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New Jersey Department of Children and Families Policy Manual

 

Manual:

CP&P

Child Protection and Permanency

Effective Date:

11-20-2014

Volume:

X

Forms

Chapter:

A

Forms

Revised Date:

8-5-2019

Subchapter:

 

1

 

Forms

Issuance:

4.22

CP&P Form 4-22, Notification of Modification, or Closure of a Kinship Legal Guardianship (KLG) Subsidy

 

Click to view, complete, or print the CP&P Form 4-22, Notification of Modification, or Closure of a Kinship Legal Guardianship (KLG) Subsidy.

 

Click to view, complete, or print this form in Spanish, CP&P Form 4-22(S).

 

WHEN TO USE IT

 

Use this letter to:

 

·         Notify a KLG caregiver(s):

-       That his, her, or their child's KLG subsidy is being modified, or closed, and

-       Of his, her, or their appeal rights;

·         Advise a KLG caregiver of the steps required to have subsidy reinstated (i.e., he or she must submit the required verification from the full time elementary or high school or day care program the child is enrolled and attending, or provide medical documentation if the child is unable to attend school, along with a completed and signed CP&P Form 4-9, CP&P Kinship Legal Guardianship Subsidy Program Annual Compliance Review Letter, page 4 of the CP&P Form 4-22).

·         Give the KLG caregiver(s) a copy of the CP&P Kinship Legal Guardianship Subsidy Program Dispute Resolution Request Form (page 3 of the form); and

·         Provide the KLG caregiver(s) a list of support services that may be helpful to the KLG caregiver's child and his or her family.

 

HOW TO USE IT

 

·         Staff of the Office of Adoption Operations, or the Local Office, prepare this letter using the on-line template in the computerized Forms Manual.

·         Send the letter of notification after a decision has been made to modify or close a KLG subsidy by the Assistant Director of Adoption Operations or his or her designee, or the Local Office Manager.

·         Print the letter on official agency letterhead.

·         The KLG caregiver(s) completes page 3, the CP&P Kinship Legal Guardianship Subsidy Program Dispute Resolution Request Form, and returns it to the Office of Adoption Operations within 20 days, if he or she wishes to appeal the Division's determination.

·         If the KLG caregiver(s) fails to return the appeal request form within the 20 days, the appeal is denied and the modification or closure of the subsidy becomes a Final Agency Decision appealable only to the Appellate Division of the State Superior Court.

·         Adoption Operations staff reviews the completed appeal request form, conduct an administrative review, and contact the KLG caregiver to discuss the request in detail, and advise him or her of the next steps, if any, regarding the appeal.

·         If the KLG subsidy has been closed, the KLG caregiver must return required verification from the full time elementary or high school or day care program the child is attending, or provide medical documentation if the child is unable to attend school, along with a completed and signed CP&P Form 4-9, CP&P Kinship Legal Guardianship Subsidy Program Annual Compliance Review Letter, which is page 4 of the CP&P Form 4-22, before the child's subsidy can be reinstated.

Related Information:

 

 

 

 

Policy History:

 

·         11-20-2014 added clarification that the stoppage applied to Medicaid as well as maintenance and clothing.

 

DISTRIBUTION

Original

-

KLG caregiver(s)

Copy

-

KLG subsidy folder