18+ Continued Care 624-05-23

(Revised 7/1/2023 ML #3737)

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A child in 18+ Continued Care is still considered to be a “child” for the purposes of foster care as noted in NDCC 27-20.3. The child is considered an adult in all other systems; therefore, relevant releases of information are needed.

 

Program Qualifications

18+ Continued Care is available to eligible foster care children up to the age of 21 if the child meets certain criteria. 18+ child must:

  1. Have aged out of foster care while under a valid court order granted to a North Dakota public agency; Human Service Zone, Tribal Nation or the Division of Juvenile Services (DJS).
  2. Not have obtained the age of 21.
  3. Need continued foster care services.
  4. Qualify in at least one of the participation categories.
  5. Sign the 18+ Continued Foster Care Agreement (SFN 60).
  6. Return to foster care within six months of their last discharge date, unless otherwise approved by the Department. Requests to re-enter beyond six months must be presented to the Department by the public agency seeking care and placement authority.

The length of time that a child is in foster care does not determine their eligibility for 18+ Continued Care.

 

A child, who ages out of foster care under the custody of another state, is not eligible for North Dakota 18+ Continued Care even if they move to North Dakota. Interstate Compact Placement of Children (ICPC) does not apply to those over the age of 18.

 

Return to Foster Care

18+ Continued Care participants must have been discharged from foster care at the age of 18 or greater from a North Dakota public agency. The agency where the child last exited foster care will be the point of contact for the child requesting a return to foster care. The child has six months to return to foster care from their last discharge date unless otherwised approved by the department. There is no limit to the number of times a child can return to foster care.

 

Children under the custody of Division of Juvenile Services

The North Dakota Department of Health and Human Services has a formal agreement with the ND Division of Juvenile Services (DJS) to offer foster care placements for children in need of out of home treatment and rehabilitation. ND law prohibits DJS from case managing a child who is not in their court ordered custody. If a child ages out of foster care under the care of DJS and requests to continue in 18+ Continued Care, the DJS case manager is responsible to refer the case and discuss transfer details with the local Human Service Zone.

 

Children under the custody of Tribal Nation

The North Dakota Department of Health and Human Services has a formal agreement with Standing Rock Sioux Tribe, Three Affiliated Tribes, Turtle Mountain Band of Chippewa and Spirit Lake Sioux Tribe. The Title IV-E agreements allow the Tribe to retain jurisdiction of children interested in participating in the 18+ Continued Care program. The Tribal Nation remains responsible for providing full case management and completing all documentation for eligibility determinations and remibursement.

  1. Tribal Title IV-E: A child under the custody of a ND Tribal Nation, who was Title IV-E eligible and meets the criteria of “aging out”, is eligible for 18+ Continued Care.
  2. Tribal Non-Title IV-E: A child under the custody of a ND Tribal Nation, who was not Title IV-E eligible upon “aging out”, may qualify for 18+ Continued Care. The child must apply and have their eligibility determined. If found to be Title IV-E eligible as “child only”, the child would be eligible to participate in the 18+ Continued Care program. If the child loses Title IV-E eligibility or reimbursability while participating in the 18+ Continued Care program, the case will close.

Participation Categories

Verification of initial and ongoing eligibility for program participation is the responsibility of the manager or the agency’s agreed upon designee. A release of information between the agency, child and verifying entity (school, employer, etc.) is needed.

 

Verification documentation is required in the child’s foster care file, however, is not required in the eligibility file for payments. The child is expected to meet the criteria in one or a combination of the following categories in order to participate in 18+ Continued Care:

 

  1. Education

Eligibility: The child must participate in secondary, post-secondary or vocational education on a full or part time basis. A child who is attending school on a part time basis is encouraged to also work or volunteer. Arrangements should be negotiated between the child and the case manager. If the child is on an extended school break (i.e. summer break) or if the next school session is more than 30 days away, the child should work or volunteer until the session begins.

 

Verification: Verification must be provided in the form of an enrollment or acceptance letter, copy of grades, a letter from the school, class schedule, tuition receipt, etc. The frequency of verification must be every 9 weeks, quarter, or semester depending on the program in which the child is involved or more often if required by the case manager. Compliance of continued eligibility must be discussed at the monthly case manager visitation meeting and at every quarterly Child and Family Team Meeting.

  1. Employment

Eligibility: The child must work at least 80 hours per month.

 

Verification: Verification must be provided in the form of a pay stub, letter from employer, a copy of an application for employment, etc. The frequency of verification must be monthly or more often if required by the case manager. Compliance of continued eligibility must be discussed at the monthly case manager visitation meeting and at every quarterly Child and Family Team Meeting.

  1. Employment Preparatory Program

Eligibility: The child must attend a program that is designed to promote or remove barriers to employment. There could also be educational components tied to this type of programming; for example, Job Corps or a welding certificate training program. If the start of the next program session is more than 30 days away, the child should work or volunteer until the program begins.

 

Verification: Verification must be provided in the form of an application, enrollment or acceptance letter, copy of grades, a letter from the program, program schedule, tuition receipt, etc. The frequency of verification must be every 9 weeks, quarter or semester depending on the program in which the child is involved or more often if required by the case manager. Compliance of continued eligibility must be discussed at the monthly case manager visitation meeting and at every quarterly Child and Family Team Meeting.

  1. Medical Condition or Disability

Eligibility: The child must be unable to participate in educational or employment activities stated above due to a medical condition or disability. A medical condition or disability would have likely been identified long before a child enters 18+ Continued Care. If a child is incapacitated and unable to sign the documentation required to participate in 18+ Continued Care; a public agency case manager can sign on their behalf if the program is explained to the child and relevant parties.

 

Verification: A statement signed by a licensed physician, physician’s assistant, psychologist, or Vocational Rehabilitation Counselor that documents the child’s medical condition or disability (which can include a mental health diagnosis) and their inability to go to school, work, or participate in job training. Compliance of continued eligibility must be discussed at the monthly case manager visitation meeting and at every quarterly Child and Family Team Meeting or more often if required by the case manager.

 

Grace Period

In the event a child does not fully meet a category set forth above, a 30-day grace period is allowable to maintain program eligibility. During the grace period, the child should engage in volunteer work while he/she awaits an offer for employment or acceptance to an educational program.

 

18+ Child Living Arrangements

The 18+ Continued Care program encourages youth to stay in family foster care while they continue to pursue independence.

The following types of living arrangements are allowable:

A child generally will not be eligible for 18+ Continued Care if they are living in an apartment not connected to a supervised independent living program. Special circumstances may be allowed, staff such as cases with Children and Family Service.

 

Higher level of care pre-approval: 18+ children in need of a higher level of care (therapeutic or facility placement) will require pre-approval from Children and Family Services.

 

Out of State: A child may be placed out of state providing there is a signed SFN 60. Courtesy case management requests of out of state partners is allowable and encouraged. Interstate Compact on the Placement of Children does not apply to those over the age of 18.

 

18 + Continued Foster Care Agreement

The 18+ Continued Foster Care Agreement (SFN 60) is a provider specific three-party agreement signed by the agency, the child, and the foster care provider. A change in foster care provider requires a new 18+ Continued Foster Care agreement.

 

Custody that extends beyond the child’s 18th birthday will remain in effect and foster care will continue until the court order expires or is vacated. An 18+ Continued Foster Care Agreement is not required if a custody order is in effect.

 

18+ Permanency Court Order Requirements

The 18+ Continued Foster Care Agreement (SFN 60) allows for a bridge in service and payment authorizing the agency placement and care responsibility until a formal court order can be obtained. Upon receipt of the signed three-party agreement, the agency will complete a detailed 18+ affidavit seeking the required judicial determinations including reasonable efforts to finalize a permanency plan.

 

An 18+ permanency court order with required judicial determinations must be obtained within 90 days of the effective date of the 18+ Continued Foster Care Agreement (SFN 60). The 18+ permanency court order must be the result of an actual hearing. Permanency hearings are required initially upon entry into 18+ Continued Care program and every 12 months thereafter.

18+ Court Order Highlights:

  1. The agency must notify the foster care provider of any hearing held with respect to the child. A copy of the written notification should be kept in the child’s case file.
  2. Majority of the cases will have a permanency plan of Another Planned Permanent Living Arrangement (APPLA). The court order must address the agency’s efforts to prepare the child to meet the permanency goal and ask the child if he/she agrees with the goal.
  3. Every child age 18 to 21, remaining or returning to foster care, must have the required permanency judicial findings noted on the Hard Card – 18+ (DN 752).
  4. No foster care payment can be made to support an 18+ child in care without the required permanency judicial determinations.
  5. It is highly recommended the case manager request the affidavit containing the case details be “incorporate by reference” and made part of the final court order.
  6. ICWA requirements do not apply in 18+ Continued Care.

Criminal Background Checks

A child who remains in or returns to foster care in 18+ Continued Care is considered a “child” for the purposes of foster care as noted in NDCC 27-20.3. A child remaining in foster care is not required to complete a fingerprint-based criminal background check. However, it is encouraged for agencies to conduct a free web-based search on the 18+ child if he/she is returning to foster care.

 

Case Management Responsibilities

All case management responsibilities applicable to children under the age of 18 will continue for a child participating in 18+ Continued Care. Case management requirements continue regardless of the child’s eligibility and program category engaged in for participation. The case is subject to quality assurance reviews as guided by state or federal regulations.

 

Case Management Highlights:

  1. Transition Plan: The case manager must develop the required transition plan (SFN 494) within 90 days of the child’s 18th birthday. The case manager must advise the child of the availability to continue in foster care and receive benefits until they reach the age of 21. To assist with educating the child, an 18+ brochure (DN 1174) is available on the Children and Family Services website. Transition planning must continue throughout the life of the 18+ case.
  2. If a child currently in foster care notifies the agency of their intent to participate in 18+ Continued Care, the agency will work with the child’s foster care provider to determine if the continued placement would be appropriate. If the placement is not appropriate, recruitment efforts for a new placement resource should begin.
  3. For a child returning to 18+ Continued Care, the case manager must complete a safety and risk assessment. If the child is in crisis, the case manager should provide crisis intervention services (i.e. connecting the child with resources that provide temporary housing, food, emergency medical care, etc.). If a foster care placement is not available at the time the child requests to return to foster care, the agency will begin recruitment efforts immediately. A child is not in 18+ foster care until a placement resource is identified and all three parties sign the 18+ Continued Foster Care Agreement (SFN 60).
  4. The foster care case manager must provide and ensure the child completes the required documents required to continue or return to care:
  1. If the child was previously Title IV-E eligible and child wishes to continue in foster care, no redetermination is necessary. However, income and assets must be reviewed to determine the child’s reimbursability.
  2. If the child was not previously Title IV-E eligible, an eligibility determination is required specific to the child.
  3. The 18+ child must complete the documentation and the case manager must provide it to the eligibility worker. After the determination is made, the eligibility worker will notify the case manager of the eligibility determination outcome for the child.
  1. School District Notification: 18+ Continued Care requires agencies to follow existing policy on school district notifications. If the child is still in school, communication with the Department of Public Instruction is encouraged to determine completion of the form for tuition standards.
  2. Family Connections: Agencies must document the child’s interest in pursuing involvement with their family after they turn age 18. If the child is interested in maintaining family connections, the agency must provide for visitation or other ongoing interactions, unless such interaction would be harmful to the child. Documentation in the case file regarding family connections must meet the requirements of all quality assurance case file reviews.
  3. Chafee Transition Program: Participation in the voluntary Chafee Transition Program is encouraged. Chafee Transition program eligibility criteria and program standards can be found in policy chapter 624-10.
  4. Foster Care Recruitment: 18+ Continued Care may require specialized recruitment efforts for family foster homes. Agencies are encouraged to include these efforts in their recruitment and retention plan as well as complete statewide search to locate the best provider match if needed.
  5. Substitute Care: When a child in foster care placed in a family foster home needs temporary care when the licensed provider is unavailable to care for the child, substitute care is arranged. Substitute care arrangements for 18+ participants must be reviewed on a case by case basis. A review of the child’s developmental abilities, decision making skills, as well as the length of time the foster parents will be unavailable must be taken into consideration when determining if the child requires ongoing supervision by a licensed provider. Case managers must authorize substitute care arrangements. The approval for 18+ substitute care arrangements must meet the safety needs and best interest of the child.
  6. Secondary Placements: Secondary placements from one primary foster care provider to another, such as pre-placement visits in a family home, are not allowed in 18+ Continued Care. Payments are limited to the primary foster care provider only, as the 18+ Continued Foster Care Agreement (SFN 60) does not include any placement resource other than the primary foster care provider. If an 18+ child must be hospitalized and the primary foster care provider agrees to remain engaged with the case and continues to offer support to the foster child during that time, the primary foster care provider is entitled to reimbursement. An 18+ child that require hospitalization beyond 14 days will require the foster care case manager to staff options with Children and Family Services. **The data management system does not allow for a secondary placement to be entered for 18+ cases.
  7. Termination from 18+ Continued Care will occur if the permanency goal is reached, one of the three parties requests to terminate the agreement, or the child reaches the age of 21.
  1. If termination is requested by the child, the agency must inform the child they have the option to return to foster care within six months from their last date of discharge.
  2. If termination is requested by the agency, the agency must notify the child via letter sent to his/her last known address detailing the decision to terminate the 18+ Continued Foster Care Agreement. A copy of this notification will become part of the child’s case file.
  3. Child is discharged and the foster care program is closed.

18+ Eligibility and Reimbursability

A child that is not Title IV-E eligible when aging out of foster care or was not Title IV-E eligible in the prior foster care episode and wishes to return to the 18+ continued care program requires a new eligibility determination.

 

Case managers must provide the eligibility staff with the following documents for an 18+ child continuing or returning to foster care:

 

Title IV-E eligible child aging out and continuing in foster care

Non-Title IV-E eligible child aging out of foster care

18+ Child Returning to Care

18+ Payments

All 18+ Continued Care children remain eligible for foster care maintenance payments. The process and items covered are consistent with policy for foster children under the age of 18. Refer to 623-05 for further details.

 

Foster care maintenance payments are authorized to the foster care provider in efforts to meet the needs of the child, even if the 18+ child is going to college and living on campus. The Child & Family Team, led by the case manager in cooperation with the foster care provider, must determine what portion the maintenance payment a provider will distribute to the 18+ child to assist in meeting the child’s needs. If the 18+ child requires minimal supervision or is not living in the home, the purpose of the maintenance payment is to support the 18+ child’s monthly living and help provide supervision regarding budgeting and independence.

 

18+ Cases - Social Security Benefits

An 18+ child in receipt of social security must meet formally with the social security office when they turn 18 to get a full understanding of their entitlement and representative payee information, etc. Typically, social security benefits for children over the age of 18 are sent directly to the child. Social security must be notified immediately when a child is no longer under the custody of the agency and when the child has exited foster care. For a child that continues in foster care and if deemed necessary, a representative payee may be assigned if the beneficiary is determined by SSA to be incapable of handling their money or determined legally incompetent.

 

The primary purpose of the SS payment is to meet the beneficiary’s current needs for food, housing, medical care, and other items for personal comfort. Case managers must work with the beneficiary to identify their needs (additional services, medical needs, expenses, etc.) and establish a budget to support the ongoing needs. It may be determined the costs of the child’s needs exceed the social security payment requiring access to foster care irregular payments.

 

IV-E Trial Independence

Trial independence is limited to Title IV-E eligible children discharged from foster care at the age of 18 or greater. The child will automatically exit care on a six-month trial independence. While discharged to trial independence, all case management responsibilities end, there is not a valid court order and the foster care program is closed. If a child returns to 18+ Continued Care and later is discharged, he/she will again be discharged on a trial independence.

 

A new eligibility determination is required upon return to 18+ Continued Care for a child that is not Title IV-E eligible prior to discharge.

 

Data Management System - 18+ Foster Care Program

The previous eligibility determination is very important when considering the case planning and data management data entry requirements for children interested in the 18+ Continued Care program.

  1. A Title IV-E Child:
  1. Continuing in the 18+ program, does not require a new foster care program or eligibility determination. The case and IV-E payments continue under the current foster care episode.
  2. Returning to the 18+ program from a trial independence will retain their Title IV-E eligibility status. A new 18+ Continued Care Agreement is required to open the foster care program.
  1. A Non-Title IV-E Child:
  1. Continuing in the 18+ program requires the current foster care program to close effective the expiration date of the court order. The 18+ agreement will start a new foster care episode beginning the day following the court order expiration; the program is entered in the same service period. The closure from foster care will allow for the child’s eligibility to be redetermined specific to the child and their dependent children.
  2. Returning to the 18+ program will require a new eligibility determination. A new 18+ Continued Care Agreement is required to open the foster care program.
  1. Multiple 18+ Agreements:
  1. When the ‘effective date’ of the 18+ Agreement is entered into the data management system, the duration dates automatically populate. The end date reflects the day prior to the child’s 21st birthday.
  2. When an 18+ Agreement is no longer valid, the case manager must “edit” the end date to accurately reflect the date the 18+ Agreement ended with a specific provider.

Additional 18+ Policy: 18+ eligibility policy can be found in 447-10 and 18+ maintenance payment policy can be found in 623-05.