APPENDIX C
Effective
Revised July
2006
Foster Care Eligibility, Initial and Ongoing
Case Order and
Order of Documentation
The financial case file
shall contain a separate section for all forms and documentation related to the
determination of foster care, IV-E, eligibility. A Social Service Case Activity Log, YA-1010
or an EES Case Activity Log shall be maintained in the front of the eligibility
file or section which documents all eligibility, payment and financial activity
and the basis for any decision made regarding conflicting documentation.
All documentation must have
relevant information highlighted.
Forms
The CFS forms in the foster
care eligibility section are limited to the (1) CFS-4030 series. The CFS-4030 A and
B and CFS 4031 A and B or 4030 C, for each episode of custody, in
chronological order with the most recent on top should be first in the case
order. Attach on-going documentation with the CFS 4031 A and
B for each annual redetermination per episode of
care.
The episode of custody shall
be documented by use of the (2) CLPR screen. Upon completion of the initial basic
eligibility determination, the (3) FOCA screen shall be printed
indicating the SOURCE OF FUNDING coded AF or GA.
Initial Legal Documentation
(4) Initial legal documentation shall follow the CFS-4030
series of forms. The initial legal
documentation includes:
•
The petition or complaint which resulted in
out of home placement,
•
The initial order awarding custody to the state,
•
The initial court order removing the child
from the home which contains (a) judicial determination of remaining in the home
is contrary to the welfare of the child and (b) that reasonable efforts have
been made to prevent the removal of the child or an emergency exists which
prevents making reasonable efforts.
Removal
Information/Living with Specified Relative
(5)
Documentation of the removal home
must be provided which supports the removal home identified on the CFS-4030
A and B. Documentation sources
include:
•
SRS intake form CFS 1000 or
the petition/complaint,
•
Police protective custody order,
•
Court report, or
•
Other initial journal entry which
may identify the home from which the child was
removed.
Identification of the AFDC Group
(6) Documentation
of the household members at the time of removal include the Face Sheet, CFS
1000 or the KAECSES PRIP screen showing program involvement group
for the month of removal.
Age and School Status
(7) Document
with educational information from the case plan for children age 18 years and
less than 19 years.
Citizenship
(8) A copy
of the child’s Social Security Number or a copy of the SS-5, Application for
Social Security Card is required for all federally funded programs and supports
citizenship. A copy of the child’s birth
certificate, hospital record or KDHE Vital Statistics Information may also be
used to document citizenship.
Deprivation
(9) Documentation
which supports initial and ongoing deprivation is dependent on deprivation factors:
•
Unemployment/underemployment;
use BASI/BARI,
•
Termination of parental
rights; use the court order terminating parental rights,
•
Death; use court reports,
case plans or receipt of survivor’s benefits,
•
Disability; use receipt
of employment related disability benefits or Social Security disability
benefits such as SSDI or SSI,
•
Continued absence of one
parent from the removal home; use court reports, case plans, CFS 1000,
critical incident reports, case logs which identify the parents continued
absence from the home.
Documentation must
support each month of payment eligibility on an ongoing basis.
Income Standard; Initial and Ongoing
(10) Completion
of the income information on the CFS 4030 A and B shall
be documented using BASI and/or
On an ongoing basis only documentation of the child’s
income is required.
Documentation
for children over the age of 16 years, or children who are less than a full
time student is the completion of income information on the CFS 4031 A and B. If the income information is zero or not
available, print the BASI and/or BARI screens from KAECSES with the
appropriate income quarter highlighted. No documentation is required for
children under age 16 years or for the earned income of a full time student.
SSI Benefits
(11) Print
screens for all members of the AFDC group from the EATSS system for the removal
month for initial SSI benefit documentation.
On an ongoing basis, only the child recipient of SSI requires
documentation of all months of receipt of SSI using the EATSS
system. Note the relationship to the
child being removed on the screen.
Resources
(12) Completion
of the resource section of the CFS 4030 A and B and CFS
4031 A and B is sufficient documentation of resources. If the resource section is left blank or not available
use the KAECSES resource screens, VEHI, UNIN, OTAP, VIQM, LCDA, COLL and
LIRE, to document the resource or unearned income level.
Placements
Upon
receipt of a Notification of Change of Placement form, update the RESP screen
in FACTS and assure the CWCBS provider has updated the PROM screen. Temporary
license status periods are payment ineligible. Under the
license tab print screen Using CLARIS
print screen licensing information under the license tab.
No
less than every 12 months from the initial eligibility determination, at the
time of redetermination of eligibility, complete
placement history section of the CFS 4031 A and B. Print the FACTS face sheet as the
documentation of complete placement history.
Child support receipts need to be rechecked and documented at each
review. See Appendix B, Section E.
(13)
Print a FACTS face sheet as
supporting documentation and at case closure.
Permanency
Judicial Determination
(14) Documentation of permanency
judicial determination is the journal entry which supports the
determination.
SUMMARY
FORM
Continue
use of the summary form developed during the 100% review for any new EP RESP
segments during the current episode of care.
Identify eligibility start and end dates using the FACTS EP resp codes.
The
summary form may be used to communicate with Regional office FACTS data entry
staff.
The
summary form is stapled to the inside left side of the foster care eligibility
determination section.