Acknowledgment of Referral / Change / Closure
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Address
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SECTION V Case Status Change
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☐ Court venue change (custody only / services transfer to another region
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☐ Family did not sign Family Case
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_4000_Forms/PPS4205.docx
Information: Name of Parent 1: Email Address: Cell Phone #: Name of Parent 2: Email Address: Cell Phone #: Street Address: City, State and Zip Code: County of
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5318.doc
KANSAS DEPARTMENT OF SOCIAL AND REHABILITATION SERVICES
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Please address referrals or questions to the appropriate staff below
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72
Regulation 8 -- Change of Placement Purpose
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https://www.dcf.ks.gov/services/PPS/Documents/ICPCtrainingmanual.pdf
SMART Vendor ID: Street Address: City, ST Zip: For Services with or without a Provider
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herein; to discuss with provider any change in client’s or agency’s status/plan; and to
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_2000_Forms/PPS2833.doc
move to new state New Address: Child-only move to new state New Address: Reason: Family new phone/email New
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_9000_Forms/PPS9121.doc
VR) services, KRS emphasizes strategies that will address the needs of people with the most
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and Family Services coordinate to address the employment and/or post-secondary education
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https://www.dcf.ks.gov/services/RS/Documents/SP-Word/4.11(d)_Strategies_includes_IE.doc
EES Program Administrators
September 22, 2011
Page 5 of 8
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M E M O R A N D U M
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SUBJECT: Implementation Instructions - KEESM Revision #49
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Potential Resources – See Summary of Changes item
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https://content.dcf.ks.gov/EES/KEESM/Implem_Memo/Implementation Memo Rev 49final_9-29-11.docxView duplicates
others share ideas for services and supports to address immediate safety and risk concerns
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© 2021 Evident Change
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_0F.docx
are no safety concerns, the risk factor shall address why they are so great that there would
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the family, a discussion of the behavioral change expected shall occur so that the family
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_3000_Forms/PPS3051_Instr.docx
DEPARTMENT OF SOCIAL AND REHABILITATION SERVICES
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A. APPLICANT AGENCY (NAME, ADDRESS, TELEPHONE
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Font size may be 10 point
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D. PROJECT DIRECTOR (NAME, TITLE, ADDRESS, TELEPHONE, E-MAIL
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https://www.dcf.ks.gov/services/PPS/Documents/Grant_Information/SFY12FamilyResourceProjectGrantApplication.docx