Attachment 6 - Referral Letter.docx

DOCX document 2 MB Posted

Attached to
Foster Care Case Management
Solicitation number
300000283718677
Issued by
Missouri

About this file

This is a referral letter issued by the Missouri Department of Social Services, Children's Division, authorizing case management services for a foster child in the department's custody. The letter serves as official documentation that a designated case manager is authorized to provide case planning and services to an assigned foster child effective on a specified date. The case manager is empowered to enroll children in school, seek medical and behavioral health care, provide informed consent for treatment pursuant to Children's Division policy, and obtain documents including medical records, birth certificates, and school records. The letter includes contact information for the Children's Division Contracted Case Management Oversight Specialist and their supervisor for inquiries or coordination purposes.

The referral letter functions as an authorization document within the Foster Care Case Management contract opportunity with the Missouri Department of Social Services. It establishes the legal framework and scope of authority for contracted case managers providing services to children in state custody. The document is blank in many fields, indicating it serves as a template to be completed for individual cases with specific child information, assigned case manager names, effective dates, and contact details for oversight personnel. This letter type is essential for formalizing the relationship between the state agency, contracted case management providers, schools, medical providers, and other entities requiring verification of case manager authority to act on behalf of the child.

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Text version

Missouri Department of Social Services Jessica Bax Director Mike Kehoe Governor P.O. Box 88 • Jefferson City, MO 65103-0088 • Phone: 573-522-8448 • Fax: 573-526-3971 www.dss.mo.gov • TDD/TTY: 800-735-2966 Relay Missouri: 711

Sara Smith Director Children’s Division

STATE 0000000597SL

Attachment 6

RE:

CHILD:
BIRTHDATE:

TO WHOM IT MAY CONCERN:

The above name child is in the custody of the Missouri Department of Social Services, Children’s Division, and is assigned to _________________________for Case Management services effective ________.

Case Managers are responsible for providing case planning and services to foster children and are authorized to: enroll children in school; seek medical and behavior health care; give informed consent for treatment, pursuant to Children’s Division policy; and obtain documents regarding the family and child, including, but not limited to, medical records, birth certificates and school records.

Children’s Division Contracted Case Management Oversight Specialist phone#: (w) ______________

Signature: ____________________Contracted Case Management
Oversight Specialist Supervisor
Phone#: (W) _______________

Date: ____________

If you have any questions, please feel free to contact the worker or supervisor listed above.

Empowering Missourians to live safe, healthy, and productive lives.

AUXILIARY AIDS AND SERVICES ARE AVAILABLE UPON REQUEST TO INDIVIDUALS WITH DISABILITIES The Missouri Department of Social Services is an Equal Opportunity Employer/Program image1.png image2.jpeg

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