DATE OF ISSUE:
APPLICABLE TO :
CWS/CMS FORM(S):
12/12/01
All Technical Assistants (TA) and Eligibility Workers (EW) responsible for a foster care eligibility determination for financial participation and their Eligibility Supervisor (ES) and
Human Services Administrator (HSA)
LEGAL BASIS: State Regulations – Division 45-202.412 and 45-203.63
RELATED POLICY RELEASED(S): Procedure Guide E303-0510, Initial Determination of Foster
Care Eligibility
NON-CWS/CMS FORM(S): DCFS 280 , Technical Assistant Action Request
DCFS 2322 , Schedule Appointment Interview with Parents(s)
Legal Guardian
DCFS 4340, Monthly Liability Determination – Voluntary
Family Reunification Services
SOC 155, Voluntary Placement Agreement – Parent/Agency
AFDC program Choice Indicator (FC 4)
SAWS 1 Notebook
Case Information Notebook
Case Notes
Client Notebook
Client Relationship History
Client Summary
Court Notebook
Court Order Summary
FC 2 Notebook
Legal Status History
Medi-Cal Notebook
Notice of Action (NA981)
Request for Verification/Certificates of Evidence
SUPERSEDES AND CANCELS:
Statement of Facts Supporting Eligibility for AFDC-Foster
Care (FC 2)
Procedure Guide E030-3100, Voluntary Placement
Agreement/Placement, dated 05/27/98
Voluntary Placement is the foster care placement of a child after the parent or guardian of the child has requested the assistance of DCFS and signed a voluntary placement agreement.
The Voluntary Placement Agreement (SOC 155) must be signed by both the parent/legal guardian and DCFS. The EW/TA must verify the date the agreement was signed in order
ELIGIBILITY E080-0630 (11/01) PAGE 1 OF 3

WHO
TA/EW
TA/EW to ensure that payment is not made for longer than 180 days. The SOC 155 is the Statemandated voluntary placement agreement. This agreement specifies the legal status of the child and the rights and obligations of the parent(s) or guardian(s). If the child will remain in placement beyond 180 days, a petition must be filed in the fifth month of placement.
A. WHEN: WITHIN 45* DAYS OF THE VOLUNTARY PLACEMENT
AGREEMENT DATE
* The eligibility determination is not complete until the ES signs the
FC2. Therefore, the EW shall process the eligibility determination within 30 days.
HOW
1.
Receive the DCFS 280 indicating a voluntary placement.
2.
Request a copy of the SOC 155 from the CSW.
NOTE: It is the responsibility of the CSW to inform the parent/guardian that (s)he must cooperate in providing the information/documentation needed in the eligibility determination.
Voluntary placement services are applicable only to minors age 17 years or younger.
3.
Contact the parent/legal guardian, via telephone, or the DCFS 2322.
4.
Conduct the face-to-face interview. See Procedure
Guide E030-0510, Initial Detemination of Foster
Care Eligibility . Obtain the DCFS 4340, from the parent/guardian.
5.
Determine eligibility to AFDC-FC based on the information received. There are two aid codes for voluntary placement cases: a) 40 for state funded voluntary placement cases. b) 42 for federal funded voluntary placement cases.
6. Create a control using the DCFS 26-1 for the beginning of the 5 th
month of placement. The reminder is to contact the CSW for an update as to the conditions of eligibility for the voluntary
ELIGIBILITY E080-0630 (11/01) PAGE 2 OF 3

WHO HOW placement case and to determine if a petition will be filed.
NOTE: The Library will pull the DCFS 26-1 upon receipt of a voluntary placement case and forward to Redetermination Manager/Secretary.
The Manager/Secretary will control DCFS
26-1(s) and assign to the Redetermination
Section to reassess conditions of eligibility.
B. WHEN: REDETERMINATION OF ELIGIBILITY TO AFDC-FC
WHO
Redetermination EW
HOW
1.
Receive the eligibility segment or a CSW/CMS application reminder indicating a redetermination of eligibility is needed.
2.
Access the CWS/CMS application. Open the existing case. Review the case information and court section. Determine if the child is to remain in placement and if a petition has been filed. a) If the child is to remain in placement, obtain the court hearing date and proceed with the redetermination of eligibility to AFDC-FC. b) If the child will return to the home of the parent, no redetermination is needed. Obtain the date the child will return home.
NOTE: If a WIC 300 petition is not filed, and the child remains in placement beyond the 180 days, the financial participation becomes county funds.
(Aid Code 49)
3.
If a child is placed with a relative and is to remain in placement beyond the 180 days and no petition has been filed, terminate foster care and refer the relative to DPSS.
4. If a child is placed in home other than a relative, reassess for State eligibility once a petition is filed.
ELIGIBILITY E080-0630 (11/01) PAGE 3 OF 3