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B.  Unique Referrals:

TN DCS Custodial Placement:  Regulation # 1 Conversion of Intrastate (TN) Placement into Interstate Placement: Relocation of Family Unit Referral:

During the course of an in-state placement, circumstances occur wherein the TN DCS resource moves to another state.  Per the permanency plan, the TN DCS custodial child who is currently in a placement with the approved TN DCS resource is to remain in placement with the TN resource as they relocate pending permanency.  With the filing of an ICPC Regulation #1 Referral as prescribed below, the child may move with the approved TN resource prior to the issuance of a placement decision by the receiving state ICPC office.  The TN resource home will be required to meet the resource home approval and/or licensure in the receiving state for the continued placement of the child, however, supervision/contact with the child and family is implemented within thirty (30) days of receipt of the referral packet/notice of placement Form ICPC 100B, Interstate Compact Report on Child’s Placement Status (CS-0523).  


The TN DCS Regional staff will convene the appropriate CFTM prior to the re-location to address the change in placement and document conclusions of the CFTM in TFACTS.  The TN DCS Regional PSD/RPS staff, appropriate private agency staff, health unit staff and the child’s GAL will be involved in this CFTM; this meeting may also include education specialists, independent living specialists or other parties as needed.


The TN DCS Regional staff will initiate the ICPC Reg. #1 Referral up to 45 days prior to the date of the re-location.  The ICPC Reg. #1 Referral is entered into TFACTS by the TN DCS Regional staff who will assign the ICPC Reg. #1 Referral to the appropriate TN ICPC Administrator/Alternate in the TFACTS system.   


One complete copy of the ICPC Reg. # 1 Referral is scanned/e-mailed or mailed to the designated TN ICPC Administrator/Alternate.  In limited situations, the TN DCS ICPC Administrator/Alternate may specifically request information to be mailed by “next day mail” to expedite the referral.


The TN DCS Regional staff will maintain a copy of ICPC documents including original documents in the Family Case File per TN DCS Policy 31.5 Organization of Family Case Files.


Concurrently, the TN DCS Regional PSD/RPS staff will document changes in the address and location of the resource home in the TFACTS.   


The ICPC Reg. #1 Referral will include the following required documentation:


ICPC Referral Checklist (CS-0796);  


An ICPC 100A - Interstate Compact Placement Request (CS-0525) accurately completed and signed/dated.  This form should contain the new address;  


Cover Letter (Per Sample in Appendix B);   


Current Family Functional Assessment (CS-0777);  


Permanency Plan in TFACTS or form CS-0577 Permanency Plan-Spanish Version. Either handwritten signed/dated copy or court ratified copy, including any revisions and/or supplemental or supporting plans, such as Interdependent Living Plan or Planned Permanent Living Arrangements (CS-0681-Request for Permanency Goal of Planned Permanent Living Arrangement);   


Current custody/guardianship order and other pertinent court documents (signed and dated) including previous petitions, custodial orders, the required annual court review

The Interstate Compact on the Placement of Children Procedures Manual

Revised: January, 2012                                                                                                                           Page 17

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