Chapter 4 : Section 5

Selecting An Out-of-Home Caregiver

Procedures

DCS Specialists, in consultation with their Program Supervisor, may place a child with a kinship caregiver (see Kinship Care for additional information). All other placing decisions are to be made by the Placement Administration, or if placing for treatment purposes in a higher level of care (TFC, BHIF, and BHRF), in consultation with the Child and Family Team or qualified behavioral health providers. See Caregiver Selection Protocols, DCS 19-03, for additional information.

To request an out-of-home caregiver for a child or sibling group, submit a Placement Service Request in Guardian. Ensure the request has the necessary information completed before submitting. Include information about the child or sibling group from the person record such as medical information, behavioral health needs, education needs, etc. See Placement Service Request Guardian User Guide for additional information.

Best Interests Considerations

In addition to other relevant factors, the following shall be considered in determining whether a caregiver is in the best interests of a child:

• The caregiver’s interest in providing permanency for the child if reunification efforts fail.

• The expressed wishes of the birth parent and child, if applicable, unless the wishes are contrary to law.

• The relationship of the caregiver with the child and the child’s family.

• The proximity to the parents’ home and the child’s home school or school district.

• The strengths and parenting style of the caregiver in relation to the child’s behavior and needs.

• The caregiver’s willingness to communicate and interact with the birth family to support parenting time and the reunification process.

• The caregiver’s ability and willingness to be the caregiver for the child and all or any siblings; and to provide or assist in maintaining frequent visitation or other ongoing contact between the child and the child’s siblings, if not placed together.

• The child’s fit with the family with regard to age, gender and sibling relationships.

• The caregiver’s ability to be supportive and affirming of the child’s identity and culture.

• For a child with behavioral health needs:

  • whether the child’s behavior will place other children in the home at risk; and

  • the caregiver’s ability to provide the necessary level of supervision to prevent harm to the child or to others by the child.

• The caregiver is a member of the child's extended family or an adult sibling, or an adult with whom the child has a significant relationship.

• The caregiver is currently providing care to minor siblings (unless contrary to the child’s or a sibling’s safety or well-being).

• The living arrangement is the least restrictive in order to meet the child’s needs.

• The caregivers can communicate in the child's language.

If ICWA applies to the child, follow caregiver guidelines found in Placement Preferences of an Indian Child.

To select an unlicensed kinship caregiver, follow the procedures found in Kinship Care.

Concurrent planning considerations

Complete the Reunification Prognosis Assessment Guide, DCS-1607 for both parents, guardians or custodians no later than 45 days from the child’s initial removal.

When the Reunification Prognosis Assessment Guide, DCS-1607 is completed and the prognosis of achieving family reunification is assessed as unlikely to occur within 12 months of the child’s initial removal, a planned set of concurrent planning activities will be implemented to:

• identify and assess potential caregivers;

• place the child with suitable caregivers; and

• confirm that the caregivers are prepared to care for the child on a permanent basis if needed.

The Department shall seek to place children who enter out-of-home care at age one or younger in a prospective permanent placement within one year after filing the dependency petition pertaining to the child’s most recent removal.

Re-entry of children into out-of-home care

When a child returns to care after reunification, notify former foster homes of the child’s re-entry into out-of-home care unless the former foster home has substantiated or outstanding allegations, reports, or investigations known to DCS.

When selecting a child’s caregiver, follow the order of preferences. When a foster home is determined to be in the child’s best interest, give preference to the most recent foster home in which the child was living, unless living in that home is not in the child’s best interest.

Contact the AAG when there are concerns that notifying or placing the child in a previous foster home will be contrary to the child’s safety or well-being.

Placing Children in Non-Relative Licensed Foster Homes

A non-relative licensed foster home may be selected when no parent, grandparent, great-grandparent, adult sibling of whole or half-blood, aunt, uncle, first cousin or person who has a significant relationship with the child can meet the needs and best interests of the child.

To obtain a non-relative, licensed foster home for a child, the DCS Specialist or designated staff will complete a DCS Placement Referral.

The Statewide Placement Administration will do the following:

• obtain and review information on available foster homes, and in relation to the best interests considerations above;

• match the child’s needs with a foster family whose characteristics and capabilities complement the needs of the child;

• contact prospective foster homes and discuss the following:

  • the child’s needs, permanency goal, and Family Contact Plan;

  • the foster parents’ ability to meet the child’s needs;

  • the foster parents’ ability and willingness to support maintenance of the child’s connections with the parents, siblings, extended family and other important connections;

  • the Department’s expectations of the foster parents; and

  • the foster parent’s willingness to consider being the living arrangement for the child and the child’s siblings, if applicable; and

• select the home and notify the DCS Specialist via email.

Upon notification of the selected home by the Statewide Placement Administration, the DCS Specialist will contact the identified foster home and:

• review the child’s needs, permanency goal, and Family Contact Plan;

• coordinate the transition of the child from the current residence into the foster home; and

• determine the reimbursement rate to be recommended (if not completed by the Statewide Placement Administration) by reviewing the documented placement needs of the child:

  • medical and any special care requirements;

  • transportation;

  • level of supervision;

  • educational; and

  • mental and behavioral health.

Placing children in foster homes in excess of the number of children allowed by the homes license

When considering placing of a child in a foster home in excess of the number of children allowed (overcapacity) by the home's license, the DCS Specialist and the Licensing Worker must both be informed of, and agree to request the proposed living arrangement.

The Department may place a child in excess of the number of children allowed and identified in the foster parent's license, if the DCS Specialist and the Licensing Worker must determine and agree that:

• there are no outstanding concerns, deficiencies, reports, or investigations regarding the foster home and;

• the child meets one of the following criteria:

  • the child is part of a sibling group that currently resides in the foster home;

  • the child is part of a sibling group that is being considered for a foster home but because of the maximum child limit, would otherwise have to be separated;

  • the child previously resided in the foster home; or

  • the child’s relationship to the caregiver is kinship.

• the foster home has the ability to safely supervise and care for additional children;

 

The DCS Specialist, Placement Administration or the Agency Licensing Worker may request approval for a foster home that is not licensed for the number of children required to accept an additional child in their home by completing the Overcapacity Placement Request, CSO-1264 and emailing it to the Office of Licensing and Regulation (OLR) at FHLDocs@azdcs.gov. See DCS 15-35 Overcapacity and Expedited Amendment Requests.

Requests to place a child in a foster home that would cause the foster home to exceed the number of children allowed by the home’s license will be reviewed and authorized during normal work hours only.

Placing Children in Therapeutic Foster Care/High Needs Foster Care

When a child exhibits significant behavioral and emotional problems, even if they do not meet the criteria for medical necessity, therapeutic foster care (TFC) services should be considered, especially when the child enters care because of severe trauma. The following circumstances are to be used when considering High Needs Foster Care (HNFC), previously DCS Funded TFC, as outlined in DCS 19-01:

• a youth who requires the services provided by a HNFC due to the severity of the abuse or neglect;

• a youth whose injuries require emergency services or hospitalization, including but not limited to:

  • fractures,

  • head or facial injuries,

  • burns (immersion, cigarette, or other unexplained burns),

  • extensive bruising, or

  • sexual abuse;

• a youth who has witnessed the death of a parent, sibling, or guardian due to domestic violence; or

• a youth who has disrupted from caregivers in the last year (including risk of disrupting from current caregiver), and whose behavior is not reasonably expected to improve while continuing to reside in a traditional foster home, group home, or shelter placement. The reasons for the disruption include but are not limited to:

  • continuous running away behavior,

  • physical or verbal aggression,

  • harm to animals,

  • prior history of frequent hospitalizations, and a recent clinical assessment finding that the youth does not need a higher level of care such as inpatient stabilization, BHIF, or BHRF,

  • prior history of being a danger to themselves or others, and a recent clinical assessment finding that the youth does not need a higher level of care such as inpatient stabilization, BHIF, or BHRF,

  • prior history of suicidal or homicidal ideation/behaviors, and a recent clinical assessment finding that the youth does not need a higher level of care such as inpatient stabilization, BHIF, or BHRF, or

  • arrests/detention;

• a caregiver report that the youth has evidenced an increase in behavioral or emotional dysregulation jeopardizing the stability of the placement despite consistent behavioral health services. Additionally, the existence of the following criteria should be considered:

  • a higher level of care was denied by Mercy Care within the last 90 days,

  • efforts to secure a family-like setting have been unsuccessful due to the youth’s behavior or emotional needs, and

  • the CFT believes that services to maintain the child’s stability with the current caregiver are in place but the youth is not showing improvement.

The decision to place a child in a HNFC is the responsibility of the Placement Administration. If a request for Therapeutic Foster Care has been denied by Mercy Care DCS CHP, provide the Placement Administration with a copy of the packet as outlined in Selecting an Out-of-Home Caregiver. For additional information, see DCS 19-01 Criteria for High Needs Foster Care.

A child may be placed in therapeutic foster care through the Child and Family Team process when determined it is medically necessary. Refer to Behavioral Health and Substance Abuse Services for Children and Young Adults for more information.

If a therapeutic foster home is court ordered for the child:

• complete a DCS Placement Referral (include the court order);

• contact the High Needs Case Manager for the child to coordinate a CFT meeting and request a higher level of care packet be completed; and

• after making contact with the potential caregiver, prepare an Addendum Report to the Court, advising the court of the status of the order, the caregiver's name, and date the service will begin. Forward the report to the court according to region procedures.

Qualified Residential Treatment Program (QRTP)

A child shall not be placed in a QRTP on the basis of no family like setting being available.

Placement Administration will consider placing a child in a Qualified Residential Treatment Program when a family like setting cannot be secured and when the child has one of the following:

• require a structured living arrangement as a result of conduct disorders or aggressive behaviors and cannot be served in a less restrictive environment;

• have experienced significant trauma as a result of physical abuse, sexual abuse, or sex trafficking and require intensive trauma- informed care and reduced staffing ratios to address the trauma;

• exhibit sexually maladaptive behaviors that cannot be addressed in a less restrictive setting; or

• identify as LGBTQ+ and will benefit by participation in a program specifically designed to serve their needs.

The DCS Specialist shall:

• contact the assigned Assistant Attorney General within 24 hours of the child being placed in the QRTP and provide notice to all parties;

• submit a Motion to Approve QRTP Placement to the assigned AAG to file with the courts within 10 days of the child being placed in the QRTP (see Court Reports);

• ensure a child being placed in a QRTP is assigned a Behavioral Health Clinic and High Needs Case Manager for services;

• ensure a Child and Family Team meeting is scheduled within 30 days of the child being placed in the QRTP; and

• ensure the child’s case plan is current and includes the QRTP as the child’s living arrangement (see Developing and Reassessing the Family Centered Case Plan).

A child shall not move from a QRTP until the child completes the program or the CFT determines a change in the level of care is needed. A discharge plan must be implemented with the DCS Specialist, QRTP Provider, CFT, the child’s family, and Mercy Care DCS CHP. Unless exigent circumstances exist, the child shall not be moved from the QRTP until a Motion for Change in Physical Custody has been granted by the court.

For children in a QRTP for 12 consecutive months, 18 nonconsecutive months or for more than 6 consecutive months for children under age 13, the Placement Administration will obtain approval from the Director to continue the living arrangement.

Placing Children in Group Homes

The Placement Administration shall consider placing the child in a group home only if:

• no parent, grandparent, member of the child’s extended family, person who has a significant relationship with the child, licensed foster home or therapeutic foster care that can meet the child’s need has been identified; and

• the child does not meet the requirements for a QRTP.

A group home may be the least restrictive living arrangement that can meet the child’s needs if:

• the child has a recent history of unsuccessful placements in family settings, despite provision of services to support placement stability; or

• the child has supervision or behavior management requirements that cannot be met in a family environment.

To obtain a group home living arrangement for a child, the DCS Specialist or designated staff will complete a DCS Placement Referral. The process and procedures are the same as in Selecting Out-of-Home Care Provider except that outreach and coordination of placement will be with group homes.

Placing Children in a Behavioral Health Residential Facility or Behavioral Health Inpatient Facility

Consult with the DCS CHP System of Care Coordinator regarding placement of the child if the child has chronic behavioral health needs. Refer to Behavioral Health and Substance Abuse Services for Children and Young Adults for more information.

If a behavioral health residential facility (formerly therapeutic group home) is court ordered for the child:

• Contact the DCS CHP System of Care Coordinator to coordinate placement services and funding.

• After making contact with the potential living arrangement, prepare an Addendum Report to the Court, advising the court of the status of the order, the provider's name, the funding source, and date the service will begin.

• Forward the report to the court according to region procedures.

• If the behavioral health group home is not medically necessary, contact the Behavioral Health Appeals Coordinator regarding an appeal.

For placement in an inpatient behavioral health facility (formerly residential treatment center), contact the DCS CHP System of Care Coordinator. See Arranging Treatment in a Behavioral Health Inpatient Facility.

DCS Employees as Out-of-Home Care Providers

An employee, who decides to apply for foster parent licensure or adoption certification, or wants to be considered as a kinship caregiver, shall provide advanced written notification of this decision to the DCS Program Supervisor and Region Program Administrator.

The assessment of a child’s living arrangement needs and placing the child shall be made in accordance with the procedures found in Placement Needs of Children in Out-of-Home Care and Adoption: Assessing Child's Needs and Preparing for Placement.

The Deputy Director of Field Operations shall approve placing the child, and approve arrangements for supervision of the employee as the caregiver prior to the child’s placement with the employee. Supervision of the child’s living arrangement shall be provided by a unit outside the employee’s Program Manager’s area.

The employee is entitled to the same benefits and supports as any other licensed foster parent or certified adoptive parent or approved kinship caregiver.

The employee must use approved leave to attend to the needs of the child in their care.

An employee who has a child placed in their care as a licensed foster parent, adoptive parent or kinship caregiver shall not:

• conduct or be responsible in any manner for the investigation of a report concerning the child while in the employee’s care;

• be responsible for the case management of the child’s case or the case involving the child’s family;

• conduct or be responsible for the evaluation of the home as a living arrangement option for the child; or

• access the child’s or the child’s family case information or request information regarding the child’s case from anyone other than the assigned DCS Specialist, Program Supervisor or Program Manager.

An employee with the Office of Licensing and Regulation who is a foster parent shall not oversee the Licensing Agency with whom they are licensed.

Any report of child abuse or neglect of the child, management of the child’s case or complaints filed concerning the care of a child while in the employee’s home shall be investigated and/or coordinated by a Program Manager whose area does not have direct supervision of the employee.

Documentation

Use the Notes/Visits in the Case tab to document the following:

• notification to the child’s previous foster parents of the child’s re-entry, and whether or not the former foster home is willing to be the caregiver;

• reason a a foster home in which the child previously resided is not in the child’s best interest, if applicable;

• reasons for not placing siblings together;

• process of selection and placement of a child in a non-relative foster home;

• reasons for exceeding a foster home’s license (overcapacity) when placing a child in a licensed foster home;

• if the child is placed in a QRTP, why the QRTP is the most appropriate living arrangement;

• process of selection and placement of a child in a group home setting; and/or

• efforts made to secure a behavioral health living arrangement for a child.

Document in Notes, when the decision is made to place a child in any congregate care setting, the reason why the child's needs are not best served in a family home.

Document in Notes when a child is placed in congregate care who otherwise should be placed in a family-like setting because no appropriate family home is available to meet the child's needs.

The DCS Specialist will ensure all records and documentation pertaining to the QRTP are maintained. See Creating and Organizing DCS Records.

Effective Date: February 13, 2023

Revision History: November 30, 2012, September 30, 2013, August 9th, 2017, August 03, 2018, November 09, 2018, January 3, 2020, February 1, 2021, October 1, 2021, December 23, 2021