10.25 Obtaining an Out of State Home Study



Practice Guidance

  • 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.​


  1. ​​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:​


  1. 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.