Department for Community Based Services

Standards of Practice Online Manual

4.29.2 Transition Planning for Youth Aging Out of OOHC or Extending Commitment

Cabinet for Health and Family Services

Department for Community Based Services
Division of Protection and Permanency
Standards of Practice Online Manual
Chapter:
Chapter 4-Out of Home Care Services (OOHC)
Effective:
8/9/2018
Section:
4.29.2 Transition Planning for Youth Aging Out of OOHC or Extending Commitment
Version:
11

When a section of SOP has been revised users will see the following: Added {This is added material}, Deleted {This is deleted material}. The bold and strikethroughs will appear on the site for fifteen (15) days after a modification and will then be removed.

Legal Authority/Introduction

LEGAL AUTHORITY: 

 

Introduction 

Independent living services should be provided according to the developmental needs and differing stages of independence of the youth.  Services should not be seen as a single event but rather as a series of activities designed over time to support the youth in attaining a level of self-sufficiency that allows for a productive adult life. 

The transition plan is initiated beginning at age seventeen (17) by the Independent Living Coordinator (ILC) and SSW and is incorporated into the case planning conferences and while the youth remains in out of home care (OOHC). This plan is designed to be personalized and youth driven, should be detailed as the youth desires and should include information regarding: 

  • Specific options for housing;
  • Health insurance;
  • Designating a health care proxy; 1
  • Education;
  • Mentoring opportunities;
  • Continuing support services;
  • Workforce supports; and
  • Employment services. 

The ILC schedules a follow up transition plan meeting with the youth at age seventeen and a half (17 ½).  The follow up meeting can be conducted via conference call, Skype, or face to face.  The ILC should inform the SSW of any changes or updates to the youth’s plan if the SSW is unable to participate in the 17 ½ meeting.  The follow up meeting is also designed to be personalized and youth driven, should be detailed as the youth desires and should include the same list of items that is included in the transition plan created when the youth turns seventeen (17) (see list above).

Within ninety (90) days of the youth attaining age eighteen (18), a meeting, facilitated by the independent living coordinator, must occur to further discuss transition planning.  The youth should be supported in making well informed decisions about their future, transition to adulthood, well-being and other aspects of their case and permanency planning (42 USC 675 (5)(H)).  

This meeting is to be held independently of a case planning conference; although it may be held on the same day, it is important that this meeting is distinct and stand alone.  The participants for a case planning conference may differ from those invited to attend the ninety (90) day transition plan meeting.  This meeting should be strength-based and directed by the youth.  The youth should have equal consideration to the adult voices during the meeting.  The independent living coordinator (ILC) should assist the youth in identifying supports to attend the meeting and may include teachers, mentors, employers, family members, foster/adoptive parents and mental health providers.

Youth aging out of foster care should be provided with the following documents:

  • certified birth certificate;
  • original social security card;
  • identification card;
  • insurance card; and
  • commitment verification letter

The birth certificate can be ordered from Vital Statistics, at no charge, with the submission of the application and Commitment Verification Letter.  Birth certificate can be ordered by the youth, any DCBS representative, foster parent, or private childcare agency. 

Practice Guidance

Definitions:
  • Eligible youth-A person who is or has been committed to the Cabinet as dependent, neglected or abused, is eighteen (18) years of age to nineteen (19) years of age and who is requesting to extend or reinstate his or her commitment to the Cabinet in order to participate in state or federal educational programs or to establish independent living arrangements;
  • Transitional living support-All benefits to which an eligible youth is entitled upon being granted extended or reinstated commitment to the Cabinet by the courts.
    • The terms of the Transitional Living Support Agreement are customized for each youth requesting transitional living support and based on the individual needs and circumstances.  A Transitional Living Support Agreement template is located under forms and resources section of this SOP.
    • The terms of the Transitional Living Support Agreement should be signed by the youth, social services worker, Guardian ad litem, and judge. 
     
  • An eligible youth, including a youth with a diagnosis or disability, is permitted to extend or reinstate his/her commitment to the Cabinet prior to attaining nineteen (19) years of age.  This reinstatement will allow the youth to be committed to the Cabinet until the age of twenty-one (21) and to receive transition living support.     
  • For youth aging out of OOHC or requesting to participate in an extension of transitional living support, the SSW may make a referral to the regional placement coordinator (RPC) for transitional services, in the county where the youth has chosen to reside, for youth in residential facilities, group homes, private agency foster homes or other similar placements.
  • For youth aging out of OOHC or recommitting the SSW may consider a special request for basic living items (e.g. bedspread, dishes, rent and utility deposits), not to exceed $250 and requires the approval of the SRA or designee.
  • Youth with a diagnosis of developmental or intellectual disability who would like to voluntarily participate in an extension of transitional living support, have the right to voluntarily extend their commitment.  Once custody of the youth is received by DCBS, the youth should be placed on the supports for community living (SCL) waiting list.
  • The birth certificate can be ordered from Vital Statistics, at no charge, with the submission of the application and Commitment Verification Letter.  Birth certificate can be ordered by the youth, any DCBS representative, foster parent, or private childcare agency. 

Procedure

General transition planning provisions

  1. The SSW informs the ILC of the first case planning conference following the youth’s seventeenth (17th) birthday.
  2. The ILC ensures that a Transition Plan is developed with input from the youth's SSW and youth at age seventeen (17), regardless of whether the youth is extending or ending commitment.
  3. At the transition plan meeting the ILC discusses with the youth, SSW and support participants what supports are in place for the child’s permanency plan. 2 
  4. The ILC records the transition plan in the National Youth Transition Data Base (NYTD) system.
  5. The SSW coordinates services with the regional Independent Living Coordinator (ILC) to ensure that youth who are committed, placed in a DCBS foster care placement and receiving Chafee IL services, are also receiving transitional services following the case planning conference after the youth reaches age seventeen (17).
  6. The SSW ensures that the case plan evaluation assessment, case plan, and service recordings for the youth reflect the following goals and tasks relevant for the youth to successfully transition out of care:
    1. Concrete and specific tasks should be identified and progress evaluated at every family team meeting (FTM) and case planning conference; 
    2. Case planning should cover all the areas listed on the transition plan, as well as any specific to the youth;
    3. If the youth is not progressing or is non-compliant with the initial transition plan then an additional FTM may assist in reviewing tasks and possibly renegotiate the identified tasks.
  7. The ILC contacts the SSW and youth, when the youth turns seventeen and a half (17 ½), to evaluate the progress of the initial transition plan. 3
  8. The ILC updates any changes to the transition plan and documents this contact in NYTD.
  9. The SSW provides the youth with the following items (when available) prior to transition of a youth from OOHC to employment, education or other setting (these items are provided at no cost to the youth):
    1. Social security card;
    2. Information about the youth’s personal and family health, including a list of health care providers;
    3. Original birth certificate;
    4. Death certificate(s) of parents, as appropriate;
    5. Pictures or lifebook;
    6. List of all schools attended;
    7. Information about the youth’s educational history;
    8. An identification card; and
    9. List of all previous placements, including names and addresses.
  10. The SSW or ILC provides the exiting youth, at age eighteen (18), a packet of information, which includes the following:
    1. List of health care providers located near the youth’s residence;
    2. List of emergency phone numbers for crisis hotlines, police, fire, medical emergency and drug/poison centers;
    3. Medical card or other insurance information (475(5)(I)); 4
    4. Employment resume, based on the youth’s part-time or full-time employment;
    5. Letters of reference to future employers;
    6. List of counseling services;
    7. List of contact persons who can help with employment, vocational training and other appropriate services as listed on the youth’s aftercare plan; and
    8. Living will directives and health care surrogate designation.
  11. The SSW reviews progress toward the youth’s transition plan goals during monthly supervisory conferences.
  12. The independent living coordinator facilitates a transition plan meeting that must occur within ninety (90) days of a youth attaining age eighteen (18). 
  13. If the youth is planning to extend commitment, the SSW, FSOS and youth:
    1. Develop and sign the Transitional Living Support Agreement during the case planning conference that occurs prior to the  youth’s eighteenth (18th) birthday, if the youth is extending commitment; or 5
    2. Develop and sign the Transitional Living Support Agreement 6 within five (5) working days of the request to reinstate commitment.
  14. An eligible youth who aged out of care at eighteen (18) is allowed to request his/her commitment to the Cabinet prior to attaining nineteen (19) years of age.  This reinstatement will allow the youth to be committed to the Cabinet until the age of twenty-one (21) and to receive transition living support. 
    1. The youth should call the Department of Community Based Services hotline at 1-877-597-2331 to request his/her commitment to the Cabinet be reinstated.
    2. Central intake staff will verify the youth's eligibility to be recommitted to the Cabinet.
    3. Central intake staff will notify the county of commitment to request reinstatement of commitment. The regional ILC will contact the youth and convene a meeting to give the youth an opportunity to explain why they would like to return to care.  The group will also discuss potential placement options and expectations if the youth returns to care.  The youth's previous social worker and/or FSOS will participate in the meeting.  The youth should also be encouraged to invite any support persons to participate.  The meeting can be conducted in person or by phone.
    4. The county of commitment will be responsible for filing a petition with the court for the youth to be reinstated into care and will be responsible for ongoing case management.
    5. Once the youth is reinstated into the care of the Cabinet, the SSW may make a referral to the regional placement coordinator (RPC) for transitional services in the county where the youth has chosen to reside. If the county is not agreeable to the youth returning to care, the ILC will advise the youth of their right to petition the court directly and provide the contact information for their previous guardian ad litem, who may assist them with the petition process.  The ILC will also advise the youth of their right to file a service complaint n accordance with 922 KAR 1:320.

 

For youth with disabilities, the SSW and ILC completes the following procedures, in addition to the general transition planning provisions (listed above):  

  1. The SSW completes an SCL waiver application by completing the Kentucky Medicaid Waiver Intake  Application (through the MWMA System) and submitting it to the Division of Family  Support, Medical Support and Benefits Branch dfs.medicaid@ky.gov (this is to be completed upon receiving youth into DCBS custody).
  2. The ILC  continues to be responsible for the following:  
    1. Development of the seventeen (17) year old transition plan;
    2. Follow-up transition plan at seventeen and a half (17 ½); and
    3. The transition plan to be held within ninety (90) days of a youth attaining age eighteen (18).
  3. The ILC invites the following individuals to the transition planning meetings (list is not all inclusive):
    1. Regional out of home care specialist;
    2. Regional independent living coordinator; 
    3. Mental health provider for the youth;
    4. Adult protective services staff; and
    5. Department for Behavioral Health, Developmental and Intellectual Disabilities staff; and
    6. Guardianship staff.
  4. The SSW ensures that the youth is placed on the SCL waiting list at the seventeen (17) year old transition planning meeting, whether or not the youth is capable of participation in the meeting. 
  5. The SSW ensures that the youth is placed on an emergency SCL waiting list at the seventeen and a half (17.5) transition planning meeting, if the youth is not recommitting and a placement has not been secured, due to the “risk of the youth being homeless” on their 18th birthday. 
  6. The SSW provides the ILC a copy of the completed transition plan. 
  7. ILC records the transition plan date in the National Youth Transition Data Base (NYTD) system.
  8. The ILC initiates discussions with the SSW and family team, with assistance from guardianship staff, to determine if guardianship will be appropriate for the youth in OOHC with disabilities.
  9. The SSW and family team, with assistance from regional staff, begin seeking a guardian for a youth in OOHC with disabilities, if it is determined that this is in the youth’s best interest.
  10. The SSW assesses family members to identify a guardian (full or limited) to assume responsibilities, outside of placement, for youth over eighteen (18) years of age.
  11. The SSW and ILC refers to the Youth Transitioning Through Foster Care Tip Sheet, Transitional Flow Chart and Resource Manual for Youth with Disabilities in Foster Care to assist in creating the transition plan for the youth with disabilities.

 

Footnotes

  1. Definition:  Someone appointed to make health care decisions for the youth, in the event that the youth is incapable of making decisions for him/herself. 
  2. The transition plan meeting is used as an opportunity to identify youth who are at risk.
  3. This meeting can be completed by phone, Skype or face to face. 
  4. Section 2004 of the Affordable Care Act added a new mandatory group for former foster care children at section 1902(a)(10)(A)(i)(IX) of the Social Security Act (the Act). Proposed 42 CFR 435.150 of the January 22, 2013 proposed rule, available at http://www.gpo.gov/fdsys/pkg/FR2013-01-22/pdf/2013-00659.pdf, would codify the provisions of section 1902(a)(10)(A)(i)(IX). Under the statute, states must cover individuals under age twenty-six (26) who were both enrolled in Medicaid and in foster care under the responsibility of the state or tribe upon attaining either age 18 or such higher age as the state or tribe has elected for termination of federal foster care assistance under title IV-E. There is no income test for eligibility under this group.
  5. Neither reinstatement of nor extension of commitment alleviates the SSW’s responsibility to continue to prepare the OOHC case plan.
  6. This agreement is developed in coordination with the youth, identifying what is expected for the youth to maintain extended/reinstated commitment.  There is autonomy to customize the agreement to the youth’s individual circumstances.

Communicate

Sign In (Editor Access Only)
Copyright © 2011 Commonwealth of Kentucky - All Rights Reserved
Kentucky Unbridled Spirit