HomeMy WebLinkAbout20123428.tiff RESOLUTION
RE: APPROVE REVISIONS TO OPERATIONS MANUAL, SECTION 2.000, SOCIAL
SERVICES DIVISION POLICIES AND PROCEDURES
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS,the Board has been presented with revisions to Section 2.000, Social Services
Division Policies and Procedures, for the Department of Human Services Operations Manual, and
WHEREAS, after review, the Board deems it advisable to approve said revisions, a copy of
which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, ex-officio Board of Social Services, that the revisions to Section 2.000, Social
Services Division Policies and Procedures, for the Department of Human Services Operations
Manual, be, and hereby are, approved.
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 3rd day of December, A.D., 2012.
BOARD OF COUNTY COMMISSIONERS
�,,,, WELD COUNTY, COLORADO
ATTEST: 011Ar ' ""' &M 5J y C
Sean P. . ' Chair L
Weld County Clerk to the Board
u ���I ills-m F.Garcia, Pro-T-m
BY: 1 1 .'/
Deputy Clerr the Boar• l '
r• a Kirkmeyer
O Fe ,4, RI
APP' . r ? AST R ('
� 'Li �r� L, • C , C d\
David E. Long
•ounty Attorney -Iteitic gatG c(c,e-
Dougl s Radema er
DEC 1 7 2012
Date of signature:
CG, 14-w (Susar�
12- 7 )- 2012-3428
HR0083
1861 • MEMORANDUM
n
L
DATE: November 29, 2012
c ouNTY
G O_ TO: Sean P. Conway, Chair, Board of County Commi Toners ktl FROM: Judy A. Griego, Director, Human c e art1ent I
RE: Revisions to Section 2.000, Social'Services Division
Policies and Procedures, Weld County Department of
Social Services Operations Manual
Enclosed for Board approval are revisions to Section 2.000, Social Services Division Policies
and Procedures, Weld County Department of Social Services Operations Manual. These
revisions were reviewed under the Board's Pass-Around Memorandum dated November 15,
2012, and approved for placement on the Board's Agenda.
The changes are being made to Section 2.317, Relative Guardianship; and Section 2.331,
Relative Guardianship Assistance Program. The primary changes to these Policies are to
incorporate the recent changes to Volume 7 that went into effect September 7,2012.
The primary change at the State level was to expand who is eligible for this program.
Originally, the program was for a family member who was a relative within the fifth degree
of kinship. It has been expanded to include caretakers who have a family-like relationship
or an individual who had a prior significant relationship with the child.
Section Citation Title of Section
2.317 Relative Guardianship
2.331 Relative Guardianship Assistance Program
If you have questions, please give me a call at extension 6510.
Human Services Division Policies and Procedures
2.317 Relative Guardianship
2.317.1 Summary of Weld County Relative Guardianship Program
Revised 8/10
Revised 11/12
The Relative Guardianship Program (as set forth in CDHS Volume 7, Section
7.311) offers possible assistance to a relative guardian to aid in achieving
permanency for an eligible child or youth. The program is intended to remove
financial or other barriers for the relative guardian of a Colorado child or youth to
allow for the relative guardian to raise the child or youth by providing assistance.
The Weld County Relative Guardianship Program shall only be considered when
all other permanency options have been exhausted. All requests are approved on
a case by case basis, based upon compelling reasons related to permanency and in
the best interest of the child. All requests must be staffed and approved by the
Child Welfare Manage and the Division Director, prior to submission to the
Department Director, who must give the final approval for any subsidy offered
pursuant to this program. The relative guardianship assistance program elements
consist of the following:
A. Reunification and adoption efforts must have been exhausted and those
goals have been ruled out based on individualized needs.
B. The program is most appropriate for older youth who choose not to be
adopted and who want to maintain familial ties while living safely and
achieving permanency with a relative guardian.
C. The program shall not supplant diligent reunification or adoption efforts.
D. Youth who are twelve (12) years and older and who refuse adoption shall
receive ongoing counseling by a professional who is knowledgeable about
adoption and permanency issues.
E. All requirements of this section relate solely to the Relative Guardianship
Assistance Program and excludes any other type of guardianship.
2.317.2 Eligibility Requirements
Compliance with the eligibility requirements for the relative guardian(s) and the
child or youth must be documented in Trails in the child's biological case by the
assigned caseworker and are as follows:
A. The prospective relative guardian must be an adult who is a relative
through the fifth degree of kinship; is related to the youth or child through
marriage or adoption; is a person ascribed by the family as having a
family-like relationship; or is an individual that had a prior significant
relationship with the child or youth.
B. The youth or child's most recent removal occurred through a court order,
or a voluntary placement agreement, and the subsequent court order for
authority for placement that includes a judicial determination that
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Human Services Division Policies and Procedures
continuation in the home would be contrary to the welfare of the youth or
child.
C. The youth or child demonstrates a strong attachment to the relative.
D. Youth who are age twelve or older are consulted about their expressed
wishes to have a Relative Guardianship arrangement.
E. Reunification and adoption are not appropriate permanency goal options
for the youth or child.
F. The prospective relative guardian has a strong commitment to caring for
the youth or child permanently.
G. The prospective relative guardian was the certified kinship foster care
parent for the youth or child for a minimum of six consecutive months
while the youth or child resided in the home, excluding breaks in full
certification due to provisional or probationary certificates being issued, or
other adverse action being taken regarding the certificate.
H. The reason why permanent placement with a prospective relative guardian
and receipt of relative guardian assistance payment is in the best interest of
the youth or child.
2.317.3 County Responsibilities
The county department shall assess and demonstrate the appropriateness of the
youth or child for the Relative Guardianship Assistance Program. This
information will be documented in Trails in the child's biological case by the
assigned caseworker.
A. Efforts to discuss adoption with the relative family foster care parent as
the more permanent option for the youth or child and the reasons that the
prospective relative guardian is unwilling to adopt. The goal of the
discussion shall be to assure that the prospective guardian makes a fully
informed decision regarding the permanency options that are available.
The discussion shall include, but not be limited to, the following areas:
1. The legal differences between termination of parental rights for
adoption and the transfer of guardianship;
2. The relationship with the birth or custodial family; and,
3. Visitation.
B. The prospective relative guardian understands the significance of
permanency through guardianship and the importance in continuing to be
a permanent family after the youth or child exits the Relative
Guardianship Assistance Program.
C. Efforts to discuss the relative guardianship assistance arrangement with
the parents or legal custodians of the youth or child, and if it was not
discussed with the parents, provide the reasons why the efforts were not
made.
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Human Services Division Policies and Procedures
D. If relinquishment or termination of parental rights occurred for the youth
or child, how the requirements for Adoption in CDHS Volume 7 Section
7.306 are met to assure that concerted efforts to achieve adoption were
made and documented. When the goal of adoption is ruled out, the
requirements in CDHS Volume 7 Section 7.306.14 B, 2 (Colorado
Adoption Resource Registry) shall be met.
E. Obtain an updated Structured Analysis Family Evaluation (SAFE) home
study with an applicable update related to the Relative Guardianship. This
will be filed in the Relative Guardianship combined record after the
guardianship appointment is made.
2.317.4 Placement with Siblings
In addition to requirements in CDHS Section 7.301.24, the County shall
document in Trails in the child's biological case by the assigned caseworker.
A. The efforts to place siblings together in the relative kinship family foster
care home.
B. The ongoing efforts to facilitate placement together, and the efforts to
maintain frequent visitation and ongoing connections for siblings that live
apart.
2.317.41 Inclusion of Siblings in a Relative Guardianship Assistance Agreement
A. Sibling(s) of a youth or child who meet all other requirements identified in
CDHS Volume 7 Section 7.311.1 except the Title IV-E eligibility may be
included in the same Relative Guardianship Assistance agreement when
there is agreement by the sibling(s) of the youth or child, prospective
relative guardian, and the county department that the arrangement is in the
best interests of the sibling(s) of the youth or child. This may occur on or
at a later date than the youth or child who is Title IV-E eligible, and
B. Relative guardianship assistance payments may be made on behalf of each
sibling in the same relative guardianship assistance agreement.
2.317.5 For Chafee Foster Care Independence Living Program
The Chafee Foster Care Independence Program (CFCIP) set forth in CDHS
Volume 7, Section 7.305.4 and Weld County Policy ??, is a federally funded
statewide independent living program that is county administered.
For youth age 16 years or older, the opportunity to participate in the Chafee
Foster Care Independence Living Program must be offered to youth participating
in the Relative Guardianship Assistance Program. This offer and the youth's
response must be documented in Trails.
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Human Services Division Policies and Procedures
A referral to the Chafee Foster Care Independence Living Program consists of a
completed, signed copy of the Independent Living Plan located in Trails and the
Chafee Independent Living Referral Form.
The assigned worker in the biological case will complete the ILP in Trails and
refer the youth to Chafee Independent Living Services, if a child is 16 years or
older before the appointment of the relative guardian. If the youth refuses the
Chafee Independent Living Services, this will be documented in Trails Contacts.
The assigned worker in the Relative Guardianship Case will complete the ILP in
Trails and refer the youth to Chafee Independent Living Services, if a child turns
16 years old after the appointment of the relative guardian. If the youth refuses
the Chafee Independent Living Services, the ILP does not need to be completed
and the refusal will be documented in Trails Contacts.
2.318.6 Probate Court Appointment
A. Relative Foster Parents must apply for appointment as Relative Guardians
through Probate Court.
1. The Relative Guardianship Assistance may reimburse qualified
relative guardians for legal fees to assist with the guardianship, if they
choose to hire an attorney. See the information regarding non-
recurring fees.
7. The Weld County Department of Human Services must be listed as
an interested party on the JDF827, Order Appointing Guardian for
Minor.
8. The Probate Court requires yearly written progress reports on the
form JDF834, Guardian's Report. A copy of this report must be sent
to the Weld County Department of Human Services by the relative
guardian.
B. Eligibility Determination must be completed at least one month prior to
the Probate Court appointment.
C. The Application must be reviewed and the Agreement signed with
prospective relative guardian and all parties date, sign, and initial the
documents before the Probate Court appointment occurs.
2.318.7 Relative Guardianship Records
A. The assigned worker for the biological Trails case must close the Trails
case within 3 days of the appointment of the Relative Guardian being
appointed.
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Human Services Division Policies and Procedures
B. The Relative Guardianship case will be opened after the biological Trails
case is opened by Subsidy Worker
C. Information in the record shall be updated when changes occur or
additional information is available.
D. Upon termination of the Relative Guardianship Assistance agreement the
Case Record shall be closed.
E. While the Relative Guardianship Assistance Agreement is in effect, a
combined record for each youth or child and the relative guardian shall be
maintained.
1. A combined record shall contain documentation about each youth or
child and the relative guardian, which is relevant to the guardianship
assistance agreement including, but not limited to, application,
Structured Analysis Family Evaluation (SAFE) home study and
applicable update(s) related to the Relative Guardianship, medical
records, placement history, specific needs requiring purchase of
services, confirmation of second opinions of professionals outside of
the county department (licensed social worker, doctor, psychologist,
or mental health specialist); annual school reports, and other
applicable reports or evaluations.
2. The county department shall determine the eligibility of the youth or
child for relative guardianship assistance on the State Department's
prescribed form no later than one calendar month prior to the court
appointment of the relative guardianship.
3. The county department shall review the information on the State
Department's prescribed form with the relative guardian. All parties
shall date, sign, and initial the document before the court appoints the
relative guardian.
4. The county department shall enter the legal relative guardianship
information for each youth or child into the State Department's
automated system within thirty (30) calendar days following the date
that the court appoints the relative guardian.
5. The relative guardian shall be informed in writing of the right to a fair
hearing.
2.318.8 Provision of Services
Following the court appointment of the relative guardianship, the county
department shall provide services to the youth or child and the relative guardian
family as addressed in the guardianship assistance agreement to assure stability
and permanency. This does not preclude providing additional services based on
current or temporary circumstances including, but not limited to, core services.
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Human Services Division Policies and Procedures
2.331 Relative Guardianship Assistance Program
Revised 11/12
2.331.1 Relative Guardianship Assistance
The Relative Guardianship Assistance program is intended to help remove
barriers for a relative guardian so that permanency is achieved for eligible youth
or children. The program provides assistance to eligible relative guardians and
children or youth, in a defined and limited manner as set forth in Colorado
Department of Human Services, Volume VII, Section 7.311.
A. The Department may make relative guardianship assistance payments and/or
provide Medicaid or medical assistance following the appointment of the
relative guardian by the probate court and continue the assistance until the
youth has reached eighteen years of age.
B. The relative guardianship assistance agreement shall be negotiated with the
guardian in good faith and shall be based on the needs of the youth or child
and the relative guardian's circumstances. This may be less than the amount
for which the youth or child qualifies.
C. The Department shall not use an income means test to determine eligibility,
but may utilize financial information regarding, including the family's
assets, liabilities and insurance benefits in negotiating initial agreements and
any subsequent changes to the relative guardianship assistance.
D. The Department determines the amount and kind of assistance to be offered
based on the following:
1. The child's documented needs.
2. The relative guardian's circumstances.
3. Public community-based programs or services that the youth or child is
eligible for shall be accessed first to address the needs of the youth or
child before a Relative Guardianship Assistance Agreement is
negotiated.
E. Assistance payments and/or Medicaid or medical assistance may be
provided to the relative guardian to partially assist with the needs of the
youth or child. The relative guardian is not required to account for how the
money was spent. Tri-annual reviews will be conducted to determine if the
current type of assistance is appropriate.
F. The maximum Relative Guardianship Assistance payment to relatives shall
be the County Basic Maintenance rate, referenced in Section 2.321.1 Exhibit
C, and is based on the age of the child at the time the Relative Guardianship
Assistance agreement is signed.
Note: The monthly respite care payment that is provided under the foster
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Human Services Division Policies and Procedures
Note: The monthly respite care payment that is provided under the foster
care program is not a benefit under the assistance program. Once a
monetary Relative Guardianship Assistance rate is established, this rate is
not eligible for cost of living increases.
The Department may consider the additional needs of the child to
determine if the Special Needs Rate for the developmentally disabled and
physically disabled apply. (Referenced in Section 2.322)
G. In addition to the Relative Guardianship Assistance payment, the
Department may also provide Relative Guardianship Assistance Case
Services on behalf of the child. Please refer to Colorado Department of
Human Services, Volume VII, Section 7.311.71 for allowable Case
services. The Department shall consider the monetary value of these
services when negotiating the amount it will pay to relative guardians.
H. The guardian shall be required to add the Weld County Department of
Human Services as an Interested Person on the form JDF 827, Order
Appointing Guardian for Minor. This will require that all future court
filings be provided to the Department for case monitoring purposes.
2.331.2 Review of Eligibility for All Ongoing Relative Guardianship Assistance
Agreements (as established in 7.311.81)
A. The guardian shall submit to the Department yearly copies of the
completed form JDF 834, Guardian's Report—Minor, for case monitoring
purposes.
B. Relative Guardianship Assistance agreements shall be reviewed every
three years. The Department shall initiate a Relative Guardianship
Assistance review form sixty (60) days prior to the three-year anniversary
of the agreement. This review is to determine if the amount and/or kind of
assistance is still appropriate given the child's needs and the circumstances
of the guardian. The Department may renegotiate the current assistance at
the time of each review. Documentation of any change of circumstance
shall be required.
C. The guardian may request a review of the agreement prior to the three-
year review if changes in the needs of the child or family circumstances
occur.
D. School attendance shall be reviewed annually in order to assure that each
child or youth that is eligible for Relative Guardianship Assistance, who
have attained the minimum age for compulsory school are;
1. Enrolled (or in the process of enrolling) in elementary/secondary
education, or
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Human Services Division Policies and Procedures
2. Instructed in elementary or secondary education at home in
accordance with the home school statute, or
3. In an independent study elementary or secondary education
program in accordance with statute, and which is administered by
the local school, school district, or Board of Cooperative Education
(BOCES), or
4. Incapable of attending school on a hill-time basis due to the
medical condition of the youth or child. The reasons shall be supported
by regularly updated information in the educational plan maintained
by the school, school district, or BOCES.
2.331.3 Termination
A. Weld County DHS will terminate Relative Guardianship assistance
agreements when the:
1. Relative guardian requests that payments end; or,
2. Youth reaches eighteen(18); or
3. Department determines the relative guardian is no longer legally
responsible for the support of the youth or child; or,
4. Youth or child is no longer receiving any support from the relative
guardian; or,
5. Department verifies the child's death or marriage of a youth or child.
Please refer to the Colorado Department of Human Services Volume VII, Section
7.311 on termination procedures for Relative Guardianship payments, Case
services and Medicaid assistance agreements.
2.331.4 Right to appeal
If the Department denies an application for relative guardianship assistance,
or reduces or terminates the assistance payment, the applicant or recipient
has the right to appeal using the procedures outlined in Section 3.850 (9 CCR
2503-1) and 7.311.92. When a family who has been denied Title IV-E relative
guardianship assistance requests a state level fair hearing, it is the responsibility
of the Administrative Law Judge to determine whether the applicant or recipient
was wrongly denied eligibility or whether the amount of the relative guardianship
assistance agreement was determined correction (see Section 7.306.41, E).
2.331.5 Relative Guardianship Assistance Negotiations
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Human Services Division Policies and Procedures
2.331.6 Initial Guardianship Assistance Negotiations
A. The Caseworker for the child shall inform the County Negotiator when a
case is ready for Relative Guardianship Assistance negotiations. The
Caseworker for the child shall advise the County Negotiator of the his/her
assessment of whether the child will qualify for the assistance and the
reasons for that belief. All negotiations will occur with the County
Negotiator rather than the Caseworker.
B. The County Negotiator shall promptly mail a letter to the prospective
relative guardian. The letter will include:
1. Statements advising the following: Relative guardianship
assistance is available under certain circumstances; the assistance
must be agreed to by all parties prior to the court appointing the
relative guardianship; and the Director of Human Services has the
final approval regarding the amount and kind of assistance.
2. The procedure and deadline for initiating relative guardianship
assistance negotiations with the County Negotiator. Failure to
respond and schedule a meeting or phone conference by the stated
deadline will result in the case being put on hold. Cases in which
there are meetings scheduled will take priority over cases that are
on hold. If a case is put on hold, the County Negotiator will
provide the Caseworker with a letter to be attached to any court
letter so that the court will know the reason for the delay in
initiating the Relative Guardianship Assistance.
3. A form which the relative may sign before a notary indicating that
they are declining any assistance.
4. An Assessment Worksheet for the relative to complete and bring to
the negotiations. This worksheet will outline the needs of the child
that might pose a barrier for the permanency of the youth or child.
5. An advisement that there must be written documentation from a
professional regarding any concerns or issues with the child or
children and that this documentation must be submitted to the
negotiator at the time of negotiations. This documentation may
take the form of letters from doctors, therapists, or other
professionals. The letter will also advise that any negotiations will
be postponed until this documentation is available.
6. An advisement that the relative may be represented by an attorney
at the meeting at their own cost if they so desire.
C. The County Negotiator will meet with the relative(s) at the scheduled
time. The County Negotiator will do the following:
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Human Services Division Policies and Procedures
1. Review the Weld County Guardianship Assistance Information
form (WC-GA-1) with the relative(s).
2. Inform relative(s) of the general maximum monthly assistance and
services available if a child qualifies.
3. Go over the Assessment Worksheet (WC-GA-3) with the
relative(s). Unless the form is filled out completely and/or all
professional documentation is provided, the meeting may be
stopped and rescheduled by the County Negotiator until that
material is provided by the relative(s).
4. The County Negotiator will match the needs identified for the child
or children according to Rule 2.331 of the Weld County
Department of Human Services Manual and Volume VII of the
Colorado Department of Human Services and will determine the
type and/or amount of assistance which the Department will offer.
Depending on the complexity of the issues, this determination
may occur at the meeting or in writing after the meeting. In either
case, the County Negotiator will offer or mail a Relative
Guardianship Assistance Acknowledgment form (WC-GA-2)
outlining the offer. Note that this offer is not binding on the
Department until it is approved by the Director of Human Services.
D. If there is an agreement, the relative(s) will indicate this on the
Guardianship Assistance Acknowledgment form by circling "agreed",
signing and returning the form to the County Negotiator. The signed
Guardianship Assistance Acknowledgment form will be placed in the file
as documentation. The County Negotiator will prepare the State
prescribed forms based on the agreement and submit these to the
relative(s) for their signature.
E. If no agreement is reached, the County Negotiator will present his/her
recommendations to the Service Utilization Unit Supervisor. The Service
Utilization Supervisor will consult with the Human Services Administrator
to determine whether negotiations will continue. This decision will be
made within 14 days of the date the County Negotiator refers the matter to
the Service Utilization Unit Supervisor. The relative(s) shall be notified
in writing from the Service Utilization Unit Supervisor whether
negotiations will continue.
F. When the determination is made that no further negotiations will take
place, the relative(s) shall be advised of the Department's final offer in a
letter from the Director of Human Services. The Guardianship Assistance
Acknowledgment form reflecting the final offer will be mailed with the
advisement letter along with the notice of their appeal rights and the
process for appeal to an administrative law judge (AU ) at the Colorado
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Department of Human Services. If the acknowledgment form is received
back signed and the relative(s) are in agreement, the County Negotiator
will proceed forward as outlined in Step D.
G. If, at any time, the relative(s) request the presence of an attorney at
negotiations, the County Negotiator may request that an Assistant County
Attorney be present.
H. Relative Guardianship Assistance applications and renewal forms are not
considered final until signed by the Weld County Director of Human
Services.
2.331.7 Relative Guardianship Assistance Renewal Negotiations
A. The County Negotiator shall review all guardianship cases every three
years. The relative guardian may be asked to submit documentation of the
youth or child's current needs. Documentation shall consist of reports or
evaluations by independent professionals.
B. All Title IV-E Relative Guardianship Assistance cases will be reviewed
annually for Medicaid eligibility as outlined in the Colorado Department
of Human Services Volume VII.
C. If the County Negotiator determines that there may be a change in
circumstance, procedures will be followed as set out in the initial subsidy
negotiations to determine the amount of assistance. Documentation shall
consist of reports or evaluations by independent professionals.
D. Relative Guardianship Assistance applications and renewal forms are not
considered final until signed by the Weld County Director of Human
Services.
E. Appeal procedures are as outlined in the initial Relative Guardianship
Assistance negotiations, Section 2.331.6.
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Social Services Division Policies and Procedures
DEPARTMENT OF HUMAN SERVICES
PO BOX A
GREELEY, CO 80632
WEBSITE: www.co.weld.co.us
Administration and Public Assistance (970) 352-1551
Child Support (970) 352-6933
•
COLORADO
WC-GA-1
WELD COUNTY RELATIVE GUARDIANSHIP INFORMATION
This document is intended to answer"Frequently Asked Questions"about the relative guardianship
assistance program. It is not intended to be a substitute for legal advice. If you have specific questions about
an issue,the caseworker or county negotiator may be able to explain further but it is recommended that you
seek legal advice from your own attorney if questions remain.
Colorado operates two relative guardianship assistance programs:
1. Title IV-E program - The federal government participates in the relative
guardianship assistance agreement on behalf of youth or children who meet the
eligibility criteria for the Title IV-E relative guardianship assistance program.
2. State and County-only (non-IV-E)program - The state and county participates in
the guardianship assistance agreement on behalf of youth or children who are not
eligible for the Title IV-E program.
A youth or child can only be eligible for one type of assistance program. If a youth or child is
eligible for a relative guardianship assistance, the state (through the county department) is
required to enter into an assistance agreement with the relative guardian as outlined in The
Fostering Connections to Success and Achieving Adoptions Act of 2008 (Public Law 110-351).
All parties must sign this agreement before relative guardianship is appointed by the court. The
relative guardian can waive the assistance but they must do so in writing. If an agreement cannot
be reached (including whether the child is IV-E eligible), the agency determines the amount of
assistance and the relative(s) are entitled to a"fair hearing" in front of an administrative law
judge if they continue to dispute the amount. There are time limits and other requirements for
that appeal and relative(s) should consult with an attorney if they have questions.
Relative Guardianship assistance is a program that provides assistance to relative(s) in certain
defined and limited ways so that permanency is achieved for an eligible youth or child. Relative
guardianship assistance is intended to help or remove financial or other barriers for a relative
guardian of a Colorado youth or child by providing assistance to the relative guardian to care for
and raise the youth or child
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Social Services Division Policies and Procedures
Eligibility Requirements
Eligibility requirements for the prospective relative guardian and youth and/or child must be
documented in the Family Services Plan in the State automated system and are as follows:
1) For the purpose of the Relative Guardianship Assistance Program, a relative is
defined as :
a. An adult who is related to the youth or child in the fifth (5th) degree of
kinship;
b. Related to the youth or child through marriage or adoption;
c. A person ascribed by the family as having a family-like relationship; or,
d. An individual that had a prior significant relationship with the youth or child.
2) The most recent removal occurred through a court order, or a voluntary placement
agreement.
3) The prospective relative guardian was the certified kinship family foster care parent
for the youth or child for a minimum of six (6) consecutive months while the youth or
child resided in the home, excluding breaks in full certification due to provisional or
probationary certificates being issued, or other adverse action taken regarding the
certificate; and,
4) Reunification and adoption are not appropriate permanency goal options for the youth
or child; and,
5) The youth or child demonstrates a strong attachment to the relative; and,
6) Youth who are age twelve (12) or older are consulted about their expressed wishes to
be placed in a relative guardianship (refer to Colorado Department of Human
Services, Volume VII, Section 7.311.2, A); and,
7) The prospective relative guardian has a strong commitment to caring for the youth or
child permanently; and,
8) The reason why permanent placement with a prospective relative guardian and receipt
of a Relative Guardian Assistance payment is in the best interests of the youth or
child.
Weld County DHS determines the amount and kind of assistance based on the following:
1) The documented needs of the youth or child at the time of the relative placement.
2) The circumstances of the relative guardian.
3) Public community-based programs or services that the youth or child is eligible for
shall be accessed first to address the needs of the youth or child before a Relative
Guardianship Assistance Agreement is negotiated.
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Social Services Division Policies and Procedures
The Department shall utilize financial information regarding the family including assets,
liabilities and insurance benefits in negotiating initial agreements and any subsequent
increases in relative guardianship assistance.
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Social Services Division Policies and Procedures
Relative Guardianship Assistance Service Available
Medicaid
1) Title IV-E Assistance Agreements
a. Youth or children who are eligible to receive a Title IV-E relative
guardianship assistance payment are categorically eligible for Medicaid. A
relative guardianship payment of at least ten dollars ($10.00) is required to
extend Medicaid coverage.
b. Medicaid eligibility shall be continued for IV-E eligible children who are
out of the home for more than 30 calendar days unless it is determined that
they are eligible for Medicaid under another program by completing the State
Department's prescribed from.
c. Medicaid eligibility for all youth or children receiving a Title IV-E Relative
Guardianship Assistance shall be re-determined annually only if the child
continues to be eligible for Medicaid. This can be done by completing the State
prescribed form or completing a form letter that the child(ren) continues to be
eligible for Medicaid. This form letter shall be sent to other states by the
county department to ensure continuation of Medicaid for a child who is
residing out of state.
2) State-County (Non-Title IV-E) Assistance Agreements
a. Youth and children who are eligible for a relative guardianship assistance
agreement, but are not Title IV-E may be eligible for Medicaid through other
categories of assistance; and/or, Temporary Assistance for Needy Families
(TANF). These programs may require an application for enrollment and are
subject to approval based on eligibility guidelines as set forth for each
program.
b. Medicaid eligibility shall be redetermined annually only when the youth or
child continues to be eligible for Medicaid. This shall be completed on the
State Department's prescribed form.
Non-recurring Relative Guardianship Expenses
1) The relative guardian shall be reimbursed total costs of non-recurring expenses
associated with obtaining relative guardianship, not to exceed $2,000 per youth or
child. Non-recurring expenses are used in order to facilitate achievement of the
guardianship for:
a. Legal fees.
b. Fees for relative guardianship, or
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c. Other expenses related to the relative guardianship of the youth or child,
such as cost of the SAFE home study and a SAFE update related to the
prospective relative guardianship completed by the Department.
2) The county department shall decide if a youth or child who is in a Relative
Guardianship Assistance agreement and for whom reimbursement is being
requested meets the criteria.
3) Documentation for non-recurring relative guardianship expenses:
a. The county department shall use the State Department's prescribed form
prior to the court appointing the relative guardianship.
b. The prospective relative guardian shall provide evidence of the needs of the
youth or child.
c. Provide evidence that the family has a Structured Analysis Family
Evaluation (SAFE) kinship family foster care home study and a SAFE update
related to the prospective relative guardianship.
d. Provide an itemized statement of the expenses to be reimbursed within (1)
one year from date of the probate court appointment of the relative
guardianship.
Relative Guardianship Assistance- The county department may authorize the
following types of relative guardianship assistance agreements:
1) Long-Term Relative Guardianship Assistance Agreement - To partially meet
the daily needs of a youth or child indefinitely. A long-term agreement is made
when the relative guardian's financial situation is a barrier to achievement of
relative guardianship and where it is unlikely to change. It may also occur when
the needs of the youth or child creates an excessive hardship on the relative
guardian's financial and emotional resources. This type of monthly payment may
continue until the circumstances change for the youth, child, or the relative
guardian, or the agreement terminates as outlined in the Relative Guardianship
Assistance Agreement.
2) Time-Limited Relative Guardianship Assistance Agreement - To partially
meet the daily needs of the youth or child for a specified period. Funds may be
used for start-up costs for items that the youth or child placed in relative
guardianship may not have, such as sufficient clothing. The agreement partially
covers unmet needs that are time-limited and non-renewable.
3) "Core" Relative Guardianship Assistance Agreement(Title IV-E only) -
means there is a minimum monthly assistance payment of at least ten dollars
($10.00) and Medicaid provided. The Department shall document any specific
needs that may occur in the future for the youth or child in the services records
and in the State Department's automated system. The agreement identifies a
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potential need for increased financial relative guardianship assistance that may be
activated at a future time.
4) "Dormant" Relative Guardianship Assistance Agreement (Non-Title IV-E
only) - means there is no adoption assistance payment provided. The Department
shall document any specific needs that may occur in the future for the youth or
child in the services record and in the State automated system. The agreement
identifies a potential need for financial relative guardianship assistance that may
be activated at a future time. Medicaid benefits may be accessed (Refer to the
Medicaid section of this form).
Medical Payments
1) Medical payments in Relative Guardianship Assistance agreements may be used
to supplement any other available resource such as a relative guardian's private
insurance that pays part but not all of the treatment (physical, mental, and
emotional) for the youth or child.
a. Payments are made directly to relative guardians for a service already received
or to a vendor for the treatment of physical, developmental disabilities, or an
emotional disturbance.
b. Shall relate directly to the barrier or barriers identified at the time the initial
agreement is approved.
2) The payments are not available for treatment of any physical, developmental
disability, or emotional disturbance diagnosed after the court appointment of the
relative guardianship.
3) The payments may only be used for Medicaid cases if the service requested is a
service that is not covered under the state Medicaid plan and relates to a need
identified at the time the youth or child is placed in relative guardianship.
4) The payments for medical services shall reflect the reasonable costs of those
services in the community where the youth or child resides
Reimbursable and Non-Reimbursable Relative Guardianship Assistance
Case Services
Case services are a type of purchased program services that support a case plan for youth
and children in Relative Guardianship Assistance.
Case services are provided to meet the special needs of a youth or child that were
identified when the youth or child is placed into a relative guardianship and which are not
covered by the Relative Guardianship Assistance or Medicaid assistance agreements.
The following are examples of reimbursable and non-reimbursable expenses
allowed under Case services:
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1) Medical
a. Orthodontia
1. Cosmetic Reasons - not reimbursable.
2. Special Needs directly related to the reason for which the youth or child
was classified as special needs, e.g. cleft palate or injury related to an
abuse will be reimbursable.
b. Eye Glasses
1. Eye glasses are not reimbursable using case services dollars as
Medicaid pays for one (1) pair of glasses per year.
2. Payment for additional eye glasses in a year or contacts related to the
child's special needs identified at the time of the initial Relative
Guardianship Assistance agreement are reimbursable.
c. Medication
1. Routine that is not related to the child's special needs - not
reimbursable.
2. If related to the special needs of a youth or child - reimbursable. The
medication must be prescribed by a licensed physician and related to
the special need identified at the time the youth or child was approved
for Relative Guardianship Assistance.
d. Special Therapies - Speech, Occupational, and Physical
1. If not available through other community and family resources -
reimbursable. Youth and school-age children should receive these
services through the education system.
2. When these services are available in hospitals and clinics - not
reimbursable as Medicaid covers these costs.
e. Special Equipment
1. Special medical needs/equipment, as prescribed by a physician may be
reimbursable. For a youth or child who is severely physically
challenged; special exceptions should not exceed $2,000 without a
supervisor's written authorization.
2) Psychological Services
a. Time-limited out-patient therapy for youth or child living in state that do not
accept Medicaid for this service - reimbursable, if related to the child's special
needs of the youth and child and a written plan is obtained from the service
provider which contains:
1. Diagnosis.
2. Prognosis.
3. Length of service.
4. Individuals who will be seen in therapy.
5. A cap on the amount of money to be spent for the psychological exam
or therapy.
6. Frequency of contact (i.e., once a week, twice a month, etc.).
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7. Type of therapy being provided (i.e. individual, group, family, etc.).
b. If time-limited out-patient therapy is available using Medicaid - not
reimbursable.
c. Day Treatment - not reimbursable as Medicaid provides for this service.
d. Residential Child Care Facility - not reimbursable as Medicaid provides for
this service.
e. In Patient Psychiatric Hospitalization - not reimbursable as Medicaid provides
for this service. (Children who are Medicaid eligible may receive some in-
patient psychiatric services under the Medicaid Program.)
3) Education Costs
a. Tutoring - not reimbursable. Education systems are required to provide all
youth and children with special needs a free appropriate public education.
b. School Tuition - not reimbursable. There will be no reimbursement for tuition
expenses through the Relative Guardianship Assistance Program. If the relative
guardian chooses for the youth or child to remain in a current private school
placement, this is an expense for which the relative guardian is responsible.
4) Respite and Day Care
a. Respite Care- reimbursable.
b. Day Care - not reimbursable
5) Other Relative Guardianship Assistance Case Services
Relative Guardianship Assistance case services for youth and children who are
Title IV-E or non-Title IV-E may be provided for a specified time to provide
needed services. It is required that these time-limited services/funds are clearly
provided on a case-by-case basis. This requirement must be clearly documented in
the agreement.
Termination of Relative Guardianship Assistance agreements
The county department shall terminate Relative Guardianship Assistance agreements
when the:
1) Relative guardian requests that payments end; or,
2) Child reaches age eighteen (18); or,
3) The Department determines the relative guardian is no longer legally responsible for
the support of the youth or child; or,
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4) Youth or child is no longer receiving any support from the relative guardian; or,
5) County of responsibility verifies the death or marriage or a youth or child.
Review of eligibility for all Relative Guardianship Assistance agreements
1) The County shall initiate the written notice of the review for Relative Guardianship
Assistance sixty (60) days prior to the three (3) year anniversary of the agreement.
2) The relative guardian may request a review of the agreement prior to the three-year
review if changes in the needs of the child or family circumstances occur.
3) Any changes in the needs of the youth or child shall relate to the original barrier(s),
identified at the time the decision was made that Relative Guardianship Assistance
was needed. The county department shall not include additional needs for Relative
Guardianship Assistance payments after the court appointment of the relative
guardianship unless genetic in nature.
Review of school attendance
1) The County shall initiate a annual written request for verification of school attendance
from the guardian(s) to assure that each child or youth that is eligible for Relative
Guardianship Assistance, who have attained the minimum age for compulsory school
are;
a. Enrolled (or in the process of enrolling) in elementary/secondary education, or
b. Instructed in elementary or secondary education at home in accordance with
the home school statute, or
c. In an independent study elementary or secondary education program in
accordance with statute, and which is administered by the local school, school
district, or Board of Cooperative Education (BOCES), or
d. Incapable of attending school on a full-time basis due to the medical condition
of the youth or child. The reasons shall be supported by regularly updated
information in the educational plan maintained by the school, school district, or
BOCES.
Right to appeal
1) When the county department denies an application for Relative Guardianship
Assistance, or reduces or terminates the assistance payment, the applicant or recipient
has the right to appeal. Using procedures outlined in Section 3.850 (9 CCR 2503-1).
2) When a family who has been denied Title IV-E Relative Guardianship Assistance
requests a state level fair hearing, it is the responsibility of the Administrative Law
Judge to determine whether the applicant or recipient was wrongly denied eligibility
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or whether the amount of the Relative Guardianship Assistance agreement was
determined correctly (see Section 7.306.41, E).
3) The relative guardian has the burden of proving extenuating circumstances and
Relative Guardianship Assistance eligibility at a state level fair hearing. The state
and/or its designee can provide factual information to assist the family in establishing
eligibility for Title IV-E Relative Guardianship Assistance.
4) When either State or Federal law requires or results in a reduction or deletion of
services, a hearing shall not be granted.
Additional Program Eligibility
Youth ages 16 to 21 who have a Relative Guardianship Assistance agreement and who
met such requirements prior to their 18th birthday, may be eligible for the Chafee Foster
Care Independence Program.
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The offer contained on this acknowledgment is not considered final until the CWSA-1,2 &3 are approved
Weld County Department of Human Services
Relative Guardianship Assistance Information Acknowledgment
WC-GA-2(Revised 11/12)
Identified below are the proposed Relative Guardianship Assistance benefits for your child.
Please review each of the possible benefit categories being offered. At the bottom of this
form you will need to CHECK Agree or Disagree, sign and date before returning the form
to the county Relative Guardianship Assistance Negotiator. If you do not agree with the
following proposal you will need to attach a letter documenting the exact benefits you are
requesting, including a specific dollar amount if applicable, how the requested benefits will
be used to address your child's special needs, and any other relevant information that will
need to be taken into consideration for negotiations.
Also included is a short summary explaining how the Relative Guardianship Assistance
proposal was determined when taking into consideration your child's specific special needs,
your family's circumstances, and the additional resources and services available to meet
your child's needs. Please be advised that per Human Services Division Policies and
Procedures 2.331.6 (C)(4) this initial proposal is not binding and is subject to final approval
by the Director of Human Services. Once an agreement has been reached, the formal state
Relative Guardianship Assistance forms will be generated and processed for all required
signatures and approval.
1. Relative Guardianship Expenses - ® Eligible ❑ Ineligible
Non-Recurring Relative Guardianship Expenses (applicable for initial agreement only).
There is a $2,000.00 ceiling for non-recurring Relative Guardianship expenses for legal
fees.
2. Medicaid - ® Eligible ❑ Ineligible
Program Type: n Title IV-E Assistance n State/County Assistance
3. Maintenance -
Program Type: n Title IV-E Assistance n State/County Assistance
Maintenance Type: (Select one)
A. n "Dormant" (Non-Title IV-E only)
Medicaid only Relative Guardianship Assistance means, no Relative
Guardianship assistance payment is provided at this time; however, due to
the previously described special needs, there exists the potential need for
services. If this is a Medicaid only Relative Guardianship agreement, it
will be reviewed as the child ages or the family circumstances change.
B. Fl "CORE" (Title IV-E only)
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A minimum monthly payment of at least ten dollars ($10.00) and
Medicaid provided. The Department shall document any specific needs
that may occur in the future for the youth or child in the services records
and in the State Department's automated system. The agreement identifies
a potential need for increased financial relative guardianship assistance
that may be activated at a future time.
C. ❑ Time-Limited—Duration/Stipulations: *Monthly Rate $
D. ❑ Long-Term (ongoing) *Monthly Rate $
Total Daily Rate: $
*Assistance payments are paid based on a daily rate; monthly rates shown
are approximate amounts only and may vary from month to month.
4. Relative Guardianship Case Services
❑ Not applicable at this time n One-Time n Ongoing
(Description):
5. Other(Description):
Description of the barriers to Relative Guardianship:
Justification for the proposed Relative Guardianship assistance:
Non-Recurring Relative Guardianship Expenses -
Medicaid -
Relative Guardianship Case Services -
$ Maintenance -
**Please note, that if a monthly maintenance or change in service is needed in the future, a
request can be made to the Department as the need arises. Written requests must be directly
related to the special needs identified in the original Relative Guardianship Assistance
Agreement that all parties signed prior to appointment and will be subject to funds available.
I/We do hereby acknowledge receipt of the information pertaining to the Relative
Guardianship Assistance Program and have discussed a Relative Guardianship Assistance with
the county negotiator.
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I/We do hereby, AGREE ❑ DISAGREE ❑, on the above proposed Relative
Guardianship Assistance benefits, relative to the appointment of guardianship of
Guardian Signature Date Guardian Signature Date
County Negotiator Signature Date
The offer contained on this acknowledgment is not considered final until the
CWS-RGA 1 or 4 and CWS-RGA 2 or 5 are approved and signed by the Weld
County Director of Human Services.
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ASSESSMENT WORKSHEET
FOR RELATIVE GUARDIANSHIP ASSISTANCE
WC-GA-3
1. BEHAVIOR MANAGEMENT - Does the child have emotional impairment and/or
behaviors which require special or extensive involvement by the relative(s) in scheduling
and monitoring of time and/or activities and/or crisis management? If yes,
please explain.
2. THERAPY/COUNSELING - Does the child attend therapy/counseling
sessions? If yes, what is the reason and how often does the child go?
3. EDUCATION - Does the child have any special educational requirements? If
yes, please explain.
4. PHYSICAL OR MEDICAL IMPAIRMENTS - Does the child have any physical or
medical impairments requiring daily medically prescribed therapy or procedures (i.e.
daily medication, etc.) If yes, please explain.
5. OTHER NEEDS TO CONSIDER - Does the child have any other needs that should be
considered for a Relative Guardianship assistance? If yes, please explain.
*** Please include professional documentation on questions answered "Yes". (i.e. letters
from doctors, therapist, etc.)
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Relative Guardianship Resource Questionnaire
WC-GA-4(Revised 11/12)
Child(ren)'s name: Date:
*** Please complete the following questions and attach a copy of your most
recent tax return. This information is required by the Federal and State rules
governing the Relative Guardianship Assistance Program.***
1) What is your family's gross monthly income? (Do not include foster or subsidy payments)
2)Number of persons supported by that income:
3) Total of persons in home:
4) List additional financial sources and amounts available to members of the household (i.e.
foster care, guardian assistance, child support, social security, rental property, etc.):
5) Does anyone in your family have unusual costs, such as medical or educational?
Yes No If yes, please explain:
6) What financial resources, other than your income, are available to meet the child's needs?
(Indicate amount by appropriate category)
$ SSD (disability of parent) include a copy of letter from Social Security
Admin.(SSA)
$ SSA (survivor's/death of birth parent) include copy of the letter from SSA.
$ SSI (child's disability) include a copy of the letter from SSA.
$ Child Support (being received by adoptive family)
$ Other(Specify)
7) Will the child become eligible for additional benefits once guardianship is obtained by you?
(Indicate kind of benefits and amounts)
8) In thinking about the needs of this child and the resources (financial, extended family,
community services, school resources, etc.) available to your family, what will be required in
addition to those resources to continue support of this child in your household? Attach
additional page if needed.
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9) Will the youth/child(ren) be added to your medical insurance policy? Yes No
(If yes, complete the following):
Effective Date of Child' Coverage:
Name of the Insurance Company:
Address (street, city, state, zip):
Name of Policy Holder:
Social Security Number:
Group/Plan#:
Policy ID#:
10) Are you capable of providing for and meeting your child's SPECIAL NEEDS without the
Relative Guardianship Assistance Program? Yes No
Optional Comments:
11) Do you feel finances are a barrier to your ability to meet the SPECIAL NEEDS of your
child? (Not including BASIC needs or expected parental responsibilities, such as food,
shelter, clothing, child care, extracurricular activities, education expenses, etc.) Yes
No
Optional Comments:
12) If a monetary payment is being requested please indicate the exact amount, the reason for
the request, and details of how the money will be spent. You will also need to provide
supporting documentation that the services provided are required to address your child's
special needs. Attach additional page if needed.
13) Do you require a specific service to be provided and/or paid for to meet your child's
special needs on a short term basis and for a limited period of time? Yes No
If yes, please indicate the exact cost of the service, the provider, company or organization
being used, and the length of time the service is needed. You will also need to provide
supporting documentation that the service provided is required to address your child's special
needs. Attach additional page if needed.
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REFUSAL OF RELATIVE
GUARDIANSHIPASSISTANCE
I/We, do affirm that on this day
Name of the relative guardian Date
The Weld County Department of Human Services has informed me of the availability of a
relative guardianship assistance in the appointment of guardianship of
Name of Child or Youth
I have conferred with my legal counsel, or I am choosing not to consult with an attorney, and I
acknowledge that the Relative Guardianship
Assistance is optional. The Weld County Department of Human Services has advised me of the
Relative Guardian Assistance Program, and at this time, I am informing you of my refusal of any
Relative
Guardianship Assistance that the Weld County Department Human Services may be able to offer
to me.
Relative Guardian Signature Date Relative Guardian Signature Date
Notary Signature Date Department Signature Date
Notary Seal
My commission Expires:
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