20.8 Short Term Emergency Care (Emergency or Illness)

Georgia State Seal

Georgia Division of Family and Children Services
Child Welfare Policy Manual

Chapter:

(20) Special Circumstances

Policy Title:

Short Term Emergency Care (Emergency or Illness)

Policy Number:

20.8

Previous Policy Number(s):

5.13

Effective Date:

December 2021

Manual Transmittal:

2021-06

Codes/References

O.C.G.A. § 15-11-130 Emergency Care and Supervision of Child Without Court Order; Immunity
O.C.G.A. § 19-7-5 Reporting of Child Abuse and Neglect
O.C.G.A. § 49-5-8 Powers and Duties of the Department
O.C.G.A. § 49-5-40 Definitions; Confidentiality of Records; Restricted Access to Records
O.C.G.A. § 49-5-41 Persons and Agencies Permitted to Access Records
Public Law (PL) 104-191 Health Insurance Portability and Accountability Act (HIPAA) of 1996
PL 113-183 Preventing Sex Trafficking and Strengthening Families Act of 2014

Requirements

The Division of Family and Children Services (DFCS) will:

  1. At its discretion, provide emergency care and supervision to a child without seeking a court order for a period not to exceed seven calendar days when the person who has physical and legal custody of the child is unable to provide care and supervision as a result of an emergency or illness under the following circumstances:

    1. The child is not in imminent danger of child abuse other than the risk of being without a caregiver; and

    2. The request is made by one of the following:

      1. The person who has physical and legal custody

      2. Law enforcement officer

      3. Emergency personnel employed by a licensed ambulance provider

      4. Fire rescue personnel

      5. Hospital administrator or designee

  2. Obtain approval from the County Director/Designee to accept a STEC (Emergency or Illness).

  3. Execute the STEC (Emergency or Illness) agreement using the Emergency Care and Supervision of Child Without a Court Order (Authorization).

  4. Allow the legal custodian to designate a caregiver to assume care and supervision of the child, at any time during the seven calendar days STEC (Emergency or Illness) period.

  5. Immediately contact the designated caregiver to facilitate the transfer of custody.

  6. Complete a diligent search to identify and locate persons who may be considered as a placement for the child while the child is in foster care (see policy 19.20 Case Management: Diligent Search).

  7. Terminate the STEC (Emergency or Illness) agreement using the Emergency Care and Supervision of Child Without a Court Order (Termination), within seven calendar days of executing the STEC, when any of the following occurs:

    1. The legal custodian or designated caregiver is able to assume care and supervision; or

    2. DFCS obtained temporary legal custody of the child through Juvenile Court.

  8. Release the child to the person having custody at the time the STEC (Emergency or Illness) agreement was executed or the designated caregiver, at any time during the seven calendar days and upon terminating the STEC agreement.

  9. Initiate legal intervention seeking temporary legal custody of the child through Juvenile Court when:

    1. The legal custodian or the designated caregiver is unable to assume care and supervision of the child prior to expiration of the seven calendar days STEC period (see policy 17.1 Legal: The Juvenile Court Process); and/or

    2. DFCS determined that there is an issue of child abuse.

    When legal intervention is required make a new report to the CICC to open an investigation, inform CICC that STEC was terminated, and the reason(s) the child was taken into custody.

  10. Adhere to Health Insurance Portability and Accountability Act and confidentiality provisions outlined in policies 2.5 Information Management: Health Insurance Portability and Accountability Act (HIPAA) and 2.6 Information Management: Confidentiality/Safeguarding Information.

  11. Document case activities in Georgia SHINES within 72 hours of the occurrence.

  12. Complete the Special Circumstance STEC in Georgia SHINES within 45 calendar days of the receipt of the intake report.

  13. Immediately report any new, known, or suspected instances of child abuse to the CPS Intake Communications Center (CICC) as outlined in policy 3.24 Intake: Mandated Reporters.

Procedures

Social Services Case Manager

  1. Participate in a supervisor staffing:

    1. Confirm the request meets the criteria for a STEC (Emergency or Illness).

    2. Discuss the reason for the STEC (Emergency or Illness) request and is it likely the legal custodian or designated caregiver is able to assume care and supervision within seven calendar days.

    3. Determine next steps.

  2. Contact the reporter for clarification and/or additional information, as needed.

  3. Arrange for language assistance (interpreter and/or translation services) for individuals identified as limited English proficient (LEP) and auxiliary aids for sensory impaired individuals in accordance with policy 1.4 Administration: Non-Discriminatory Child Welfare Practices.

  4. Conduct a face-to-face contact with the parent(s) when they are able to participate in decision making, or with the individual legally authorized to request STEC (Emergency or Illness):

    1. Explain DFCS’ obligation to maintain confidentiality and safeguard information to prevent unauthorized disclosure:

      1. Personal information provided during STEC will be kept confidential (see policy 2.6 Information Management: Confidentiality/Safeguarding Information).

      2. DFCS cannot share protected health information (PHI) with any person, agency, or contractor without prior written authorization from the owner of the PHI, unless otherwise permitted by law. Provide a copy of the HIPAA Notice of Privacy Practices and obtain signature(s). See policy 2.5 Information Management: Health Insurance Portability and Accountability Act (HIPAA).

      3. The type of information that will be maintained in the DFCS case record and of the information that can and cannot be released to the parent/guardian upon request. Provide a copy of the Notice of Case Record Information Available to Parents/Guardians and obtain signatures (see policy 2.10 Information Management: J.J. v. Ledbetter Parent or Guardian Request for Information).

    2. Explain the parameters of the STEC (Emergency or Illness) agreement:

      1. Allows DFCS to provide emergency care and supervision to any child without seeking a court order when there is an emergency or illness, and the parent(s) of the child is unable to provide care and supervision;

      2. The STEC agreement must be terminated within seven calendar days;

      3. At any time during the seven calendar days, allows the authorization of a designated caregiver to provide care and supervision to the child, permitting DFCS to release the child to the designated caregiver; and

      4. DFCS is required to seek temporary legal custody of the child through Juvenile Court if the child’s legal custodian or designated caregiver does not assume custody of the child within seven calendar days or it is determined there is an issue of child abuse.

    3. Assess the parent’s condition including their ability to regain physical custody of the child within seven calendar days. Request the parent(s) complete an Authorization for Release of Information (ROI) when it is necessary in accordance with policy 2.6 Information Management: Confidentiality/ Safeguarding Information.

    4. Develop a plan with the legal custodian to regain physical custody of the child within seven calendar days. Inquire if there is anyone he/she wishes to designate as a caregiver for the child.

    5. Gather information about each child:

      1. Demographic information (name, date of birth, social security number);

      2. Any medical conditions or allergies, including any that require immediate attention;

      3. Any medication(s) the child is taking;

      4. Health insurance coverage and plan information;

      5. Where the child attends school; and

      6. Whether the situation has been discussed with the child.

  5. Interview the individuals who provided emergency aid to the child (i.e., emergency medical technician (EMT), law enforcement, or healthcare professionals) or who may have additional well-being information.

  6. Interview and observe each child to assess health and general well-being, including:

    1. Need for medical attention

    2. Any medical conditions or allergies, including any that require immediate attention

    3. Medication(s) taken

    4. Any health insurance coverage and plan information

    5. For school age, what school does he/she attend

    6. Their understanding of the situation

    7. Any kin who can provide care and supervision

  7. Consult with the Social Services Supervisor (SSS) and discuss the information gathered:

    1. The reason for the STEC (Emergency or Illness) request;

    2. Does the situation meet STEC (Emergency or Illness) criteria,

    3. The plan for the legal custodian to regain custody or the designated caregiver to provide care and supervision of the child(ren) within seven calendar days;

    4. The general well-being and health of the child(ren);

    5. Services that can support the family during the recovery process; and

    6. Next steps.

  8. Obtain approval from the County Director/Designee to initiate the STEC (Emergency or Illness) agreement.

  9. Execute the STEC (Emergency or Illness) agreement by completing the Emergency Care and Supervision of Child Without a Court Order (Authorization):

    1. Document the information on any caregiver designated by the legal custodian.

      If the parent(s) designated a caregiver for the child and there is a reason to believe the parent’s ability to make decisions is compromised, consult with the physician regarding the parent’s ability to make decisions concerning the child’s well-being. If the physician believes the parent is mentally competent, request the physician complete the Physician Confirmation of Capacity of Physical and Legal Custodian section of the Emergency Care and Supervision of Child Without a Court Order (Authorization).

    2. Obtain the signatures of the legal custodian (if able), the requestor (as applicable), witness, and County Director/Designee.

    3. Provide a copy of the fully executed Emergency Care and Supervision of Child Without a Court Order (Authorization) to the legal custodian.

  10. Document the STEC (Emergency or Illness) in Georgia SHINES:

    1. Upload to External Documentation the executed Emergency Care and Supervision of Child Without a Court Order (Authorization).

    2. Complete the Custody Tab in Georgia SHINES generating the FCC stage:

      1. Select the STEC radio button under the Removal Date section on the Custody page; and

      2. Select “Court Ordered” as the removal type and “Caretaker’s Inability to Cope due to Illness or Other Reason”.

  11. Arrange for a placement in accordance with policy 10.1 Foster Care: Placement of a Child.

  12. Participate in the case transfer process in accordance with policy 19.4 Case Management: Case Transfer.

  13. Obtain a medical evaluation for the child immediately, when necessary.

  14. Immediately (24 hours) contact any designated caregiver to assume care of the child.

    1. Explain the circumstances and that they have been designated as a caregiver for the child;

    2. Confirm their willingness to assume care of the child; and

    3. Schedule the transfer of physical custody of the child.

  15. Have the legal custodian complete the Authorize Release to Designated Caregiver (Person or Facility) section of the Emergency Care and Supervision of Child Without a Court Order (Termination) when he/she wishes to designate a caregiver for the child(ren).

  16. Terminate the STEC (Emergency or Illness) agreement using the Emergency Care and Supervision of Child Without a Court Order (Termination).

    1. If the child will be released to the legal custodian.

      1. Have the legal custodian complete the Release to Physical and Legal Custodian section of the Emergency Care and Supervision of Child Without a Court Order (Termination).

      2. Release the child to the person having custody at the time the STEC agreement was executed.

    2. If the child will be released to a designated caregiver.

      1. If the legal custodian designated a caregiver for the child and there is reason to believe the legal custodian’s ability to make decisions is compromised, consult with the physician regarding their ability to make decisions concerning the child’s well-being. If the physician indicates the legal custodian is mentally competent, request the physician complete the Physician Confirmation of Capacity of Physical & Legal Custodian section of the Emergency Care and Supervision of Child Without a Court Order (Termination.

      2. In conjunction with the designated caregiver, complete the Authorize Release to Designated Caregiver (Person or Facility) section of the Emergency Care and Supervision of Child Without a Court Order (Termination).

      3. Obtain a copy of the designated caregiver’s picture identification.

      4. Immediately notify the legal custodian of the transfer of custody to the designated caregiver.

    3. If DFCS obtained temporary legal custody of the child through Juvenile Court.

      1. Specify the DFCS responsibility terminated effective date as the date DFCS obtained temporary legal custody of the child and sign the form.

      2. Make a new report to the CICC to open an investigation in accordance with policy 3.24 Intake: Mandated Reporters. Inform CICC that STEC was terminated and the reason(s) the child was taken into custody. Documentation of legal actions related to the court ordered temporary legal custody will be captured in the investigation.

    4. Provide a copy of the completed Emergency Care and Supervision of Child Without a Court Order (Termination) to the legal custodian.

    5. Upload the signed Emergency Care and Supervision of Child Without a Court Order (Termination) to Georgia SHINES External Documentation.

    This may be completed by the permanency SSCM.

  17. Submit the Special Circumstance Short Term Emergency Care (Emergency or Illness) to the SSS for approval within 45 calendar days from the receipt of the intake report.

  18. Close the foster care case in Georgia SHINES in accordance with policy 10.26 Foster Care: Case Closure.

    This will be completed by the permanency SSCM.

Social Services Supervisor

  1. Conduct a staffing with the SSCM, prior to the initial contact:

    1. Confirm the request meets the criteria for a STEC (Emergency or Illness).

    2. Discuss the reason for the STEC (Emergency or Illness) request and is it likely the legal custodian or designated caregiver is able to assume care and supervision within seven calendar days.

    3. Determine next steps.

  2. Document the supervisor staffing in Georgia SHINES within 72 hours of occurrence (see policy 19.6 Case Management: Supervisor Staffing).

  3. Oversee the execution of the STEC (Emergency or Illness) agreement:

    1. Ensure approval is obtained from the County Director/Designee.

    2. Review the Emergency Care and Supervision of Child Without a Court Order (Authorization) for accuracy.

    3. Verify the STEC (Emergency or Illness) is documented in Georgia SHINES.

      1. The executed Emergency Care and Supervision of Child Without a Court Order (Authorization) is uploaded to External Documentation.

      2. The Custody Tab is completed generating the FCC stage.

      3. Review and approve Legal Actions

  4. Assist the SSCM in arranging a placement for the child in accordance with policy 10.1 Foster Care: Placement of a Child.

  5. Ensure immediate contact is established with any designated caregiver for the child to expedite the transfer of custody.

  6. Participate in the case transfer process in accordance with policy 19.4 Case Management: Case Transfer.

  7. Ensure the STEC (Emergency or Illness) agreement is terminated within seven calendar days of executing the STEC.

    1. Ensure the child is immediately released to the person having custody at the time the STEC agreement was executed or the designated caregiver, when able to assume care and supervision of the child.

      Verify the physician is consulted if the legal custodian designated a caregiver for the child and there is reason to believe the legal custodian’s ability to make decisions is compromised.

    2. Review the Emergency Care and Supervision of Child Without a Court Order (Termination) for accuracy.

    3. Verify the STEC termination is documented in Georgia SHINES.

      1. The Emergency Care and Supervision of Child Without a Court Order (Termination) is uploaded to External Documentation.

      2. Review and approve Legal Actions

    This may be completed by the permanency SSS.

  8. Ensure legal intervention is initiated seeking temporary legal custody of the child through Juvenile Court when the legal custodian or designated caregiver is unable to assume care for the child prior to expiration of the seven calendar days STEC period or when there is an issue of child abuse (see policy 17.1 Legal: The Juvenile Court Process).

  9. Ensure a new report is made to the CICC to open an investigation in accordance with policy 3.24 Intake: Mandated Reporters when temporary legal custody of the child was obtained through Juvenile Court.

  10. Review the submitted Special Circumstance Short Term Emergency Care (Emergency or Illness) and make an approval decision in Georgia SHINES within 45 calendar days of receipt of the intake report.

  11. Close the foster care case in Georgia SHINES in accordance with policy 10.26 Foster Care: Case Closure.

    This will be completed by the permanency SSS.

Practice Guidance

DFCS is legally authorized to provide emergency care and supervision to a child without seeking a court order for a period not to exceed seven calendar days when there is an emergency or illness involving the person having physical and legal custody of the child that renders them unable to provide care and supervision; and the child is not at imminent risk of child abuse other than the risk of being without a caregiver. Once executed, the STEC authorization gives DFCS the same rights and powers regarding the child as the parent, guardian or legal custodian including the authority to consent to medical care.

The request for STEC (emergency or illness) may only be accepted from the following legally authorized individuals:

  1. Parent(s), guardian, or legal custodian

  2. Law enforcement officer

  3. Emergency personnel employed by a licensed ambulance provider

  4. Fire rescue personnel

  5. Hospital administrator or designee

At any point, during the seven calendar days STEC period, the parent, guardian, or legal custodian may authorize a designated caregiver. A designated caregiver is a person who has agreed to assume care and supervision of the child during the emergency or illness. The parent, guardian, or legal custodian may designate whomever he/she wishes as a caregiver. While the aforementioned individuals are legally authorized to request a STEC (Emergency or Illness), they are not legally authorized to designate a caregiver for the child. When the parent, guardian or legal custodian designates a caregiver and there is reason to believe their cognitive ability is compromised, consult with the treating physician to confirm competency, and request the physician complete the Physician Confirmation of Capacity of Physical & Legal Custodian section of the Emergency Care and Supervision of Child Without a Court Order (Authorization)/(Termination).

Immediately following executing STEC agreement, DFCS is responsible for initiating contact with the designated caregiver to determine their willingness and ability to assume physical custody of the child. During contact, the SSCM should be observing for any obvious signs of psychological, emotional, or intellectual limitations that could impair their ability to care for the child (e.g., mental impairment, the influence of medication, drugs, or alcohol). Confirmation of the designated caregiver’s identity must be obtained by reviewing and making a copy of a valid picture identification. The STEC (Emergency or Illness) agreement must be terminated prior to releasing the child to the designated caregiver. When there are concerns about the designated caregiver’s ability to provide care and supervision, consult with the SSS to determine next steps.

Terminating the STEC, relieves DFCS of all responsibility for the child. Terminate the STEC, by completing the Emergency Care and Supervision of a Child Without a Court Order (Termination) form. The STEC must be terminated, when either of the following occurs:

  1. The parent, guardian, legal custodian, or designated caregiver assumes care and supervision of the child; or

  2. DFCS filed a dependency petition in Juvenile Court seeking temporary legal custody of the child.

Time Limits for Short Term Emergency Care

STEC is allowable by law for up to seven calendar days. When the legal custodian or designated caregiver is unable to assume care and supervision of the child within seven calendar days of executing the STEC (emergency or illness) agreement, DFCS must seek temporary legal custody of the child (see policy 17.1 Legal: The Juvenile Court Process). DFCS must also make a new report to the CICC to initiate an investigation.

Forms and Tools

Emergency Care and Supervision of Child Without a Court Order (Authorization)
Emergency Care and Supervision of Child Without a Court Order (Authorization) (Spanish)
Emergency Care and Supervision of Child Without a Court Order (Termination)
Emergency Care and Supervision of Child Without a Court Order (Termination) (Spanish)
Notice of Case Record Information Available to Parents/Guardians
Notice of Case Record Information Available to Parents/Guardians (Spanish)
Notice of Privacy Practices
Notice of Privacy Practices (Spanish)