The initial service level is for children who are in DFPS conservatorship for the first time. For children who require a service level higher than Basic, the caseworker must request an authorized service level (ASL) from the third-party contractor (Youth for Tomorrow).
The caseworker must submit the following forms and documentation:
- Form 2089 Service Level Authorization form located in IMPACT under the Placement tab.
- Form 2087 Application for PlacementWord Document or Form 2087ex Alternative Application for Placement of Children in Residential Care [sic, broken link]Word Document.
- For children with emotional disturbance: Psychological or psychiatric evaluations completed within the past 14 months.
- Child and Adolescent Needs Assessment (CANS), if applicable.
- For children with primary medical needs: An evaluation by a physician, physician's assistant, or nurse practitioner, describing medical conditions or disabilities.
The caseworker may also submit information describing any extenuating circumstances, incident reports, and so on.
The DFPS caseworker must work with the provider to obtain appropriate paperwork to submit a child or youth’s information to the third-party contractor for an initial service level.
When a child or youth is leaving a hospital, the CPS supervisor may request that the third party reviewer complete an initial ASL within one working day or 24 hours of the discharge.
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