Attachment A: Planned Permanency Agreement
Planned Permanency Agreement
- The persons involved in this plan believe that it is in the best interest of _______________________________________ (child(ren)’s names) that they remain in care with ____________________________ (placement provider) until jurisdiction is terminated.
- I (We), parent(s) of __________________________, agree that it is in the best interest of my (our) child(ren) to remain in care with _________________ until they reach adulthood.
- I (We) understand that all decisions relating to the care of my child will be made by _____________________, who has agreed to provide permanent care for my child(ren).
- I (We) agree to continue to provide financial support for my (our) children in accordance with the order of the court and/or Child Support Enforcement.
- I (We) agree to enter into a visitation agreement with the placement provider if I desire to continue contact with my child(ren).
- We, the Children’s Division, agree to maintain and support the permanent placement of the aforementioned child(ren). We will not disrupt the placement except when the child’s safety and well-being is in jeopardy or the placement provider or child request termination.
- I (We), __________________________________, the placement provider of ____________________________ agree to be the primary permanent caretakers for this child(ren) until this agreement is terminated. I (We) will not ask for him/her to be removed from my (our) home except under serious or unusual circumstances. We agree to share information with the Children’s Division and with the birth/legal parent(s), _________________________.
- I __________________________________ (child) understand that I will remain in the home of _______________________________ because I want to be part of this family until I am on my own and self-supporting.
The Children’s Division will continue to provide maintenance payment, medical and therapeutic services and all other normal support services for which placement provider and child are eligible.
The Children’s Division agrees to advise (parents) ___________________________, of any changes in their child(ren)’s placement provided the Children’s Division is made aware of (parent’s) _________________________________ whereabouts.
__________________________ _________________________
Child Date
__________________________ _________________________
Birth/Legal Parent Date
__________________________ _________________________
Birth/Legal Parent Date
__________________________ _________________________
Placement Provider Date
__________________________ _________________________
Placement Provider Date
__________________________ _________________________
Children’s Services Worker Date
__________________________ _________________________
Juvenile Officer Date
__________________________ _________________________
Commissioner Date
__________________________ _________________________
Judge Date