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Chapter IV: 1201 Child Placement Services

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Reviews for Young Adults 18+ Participating in CARS Agreements

When a foster youth is 18-21 years of age and signs a CARS agreement, he or she is participating as an equal party in a contractual agreement with the DSS. The Services Agreement form is no longer appropriate or required. However, it is important to meet regularly with the young adult to assure that the conditions of the agreement are met and that the young adult is on track for his or her transition to self-sufficiency. Persons involved with the young adult (employer, caregiver, representative of school, friends, family, etc.) may be invited by the young adult to these planning sessions. Agency participation should include the social worker, supervisor, LINKS liaison in addition to any community representatives that may have relevant input.

DSS/Student Contractual Agreement

For Continuing Residential Support (CARS)

For Persons Ages Eighteen to Twenty one Years p

For Emancipated Persons Under the Age of Eighteen Years p

I, _____________________________ hereby request to remain in the placement responsibility of the _________________ County Department of Social Services. I understand that my signature on this agreement gives the __________________ County Department of Social Services the authority to continue my placement in foster care and to provide foster care services and other services for which I am eligible.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

I understand that I must remain enrolled in a full-time program of academic or vocational training, or accepted for full-time enrollment for the next term in an academic or vocational program in order for foster care assistance payments to be paid on my behalf. I also understand that my eligibility for LINKS services or transitional assistance is not dependent on my participation in this contract.

I understand that both the Department of Social Services and I have the right to rescind this agreement. I agree to discuss any problems arising from the placement with the social worker, and am committed to handling my responsibility in working through any problems that are within my control. I agree to notify the agency and placement provider in advance if I decide to leave school, the vocational program, or foster care. I also understand that this agreement will automatically end on my twenty-first birthday.

Requested by:____________________________ Date _______________________

Accepted by: ____________________________ Date _______________________

Approved by: ____________________________ Date _______________________

DSS-5108

DSS/Student Contractual Agreement for Continuing Residential Support

(CARS)

Six Month Review

_____________________

date

Young Adult Responsibilities

Educational

School/vocational program attending__________________________ Hrs. / week_____

Progress during previous 6 months:__________________________________________

Grade point average:___________ Date of expected completion: ____________

Employment

Where employed:________________________________________________________

Address:_______________________________________________________________

Hrs. Part time: ______ Hrs. Full time _____

Employment evaluation by employer Excellent ___ Satisfactory ___ Unsatisfactory ___

Employment evaluation by young adult: Excellent __ Satisfactory __ Unsatisfactory ___ Not employed ____

Placement

Location of foster care placement:___________________________________________

Placement provider ______________________________________________________

Evaluation by young adult regarding appropriateness of placement

Excellent _____Satisfactory _____ Unsatisfactory _______

Does the student wish to remain in this placement? Yes ___ No___

Does the student wish to continue in voluntary placement? Yes __ No __

Expected termination date:___________________

Skill Development:

Identified strengths ______________________________________________________

______________________________________________________________________

Identified needs _________________________________________________________

______________________________________________________________________

Services Requested: _____________________________________________________

_____________________________________________________________________

Comments:

Agency Responsibilities

Type of foster care placement: _____________________________________________

Placement provider ______________________________________________________

Evaluation by placement provider regarding use of placement:

Excellent _____Satisfactory _____ Unsatisfactory _______

Is agency willing to continue to provide this placement? Yes __ No __

Services Provided to Young Adult During Previous Six Months

Educational Assistance:

Vocational Assistance:

Life Skills Training:

Transitional Housing:

Personal Counseling;

Strengthening Personal Support System

Other

Services to be Provided by DSS During Next Period, Including Frequency

______________________________________________________________________

______________________________________________________________________

________________________________________________________________________

_______________________________________________________________________

______________________________________________________________________

____________________________________________________________________________________________________________________________________________

______________________________________________________________________

Student Date

____________________________________ __________________________

Care Provider Date

____________________________________ __________________________

Social Worker Date:

DSS-5108-A

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