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NJ DCF Logo with reverse copy 

 

New Jersey Department of Children and Families Policy Manual

 

Manual:

CP&P

Child Protection and Permanency

Effective Date:

2-5-2018

Volume:

X

Forms

Chapter:

A

Forms

Revised Date:

10-04-2021

Subchapter:

1

Forms

Issuance:

4.8

CP&P Form 4-8, Kinship Legal Guardianship (KLG) Subsidy Agreement

 

Click here to view, print, or complete the CP&P Form 4-8, Kinship Legal Guardianship (KLG) Subsidy Agreement.

 

A Spanish version of this form will be forthcoming.    

 

WHEN TO USE THIS FORM:

 

Use this agreement to document the terms and conditions of a KLG Subsidy and identify the Successor Guardian. This agreement must be reviewed, approved, and signed by the Assistant Director of the Office of Adoption Operations, or his or her designee, before it is signed by the kin caregiver.

 

The agreement is effective the date the court order is granted awarding kinship legal guardianship of the child. The agreement

·         Identifies the rights and responsibilities of the KLG caregiver under the CP&P KLG Subsidy Program;

·         Identifies the responsibilities of CP&P to the child and the KLG caregiver under the Program;

·         Identifies the Successor Guardian;

·         Informs the KLG caregiver of the conditions that terminate the child’s participation in the Program.

 

HOW TO USE THIS FORM:

 

After meeting with the kin caregiver and discussing the differences between adoption and kinship legal guardianship, and the conditions and terms of the KLG subsidy, the assigned Worker prepares CP&P Form 4-8 using the on-line template.

 

The assigned Worker sends the unsigned form in the KLG subsidy request packet to the Office of Adoption Operations, CC #966, for approval.

 

Upon receipt of the approved and signed agreement from the Office of Adoption Operations, the Worker asks the kin caregiver to sign the form, if the kin caregiver is in agreement with its terms and conditions. A copy of the signed agreement is given to the kin caregiver.

 

After the court order is awarded, include another copy of the approved and signed agreement in the packet sent to the kinship legal guardian. The packet also includes a copy of the court order.

 

See CP&P-IV-D-2-200, KLG Subsidy Program

 

TIPS FOR COMPLETING THE FORM

 

•    Enter identifying information.

•    Indicate whether the child is Title IV-E eligible.

•    Under number two of the Division's responsibilities, enter the approved and agreed upon subsidy rates (monthly and annually) for the child (the subsidy rate cannot exceed the resource care rate which would have been paid if the child had remained in resource family care).

•    On page two, indicate whether the child is attending school.

•    In the text field for the Worker, enter either the name of the assigned Worker, or the Resource Family Support Worker or designee.

      In the text field, enter the information to identify the Successor Guardian.

 

 

DISTRIBUTION

 

Original   -      KLG subsidy folder (sent to the Adoption and                                                                           Kinship Legal Guardianship Subsidy Unit after                                                                         the KLG order is granted)

Copy        -     Kin caregiver

Copy        -     Child's case record