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:
4/26/2021
Section:
4.29.2 Transition Planning for Youth Aging Out of OOHC or Extending Commitment
Version:
13

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Legal Authority/Introduction

LEGAL AUTHORITY: 

 

Introduction 

"Without the proper information how else would we know what to expect or what to choose?  I thought the transition planning was very useful.”  – Carly age 20.  Transition planning is essential to ensure youth have the necessary information to make informed decisions about their future.

The Family First Prevention Services Act (FFPSA) declares the importance for states to assist youth preparing for a successful transition to adulthood and making a permanent connection with a caring adult.  For a young person, who may transition from foster care at age eighteen (18), permanency may look different than the normal practice standards of helping a young person achieve permanency.  Permanency in situations like this means having stable, reliable, and supportive lifelong connections.  Youth transitioning from foster care are often unsure about who they can depend on for ongoing support.  Many of their significant relationships with adults have been based on professional connections, which will terminate once the transition from care is completed.  It is very important to the youth’s success to assist them in identifying those adults who will continue to provide various supports through and beyond transition from care.  The independent living specialist (ILS) will assist the youth in identifying supports to attend the transition planning meetings and may include teachers, mentors, employers, family members, foster/adoptive parents, guardian ad litems, mental health providers, etc.  The youth’s social worker or FSOS must participate in all transition meetings (participation can be by phone).  During the transition planning meeting, the ILS will educate everyone in attendance about the permanency pact tool and discuss next steps in completing a permanency pact ceremony for those interested.   

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. 

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 the 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 transitional living support.     
  • For youth transitioning from out-of-home care (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.
  • 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 the Department of Community Based Services (DCBS), the youth should be placed on the supports for community living (SCL) waiting list.

 

Procedure  

For a child age fourteen (14) and over, the case plan should include a list of the programs and services that will help the child prepare for the transition from foster care to a successful adulthood.  1

The formal transition plan meeting is initiated beginning at age seventeen (17) by the ILS for youth who remain in OOHC.  The meeting may be incorporated into the case planning conference.  This plan is designed to be personalized and youth driven, should be as detailed as the youth desires, and should include information regarding: 

  • Specific options for housing;
  • Health insurance; 2
  • Designating a health care proxy; 3
  • Education;
  • Mentoring opportunities;
  • Continuing support services;
  • Workforce supports; and
  • Employment services. 

 

The ILS will assist the youth in identifying supports to attend the transition planning meetings.  Supports may include teachers, mentors, employers, family members, foster/adoptive parents, guardian ad litems, mental health providers, etc.  The youth’s SSW or FSOS must participate in all transition meetings (participation can be by phone).  During the transition planning meeting, the ILS will educate everyone in attendance about the Permanency Pact tool and discuss the next steps in completing a permanency pact ceremony for those interested.  For youth placed more than sixty (60) miles away from their office, the ILS should make every effort to utilize Zoom or Microsoft Teams group meeting technology.  

Within ninety (90) calendar days prior to the youth attaining age eighteen (18), a meeting facilitated by the ILS must occur, face-to-face, 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)).  4 

 

This meeting is different from the intitial formal transition plan meeting and should 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 ILS shall provide every youth an FYI Binder at the ninety (90) day transition meeting, which includes resources to aid in the successful transition to adulthood. The ILS will also facilitate meetings for youth in OOHC at nineteen (19) years old, twenty (20) years old, and within ninety (90) calendar days prior to their twenty-first (21st) birthday.  For youth placed more than sixty (60) miles away from their office, the ILS should make every effort to utilize Zoom or Microsoft Teams group meeting technology.   

 

For youth transitioning from OOHC:

The SSW: 

  1. Will complete an Exit Checklist and provide the youth the following documents:
    1. Certified birth certificate; All youth in OOHC are entitled to a free certified birth certificate.  The birth certificate can be ordered by the youth, any DCBS representative, or private child care (PCC) staff.  Youth in OOHC may request a birth certificate via Kentucky RISE.  DCBS staff may request a birth certificate on the TWIST home screen.  PCC staff may request a birth certificate for a youth in OOHC on the PCC portal homepage; 5 6
    2. Original Social Security card;
    3. Identification card;
    4. Custody Verification Letter​; 7
    5. Health insurance card;
    6. Medical records; an
    7. Information about the youth's education history.
  2. ​Will ensure the youth has completed an exit survey or will complete on youth's behalf, prior to exiting the youth from care. The survey can be found at Kentucky Rise; and 
  3. May consider a special request to provide two hundred fifty dollars ($250) to assist the youth in transitioning to independence.  The request requires the approval of the service region administrator (SRA) or designee.  

The Independent Living Specialist (ILS):

  1. Will encourage youth to create an ifoster account and save a copy of their vital documents to their digital locker; and
  2. Should provide a paper or electronic exit packet, which provides information on community resources and supports. 

For youth extending commitment:

  1. ​With the agreeance of the courts and DCBS, a youth in OOHC may choose to extend commitment to receive transitional living support.  If the youth desires to extend commitment and DCBS is not in agreement, the ILS will advise the youth of their right to file a service complaint in accordance with 922 KAR 1:320.
  2. The SSW can now create extended commitment cases within TWIST from request and agency cases when an individual turns eighteen (18) years old and extends commitment.  A new path at intake has been created for dependency/recommitment.  This will be used for individuals who exited OOHC on their eighteenth (18th) birthday and choose to recommit to the Cabinet prior to their nineteenth (19th) birthday.
  3. The SSW should create an extended commitment case in TWIST once the youth is at least eighteen (18) years old and a new case plan is due.  
    1. ​If the youth extending commitment is a parent and there is a child in their request case, the SSW will be able to select the child to be included in the new extended commitment case once it is created.
    2. If the youth extending commitment is a parent who is coming from an agency case and has a child in a different request case, the youth’s child should be added to the new extended commitment case once it is created. 
  4. The SSW, ILS, and youth should develop and sign the Transitional Living Support Agreement during the ninety (90) calendar day transition-planning meeting or prior to their court hearing to extend commitment.  All youth on extended commitment must:
    1. ​Maintain full-time employment (at least thirty (30) hours per week); 
    2. Attend high school or a post-secondary program full-time;
    3. Work part-time and participate in a post-secondary program part-time; or
    4. Be incapable of doing any of the above described activities due to diagnosed disability or medical condition.  Incapability is supported by regularly updated information in the youth's case plan.  

The youth’s Transitional Living Support Agreement and plan to either work and/or attend school should be customized to the youth’s individual circumstances, capabilities, and goals.


Youth must maintain the minimum requirements for being on extended commitment.  Youth who do not maintain these requirements will be placed on a probation contract.  An additional family team meeting (FTM) may also assist in reviewing and potentially renegotiating the agreement. 

For youth who remain noncompliant, DCBS may notify the court of their intent to terminate the commitment.  Prior to filing an intent to end the youth's commitment, the SSW will provide the youth and the regional ILS notification of the Cabinet's intent to end commitment.  In this event, the SSW must advise the youth of their right to file a service complaint in accordance 922 KAR 1:320 and provide the youth with a letter of intent to terminate commitment. If the youth does not file a service complaint within three (3) business days, DCBS may move forward with notifying the court of their intent to terminate commitment.   If the youth files a service complaint, DCBS must wait until the complaint has been heard and a final determination is made before notifying the court of their intent to terminate commitment.  An exception to terminate commitment prior to the final determination of the appeal may be requested should the youth’s commitment pose a safety concern by submitting a memo to the Transitional Services Branch.

In addition to the minimum requirements above, youth on extended commitment must also:

  1. Maintain their FYI Binder;
  2. Work toward milestones prescribed by the independent living guidelines for youth on extended commitment.  Youth who complete the minimally required milestones will receive an incentive at their annual transition meeting; and
  3. Provide monthly documentation to confirm that they are meeting the work and/or school requirement.  For youth placed in scattered site apartment settings, program staff will withhold stipend until the youth provides required documentation.

Youth living in scattered site placement:

Youth must be at least eighteen (18) years old to be placed in a scattered site apartment placement.  However, youth should not automatically be considered appropriate for a scattered site apartment upon turning eighteen (18) years old.  The SSW is encouraged to use the Independent Living Readiness Checklist as a tool to assess when a youth is ready to transition to a scattered site placement.  

SSW should consider the following when placing a youth in a scattered site placement:

  • Youth should demonstrate a certain level of maturity and mastery of basic life skills prior to being placed in a scattered site apartment.
  • Has the youth earned a high school diploma?
  • Has the youth completed the independent living curriculum and received the incentive?
  • Has the youth been stable in their current placement for at least three (3) months?
  • Is the youth currently placed in a residential setting?  If yes, has a search been completed to identify a foster home for the youth?  A step down to a foster home is more ideal than transitioning directly to a scattered site program.
  • Has the youth demonstrated the ability to properly administer their medication and tend to their other mental/physical health needs?
  • Has the youth demonstrated the ability to complete minimal basic life skills such as cooking meals, cleaning, and maintaining home safety?
  • Does the youth have a state issued identification card, Social Security card, and birth certificate? 
  • Has the youth created an ifoster account and saved their vital documents in a digital locker?
  • Has the youth completed a career assessment?

SSW should also make efforts to avoid moving youth from one independent living program (ILP) program to another one in the same locale.  SSW should work with program staff to address issues and involve the PCC liaison in central office if needed. 

For youth placed in scattered site apartment settings, program staff will withhold rent each month from their stipend and maintain the money in a savings account for the youth.  Program staff will provide a monthly ledger of savings balance to the youth. 

For youth placed in scattered site apartment settings, program staff and youth will complete a walk-through of the unit upon move in and exit.  The cost of repair to the unit for any damages caused by the youth may be recouped from the youth’s savings, up to five hundred dollars ($500).
Within thirty (30) calendar days of exiting the program, program staff must provide the youth their savings.

Youth requesting to return to care:

An eligible youth who has transitioned out of care at age eighteen (18), is allowed to request his/her commitment to the Cabinet be reinstated prior to attaining age nineteen (19).  This reinstatement will allow the youth to be committed to the Cabinet until the age of twenty-one (21) and to receive transitional living support.  The following applies when a youth requests that commitment to the Cabinet be reinstated:

  1. Youth will complete a request to return to care at kyrise.ky.gov Kentucky RISE;
  2. Central office will notify the appropriate regional ILS of the request;
  3. The regional ILS 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 SSW 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 previous county of commitment will be responsible for filing a petition with the court for the youth to be reinstated into the Cabinet's care and will be responsible for ongoing case management; and
  5. Once the youth is reinstated into the care of the Cabinet, the SSW may make a referral to the 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 ILS 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 ILS will also advise the youth of their right to file a service complaint in accordance with 922 KAR 1:320.

 

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


Youth with Disabilities Overview


 
The benefits of extending commitment to the Cabinet until age twenty-one (21) should be extensively explained to youth who have an IQ below 70, have an intellectual or developmental disability, or who have severe mental illness, etc.  If a youth in this category does not agree to extend commitment or wants to leave care at some point after extending commitment, the SSW should consult with the Division of Guardianship FSOS to determine the need to file a petition for full or limited guardianship for the youth.  If guardianship determines the need for a guardian, then the SSW should file a guardianship petition (or potentially an emergency guardianship petition) with the district court where the youth resides.  If guardianship is not recommended, the SSW can make a referral to adult protective services (APS) for general adult services, if needed.  8
 

In situations where a youth who qualifies for guardianship refuses to extend commitment to the Cabinet and state guardianship is pursued, dual commitment can occur.  In this case, the state is granted guardianship of the youth and can make the decision for the youth's commitment to be extended with the Cabinet.  These situations should be limited and should only be pursued when it is certain that the youth will not voluntarily extend commitment with the Cabinet, and the Division of Guardianship FSOS agrees that this is the best option for the youth.  In cases where dual commitment has occurred, SSW should notify the OOHC Branch.

 
In situations where a youth with an IQ below 70 and/or an intellectual or developmental disability remain on extended commitment with the Cabinet until they transition out of care at age twenty-one (21), the SSW should ensure that the following tasks are initiated at age twenty and a half (20.5):
  1. Contact the CBW to v​erify that SSI benefits are in place for the youth when they transition out of the Cabinet's care.  These benefits should initially be pursued when the youth turns seventeen and a half (17.5), if they have not been applied for sooner;
  2. Complete all necessary documentation for the youth to potentially be allocated a Supports for Community Living (SCL) waiver.  This documentation includes: 
    1. ​The SCL Emergency Request Form; and
    2. An updated psychological evaluation, which includes an IQ score and adaptive behavior testing taken within the previous two (2) years.
  3. Email required documentation to SCLER@ky.gov; ​9 and 
  4. Consult with the guardianship FSOS where the youth resides to discuss the intention of filing a petition for state guardianship, as needed.  The guardianship petition should be filed with the district court in the county where the youth resides. 10​
​For youth with disabilities, including intellectual and developmental delays, the SSW and ILS completes the following procedures, in addition to the general transition planning provisions (listed above):

 

The SSW:

  1. ​Ensures the youth has an updated psychological examination that includes an IQ score, as well as adaptive behavior testing;
  2. For cases with a youth who has an IQ below 70, intellectual or developmental delays, severe mental illness, etc., completes a Medicaid waiver management application (MWMA) to determine if the youth can be placed on the SCL waiting list or other waiver services, as needed;
  3. Emails the MWMA and the most recent psychological examination with an IQ score and adaptive behavior testing to DFS.medicaid@ky.gov; 11
  4. Contacts the CBW to ensure that the youth’s case has been reviewed for SSI eligibility.
    1. If a youth is receiving SSI, the SSW ensures that the re-determination documentation for adult disability benefits is completed for the youth starting at age seventeen and a half (17.5).
    2. If a youth is not receiving SSI benefits or is receiving title IV-E benefits, the SSW ensures that the application process begins at age seventeen and a half (17.5) to determine SSI eligibility.  The SSW can contact Public Consulting Group (PCG) to assist with the SSI eligibility determination process.
  5. Consults with the Division of Guardianship FSOS to determine the need for a guardian (full or limited) for the youth in the future;
    1. If the guardianship FSOS advises that the youth may need a guardian in the future, the SSW assesses the youth's family members to determine if any are appropriate or available to be guardian of the youth.
    2. If no appropriate family members are identified as a potential guardian for the youth, the SSW communicates to the Division of Guardianship the need for state guardianship in the future.
    3. The SSW notifies the Division of Guardianship prior to the youth transitioning from foster care that a petition for state guardianship will be filed.
  6. ​Makes every effort to ensure the applicable resources such as SSI, SCL, guardianship, etc. are in place prior to a youth who has an IQ below seventy (70) and/or low adaptive functioning capabilities transitions from foster care.

     

The ILS:  


 
  1. Facilitates the transition planning meeting of the seventeen (17) year old ;
  2. Should ensure the transition plan is completed within ninety (90) calendar days prior to the youth attaining age eighteen (18);
  3. Invites the following individuals to the transition planning meetings (list is not all inclusive):
    1. The youth’s SSW (social workers or their FSOS must participate in all transition planning meetings);
    2. Mental health provider for the youth;
    3. APS staff; 
    4. Department for Behavioral Health, Developmental and Intellectual Disabilities staff (DBHDID); and
    5. Guardianship staff.  SSW will ensure guardianship staff is invited to transition planning meetings for youth with disabilities, and document on the transition plan if guardianship staff is not in attendance.
The SSW and ILS should refer to the following resources:
 
  • Youth transitioning thru through foster care tip sheet;
  • Transitional Flow Chart; and 
  • Transitioning Youth with Disabilities Resource Manual and webinar.  

 
​​​​
 

Footnotes

  1. P.L. 113 requires the case plan, for youth age fourteen (14) and older, to include a written description of the programs and services which will help such child prepare for the transition from foster care to a successful adulthood.
  2. 42 CFR 435.150 requires states to cover individuals under age twenty-six (26) who were both enrolled in Medicaid and in foster care under the responsibility of the state upon attaining either age eighteen (18) or such higher age as the state has elected for termination of federal foster care assistance under title IV-E. There is no income test for eligibility under this group.
  3. P.L. 111-148 requires providing foster youth with information about designating a Power of Attorney for Health Care.  Someone appointed to make health care decisions for the youth, in the event that the youth is incapable of making decisions for him/herself.
  4. P.L. 110-351 requires a transition plan be developed at the direction of the youth during the ninety (90) calendar day period prior to the youth aging out of care. The plan must contain specific options on housing, health insurance, education, local opportunities for mentors/continuing support services, and workforce support/employment services.
  5. P.L. 114 requires state child welfare agencies to provide foster youth aging out of care at age eighteen (18) or greater if the state has so elected, with a birth certificate, a Social Security card, health insurance information, medical records, and a driver's license or state identification card.
  6. KRS 213.141: Effective 7/1/18, no fee or compensation shall be allowed or paid for furnishing a  certificate of birth to a child who is in the custody of or committed to the cabinet, including a child who has extended commitment to the cabinet in accordance with KRS 610.110 (6).
  7. P.L. 115-123: Effective 2/9/18, states must provide a youth, in foster care for more than six (6) months, official documentation necessary to prove the child was previously in foster care prior to transitioning out of foster care.
  8. It is important to note that even if a youth who has an IQ below 70 or an intellectual or developmental disability extends commitment to the Cabinet, the Cabinet is not the youth's guardian.  For this reason, the steps detailed above should be taken if a youth does not want to extend commitment or wants to leave care at any point after commitment is extended.​​
  9. It is important to begin the process of applying for the SCL waiver when the youth is age twenty and a half (20.5) to ensure that the best permanency outcome for the youth can be determined prior to the youth attaining age twenty-one (21) and transitioning out of the Cabinet's care.  Applying at age twenty and a half (20.5) allows sufficient time to submit necessary documentation for potential SCL allocation.  This also allows time for the SSW to plan for an alternative placement option if the youth is not allocated an SCL waiver.​
  10. It is important to begin the process of filing for guardianship for a youth when the youth is age twenty and a half (20.5) to allow the SSW sufficient time to complete all the necessary documentation for the petition.  It also allows sufficient time for the guardianship hearing to be held prior to the youth attaining age twenty-one (21), as in some counties; it could take several months before the court hearing can be scheduled.
  11. Community mental health centers (CMHCs) are located throughout the state and can assist DCBS staff in completing SCL applications.

 

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