Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 15 - Children and Family Services › Rule 016.15.12-008 - W-9 Requirements Removal; Subsidized Guardianship; Revisions to Section I; Internal Review and Appeals; Assement of Child Maltreatment Reports; Early Intervention and FASD

Current through Register Vol. 49, No. 6, June, 2024
PROCEDURE VIII-18: Payment for Non-recurring Adoption
				Expenses and Special Subsidy
The Adoption Specialist will:
A. Submit a billing packet to the Adoption
			 Subsidy Coordinator for non-recurring adoption *- -expenses
			 (non-recurringadoption expenses shall not exceed a total of $1,500.00) within
			 60 days after the finalization of the adoption.
B. For non-travel related expenses, the
			 packet will include the DHS»-1914, W-9roriginal invoice, a copy of the
			 CFS-428 and final adoption decree.
C. For travel related expenses the packet
			 will include the DHS-75, TR-1, receipts, a copy of the CFS-428 and the final
			 adoption decree.
}
D. For payment of a special subsidy, the
			 packafcwill include: PHS-1914, originaI invoice, copy of the CFS-428 and the
			 final adoptibh decree.
The Adoption Subsidy Coordinator will;
A. Review, code, and forward each completed
			 billingpacket within 10 working days and forward*-
-
to the
			 manager of the Adoption Services Unit for approval.
The Manager of the Adoption Services Unit will:
A. Forward the approved packet to
			 the office of finance for payment within 10 working days of
'"
			 -
receipt from the subsidy coordinator.
PROCEDURE VIII-18: Payment for Non-recurring Adoption
				Expenses and Special Subsidy
01/2013
The Adoption Specialist will:
A. Submit a billing packet to the Adoption
			 Subsidy Coordinator for non-recurring adoption expenses (non-recurring adoption
			 expenses shall not exceed a total of $1,500.00) within 60 days after the
			 finalization of the adoption.
B.
			 For non-travel related expenses, the packet will Include the DHS-1914, original
			 invoice, a copy of the CFS-428 and final adoption decree.
C. For travel related expenses the packet
			 will include the DHS-75, TR-1, receipts, a copy of the CFS-428 and the final
			 adoption decree.
D. For payment of
			 a special subsidy, the packet will include: DHS-1914, original invoice, copy of
			 the CFS-428 and the final adoption decree.
The Adoption Subsidy Coordinator will:
A. Review, code, and forward each completed
			 billing packet within 10 working days and forward to the manager of the
			 Adoption Services Unit for approval.
The Managerof the Adoption Services Unit will;
A. Forward the approved packet to
			 the office of finance for payment within 10 working days of receipt from the
			 subsidy coordinator.
APPEMPIX 4: FOSTER HOME RECORDS
01/2013
Special divided folders will be used for the case records of
				foster homes. When a foster home is approved, the foster home record should
				include the Items listed below. All documents should be filed in chronological
				order with the most current on top.
Front left:
* Approval or Denial Letter
* CFS-475-A: Initial Approval Checklist for Foster Home Record
* Verification of marriage and/or divorce, if applicable
* All Records Checks;
o Results of the CFS-316: Child Maltrieatment Central Registry
				Check fofeach applicable household member, all information received and, in
				case of a;repprt of violations, a summary of the fece-to-face discussion,
				determtnatibn[GREATER THAN]and;reasons for the determinations o Results of the
				APS-OOOIf Authorization for Adult Maltreatment Central Registry check for each
				applicable household member, all information received and, in case of a report
				of violations, a summary of the face-to-face discussion, deterniinatlon, and
				reasons for the determinations o CFS-341: Certification of Absence of Griminal
				Record, if children age of 10 thru 17 reside in the household o Results of the
				CFS-342i St&te Police Criminal Record Check for each applicable household
				member»allinfbrmatioriTeceivedand, incase of a report of violations,
				asummary of the face-to-face discussion/determination, and reasons for the
				determination a Resultftof the FBI Crimilial Background Check for each
				applicable household member, all informatiort received and, in case of a report
				of violations, a summary of the face-to-face discussion, determination, and
				reasons for the determinations o Results of ihe ASVSP check for each foster
				parent and applicable teenage driver
Copy of driver's license for each applicable driver
Documentation of current auto insurance * CFS-446: In-Home
				Consultation Visit Report
* CFS-363: Foster/Adoptive Applicant Smoking
				Certification
* CFS-404: General Medical Report
* Current immunization records for all children in the
				home
* Documentation of current rabies vaccinations for all
				household pets
* CFS-409: Foster/Adoptive Family Preference Checklist
* CFS-455: Request/Consent for Health Department Services, when
				appropriate
* CFS-480: Alternate Compliance of Water Supply Agreement, when
				appropriate
* CFS-484:
Landlord Notification of Potential
				Tenant Foster Care Services, when appropriate
* Written approval from Fire Department forapproved alternate
				escape route, when appropriate
* Current floor plan
* Documentation of homeowner's or renter's insurance and
				general liability insurance '
* Written approval from the owner of the home that the
				applicantsmay care for children in foster care, when appropriate
* Three completed, positive SAFE/eference letters
* SAFE Home Study Final Report and supporttngdocuments (e.g.
				SAFE Questionnaires I & II, Psychosocial Inventory), ,,
* Alternative compliance and/dr policy waiver approval, if
				applicable
* Current certifiiiation in CPR and Standard First Aid
* Summary with Recommendations
* CFS-462: initial Foster Home Agreement
* CFS-462-A; Foster Home Agreement Addendum on each child
				currently placed in the home
* CF5-474: Provisional Foster Home Orientation Checklist (for
				provisionals only)
* CFS-452: Provisional Foster Home Verification (for
				provisionals only) Front Right:
* Placement history *--W-9
Center Left:
* CFS-475-B: Quarterly Monitoring Checklist for Foster Home
* Any documentation gathered during the quarterly visit
Center Right:
* Letter of Notification of Disposition of Reevaluation or of
				Closure
* CFS-475-C: Reevaluation Checklist for Foster/Pre-Adoptive
				Home
* Any documentation gathered during the reevaluation visit
				(e.g. updated auto insurance, updated CPR
certificate, etc.)
* CFS-451: Foster Parent Reevaluation
* SAFE Update Report
* Documentation of 15 hours of continuing education
» Documentation of quarterly emergency evacuation
				drills
* CFS-475-G: Checklist for Foster Home Closure, when
				appropriate
* Reevaluation Summary or Closure Summary
Back
				Left:
* CFS-475-D: Transfer of a Foster Home to Another County, when
				appropriate
* CFS-475-E: Complaint Against Foster Family Other Than
				Maltreatment, when appropriate
* CFS-475-F:True Reports of Child Maltreatment Against Foster
				Family Members, when appropriate
Back Right:
* CF5-419: Foster Family Support System Information
Current results of all applicable background checks for FFSS
				members
I
APPENDIX 4: FOSTER HOME
				RECORDS
01/2013
Special divided folders will be used for the case records of
				foster homes. When a foster home is approved, the foster home record should
				include the items listed
be\ow.
All documents should be filed
				in chronological order with the most current on top.
Front left;
* Approval or Denial Letter
* CFS-47S-A: Initial Approval Checklist for Foster Home Record
* Verification of marriage and/or divorce, if applicable
* All Records Checks:
o Results of the CFS-316: Child Maltreatment Central Registry
				Check for each applicable household member, all Information received and;
				inxase of a report of violations, a summary of the fece-to-face discussion,
				determination, and reasons forthe determinations o Results of the APS-0l)01:
				Authorization for Adult Maltreatment Central Registry check for each applicable
				household hiember, all Information received and, in case of a report of
				violations, a summary of the face-to-ftce discussion, determination, and
				reasons for the determinations o CFS-341: Certification of Absence of Criminal
				Record* if children age of 10 thru 17 reside in the household ;
O; Results of the CFS-342: State Police Criminal Record Check
				for each applicable household member, all information received and, in case of
				a report of violations, a summary of the face-to-face discussion,
				determfnatiani;and reasons for the determination o Results of the FBI Criminal
				Background Check for each applicable household member, all informatipn received
				and, in case of a reportofviolatrons, a summary of the face-to-face discussion;
				determination, and reasons forthe determinations o Results of the ASVSP check
				for each foster parent and applicable teenage driver
Copy of driver's license for each applicable driver
Documentation of current auto insurance * CFS-446: In-Home
				Consultation Visit Report
* CFS-363: Foster/Adoptive Applicant Smoking
				Certification
* CFS-404: General Medical Report
* Current immunization records for all children in tlie
				home
* Documentation of current rabies vaccinations for all
				household pets
* CFS-409: Foster/Adoptive Family Preference Checklist
* CFS-4S5: Request/Consent for Health Department Services, when
				appropriate
* CFS-480; Alternate Compliance of Water Supply Agreement, when
				appropriate
* CFS-464:
Landlord Notification of Potential
				Tenant Foster Care Services, when appropriate
* Written approval from Fire Department forapproved alternate
				escape route, when appropriate
* Current floor plan
* Documentation of homeowner's or renter's insurance and
				general liability insurance
* Written approval from the owner of the home that the
				applicants may care for children in foster care, when appropriate
* Three completed, positive SAFE reference letters
* SAFE Home Study Final Report and supporting documents (e.g.
				SAFE Questionnaires I fill, Psychosocial Inventory)
* Alternative compliance and/or policy waiver approval, if
				applicable
* Current certification in CPR and Standard First Aid
* Summary with Recommendations
* CFS-462; Initial Foster Home Agreement
* CFS-462-A: Foster Home Agreement Addendum on each child
				currently placed in the home
* CFS-474: Provisional Foster Home Orientation Checklist (for
				provisionals only)
* CFS-452: Provisional Foster Home Verification (for
				provisionals only) Front Right;
* Placement history Center Left:
* CFS-475-B: Quarterly Monitoring Checklist for Foster Home
* Any documentation gathered during the quarterly visit
Center Right:
* Letter of Notification of Disposition of Reevaluation or of
				Closure
* CFS-475-C; Reevaluation Checklist for Foster/Pre-Adoptive
				Home
* Any documentation gathered during tiie reevaluation visit
				(e.g. updated auto insurance, updated CPR certificate, etc.)
* CFS-451: Foster Parent Reevaluation
* SAFE Update Report
* Documentation of 15 hours of continuing education
* Documentation of quarterly emergency evacuation drills
* CFS-475-G: Checiclist for Foster Home Closure, when
				appropriate
* Reevaluation Summary or Closure Summary
Back
				Left:
* CFS-475-D; Transfer of a Foster Home to Another County, when
				appropriate
* CFS-475-E:ComplaintAgainstFoster Family Other Than
				Maltreatment, when appropriate
* CFS-475-F;True Reports of Child Maltreatment Against Foster
				Family Members, when appropriate
Back Right:
* CFS-419: Foster Family Support System Information
* Current results of all applicable background checks for FFSS
				members
DCFS SUMMARY OF CHANGES FOR JULY 2012 PROMULGATION
SUMMARY OF DCFS REGUUR PROMULGATION
The purpose of this regular promulgation is to:
* Add a list of all components expected in the Subsidized
				Guardianship Referral Packet.
* Include process for completion of form CFS-435-D:
				Recommendation for FInalization of Guardianship.
* Clarify that annual subsidized guardianship review includes
				court-required annual progress report that is filed with the court by Office of
				Chief Counsel and outline role of DCFS and Office of Chief Counsel in filing
				court-required annual progress report as well as timeframes regarding annual
				report and review.
* Update for general formatting and organizational
				purposes.
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POLICY Vlll-L: SUBSIDIZED GUARDIANSHIP
01/2013
ANNUAL
PROGRESS REPORT and
REVIEW of SUBSIDIZED GUARDIANSHIP AGREEMENT
An
annual progress report and
review of the subsidized guardianship agreement are required annually in order
				for the subsidized guardianship and subsidized guardianship payments of any
				amount or payment rate to continue. The
proRress report
				and
review shall be conducted by the Division of Family Services
				(DCFS) Permanency Specialist or designee
while the Office of Chief
				Counsel shall file the annual progress report with the court. An accounting of
				the guardianship subsidy is not required
. Documentation of
				continued eligibility is required for the review. The subsidized guardianship
				payments granted at the time of review will reflect the child's current,
				documented level of need.
PROCEDURE Vlll-Ll: Initial Subsidized
				Guardianship Program Determination
01/2013
If
a goal of
guardianship with a
				relative has been determined to be in the child's best Interest, the FSW
				will:
A. Gather and review all
			 relevant documentation to determine the child's eligibility for the Subsidized
			 Guardianship Program.
B. Complete
			 CFS-435-A: Subsidized Guardianship Program Application and Checklist with the
			 child {If age appropriate), prospective relative guardians, and child's
			 biological parents (If appropriate) to make the initial determination that the
			 child and prospective relative guardians meet all subsidized guardianship
			 eligibility requirements.
C. Submit
			 the completed CFS-435-A to the FSW Supervisor for review and approval
and attach the following to complete the referral
			 packet:
1)
Case
			 history memorandum
2)
CFS-404: Medical Report
3)
CFS-446: In Home Consultation
			 Visit Report
4)
CFS-475-A: Initial Checklist for Foster/Adoptive Home
			 Assessment
5)
Final SAFE Home Study Report or Update, as
			 applicable
6)
Case Plan (updated to reflect guardianship goal and other required
			 program information; see Case Plan Requirements for Subsidized Guardianship in
			 policy section above)
7)
Court Orders (documenting
			 reasonable efforts ruling out reunification and
			 adoption)
8)
Court Reports (file marked)
9)
CHRIS Notes relevant to the
			 subsidized guardianship referral (e.g., visitations, staffing, home visits;
			 adoption specialist involvement and/or services)
10)
Notarized statement from
			 relative verifying discussion of all permanency options available and
			 understanding of those options as well as decision to elect guardianship and
			 apply for a subsidy
11)
Any other documentation that
			 would be important to the child's case (education records. DPS. SSI,S SA,
			 medical passport, child consent form, therapist or counseling
			 reports)