10.25 Obtaining an Out of State Home Study

Legal Authority

The referral packet should contain (in the following order) a:
ICPC Cover Letter/Statement of Family Case Manager which is required by the Interstate Compact on the Placement of Children (ICPC), to include: ¹

The child(ren)’s name, date of birth, race, sex, and Social Security number;
The placement resource’s name, address, telephone number, Social Security number, and relationship to the child(ren);
The SSW’s office address, telephone number, and e-mail address; and
A brief overview regarding the adoptive referral request.

Court commitment/custody orders current and dated within the last twelve (12) months;
Court order documenting the termination of parental rights (TPR);
Child’s current presentation summary packet; Home study, if applicable or complete;
Non-Indian Affidavit;
Completed ICPC Financial/Medical Plan form regarding how the resource/Cabinet for Health and Family Services (Cabinet/CHFS) will meet the financial and medical needs of the child;
Signed Purchase of Services Agreement letter, if applicable;
Statement of After Placement Services form, if applicable;
Verification of title IV-E eligibility;
Copy of the child(ren)’s birth certificate(s);
Copy of the child(ren)'s Social Security card;
The original ICPC-100A Interstate Compact on the Placement of Children Request requesting the home study and possible placement;
Recent medical health, mental health, and educational records; and
Most recent copy of the case plan.

The SSW submits a comprehensive referral packet electronically using TWIST screens when it is believed that the placement is appropriate and an adoptive referral is desired:

Click on cover letter link in the Forms and Resources box to complete the template provided. This will create a consistent, uniform format to be submitted to the receiving state along with prompting the user to complete the necessary information required on the cover letter.