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CHAPTER XIII: CHILD WELFARE FUNDING MANUAL
CHANGE NOTICE 02-2009
FEBRUARY 2009
PHYSICIAN LETTER REGARDING HIV STATUS OF CHILD
DSS 5758 - REQUEST FOR REIMBURSEMENT SUPPLEMENTAL BOARD PAYMENT
HIV POSITIVE FOSTER CHILDREN
DSS 5274 - REQUEST FOR ADJUSTMENT TO FOSTER CARE ASSISTANCE PAYMENT
DSS 5272 - NC DIVISION OF SOCIAL SERVICES CHILDREN’S FACILITY LICENSE INFORMATION
VERIFICATION OF TEA ELIGIBILITY
MOE ELIGIBILITY DOCUMENTATION FORMS
DSS-5120 TITLE IV-E ELIGIBILITY DETERMINATION
DSS-5120A TITLE IV-E ELIGIBILITY REDETERMINATION
ADOPTION FORMS
DSS-5115 ADOPTION ASSISTANCE PROGRAM PAYMENT INSTRUCTIONS
DSS-5012 ADOPTION ASSISTANCE ELIGIBILITY CHECKLIST
DSS-5013 ADOPTION ASSISTANCE AGREEMENT
APPLICATION FOR REIMBURSEMENT OF NON-RECURRING ADOPTION COSTS
AGREEMENT FOR REIMBURSEMENT OF NON-RECURRING ADOPTION COSTS
SPECIAL CHILDREN ADOPTION ASSISTANCE FUND FORMS
DSS-5211 REQUEST FOR PAYMENT
DSS-5212 SUPPLEMENTAL ADOPTION ASSISTANCE AGREEMENT
DSS-5213 VERIFICATION OF CHILD’S NEED FOR DAILY SUPERVISION
AGENCY VERIFICATION OF LEGAL CUSTODY AND CHILD’S LIVING ARRANGEMENT
FOR PAST SIX MONTHS
DSS-5215 VERIFICATION OF CHILD’S HEALTH CONDITION
ICAMA FORMS
DSS-5248 ICAMA FORM 6.02 NOTICE OF ACTION
DSS-5249 ICAMA FORM 6.01 NOTICE OF MEDICAID ELIGIBILITY/CASE ACTIVATION
DSS-5250 ICAMA FORM 6.03 REPORT OF CHANGE IN CHILD(REN)/FAMILY STATUS
DSS-5216 LINKS AUTHORIZATION FOR FUNDS ACCESS
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For questions or clarification on any of the policy contained in these manuals, please contact your local county office. |
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