the needs of the child and family.
  2. The program has two goals:
    1. Ensure that the physical and emotional health, developmental status, and educational adjustment of children in the care of the state have been assessed and any significant needs addressed; and
    2. Identify and help resolve obstacles to reunification, adoption, guardianship, or other permanent plan.

45432. Eligibility

CA and Harborview give priority for the service to those children identified as likely to need long term care because the children face physical, emotional, medical, mental, or other long-term challenges that serve as barriers to achieving a plan for permanency.

45433. Service Description

  1. The contractor's program social worker and a pediatrician will conduct each assessment. The social worker and the pediatrician will review case information and consult with key people in the child's life, including the DCFS social worker, parents, foster parents, the child's primary care physician, teacher, and other involved professionals.
  2. The standard assessment consists of structured clinical interviews and the administration of standardized measures. A multi-disciplinary team representing pediatrics, psychiatry, psychology, social work, DCFS, and other consultants (e. g., ethnic/cultural and foster/adoptive parent) will review the preliminary results of the assessment.
  3. All important parties in the child's life will be involved in the development of a concrete plan to address the child's health needs and to establish the best possible permanent family connection for the child.
  4. A Harborview program social worker will provide six months of follow-up services to assist the DCFS social worker with the implementation of the child's plan.

45434. Procedures for Access

CA social workers refer children to the regional Foster Care Assessment Program coordinator in accordance with local procedures. The coordinator assists in prioritizing and processing referrals.

4544. Responsible Living Skills Program

45441. Service Definition

  1. Responsible Living Skills (RLS) programs provide permanent residential placements for dependent street youth aged 14-18.
    1. RLS programs provide youth with a permanent placement setting in concert with services critical for the youth's successful transition into adulthood.
    2. RLS programs employ a positive youth development philosophy that focuses primarily on promoting a youth's positive development rather than identification and resolution of problems.
    3. RLS programs may take the form of either group or single-family residential placement settings, depending upon proposals submitted for approval by individual RLS providers.
  2. “Street youth” means a person under the age of eighteen who lives outdoors or in another unsafe location not intended for occupancy by the minor and who is not residing with his/her biological/adoptive parent(s) or at his/her legally authorized residence. Typically, these youth do not have families who are available to them, and traditional placement alternatives such as foster or group care have not met their needs.
  3. RLS programs employ a service delivery model designed primarily to achieve competency in independent living skills for adolescents placed there. Specifically, RLS programs will focus on assisting youth in achieving competency in:
    1. Basic education, e.g., a GED;
    2. Job skills;
    3. Basic life skills (including but not limited to):
      1. Money management;
      2. Nutrition/meal preparation;
      3. Household skills;
      4. Parenting ;
      5. Health care;
      6. Access to community resources; and
      7. Transportation and housing options.
  4. RLS programs will also provide/facilitate group and individual counseling as is appropriate. However, RLS programs are not BRS programs; they are intended for street youth committed to stabilizing their lives. Youth referred to an RLS program should exhibit significant degrees of impulse and behavioral controls.

45442. Eligibility

  1. The priority and eligibility criteria for referrals are:
    1. Dependent street youth aged sixteen to eighteen years of age, whose permanency plan is independent living.
    2. Dependent street youth fourteen and fifteen years of age, who are not succeeding in family-based foster care. Placement of youth in this age range should be with the intent of enabling the youth to make a transition from a street living situation to a more stable placement setting.
    3. Criteria are all located in statute, and therefore Exceptions-to-Policy to waive one or all of these eligibility criteria are not permitted:
      1. Any youth referred to an RLS program must have previously resided in either a Secure Crisis Residential Center or a HOPE Center; the youth's social worker may waive this requirement if the social worker feels that given the minor's current circumstances, this is the most appropriate placement for the youth.
      2. Youth must be a dependent youth under Chapter 13.34 prior to entry into an RLS program;
      3. The youth's primary and alternative permanency plan must not be Return Home.
  2. Law Enforcement Access: Youth may not be placed directly into an RLS program by law enforcement. If the youth is a reported runaway, or if law enforcement is involved due to a family-in-conflict situation, the case is handled as any other FRS case, and placement, if required, made with extended family, CRC, SCRC, or other resource as appropriate.

45443. Procedures for Access

  1. Street youth may be identified as potential referrals to RLS program services through the following means:
    1. HOPE Center: As part of a HOPE Center's permanency placement planning function, a Placement and Liaison Specialist (PALS) may contact the assigned DCFS social worker to discuss the youth's eligibility for placement in an RLS program.
    2. DCFS Staff: DCFS staff may also identify dependent youth among their caseloads that will not be returning home and also meet the other eligibility criteria.
    3. Secure CRC: While in residence at a SCRC, the youth may be identified as appropriate for RLS program services. The SCRC would discuss the youth's eligibility with the assigned DCFS social worker.
    4. The assigned DCFS Social Worker will refer the case to their Regional RLS Program Coordinator. If the RLSP Coordinator deems the referral appropriate, the case will be discussed with the provider. The contractor, youth and the DCFS social worker will mutually agree upon a youth's admission based on:
      1. The RLS Program offers services that meet the youth's needs as identified in the Report to the Court;
      2. The youth desires to participate in learning independent living skills;
      3. The youth demonstrates sufficient behavioral control to participate and benefit from the program.

45444. Legal Authorization for Placement

  1. The legal status of any youth placed in an RLS program must be a dependent youth per Chapter 13.34 RCW. There is no authority to execute an Exception-to-Policy waiver.
  2. Additionally, a youth's primary and alternative permanency plan, per RCW 13.34.145, must not be Return Home.

45445. Length of Stay

Youth must not have reached their eighteenth birthday prior to admittance into residence. Youth may reside in an RLS program until age eighteen. However, youth eighteen to twenty years of age may continue to remain in residence voluntarily until completion of a GED or graduation from high school.

45446. Re-Admission to an RLS Program

  1. Youth who leave an RLS program and are subsequently discharged (e.g., youth who run away and/or are placed in an alternative placement setting due to non-compliance with the RLS program), may be re-admitted if the youth's social worker and the RLS program determine that re-admittance is warranted.
  2. Some factors for re-admittance would be based on the review of the situation, motivation of the youth, and any safety concerns for the youth and/or other residents.
  3. The RLS program shall obtain written authorization from DCFS prior to re-admittance of the youth.

45447. Case Coordination

  1. Upon admittance into residency, the youth's DCFS social worker will provide the RLS program an Initial Baseline Assessment (IBL) tool.
  2. Collaboratively, the RLS program and the DCFS social worker will utilize the IBL to establish an Independent Living Plan. The ILP will be developed within 30 days of a youth's entry into the RLS program.
  3. A physical evaluation is required for any youth entering the RLS program if that youth has not had a physical exam within the last calendar year.

45448. Exit from an RLS Program

  1. A youth shall exit an RLS program upon completion of one of the following:
    1. The youth turns 18 and desires to leave the program;
    2. The youth, between the ages of 18 - 20 that voluntarily remains enrolled in the program, completes either their GED or High School program. RCW 74.15.220

4545. HOPE Centers

45451. Service Description

  1. HOPE Centers provide temporary 30-day residential placement, assessment, and permanency planning services for "street youth." The HOPE Center has the authority to decline placement. The department and other service providers must not use HOPE Centers as crisis residential placements.
  2. HOPE Centers utilize a "youth development focus" approach to service delivery, and will provide community-based outreach in the areas street youth frequent. Through community relationship building development and outreach efforts, HOPE Center staff will assess street youth to determine the youth's desires and service needs.
  3. Typically, the street youth do not have families who are available to them, and traditional placement alternatives such as foster or group care have not met their needs. During the street youth's stay, HOPE Center staff will conduct a series of comprehensive assessments: the youth's health, mental health, substance abuse issues, and basic educational competency. The HOPE Center, in concert with the assigned CA social worker, will utilize these assessments to develop a permanent placement plan in conjunction with linking the adolescent to transitional living services or reconciliation with the youth's parents or legal guardian.

45452. Definition

"Street Youth" means a person under the age of 18 years of age who:

  1. lives outdoors or in another unsafe location not intended for occupancy of a minor and who is not residing with his or her parent or a legally authorized residence; or
  2. without placement in a HOPE center, will continue to participate in increasingly risky behaviors associated with Street Youth. These risky behaviors include, but are not limited to:
    1. Brief episodes of homelessness
    2. Criminal activity
    3. Prostitution
    4. Substance use/abuse
    5. Other survival based behaviors related to street-life

45453. Eligibility

  1. Street youth up to 18 years of age are eligible for admission into a HOPE Center based upon the HOPE Center's determination that:
    1. The program has the ability to address the identified service needs;
    2. The program can meet the health and safety needs of the youth; and
    3. The program can still meet the health and safety needs of the other youth in residence if this youth is admitted to the program.

45454. Procedures

  1. Admission

      Street youth may access HOPE Center services through the following means:

    1. Self Referral
      1. Youth may self-present at HOPE Centers for services at any time. The HOPE Center's Placement and Liaison Specialist (PAL) shall meet with the youth within eight hours of the youth self-presenting for services. In addition to assessing the youth's appropriateness for services, the PAL is also responsible for assessing the youth's current legal status within the eight hours.
      2. The PAL must attempt to notify the youth's parent(s) or legal guardian and inform them of the youth's entry into the HOPE Center
      3. The PAL shall notify CA as soon as possible and make a referral for services. Upon receipt of such a referral from the HOPE Center, CA shall assign a social worker.
      4. The CA social worker must ensure that a legal authorization to place is obtained, if one isn't already established, within the initial 72 hours of placement.
    2. CA Staff
      1. CA staff may identify youth that are appropriate for HOPE Center placements. CA will arrange and discuss the case referral information with the HOPE Center's PALS. The youth and the youth's family may or may not be included, as is case appropriate and as best meets the service needs of the youth.
      2. If the HOPE Center agrees to accept placement of the youth, the CA social worker and the HOPE Center will coordinate the intake with the youth and the youth's parent or legal guardian.
      3. The CA social worker must ensure that a legal authorization to place is obtained, if one isn't already established, within the initial 72 hours of placement, excluding weekends and holidays.
    3. Transfer from a CRC
      1. Youth may be transferred from either a semi-secure or a secure CRC program into a HOPE Center, when appropriate. CRC staff will contact either the HOPE Center PALS or the CA assigned social worker and make a referral. CA and the HOPE Center will discuss the referral, and if there is agreement regarding the placement, again involving the youth and the youth's family, the HOPE Center will facilitate the intake process.
      2. The CA social worker must ensure that a legal authorization to place is obtained, if one isn't already established, within the initial 72 hours of placement, excluding weekends and holidays.
    4. Placement

      Legal Authority for Placement of a youth must be obtained no later than 72 hours following admission to a HOPE Center.

      1. For street youth, for whom the department has no outstanding legal authority for placement:
        1. Parental consent between the HOPE Center and parent or legal guardian with CA approval for youth to continue placement to reunify with family or obtain safe legally authorized housing.
        2. OR

        3. Voluntary Placement Agreement (VPA) must be developed according to the VPA policy.
      2. If CA or the HOPE center is unable to obtain a VPA or Parental Consent, the DCFS social worker will initiate the process to file a CHINS petition.
      3. CA staff should consider a dependency action only if it is clear the youth has no parent available, will remain in long-term care, or will be entering a Responsible Living Skills Program.
    5. Law Enforcement

      Youth should not be placed involuntarily into a HOPE Center program by law enforcement. If a youth is a reported runaway, or if law enforcement is involved due to a family-in-conflict situation, the case is handled as any other FRS case, and placement, if required, is made with extended family, CRC, S-CRC, or other resource as appropriate. However, for street youth who wish to avail themselves of HOPE Center services, the law enforcement officer may assist the youth in accessing this service.

  2. Information Sharing
    1. As an integral part of the intake process, CA and the HOPE Center will share case information. The youth and his/her parent(s) or legal guardian may also be involved, along with anyone else integral to the case, as is deemed appropriate to meet the service needs of the youth being placed.
    2. The purposes of the information sharing sessions are to:
      1. Establish the appropriateness of the placement;
      2. Obtain some level of commitment from the youth's towards his/her involvement to the program;
      3. Identify the appropriate legal authorization for placement;
      4. Identify any emergent service needs the youth may have, and develop a plan to meet these needs;
      5. Identify CA and HOPE Center roles/responsibilities regarding service collaboration; and
      6. Arrange an intake date and time if the HOPE Center agrees to accept the youth into residence.
  3. Length-of-Stay
    1. Youth must not reside in a HOPE Center longer than it takes to facilitate family reconciliation and return of the youth to the youth's home or to develop an alternative long-term placement plan.
    2. Placements must not exceed 30 days. Only the CA Regional Administrator or the Regional Administrator's designee may grant extensions. CA must forward a copy of the Regional Administrator or designee's written approved extension to the HOPE Center.
    3. CA may extend a youth's placement only for an additional 30 days maximum, based upon the youth's long-term placement options.
  4. Case Coordination
    1. Case coordination involves regular contact between the assigned CA social worker and the HOPE Center PALS. Both the CA social worker and the HOPE Center will maintain written records of all case coordination efforts in their respective client files.
    2. Beginning from the time the youth is admitted into the program, the CA social worker and the HOPE Center will be engaged in discharge planning efforts. It is important that all parties are involved in the progress towards the stated outcome goals, especially in cases where the progress is seen as unsatisfactory, and the youth will need transfer to an alternative program.
  5. Re-Admission to HOPE Centers
    1. If a youth runs away from a HOPE Center, Center staff must file a runaway report and notify the youth's parent(s) or legal guardian. If the youth is gone more than 24 hours, the Center should discharge the youth from the program.
    2. The youth may or may not be re-admitted upon the youth's return, based upon the circumstances and the needs of the other youth awaiting admittance to the program.
    3. Re-admittance to a HOPE Center must involve the youth's agreement to return and to continue program participation and the HOPE Center's agreement to the youth's re-admittance.
  6. Payment-CA staff make payment to HOPE Centers in accordance with SSPS Manual instructions.

45455. Program Parameters

Purpose of Program Evaluation of the youth in the domains of health, mental health, substance abuse, and basic educational competency. Assess ongoing service needs, and develop long-term placement plan
Entry into HOPE Center Program Access to program is either 1) via self referral; 2) through the Hope Center program's outreach staff; or 3) through CA referrals to the HOPE Center
Eligibility – Placement Criteria Street Youth
Legal Authorization for Placement After 72 hours, legal guardian must sign a Voluntary Placement Agreement, a CHINS must be filed, or a dependency order obtained
Time Frames (length of stay) 72 hour initial stays – up to 30 days (May be extended under limited circumstances)
Mental Health Evaluation A CDMHP evaluation must be done if there is an emergent need for hospitalization. A Certified Mental Health Counselor can do routine metal status evaluations within 48 of intake into a HOPE Center
Medical Examination Youth must receive a physical examination if they have not had one within the past 12 months
Substance Abuse Evaluation Complete a drug and alcohol evaluation; Involve DASA if necessary
Educational Assessment Arrange an educational assessment to measure the youth's competency level in reading, writing and math; measure any learning disabilities or remedial educational needs required
Case Plan Reconciliation with legal guardian; assessment of on-going service needs; long-term residential placement plan
Sexually Exploited Youth

Any person under the age of eighteen who is a victim of one of the following crimes:

  • Commercial sexual abuse of a minor (RCW 9.68A.100),
  • Promoting commercial sexual abuse of a minor (RCW 9.68A.101) or
  • Promoting travel for commercial sexual abuse of a minor (RCW 9.68A.102)

4550. Children Missing from Care

Purpose Statement Provide direction to CA staff regarding responsibilities when a youth is missing from care and then returns to out-of-home placement. Youth who run from out-of-home care are putting their safety and well-being at risk. When a youth runs from out-of-home care, staff need to act quickly to locate and address the youth's reasons for leaving and develop a run prevention plan.
Laws

WAC 388-148-0123

Policy

Youth Missing From Care:

  1. CA Staff must make active efforts to locate a youth missing from care within 24 hours of notification.
    Note: Efforts include making contact with all individuals or agencies important to a youth's case.
  2. CA staff will inform caregivers of the requirement to file a run report with law enforcement (LE) and contact Washington State Patrol (WSP) Clearinghouse when a youth is missing from care.
  3. A run report must be filed with law enforcement and Washington State Patrol Clearing house when a youth is missing from care.
  4. When a youth is missing from care overnight or longer, the case must be staffed with a supervisor within two calendar days, excluding weekends and holidays.
  5. An attorney must be requested (if the youth does not have an attorney) for all youth missing from care overnight or longer.
  6. CA staff must contact law enforcement and Washington State Patrol Clearing house for a youth still on the run at 18 years of age to eliminate the run report.

Youth Returning to Care:

  1. Law enforcement, WSP Clearinghouse and individuals or agencies involved with the youth must be contacted within 24 hours when the youth returns to out of home care.
  2. A debriefing interview must be conducted with the youth within two calendar days (excluding weekends and holidays) of returning to out of home care. Evaluate the youth for health and safety concerns and assist with appropriate care and safe placement (if needed).
  3. A Run Prevention Plan must be developed with the youth and caregiver within seven calendar days of the youth returning to out of home care.
Procedures

Youth Missing From Care:

  1. Create the Temporary Situation in Placement in FamLink to document youth is on the run.
  2. Document LE run report number provided by the caregiver in a case note. If caregiver did not file a run report, immediately contact LE to file a run report and contact WSP Clearinghouse at (1-800-543-5678).
  3. Notify individuals or agencies important to a youth within 24 hours of knowing the youth is missing. Individuals to notify may include:
    1. Legal parent or guardian
    2. Child's Attorney, CASA, GAL
    3. School
    4. Therapist
    5. Tribe
  4. Hold a Missing from Care (MFC) staffing with the supervisor within two calendar days (excluding weekends and holidays) for youth missing from care overnight or longer. Document the staffing results in FamLink. The MFC staffing includes:
    1. Search strategies and efforts
    2. Protective factors and vulnerabilities of youth
    3. Individuals contacted
    4. Potential reasons for run
    5. Does the youth need an attorney appointed
    6. Determine if a pick up order and warrant is needed
    7. Discuss if a court hearing should be scheduled. Some factors to consider when making this determination are:
      1. Placement problems or no appropriate placement options available
      2. All other efforts and interventions have failed
      3. Youth is a chronic runner
      4. Court sanctions would be an effective deterrent for the youth
  5. If supervisor determines appropriate, write and file a declaration for a pickup order or warrant for the youth with the court (if the court allows).
  6. If a court hearing is scheduled, factors to discuss are:
    1. Placement problems or no appropriate placement options available
    2. Additional services needed to support or stabilize the youth
    3. Discuss search and run prevention strategies that have occurred
    4. Efforts that have been made but not successful
  7. Document in a case note (at least monthly) until youth returns to out of home care or ages out of care and include the following:
    1. Continued efforts to locate youth
    2. Contact with the youth
    3. Other contact disclosing critical information related to the youth health, safety, or whereabouts
    4. Any follow-up action taken

Youth Returning to Care:

  1. Notify LE, WSP Clearing house and other individuals important to the youth's case, within 24 hours of the youth's return to care.
  2. Assess and address any identified health or safety concerns and assist the youth in appropriate care within 24 hours of returning to care.
  3. Close the Temporary Situation in Placement and open the youth's current placement in FamLink.
  4. Conduct a debriefing interview with the youth within two calendar days (excluding weekends and holidays) of returning to out of home care. Discuss with the youth reason for running and gather valuable information by asking questions on DSHS form 15-309. Document the interview discussion in a case note or complete and upload the completed 15-309 form.
  5. Develop a run prevention plan with the youth and caregiver within seven calendar days. Document the details of the run prevention plan in a case note or upload the completed DSHS 10-484 form.
Forms and Tools

DSHS 10-484

DSHS 15-309

Resources

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