Attachment 11 - Contracted Case Management External Inquiry Form.docx

DOCX document 22 KB Posted

Attached to
Foster Care Case Management
Solicitation number
300000284009834
Issued by
Missouri

About this file

This is an External Inquiry (EI) Form used by the Foster Care Case Management Consortium and its sub-agencies in Missouri to document and track concerns raised by external parties regarding case management services. The form serves as a standardized mechanism for receiving, processing, and responding to inquiries from multiple sources including legislative offices, the Governor's office, the Department of Social Services, juvenile and family courts, and departmental oversight staff. When concerns are submitted, the responsible case management sub-agency must document the child(ren) involved using their DCN (case identifier), the nature of the concern with relevant dates, and the relationship of the inquiring party to the case. The form categorizes concerns into three primary types based on their source, with corresponding response timelines: concerns from constituent units or legislative/gubernatorial offices require either a three-business-day response (for written inquiries) or a five-business-day response (for written concerns and phone calls), while concerns from juvenile and family courts or departmental oversight staff require five-business-day responses. All response categories mandate that the individual bringing forth the concern be contacted within 24 hours.

The form includes sections for documenting how situations were resolved and requires completion and sign-off by both state agency staff and Foster Care Case Management (FCCM) staff. The form implements a coordination protocol requiring that CD Constituent Staff copy CD Oversight Staff when submitting the inquiry, and FCCM staff must copy CD Oversight Staff when returning completed forms. This structured process ensures accountability and oversight of external inquiries related to foster care case management services across the consortium and its sub-agencies.

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Text version

STATE 0000000597SL

Attachment 11

Contracted Case Management External Inquiry (EI) Form

Case Management Consortium:

Case Management Sub-Agency:

Individual to contact: Telephone #:

Individual’s relationship to the case:

Child(ren) name and DCN(s)

Issue of Concern (Include dates if known):

Type of Concern:

1. Concern to CD Constituent Unit

|_| Legislative/Governor/Department Inquiry

|_| Send copy of written response within 3 business days: call individual bringing forth the concern within 24 hrs.

|_| Written Concern

|_| Send copy of written response within 5 business days: call individual bringing forth the concern within 24 hrs.

|_| Phone Call

|_|Complete section below within 5 business days; call individual bringing forth the concern within 24 hours.

2. Concern brought forth by the Juvenile or Family Court

|_| Complete section below within 5 business days; call individual bringing forth the concern within 24 hours.

3. Concern to CD Oversight Staff

|_| Complete section below within 5 business days; call individual bringing forth the concern within 24 hours.

How was the situation resolved? Complete when the constituent unit or CD Oversight staff notifies of a concern needing to be addressed.

State Agency Staff completing the form: Date: _ _

FCCM Staff responding and returning the form: _ Date: _ _

CD Constituent Staff are to cc CD Oversight Staff when sending this form to FCCM

FCCM are to cc CD Oversight staff when returning this form to the CD Constituent staff

File details come from the government source that posted it. Updated .