Forms 623-05-60

(NEW 5/1/21 ML #3617)

View Archives

PI 22-01

 

 

Foster care payment related forms include:

  1. Credit Form, SFN 827

Any payments to the Department for foster care refunds and reimbursements must be submitted with Credit Form, SFN 827. The child’s name and foster care case number must be included to ensure proper credit. An overpayment or a receivable must exist in the payment system before the SFN 827 is submitted to Fiscal Administration. Fiscal will use the service month, match code, and description of payment provided on the form to properly apply the payment.

  1. Foster Care - Child Care Invoice, SFN 920

The Foster Care – Child Care Invoice, SFN 920, is required for child care providers and foster care providers when claiming child care reimbursement for foster care children in paid foster care placements.

  1. Notice of Change, SFN 45

The Notice of Change, SFN 45, is a required form which must be completed by the foster care case manager when changes occur in the child's case; including placement, foster care status, and parent information. The intent of this form is to quickly update/alert the eligibility worker to make payment authorization adjustments accordingly. Overpayments will occur if the eligibility worker is not notified by the foster care case manager of a placement/status change.

CFS Eligibility Unit staff must forward a copy of the completed form to Child Support if there is a change in health information or parent information.

  1. Irregular Foster Care Payments, SFN 1042

Foster care case managers must complete this form when the irregular payment requires special instructions, (ex: max mileage vs gas receipt), payment limitations or the irregular payment category does not require a receipt. Receipts for foster care expenditures that are not subject to special instructions or limitations will be authorized by the CFS Eligibility Unit without the requirement of prior approval. All irregular payments are subject to category maximums for every foster child in a licensed setting. The custodial agency will be responsible for any reimbursement exceeding the child's annual maximums.