PURPOSE: Except as otherwise expressly set forth in this rule, this rule applies to child placing agencies licensed pursuant to sections 210.481 to 210.536, RSMo and to intermediaries as defined in section 453.014, RSMo (includes attorneys licensed pursuant to Chapter 484, RSMo; physicians licensed pursuant to Chapter 334, RSMo; or clergyman of the parents) and who, in the absence of a child placing agency representing the child, place a child outside the home of the child’s parent(s) or guardian, or who advertise or hold themselves out as performing such services (collectively), “adoption intermediaries.” This rule sets forth rules relating to birth parents, pre-placement and placement services to the child, adoptive family services, placement services, post-placement services to the family, adoption disruption services, and international placements. Only those rules which specify adoption intermediaries apply to adoption intermediaries. All rules apply to child placing agencies.

PUBLISHER’S NOTE: The secretary of state has determined that the publication of the entire text of the material which is incorporated by reference as a portion of this rule would be unduly cumbersome or expensive. This material as incorporated by reference in this rule shall be maintained by the agency at its headquarters and shall be made available to the public for inspection and copying at no more than the actual cost of reproduction. This note applies only to the reference material. The entire text of the rule is printed here.

1. (1) General Program Requirements.

   1. (A) A child placing agency shall maintain and make available to its clients information on resources in the community which may be of use to foster or adoptive parents, birth parents, children and adult adoptees.
   2. (B) A child placing agency shall ensure access to its services by eligible persons with disabilities.
   3. (C) A child placing agency shall maintain and keep on file a grievance procedure for clients.
   4. (D) A child placing agency or adoption intermediary shall be in compliance with all applicable laws including Interstate Compact on the Placement of Children (ICPC), Interstate Compact on Adoption and Medical Assistance (ICAMA), and Indian Child Welfare Act (ICWA).

2. (2) Services to Birth Parents.

   1. (A) Before services are provided an agency shall provide a written description of its current program for birth parents, including information on the agency’s services, options available for birth parents and the adoption process.
   2. (B) Before financial liability is incurred or care of the child is transferred by power of attorney or court order, an agency shall make available to birth parents a verbal explanation of and a written agreement with the agency, describing specific services to be provided, fees to be charged, and rights and responsibilities of both parties.

   3. (C) When a child placing agency or adoption intermediary accepts or obtains the waiver of necessity of consent to future adoption or consent to termination of parental rights of a child, it can do so only after determining that the birth parents or legal guardians are not acting under duress. (Specifically, this waiver of consent may be taken on the “Consent to Termination of Parental Rights and Consent to Adoption” form developed by and made available through the local County Office of the Children’s Division, or Children’s Division Central Office, PO Box 88, Jefferson City, MO 65103, or the Court.)

      1. 1. The birth parent(s) shall not be

required to sign a statement committing him/her to any definite plan for the unborn child in order to obtain services from the agency.

1. 2. The birth parent(s) shall not be

required to waive the necessity of consent to future adoption or to consent to termination of parental rights for a child for adoption in order to receive medical services, maternity or residential care, or any other agency service.

1. 3. A child placing agency that directly

provides residential care, foster home care, and/or maternity home services to clients shall ensure that such facilities and/or homes meet applicable state licensing, certification, or local zoning requirements.

1. 4. The birth mother shall be encouraged

to identify all possible birth and/or legal fathers and reasonable efforts shall be made to locate them.

1. 5. All birth and legal parents shall be

informed of their options including parenting or making an adoption plan.

1. 6. Appropriate legal authorities shall be

notified when a birth parent is a minor or incompetent so that a guardian ad litem can be appointed as required by Chapter 453, RSMo.

1. 7. Before placement of a child, it shall

be documented that the birth parents were—

1. A. Offered counseling by a child plac-

ing agency that fully explores alternative plans for the child, including, but not limited to, temporary foster care, day care, and care by relatives;

1. B. Informed by the child placing agen-

cy or adoption intermediary that their decision must be free, knowing, and voluntary regardless of their age;

1. C. Prepared by the child placing agen-

cy, along with the child, for placement and separation;

1. D. Referred to other community

resources when the agency cannot provide needed services;

1. E. Informed of the existing laws

regarding contact and disclosure of information;

1. F. Asked to submit complete medical

and social information on forms prescribed or approved by the division (birth parent, social and medical history); and

1. G. Asked to update and submit to the

agency changes of address(es) and/or any significant medical information now and in the future.

1. 8. A child placing agency and, as appli-

cable, the adoption intermediary shall explain the significance of placement to the birth and legal parents and document acknowledgment of said explanations and take appropriate actions including the following:

1. A. The full terms of this understand-

ing shall be delineated in writing, signed and dated by the birth parent(s) and agency, if applicable, and maintained on file;

1. B. The birth parent(s) shall be given

the opportunity to state any preferences that s/he may have affecting the selection of the adoptive family;

1. C. A child placing agency or adoption

intermediary shall act in the best interests of the child in recommending the adoptive family;

1. D. A child placing agency or the

adoption intermediary shall not take a waiver of necessity of consent to future adoption, consent to termination of parental rights or Consent to Adoption before allowed by statute; and

1. E. A child placing agency or the

adoption intermediary shall document those parents who cannot read, fully understand the meaning of waiver of necessity of consent to future adoption or consent to termination of parental rights.

1. 9. While the parent(s) has the legal right

to resume custody, a child placing agency shall not delay returning a child solely because the parent(s) is unable to pay medical and/or other fees.

1. 10. A child placing agency shall request

the court to take appropriate action as necessary for the protection of the child.

1. 11. After the child is placed for adop-

tion, a child placing agency shall provide post-placement supportive services to the birth parent(s) to help them adjust to the placement and to deal with any concerns, including at least one (1) in-person contact if requested by the parent.

1. (3) Pre-Placement and Placement Services to the Child.

   1. (A) Prior to adoptive placement, a comprehensive and documented assessment, as required pursuant to section 453.026, RSMo, of each child’s medical, psychological, and social development shall be completed on an age-appropriate basis by or at the direction of a child placing agency or adoption intermediary. In preparing this assessment, the agency or adoption intermediary shall have the duty to inquire and obtain reports and information into the following matters concerning the prospective adoptive child, if such report or information is appropriate given the age of the child:

      1. 1. A medical examination of the child

within a reasonable period of time prior to placement, meaning at least within thirty (30) days prior to, or ten (10) days after, adoptive placement;

1. 2. Medical, social, and cultural/ethnic

background information about the child’s birth family;

1. 3. Information on previous alternative

care or adoptive placements, if applicable;

1. 4. Any specialized evaluations, if appli-

cable;

1. 5. Assessment of the child’s needs by

one who is authorized to make such an assessment under section 453.070.2, RSMo;

1. 6. The child’s involvement in the adop-

tion or reason(s) for not involving the child;

1. 7. An evaluation of the feasibility of

placement with birth sibling(s);

1. 8. Developmental history of the

prospective adoptive child—

1. A. Birth and health history;

2. B. Early development—

   1. (I) Locomotor;
   2. (II) Developmental milestones;
   3. (III) Feeding;
   4. (IV) Sleeping; and
   5. (V) Temperament;
3. C. Current development;
4. D. A written synopsis of any profes-

sional evaluation and treatment recommendations for the child, including medical, educational, dental, psychological, psychiatric, etc.;

1. E. Child’s experiences—

   1. (I) Maternal attitudes during preg-

nancy and early infancy including prenatal care and drug usage;

1. (II) Continuity of parental care and

affection;

1. (III) Foster care placements;
2. (IV) Separation and attachment

issues; and

1. (V) Any history of abuse or

neglect; and

1. F. Language skills or education; and
2. 9. Compliance with ICWA.

3. (B) A child placing agency that is unable to locate an appropriate adoptive family within ninety (90) calendar days of the date the child was legally freed for adoption shall—

   1. 1. Refer the child to the Adoption

Resource Exchange, or any successor statewide exchange;

1. 2. Refer the child to an interstate or

national adoption exchange; and

1. 3. A child placing agency may refer a

child to any adoption exchange(s) earlier than is required.

1. (C) A child placing agency placing a special needs child shall document its efforts to facilitate an adoptive placement.

2. (D) Preparation for adoptive placement shall be done in cooperation with the primary caregiver to supply the adoptive family with all necessary social, physical, and developmental background.

   1. 1. The placement should include the

temporary caregiver(s) in a meeting with the adoptive family.

1. 2. Pre-placement visits should take

place in length and frequency that is appropriate to the child’s age, his/her needs, and response and adjustment to the new family.

1. (E) For children over thirty-six (36) months, preparation for adoptive placement should include the primary caregiver(s) and private interviews with the child to discuss the placement plan, as age and developmentally appropriate.

   1. 1. The child’s understanding of and

response to these pre-placement interviews shall be documented in the record.

1. 2. Counseling should include explo-

ration of the child’s understanding of what is taking place and the child’s feelings about adoption and separation and loss.

1. (F) The pre-placement services shall be recorded in the child’s record.

1. (4) Adoptive Family Services.

   1. (A) Before services are provided, a child placing agency shall provide orientation to prospective adoptive parents to acquaint them with the agency’s policies and practices, fee schedules, grievance procedures, the approximate time the assessment will take, eligibility standards, adoption risk issues, availability of subsidy for special needs children, and the types of children available so as to enable them to make an informed decision to proceed.

   2. (B) A child placing agency shall make available to prospective adoptive parents a verbal explanation of and a written agreement with the agency, describing specific services to be provided, fee ranges, and rights and responsibilities of both parties. Said explanation and agreement shall include the following, if applicable:

      1. 1. Physician’s expenses;
      2. 2. Hospital and other medical expenses;
      3. 3. Court costs and fees for legal ser-

vices;

1. 4. Agency fees or expenses—

   1. A. Counseling services;
   2. B. Family assessment services;
   3. C. Birth parent services;
   4. D. Foster care services;
   5. E. Preand post-placement social ser-

vices;

1. F. Transportation;
2. G. Contracted services, if applicable;
3. H. Any other services as may be rea-

sonably foreseeable; and

1. I. Child-finding services.
2. (C) A written description of the adoption program shall be provided to applicants upon request.

3. (D) A child placing agency or adoption intermediary shall complete, or cause to be completed, an adoptive family assessment of each eligible adoptive family prior to the placement of a child in the home. This assessment shall be completed by a person or agency as stipulated in section 453.070.2, RSMo.

   1. 1. The family assessment process shall

consist of—

1. A. An individual interview with each

applicant;

1. B. A joint interview with co-appli-

cants;

1. C. Confidential interviews, with all

members of the applicants’ household, as age appropriate; and

1. D. A visit to the residence of the

applicant(s) which includes a complete inspection of the home.

1. 2. The family assessment process shall

include a minimum of at least two (2) separate visits on nonconsecutive days.

1. 3. The written family assessment shall

include:

1. A. Identifying information on each

member of the household including:

1. (I) Full name(s), including maiden

and aliases, if applicable;

1. (II) Current address and phone 13 CSR 35-73

number; and previous addresses if less than five (5) years at current address;

1. (III) Date and place of birth;
2. (IV) Citizenship;
3. (V) Social Security number;
4. (VI) Race and ethnic background;
5. (VII) Religion, if applicable; (VIII) Veteran’s status, if applica-

ble;

1. (IX) Education;
2. (X) Place of employment, address,

and telephone numbers;

1. (XI) Any children, including those

not in the home; and

1. (XII) Physical description;
2. B. A social history on each applicant

which shall include:

1. (I) Description of the applicant’s

family of origin, including type of family structure, values, child rearing, relationships past and present, and discipline methods. If the family of origin was dysfunctional (for example, alcoholism, abuse) describe how the applicant has coped with the issues in his/her adult life;

1. (II) Educational and occupational

history including current employment;

1. (III) Marital history and current

relationships;

1. (IV) Interests and hobbies;
2. (V) Physical and mental health his-

tory including psychiatric treatment, if any, and extent of alcohol and drug use;

1. (VI) Applicant’s personality, in-

cluding applicant’s perceived strengths and weaknesses, emotional stability and maturity; and

1. (VII) Religious beliefs and prac-

tices;

1. C. Parenting background of the appli-

cation(s) which shall include:

1. (I) Motivation to adopt;
2. (II) Awareness of adoption issues

such as talking to the child about his/her adopted status, identity issues with adoptees, grief and loss in adoption, openness, search;

1. (III) Applicant’s readiness to seek

family counseling if needed;

1. (IV) Philosophies on child rearing

and discipline;

1. (V) Attitudes and acceptance of

adoption by other significant family members and friends;

1. (VI) Location and description of

physical residence, including type of community and school district available;

1. (VII) If the family contains school

age child(ren), reports from school personnel regarding school adjustment; (VIII) Child care arrangements;

1. (IX) Description of children and

adopted children’s background factors the applicants can accept;

1. (X) Financial status and manage-

ment;

1. (XI) For special needs adoption,

awareness of the child’s special needs and appropriate ways to meet those needs; and

1. (XII) For trans-racial or trans-cul-

tural adoption, the applicant’s awareness of and sensitivity to differences, how they plan to impact a positive identity, and expose the child to his/her cultural/ethnic heritage;

1. D. Supplemental documentation shall

include:

1. (I) A total of no less than four (4)

reference letters; including, but not limited to, one (1), employment related reference per applicant (if applicable) from one (1) who has worked with the person within the last five (5) years, one (1) relative, and one (1) nonrelated personal reference;

1. (II) Child abuse and neglect back-

ground screening check Child Abuse and Neglect Central Registry Unit (CA/N CRU), no more than six (6) months old;

1. (III) Criminal arrest records from a

state law enforcement agency, no more than six (6) months old;

1. (IV) Criminal conviction records

including a fingerprint search, from a state law enforcement agency;

1. (V) Any findings on child abuse or

criminal records shall be followed up by requesting a copy of the child abuse investigation report or the police report;

1. (VI) Written medical reports, no

more than twelve (12) months old, on all adult members of the household;

1. (VII) Verifications of marriage(s)

and divorces if applicable; (VIII) Written documentation of income and financial resources, including a copy of the latest Federal Income Tax 1040 form verifying adjusted gross income;

1. (IX) Other family assessments and

recommendations, if applicable; and

1. (X) Birth and death certificates;

and

1. E. Impressions and recommenda-

tions.

1. (E) Adoptive family assessments shall be updated annually. An update shall also be completed if there is a significant change in the family situation (for example, job change, address change). It shall include:

   1. 1. One (1) or more interviews with all

members of the family;

1. 2. Medical reports on all household

members biennially unless otherwise indicated;

1. 3. Child abuse/neglect reports on all

adults completed within the last thirty (30) days;

1. 4. Arrest record check completed within

the last thirty (30) days;

1. 5. Evaluation of any previous place-

ments; and

1. 6. A summary of additional children to

be adopted.

1. (5) Placement Services.

   1. (A) Prepare child and family for adoption, including discussion of—

      1. 1. Understanding and acceptance of the

child’s background;

1. 2. Separation from birth family;
2. 3. Planning for continued contact, if

applicable;

1. 4. Meaning of and desire for adoption;
2. 5. Placement with siblings, if planned;
3. 6. Plans to encourage and preserve the

child’s ethnic and cultural identity;

1. 7. The adoption process, transfer of cus-

tody, period of supervision, and finalization; and

1. 8. Child’s needs and any special con-

cerns.

1. (B) A child placing agency shall document the reason(s) placing the child with the adoptive family is in the child’s best interest.

2. (C) A child placing agency shall make reasonable efforts to place siblings together. When sibling placement is not a possibility the agency or adoption intermediary shall document—

   1. 1. Efforts made to place siblings togeth-

er;

1. 2. Reasons why such a resource/place-

ment is not possible/available.

1. 3. Plan for contact with siblings or rea-

sons for no contact.

1. (D) A child placing agency shall make reasonable efforts to place in an adoptive home of similar racial or cultural background in compliance with the Multi-Ethnic Placement Act (MEPA). When such placement is not a possibility the agency shall document—

   1. 1. Efforts made to locate such a home;

and

1. 2. Reasons why such a resource/place-

ment is not possible/available.

1. (E) A child placing agency shall enter a written agreement with the adoptive parents specifying the rights and responsibilities of each regarding the child during the supervision period.
2. (F) When more than one (1) child placing agency is involved in a placement, both agencies shall share information and develop a mutual written agreement on the services to be provided by each.

3. (G) A child placing agency shall provide the following information, to adoptive parent(s) while maintaining confidentiality as appropriate:

   1. 1. Written history of the child including

developmental and medical history;

1. 2. Reason(s) the birth parent(s) made an

adoption plan;

1. 3. A written synopsis of any professional

evaluation and treatment recommendations for the child (for example, medical, educational, dental, psychological, psychiatric, etc.); and

1. 4. Any resources, which may be avail-

able to the adoptive families, such as—

1. A. Missouri Adoption Subsidy Pro-

gram (MASP);

1. B. Payment for nonrecurring adoption

expenses only;

1. C. Missouri Adoption Tax Credit;
2. D. Supplemental Security Income;
3. E. Social Security benefits; and
4. F. Laws relating to health insurance.

1. (6) Post-Placement Services to Family.

   1. (A) A child placing agency shall provide education, training, and support to the family, to facilitate positive adjustment to the placement.

   2. (B) A child placing agency shall maintain contact with the family during the supervision period.

      1. 1. For children thirty-six (36) months of

age and under, the agency shall—

1. A. Conduct, at a minimum, quarterly

home visits until the adoption is final;

1. B. Conduct monthly telephone con-

tacts between home visits; and

1. C. Receive regular written reports

from the child’s pediatri cian.

1. 2. For children over thirty-six (36)

months of age or children with special needs, the agency shall—

1. A. Conduct one (1) home visit within

the first ten (10) days of placement, then, at a minimum, quarterly until the adoption is finalized;

1. B. Conduct monthly telephone con-

tacts between home visits;

1. C. Receive regular written reports

from the child’s pediatri cian;

1. D. If the child is in school, receive

one (1) report from the school personnel regarding the child’s progress every school quarter;

1. E. Interview the child privately to dis-

cuss the child’s feelings about the adoption during each supervisory visit.

1. (C) Document in the child’s record that all members of the adoptive family’s household were interviewed during supervision.

2. (D) Document in the child’s record that the following issues were discussed:

   1. 1. How the addition of this child into the

family has changed marital and sibling relationships and how extended family and friends have reacted to the adoption;

1. 2. What role each family member has

assumed in child care;

1. 3. How parents have coped with adjust-

ments, additional responsibilities, discipline, physical, psychological, emotional, and financial stresses;

1. 4. How family is imparting knowledge

of child’s history, as age appropriate; and

1. 5. The child’s adjustment including

health, school, and family.

1. (E) Prior to finalization, the family will provide documentation to the child placing agency that provisions have been made to provide for the care of child in the event of the parents inability to provide care.

1. (7) Disruption of Placement.

   1. (A) A child placing agency shall have and follow a written policy on procedures to be followed in the event of an adoptive placement disruption which shall include:

      1. 1. A thorough assessment of the reasons

for the disruption;

1. 2. Provision of counseling services to

the adoptive family and child as needed; and

1. 3. Provision for temporary care of the

child until another permanent plan can be made.

1. (B) A child placing agency maintains responsibility for the health and welfare of a child. When it becomes necessary to remove a child from a placement the agency shall—

   1. 1. Take appropriate action to insure the

child’s health and well being;

1. 2. Seek an appropriate adoptive resource

for the child; and

1. 3. Advise the appropriate court(s) of

placement changes.

1. (C) The division shall be notified in writing within three (3) working days of all disruptions.

1. (8) International Placements.

   1. (A) Families being considered for the placement of a child from a foreign country shall meet all criteria for families adopting a child born in Missouri as specified in 13 CSR 35-73.080(4).
   2. (B) Families residing in states other than Missouri, but adopting children from a Missouri resource, must also complete a criminal record check and child abuse and neglect screening in their state of residence.
   3. (C) In countries where foreign government authorization or licensure of orphanages, lawyers, or others working in the field of adoption is required, agencies shall enter into agreements and working relationships regarding an adoption with those who meet the requirements of the foreign government.
   4. (D) In countries where an agency based in Missouri is required to obtain a license or other authorization from that country, a copy of said license or authorization shall be filed with the division.

   5. (E) In the event that the adoptive placement ends in a disruption, the same procedure as stated in 13 CSR 35-73.080(7) shall be followed.

      1. 1. If the disruption occurs prior to the

finalization of the adoption, the placing agency shall be responsible for the care and replacement of the child, as discussed in 13 CSR 35-73.080(7).

1. 2. If the child placing agency is an agen-

cy located in the state other than Missouri, applicable provisions of the ICPC shall be followed.

1. 3. If the child placing agency is a Mis-

souri agency and the child is placed in a state other than Missouri and the adoption disrupts, applicable provisions of the ICPC shall be followed.

1. (F) Pre-Placement Planning.

   1. 1. A child placing agency evaluating the

prospective adoptive parents shall include in their discussion with and evaluation of the adoptive family:

1. A. Discussion of the family’s intent

and ability to help the child maintain cultural/ethnic identity and familiarity with the country of origin;

1. B. Discussion of factors particular to

child’s country of origin (such as, medical, developmental concerns);

1. C. Community resources available to

assist the prospective adoptive parents with the adjustment following the placement of the child; and

1. D. Coping with any language, cultur-

al, or other barriers that may affect the placement.

1. 2. A child placing agency must evaluate

the prospective adoptive parents for the placement of a child from a foreign country, including discussion about the child’s acceptance within the immediate and extended family, and the community at large.

1. 3. For international placement situations

where the prospective adoptive parents must travel to the foreign country, assistance from the placing agency should include assisting or preparing the family for such travel, assistance with passport and visa, any immuniza - tions, or health concerns and preparation for travel within the foreign culture.

1. 4. A child placing agency shall obtain

and document all available infor mation about the birth parents.

1. (G) Post-placement services.

   1. 1. Post-placement services shall be pro-

vided in compliance with provisions of rule 13 CSR 35-73.080(6). 13 CSR 35-73

1. 2. Attention shall be given to the child’s

acceptance within the extended family and the community at large.

1. 3. Discussion shall focus on any differ-

ences in appearance of the child from the family and how those differences are being addressed and resolved.

1. 4. Health concerns relative to the child’s

country of origin shall be noted and followed by a physician as needed and shall be discussed by the worker and the family.

1. 5. Post-placement reports shall be com-

pleted and forwarded to the country of origin as required by that country.

1. 6. The agency shall offer information to

the family regarding recognition of foreign decree, transfer of custody, and adoption as needed.

1. 7. Certified copies of the final decree of

the adoption shall be kept in the case record and forwarded to the country of origin as needed. A translation of said decree shall be retained if applicable.

1. 8. Families shall be encouraged to com-

plete naturalization proceedings on their adopted child.

1. (9) A child placing agency that provides services for adoption must comply with all provisions of the licensing rules.

AUTHORITY section 207.020, RSMo 2016.* This rule originally filed as 13 CSR 40- 73.080. Original rule filed Sept. 18, 1956, effective Sept. 28, 1956. Refiled: March 12, 1976. Amended: Filed Nov. 6, 1981, effective Feb. 11, 1982. Rescinded: Filed Jan. 14, 1997, effective July 30, 1997. Readopted: Filed Feb. 6, 1997, effective July 30, 1997. Emergency amendment filed Jan. 15, 1998, effective Feb. 1, 1998, expired July 30, 1998. Amended: Filed Jan. 15, 1998, effective July 30, 1998. Moved to 13 CSR 35-73.080 and amended: Filed Sept. 7, 2018, effective April 30, 2019.

*Original authority: 207.020, RSMo 1945, amended 1961, 1965, 1977, 1981, 1982, 1986, 1993, 2014.