10848_ITN_Exhibit 3_Youth_Discharge_Form.pdf
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- Attached to
- CINS/FINS & Statewide Respite Care Services
- Solicitation number
- ITN-09961
- Issued by
- Leon County, Florida
About this file
This document is an Invitation to Negotiate (ITN) issued by the Florida Department of Juvenile Justice (DJJ) 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 Department seeks to select a lead agency that will subcontract for and provide management and administrative oversight of a statewide network of community-based respite care service providers. The CINS/FINS residential services shall be provided to youth between 10 and 18 years of age, and the non-residential services shall be provided to youth between 6 and 18 years of age. The plan for programming includes contracting with local service providers to deliver services to CINS/FINS youth and families, provide statewide support services, data collection and reporting, management, and enforcement of provisions described in the Services Sought attachment.
The Department is seeking proposals from respondents that will deliver all service components inclusive - CINS/FINS, Statewide Respite Care Services, and evidence-based or promising practices delinquency prevention programming. The Statewide Respite Care Services are for youth between the ages of 10 up to 18 years of age, who either have been charged with an offense of domestic violence, are on probation and referred by the Department, or are in need of respite services and have been issued a pre-delinquency citation. A Youth Discharge form with a properly prepared invoice shall be submitted directly to the Department's Contract Manager within 15 business days following the end of the month for which services were rendered.
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Text version
ITN #10848
EXHIBIT 3
SAMPLE YOUTH DISCHARGE FORM
Youth’s Name (First initial, Last name) _____________________________________________
JJIS Number ___________________________________________________________________
Admission Date_________________________________________________________________
Discharge Date_________________________________________________________________
Program Instructor’s Signature____________________________________________________
*If services are not rendered in a 30 day period, the youth will be released/discharged from the program.
A Youth Discharge form with a properly prepared invoice shall be submitted directly to the Department’s Contract Manager within 15 business days following the end of the month for which services were rendered.
File details come from the government source that posted it. Updated .