The following are special procedures the Family Centered Out of Home (FCOOH) Case Manager will follow whenever a child who is in the care and custody of the Children’s Division residing in an out of home placement dies:

• Notify the Supervisor immediately that a Child in CD custody has died.  This will include any sudden or unexpected death, as well as a foreseeable death due to illness.
• Supervisor shall initiate the Fatality/Critical Event Reporting and Review Protocol.

If the child died under suspicious circumstances, or if there is reason to believe the child died from child abuse or neglect, the Children’s Service Worker shall:

• File a report with CANHU right away;
• Assure that no other children are at risk of immediate harm. Assure the safety of other children by:
• Contacting Law Enforcement at once if there is reason to believe any other children are at risk of immediate harm;
• Immediately contacting the Case Manager and/or the Supervisor regarding any other children who are in the home to notify them of any concerns; and
• Advising the Licensing Worker and/or Supervisor of the situation.
• Immediately notify the juvenile office and/or family/juvenile court of jurisdiction and the Guardian Ad Litem and/or CASA of the child’s death
• Immediately make personal contact with the biological parents to notify them of their child’s death. Do not notify the family of the child’s death by phone or by mail.
• If the biological parents reside in another county or out of state, the worker shall request assistance from the worker in the other county or state to make personal notification.
• The worker should coordinate efforts with other persons involved who may be communicating with the family or coordinating services, such as another worker, Contracted Case Manager, OHI Investigator, Law Enforcement Officer, or Juvenile Officer, so that the primary or extended family does not experience multiple or unnecessary contacts which may only add to their grief or despair.
• Provide supportive services and referrals as necessary to assist the family with grieving or other issues.

The child’s death will have a profound impact on the parent and placement provider.  The worker should be particularly sensitive to their loss and offer appropriate support.

• Consult with the Supervisor for the need to schedule a Family Support Team meeting to modify the family’s case plan as a result of the child’s death.  Allow ample time for the family to grieve and for funeral proceedings when scheduling the FST.  Continue to work with the family as directed by the Supervisor.
• Cooperate with the Children’s Division CA/N Investigator assigned to the investigation, including an Investigator from the Out of Home Investigations Unit, if applicable.
• Provide any information available that may assist in the investigation, including access to the case record.
• Inform your supervisor that the fatality is being investigated.
• If the child was less than 18 years of age, the Children’s Service Worker will need to determine if the coroner or medical examiner has been notified under the provisions of Missouri Revised Statutes chapters 58.452 and 58.772. If notification has not been made, the worker will need to notify the coroner or medical examiner of the child’s death.
• Additionally, notify the coroner when there is reasonable ground to believe that the child died as a result of:
• Violence by homicide, suicide or accident;
• Criminal abortions, including those self-induced;
• Some unforeseen sudden occurrence and the deceased had not been attended by a physician during the 36 hour period proceeding the death;
• Any injury or illness while in the custody of the law or while an inmate in a public institution.
• In any unusual or suspicious manner;
• The coroner or medical examiner will, if appropriate, contact the chairman of the Child Fatality Review Panel.
• Contact all other persons who have knowledge of the circumstances of the death. This may include physicians, police, placement providers, school personnel, witnesses, etc.
• The family Children’s Service Worker shall gather and document in the case record, all pertinent facts regarding the child’s death including:
• Cause of death;
• Time of death;
• Location of death; and
• Circumstances surrounding the child’s death and any witnesses.
• Current case status information (date case was opened and reason, summary of court activity, Name, address and phone number of GAL, past and current services received by family);
• List of other children remaining in the household with the alleged perpetrator and how their safety has been assured (attach a safety re-assessment form);
• A summary of progress or lack of progress made recently (attach most recent treatment plan);
• Date(s) of most recent contact(s) made with the family;
• CD history with the family (CA/N, Alternative Care/Adoption; prior FCS history);
• List of other agencies involved; and
• Other pertinent facts of case
• Update/close the FCS and AC Functions in FACES (if applicable), and assure that the information in FACES is updated as soon as possible.
• The Supervisor is to complete and submit a Critical Event Report (CS-23) to the Circuit Manager, or designee to allow enough time for review so that summary can be forwarded to central office.
• Provide the coroner/medical examiner and funeral home information for completion of the death certificate.
• Advise any agency the child was receiving benefits from such as SSI, VA, insurance companies, etc.
• A copy of the child’s death certificate may be provided upon request.
• Inform the eligibility analyst that the child’s KIDS account can be closed.

Burial Arrangements

When the death occurs of a child in CD care and custody, placed in out-of-home care, the family’s worker will work with the biological family regarding burial arrangements and expenses. If the biological family is willing and able to assume responsibility for the burial, they should be encouraged to do so.  The family worker shall explore resources such as insurance policies, Social Security and other benefits.

If the biological family is not able to assume responsibility, the worker shall contact a local funeral home to provide a dignified burial within the acceptable standards of the community. To the extent possible, consider the wishes of the biological and foster family in making arrangements for the child’s burial.  Payment, not to exceed $1,500.00, will be made through SAMII.  An itemized list of expenses will need to be attached to the payment.

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.