Ky.gov
Effective: 12/5/2022

4.12 Out of State Placement

Legal Authority

Introduction

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

Practice Guidance

Procedure

  1. ​The Regional Placement Coordinator (RPC) consults with the Children’s Review Program (CRP) statewide placement office when it has been determined that a child needs the services of an OOS facility and all in-state possibilities have been exhausted: 
  2. The CRP statewide placement office seeks the approval of the Department for Community Based Services (DCBS) Division of Protection and Permanency (DPP) director or designee to begin the OOS placement referral process by emailing a request to the Clinical Services Branch. 
  3. Upon review and concurrence with the DPP director or designee and the Clinical Services Branch, an e-mail is sent to the CRP statewide placement office approving the search. 
  4. The CRP statewide placement office follows the steps below upon receipt of approval from the DPP director or designee:
    1. Contacts potential OOS placements, prioritizing (in part) according to proximity to the child’s home county; 
    2. Provides instructions to the potential provider regarding participation with Kentucky Medicaid and pre-approval, and follows up as appropriate; ​
    3. Informs the RPC, FSOS, and SSW once an appropriate placement with a Kentucky Medicaid provider is located. 2 
  5. If the FSOS and SSW are in agreement with the placement, the CRP statewide placement office contacts the facility to determine when the child can be admitted. 
  6. The SSW submits the Interstate Compact on the Placement of Children (ICPC) approval request electronically throught TWIST utilizing 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. DPP-100A;
    3. Correspondence (letter/email) from CRP or regional/central office that states in-state placements are not appropriate; 
    4. Acceptance letter/correspondence from the out of state facility; 
    5. Memo of approval from the DPP director or designee; 
    6. Current court commitment/custody orders, dated within the last twelve (12) months (calendars or dockets do not meet this requirement); 
    7. Current assessment; 
    8. Admission/discharge information from other recent treatment programs; 
    9. Information regarding the child’s DSM V diagnosis and IQ; 
    10. Completed ICPC Financial/Medical Plan; 
    11. Title IV-E eligibility (OOHC-1262-Title IV-E Eligibility/ Reimbursement Summary form). 
  7. 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. 
  8. The SRA assigns a regional designee to follow up on the financial aspect of the placement (including Medicaid precertification). 3 
  9. 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. The ICPC-100B should be submitted to the KY ICPC office within three (3) working days of placement being made.   
  10. The DCA of Kentucky sends written correspondence (100B) to the DCA of the state in which the facility is located; 
  11. The SSW obtains travel approval from the interstate office and forwards it to the SRA. 
  12. 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 
  13. 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. 
  14. 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. 
  15. 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: 
    • 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; 
    • Notifies the Director of Protection and Permanency in central office at (502) 564-6852; and 
    • ​Consults with the SSW and FSOS and notifies the RPC as to whether a new search for an in-state placement is appropriate.
OOS placement may be considered when:

  1. ​It has been determined that a youth has treatment needs cannot be met within the in-state provider network; 
  2. The youth is in need of residential or psychiatric residential treatment facility (PRTF) treatment and no in-state providers have accepted for placement after two (2) in-state referrals have been completed; or
  3. The youth is in need of residential or PRTF treatment and the only in-state acceptances are for waiting lists with anticipated wait of two (2) months or longer. 

Related Information

  • Clinical Services Branch
    275 East Main Street, 3E-D
    Frankfort, KY 40621

Footnotes

  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 OOS 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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Documents

Revisions

​12/6 Deletion:  

  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 

12/5/22  Change submission of request from Out-of-Home Care branch to Clinical Services Branch.