2390 Families Who Are Unable to Obtain Mental Health Services for Children with Severe

2390 Families Who Are Unable to Obtain Mental Health Services for Children with Severe Emotional Disturbance

CPS December 2015

For additional information, see the Investigation and Referral to DSHS Residential Treatment Center Bed Resource GuidePDF Document.

A caseworker must complete additional tasks and actions, beyond the typical investigation tasks, when the caseworker is assigned to an investigation in which:

• a child with severe emotional disturbance is alleged to be abused or neglected; and

• the family is refusing to allow the child to remain in or return home due to the parent’s inability to obtain mental health services for the child.

The purpose of these actions is to determine whether the parent’s refusal to allow the child to remain in or return to the home is based solely on the parent’s inability to obtain mental health services for the child. If the determination shows the parents’ actions meet this criterion, the caseworker must:

determine whether DFPS can avoid removing the child, which includes determining if the parent can place the child in a Residential Treatment Center (RTC) bed funded by the Department of State Health Services (DSHS); and

in the event of removal, discuss with the parent the possibility of DFPS and the parent being joint temporary managing conservators of the child, unless it is not in the best interests of the child to do so.

notify the state office mental health specialist at if they receive such a case, for assistance with the process.

Obtaining the Child’s Mental Health History

The caseworker must obtain the child’s mental health history.

For a list of items needed as part of this history, see the Investigation and Referral to DSHS Residential Treatment Center Bed Resource GuidePDF Document.

Psychological Evaluation Within Last Six Months

If the child has had a psychological evaluation within the past six months, the caseworker must ask the parent for a copy of the evaluation and attach the copy to Form 2037PDF DocumentExternal Link Referral for DSHS Funded RTC Bed (Child Not in DFPS Conservatorship).

DFPS is not responsible for obtaining, arranging or paying for the actual evaluation of the child.

See the Investigation and Referral to DSHS Residential Treatment Center Bed Resource GuidePDF Document.

2391 Assessing the Basis for the Parent’s Refusal to Allow the Child to Remain in or Return to the Child’s Home

CPS December 2015

When a parent is refusing to allow a child with severe emotional disturbance to remain in or return to the home, the caseworker must determine whether this refusal is based solely on the parent’s inability to obtain mental health services needed for the child’s safety and well-being, and whether the parent exhausted all reasonable means available to obtain mental health services.

Determining the basis for this refusal is necessary to:

• evaluate the child’s eligibility for referral to a DSHS funded RTC bed;

• determine whether it is not in the child’s best interest for the parent to be appointed joint temporary managing conservators with DFPS, if DFPS seeks to remove the child; and

• appropriately provide dispositions for the allegations of abuse or neglect.

Assessment Criteria

The caseworker must assess the specific conditions of the case when determining the basis for refusal. However, the caseworker must always assess the following criteria:

• Is the family unable to access appropriate mental health treatment to meet the child’s needs due to the family’s financial resources, the lack of appropriate services available in the community, or other reasons?

• Has the parent followed the recommendations of the mental health professionals who have treated the child, including complying with recommendations about actions the parent, child, or family need to take? If the parent disagrees with a professional’s recommendations, has the parent discussed their concerns with the professional or sought other mental health professionals for assistance or treatment, if possible?

• Has the current investigation ruled out abuse or neglect of the child with severe emotional disturbance?

Determination

The caseworker may determine that the parent’s refusal to allow the child to be in the home is based solely on the parent’s inability to obtain the necessary mental health services for the child if:

• the assessment criteria are met;

• circumstances in the family support this determination; and

• the supervisor approves.

Making a Disposition for Allegations

DFPS must not make a reason to believe (RTB) finding of abuse or neglect by a parent who refuses to permit the child to remain in or return to the child’s home if:

• the child has a severe emotional disturbance;

• the parent’s refusal is based solely on the parent’s inability to obtain mental health services necessary to protect the safety and well-being of the child; and

• the parent has exhausted all reasonable means available to the parent to obtain the mental health services necessary to protect the safety and well-being of the child.

Texas Family Code Sections 261.001(4)(B)External Link and 261.002(b)(i)External Link

Relinquish Custody Question on Allegation Detail Page

If the caseworker rules out the allegation of abuse or neglect by a parent who refuses to permit the child to remain in or return to the child’s home, and the above three criteria are met, the caseworker must answer YES to the question:

“Is the primary caregiver seeking to relinquish custody of this alleged victim solely to obtain mental health services for the child? Yes No”

2392 Referring the Child for a Residential Treatment Center Bed Funded by DSHS

CPS December 2015

When the parent is refusing to allow a child with severe emotional disturbance to remain in or return to the child’s home, the caseworker must make reasonable efforts to prevent removal and placement by DFPS.

As part of these efforts, the caseworker must refer the child for placement by the parent in a residential treatment center (RTC) bed funded by the Department of State Health Services (DSHS), if the child meets referral criteria.

2392.1 Referral Criteria

CPS December 2015

Before completing the referral for a DSHS-funded RTC bed, the caseworker must determine if the child and family meet all of the following referral criteria:

• The family is involved in an open investigation, and DFPS has not taken conservatorship of the child.

• The family is not eligible for DFPS post adoption substitute care services.

• The parent’s refusal is based solely on their inability to obtain mental health services necessary to protect the safety and well-being of the child.

• The disposition of “Ruled-Out” will be given to allegations involving the parent and the child with severe emotional disturbance, based on evidence gathered by the time Form 2037PDF DocumentExternal Link is submitted.

• The child is between five and seventeen years of age.

• The child has an IQ of at least 70.

• The child is a U.S. citizen.

• The child has a mental health diagnosis given by a licensed mental health professional that is recognized by the current version of the Diagnostic and Statistical Manual of Mental Disorders, and the child’s mental health condition results in severe mental, behavioral, or emotional impairments in functioning.

For a detailed definition of Severe Emotional Disturbance, see the Investigation and Referral to DSHS Residential Treatment Center Bed Resource GuidePDF Document.

The parent must provide the caseworker with:

• results of testing that show the child’s IQ and mental health diagnosis; and

• documentation that the child is a U.S. citizen.

If the caseworker and supervisor agree the family and child meet the eligibility criteria, the caseworker must:

• complete Form 2037PDF DocumentExternal Link Referral for DSHS Funded RTC Bed (Child Not in DFPS Conservatorship);

• scan in a psychological evaluation on the child completed within the last six months; and

• email the form (and psychological evaluation) to the CPS mental health program specialist in state office at .

The caseworker and supervisor do not contact DSHS directly because contact is made by state office.

2392.2 Providing Crisis Services During the Referral Process

CPS December 2015

Any time there is an emergency in the family during the referral process, the caseworker must immediately notify the CPS mental health specialist for assistance in getting crisis services for the family.

The CPS Mental Health specialist, DSHS RTC Coordinator, investigation caseworker, and family must meet to plan for and provide crisis intervention services to prevent the child from coming into CPS foster care during the referral process.

Investigation Caseworker Responsibilities

Investigation caseworkers must help families maintain safety and stability during the referral process so eligible children can be placed in DSHS funded RTC beds when a placement becomes available. The investigation caseworker must:

• if necessary, establish a safety plan with the family to guide them towards services or actions that help keep the family safe and stable;

• convene a Family Team Meeting to decide how to ensure the safety of the child;

• attend a Community Resource Coordination Group (CRCG) in person or by telephone, if a CRCG is convened during the referral process; or

• take other protective and stabilizing actions as appropriate.

2392.3 Responding to the Referral Process Outcome

CPS December 2015

The investigation caseworker must staff the case with the supervisor to determine next steps when the CPS mental health specialist notifies the investigation caseworker that one of the following results has occurred.

Parents Place the Child in a RTC Funded by DSHS

The investigation caseworker must close the investigation when the child is placed in the DSHS funded RTC, unless other children in the home require further CPS intervention.

The Child is Not Placed in a RTC Funded by DSHS, and DFPS Removal Does Not Appear Necessary

When the child is not placed in a DSHS funded RTC bed, the CPS mental health specialist must inform the investigation caseworker. If DFPS removal does not appear necessary, CPS staff must close the investigation, unless the children in the home require further CPS intervention.

2393 If DFPS Removal Appears Necessary

CPS December 2015

2393.1 Discussing the Option of Joint Temporary Managing Conservatorship

CPS December 2015

If DFPS removal appears necessary, the investigation caseworker must discuss with the parent the option of asking the court to appoint DFPS and the parent to be Joint Temporary Managing Conservators (JMC) of the child, unless DFPS determines it would not be in the best interests of the child to have joint conservatorship.

The investigation caseworker must also discuss the option with the parent in post adoption conservatorship services under 6954 Post Adoption Substitute Care Services, unless it is not in the child’s best interest.

Determination

The caseworker must not discuss joint temporary managing conservatorship of the child with the parents until the supervisor and program director have approved:

• the removal of the child; and

• the caseworker going forward with a discussion of joint temporary managing conservatorship with the parents.

If the decision is made to discuss joint temporary managing conservatorship with the parents, and the parent is interested, the caseworker must discuss with the county or district attorney whether to include this request in the petition.

If the county or district attorney declines to file for DPFS-parent joint temporary managing conservatorship, the caseworker must staff the case with the Regional Attorney.

Documenting the Discussion

The caseworker must document the following in the narrative in the FSU stage in IMPACT:

• Whether joint temporary managing conservatorship was discussed with the parent; and

• Whether the parent wanted joint temporary managing conservatorship, and if not, why not.

2393.2 Documenting Removal

CPS December 2015

When documenting removal of a child with severe emotional disturbance solely because the family was unable to obtain mental health services, the caseworker must complete the following in IMPACT.

Child Placement Characteristics on the Person Detail Page

The caseworker must select one or more of the following in IMPACT, as appropriate to the child’s condition:

• Bipolar

• Conduct Disorder

• Depression

• Emotionally Disturbed

• Mood Disorder

• Oppositional Defiant Disorder

• Post-Traumatic Stress disorder

• Psychotic Disorder

• Reactive Attachment Disorder

• Other Behavior Problem

Removal Reason on the Conservatorship Removal Page

On the Conservatorship Removal page, the caseworker must select the Removal Reason “A/N risk - Primary caregiver relinquishes custody of this child solely to obtain mental health services for the child”.