10848_ITN_Exhibit 3_Youth_Discharge_Form.pdf

This document is a sample Youth Discharge Form related to an Invitation to Negotiate (ITN) issued by the Florida Department of Juvenile Justice (DJJ) Solicitation #10848 for Children In Need of Services/Families In Need of Services (CINS/FINS), Statewide Respite Care Services, and evidence-based or promising practices delinquency programming. The ITN seeks proposals from community, faith-based, not-for-profit organizations, LLCs, and/or local government divisions to provide residential and non-residential statewide services for CINS/FINS youth and families, including contracting with local service providers, providing statewide support services, data collection and reporting, management, and enforcement of the specified service requirements. The CINS/FINS residential services are for youth between 10-18 years old, and the non-residential services are for youth between 6-18 years old. Additionally, the Department seeks to procure a lead agency to subcontract and provide management and administrative oversight of a statewide network of community-based respite care service providers for youth between 10-18 years old who have been charged with domestic violence, are on probation, or are in need of respite services.

The sample Youth Discharge Form indicates that if services are not rendered within a 30-day period, the youth will be released/discharged from the program. The form must be submitted with a properly prepared invoice to the Department's Contract Manager within 15 business days following the end of the month for which services were rendered.