back| <<Child Welfare Manual>>
<< Chapter 24 >> |<<Previous>>| <<Next>>

24.5  Custody Diversion Protocol

The Custody Diversion Protocol is only to be used when a parent is verbalizing the intent to surrender legal custody of his/her child solely to access needed mental health services, or the parent sees relinquishment of custody as the only option available to obtain such services.  This protocol is predicated upon the belief that no parent should voluntarily have to relinquish custody of his/her child in order to access mental health services if clinically appropriate services and supports, either within or outside the home setting, can be provided to the youth and family.

Families may feel compelled to relinquish custody due to conflicting information about obtaining appropriate treatment for their children, including information from facilities which may be unaware of community-based alternatives to residential care that may be available to families.  Staff must recognize the family’s need for help and provide them with both objective information and realistic treatment options.

Custody Diversion Protocol Steps

Entry

A parent/legal guardian or hospital/residential treatment center contacts a representative of a Juvenile Court, Children’s Division (CD) or Department of Mental Health (DMH), reporting that the parent may not allow the child to remain/return home at this time, opting to give up custody instead:

  1. If the child is currently in an out-of-home placement and a representative of the Juvenile Office (JO) or CD is contacted, staff should ask if the legal guardian has made a recent referral to the appropriate Community Mental Health Center/ Administrative Agent, hereafter referred to as CMHC/AA, of the DMH.  If this has not been done and the legal guardian is willing to do so and maintain custody at this time, the JO or CD staff should provide contact information for the CMHC/AA to the parent/legal guardian.  A referral in order to access mental health services through the protocol would not be necessary at this time.
  2. If a recent referral had been made to the CMHC/AA and the legal guardian continues to express a desire to voluntarily relinquish custody, the JO or CD staff should tell the caller that the legal guardian should call the designated representative of the CMHC/AA, which serves the home area of the child (where the legal guardian/custodian resides).  The DMH has designated CMHC/AA staff specifically to serve as contacts for the Custody Diversion Protocol.  Likewise, specific contact persons have been identified by the CD and JO in each judicial circuit.  Additionally, CD, JO, or CMHC/AA staff should explain that custody will not be accepted at this time and that an assessment process must first occur.  The hospital/residential center where the child is currently admitted should be informed that no decisions on alternative placement will likely occur for 3-7 days.

    3. NOTE:  Local staff should collaborate with DMH and JO to inform private providers, hospitals, and residential treatment agencies of the protocol and encourage proactive discharge planning.

  3. If the child is currently living at home and the parent/legal guardian contacts any of the agencies, the same process noted above should be used.
  4. If the parent/legal guardian comes in person to the local CD or JO with the child and safety in not a concern at this time, the process should be explained and the parent encouraged to contact the CMHC/AA with the child returning home at this time.  If the parent/legal guardian refuses to take the child home, the agency initially contacted should immediately call an emergency meeting (in person or by phone) with the contacts of the other two agencies and develop an emergency plan for placement.  The assessment process outlined below should then continue.
  5. It is the responsibility of the agency receiving the initial call to ensure that utilization of the Custody Diversion Protocol is appropriate.  The agency receiving the initial call should complete and forward to the CMHC/AA screening information after obtaining witnessed oral permission from the legal guardian.  The screening information ensures that the protocol is being applied under appropriate circumstances.  (See attached Screening and Feedback Form.)

DMH Contact:

  1. If it appears upon notification that a parent intends to give up custody to access mental health treatment services, the CMHC/AA will arrange with the parent/guardian of the child to conduct a level of care assessment as soon as possible or within no later than 2 business days.
  2. If there is information that the youth is a client of a DMH Regional Center and/or has a diagnosis of mental retardation or a significant developmental disorder, the Regional Center will be contacted by the CMHC/AA to participate in the assessment process.
  3. If the child is placed out of the home, the DMH assessment will likely occur at the hospital or residential treatment center.
  4. The DMH assessment shall examine the child/youth’s current mental health needs along with the family’s perceptions of the child’s needs and identify any risk factors through conducting a clinical interview with the child, obtaining a history of past needs and services, and obtaining information from past and current caretakers to establish the level of care needed for the child related to mental health issues.
  5. If, in the course of the assessment, abuse and neglect is suspected, the CA/N Hotline should be contacted as required by law (210.115 RSMo.).
  6. Upon completion of the assessment and/or if there is a significant delay in arranging the assessment, the CMHC/AA and/or Regional Center should complete the lower half of the received Screening and Feedback Form and forward it to the appropriate referring party.  This is to notify the referring party if there is a significant delay in completing the assessment and identify any interim safety concerns and/or to notify the referring party of the outcome of the assessment.
  7. A meeting should be conducted with the parent/guardian, outlining the results of the level of care assessment, service options, and fiscal resources necessary to implement the plan.  If the parent/guardian is in agreement with the assessment and services offered, such services, including out-of-home placement, may then be accepted by the parent and implemented by the CMHC/AA and/or Regional Center with no need for a change in custody or a VPA.  Such a scenario constitutes “business as usual” and represents the customary manner by which families are served by the CMHC/AA and/or Regional Center.
  8. If, through the assessment, it appears that a temporary placement outside of the family home would be clinically appropriate yet is otherwise unavailable from the CMHC/AA and/or Regional Center and the child remains at risk of entering CD custody, a Voluntary Placement Agreement (VPA) through the CD may be explored.  The CMHC/AA and/or Regional Center should provide a brief explanation of a VPA to the parent/guardian and explain that a referral could be made to the CD to access this agreement.  If the parent is agreeable, the CMHC/AA and/or Regional Center should contact the CD, requesting a meeting be scheduled with the parents, CD, and CMHC/AA and/or Regional Center to review the assessment and the possibility of utilizing a VPA.
  9. If the parent/guardian rejects the services outlined through the level of care assessment after an attempt to obtain consensus on a plan and continues to request out of home placement and/or plans to give up custody of his/her child to CD, then the local CD representative should be contacted.
  10. The CMHC/AA and/or Regional Center staff should attempt to obtain voluntary authorization from the parent/guardian to share information with CD and contact the CD designee in that county to initiate a screening by CD.  If the parent refuses to have information shared and continues to choose to give up custody, it should be explained to the parent that a CA/N hotline call will be placed.
  11. If a child is currently in a placement outside of his/her county of residence, the CMHC/AA and/or Regional Center may elect to contact the CMHC/AA and/or Regional Center that serves the county in which the treatment center operates and request a courtesy assessment.  However, it is the responsibility of the CMHC/AA and/or Regional Center in the county of residence of the parent/guardian for making final determination and developing, implementing, and coordinating the service plan unless specifically agreed to otherwise.

CD Contact:

  1. CD, upon notification from the CMHC/AA and/or Regional Center representative, with appropriate consents for information release or via the Child Abuse/Neglect Hotline, will initiate a screening to be completed as soon as possible or than within no later than 2 business days.  In addition, staff should document that the Division responded, and the disposition of our involvement in participating in the custody diversion protocol.  No formal information system is required in this instance, but this information should be provided to the Circuit Managers.  If the case is brought to the Division’s attention through a non-CA/N referral such as a mandated (M) or preventive services (P) referral, staff should document all activity in the record as currently required.  Those calls from the Hotline which are classified as CA/N reports should generally be addressed as Family Assessments and documented per current policy.

    2. NOTE:  Regardless of how the case was brought to the division’s attention, the screening described in #2 below shall apply and shall be completed within two business days of CD notification.

  2. This screening will determine child safety and risk, any indicators of abuse/neglect, and the family’s perception of the mental health needs of the child.  CD policy and statute shall be followed relating to the observation of the child.  This screening will determine whether there is a need for services through the CD and identify any community-based services that CD can add to the plan, OR, if there is evidence of abuse or neglect, whether CD should remain involved and if any court action is required.
  3. Upon completion of the CD screening, the CD designee and CMHC/AA and/or Regional Center designee will confer to develop a plan and determine which agency will take the lead in contacting the parent/guardian to arrange a meeting.
  4. CD and CMHC/AA and/or Regional Center staff will meet with the parent/guardian to review the DMH assessment and CD screening to identify service options and to develop a plan.  Next, one of the following steps will be pursued:

Court Involvement/Early Reunification:

  1. CD will notify the JO of the need to obtain temporary custody of the child based on the CD assessment and/or meeting outcome cited above.
  2. CD, JO, CMHC/AA and/or Regional Center will develop a temporary plan for placement and services that best meet the child’s needs.
  3. Within 72 hours of the child placed in the temporary custody of CD, CD shall convene a meeting with all involved/interested parties, including the parent/guardian, to examine the child’s and family’s needs and identify service options.  Staff should follow the processes introduced in Memo CD04-83 and Child Welfare Manual Addition:  Section 4, Chapter 24, Medical/Mental Health Planning, 24.4 – Identification of Children in the Custody of the Children’s Division Solely for the Purpose of Accessing Mental Health Services to address youth who have entered CD custody solely for the purpose of accessing mental health services.
  4. If the court has ordered custody placed with CD pursuant to 211.181.1(5) RSMo., this team will develop a plan and submit it to the court within 30 days.  The court may then return the child to the custody of the parent or further adjudicate.

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

CD04-83, CD05-05, CD05-48, CD05-50, CD05-51, CD06-76,

Memoranda History: