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Description: NJ DCF Logo with reverse copy 

 

New Jersey Department of Children and Families Policy Manual

 

Manual:

CP&P

Child Protection & Permanency

Effective Date:

Volume:

X

Forms

Chapter:

A

Forms

 

2-5-2018

Subchapter:

1

Forms

Issuance:

5.43

CP&P Form 5-43, Transitional Plan for YOUth Success

 

Click here to view CP&P Form 5-43, Transitional Plan for YOUth Success

 

Click here to view CP&P Form 5-43(S). Transitional Plan for YOUth Success

 

WHEN TO USE IT

 

This federally required form assists youths who are placed out-of-home to create a plan to identify goals and the steps needed to achieve those goals: 

 

·         When the youth is 14 years of age or older and in an out-of-home placement/living arrangement which would include, but not limited to:

o   Resource Home (Related and Unrelated);

o   Treatment Home and any other Children’s System of Care (CSOC) paid out-of-home treatment;

o   Pre-adoptive/Select Home;

o   Independent Living Arrangement;

o   Transitional Living Program;

o   Shelter Placement; and

o   College Dorm.

 

·         Within 90 calendar days of a youth’s 14th birthday or within 90 days of entering out-of-home placement for a youth over the age of 14.

·         Every six months, at a minimum, re-evaluate status and progress; and

·         Within 90 calendar days prior to closing the case.

 

Note: Youths ages 14-17 both require the Transitional Plan for YOUth Success 5-43, and the Case Plan (CP&P Form 26-81). For young adults 18-21, the Transitional Plan for YOUth Success is the only needed planning document.

 

 

HOW TO USE IT

 

The Worker and youth complete the form in conjunction with the Independent Living Assessment (Casey Life Skills Assessment) located at http://lifeskills.casey.org/.

 

The Worker prints the form and completes it by hand with the youth and other interested parties, such as, but not limited to:

 

 

·         Family members,

·         Caring adult(s), and

·         Others who care about and support the youth’s success.

 

The goal is for a coordinated Transitional Plan to be in place for all agencies or providers involved with the youth. The Worker takes the lead by bringing individual service providers together in the planning and development process.

 

When the NJ SPIRIT version of this form is available, Workers must also enter the information from the hand-written form into the NJ SPIRIT application. Note: Certain fields on the form will pre-populate.

 

Supervisory approval of the Transitional Plan is required. Supervisors sign the hard copy of the form. In addition, when the NJ SPIRIT version of the form is available, Supervisors must access approval under the “Options” drop down menu, via the standard “Approval” window.

 

TIPS FOR COMPLETING THE FORM

 

Workers assist the youth to identify:

 

·         Long-term and short-term goals;

·         Objectives;

·         Action-steps that are clear, measurable, action-oriented, and realistic.

 

Note: The steps include timeframes for completion as well as who is responsible for completing and/or assisting to complete it.

 

For Example:

 

Long-Term Supportive Relationships Goal: To maintain a lasting relationship with appropriate adults.

 

Short-Term Supportive Relationships Goal: To identify people to have a long-term, caring connection with.

 

Objectives: To establish relationships with caring adults who may provide support and guidance.

 

 

Steps:

By a mutually agreed upon date:

 

1)    The Worker refers the youth to a permanency service.

2)    The permanency service Worker searches the case record to find people who have been in the youth’s life.

3)    The permanency service Worker gives the list of the identified individuals to the Worker.

4)    The Worker shares the list of identified individuals with the youth.

 

Note: The Worker obtains the youth adult’s initials on the form, in each of the following domains:

 

·         Supportive Relationships and Community Connections;

·         Education;

·         Employment;

·         Living Arrangement/Housing;

·         Health; and

·         Transitional Services and Supports.

 

Progress:  Document progress of completing the objectives and goals utilizing the rating scale section of the form.

 

·         Accomplished – youth completed the steps to reach the identified objective.

·         Positive Progress – youth is actively working towards accomplishing a step or objective.

·         Ongoing – youth continues to work towards accomplishing a step or objective.

·         No Change – youth has not worked on a step or objective but plans to still work towards completing the identified steps.

·         New Path – youth decides to take a new direction/approach and chooses to identify new objectives and steps to reach his or her goal.

 

When a goal has been achieved, the Worker and youth collaborate to develop additional goal(s) with action steps.

 

OTHER RELATED INFORMATION

 

Click here to print or view the Transitional Plan for YOUth Success Reference Guide.

 

 

 

 

DISTRIBUTION

 

Original          -           Case Record

Copy               -           Youth

Copy             -            Youth Parent(s)

Note: If the youth is under 18, and parental rights have not been terminated, the parent must receive a copy of the plan. If the youth is 18 or older releasing the plan is at the discretion of the youth

Copy             -            Law Guardian

Note: if the youth is under 18, the Law Guardian must receive a copy of the plan. If the youth is 18 or older releasing the plan is at the discretion of the youth

Copy               -           Contracted Provider(s)

Copy               -           Child Placement Review Board

Copy               -           Resource Parent