CHAPTER 108
LICENSING AND REGULATION OF CHILD-PLACING AGENCIES
[Prior to 7/1/83, Social Services [770] Ch 108]
[Prior to 2/11/87, Human Services [498]]
Preamble
This chapter establishes licensing procedures for all child-placing agencies authorized by Iowa Code chapter 238. Included in this chapter are rules relating to: the licensing process; administration and organization; foster care services; adoption services; and supervised apartment living services.
441—108.1(238) Definitions.
“Administrator” means the person who is designated to have day-to-day responsibility for the administration of a child-placing agency, and who ensures that the mission of the agency and laws relating to the welfare and protection of children are carried out.
“Adoptive applicant” means the person who has requested approval for placement of a child for adoption from a licensed child-placing agency.
“Adoptive family” means an approved person or persons who have a child placed in their home for the purpose of adoption and are being supervised by the agency or who have a child in their home who has been legally adopted and is entitled to the same benefits as a child born to the parents.
“Approved living arrangement” means that the living situation shall be located so as to provide reasonably convenient access to schools, places of employment, or services required by the youth, comply with applicable state and local zoning, fire, and sanitary regulations, and be reasonably priced so as to fit within the youth’s budget.
“Caseworker” means the person who works directly with children, their families, and other relevant individuals and who has primary responsibility for the development, implementation, and review of the agency’s service plans for the child and parents; or who completes foster care or adoptive family home studies or supervises foster family or adoptive placements; or who supervises children placed in approved supervised apartment living arrangements.
“Child” shall mean the same as defined by Iowa Code section 234.1.
“Child-placing agency” means an agency organized within the state of Iowa for the purpose of receiving minor children for placement, supervision, or both in private family homes for foster care; or for adoption; or the placement, supervision, or both of children who are 16 years of age and older living in approved supervised apartment living placements.
“Department” means the department of human services.
“Parent” means custodial and noncustodial parent.
“Safety-related information” means information that indicates whether the child has behaved in a manner that threatened the safety of another person, has committed a violent act causing bodily injury to another person, or has been a victim or perpetrator of sexual abuse.
“Sibling” means two or more persons having at least one common parent.
“Supervised apartment living placement” means the placement of a child who is at least 16 years of age in an approved living arrangement which provides an environment in which the child can experience living in the community with minimum supervision.
“Volunteer” means any nonpaid person who donates time to an agency, either in working with an individual or groups of clients. A volunteer may also be a student intern.
441—108.2(238) Licensing procedure.
	108.2(1) Right to apply. Any person or agency has the right to make application for a child-placing license. When applying for a child-placing license, the applicant shall indicate the services for which licensure is being requested.
	108.2(2) Application. An agency or person applying for a license shall complete Form 470-0723, Application for License or Certificate of Approval. The application shall be completed and signed by the administrator or the appropriate officer and submitted to the department.
	a. 	The applicant shall report withdrawal of an application to the department within 30 days of the withdrawal decision.
	b. 	Each application shall be evaluated by the department to ensure that all requirements are met.
	c. 	The applicant shall provide requested reports and information relevant to the licensing determination to the department.
	108.2(3) Applications for renewal. Applications for renewal shall be made to the department at least 30 but no more than 90 days before expiration of the license.
	108.2(4) Notification. Agencies shall be notified of approval or denial within 90 days of application or reapplication.
	108.2(5) Certificate of license. The department shall issue or renew Form 470-3623, Certificate of License, every three years, without cost, to any child-placing agency which meets the minimum requirements applicable to child-placing agencies as defined by Iowa Code chapter 238 and this chapter. The license shall be posted in a conspicuous place on the licensed premises.
	108.2(6) Provisional license. A provisional license may be issued to an agency which does not meet all licensing requirements when the failure to meet all licensing requirements does not pose a danger to the health, safety, or well-being of the children being served. It is issued until the agency meets all requirements, up to a maximum time period of one year. A provisional license is issued when the applicant has signed a written statement which includes the following:
	a. 	The deficiencies necessitating the provisional license, including the specific requirements which are not met.
	b. 	A plan for correcting the deficiencies.
	c. 	The date by which the requirements will be met.
	108.2(7) Suspension of a license. The suspension of a child-placing license prohibits the agency from engaging in any child-placing activities during the period of the suspension. The department shall suspend a license when the agency’s failure to meet the requirements poses a danger to the health, safety, or well-being of the children being served. The suspension of a license shall not extend beyond 12 months, and the existence of the condition requiring suspension shall be corrected within a year and documented in the agency’s record.
The agency shall submit a written statement for approval by the department. The statement shall include the following:
	a. 	The deficiencies necessitating the suspended license, including the specific requirements which are not met.
	b. 	A plan for correcting the deficiencies.
	c. 	The date by which the requirements will be met.
	108.2(8) Completed corrective action. When the corrective action plan is completed on or before the date specified on the provisional license or notice of suspension, a full license shall be issued for the remainder of the licensing period.
	108.2(9) Denial or revocation of a license. The department shall deny an application or reapplication for a license or revoke a license when the applicant fails to meet the licensing requirements or when any of the following conditions exist:
	a. 	The agency is operating without due regard to the health, safety, and well-being of the children being served.
	b. 	A provisional license is not approved.
	c. 	The recipient of a provisional license fails to complete the corrective action plan within the time allowed.
	d. 	An agency with a suspended license fails to complete the corrective action plan on time and a provisional license is not appropriate.
	e. 	The agency misuses public funds.
	f. 	The agency refuses to cooperate with child protective investigations involving children placed by the agency.
	g. 	The agency continuously and significantly violates licensing requirements.
	108.2(10) Method and content of notice. The notice of denial, revocation, or suspension shall be sent by restricted certified mail and shall include the following:
	a. 	A specific description of the condition requiring the suspension, denial or revocation.
	b. 	The specific laws or rules violated.
	c. 	The effective date of denial, revocation or suspension.
	108.2(11) Right to appeal. Any agency which disagrees with the department’s licensing decision may appeal to the department. The appeal shall be filed within 30 days of receipt of the licensing decision.
441—108.3(238) Administration and organization.
	108.3(1) Statement of purpose. The agency shall have a written statement of its child-placing philosophy, purpose, and program. The statement shall contain a description of services and methods for service delivery and a description of the persons for whom the services will be provided. The statement shall be available to the public.
	108.3(2) Governing board. The agency shall have a governing board which, together with the executive, shall be responsible for making policy and for financing and general management of the agency. The governing board may be either the board of directors or the owners of the agency. If the governing board is a board of directors, the following rules shall apply:
	a. 	The agency shall provide for continuity of board membership.
	b. 	The board shall meet regularly for the purpose of ensuring the proper operation of the agency and fulfilling its responsibilities.
	c. 	The minutes of each meeting of the board shall be kept and made a part of the permanent record of the agency.
	108.3(3) Annual report. A child-placing agency shall require the administrator to submit a written annual report of the agency’s activities. The report shall include fiscal and statistical sections indicating receipts and disbursements, number of clients served, and programs. The annual report shall be available to the department.
	108.3(4) Table of organization. A table of organization, including the identification of lines of responsibility and authority for policy making and service to clients, shall be available to agency staff and to the department.
	108.3(5) Finances. The licensee shall:
	a. 	Annually develop and implement a plan of financing which is necessary for the operation of the agency in carrying out its programs, ensuring proper care for children, and meeting requirements for licensing.
	b. 	Annually provide either an audit or a detailed financial statement prepared by an independent fiscal agency that provides a review of receipts and disbursements and a statement of fund balances.
	c. 	Retain fiscal records for five years.
	108.3(6) Employment of administrator. The agency shall employ a qualified administrator and shall delegate to the administrator the responsibility for the administration of the agency. The administrator shall ensure that the mission of the agency and laws relating to the welfare and protection of children are carried out.
	108.3(7) Office space, equipment and supplies. The agency shall provide and maintain sufficient office space, equipment, and supplies to ensure delivery of services.
441—108.4(238) Staff qualifications. An agency employee or volunteer shall be a person of good character, emotional stability, and have necessary ability, experience, and education to perform the duties assigned. An employee or volunteer shall not have a criminal record or founded child abuse report, unless the department has evaluated the crime or founded report and concluded that the crime or report does not merit prohibition of employment or licensure.
	108.4(1) Contracted employees. A child-placing agency which contracts for services shall ensure that contracted employees meet the same qualifications, training, and evaluation requirements as those of workers in employed positions. A child-placing agency is responsible for the services provided by contracted providers as well as volunteers and agency employees.
	108.4(2) Qualifications of administrator. An agency administrator shall possess one of the following:
	a. 	A master’s degree in social work, sociology, psychology, guidance and counseling, a related area of human services, education, business administration, or public administration and two years of experience in a public or private social services agency.
	b. 	A bachelor’s degree in social work, sociology, psychology, guidance and counseling, a related area of human services, education, business administration, or public administration and four years of experience in a public or private social services agency.
	108.4(3) Caseworker qualifications. Therapy and counseling services, psychosocial evaluation and assessment and care plan development shall be provided by staff who meet one of the following minimum education and experience criteria:
	a. 	Graduation from an accredited four-year college or university and the equivalent of three years of full-time experience in social work or experience in the delivery of human services in a public or private agency. In addition, these individuals shall have been employed by the agency prior to September 1, 1993. Persons meeting this criterion will not be qualified to provide therapy and counseling if they change place of employment.
	b. 	Graduation from an accredited four-year college, institute or university with a bachelor’s degree in social work from a program accredited by the council on social work education.
	c. 	Graduation from an accredited four-year college or university with a bachelor’s degree in a human service field related to social work and the equivalent of two years of full-time experience in social work or experience in the delivery of human services in a public or private agency.
	d. 	Graduation from an accredited four-year college or university with a master’s degree in social work or related human service field.
	e. 	Any equivalent combination of graduate education in the social or behavioral sciences from an accredited four-year college or university and qualifying experience up to a maximum of 30 semester hours for one year of the required experience.
	108.4(4) Person filling more than one position. A person functioning in more than one position specified by these rules shall meet the requirements for each of the positions the person fills.
441—108.5(238) Staffing requirements.
	108.5(1) Number of staff. The agency shall employ a sufficient number of competent staff to perform duties as required by licensing rules for those programs operated by the agency. This shall include the following:
	a. 	Administration of services offered by the agency.
	b. 	Selection and appointment of qualified staff.
	c. 	Provision for staff training.
	108.5(2) Staffing caseload. The agency shall develop a written policy regarding a staffing ratio based on the workload necessary to provide services in accordance with the agency’s program statements. The staffing ratio shall take into consideration all of the following:
	a. 	Qualifications of the caseworkers.
	b. 	Types of children served and their special needs.
	c. 	Types and intensity of services to be provided.
	d. 	Distances involved in provision of services.
	e. 	Other functions or responsibilities of the caseworkers.
441—108.6(238) Personnel administration.
	108.6(1) Personnel policies. An agency shall develop personnel policies in writing that identify responsibilities of the organization and staff. The policies shall specify hours of work, grievance procedures, sick leave, vacation and all other benefits. A copy of the policies shall be made available to the employee at time of hire.
	108.6(2) Job description and evaluation. There shall be a written job description for each employee, volunteer, and contracted position identifying duties, qualifications, education, training requirements, and lines of authority. A copy shall be made available to the employees, volunteers, and contracted workers. There shall be a written evaluation of an employee’s or contracted worker’s performance within six months of being hired or contracted, and annually thereafter.
	108.6(3) Staff training. An agency shall provide orientation training on the agency’s purpose, policies and procedures within one month of hire and 24 hours of training in the first year of employment for all employed and contracted casework staff. The 24 hours of training shall include: training on family foster care services, adoption services, supervised apartment living services, or children and families’ mental health topics, and 2 hours of training related to the identification and reporting of child abuse for all employed or contracted casework staff in accordance with Iowa Code section 232.69. An agency shall provide 12 hours of training per year after the first year of employment for all employed or contracted casework staff. The 12 hours of training shall include: training on family foster care services, adoption services, supervised apartment living services, or children and families’ mental health topics and child abuse training every five years in accordance with Iowa Code section 232.69.
The training formats that shall qualify as training are as follows: in-service training, seminars, conferences, workshops, institutes, visiting other facilities, and meeting with consultants.
The training provided shall be documented. The documentation shall include the training topic, format, date and number of hours.
	108.6(4) Volunteers. An agency which utilizes volunteer or student intern staff to work directly with a particular child or group of children shall have a written plan for using these volunteers. This plan shall be given to all volunteer staff and shall indicate that all volunteers are:
	a. 	To be supervised directly by a paid staff member.
	b. 	To be trained and oriented in the philosophy of the agency, the needs of the clients being served, and the methods of meeting these needs.
	c. 	To be subject to the character and reference disclosure and checks required of employed and contracted applicants and employees.
	d. 	To be subject to the same confidentiality rules as paid or contracted staff.
	e. 	To assist and supplement paid staff only, and not replace them.
	108.6(5) Personnel records. A confidential personnel record shall be maintained for each employee, contracted agent, and volunteer. The record shall contain all of the following information:
	a. 	Name and address.
	b. 	Record of training sessions attended, including dates and content of training.
	c. 	Record of criminal convictions and the department’s evaluation of same.
	d. 	Record of founded child abuse reports and the department’s evaluation of same.
441—108.7(238) Foster care services.
	108.7(1) Program statement. An agency authorized to place children in foster care shall have a current written program statement. This statement shall be made available to all agency foster parents, foster children, their parents, referring agencies, and all persons making formal inquiry regarding foster care. The program statement shall include all of the following:
	a. 	Types of foster care provided.
	b. 	Types of children accepted for foster care.
	c. 	Types of services provided to the children, their families, and their foster families.
	d. 	Fees and application costs, if any.
	e. 	A statement informing applicants of the right to appeal the agency’s decision regarding nonapproval of the family for placement of a child for foster care.
	108.7(2) Agency’s authorization to place. The agency shall obtain a signed placement agreement from the child’s custodial parent or legal custodian within 48 hours of placement.
	108.7(3) Preplacement documentation. Except for emergency placements, a child shall be placed in the agency’s foster care program only after the agency determines that its foster care program is an appropriate resource.
	108.7(4) Placement of siblings. Preference shall be given to placing children from the same family together. If this is not in the best interest of the child, the reasons shall be documented in the child’s record.
	108.7(5) Consideration of racial and cultural identity. Race, color, or national origin may not be routinely considered in placement selections. Placement decisions shall be made consistent with the best interests and special needs of the child.
	108.7(6) Placement preparation. An agency shall document the preparation for each child placed in foster care. Preparation shall be appropriate to the child’s age, individual needs, the circumstances requiring placement, and the special problems presented. Preparation activities shall, when possible, include:
	a. 	Face-to-face visits.
	b. 	A description provided to the child of the foster family.
	c. 	A description of the child’s strengths and needs and safety-related information provided to the foster family. Safety-related information shall be withheld only if:
	(1)	Withholding the information is ordered by the court; or
	(2)	The department or the agency developing the service plan determines that providing the information would be detrimental to the child or to the family with whom the child is living.
	d. 	Any other activities deemed significant.
	108.7(7) Initial placement outline. If a placement outline is not in the child’s case permanency plan, a brief outline documenting all of the following shall be entered in the child’s case record within five working days after placement:
	a. 	Name, birthdate, sex, race, and other significant identifying information.
	b. 	Date of placement.
	c. 	Name and address of parents or legal guardian.
	d. 	Names and whereabouts of siblings.
	e. 	Religious preference.
	f. 	Immediate and significant health needs including the child’s physical and emotional state at the time of placement.
	g. 	The circumstances leading to the need for foster care.
	h. 	Known previous out-of-home placements.
	i. 	The immediate needs of the child and parents and services to be provided to meet these needs.
	j. 	The name, address, and telephone number of the referring agent or worker.
	108.7(8) Education. Within ten school days of placement, provisions shall be made by the agency for enrollment of each child of school age into a school program.
	108.7(9) Clothing. An agency shall make provisions for adequate and individualized clothing for each child admitted into foster care.
	108.7(10) Monthly visit. Each child in care shall be personally visited by the assigned caseworker at least once a month.
	108.7(11) Parent and child contact. Provisions for contact between parents and children shall be made except where the parental rights have been terminated or where the court has determined that visits or contact are detrimental to the child.
	a. 	If the mother is breastfeeding the child:
	(1)	An assessment shall be made whether continuation of breastfeeding is in the best interest of the child; and
	(2)	A plan shall be developed to support the mother’s breastfeeding efforts, if appropriate.
	b. 	The parents and child shall be informed of the contact plan in a manner consistent with their capacity to understand.
	108.7(12) Health and dental program. An agency shall provide for a complete health and dental program for each child. An agency shall have a written procedure for handling medical emergencies on a 24-hour basis. A copy of the procedure shall be given to each foster home.
	a. 	The agency shall obtain written authorization from the parent or legal guardian to provide medical, psychiatric, dental, anesthesia, immunization, substance abuse evaluation, and emergency surgical treatment. Only the parent or legal guardian shall consent to nonemergency surgery, unless ordered by court. If the child’s parent prohibits medical examination, immunization, or treatment based on religious grounds, the agency shall obtain a signed statement from the parent that specifies the prohibitions. In potentially life-threatening situations, the agency shall refer the child’s care to appropriate medical and legal authorities.
	b. 	A child shall have a physical examination at least annually. This shall be performed by a licensed physician, physician’s assistant or licensed nurse practitioner.
	c. 	A child shall have current immunizations as required by the department of public health. If documentation of prior immunization is unavailable, immunizations shall begin within 30 days of placement, unless contraindicated and unless a statement from a physician to that effect is included in the child’s medical record. A statement from physician, referring agency, parent, or guardian indicating immunizations are current is sufficient documentation of immunizations.
	d. 	An agency shall provide for dental examinations and treatment; the initial referral at 12 months of age, the next at 24 months of age, then every 6 months.
	e. 	A health record shall be maintained for each child and shall include all of the following:
	(1)	Authorization for medical care.
	(2)	A medical history and copies of required physical examinations.
	(3)	A record of medical and dental care, treatment and prescribed medication, immunizations, accidents requiring medical treatment, and hospitalizations. At the time of discharge from agency foster care, a summary of this record shall be provided to the legal custodian. Information about drug evaluation or treatment, venereal disease tests, HIV tests, and pregnancy tests shall be excluded.
	108.7(13) Service plan development and review. The provider shall develop and revise service plans for each child in placement. An initial service plan shall be developed within 30 calendar days of placement in foster care. The provider shall identify qualified persons to monitor the services identified in the service plan to ensure that the plan continues to be necessary, appropriate, and addresses the permanency goal. Service plans shall be developed and reviewed as follows:
	a. 	The service plan shall be developed and revised in collaboration with the referral worker, child, family, and the foster parents unless the service plan contains documentation for the treatment rationale for the lack of involvement of one of these parties. The provider shall document the dates and content of the collaboration on the initial and revised service plans. The provider shall provide a copy of the initial and revised service plans to the child’s parent and the referring agency, unless otherwise ordered by the court. The initial and revised service plan shall identify the following:
	(1)	Strengths and needs of the child and parents.
	(2)	Goals, which are statements of outcomes to be achieved in meeting the needs of the child including the child’s permanency needs.
	(3)	Objectives, which are specific, measurable and time-limited statements of indicators, levels of competence, or accomplishments which are necessary for progress toward each goal.
	(4)	Specific treatment service activities to be provided to achieve the objectives.
	(5)	Designation of the persons responsible for providing the services.
	(6)	Date of initiation and service plan development.
	(7)	Anticipated duration of services.
	b. 	All service plans shall be reviewed 90 calendar days from the initiation of services and every 90 calendar days thereafter for the duration of the services or when the needs of the child or the services necessary for the parents to meet the needs of the child have changed and these changes significantly affect goals, objectives and service activities. The review shall determine if the services continue to be necessary, appropriate and consistent with the child’s permanency goal. The reviewer shall revise the service plan to reflect the services that are necessary, appropriate, and consistent with the child’s permanency goal.
	108.7(14) Information for foster parents. At the time of placement, an agency shall provide foster parents with all of the following if known:
	a. 	Name of the child, agency caseworker, and referring agency.
	b. 	Information about the child’s known behavioral characteristics including safety-related information, needs, and plans for the child and family. Safety-related information shall be withheld only if:
	(1)	Withholding the information is ordered by the court, or
	(2)	The department or the agency developing the service plan determines that providing the information would be detrimental to the child or to the family with whom the child is living.
	c. 	Written consent to obtain routine, nonsurgical medical care and to authorize emergency medical and surgical treatment, anesthesia, and immunizations for each child placed in the foster home.
	d. 	A copy of the child’s current physical examination and medical history when completed.
As this information becomes available to the agency, foster parents shall be informed immediately.
	108.7(15) Religious policy. The agency shall have a written policy on religious participation and training for foster children. The agency shall provide the policy to parents and foster parents and shall ensure that the policy is adhered to in each foster home.
	108.7(16) Mail. There shall be a written policy which ensures that foster children are permitted to send and receive mail, unless documented that this practice is contraindicated.
	108.7(17) Allowance policy. An agency shall have a written policy addressing payment of and accounting for personal allowances for foster children.
	108.7(18) Reporting hospitalization or death of child. Any serious injury or illness requiring hospitalization of a child in care shall be reported to the parent and the responsible agency as soon as possible. Efforts to notify parents and responsible agency staff shall be documented in the child’s record. The death of a child shall be reported immediately to the parent or next of kin and to the referring agency.
	108.7(19) Foster care records. The agency shall maintain confidential individual records for each child placed in a foster home. The record shall include:
	a. 	The initial placement outline. (Refer to subrule 108.7(7).)
	b. 	All legal documents pertaining to the child.
	c. 	The child’s health record, including psychological and psychiatric reports.
	d. 	The summary narrative which reflects the dates and content of the caseworker’s contact regarding the child.
	e. 	Educational records and reports.
	f. 	All service plans developed by the agency.
	g. 	Case permanency plans developed by the referring agency.
	h. 	A record of foster placements made by the agency including foster parents’ names and addresses and dates of placements.
	108.7(20) Termination of foster care. When a foster care placement is terminated, all of the following information shall be documented in the child’s record within 30 days:
	a. 	Reason for termination.
	b. 	Current location of the child, unless the child was placed for adoption. In that case the record shall state only that the child was placed for adoption and shall not disclose the identity of the adoptive family unless the adoptive family agrees to disclosure of identity prior to finalizing of adoption.
	c. 	Steps remaining to achieve permanency plan goal.
	d. 	Provisions for follow-up, if any.
	e. 	For unplanned terminations, a summary explaining the circumstances.
441—108.8(238) Foster home studies. The agency shall provide information to prospective foster parents about foster care, agency policies, licensing requirements for foster care, the children needing foster care, the licensing process and the reimbursement rates.
	108.8(1) Licensing procedures.
	a. 	Availability of applications. The agency may provide Form 470-0689, Foster Family Home License Application, to anyone requesting to be licensed.
	b. 	Licensing study. The agency may complete a licensing study of the family.
	c. 	New applications. If the child-placing agency decides to complete the initial licensing study, the agency shall submit to the department all documents and information required by 441—Chapter 113 pertaining to the licensing and regulation of foster family homes. This shall include a narrative evaluation of the foster family home which reflects a thorough study of each foster family. The narrative shall document at least two face-to-face interviews with the prospective foster family and at least one face-to-face interview with each member of the household before the placement of a child. At least one interview shall take place in the applicant’s home. The narrative summary of the family study shall assess all of the following:
	(1)	Motivation for foster care.
	(2)	Family’s and extended family’s attitude toward accepting foster children.
	(3)	Family’s attitude toward foster children’s parents.
	(4)	Emotional stability, physical health, and compatibility of foster parents, and ways they cope with change and stress.
	(5)	Adjustment of own children, if any.
	(6)	Assessment of the child-caring skills, including disciplinary techniques used.
	(7)	Strengths and weaknesses of each member of the household.
	(8)	Types of children desired.
	(9)	Type of children, if any, for whom placement with the family would be appropriate.
	(10)	Recommendation as to the number, age, sex, characteristics, and special needs of children best served by this family.
	(11)	Assessment of the need for training and a plan for providing the needed training.
	(12)	Any other pertinent information that might assist the agency in making the licensing recommendation.
	(13)	Record checks. The licensed child-placing agency shall submit record checks for each applicant and for anyone who is 14 years of age or older living in the home of the applicant to determine whether they have any founded child abuse reports or criminal convictions or have been placed on the sex offender registry. The licensed child-placing agency shall use Form 470-0643, Request for Child Abuse Information, and Form 595-1396, DHS Criminal History Record Check, Form B, for this purpose. Each person subject to record checks shall also be fingerprinted for a national criminal history check. The department’s contractor for the recruitment and retention of resource families shall assist applicants in completing required record checks, including fingerprinting. Any criminal or abuse records discovered shall be evaluated according to the procedures in rule 441—113.13(237).
	(14)	Health of foster parents and impact of medical conditions on their ability to foster a child.
	(15)	Income information.
	(16)	Documentation that at least three references have been received and the responses reviewed.
	108.8(2) Licensing decision. The department shall make the licensing decision and notify the applicant and the child-placing agency within 30 days of the licensing decision. In no case shall a child be placed in a foster home before licensing approval.
	a. 	A full license shall be issued to foster families meeting all necessary criteria for a full licensure.
	b. 	A provisional license may be issued for up to one year if the foster family fails to meet all requirements for licensure. When an agency recommends, because of rule violation, that a foster home receive a provisional license at the time the license is issued or renewed, the agency shall document the violation in the foster home file, and shall send the following to the department:
	(1)	A copy of the assessment of the rule violation and recommendation.
	(2)	A copy of the foster home’s plan to achieve rule compliance within stipulated time frames.
	c. 	When an agency recommends that a foster home license be denied or revoked, the agency shall send the following documents to the department:
	(1)	A copy of the assessment of rule compliance and the foster family’s reaction to the assessment.
	(2)	The agency’s recommendation and supporting rationale.
	(3)	Other appropriate documents supporting the findings.
	108.8(3) Reapplications. At least 30 days before the expiration of the license, the agency shall submit all documents and information required by 441—Chapter 113 pertaining to the licensing and regulation of foster family homes. This shall include an update of the narrative noting any changes that may have occurred in the foster family’s living arrangement or life style and any other pertinent information that might assist in making the licensing decision, including an assessment of the foster family’s ability to provide foster care.
	108.8(4) Unannounced visits. The agency shall conduct at least one annual unannounced visit to each licensed foster family home the agency inspects to meet the requirements of Iowa Code section 237.7.
	108.8(5) Complaints. When an agency receives a complaint which may indicate possible violation of the foster care licensing rules, the agency shall, within five working days of receiving the complaint, either conduct an investigation to assess compliance with applicable rules or refer the complaint to the department for investigation. If the agency conducts the investigation, the agency shall submit a written report of the investigation to the department within ten working days of receiving the complaint with a statement of rule violation and a recommendation regarding the license of the foster family home. The written report shall be filed in the foster parents’ file.
	108.8(6) Foster family training. The agency shall ensure that each foster home recommended for foster family license has complied with the training requirements in 441—113.8(237).
Within six months of licensure and every five years thereafter, each foster parent shall obtain mandatory reporter training relating to identification and reporting of child abuse.
	108.8(7) Placement agreement. When a child is placed with a foster family, the agency shall have a signed agreement with each foster family home including the expectations and responsibilities of both the agency and the foster family, the services to be provided, and the financial arrangements for children placed in the home.
	108.8(8) Foster family home records. The agency shall keep separate records for each foster family home. The agency shall begin the record at the time of application. Foster family home records shall contain:
	a. 	The application.
	b. 	Family assessment.
	c. 	Most recent medical reports on foster family members.
	d. 	Summary of dates and content of worker’s contacts relating to licensing or relicensing.
	e. 	Reference letters.
	f. 	Annual assessment of strengths and weaknesses of the foster family relative to the care of individual children placed with them.
441—108.9(238) Adoption services.
	108.9(1) Program statement. An agency licensed to place children for adoption shall have a current written program statement which shall include all of the following:
	a. 	Types of children to be placed.
	b. 	Eligibility requirements for adoptive families.
	c. 	Services provided during the adoption process.
	d. 	Services to the birth parents upon relinquishment.
	e. 	Postadoption services to adoptive families, if offered.
	f. 	Fees and application costs.
	g. 	A statement that payment of fees does not ensure adoption approval.
	h. 	A statement informing applicants of the right to appeal the agency’s decision regarding nonapproval of the family for placement of a child for adoption, or other adverse decisions.
The program statement shall be made available to referring agencies and to all persons making formal inquiry regarding adoption.
	108.9(2) Services to birth families. An agency which offers services to birth parents who are considering relinquishing a child for adoption shall provide a minimum of three hours of counseling, or any additional hours of counseling necessary to assist the parents in making an informed decision regarding their child’s adoption, consistent with the child’s best interest. The counseling of the birth parents shall begin when the birth parents begin the intake process. This shall be documented in the service plan format.
	a. 	Intake process. When an agency agrees to provide services to the birth parents, intake interviews shall be conducted, including provision of information to the birth parents regarding the adoption process and their rights and role.
	b. 	Background information. A collection of information about the birth parents and the child shall include, but need not be limited to:
	(1)	The child’s legal status, or due date if unborn.
	(2)	The child’s physical description, medical and mental health history, developmental information, and other pertinent information necessary for a child study.
	(3)	Identification of any specific needs of the child and the type of family to be considered for adoptive placement.
	(4)	The birth parents’ strengths and needs.
	(5)	The involvement of the birth parents and significant others in the child’s care.
	(6)	The birth family’s physical description, medical and mental health history, educational level, any problematic areas including substance and alcohol abuse.
	(7)	An affidavit signed by the birth parents regarding wishes for the court to reveal, or not reveal, their names to the child pursuant to Iowa Code chapter 600.
	(8)	Any additional information the birth family wishes to have included in the child’s adoption record.
	108.9(3) Preparation of child for adoptive placement. Preparing a child, especially an older child, includes activities designed to enable a child to make a transition to an adoptive placement. The activities shall include, but are not limited to:
	a. 	Counseling regarding issues of separation, loss, grief, guilt, anger and adjustment to an adoptive family.
	b. 	Preparation of a life book.
	c. 	Provision of age-appropriate information regarding community resources available, such as children’s support group to assist the child in the transition and integration into the adoptive family.
	108.9(4) Services to adoptive applicants.
	a. 	Application process. Before proceeding with an adoptive home study, the agency shall have received an application for adoption from the person or persons wishing to adopt a child. The application form shall include information about the applicant’s intent to become an adoptive parent, and the basic data about the applicant’s family, home, financial status, health, and references.
	b. 	Explanation of the adoption process. The agency shall provide the applicant an explanation of the entire adoption process, including the legal procedures, the agency policies and procedures regarding placement of children, and the children available for adoption.
	c. 	Adoptive home study. The home study consists of a family assessment which shall include at least two face-to-face interviews with the applicant and at least one face-to-face interview with each member of the household. At least one interview shall take place in the applicant’s home. The assessment shall include, but need not be limited to, the following:
	(1)	Motivation for adoption and whether the family has biological, adopted or foster children.
	(2)	Family and extended family’s attitude toward accepting an adopted child, and plans for discussing adoption with the child.
	(3)	The attitude toward adoption of the significant other people involved with the family.
	(4)	Emotional stability; marital history, including verification of marriages and divorces; assessment of marital relationship; and compatibility of the adoptive parents.
	(5)	Ability to cope with problems, stress, frustrations, crises, separation and loss.
	(6)	Medical, mental, or emotional conditions which may affect the applicant’s ability to parent a child.
	(7)	Ability to provide for the child’s physical and emotional needs and respect the child’s cultural and religious identity.
	(8)	Adjustment of biological and previously adopted children, if any, including their attitudes toward adoption, relationship with others, and school performance.
	(9)	Capacity to give and receive affection.
	(10)	Statements from at least three references provided by the family and other unsolicited references that the agency may wish to contact.
	(11)	Attitudes of the adoptive applicants toward the birth parents and the reasons the child is available for adoption.
	(12)	Income information, ability to provide for a child, and a statement as to the need for adoption subsidy for a special needs child, or children.
	(13)	Disciplinary practices that will be used.
	(14)	History of abuse by family members and treatment.
	(15)	Assessment of, commitment to, and capacity to maintain other significant relationships.
	(16)	Substance use or abuse by members of the family and treatment.
	(17)	Recommendations for type of child, number, age, sex, characteristics, and special needs of children best parented by this family.
	d. 	Record checks. The licensed child-placing agency shall submit record checks for each applicant and for anyone who is 14 years of age or older living in the home of the applicant to determine whether they have any founded child abuse reports or criminal convictions or have been placed on the sex offender registry. The licensed child-placing agency shall use Form 470-0643, Request for Child Abuse Information, and Form 595-1396, DHS Criminal History Record Check, Form B, for this purpose.
If there is a record of founded child abuse or a criminal conviction for the applicant, or anyone living in the home of the applicant, the licensed child-placing agency shall not approve the applicant as an adoptive family, unless an evaluation determines that the abuse or criminal conviction does not warrant prohibition of approval.
Exception:  The person making the investigation shall not approve a prospective applicant and the department shall not perform an evaluation if the applicant or anyone living in the home of the applicant has been convicted of a felony offense as set forth in Iowa Code section 600.8(2)“b.” The person making the investigation shall not approve a prospective applicant and shall not perform an evaluation if the applicant or anyone living in the home of the applicant has committed a crime in another state that would be a forcible felony if the crime would have been committed in Iowa, as set forth in Iowa Code section 600.8(2)“b.”
The evaluation shall consider the nature and seriousness of the abuse or crime, the time elapsed since the commission of the founded abuse or crime, the circumstances under which the abuse or crime was committed, the degree of rehabilitation, the likelihood that the person will commit the abuse or crime again, and the number of abuses or crimes committed by the person. The person with the criminal conviction or founded child abuse report shall complete and return Form 470-2310, Record Check Evaluation, within ten calendar days of the date on the form to be used to assist in the evaluation. Failure of the person to complete and return Form 470-2310 within the specified time frame shall result in denial of approval for adoption.
	(1)	If the applicant, or anyone living in the home of the applicant, has been convicted of a simple misdemeanor or a serious misdemeanor that occurred five or more years prior to application, the evaluation and decision may be made by the licensed child-placing agency. The licensed child-placing agency shall notify the applicant of the results of the evaluation.
	(2)	If the applicant, or anyone living in the home of the applicant, has a founded child abuse report, has been convicted of an aggravated misdemeanor or felony at any time, or has been convicted of a simple or serious misdemeanor that occurred within five years prior to application, the licensed child-placing agency shall initially conduct the evaluation.
	1.	If the licensed child-placing agency determines that the abuse or crime does warrant prohibition of approval, the licensed child-placing agency shall notify the applicant of the results of the evaluation.
	2.	If the child-placing agency believes that the applicant should be approved despite the abuse or criminal conviction, the agency shall provide copies of Form 470-2310, Record Check Evaluation, and Form 470-2386, Record Check Decision, to the Department of Human Services, Administrator, Division of Behavioral, Developmental, and Protective Services, 1305 East Walnut Street, Des Moines, Iowa 50319-0114. Within 30 days, the administrator shall determine whether the abuse or crime merits prohibition of approval and shall notify the child-placing agency in writing of that decision.
The licensed child-placing agency shall also notify the family in writing no later than 30 days after completion of the home study of the agency’s decision regarding approval for placement of a child. If the family is denied, the agency shall state the reasons for denial. The agency worker and supervisor shall date and sign the adoptive home study. The agency shall provide a copy of the home study to the family. An agency shall not place a child in an adoptive home before the family is approved, or before a placement agreement is signed by the family and the agency.
	e. 	A home study update is required if the adoptive home study was written more than one year previously, in accordance with Iowa Code section 600.8. The preplacement assessment update shall be conducted by completing the following:
	(1)	The child abuse and criminal record checks shall be repeated and any abuses or convictions of crimes since the last record check shall be evaluated using the same process.
	(2)	A minimum of one home visit shall be conducted with the approved adoptive family.
	(3)	The information in the approved adoptive home study shall be reassessed.
	(4)	A written report of the assessment and updated adoptive home study shall be completed, dated, signed by the worker and the supervisor, and provided to the adoptive family.
	108.9(5) Services to adoptive families.
	a. 	Preparation of the family includes activities designed to prepare the adoptive family for the placement of a particular child. These activities shall assist the adoptive family in expanding its knowledge and understanding of the child and enhance the family’s readiness to accept the child into their family and encourage their commitment. The activities shall include, but not be limited to:
	(1)	Providing background information on the child and the birth family, including a child study that includes past experiences such as foster and adoptive placements.
	(2)	Providing information regarding the special needs and characteristics of the child.
	(3)	Providing information regarding an older child’s anticipated behavior.
	(4)	Discussing the impact that adding a new member to their family may have on all current family members.
	(5)	Discussing the issues of separation, loss, grief, anger, and guilt that adoptive children experience at various developmental stages.
	(6)	Providing the family with community resources that are available, such as support groups.
	b. 	Preplacement services include the preplacement visits of the child and approved family and any activities necessary to plan, conduct, and assess these transitional visits before the placement of the child in the adoptive family’s home for the purpose of adoption.
	c. 	Postplacement services include postplacement supervision, support, crisis intervention, and required reports to the court. The postplacement services are provided from the time the child is placed with an approved adoptive family until finalization of the adoption occurs.
A minimum of three face-to-face postplacement visits are required, or if the family is experiencing problems, as many as are necessary to support the placement. At least two of the visits shall be in the adoptive home. At a minimum the first visit shall be completed within 30 days after placement; the second visit within 90 days after placement; and the final visit before granting consent to adopt.
Observations made during the home visits shall be recorded in the family’s adoption file and used by the agency in making written recommendations to the court regarding finalization of the adoption.
Postplacement supervision should focus on the following:
	(1)	Integration and interaction of the child with the family.
	(2)	Changes in the family functioning which may be due to the placement.
	(3)	Social, emotional adjustment of the child and school adjustment of a child who is attending a school.
	(4)	Child’s growth and development since placement with the adoptive family.
	(5)	Changes that have occurred in the family since the placement.
	(6)	Family’s method of dealing with testing behaviors and discipline.
	(7)	Behavioral evidence of the degree of bonding that is taking place and the degree to which the child is becoming a permanent member of the adoptive family.
	d. 	Postadoption services. The agency shall provide postadoption services to adoptive parents and adoptees, or shall refer adoptive parents and adoptees to other community resources for the services.
	108.9(6) Placement of siblings. Preference shall be given to placing children from the same family together. If this is not possible, or is not in the best interest of the children, the reasons shall be documented in the record. Efforts shall be made to provide continued contact between siblings after finalized adoptions if the siblings are not placed together.
	108.9(7) Racial and cultural background. Race, color, or national origin may not be routinely considered in placement selections. Placement decisions shall be made consistent with the best interests and special needs of the child.
	108.9(8) Religious policy. There shall be a written policy on religious participation for prospective placing parents, adoptive parents, and adoptees. The policy shall be made available to referral sources as well.
	108.9(9) Adoption records. The agency shall keep separate records for each prospective, approved, or active adoptive family. Contents of these records shall be as follows:
	a. 	The application.
	b. 	The adoptive home study.
	c. 	Current medical records.
	d. 	All references.
	e. 	All legal documents pertaining to the adoption.
	f. 	Birth family information and background report, including physical descriptions, medical and mental health history, educational level, developmental history, problem areas such as substance or alcohol abuse.
	g. 	Summary narrative on the placement decision and the preplacement and postplacement contacts with the adoptive family and child.
	h. 	Information pertaining to the child including, but not limited to: physical, medical, and mental health; problem areas, including verification of the child’s special needs; and whether or not a referral was made to the department for adoption subsidy.
	i. 	In the event a family is not approved for placement of a child, the narrative shall clearly indicate the reason.
	j. 	In the event a family is approved, but no child is placed with them, the narrative shall clearly indicate the reason.
	108.9(10) Right to appeal. An adoptive applicant or an adoptive family may appeal an adverse decision made by a licensed agency. The appeal shall be filed with the department within 30 days of the notice of decision to the applicant or family by the licensed agency.
	108.9(11) Disposition of records. When an adoption has occurred, the agency must maintain all records regarding the child, the birth family, and the adoptive family or families, forever. Any subsequent information received following the adoption finalization shall be placed in the adoption record. If the agency closes, all adoption records shall be forwarded to the department.
441—108.10(238) Supervised apartment living placement services. An agency seeking to obtain a child-placing license which authorizes the agency to place or supervise children in supervised apartment living placements shall meet the standards in rules 441—108.2(238) to 441—108.6(238).
	108.10(1) Program statement. An agency authorized to place or supervise children in supervised apartment living placements shall have a current written program statement which shall be provided to all children placed in supervised apartment living. The statement shall include all of the following:
	a. 	A description of the types of living arrangements approved by the agency.
	b. 	The eligibility requirements for the children who may be placed in a supervised apartment living placement.
	c. 	The means of financial support for the children.
	d. 	The expectations the agency has for children while placed in a supervised apartment living placement.
	e. 	Services provided to the children.
	f. 	Provisions for emergency medical care.
	g. 	A description of the education and community activity options that are available.
	108.10(2) Basis for placement. Before placing a child in supervised apartment living, an agency shall document all of the following:
	a. 	The child is at least 16 years of age.
	b. 	An initial assessment has been made that identifies the child’s strengths and needs as these pertain to the child’s ability to live independently.
	c. 	The child has the capacity to function outside the structure of a foster family or group care setting.
	d. 	The selection of a supervised apartment living placement is the most appropriate placement for the child.
	e. 	The child will be involved in school or an educational or vocational program, work, or a combination thereof, as indicated in the child’s individual service plan.
	f. 	The child has entered into a mutually agreed-upon written contract with the agency which specifies the responsibilities of the agency and the child. This contract shall be reviewed with the child quarterly.
	g. 	The agency has determined, through a visit to the living arrangement, that the following minimum standards for approval have been met:
	(1)	The living arrangement provides reasonably convenient access to schools, places of employment, and services required by the child.
	(2)	The living arrangement is in compliance with the applicable state and local zoning, fire, sanitary, and safety regulations.
	(3)	The living arrangement is reasonably priced to fit within the child’s budget.
	h. 	The agency has determined, based on the criteria in this subrule, that the agency’s program can meet the needs of the child.
	108.10(3) Services provided. The following services are required:
	a. 	Ongoing assessment that identifies the child’s strengths and needs as these pertain to the child’s ability to live independently.
	b. 	Development of an individual service plan by the agency worker within 30 days of the child’s placement. The service plan shall be developed in consultation with the child, the child’s family (unless a reason for noninvolvement is documented in the case record), and referring worker and shall be signed by all involved. The individual service plan shall be reviewed and updated quarterly or more often as necessary and shall be signed by all involved. The plan shall document the following:
	(1)	The goals that are intended to meet the specific needs of the child and the projected dates of accomplishment.
	(2)	The objectives (action steps) to be taken by the child and the agency and the projected dates of accomplishment to meet the child’s goals.
	(3)	The services and activities necessary to achieve the child’s goals and facilitate objectives (action steps), the frequency of services or activities, and the persons responsible.
	(4)	A budget, developed with the child, based upon the child’s monthly maintenance payment, any start-up allowance, and any earned or unearned income or assistance (such as food assistance). The agency worker shall work with the child to ensure that needed items are purchased and that bills are paid.
	(5)	In the quarterly update, the child’s progress toward the goals and objectives and the child’s compliance with the service plan.
	c. 	Supervision to assist the child in developing the needed structure to live in this setting and in locating and using other needed services. Supervision shall include guidance, oversight, and behavior monitoring.
	(1)	If the child is under age 18, supervision shall include a minimum of weekly face-to-face contacts.
	(2)	For children aged 18 or older, supervision shall include face-to-face contact at least every other week.
	(3)	Agency staff shall be present on site in a cluster setting at any time when more than one child is present in the living arrangement and shall be available to the children 24 hours a day, seven days a week.
	(4)	The agency shall provide a means for children in a scattered site setting to contact agency personnel 24 hours a day, seven days a week.
	(5)	The agency shall ensure that each child has access to and is receiving necessary medical care.
	d. 	Documented observation by the agency worker that:
	(1)	The living situation is an environment that allows for the child’s social and emotional needs to be met;
	(2)	There is an operating smoke alarm on each level of occupancy;
	(3)	The child has access to a telephone; and
	(4)	There is no reasonable cause for believing that the child’s mode of living presents any unacceptable risks to the child’s health or safety.
	108.10(4) Record. In addition to any other documentation requirements, an agency shall maintain a record for each child in a supervised apartment living placement. The record shall contain all of the following:
	a. 	The name, date of birth, sex, and address of the child and information on how the child can be contacted.
	b. 	Documentation of financial support sufficient to meet the child’s housing, clothing, food, and miscellaneous expenses.
	c. 	Name, address, and telephone number of guardian, if applicable, and referring worker.
	d. 	Medical records.
	e. 	Educational and employment records.
	f. 	All of the individual service plans and updated reviews.
	g. 	Documentation of visits.
	108.10(5) Staffing requirements. Each child in a supervised apartment living placement shall receive an agreed-upon number of hours of casework services per month. This shall be recorded in the child’s individual service plan.
[ARC 8901B, IAB 6/30/10, effective 9/1/10; ARC 9730B, IAB 9/7/11, effective 11/1/11]
These rules are intended to implement Iowa Code chapter 238.
[Filed December 14, 1967]
[Filed 6/25/76, Notice 5/17/76—published 7/12/76, effective 8/16/76]
[Filed emergency 2/10/84—published 2/29/84, effective 2/10/84]
[Filed emergency 1/15/87—published 2/11/87, effective 1/15/87]
[Filed emergency 6/19/87—published 7/15/87, effective 7/1/87]
[Filed 8/28/87, Notice 7/15/87—published 9/23/87, effective 11/1/87]
[Filed 8/12/93, Notice 2/17/93—published 9/1/93, effective 11/1/93]
[Filed 1/12/94, Notice 11/24/93—published 2/2/94, effective 3/9/94]
[Filed emergency 12/15/94—published 1/4/95, effective 2/1/95]
[Filed 2/16/95, Notice 1/4/95—published 3/15/95, effective 5/1/95]
[Filed 6/13/96, Notice 4/24/96—published 7/3/96, effective 9/1/96]
[Filed 10/15/97, Notice 7/30/97—published 11/5/97, effective 1/1/98]
[Filed 4/15/99, Notice 2/10/99—published 5/5/99, effective 7/1/99]
[Filed 9/12/00, Notice 7/26/00—published 10/4/00, effective 12/1/00]
[Filed emergency 5/9/01—published 5/30/01, effective 5/9/01]
[Filed 5/9/01, Notice 3/21/01—published 5/30/01, effective 8/1/01]
[Filed 7/11/01, Notice 5/30/01—published 8/8/01, effective 10/1/01]
[Filed 11/18/02, Notice 8/21/02—published 12/11/02, effective 2/1/03]
[Filed 3/11/04, Notice 1/21/04—published 3/31/04, effective 6/1/04]
[Filed 11/16/05, Notice 9/28/05—published 12/7/05, effective 1/11/06]
[Filed emergency 6/14/07—published 7/4/07, effective 7/1/07]
[Filed 9/12/07, Notice 7/4/07—published 10/10/07, effective 11/14/07]
[Filed ARC 8901B (Notice ARC 8582B, IAB 3/10/10), IAB 6/30/10, effective 9/1/10]
[Filed ARC 9730B (Notice ARC 9563B, IAB 6/15/11), IAB 9/7/11, effective 11/1/11]