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Foster Care and Adoption IV-E Policy

Foster Care and Adoption IV-E Policy

This policy is used to determine eligibility for IV-E foster care and adoption maintenance

payments and Medicaid assistance through the coordination of the Economic Assistance

and Social Services units. That collaboration ensures eligibility requirements are met,

monitored and maintained.

IV-E Foster Care

Table of Contents

Subject Index

Chapter 1 Purpose and Definition

Chapter 2 Application Process

Chapter 3 AFDC Eligibility Factors

Chapter 4 Removal From Home

Chapter 5 IV-Placement

Chapter 6 IV-E Facilities

Chapter 7 IV-E Court Orders

Chapter 8 IV-E Verifications

Chapter 9 Budgeting

Chapter 10 Reimbursement Standards

Chapter 11 Date of Entitlement

Chapter 12 Case Plans

Chapter 13 Case Management

Chapter 14 Notification

Chapter 15 Review of Eligibilty

Chapter 16 15 of 22 Rule

Chapter 17 Interstate Compact

Chapter 18 Administrative Payments

Chapter 19 Quality Assurance

DFS Form F-SS501A: Placement Application

Attachment 1: Citizenship and Immigration

Attachment 2: Verification Evidence

Attachment 3: Sample Court Orders

IV-E Subsidized Adoption

Title IV-E is intended for financial needs of the special needs child, including maintenance costs, 

medical treatment and costs incurred for the adoption, training, care, education and counseling of the child.

Table of Contents

Chapter 1 Purpose and Definition

Chapter 2 Application Process

Chapter 3 Verification

Chapter 4 Eligible Persons

Chapter 5 Eligibility Requirements

Chapter 6 Review of Eligibility

Chapter 7 Adoption Compliance Files

Chapter 8 ICAMA


Table I Foster Care Time Frames and Flow Chart

Table II Child Placement, Flow Chart

Table III Eligibility Chart

Table IV Initial Eligibility Flow Chart

Table V Medical Coverage Group Codes

Table VI AFDC Income Guidelines in Effect 7/1/96

Table VII - Facilities


Attachment 1 - Citizenship Eligiblity

Attachment 2 - Verification Evidence

Attachment 3 - Sample Court Order


Instructions for Forms

DFS 541 - Child Support Cover Letter

DFS 543 - Report to Child Support Enforcement (Absent Parent Form)

DFS 544 - Notice of Retained Child Support

DFS 545/546 FC - Child in Placement - Child Support Cooperation/Good Cause Claim

DFS 601 FC - Authorization to Release/Request Information

DFS 602 - Foster Care Periodic Review

DFS 603 - Foster Care Case Narrative

DFS 604 -  Economic Assistance Supervisory Review Form - IV-E Foster Care

DFS 607 - Subsidized Adoption Periodic Review - Caseworker

DFS 607A - Subsidized Adoption Periodic Review - Adoptive Parent

DFS 608 - Court Order Summary

DFS 609 -  IV-E File Face Sheet

DFS 610 - School Verification

F-SS14 -  Child Support Financial Affidavit

F-SS60A -  Foster Care Certificate

F-SS501A - Placement Application

F-SS611 -  Temporary Authorization for Medical Services for Children

F-SS615 - Deprivation Statement

F-SS616 -  Placement Information Checklist