All direct services to clients in active cases, (including children in foster and adoptive homes), must be authorized in writing by the appropriate worker and supervisor before the service is delivered.

Unauthorized or incorrectly authorized services will not be paid:

To authorize services, workers send the contractor a complete referral that contains:

 •  a signed and dated Form 2054, Service Authorization.

     Form 2054 serves as an eligibility document and cannot be backdated. The print date must be clearly visible on the form, and the service must begin on or after the print date. Because a contractor is subject to loss of reimbursement, the contractor must have the service authorization form in hand before providing services.

     A properly completed Form 2054 Service Authorization contains the:

 •  name of the contractor and contract number;

 •  names of client or family members who are to receive services;

 •  types services requested;

 •  number of units for each service requested;

 •  time limit for the service. Enter the effective (start) date and the end date in the IMPACT system. The end and termination dates are always the same on the original Form 2054, Service Authorization. Service may be provided for fewer than six months, but may not exceed six months;

 •  CPS worker's signature and signature date; and

 •  CPS supervisor's signature and signature date.

 •  any regional form specific to the service; and

 •  sufficient documentation for the contractor to understand the client's circumstances and involvement with CPS, that is, a plan of service, investigation report, risk assessment tool, report to the court, and so on.