Title: Christopher and Renee Young, Appellants, vs. Family Support Division, State of Missouri Department of Social Services, Respondent.
Citation: N/A
Docket Number: SC89190
State: Missouri
Issuer: Missouri Supreme Court
Date: March 17, 2009

SUPREME COURT OF MISSOURI 
en banc 
 
 
CHRISTOPHER and RENEE YOUNG,  
) 
 
 
 
 
 
 
 
) 
 
 
 
 
Appellants,  
 
) 
 
 
 
 
 
 
 
) 
v. 
 
 
 
 
 
 
) 
No. SC89190 
 
 
 
 
 
 
 
) 
CHILDREN'S DIVISION, STATE  
 
) 
OF MISSOURI DEPARTMENT   
 
 
) 
OF SOCIAL SERVICES,  
 
 
) 
 
 
 
 
 
 
 
) 
 
 
 
Respondent.  
 
) 
 
 
APPEAL FROM THE CIRCUIT COURT OF JEFFERSON COUNTY 
The Honorable Gary Kramer, Judge 
 
This opinion was modified by the Court's own motion on May 5, 2009. 
 
 
Christopher and Renee Young seek review of a decision from the children's 
division of the department of social services denying their request for an adoption 
subsidy through the behavioral foster care ("BFC") program.  This Court has jurisdiction 
under Mo. Const. art. V sec. 10, as this case is taken on transfer after opinion by the court 
of appeals.  Because the division's decision is not based on a promulgated rule, the 
decision is unauthorized by law.  The circuit court judgment affirming the division's 
decision is reversed, and the cause is remanded to the circuit court.  The circuit court is 
directed then to remand to the division. 
 
 
2
Factual and Procedural Background1 
 
In February 2001, J.Y. and H.Y., foster children and biological siblings then aged 
6 and 4 respectively, were placed in the Youngs' care.  In March 2003, the Youngs 
adopted J.Y. and H.Y.  The Youngs received the basic adoption subsidy from the division 
for both children from the date of the adoption.  In December 2003, the Youngs adopted 
B.Y., the younger, biological brother J.Y. and H.Y.  The Youngs entered into another 
subsidy agreement with the division in December 2003 after B.Y.'s adoption, although no 
changes were made to the subsidy amounts the Youngs received for J.Y. and H.Y. 
 
In March 2004, the Youngs requested placement of J.Y. and H.Y. into the BFC 
program.  The BFC program provides a higher monthly stipend to foster and adoptive 
parents of children with behavioral problems. 
 
After the Youngs inquired into the program, Trish Sparks, an adoption specialist 
with the division, mailed the Youngs a referral packet with information and forms for the 
Youngs to complete.  Once the Youngs returned the forms, Ms. Sparks sent the 
information to the BFC unit workers, and "staffing" meetings were held September 14, 
2004, and October 12, 2004.  Following the first staff meeting, the Youngs were asked to 
supply some additional documentation.  On January 27, 2005, the division denied the 
Youngs' BFC subsidy request. 
 
On February 1, 2005, the Youngs filed an application requesting a hearing to 
review the denial of the BFC adoption subsidy.  On April 27, 2005, the division 
                                             
 
1 This Court transferred this case after an opinion by the Court of Appeals, Eastern 
District, authored by the Honorable Sherri B. Sullivan.  Substantial portions of that 
opinion are used without further attribution.   
 
3
conducted a hearing.  At the hearing, Ms. Sparks testified that she discussed the BFC 
program with the Youngs before J.Y. and H.Y. were adopted and that the Youngs 
approached her about the program after B.Y.'s adoption.  Ms. Sparks participated in the 
staffing meetings as part of the staffing team but was not familiar with the BFC program 
criteria.  Ms. Sparks testified that Marie Clark, a consultant for the division, makes a 
recommendation to the team and then the team makes the final decision of whether to 
accept a child into the BFC program. 
J.Y. 
 
Dr. David Lipsitz, a clinical psychologist, conducted a psychological evaluation of 
J.Y. in May 2004.  Dr. Lipsitz diagnosed J.Y. with attention deficit hyperactivity disorder 
("ADHD"), oppositional defiant disorder and impulse control disorder.  Dr. Lipsitz 
reported J.Y. becomes upset easily, is emotionally volatile, has difficulty coping, and has 
an exaggerated need for attention and affection.  Dr. Lipsitz reported J.Y. will act out 
inappropriately in an attempt to gratify his needs and, as a result, frequently comes into 
conflict with others. 
 
Rhonda Kane, a therapist, evaluated J.Y. in July and October 2004.  Ms. Kane's 
report indicated she believed J.Y. was probably dangerous to others, was severely 
impulsive with consistent and persistent symptoms, and needed intense supervision. 
 
J.Y.'s school and daycare reported numerous incidents of problems with J.Y. over 
a three-year period.  One incident occurred at J.Y.'s school, in the year preceding the staff 
meetings, in which J.Y. and another student were throwing rocks at each other.  The 
school has an accommodation plan to address J.Y.'s ADHD and behavioral issues 
 
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through positive reinforcement and time-outs.  The incidents reported from J.Y.'s daycare 
in the year leading up to the staff meetings included: (1) three incidents in September 
2003 of J.Y. kicking or throwing things; (2) two incidents in October 2003 where J.Y. 
kicked or bit another child; (3) two incidents in 2004 where J.Y. shoved or punched H.Y.; 
(4) being disrespectful to a teacher; (5) kicking and throwing things when asked to stop 
wrestling with a smaller child; and (6) slapping B.Y. in the face while wrestling. 
 
Ms. Young testified J.Y. has asthma and takes several medications daily.  J.Y.'s 
asthma limits his activities, which makes him angry and upset.  Ms. Young stated J.Y. is 
very aggressive and violent to others.  Ms. Young testified J.Y. cannot be reasoned with 
or comforted when he is angry.  When angry, J.Y. throws things, punches and kicks.  The 
Youngs cannot go out socially as a family because J.Y. throws tantrums, breaks things 
and hurts other people's children. 
 
Ms. Young testified additional incidents occurred at J.Y.'s school and daycare that 
were not in the incident reports because the facilities do not write up every incident, 
particularly because J.Y.'s behaviors are everyday problems.  Ms. Young stated J.Y.'s 
behavior is better at school than at home and daycare because his aggression comes out 
more while playing than during the regimented school schedule. 
 
Mr. Young testified he adjusted his work schedule so he can pick up the children 
right after school because it helps eliminate many of J.Y.'s tantrums.  Mr. Young stated 
J.Y. got into a physical fight with a neighbor boy in the fall of 2004 and recently "choke 
tagged" a boy three years younger.  Mr. Young testified J.Y. no longer plays baseball 
because J.Y. argued with the coach, threw things and refused to play if he did not get his 
 
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way.  Mr. Young testified the children act better when they are supervised by him or Ms. 
Young. 
H.Y. 
 
Dr. Lipsitz conducted a psychological evaluation on H.Y. in April 2004.  Dr. 
Lipsitz diagnosed H.Y. with ADHD and impulse control disorder.  Dr. Lipsitz found 
H.Y. had problems with her primary support group and in her social environment.  Ms. 
Kane reported H.Y. was moderately impulsive, had mild emotional and conduct 
disturbance, and had mild oppositional behavior with consistent and persistent symptoms.  
Ms. Kane found H.Y. to be possibly dangerous to others. 
 
H.Y.'s school and daycare reported numerous instances in an approximately two-
year period.  In the year preceding the staffing meetings, H.Y.'s school reported only one 
disciplinary incident in which H.Y. stole a bottle of water.  The incidents reported by 
H.Y.'s daycare in the year preceding the staff meetings included: (1) kicking a television 
screen; (2) wandering away from the group while waiting for the bus; (3) hitting another 
child in the head with rolled-up paper; and (4) fighting with J.Y.  Ms. Young testified the 
daycare and school do not write up every incident, particularly because H.Y.'s behaviors 
are everyday problems. 
 
Ms. Young testified H.Y. is not allowed to play with other children alone because 
she has acted out sexually at home, daycare and school.  Ms. Young testified H.Y. is not 
allowed to wear dresses because she acts out sexually.  Ms. Young testified there has 
been only one incident of H.Y. acting out sexually at home because she and Mr. Young 
do not let H.Y. out of their sight.  Ms. Young stated H.Y. cannot be trusted without 
 
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constant supervision in any setting because she gets into things and steals.  Ms. Young 
testified H.Y. also picks at sores and has used paperclips to pierce her ears. 
 
Ms. Young testified that since J.Y. and H.Y. were placed in their home in 
February 2001, some of the children's behaviors have gotten better while others have 
gotten worse.  Ms. Young stated she has to have three babysitters watch the children at a 
time in case J.Y. throws a tantrum and to ensure H.Y. is being watched constantly. 
 
Marie Clark is the director of The Behavioral Institute. Ms. Clark has a master's 
degree in psychology and a post-graduate certificate in mental and family therapy.  Ms. 
Clark does not evaluate children but is a consultant who reviews the information 
presented at the staff meetings to determine if the children meet the criteria for the BFC 
program.  Ms. Clark participated in the staff meetings for the Young children.  Prior to 
the meetings, Ms. Clark reviewed the Young children's referral packets and the 
accompanying reports. 
 
Ms. Clark stated that, when considering a child for the BFC program, the division 
looks for behaviors beyond those that are typically seen for children in foster care and 
that would be disruptive to the child's foster care or adoption placement.  The division 
looks for behaviors across all areas of the children's lives, including at school, home, 
daycare or wherever else the child interacts.  Ms. Clark stated that the division looks "for 
behaviors that occur on a daily basis" and that the behaviors "need to be pretty frequent."  
Ms. Clark testified that while "significant behavior" usually means on a daily basis, the 
behaviors do not have to occur daily but instead must occur on a regular basis.  Ms. Clark 
 
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stated that she looks for behaviors that have occurred in the last six to 12 months and that 
earlier reports are too old to support a finding of a current behavioral problem. 
 
Ms. Clark testified Dr. Lipsitz's diagnoses did not, by themselves, qualify the 
children for the BFC program.  Instead, the division looks at the children's specific 
behaviors.  Ms. Clark classified many of H.Y.'s issues as symptoms of ADHD and not as 
behavior apart from ADHD.  Although more than half the children in the BFC program 
have ADHD, Ms. Clark testified children with ADHD who are accepted into the BFC 
program usually have a significant additional issue. 
 
In addition, Ms. Clark classified some of H.Y.'s and J.Y.'s issues raised by Dr. 
Lipsitz as therapeutic issues.  Ms. Clark characterized therapeutic issues as those that 
need to be modified through therapy, while behavioral issues are modified with various 
types of behavioral intervention.  Ms. Clark found Ms. Kane's counseling reports for the 
children presented strictly therapeutic issues that were being addressed in therapy. 
 
Ms. Clark also testified that Ms. Kane's reports lacked documentation supporting 
her assessment that J.Y. is probably dangerous and is consistently and persistently 
symptomatic or that H.Y. is defiant in different types of settings and injurious to other 
people frequently. 
 
Ms. Clark testified that the division considers the parents' reports about the 
children's behaviors and that the Youngs did not indicate the behaviors were occurring on 
a regular basis.  As Ms. Clark recalled, the Youngs stated at the staff meeting that they 
were managing the children's problems successfully.  Ms. Clark stated that the division 
looks for daily occurrences first and that they were not present in this case. 
 
8
 
Ms. Clark testified some of the incidents reported by J.Y.'s school and daycare 
supported a finding that J.Y. had a behavioral problem, while others were not severe 
enough to be considered a problem.  Ms. Clark considered the daycare reports but 
questioned whether the daycare had proper supervision because similar behavior was not 
occurring at school.  Ms. Clark testified J.Y. was denied for the BFC program because 
most of the discipline incident reports for J.Y. were for minor incidents and were too old 
to reflect J.Y.'s present condition, the behaviors were not occurring across all settings, 
and the behaviors were not occurring frequently enough. 
 
Ms. Clark considered the incident reports about H.Y. but found that many of them 
were not serious enough to qualify her for the BFC program.  Ms. Clark also noted there 
was a lack of documentation that H.Y. had been acting out sexually.  Ms. Clark denied 
H.Y.'s BFC referral due to a finding that the behaviors were not severe enough or 
currently occurring frequently enough and across all settings. 
 
On November 9, 2005, the division affirmed the denial of BFC benefits.  The 
division held that little evidence supported a finding that the children's behavioral 
problems were at the level of severity or occurred consistently enough to meet the BFC 
program criteria. 
 
On September 11, 2006, the Youngs filed a petition in the circuit court seeking 
review of the division's decision.  On January 16, 2007, the circuit court affirmed the 
division's decision, finding that although a different ruling would have been appropriate, 
the court was constrained to find the division's decision was supported by substantial 
competent evidence and was not clearly against the weight of that evidence.  The Youngs 
 
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subsequently filed this appeal.   
Points on Appeal 
 
The Youngs raise five points on appeal.  First, they assert that the division's denial 
of the Youngs' request for the BFC adoption subsidy benefits was unauthorized by law, 
arbitrary and unreasonable because the division is required to adopt formal rules and 
regulations governing whether applicants qualify for the BFC subsidy.  Second, the 
Youngs claim that the child welfare manual provisions regarding adoption subsidies do 
not have the force of law because they do not constitute "rules and eligibility 
requirements."  Third, the Youngs submit that, in making its decision, the division 
erroneously relied on factors unstated in any statute, regulation or in its own manual by 
requiring that the children's behavioral problems be severe, occur daily and occur across 
all settings.  Fourth, the Youngs assert that the division's decision was not based on 
competent and substantial evidence based on the whole record, because all the evidence 
showed that J.Y. and H.Y. had significant behavioral problems that met or exceeded the 
criteria for the BFC subsidy.  Finally, the Youngs claim that the division's decision was 
unauthorized by law and was arbitrary, capricious and unreasonable because federal and 
state law and the public policy stated therein require that the adoption subsidy program be 
used to provide permanent homes for abused and neglected children. 
Standard of Review 
 
"In an appeal following judicial review of an agency's administrative action, this 
Court reviews the decision of the agency, not the circuit court."  TAP Pharmaceutical 
Products, Inc. v. State Board of Pharmacy, 238 S.W.3d 140, 141 (Mo. banc 2007).  
 
10
"Pursuant to section 536.140.2, this Court reviews to determine 'whether the agency's 
findings are supported by competent and substantial evidence on the record as a whole; 
whether the decision is arbitrary, capricious, unreasonable or involves an abuse of 
discretion; or whether the decision is unauthorized by law.'"  Id. at 142 (quoting 
Community Bancshares, Inc. v. Secretary of State, 43 S.W.3d 821, 823 (Mo. banc 2001)). 
Discussion 
 
In their first point, the Youngs assert that the division's denial of their request for 
the BFC rate of adoption subsidy benefits was unauthorized by law, arbitrary and 
unreasonable because the division is required by this Court's opinion in Department of 
Social Services v. Little Hills Healthcare, L.L.C., 236 S.W.3d 637 (Mo. banc 2007), and 
section 453.074, RSMo 2000,2 to adopt formal rules and regulations governing 
applicants' qualification for the BFC subsidy. 
   
In Little Hills, this Court addressed whether the division of medical devices 
("DMS") was required to promulgate a rule for the method it uses to annually calculate 
the "estimated Medicaid days" of Medicaid service providers.  236 S.W.3d at 639.  
Section 208.153.1, provided that DMS "shall by rule and regulation define the reasonable 
costs, manner, extent, quantity, quality, charges and fees" for medical assistance services.  
Little Hills, 236 S.W.3d at 639 n.3.  DMS had no regulations setting forth the precise 
method for calculating the "estimated Medicaid days."  Id. at 639.  DMS considered three 
general components, but had no regulations for calculating each of the components.  Id. 
                                             
 
2  All statutory references are to RSMo 2000 unless otherwise noted. 
 
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at 639-40.  This led to inconsistent "estimated Medicaid days" for Medicaid service 
providers from year to year.  Id. at 640.   
 
This Court found that "[w]hether an agency decision should be promulgated as a 
rule is a determination that is guided by section 536.010(6), RSMo Supp. 2006."  Id. at 
641.  That section states, in relevant part: 
"Rule" means each agency statement of general applicability that 
implements, interprets, or prescribes law or policy, or that describes the 
organization, procedure, or practice requirements of any agency.  The term 
includes the amendment or repeal of an existing rule, but does not include: 
(a) A statement concerning only the internal management of an 
 
agency and which does not substantially affect the legal rights of, or 
 
procedures available to, the public or any segment thereof; 
(b) A declaratory ruling issued pursuant to section 536.050, or an 
interpretation issued by an agency with respect to a specific set of 
facts and intended to apply on to that specific set of facts; 
(c) An intergovernmental, interagency, or intraagency memorandum, 
directive, manual or other communication which does not 
substantially affect the legal rights of, or procedures available to, the 
public or any segment thereof; 
 
Section 536.010(6) (emphasis added). 
 
Among its arguments that the "estimated Medicaid days" calculation does not fall 
under rulemaking, DMS asserted that the calculations were not generally applicable 
because they "related to specific facts for specific providers."  Little Hills, 236 S.W.3d at 
642.  This Court disagreed and found that because, in each year, DMS applies one 
method for calculating "estimated Medicaid days" for all Medicaid service providers, the 
standard used to make the decision was a standard of "general applicability" for 
rulemaking purposes.  Id. 
 
This Court also addressed the effect of DMS's failure to promulgate a rule.  Id. at 
643.  "[A] failure to promulgate a rule as required voids the decision that should have 
 
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been properly promulgated as a rule."  Id. (citing NME Hospitals, Inc v. DMS, 850 
S.W.2d 71, 74-75 (Mo. banc 1993)).  DMS's "estimated Medicaid days" decision, then, 
was invalid because it was based on criteria or methodology that should have been 
promulgated as a rule.  Id. at 643-44.   
 
The division here attempts to distinguish this case from Little Hills on two 
grounds.  First, the division argues that section 453.074 is not similar to section 
208.153.1.  Section 453.074.1 states the division, in administering the subsidy program, 
"shall ... (2) Provide all petitioners for adoption with the rules and eligibility 
requirements for subsidies[.]"  (Emphasis added).  Section 208.153.1, on the other hand, 
provided that DMS "shall by rule and regulation define the reasonable costs, manner, 
extent, quantity, quality, charges and fees" for medical assistance services.  (Emphasis 
added).  Because section 453.074.1 just states that rules and eligibility requirements shall 
be provided, instead of stating that the eligibility requirements shall be defined by rule 
and regulation, the division argues that the Court's reasoning in Little Hills does not 
apply.  
 
Contrary to the division's suggestion, the holding in Little Hills was not dependent 
on the statutory language of section 208.153.1.3  As stated in Little Hills, section 
536.010(6), defining an administrative "rule," guides the determination of whether the 
agency policy should be promulgated as a rule.  236 S.W.3d at 641-42.   
                                             
 
3 Even if Little Hills had relied on section 208.153.1, the division fails to explain 
persuasively why the differing language between the statutes requires rulemaking in one 
and not the other. 
   
 
13
 
In its brief, the division also attempts to distinguish this case from Little Hills on 
the basis that, unlike the methodology used to calculate "estimated Medicaid days," the 
criteria used to decide whether a child is eligible for BFC subsidy cannot be applied in a 
uniform fashion because it "requires that the division consider the specific needs and 
behavioral issues of each child on a case-by-case basis."  As such, the division argues, the 
criteria for those decisions are not generally applicable and, therefore, are not subject to 
rulemaking. 
 
The division is correct that the decision of whether a child is eligible for BFC 
subsidy is an individualized determination relating to the specific facts and circumstances 
of that particular child.4  But that is not the decision that must be promulgated as a rule.  
Here, as in Little Hills, at issue is the validity of an individualized decision that is based 
on a set of standards that has not been promulgated as a rule.  In both these cases, it is the 
agency's policy of what criteria and methodology apply in making individualized 
determinations that must be promulgated as rules, because that policy is generally 
applicable.  Here, the BFC subsidy application procedure, the required standard of proof, 
the type of evidence required, what behaviors qualify, how frequent and recent the 
behaviors must be, and whether professional treatment is required are all examples of 
eligibility requirements that are generally applicable to all children.   
 
The division also asserts that it "uses the [Child Welfare] Manual, for itself and 
parents, to implement the adoption subsidy program."  The manual sets forth a list of 
                                             
 
4 As section 453.073, RSMo 2000, states, the division decides the monetary amount of a 
subsidy to an adopted child with "reference to the needs of the child, including 
consideration of the physical and mental condition, and age of the child in each case ...."  
 
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characteristics a BFC program candidate may exhibit.  Child Welfare Manual, section 4, 
chapter 14, 5-7.  This list includes: (1) behaviors that, if not modified, could result in the 
youth being designated as a status offender; (2) a history of irresponsible or inappropriate 
sexual behavior that has resulted in the need for extraordinary supervision; (3) 
threatening, intimidating or destructive behavior that is demonstrated by multiple 
incidents over a period of time; (4) problems of defiance when dealing with authority 
figures; (5) significant problems with peer relations; (6) significant problems at school 
that affect academic achievement or social adjustment; (7) significant problems with 
lying, stealing or manipulating; (8) significant problems with temper control; (9) mild 
substance abuse-related problems; (10) oppositional behavior that contributes to 
placement disruptions and an inability to function productively with peers, parent figures 
and/or birth family; (11) any of the above behaviors, coupled with medical problems; or 
(12) any of the above behaviors displayed by one or more children of a sibling group, 
qualifying the entire sibling group for placement together, if appropriate.  Id.  The 
manual, however, has not been promulgated as a rule under the Missouri Administrative 
Procedure Act ("MAPA") rulemaking procedures.  Further, while the division claims that 
it uses the child welfare manual in deciding who qualifies for BFC subsidy, it denies that 
the child welfare manual contains the BFC subsidy eligibility requirements. 
 
"Any agency announcement of policy or interpretation of law that has future effect 
and acts on unnamed and unspecified facts is a 'rule.'"  Little Hills, 236 S.W.3d at 642 
(citing NME Hospitals, 850 S.W.2d at 74).  The criteria and methodology the division 
uses in determining a child's qualification for BFC subsidy under section 453.073 meets 
 
15
the definition of "rule" under section 536.010(6) as an "agency statement of general 
applicability that implements, interprets, or prescribes law or policy, or that describes the 
organization, procedure, or practice requirements of any agency."  As such, the division's 
eligibility requirements must be promulgated under rulemaking procedures,5 or else they 
are void.  Id. at 643.    
 
What is the effect of the division's failure to promulgate a rule on the division's 
determination that the Youngs were not entitled to the BFC subsidy?  Again, Little Hills 
is instructive.  In Little Hills, not only did the agency's failure to promulgate a rule void 
the agency's policy that should have been properly promulgated as a rule, but it also 
invalidated the agency's determination of the hospital's benefits that was based on the 
void rule.  Little Hills, 236 S.W. at 643-44.  Similarly, here, the division denied the 
Youngs' petitions for BFC subsidy based on standards and procedure that should have 
been promulgated as a rule; therefore, the division's denial is void. 
The Youngs further ask this Court to remand this case with directions to find that 
the Youngs are eligible for the BFC program.  In this regard, section 453.073, is not 
helpful.  It states that the monetary amount of a subsidy to an adopted child is determined 
with "reference to the needs of the child, including consideration of the physical and 
mental condition, and age of the child in each case …."  Id.  The correct monetary 
amount can be determined only after the necessary rules to make a BFC subsidy 
eligibility determination have been promulgated.  
                                             
 
5 "The purpose of the notice and comment procedures is to provide information to the 
agency through statements of those in support of or in opposition to the proposed rule."  
NME Hospitals, 850 S.W.2d at 74. 
 
16
 
This Court is cognizant that the Youngs first applied for the BFC subsidy five 
years ago and seek a long-awaited conclusion to this matter.  The division should proceed 
expeditiously with adoption of the necessary rules and a determination of the Youngs' 
application for the BFC subsidy.  If the division decides that the Youngs are entitled to 
the BFC subsidy, the subsidies should be awarded retroactively as allowed by law.  See 
J.P. v. Department of Social Services, 752 S.W.2d 847, 851 (Mo. App. 1988).  
 
The circuit court judgment affirming the division's decision to deny the Youngs' 
application for BFC subsidy is reversed, and the case is remanded.  The circuit court shall 
remand the matter to the division so that the division expeditiously can determine the 
Youngs' application.   
  
 
 
 
 
 
 
 
_________________________________  
 
 
 
 
 
 
 
  PATRICIA BRECKENRIDGE, JUDGE 
 
 
Stith, C.J., Price, Teitelman and 
Russell, JJ., and Hardwick and 
McGraw, Sp.JJ, concur.  Wolff  
and Fischer, JJ., not participating.