18.2 Residential Treatment Referral (CS-9)

The CS-9 focuses on the chronicity of behavior and includes the use of Childhood Severity of Psychiatric Illness (CSPI). The CSPI is an assessment tool developed to assist in the management and planning of appropriate services for children, ages six (6) and over, and adolescents. It is a decision support tool for Children’s Service Workers and clinical decision-makers. The CSPI provides for the structured assessment of children with possible mental health service needs, along a set of dimensions found to be relevant to clinical decision making. The instrument is simple to complete and interrater reliability is high. It is designed to provide information regarding children’s mental health needs for utilization during service system planning and quality assurance monitoring. Its use will enhance our ability to make differential decisions regarding a child’s need for residential treatment. The CSPI also serves as the eligibility determination process for youth being enrolled in the MO HealthNet Rehabilitation Option. This program allows The Children’s Division (CD) to access federal funding to purchase rehabilitative services to meet children’s identified mental health service needs. It is critical that the ACTS system be updated as soon as the CSPI is completed.

Revisions to the CS-9 are reflective of a wider agency strategy aimed at reducing a traditional reliance on costly and protracted residential placement for children and youth. It is critical staff recognize that when youth are admitted for residential treatment, overall planning for discharge must begin at the time of admission.

NOTE: No child is to remain in residential treatment beyond six (6) months without a full review coordinated by the area director. The goal is for the child to be placed from residential treatment into a less restrictive placement setting.

Whenever possible, that setting should be with the child’s family (if the child’s needs can be met there) with the necessary support services being provided by community resources. Because goal setting and treatment plan development is done by the Family Support Team (FST), with input from the family, the youth, and the residential treatment facility, those service needs will be documented. Development of the resources should be accomplished while the youth and family are receiving therapeutic services provided by the residential facility.

NOTE: Placement of youth must be within a fifty (50) mile radius of their family whenever possible. When making a placement of a youth into a residential treatment facility located 50 miles or more from the county of jurisdiction, the Children’s Service Worker must document that an exhaustive local search was conducted and that the child’s treatment needs may not be met within the 50 mile radius. Meeting the child’s special needs will take priority over placement in proximity to the parent(s) when selecting a provider, if both standards cannot be satisfied.

Placement of children in residential child-care agencies should be expected to last for only six (6) months. The Residential Care Screening Team (RCST) Coordinator must approve recommendations for extension, after review by the area director.

NOTE: A copy of any court order identifying a specific facility and payment for these services for the child’s placement must be sent to the Deputy Director/Children’s Services, via supervisory lines, for immediate review by the Division of Legal Services (DLS) and RCST Coordinator.

Memoranda History: (prior to 1/31/07)

CD06-52