Center for Children, Families and Workforce Development

The CPS worker is the representative guardian for any child under the care of the Child and Family Services Division (CFSD). Their job is to ensure that the child is safe whether that is in the child’s home, a foster home or other out-of-home placement. They are responsible for anything regarding the child’s legal care, medical care, travel, and case management services. They are required to make monthly home visits.

• The CPS worker is the case manager for the child and for the birth parents and is working to reunify them.
• You can call your CPS worker for anything that relates to the child and the child’s direct care needs.
• Your licensing worker (Resource Family Specialist) can help you navigate the expectations of the foster home and answer questions you might have regarding child care and disciplinary techniques. They can also recommend ways to better meet the child’s needs.

The relationship with your caseworker should be an open communication relationship so you can call any time you have questions or concerns.

You can contact your licensing worker (Resource Family Specialist) when you have questions about foster care licensing.

It is best to address phone protocols during your first meeting with the CPS worker. You should discuss when and why you may need to contact the worker and who to contact if they are unavailable (after working hours, vacation).  If they are not responding to your calls, you should contact their supervisor. If you receive no response in 5-7 days you should contact the Regional Administrator.

In a case of physical danger (child runs away, is harming herself or others, etc.) or medical concerns (illness, broken bone, stitches, etc.) take care of the immediate need first by calling 911 or going to the emergency room.

Following this action, you must contact Centralized Intake to inform the on-call worker of the situation. Call (866) 820-5437.

Legal: A foster parent generally has the right to know the content of the child's treatment while they are in your care. Foster parents do not have a right to mental health professional’s private therapy notes. The Health Insurance Portability and Accountability Act (HIPAA) does allow mental health providers the option to release personal psychotherapy notes to the child’s Personal Representative. The child’s Personal Representative is usually the child’s parent or legal guardian (as defined by state law). A foster parent may not be the child’s identified Personal Representative, in which case, professionals are not legally required to release or share information about the child with them. More resources regarding accessing medical records and rules for information release for providers are discussed below.  

Clinical Practice: As a child grows into adolescence and adulthood, the surrounding zone of privacy should increase, thus making room for a more defined sense of self and greater autonomy. Good clinical treatment may require what the law generally refuses — a zone of privacy. Each therapist may have slightly different boundaries but will likely be trying to respect the child’s privacy. They may just give you advice or only opt to inform you if they feel the child is at risk.

Ethics: Whatever the therapist chooses to disclose to foster parents should not come as a surprise to the youth or the foster parents. Clear parameters on what is private and what will be shared should happen the first time a clinician meets with a child and discussed throughout the sessions when anything changes.

Additional Resources for families: 

• Infographic on Accessing Child's Mental Health Record
• Fact Sheet for Parents: HIPAA and Access to Medical Records
• Foster Parent Resource Guide: Annie E. Casey Foundation

Additional Resources for professionals supporting families:

• Professional Judgement Infographic
• Access to Psychotherapy Notes: HIPAA
• National Association of Social Workers Code of Ethics (NASW)
• American Counseling Association Code of Ethics (ACA)
• American Psychological Association Code of Ethics (ACA)

The child’s therapist should address both of these questions during the first meeting. If not, you should ask the therapist what information they need to help the child. Some therapists might prefer a weekly check-in at the start of the meeting, while others might do so periodically. The therapist should also explain what is confidential between the child and therapist, and what information can be shared with you. Your concerns should also be shared with your CPS worker.

It's important that you immediately call 911, or safely transport your child to an emergency room if your child has stated that they have a plan to carry out a suicide, have the resources to follow through with the plan, and they will not agree to be safe.

As a follow-up, it is important to find a licensed professional who specializes in working with youth who are suicidal with the approval of the CPS worker.

Suicide Prevention Resource: 

Crisis Text Line: Crisis counselors available 24/7 to answer texts on a variety of topics. Consider programming into your child's mobile device.  

• Text “mt” to 741-741

• (800) 273-TALK

State of Montana Suicide Prevention Resources: A list of programming and resources for Montanans.

Self-harm, also known as non-suicidal self-injury, can be alarming. It is important that the child undergoes a suicide assessment by a professional therapist to discern if their self-harm is suicidal ideation or a need to learn healthier coping techniques. Young people self-harm for many reasons including depression, attempting to cope with sadness or shame, experiencing deep self-loathing, lack of control in their lives, having a difficult time verbalizing overwhelming emotions, or general feelings of helplessness. 

It is important to be empathetic and listen to the child’s concerns. The child must feel safe and supported to discuss their feelings and actions. The child may be resistant to help, so be patient and seek professional advice. Open dialogue about ‘triggers’ and finding less severe options (e.g. holding ice cubes, sucking a lemon peel, punching a pillow, snapping rubber bands) can help as you work together to overcome this behavior. It is important to stay positive, know this is a process, and be empathetic when the child has setbacks. 

Ways to be supportive:

• DO talk age appropriately and openly about suicide.
• DO dress all wounds that are fresh or seek immediate medical care for serious injuries.
• DO be willing to listen and allow expressions of all feeling.
• DO ask direct questions such as, "Are you suicidal?", "What did you use to inflict self-harm?", "What thoughts are going through your mind when you want to die/hurt yourself?"
• DO check-in with them regularly and set boundaries around closed doors.
• DO remove means of harm, such as weapons, rope, or pills.
• DO write a safety plan or download an app such as MY3 or Suicide Safety Plan app.
• DO get involved, be available, and show interest and support.
• DO seek professional help when needed. 

Ways of not helping:

• Do NOT interrupt or say “but” following their sharing. “But” can feel invalidating to someone who may already be struggling with poor self-image.
• Do NOT punish them for their behaviors - this will further isolate and put them at risk. 
• Do NOT remove their natural supports, such as banning spending time with friends or communicating through the phone or social media.
• Do NOT overreact but be honest with your feeling.
• Do NOT dismiss or 'one-up' ("You think your day was bad....”) someone who is reaching out for help. 
• Do NOT keep their suicidal ideation or self-harm a secret. Seek support and professional help.

Play therapy is a way of being with the child that honors their unique developmental level and looks for ways of helping in the “language” of play. Licensed mental health professionals use play to help their clients, typically children between the ages of three to 12 years, better express themselves and resolve their problems.

Mental health agencies, schools, hospitals, and private practitioners have utilized play therapy as a primary intervention or as supportive therapy for:

• Behavioral problems, such as anger management, grief and loss, divorce and abandonment, and crisis and trauma.
• Behavioral disorders, such as anxiety, depression, attention deficit hyperactivity (ADHD), autism, academic and social developmental, physical and learning disabilities, and conduct disorders.

If the child is placed with you through CPS, they will take care of enrolling your child in Healthy Montana Kids (HMK)/Medicaid. You should receive a copy of the child’s Medicaid card when it is available. If you need a copy, call your local CPS office or your CPS worker.

Even if you do not have a copy of the card, your child can still receive care. Any health care provider can look up the child’s health care number using the child’s social security number (if available) and date of birth.

If the child is placed with you through a kinship placement, verify with the CPS worker that your child is signed up for health coverage, as it may be your responsibility to sign your child up for Healthy Montana Kids (HMK)/Medicaid.

If you have questions about your child’s benefits you can call the Montana Public Assistance Helpline at (888) 706-1535.

Medicaid should already be active for kids placed in out-of-home care.

Any health care provider can look up the child’s health care number using the child’s social security number and date of birth.

Medicaid should be billed for all Medicaid eligible services. If you or provider is unsure if it is Medicaid approved get prior approval from CPS before accessing services. If there are problems with billing, have the provider contact CFSD.

You should never take financial responsibility for medical costs.

Yes, this is a great use of your monthly stipend. Also, seek resources within the community for scholarships for these types of activities, as many communities have funds and scholarships to assist.

Children age 14 and up are eligible for Chaffee services if in foster care through CFSD. If they are enrolled there may funding to assist with some of these expenses. Contact your CPS or the Chafee Program Office in Central Office about Chafee Services for your child.

An Individualized Education Plan (IEP) is an important legal document that is required for your child to receive specialized education services. It identifies your child’s learning needs, the services the school will provide, and how progress will be measured.

What is the IEP Process?

Parents, case managers, teachers, a counselor, a doctor or anyone else who suspects a child is struggling academically can request an evaluation. The school psychologist and other professionals may give your child various tests. They may observe your child in the classroom. Keep in mind that a physician or another medical professional (not the school) diagnoses medical conditions like Attention Deficit Hyperactivity Disorder (ADHD). School evaluators do not offer “diagnoses.”

Eligibility Meeting

Following the evaluation, the IEP team, which includes parents and school officials, decides whether or not your child needs specialized educational services in order to learn the general education curriculum. If the IEP team agrees that your child needs services, then the next step is to create an IEP. If your child is found ineligible, you can still try to get services for your child. For instance, you might pursue a 504 plan.

The Plan

IEPs are designed to meet children’s unique needs so every IEP will look different. However, by law all IEPs must contain the following elements:

• The child’s present levels of academic and functional performance — how the child is currently doing in school.
• Annual education goals for the child and how the school will track progress.
• The services the child will receive, which may include special education, related, supplementary and extended school year services.
• The timing of services — when they start, how often they occur and how long they last.
• Any accommodations — changes to the child’s learning environment.
• Any modifications — changes to what the child is expected to learn or know.
• How the child will participate in standardized tests.
• How the child will be included in general education classes and school activities.

A surrogate parent is responsible for representing the child when evaluations are needed to identify the child’s educational needs, evaluation of ongoing educational progress, formulation and implementation of an Individual Education Plan (IEP), advocating for the child when there is disagreement with the school’s intended educational plan, etc.   

A surrogate parent cannot be a representative of the state or local agency providing educational services for the child. The surrogate parent may not have a vested interest that will conflict with the person’s representation and protection of the child. For example, the child’s surrogate parent cannot be the child’s Child Protection Specialist if the child is in the custody of the state. The surrogate should be knowledgeable of the education system, special education requirements, and the legal rights of the child in the educational setting. When possible, the surrogate parent must be familiar with the cultural and/or language background of the child.

Additional Resources

Montana Office of Public Instruction IEP Facilitation info

Montana Office of Public Instruction Special Education Forms and Guidance 

A 504 plan is a formal plan that schools develop to give children with disabilities the supports they need. These plans prevent discrimination and protect the rights of children with disabilities in school. These plans are covered under Section 504 of the Rehabilitation Act, which is a civil rights law. These plans are not part of special education so they don’t provide individualized instruction as IEPs do. A central purpose of 504 plans is to give children with disabilities access to the same education their classmates are receiving.

What is the 504 Process?

The process for getting a 504 plan is much different, and simpler than the process for getting an IEP, but it varies between school districts. Children do not need to receive a full evaluation to get a 504 plan, although many do. In fact, schools often suggest a 504 plan if a child does not qualify for special education but needs support. With 504 plans, schools review information about a student from a variety of sources. One source utilized might be a medical diagnosis. Schools might also look at the student’s grades, test scores, and teacher recommendations.

Parents or schools can request a 504 plan through the school district’s 504 coordinator, who may also be the IEP coordinator. (Ask the principal if you are unsure who to contact.) The request must be made in writing. The school will then hold a meeting to decide if the child qualifies and what supports are appropriate.

To get a 504 plan, there are two requirements:

• The child has a disability, which can include many learning or concentration problems.
• The disability must interfere with the child’s ability to learn in a general education classroom.

There is no standard 504 plan. Unlike an IEP, a 504 plan does not have to be a written document, although a written plan is recommended. A 504 plan generally includes the following criteria or components:

• Specific accommodations, supports or services for the child
• Names of who will provide each service
• Name of the person responsible for ensuring the plan is developed

Additional Resources

Montana Office of Public Instruction Parent and Educator Resource Guide to Section 504 

Montana Department of Public Health and Human Services 'Know Your Rights' in Education 

• Notify your CPS
• Under 3 years: Early Childhood Intervention Specialist
• Pediatrician
• School testing referral
• Speech/occupational therapist

* Availability of these services is dependent on state funding

A Behavior Specialist is an on-site school specialist who provides direct support to children with behavior and emotional needs. Many of them are connected to Comprehensive School and Community Treatment (CSCT) programs and have daily contact with the kids. For students who also have an IEP, these specialists work with the para-educators to meet the child’s needs.

CSCT operates as a team and includes the behavior specialist, school counselor, teachers, staff, and paraprofessionals. They use different interventions based on the child’s needs and 504 or IEP plans.

First, try to identify what is triggering the behavior and attempt to remove it. For example, if the trigger is another child in the home, provide them with space away from each other.

If the child is upset about something you cannot identify, change how you respond. Provide them with choices such as “you can either go to your room or choose to help me cook dinner.”

Timeouts sometimes communicate to children that you only want to be with a child (or “them”) when they are “behaving”. Simply being in the same area while they experience what they are going through without correcting their behavior, may communicate safety and security. Instead of a timeout where you send them to their room, try a “time in” where you and the child engage in an activity together like cooking dinner or going on a walk. A “time in” is a way to stop an experience that is not working for either of you by doing something together that does work.

Foster parents are not allowed to put children in “holds.” Instead, it is important to assess what are the contributing factors to their outburst.

If outbursts are a frequent occurrence, make their bedroom simple and safe, just the bed and dresser.

Notify your CPS worker of behavior concerns. You may also ask an RFS for suggestions about training or educational opportunities to gain additional skills or resources to meet children’s needs.

All children are different so there are no behaviors that you are guaranteed to see but it is common for neglected children to be behind developmentally for their given age group. After spending time in a safe environment, children are usually able to progress quickly.

Remember, if you are seeing outbursts from the children in your care, it is usually not about you. Notify your CPS of behavior concerns and contact your RFS for information regarding education or training that can assist you in developing the skills necessary to help a child manage their emotions and behaviors.

Ages 0-3: Children this age may have delays in communication skills, toilet training, and how they communicate distress. Frustration may present itself as anger with fits, screaming, and crying.

Ages 3-6: At this age, children in your care may have delays in communication skills and behave more like toddlers having tantrums. They may also have difficulty identifying feelings or reasons for having these feelings and why they might be frustrated. In addition, you may encounter children who exhibit chronic somatic symptoms, such as stomach aches or re-occurring colds.

Ages 6-11: At this age, children’s identity is often related to peer relationships. If they are having difficulties with peer relationships, they may demonstrate distress in peer-related situations. For example, they may have less interest in school, exhibit poor concentration in class, and lose interest in activities.

Lack of control is a common feeling at this age so they are often trying to gain control of what they can. For example, they can control where they go to the bathroom or may hoard food. They may display more reactive behaviors, such as throwing things across the room or causing harm to themselves or others. They may also have somatic symptoms (feeling sick).

Ages 11-18: At this age, they are often trying to find where they feel accepted so they may engage in risky behaviors, substance use, or sexualized behaviors because it is where they feel accepted, not because they are trying to be defiant or that they are interested in the behavior.

• Mental health symptoms - It is important to contact your child’s doctor or therapist if you observe signs of depression, anxiety, self-harm, suicide ideation, anger expressed outwardly or in isolation. 

Having been exposed to drugs and alcohol in utero does not equate with addiction but they are at an increased risk. Their developmental outcomes (physical, intellectual, social and emotional) may be delayed and should be monitored.

They may have symptoms of withdrawal as infants (difficult to soothe and noticeably uncomfortable). The child’s doctor, nurse, and/or CPS worker can provide suggestions to meet the child’s needs.

National Organization on Fetal Alcohol Syndrome provides resources for parents/caregivers raising children who have been exposed 

Podcast by Dr. Bonnie Stephens, Medical Director of the Neonatal Intensive Care Unit at Community Medical Center. Dr. Stephens discusses the impacts of drugs on babies during prenatal development and the developmental effects this exposure has on children as they age. 

A positive test for meth means that there is meth in the child’s system. A positive drug screen does not equate with addiction, as children do not have to be intentionally exposed to the drug to have it in their systems. There are many ways that children can be exposed to meth, such as breathing it in when being smoked in the house, touching it on a surface, or from residue falling on the floor.

Infants may exhibit symptoms of withdrawal, be difficult to soothe, or noticeably uncomfortable, but these symptoms do not mean they are “high.”

New England Journal of Medicine provides a short video about care for babies with NAS

The removal of a child does not mean the birth parents are dangerous or that they do not love their children. The CPS worker will tell you if there are specific safety concerns that they are aware of.

The CPS worker will inform the foster parent what kind of contact is allowed.

It is important for the child to have a relationship with their family of origin as they work toward reunification. As a result, your care for the child in both actions and words should support this.

Remember, reunification is the ultimate goal for these children so visits with their families are important, even though they may be very difficult for both you and the child.

Preparing them for the visit and following up with them after the visit can help them to process their negative emotions.

The behaviors displayed by these children vary greatly but it is common to see heightened behaviors such as dysregulation or withdrawal. It is also common to see them regress, or return to more childlike behaviors. For example, they might start wetting the bed even though they are potty-trained. These behaviors are often due to the child processing grief and loss from their family of origin. Be prepared to accept the child’s unpredictable emotional changes after these visits, be patient with them, and reassure them this is normal. These behaviors are important to relay to the child’s therapist and/or doctor and CPS.

According to policy, the child needs to have a medical, dental, vision, and mental health appointments (as needed) within a specified timeframe of entering foster care. Recommendations made by these providers should be reported to the CPS worker and adhered to.

• A well-child doctor visit must occur within 30 days of coming into CPS care.
• Essentially, the child has the right to access any service that is recommended while in your care.

Yes, it is highly recommended that you attend these meetings because you are the primary caretaker and your input and insight is important to the process. These meetings are also an opportunity for you to learn more about the family of origin, the family of origin to learn about you, and for you to review progress made toward reunification. It is common for foster parents to be frustrated with the lack of information about the family of origin’s progress. These meetings serve as an opportunity for you to gather information that your worker has not been able to provide you with, due to the birth parents’ right to confidentiality.

Be patient with the child, the worker, the process, and with yourself. This is often easier said than done. You have a very difficult role in this process as you provide care for these children each day. Your opinion matters and your observations should be expressed to the professionals who are involved with the child’s case. Keep in mind that it is important to ask for help when you need it. The child’s health and well-being are directly connected to yours. Ask for emotional support and respite care when you need it to help ensure that you are able to meet your foster child’s many care needs.    

• Be willing and open to learning new and different skills and parenting styles.
• Listen, support, care, nurture and be consistent.