21.5.1  Referral and Assessment

County offices shall establish the following protocol to ensure eligible young adults that were former foster care youth coming into the agency shall have access to services:

1. Prior to a youth being released from foster care on or after his/her 18th birthday, the CSW should have a discussion with the youth informing them of services available when they do exit custody.  Each county office should have Exit Packets readily available to give to youth, per Memorandum CD07-34, which contains MO Health Net information, the Chafe Aftercare Pamphlet, an Education and Training Voucher (ETV) brochure, and any additional resources pertinent to their own local communities.
2. When the young adult’s first contact with the agency is through FSD, the FSD worker shall follow procedures instructed through the IM00-191 memo, dated December 27, 2000, on the process of collaborating with or referring the young adult to Children’s Division (CD).  FSD staff will refer the young adult to the Children’s Division (CD) liaison/contact person for former foster care youth during the application process.
3. If liaison/contact person is not available in a county, then the CD supervisor will be responsible for the assignment of the referral.  In the absence of, or if there is not a CD supervisor based in the county, the assignment of the referral shall be the responsibility of the Circuit Manager.
4. The assigned CD staff shall meet with and provide the young adult with the CFCIP Support Application (CS-ILP-4) form to complete.  When completed the form will provide the following information:
   • Identifying information for the young adult;
   • Current housing situation and household composition;
   • Educational level and completion;
   • Employment and salary information;
   • Current and outstanding bills;
   • Medical/mental health needs and access;
   • Available family/community resources;
   • Current/future needs;
   • Ability/inability to reach self-sufficiency and continued independence;
   • Present and future goals; and
   • Willingness to accept personal responsibility.

CD staff or the Older Youth Transition Specialist shall complete a database search to confirm the current age of the young adult and the age at discharge to ensure program eligibility and document the findings on the Older Youth Program Referral form.  Upon making contact with the young adult and receiving information of the young adult’s need for Chafee Aftercare services, the CD county liaison/contact person for former foster care youth shall immediately notify the Older Youth Transition Specialist assigned to their county by faxing or mailing the Older Youth Program Referral form and, if completed, CFCIP Support Application (CS-ILP-4) to the Older Youth Transition Specialist.  The Older Youth Transition Specialist shall assist the young adult in designing a plan that is realistic and supports their efforts to become self-sufficient or to continue to live independently.  The agreement shall be updated or renegotiated as often as needed, but at a minimum, within 90 days, to review the progress made. 

When a young adult coming into the agency is in a state of crisis or in imminent need, the county liaison/contact person for former foster care youth shall contact the Older Youth Transition Specialist so that they may begin assessing the immediate needs of the young adult to formulate a plan to divert crisis using community resources or Chafee funds.  Older Youth Transition Specialist shall:

1. Identify immediate and ongoing service needs.
2. Assist the young adult in developing a self-sufficiency plan.
3. Link the young adult to existing community/state agency resources to meet imminent needs.
4. Provide emergency assistance/crisis intervention funding and linkage as need.
5. Each request for assistance with emergency/crisis intervention funds exceeding $200.00 shall require the approval of Regional Office. 

In the event the Older Youth Transition Specialist is not accessible, the county liaison/contact person for former foster care youth may contact the Older Youth Transition Specialist’s supervisor or the Program Development Specialist for the Older Youth Program at Central Office. Even in the crisis situation the county liaison/contact person for former foster care youth will follow the procedure of referring the young adult to the designated Older Youth Transition Specialist, by faxing the Older Youth Program Referral form to the appropriate, available Older Youth Program staff. The Older Youth Transition Specialist or Older Youth Program staff shall immediately follow up with the county liaison/contact person for former foster care youth involved with the young adult.

21.5.2 Healthcare for Former Foster Care Youth

Youth who have exited the State’s custody on or after their 18th birthday and are not yet 21 years old are automatically eligible for MO HealthNet coverage, formerly known as Medicaid.  Youth are eligible without regard to their income or assets, per RSMo 208.151.1 (SB 577, 2007).  Address information will be shared with the Division of Medical Services (DMS) so that the youth may receive a MO HealthNet card.  Once the youth receives their healthcare card they should enroll into a MO HealthNet Managed Care plan for their physical healthcare; if they reside in a geographic area covered by Managed Care.  Their behavioral healthcare will be provided on a fee-for-service basis.

For those youth who are Missouri residents but are attending an out-of-state school or on a visit outside of Missouri, the out-of-state provider must be willing to enroll in the MO HealthNet program.

When a youth exits CD custody, the CSW will close the Alternative Care Client form, SS-61, in order to capture the exit data in our information system.  Upon the closing, the system will automatically populate the youth as LSM, which denotes the youth is eligible for MO HealthNet coverage only.

Each county has designated liaison/contact person(s) for those LSM youth to contact and to ensure address changes are made in the FACES system.  The contact/liaison is responsible for referring the youth to an Older Youth Transition Specialist, if necessary.  The liaison/contact person should provide an Exit Packet to the youth at the time of contact.  There are no requirements to maintain contact with these youth or to provide any on-going case management services.

Eligible youth receiving MO HealthNet services through Family Support Division (FSD) will continue with their current healthcare coverage.  If the eligible youth currently receiving FSD services becomes ineligible for healthcare through FSD, FSD will refer the youth to the CD.

If the former foster care youth already has health insurance or obtains health insurance from another source such as employment, they must use their third party insurance before using MO HealthNet.  The youth will need to inform their medical/behavioral services provider that they are eligible for MO HealthNet.

21.5.3  Maximum Expenditures Guidelines

It is difficult to ascertain the needs and array of services former foster care youth may require.  Although the Act increased federal funding, it is not possible to meet all the needs of youth and former foster youth who are eligible for Chafee.  It is not the intent of the Division to deny any eligible youth access to Chafee services.  However, in order to ensure funds are not overspent, it is necessary to place categorical, annual, and lifetime spending caps on available services:

1. Maximum lifetime expenditure cap, per youth for all services, excluding educational assistance is $3,500.00.
2. Maximum lifetime expenditure cap for emergency/crisis intervention funds is $1,000.00.
3. Maximum lifetime expenditure cap for room and board services is $2,000.00.
4. Maximum lifetime expenditure cap for support services is $500.00.
5. Educational/Vocational tuition and book assistance is capped at $3,500.00 per academic year, per youth, and is to be reviewed each academic semester.

NOTE:  There may be on rare occasions a need to exceed the maximum expenditures limit to meet the individualized needs of the young adult.  If it becomes necessary to exceed the maximum limit, a request shall be submitted to the Regional Director or Director’s designee.

It will be the responsibility of the Older Youth Transition Specialist to track all Chafee Aftercare service expenditures. 

21.5.4  Procedural Guidelines for Service Delivery

Chafee funds may be expended for a variety of reasons and should be used as a support for the young adult, not as an on-going supplemental funding source.  Expenditures may include, but should not be limited to, emergency/crisis intervention, housing/room and board, educational assistance, job training/employment assistance, and support services.

21.5.4.1  Emergency/Crisis Intervention

We recognize we may encounter emergency/crisis situations at any time throughout our lives.  We look to family/friends for assistance and support.  The young emancipated foster youth may not always have these resources.  Emergency/Crisis intervention funds are intended to be used as a safety net to assist these young adults when possible and appropriate.  These funds shall be considered on a short term basis to enable the young adult to continue to strive towards independence and self-sufficiency.  These may include, but should not be limited to, food, emergency auto repairs, utility payments and emergency shelter.  It is expected that a ninety-(90) day time frame or less will be used to stabilize the young adult and allow them to continue to be self-sufficient.

The maximum spending limit for emergency crisis intervention funds for former foster youth (ages 18-21) is $1,000.00 per youth for the entire eligibility period.  Before the emergency/crisis intervention funds are administered, the following shall occur:

• Designated county liaison/contact person or Older Youth Transition Specialist shall assess the needs of the eligible young adult by assisting the young adult in completing the CS-ILP-4, CFCIP Support Application;
• Older Youth Transition Specialist shall assist the eligible young adult in developing an individualized case plan; and
• Older Youth Transition Specialist shall refer/assist the young adult to explore and utilize all available community resources before accessing Chafee funds.

21.5.4.2  Housing/Room and Board

One of the biggest steps youth will make in the transition from foster care to living independently is assuming the responsibility for their own housing.  Housing options are limited by factors such as cost, availability of suitable housing especially in the rural areas, and the willingness of landlords to rent to this young population.  Division staff should recognize that these are young adults seeking guidelines and assistance to meet their own goals and the Division is no longer their legal guardian.  Involve young adults at every level of the assessment and delivery of services.  Emphasis is placed on shared decision making.  Using the individual comprehensive assessment, we must maximize the use of identified community resources to assist in meeting housing needs.  The following guidelines are to be used in meeting housing needs based on the youth’s comprehensive assessment:

• Refer and utilize all available community resources;
• Identify what services are already available;
• Identify where efforts should be concentrated to locate, recruit, and cultivate resources to meet the youth’s needs;
• Work with current contracted providers to develop options to meet the youth’s needs;
• Develop current foster homes, transitional living advocate homes as resources for former foster youth; and
• Identify available Native American host families for youth of Native American descent.

The Older Youth Transition Specialist shall work with youth to encourage a safe and appropriate environment.  Housing options may include, but not limited to, the following:

• Supervised apartments;
• Shared homes;
• Live-in adult apartments;
• Host homes;
• Boarding homes;
• Shelters;
• Section VIII or subsidized housing; and
• Transitional living group homes/scattered site apartments.

The Act leaves the definition of room and board to each state to define.  It does limit, however, the portion of the funds that can be used to 30 percent for this purpose.  Parameters for assistance available under this identified need are food, rent, security and utility deposits, start up kits, basic furniture and necessities.  Maximum lifetime limit of $2,000.00 is set to anticipate different cost factors in different areas of the state. 

21.5.4.3   Support Services

The ability of young people exiting or who have exited foster care to develop a support network, and the influence of informal role models to serve as mentors in a support network is critical.  While each of the young adult’s needs is important in its own right, we are increasingly learning the importance of significant adult relationships in supporting young adults during the transition to adulthood.  Support services for former foster youth must focus on a larger target than the establishment of mentoring relationships.  As we identify the important resources, which will be needed by these young adults to support their efforts to achieve independence, we must develop partnerships with public and private agencies that already offer the needed services.  Emphasis is placed on connecting or referring youth rather than providing financial assistance.  However, financial assistance may be provided on a short-term basis until other community resources are available or until the young adult becomes self-sufficient.

Support services should include, but are not limited to the following:

1. Life Skills – Our ILP curriculum must clearly have a life skills component that is both specific and intentional and provides youth with tangible and intangible skills.  It must provide youth with real-world practice experiences.  Refer the former foster youth to life skills classes if the youth has not previously completed the classes.  The youth may need only a particular module to expand their skills and will not need to complete the entire curriculum.  The youth may also take “booster/refresher” courses as needed.
2. Transportation – Identified as a critical component in order for the youth to maintain employment or continue with their education.  Must be safe and reliable.  Bus passes and taxi vouchers may be provided to assist youth.  In rural areas where public transportation is not available, it is essential to connect youth with community services.
3. Health Care – It is suggested that current foster and former foster care youth are more likely to have health and mental health problems than the general population.  Therefore, it is imperative that physical and mental health needs be met for youth to succeed in other realms. MO HealthNet coverage is available for former foster care youth ages 18-21 without regard to income or assets, per RSMo 208.151.1.  Former foster care youth are required to enroll into a MO HealthNet Managed Care plan for their physical healthcare, if they reside in a geographic area covered by Managed Care.  Their behavioral healthcare will be provided on a fee-for-service basis. If the former foster care youth already has health insurance or obtains health insurance from another source such as employment, they must use their third party insurance before using MO HealthNet.  The youth will need to inform the provider of their medical/behavioral services that they are eligible for MO HealthNet.
4. Mentoring – Research has indicated one of the key factors why some foster children succeed when others do not is the presence of a significant adult in the lives of youth who succeed.  Committed and skilled adults are essential to guide and help young people maneuver in the world on their own.  Although career role models serve a significant purpose, it must also include personal connections.  The significant adult might be a biological family member, an adopted family, former foster family, teacher, counselor, peer, former case manager or any number of other people.  Any of these people who have a connection to the young adult may be more than willing to serve as a mentor, if asked.
5. Child Care – Appropriate and affordable childcare is a crucial need for young parents.  It is difficult for the young parent to move towards self-sufficiency by obtaining an education or gainful employment when childcare is an issue and is not addressed.  Programs such as HeadStart and Parents as Teachers are available.  Other resources may include volunteer Resource Moms, school-based childcare and state subsidies.
6. Other – Work related expenses including clothes, shoes, criminal checks, etc., application fees and credit checks may also qualify for assistance.

Expenditures are capped at a lifetime maximum of $500.00 for any one, or, a combination of support services.

21.5.4.4  Education and Training Vouchers

The Education and Training Vouchers Program is also available to former foster care youth eligible for Aftercare services.  Refer to section 21.3.7 Education and Training Vouchers  for current foster care youth.

21.5.4.5   Job Training/Employment Assistance

All youth need opportunities to explore career options available to them.  The future is bleak for youth entering the job market with low educational attainment and poor job-readiness skills.  Providing young people with adults who care about them and can serve as career role models can also assist them in striving for higher-wage positions with a continuing career pathway.  Our focus should be on longer-term and more intensive career training as opposed to training that is designed for immediate employment, requiring relatively little skills training.  Emphasis must be placed on information and referral to the community/state agency resources.

All employability/training plans should be developed with the young adults based on their interests and strengths.  The development of the training plan should be a collaborative effort among division staff (FSD&CD), One Stop Centers, the young adult and other community partners.  The training plan may require job search/placement assistance, work readiness training, classroom occupational skill training, adult education literacy or a combination of these training activities.  The training plan may direct the youth to work part-time, temporary, internships or on-the-job training.  Each training plan should be individualized to the young adult.

Job training may be accessed through the One Stop Center and the youth’s eligibility for other programs including financial aid.  Other funding sources of the One Stop partners should be explored including Vocational Rehabilitation and Job Corps.

21.5.4.6  System Changes/Case Record Documentation

In compliance with the Foster Care Independence Act, the Division will collect data, track characteristics of the youth receiving services through Chafee, and the quantity and quality of the services provided.  The Older Youth Transition Specialist will enter a Chafee Aftercare youth into ACTS via the ZCEE and the three screens that follow.  The flow is identical to opening or re-opening a child using ZCAA or ZCCC, except requiring fewer fields.  Certain fields are automatically populated when an action code of E is used with the youth’s DCN.  The following are required fields to properly open a Chafee Aftercare youth into ACTS:

The ACTS logic will look to see if the youth is eligible for Chafee services by checking that the youth is between the ages of 18 –21 and the youth exited custody on or after his/her 18th birthday.  If the youth does not meet these criteria, an error message will be received.

Case Record Documentation

The Older Youth Transition Specialist shall maintain a record for each young adult returning to the Division for assistance by setting up a new record.  Other sections may be set up in the record, but the following outline for case record organization is required at a minimum:

1. Treatment Services Section:
   • SS-61; and
   • Narrative in chronological format.
2. Forms Section:
   • CFCIP Support Application – CS-ILP-4;
   • Individualized agreement/pact signed by the young adult and Older Youth Transition Specialist.  The Family Self-Sufficiency Pact, IM-300 may be used;
   • Payment history, retaining copies of CS-65 or DBF-14; and
   • SS-6, Authorization for Release of Information.
3. Correspondence Section:
   • Documentation of referrals to community resources.  The Referral and Transmittal, IM-311 form may be used.
   • Any letters sent/received through outside mail.
4. Administrative Review Section

A Peer Record Review will be conducted on a quarterly basis to coincide with the Older Youth Transition Specialists’ meeting.  This process is to ensure documentation of essential service components exists in the record and to provide an opportunity for periodic examination of service quality.  A minimum of 10% of the cases will be reviewed per year, with a minimum of two cases per quarter.  Cases to be reviewed will be selected on a random basis, consisting of open and recently closed cases.  Recently closed cases are defined as those closed within the last three months.  DSS Research and Evaluation will identity the randomly selected cases.  Prior to the meeting the Older Youth Transition Specialists will be provided with the list of cases to be reviewed.  Items to be examined may include but are not limited to the following:

• Updated SS-61;
• Completed CS-ILP-4 (Strengths, needs, community/family resources and clear understanding of the young adult identified);
• Timeframes of meeting with the young adult are met;
• Individualized agreement/pact signed by the young adult and Older Youth Transition Specialist;
• Documentation of community referrals;
• Documentation of actual services provided;
• Entries of contact made by or for the young adult documented;
• Narrative entries signed and dated; and
• Cased closed in a timely manner.

A checklist of the above items will be provided at the time of the review.  The checklist will be completed and signed by a minimum of two members of the review team.

Members of the review team may consist of Older Youth Transition Specialists, their supervisors, Regional or Central Office staff.  The checklist will be filed in this section when completed.

21.5.4.7  Case Closing

The young adult may request services only once or return intermittently as services are needed.  If the young adult comes into the agency with an immediate need (e.g. car needs repair and is necessary to get to work and/or school) and would like assistance in meeting only this need, the ILP Specialist or designee shall assist in meeting this need.  The SS-61 shall be reopened and other necessary forms completed as indicated above.  In an effort to prevent future urgent needs or crisis with this young adult, the ILP Specialist or designee may offer additional assistance in budgeting or make a referral to an existing community program on budgeting.  Once the urgent need has been met, and the young adult does not require additional services, the case may be closed.  If there are multiple requests for services throughout the young adult’s eligibility, the SS-61 shall be opened and closed at each interval.

The CS-ILP-4 shall be completed or updated at each interval, if it has been six months or more since the last service.

When a young adult comes into the Division for assistance requiring longer-term services, the case shall remain open until such time that all referrals are made and/or service needs are addressed.  For young adults needing tuition/book assistance only, the case shall be open at the time of the request and remain open until educational payments have been made.  For young adults requiring tuition/books assistance, the record shall remain open until such time all service needs/referrals are addressed.  Any activity shall be documented in the case file.

21.5.4.8   Timeframes and Exceptions

For youth that remaining in state care and custody after age 18 is not an option or if the youth has developed a reasonable and acceptable aftercare plan and requested to leave custody, Chafee services should be used as a safety net, not a supplemental funding source, to assist them in reaching self-sufficiency and independence.

Former foster youth who left care at age 18 or after, but have not reached age 21 may choose to request assistance only once or return intermittently to seek assistance as needed.  The Act is very clear; funding can not be expended for room and board for any child who has not reached 18 years of age or for young adults upon reaching their 21st birthday.  There are no exceptions to this law.  Former foster youth who left care prior to age 18 are not eligible for Chafee services.  All Chafee services must end for the young adult upon reaching his/her 21st birthday, regardless of the legal status.

Categorical, annual, and/or lifetime spending caps apply throughout the eligibility period with a lifetime maximum of $3,500.00, excluding education assistance/job training.  Any exceptions may be submitted to Central Office through normal supervisory channels.