Case Plan Requirements

For a child placed in a residential treatment setting the Children’s Division or contracted case management agency must document the following in the child’s case plan:

1. The reasonable and good faith effort of the agency to identify and include all the individuals required to be on the child’s family support team (FST);
2. All contact information for members of the FST, as well as contact information for other family members and fictive kin who are not part of the FST;
3. Evidence that meetings of the FST, including meetings relating to the required 30-day assessment of the appropriateness of the residential treatment setting, are held at a time and place convenient for family;
4. If reunification is the goal, evidence demonstrating that the parent from whom the child was removed provided input on the members of the FST;
5. Evidence that the required 30-day assessment to determine the appropriateness of the residential treatment setting is determined in conjunction with the FST;
6. The placement preferences of the FST relative to the required 30-day assessment that recognizes children should be placed with their siblings unless there is a finding by the court that such a placement is contrary to their best interest;
7. If the placement preferences of the FST and child are not the placement setting recommended by the Independent Assessor conducting the required 30-day assessment, the reasons why the preferences of the team and of the child were not recommended; and
8. The written recommendation by the Independent Assessor regarding the appropriateness of the residential placement and the court approval or disapproval of the placement.

Progress Reports from Licensed Residential Treatment Placement Providers

Facilities under contract with the Division for residential treatment services are required to complete treatment plan and progress reports for the child receiving residential treatment. Such reports shall be submitted to the child’s case manager and the RCST Coordinator at the following intervals:

• Residential Treatment (Level II and III): Treatment plans must be developed within fifteen (15) days of placement. Treatment plans must be reviewed quarterly, every ninety (90) days. (See 13 CSR 35-71.060 and 13 CSR 35-71.130)
• Intensive Residential Treatment (Level IV): Treatment plans must be developed within ten (10) days of placement. Treatment plans must be reviewed monthly, every thirty (30) days. (See 13 CSR 35-71.140)

The residential facility shall provide the case manager and the RCST Coordinator a monthly progress report of the child’s treatment within fifteen (15) calendar days of each calendar month following the month of service. The facility shall submit the monthly progress report to the RCST Coordinator at the same time as the invoice for payment for the service month. This report must be submitted using the Department’s online invoicing system as described in the residential treatment service’s contract.

This monthly report shall include, at a minimum:

• An itemized statement describing the actual services provided to each child during the reporting period, including, duration of all individual, family, and group therapies actually provided during the reporting period; notations if the therapies and/or services are part of a specialized program such as chemical dependency/substance use treatments, child with problem sexual behaviors, etc.;
• A summary of the child’s educational progress during the reporting period; and
• A summary of the child’s health, behavioral health, and mental health care during the reporting period, including compliance with the requirements of the Settlement Agreement in M.B. vs Tidball which can be found at: https://dss.mo.gov/notice-of-proposed-class-action-settlement.htm.
• All treatment sessions which were not provided in accordance with the child’s treatment plan, shall be disclosed to the case manager and RCST Coordinator in writing, by the following reporting month, and documented in the child’s record. A child’s refusal to participate in treatment sessions shall be documented in the treatment record.

Case Managers shall review the child’s progress reports to ensure that the services provided to the child remain consistent with the child’s ongoing treatment needs. The case manager shall address any discrepancies found in the progress reports with the residential provider in a timely manner.

Treatment plans and treatment reviews shall be completed by the facility in accordance with state regulation 13 CSR 35-71 Licensing Rules for Residential Treatment Agencies for Children and Youth. The full regulation can be accessed at: https://www.sos.mo.gov/cmsimages/adrules/csr/current/13csr/13c35-71.pdf

The facility shall complete the Monthly Medical Log utilizing form CD-265 Medical Log which may be found at http://dss.mo.gov/cd/info/forms and the providers Medication Administration Record (MAR) within five (5) calendar days of each calendar month following the month of service to the child’s case manager. The written documentation must contain all medication administered for the month, including the dosage, any adverse reactions, any new medications prescribed, including the dosage, prescriber notes from any medication monitoring appointments, and the dates/times of any upcoming appointments.