Transitional Living Services for Youth 14-21 (Checklist)



Youth Name:_________________________________________ Case ID #:__________________________________ Form 2557b

Transitional Living Services for Youth 14-21 (Checklist)

Annual review to be completed the month of the youth's birth date

|Ages |14-15 |16 |17 |18 |19-21 |

| |If youth has a disability or is |Conduct/Review case mining activities to|Conduct/Review case mining activities to |Conduct/Review case mining activities to |COS or Transition Planning meeting held|

|Permanency |medical fragile and requires long term|support permanency planning goals and |support permanency planning goals and |support permanency planning goals and |annually if in the extended care or |

|Planning |care or support into adulthood, the |activities |activities |activities |return to care program. |

| |CVS Supervisor will conduct a case |Review educational needs and identify |Review educational needs and identify |Review educational needs and identify |CPS service plan and other service |

| |review and staffing to determine if a |necessary support for HS graduation |necessary report for HS graduation (including|necessary report for HS graduation |provider staffings are incorporated in |

| |Circles of Support (COS) is needed |Circles of Support (COS) or Transition |credit recovery) |(including credit recovery) |the transition plan, including |

| |prior to the youth turning 16. |Planning Meeting (TPM) replace |COS or Transition Planning Meeting held |Conservatorship ends: Voluntary Extended |citizenship issues. |

| |Citizenship Status: verification of |permanency conference (additions to |annually |foster care begins |Verify receipt of or issue ACCESS |

| |status. If necessary, consult with |child service plan). |CPS service plan and other service provider |COS or Transition Planning meeting held |GRANTED-Foster Care Handbook |

| |SIJS for assistance |CPS service plan and other service |staffings are incorporated in the transition |annually |Provide contact information for the |

| |Identify caring adult for on-going |provider staffings are incorporated in |plan, including citizenship issues. |Verify receipt of or issue ACCESS |regional youth specialist and Youth |

| |support after the youth turns 18 |the transition plan, including |Transition planning services progress |GRANTED-Foster Care Handbook |Leadership Council (YLC) |

| |Conduct/Review case mining activities |citizenship issues. |reported in placement review hearings |Provide contact information for the |Court continuance and review for |

| |to support permanency planning goals |Court report must identify the services |Identify caring adult for on-going support |regional youth specialist and Youth |special circumstances |

| |and activities |needed to assist the youth in |after the youth turns 18. |Leadership Council (YLC) |Six month periodic review and annual |

| |Verify receipt of or issue ACCESS |transitioning to adult life |Verify receipt of or issue ACCESS |CPS service plan and other service |permanency hearing review by court or |

| |GRANTED-Foster Care Handbook |Identify caring adult for on-going |GRANTED-Foster Care Handbook |provider staffings are incorporated in the|administrative methods |

| |Provide contact information for the |support after the youth turns 18. |Provide contact information for the regional |transition plan, including citizenship |Transition Plan review or update must |

| |regional youth specialist and Youth |Verify receipt of or issue ACCESS |youth specialist and Youth Leadership Council|issues. |occur and be documented 90 days before |

| |Leadership Council (YLC) |GRANTED-Foster Care Handbook |(YLC) |Six month periodic review and annual |leaving care |

| | |Provide contact information for the |If youth has a disability or is medical |permanency hearing review by court or |If youth has a disability or is medical|

| | |regional youth specialist and Youth |fragile and requires long term care or |administrative methods |fragile and requires long term care or |

| | |Leadership Council (YLC) |support into adulthood consult with |Transition Plan review or update must |support into adulthood at least six |

| | |If youth has a disability or is medical |Developmental Disability Specialist to |occur and be documented within 90 days |months prior to transition unless the |

| | |fragile and requires long term care or |ensure: |before leaving care |youth has a DADS guardian consult with |

| | |support into adulthood, consult with |See comments under Age 16 |If youth has a disability or is medical |Developmental Disability Specialist to |

| | |Developmental Disability Specialist to |Youth with substantial incapacitation are |fragile and requires long term care or |ensure: |

| | |ensure: |referred to DADS Guardianship |support into adulthood at least six months|See comments under Age 18 |

| | |Youth is placed on appropriate Medicaid |SSI Coordinator to ensure; that the youth's |prior to transition unless the youth has a|SSI Coordinator to ensure that the |

| | |Waiver lists |SSI application will be submitted at least |DADS guardian consult with Developmental |youth's SSI application will be |

| | |Youth with substantial incapacitation |six months before the youth turns 18: and |Disability Specialist to ensure: |submitted at least six months before |

| | |are referred to DADS Guardianship |STAR Health Service Manager- to coordinate |See comments under Age 17 |the youth turns 18: and |

| | |Appropriate long-term care resources |the youth's transition to medical services |SSI Coordinator to ensure; that the |STAR Health Service Manager- to |

| | |through other state agencies are |that are covered by SSI if the youth will no |youth's SSI application will be submitted |coordinate the youth's transition to |

| | |considered and arranged |longer be covered by STAR Health |at least six months before the youth turns|medical services that are covered by |

| | |Citizenship Status: verification of |Youth at 17 yrs, 8 Months: |18: and |SSI if the youth will no longer be |

| | |status. If necessary, consult with SIJS |Extended court jurisdiction in some cases if |STAR Health Service Manager- to coordinate|covered by STAR Health |

| | |for assistance as this may impact DADS |youth requests (must occur before youth turns|the youth's transition to medical services|If the youth does have a DADS guardian |

| | |Guardianship and other adult services |18) |that is covered by SSI if the youth will |determine DADS plan for long term care |

| | | |Transition Plan review or update must occur |no longer be covered by STAR Health. |for the youth. |

| | | |and be documented within 90 days before |If the youth does have a DADS guardian | |

| | | |turning 18. |determine DADS plan for long term care for|Page 1 |

| | | | |the youth. | |

| | | | | | |

|Ages |14-15 |16 |17 |18-21 |22-25 |

| |Experiential life skills training in |PAL Services -Ansell-Casey Life Skills |PAL Services-Life Skills Training and Case |PAL-Transitional Living Allowance, |Transition Center Services |

|Transitional |placement |Assessment and PAL Life Skills Training |Management (until age 18) |Aftercare Room & Board, and Case |Education and Training Voucher (ETV) |

|Living Services |Introduction to Transition Centers | |Assess for Extended Care Program eligibility-|Management services |eligible (age 16-23)-Higher Education |

| |Other identified activities to support|Continue experiential life skills |Voluntary Agreement must be signed prior to |Transition Center Services |Tuition and Fee Waiver (must be used |

| |PAL readiness such as the Teen |training in placement |the youth's 18th birthday if eligible |Extended Care Program |before age 25) |

| |Conference. |Education and Training Voucher (ETV) |Transition Center Services |Return to Care Program |Former Foster Youth in Higher |

| |Introduction to Higher Education |eligible (age 16-23)-Dual credit |Continue experiential life skills |Education and Training Voucher (ETV) |Education-medical services (FFCHE) (21 |

| |opportunities through campus tours |courses. |training in placement |eligible (age 16-23)-Higher Education |up to 23) |

| |and other campus activities |Tuition and Fee Waiver Exemption (high |National Youth in Transition |Tuition and Fee Waiver |Refer to Local workforce centers for |

| |(Coordinate with Youth Specialist or |school dual credit course) |Database Survey-baseline |Exemption Letter |employment and training programs. |

| |Education Specialist) |Transition Center services |population |Transitional Medicaid / STAR Health - age |Register in WorkInTexas. |

| |Provide contact Information for |Determine eligibility for WIA youth |Education and Training Voucher (ETV) eligible|18-21 |Information about State Employment |

| |regional Youth Specialists and Youth |employment programs-local workforce |(age 16-23)-Dual Credit course or Higher |Former Foster Youth in Higher |Preference to Former Foster Youth |

| |Leadership Council (YLC) |center referral. |Education |Education-medical services (FFCHE) (21 up | |

| | | |Tuition and Fee Waiver Exemption |to 23) | |

| | | |Letter |Eligible for WIA youth or adult employment| |

| | | |Transitional Medicaid / STAR Health age |and training programs-local workforce | |

| | | |18-21 |center referral. Register in WorkInTexas.| |

| | | |Receives Information on Medical Power of | | |

| | | |Attorney (90 days before age 18) |Information on the National Youth in | |

| | | |Receives Youth Transition Portfolio that |Transition Database Follow-up Survey (age | |

| | | |includes all required personal documents (90 |19 & 21, if applicable) | |

| | | |days before age 18) |Information about State Employment | |

| | | |Provide Contact Information for regional Lead|Preference to Former Foster Youth | |

| | | |PAL Staff | | |

| | | |Receives Education Portfolio (Green Binder) | | |

| | | |90 days before age 18. | | |

| | | |Receives Health Passport and other medical | | |

| | | |records | | |

| | | |Eligible for WIA youth employment and | | |

| | | |training programs-local workforce center | | |

| | | |referral. Register in WorkInTexas. | | |

Education and Training Voucher website: ETV or 1-877-268-4063

Texas Youth Connection Website:

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