Mississippi Administrative Code › Title 18 - HUMAN SERVICES › Part 6 - Division of Family and Children's Services › Chapter 1 - DFCS Policy Manual › Section 18-6-1-D - Foster Care Policy › Section 18-6-1-D-XII - APPENDICES › Appendix 18-6-1-D-XII-B

Current through June 25, 2024
Contract for Foster
						Care
THIS AGREEMENT
is entered into this day,
						between (a) ________________________ and (a) ___________________ as parents or
						legal guardian of (b) ________________________, and the (c)
						____________________ County Department of Human Services.
WITNESSETH:
Because I/we, (d) ______________________, as parent of
						the above named child, are presently in need of a proper home situation and
						guidance of my/our child, we agree to enter into this agreement with the above
						named County Department of Human Services for voluntary foster placement with
						said County Department of Human Services exceed 180 days.
I.
(1) Parent agrees to place said child, into the temporary
						full care and custody of said County Department of Human Services for the
						purpose of placing said child into a foster home or other appropriate
						placement.
(2) That said County Department of Human Services has the
						immediate right to place said child in a suitable environment as deemed
						necessary and proper for the wellbeing of said child, including the
						authorization of medical and surgical procedures upon the advice of a licensed
						physician. Parents further release and discharge the Department of Human
						Services, its employees, agents and others acting on its behalf from any and
						all claims, demands, liability and damages of whatsoever nature, arising out of
						this foster placement.
(3) Parents agree to pay (e) _______________ dollars per
						(f) ________________ as support, to help cover the expense of this placement.
(4) Parents agree to cooperate with the said County
						Department of Human Services to develop a schedule of visits and contracts with
						said child working toward the return of said child within a specified time
						period, not to exceed 180 days.
II.
(1) The above named County Department of Human Services
						agrees to accept temporary full care and custody of said child, and place said
						child in a suitable environment.
(2) The above named County Department of Human Services
						agrees to pay a board payment to the people/person designated as the foster
						parent of said child, and to supervise the foster home in accordance with the
						approved standards of foster care as established by the State Department of
						Human Services.
(3) The above named County Department of Human Services
						agrees to cooperate with the natural parents in establishing a schedule of
						visits, and further to develop a plan, including the provision of available
						support services, leading towards the return of said child within a specified
						period not to exceed 180 days.
III.
Both parties acknowledge and expressly agree to the
						following:
1. This contract does not award full permanent care and
						custody of said minor, and this contract does not award full permanent care and
						custody of said minor, and this contract does not in any way amount to a
						release of said child for adoption, or act as a waiver of any parental rights,
						provided that said parties act in good faith to fulfill the intent of this
						agreement.
2. The failure of the parents to provide the monthly
						child support payments without proper cause and failure to cooperate with the
						above named County Department of Human Services for the return of said child,
						or the failure to maintain contact with said child either personally, by phone
						or by mail, shall constitute sufficient cause for said County Department of
						Human Services to seek court ordered custody on the grounds of neglect by
						abandonment and/or to begin the process of Termination of Parental Rights, and
						the placement of said child for adoption under the laws of the State of
						Mississippi.
3. It is further understood that parents are entitled and
						encouraged to maintain contact with their child and the Department of Human
						Services shall make every effort to arrange visits at the mutual convenience of
						the Department of Human Services and the parents, unless barred from doing so
						by Court Order, or upon the written advice and counsel of a qualified
						psychological source.
4. It is understood and agreed that said parents may
						regain the custody and control of said child, upon two weeks' notice in writing
						to the (g) __________________________ County Department of Human Services.
5. This Contract will expire 180 days from the date of
						its signing.
WITNESS OUR SIGNATURES:
_______________________________
						__________________________________
Father(signature or mark) Date Area Social Work
						Supervisor Date
_______________________________
						__________________________________
Mother (signature or mark) Date Witness Date
__________________________________
Witness Date