DOB APPROVAL STAMP (If Required) Revised 05/03/2022
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Department for Children and Families Rebecca Gerhardt 785-296-3825
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Agency Agency Contact Contact Phone Number
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https://www.dcf.ks.gov/Newsroom/Documents/Economic_Impact_Statement-Rules_and_Regulations-JCIC 9-22-2023.pdf
PPS 1011 State of Kansas REV Apr. 18 Department for Children and Families Child Abuse and Neglect
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Agency Name: Mailing address: Email Address: Phone Number: ( ) I understand that all
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_1000_Forms/PPS1011.pdf
Kansas Department of Social and
Rehabilitation Services
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Prepared by:
SRS Office of Financial
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Docking State Office Building, 915 S.W. Harrison, Topeka, KS 66612; (785) 296-6217; e-mail
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https://www.dcf.ks.gov/Agency/Documents/SSBG_StatePlan_SFY2012.pdf
The Income Withholding for Support (IWO) is the OMB-approved form used for income withholding in
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• Tribal, intrastate, and interstate cases enforced under Title IV-D of the Social
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https://www.dcf.ks.gov/services/CSS/Documents/iwo_instructions.pdf
(Donor must have picture ID to show to collection site personnel
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Type of Test to Be Conducted: Drug Test (NIDA/5) Panel
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Normal Collection - H39 Screen 5, PCP
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852-5201 or email
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https://content.dcf.ks.gov/ees/KEESM/Forms/ES-4108_Collection_Site_Passport.pdfView duplicates
State of Kansas PPS 8400H Department for Children and Families Rev. 1/2023 Prevention and Protection Services Page 1 of 20
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Quality Residential Treatment Program (QRTP) Site Visit
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_8000_Forms/PPS8400H.pdfView duplicates
Send a scan of the form to the EBT Unit as an attachment to an e-mail to DCF.EBTMAIL@ks.gov
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portions of the form are completed, email the completed form to the Administrative Office
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https://content.dcf.ks.gov/EES/KEESM/Forms/ES-3142EBT_Ben_Repay05-22.pdfView duplicates
Required Elements for Submission of the Unified or Combined State Plan and Plan Modifications under the Workforce Innovation and Opportunity Act
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States must have approved Unified or
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https://www.dcf.ks.gov/services/RS/Documents/WIOA Combined Portion of State Plan ps 12-14-19.pdf
front end, from intake to investigations, is struggling with
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timeliness, consistency and comprehensiveness, potentially leading to
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adverse outcomes for kids and families
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Email
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https://www.dcf.ks.gov/Agency/Documents/Kansas Assessment Conducted by AECF.pdf
The Kansas Department for Children and Families (DCF) works with approximately 750 youth from
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please call 785-296-3944 or send an email to dcf.H4H@ks.gov. Wrapped gifts and gift cards
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https://www.dcf.ks.gov/services/PPS/Documents/HopeForTheHolidays.pdf