With the 2004 passage of House Bill 1453, the Voluntary Placement Agreement was introduced and established in statute (210.122 RSMo). The Voluntary Placement Agreement is predicated upon the belief that no parent should have to relinquish custody of a child solely in order to access clinically indicated mental health services.

Definition

The Voluntary Placement Agreement (VPA) is a written agreement between the Department of Social Services (DSS)/Children’s Division (CD) and a parent, legal guardian, or custodian of a child under the age of eighteen (18) in need of mental health treatment.  The agreement is only used when an out-of-home placement is recommended by DMH and the Custody Diversion Protocol cannot otherwise divert the need for such placement.  DMH determines the need for mental health services and administers the placement and care of a child while the parent, legal guardian, or custodian of the child retains legal custody.

Practice

The VPA will only be made available to a parent in conjunction with, and only after staff has utilized the Custody Diversion Protocol which serves to link parents with DMH services for their child. The Custody Diversion Protocol reflects the mutual commitment of CD, DMH and its Community Mental Health Centers/Administrative Agents (CMHC/AA), Regional Offices, and/or Adolescent CSTAR providers, and the local Juvenile/Family Courts to assist parents in accessing needed mental health services for their children without a needless transfer of legal custody.  The VPA requires the commitment of a parent to be an active participant in his/her child’s treatment. A VPA may not exceed 180 days in duration.

Local CD CDP Designees are responsible for guiding and assisting throughout the CDP process and monitoring the family’s progress through the duration of the VPA.  A Family Support Team (FST) meeting must be held within 72 hours of placement to develop permanency and treatment plans.  The local CD case worker will ensure FSTs are scheduled as necessary.  Designated staff from CD, Community Mental Health Centers, DMH Regional Office, and/or Adolescent CSTAR providers, the child’s family, and children who are able to effectively participate in meetings must be invited to attend all FSTs.

FSTs need to be scheduled to occur around but not later than 100 and 150 days of the date the child is placed. The child and family’s progress will be reviewed to ensure appropriate transition planning occurs prior to the maximum 180 day VPA closure.  If the child is unable to return home a determination must be made as to continuous care being provided by other available resources or CD petitioning the court for custody.  The local Custody Diversion Protocol designees will be required to attend any hearings and testify in support of the plan to petition the court for custody.

DMH may arrange for a staffing for a youth served through a VPA. The DMH provider will notify the local Custody Diversion Protocol designee of meetings held on the child’s behalf. The local Custody Diversion Protocol designee should maintain consistent communication with the DMH provider on each child served through a VPA.

Children placed in Voluntary Placements are subject to the Adoption and Safe Families Act (ASFA) requirements.  Within sixty (60) days of the date the child is removed from the home, a case plan must be developed.  To meet the requirements of Section 472 (a) (1) of the Social Security Act a removal from the home must occur pursuant to:

• A VPA entered into by a parent or guardian which leads to removal (i.e. a non-physical or paper removal of custody) of the child from the home; or
• A judicial order for removal of the child from a parent or specified relative.

Financing

Funding for treatment services under a VPA will be provided by DMH or the CMHC/AA, Regional Center, and/or Adolescent CSTAR provider up front with Department of Social Services appropriation accessed through an interdepartmental funds transfer. Local CD staff will not authorize payment for residential treatment or any other services for children placed through a VPA.  Youth active in a VPA will be eligible for MO HealthNet coverage through the Family Support Division. The youth’s SSI benefits and/or private insurance, as well as other means of financial support, must be explored prior to VPA approval.  If the family receives SSI benefits for the youth, it is the family’s responsibility to contact the Social Security Administration and inform them of an out-of-home placement.

Procedure:

1. As a part of the CDP, DMH must conduct an assessment and it should establish that out-of-home placement is clinically appropriate and if there are no other means of financial support, the local CD CDP Designee can explore a VPA.
2. If it is determined that a VPA is to be requested, the agreement must be reviewed and signed by the parent(s) and the CD-CDP designee. At the time a VPA is presented to a parent, CD staff shall, in conjunction with the parent, complete the Children’s Severity of Psychiatric Illness (CSPI). The CSPI is included as part of the CS-9.  Staff do not have to complete the entire CS-9, only the CSPI.
3. The signed agreement must then be sent to the CD Central Office designee responsible for the oversight of the VPA program for final approval. VPAs must be signed by the CD Central Office designee before it will be considered officially approved, and a placement made.
4. If the VPA is approved, the CD-CDP designee will then send a copy of the agreement to the local DMH CDP Designee responsible for placement.
5. The local DMH Administrative Agent, Regional Office or Adolescent CSTAR provider should send a copy of the signed agreement with the identified placement date back to the local CDP designee. This should be completed within 5 days of placement. If the identified placement provider is requesting rates which exceed the standard contract rate for the Division of Behavioral Health, CD Central Office review and prior approval is required.
6. If the approved agreement is not returned with a placement date within five (5) days the CD-CDP should contact the DMH Administrative Agent, Regional Office or Adolescent CSTAR provider to request the begin date. A copy of the signed agreement will then be sent to the RCST Coordinator and Central Office designee responsible for the oversight of the VPA program within 10 days from receipt of the signed agreement with the placement date added.  The VPA begin date is the date the child is placed in an out-of-home setting for treatment.  The RCST Coordinator shall be responsible for entering the VPA begin date and the CSPI rehab date in FACES.  For additional instructions see CD09-103.
7. VPAs may not exceed one hundred eighty (180) days in duration. In the event the child is in placement less than 180 days, subsequent agreements can only be approved with the authorization of the CD Director. Total period of placement under one or multiple VPAs shall not exceed 180 consecutive days from the first day the child is placed in out-of-home care.
8. The DMH provider is to notify the local CD-CDP designee any time a child is returned home. It is the local CD-CDP designee’s responsibility to then notify the RCST Coordinator and the CD Central Office designee.  It is the RCST Coordinator’s responsibility to update FACES once a child is returned home.  The duration of the VPA may be for as short a period as the parties agree is in the best interests of the child.
9. The FACES system will automatically close a youth (in legal status V) the day the length of a VPA reaches 180 days in duration and the day before the child reaches his/her eighteenth (18th) birthday. However, if a youth is returned home prior to the 180 day maximum, the FACES system should be updated with a close date one day following the date the youth returned home.

NOTE: Although the FACES system will automatically close the SS-61 upon the youth’s eighteenth birthday a VPA may extend beyond such. The RCST Coordinator must update the FACES system to reflect one day following the actual date the youth returned home or the day the length of the VPA reaches 180 days in duration.

Related Practice Points and Memos:

7-9-19 – PP19 CM-01 – Timely Informed Consent – Inpatient Hospitalizations and Medication Management Checkups

7-26-19 – CD19-47 – Informed Consent for Psychotropic Medication (Form CD-275)

10-11-19 – DK19-04 – Immediate Implementation of Best Practices Regarding Behavioral Health Care and Medical Records

4-9-20 – PP20-CM-03 – Mandatory Psychotropic Medication Reviews

7-23-20 CD20-34 –Introduction to Child Welfare Manual policy updates to align with best practices and comply with Joint Settlement Agreement requirements.