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Effective: 4/25/2024

4.53 Bed-Hold-Private Child Caring (PCC) / Residential or Private Child Placing (PCP) Foster Care Placement

Legal Authority

Introduction

​​​​​​​​​​​​​When a child is placed in a private child caring (PCC) residential placement, private child-placing (PCP) foster placement, Department for Community Based Services (DCBS) foster placement, or emergency shelter placement, it is sometimes necessary for the placement provider or SSW to request a bed-hold. A bed-hold may be requested when a child is:

  • Hospitalized; or 
  • Missing from care. 

The purpose of a bed-hold is to ensure that a child can return to the same placement setting to promote attachment and continuity of care. Therefore, bed-holds are only applicable if the child is returning to the same foster home or the same program within a PCC residential facility. If it is not the intent for the child to return to the same placement of the program, a bed-hold request will not be approved. The only exception would be during the period of a two (2) week notice.  

Practice Guidance

Practice Guidance for PCP/PCCs
  • Payment for the approved bed-hold is retroactive to the date the child disrupted from the placement. 
  • If a two (2) two-week notice was given before the child missing from care or hospitalization, the SSW may complete​ a bed-hold for the duration of the two (2) week notice so that the youth can return to the original placement while a new placement is being located.  ​
  • During the bed-hold period:
    • ​If the provider determines that it cannot meet the needs of the child and does not wish for the child to return, the provider submits a two (2) week written notice of discharge to the Cabinet for Health and Family Services (Cabinet/CHFS).
    • If a child is discharged from a hospital or returns after missing from care prior to the expiration of the provider's two (2) week notice of discharge, the provider is obligated to maintain placement until the two (2) week notice is fulfilled.
    • If the child does not return to the placement before​ the expiration of the two (2) week notice of discharge, the date of disruption becomes the discharge date for the child. If this occurs, CHFS is not obligated to make payment for any of the bed-hold days.
  • During the onset of the hospitalization or time the child is missing from care,  the PCP/PCC agrees to hold placement for the child, the SSW agrees that the plan is for the child to return to the same foster home, and the request for a bed-hold is initiated by the PCC/PCP.  The Cabinet will respond, in writing, to the written request for a bed hold within two (2) working days of the request. Once a bed-hold has been authorized, the Cabinet is responsible for payment of the bed-hold, even if the child cannot return to the placement due to circumstances beyond the PCP/PCC's control.  
  • If for any reason, the Cabinet determines at any time during the approved bed-hold period that the child will not return to the same placement, written notice will be provided to the PCC/PCP, and bed-hold days shall be paid only up to the date of the notice to the PCC/PCP.  The date of the Cabinet’s notice to the PCC/PCP will be considered the discharge date. 
  • Paid bed-holds are not applicable when a PCC/PCP transfers a child between its own programs, (i.e., facility and/or foster homes). ​
  • If the provider requests a bed-hold for an appropriate situation and CHFS does not approve it, the provider does not have to provide the Cabinet with a two (2) week notice of discharge and the disruption date becomes the child's discharge date.
  • Per contractual agreement, the SSW must respond within two (2) business days to the provider's request for a bed-hold. If no response is received within that timeframe, the provider is not obligated to hold the bed. 
  • For medically necessary reasons, the service region administrator (SRA) or designee (service region administrative associate (SRAA) or service region clinical associate (SRCA)) may approve an additional two (2) week bed-0hold (four (4) weeks total), in writing. 
  • If the child’s absence from a placement exceeds two (2) weeks, or four (4) weeks with approved medical need, and the child returns to the private placement, it is considered a new admission. 
  • If a child is placed in detention while they are in a private residential or foster care placement, CHFS will not pay for a bed-hold for this child. This is considered a placement move. ​
  • A bed-hold may be requested for youth who are on extended commitment.
  • A bed-hold may be requested for youth who are placed in a PCC through post-adoptive placement stabilization services (PAPSS). 
Practice Guidance for DCBS Foster Homes
  • Payment for the approved bed-hold is retroactive to the date the child disrupted from the placement.
  • If a two (2) week notice was given prior to the child missing from care/hospitalization the SSW may complete a bed-hold for the duration of the two (2) week notice so that the youth may return to the original placement while the new placement is being located.
  • During the bed-hold period, if the foster parent determines that they cannot meet the needs of the child and does not wish for the child to return, the foster parent is to notify the Cabinet at two (2) weeks prior to requesting that a child be removed from the home, except when an identifiable risk to the health and safety of the foster child or foster family exists.
  • If a child is discharged from a hospital or returns after missing from care prior to the expiration of the foster parent's two (2) weeks notice, the foster parent is obligated to maintain placement until the two (2) week notice is fulfilled.  If the child does not return to the placement prior to the expiration of the two (2) week notice, the date of disruption becomes the discharge date for the child.  If this occurs, the Cabinet is not obligated to make payment for any of the bed-hold days.
  • If the foster parent requests a bed-hold for an appropriate situation and the Cabinet does not approve it, the foster parent does not have to provide the Cabinet with a two (2) week notice of discharge and the disruption date becomes the child's discharge date.
  • The SSW must respond within two (2) working days to the foster parent's request for a bed-hold. If no response is received within that timeframe, the foster parent is not obligated to hold the bed.
  • The SSW uploads the bed-hold into TWIST and sends a copy to the recruitment and certification (R&C) worker.  
  • For medically necessary reasons, the SRA or designee (SRAA or SRCA) may approve an additional two (2) week bed-hold (four (4) weeks total), in writing.
  • If the child’s absence from a placement exceeds two (2) weeks, or four (4) weeks with approved medical need, and the child returns to the placement, it is considered a new admission.
  • If a child is placed in detention while they are in foster care placement, the Cabinet will not pay for a bed-hold for this child.  This is considered a placement move. ​



Procedure

The SSW:
  1. Requests approval, in writing, for the following types of bed-holds from: 
    1. The SRA or designee (SRAA or SRCA) to hold a bed for up to two (2) weeks for a child who is away from a placement with the intent for the child to return to the same placement (for foster care this means the child will return to the same family that they left) during those two (2) weeks; 
    2. The SRA or designee (SRAA or SRCA) when requesting a bed-hold for a child who is missing from care; 
    3. The FSOS for up to two (2) weeks when a child has a temporary stay at a psychiatric hospital and the child is expected to be released within two (2) weeks; 
    4. The Out-of-Home Care (OOHC) branch manager to hold a bed for up to two (2) weeks for a youth who has a stay at a hospital, or is missing from care​​, with the intent for the child to return to the same emergency shelter placement within two (2) weeks. 
  2. Provides the private agency with the approved written request within two (2) working days of the child’s placement disruption; 
  3. Provides the private agency with the approved written request (Bed-Hold Request form), signed by the SRA or designee (SRAA or SRCA) for the extension, within the first two (2) weeks of the child’s bed-hold.
If the decision is made by DCBS staff during the two (2) week or four (4) week bed-hold, that it is no longer the intent for the child to return to the placement:
  1. The SSW cancels the bed-hold by notifying the private agency,or the DCBS foster parent,  in writing (Request for Bed-Hold​); and 
  2. The bed-hold is paid through the date in which the written cancellation of the bed-hold was provided to the private agency or the DCBS foster parent.

Documents

Revisions

4/25/2024

Addition:  

  • Missing from care.
  • A bed hold may be requested for youth who are placed in a PCC through PAPSS. 

Deletion: 
AWOL (absent without leave)