Department for Community Based Services

Standards of Practice Online Manual

4.12 Out of State Placement

Cabinet for Health and Family Services

Department for Community Based Services
Division of Protection and Permanency
Standards of Practice Online Manual
Chapter 4-Out of Home Care Services (OOHC)
4.12 Out of State Placement

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Legal Authority/Introduction


A child may be placed in an out of state placement when the child is in need of specialized services that are not available in the state of Kentucky.


  1. The Regional Placement Coordinator (RPC) consults with the Children’s Review Program (CRP) statewide placement office and follows the steps below when it has been determined that a child needs the services of an out-of-state facility and all in-state possibilities have been exhausted:
    1. Requests approval to begin out of state referrals if no new possibilities are formulated; 1 
    2. Contacts potential out of state placements, prioritizing (in part) according to proximity to the child’s home county upon approval of the search by the CRP statewide placement office;
    3. Provides instructions to the potential provider as to participation with Kentucky Medicaid and pre-approval, and follows up as appropriate;
    4. Informs the SSW once an appropriate placement with a Kentucky Medicaid provider is located. 2
  2. The CRP statewide placement office seeks the approval of the DCBS Division of Protection and Permanency Director to begin the out of state placement referral process by faxing (502-564-5995) a written request to the Out of Home Care Branch.
  3. Upon review and concurrence with the Director of Protection and Permananey and the Out of Home Care Branch, an e-mail is sent to the CRP statewide placement office approving the search. 
  4. The SSW contacts the facility to determine when the child can be admitted, with the understanding that placement has not yet been approved.
  5. The SSW requests, through supervisory and regional channels, approval of the interstate placement by the DCBS Division of Protection and Permanency Director.
  6. The SSW submits one (1) referral packet via e-mail to or to the adress below to request a residential treatment center (RTC):

    Deputy Compact Administrator
    Kentucky Interstate Compact Office
    275 East Main Street, 3E-D
    Frankfort, KY 40621.
  7. The SSW utilizes the ICPC Referral Packet Checklist for Out of State Residential Placements and ensures the referral packet contains the information below in the following order:
    1. The ICPC Cover Letter;
    2. Correspondence (letter/email) from CRP or regional/central office that states in state placements are not appropriate;
    3. Acceptance letter/correspondence from the out of state facility;
    4. Current court commitment/custody orders, dated within the last twelve (12) months (calendars or dockets do not meet this requirement);
    5. Current assessment;
    6. Admission/discharge information from other recent treatment programs;
    7. Information regarding the child’s DSM IV diagnosis and IQ;
    8. Completed ICPC Financial/Medical Plan;
    9. Title IV-E eligibility (OOHC-1262-Title IV-E Eligibility/ Reimbursement Summary form).
  8. The Out of Home Care Branch notifies the SRA or designee of their decision to approve or deny out of state placement within four (4) working days of receipt of the request.
  9. The Deputy compact Administrator (DCA) of Kentucky notifies the SSW and/or the FSOS in writing of approval, upon approval by the DCA or the receiving state.
  10. The SRA assigns a regional designee to follow up on the financial aspect of the placement (including Medicaid precertification). 3
  11. The SSW notifies the RPC and the DCA of Kentucky in writing, using the ICPC-100B Interstate Compact Report on the Child's Placement Status, when placement has taken place or if the approved facility will not be used.
  12. The DCA of Kentucky sends written correspondence (100B) to the DCA of the state in which the facility is located;
  13. The SSW obtains travel approval from the interstate office and forwards it to the SRA.
  14. The SSW follows procedures outlined in SOP 4.54 Transportation and Out of State Travel with a Child in the Custody of the Cabinet  when transporting a child
  15. The SSW notifies the DCA of Kentucky in writing/email if the child is placed in the approved out of state facility and the child returns or is released back to Kentucky.
  16. The SSW has the facility sign a DPP-1278R-OUt of State Psychiatric Hospital/Residential Program Services Agreement or similar provider agreement at the time of the child's admission to an out of state facility.
  17. The DCA of Kentucky closes the interstate case and copies the SSW or FSOS on the correspondence. 4



Clarifications and Contingencies

The regional designee:

  1. Requests that the provider assist with an appeal if a child is decertified;
  2. Completes the following steps if the appeal is not successful:
    1. Ensures that payment to the provider will come from the regional budget as agreed on the DPP-1285R Out of State Psychiatric Hospital/Residential Program Services Agreement, or similar provider agreement;
    2. Notifies the Director of Protection and Permanency in central office at (502) 564-6852; and
    3. Consults with the SSW and FSOS and notifies the RPC as to whether a new search for an in-state placement is appropriate.

Related Information

  • Out of Home Care Branch
    275 East Main Street, 3E-D
    Frankfort, KY 40621 


  1. The request includes documentation of all in state referrals, as well as the recommendation and/or agreement by the SSW and FSOS to begin the out of state referral process.
  2. The cabinet uses a participating Kentucky Medicaid provider first.
  3. The designee’s name is given to the provider at the time of the child’s admission.
  4. It is recommended that a pre-placement visit be scheduled if at all possible.


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