Successor Guardian. Federal law requires a successor legal guardian be identified in the Guardianship Assistance Program Agreement. If the said guardian dies or becomes incapacitated and is unable to care for the child, a successor legal guardian is to be named on this agreement. The successor guardian will assume responsibility for caring for the child and will receive the monthly guardianship subsidy noted on this agreement when the following criteria are met:
Successor Guardian. The Adoption and Guardianship Office AGREEMENT PROVISIONS Medical bills will not be processed for payment until the successor guardian(s) and the adoption and guardianship assistance program manager or MDHHS designee have signed the agreement and the DHS-1344-SG, is processed by the AGAO; see GDM 735, Juvenile Guardianship Medical Subsidy Eligibility for detailed medical subsidy policy. The AGAO is responsible for preparing and sending the appropriate agreement for the child, to the successor guardian(s) when the child is determined eligible. The successor guardian(s) is responsible for the following agreement procedures: • Reviewing and completing each agreement according to the agreement instructions. • Signing each agreement and obtaining a witness signature on each agreement. • Returning the agreement(s) to the AGAO. Upon receipt of the completed and signed agreement, the AGAO is responsible for the following agreement procedures: • Reviewing the agreement(s) for completeness and accuracy and resolving all problems before proceeding. • Obtaining the adoption and guardianship assistance program manager or MDHHS designee signature on the agreement(s). • Returning the original agreement(s) to the successor guardian(s).
Successor Guardian. In the event that the relative guardian(s) of the child dies or is no longer able to care for the child, the relative guardian(s) may identify in this Agreement a successor guardian to potentially assist in expediting permanency for the child if and when the relative guardian can no longer fulfill guardianship responsibilities. A successor guardian and all household members within that individual’s home must submit applicable Child Maltreatment Central Registry checks, applicable State Police Criminal Record checks, and applicable Vehicle Safety Checks and be deemed eligible based on the results of those checks before being identified as a potential successor guardian in the Subsidized Guardianship Agreement or in any amendments to the Subsidized Guardianship Agreement. Identification of a successor guardian in the Subsidized Guardianship Agreement will not guarantee an automatic transfer of guardianship in the event that the current relative guardian is no longer able to fulfill guardianship responsibilities. If the initial relative guardian dies or is otherwise incapacitated and a successor guardian was named in the initial Subsidized Guardianship Agreement (or any amendments to the Agreement), a petition may be filed for the successor guardian to assume guardianship at that point in time. After a new Subsidized Guardianship Agreement is signed by the successor guardian and DCFS and the new guardianship is entered before the court, the subsidized guardianship assistance payments will be made to the successor guardian at that point in time, provided the child continues to meet all subsidized guardianship eligibility criteria. If the initial relative guardian is no longer able to fulfill guardianship duties for any reason(s) other than death or incapacitation, the role of a successor guardian in the child’s life will be determined on a case-by-case basis by the Division and other appropriate parties. If the above successor guardian requirements have been met (i.e., applicable background checks have been received and deemed eligible) and all supporting documentation is filed in the provider record, please enter the successor guardian information below: Successor Guardian Full Name(s)) ( ) - (Address) (Telephone #)
Successor Guardian. In the event that the relative custodian(s) or successor guardian(s) of the child dies or becomes incapacitated, the relative custodian(s) or successor guardian(s) may identify in this agreement a prospective successor guardian to provide care and guardianship of the child if and when the relative custodian or successor guardian(s) can no longer fulfill guardianship responsibilities. The successor guardian does not need to be a relative or licensed as a xxxxxx parent to receive kinship guardianship assistance payments. The successor guardian must be named in the agreement or addendum prior to the relative custodian’s or successor guardian(s)’s death or incapacitation. In order for a successor guardian(s) to receive kinship guardianship assistance payments, a new Kinship Guardianship Assistance Agreement will need to be completed outlining the terms of the kinship guardianship assistance and responsibilities of the successor guardian. The successor guardian(s) must complete a fingerprint based criminal background check and a Child Protective Services Central Registry search on all adults residing in the home. The successor guardian(s) must obtain legal custody of the child. After the agreement has been signed by the all parties and the court has granted legal custody to the successor guardian(s), payments may begin to the successor guardian(s) provided that they have met all the above requirements. Name of Prospective Successor Guardian: Address: Telephone Number:
Successor Guardian. The establishment of a successor guardian is required as a condition for continuation of kinship guardianship assistance. If the relative guardian dies, is incapacitated or unable to continue to care for the child[ren], a successor legal guardian must be named in the Kinship Guardianship Assistance Agreement, including any amendments to the agreement thereafter.
Successor Guardian. Kinship guardianship assistance payments will be made to a successor guardian named in this agreement, or in an amendment to this agreement, in the event of the death or incapacity of the relative guardian and the appointment of the successor by the court as the legal guardian of the child named in this agreement and approval by the social services district after required clearances are conducted upon the standards established by the Office of Children and Family Services. Payments to the successor guardian are subject to the terms OCFS-4431 (02/2018) 13 of 13 and conditions of this agreement as applicable to the relative guardian. Such terms and conditions include, but are not limited to, certification and documentation requirements and the obligation to notify the social services district of any changes in circumstances that would make the successor guardian ineligible for payment, such as if the successor guardian is no longer the legal guardian of the child.
Successor Guardian. In the event that the Guardian becomes incapacitated or dies, a Successor to the Guardianship Subsidy payment can be identified. If a Successor is not identified on this agreement, a person can be identified during future renewals or revisions. The Permanent Guardian(s) have identified the following Successor Guardian(s): Successor Guardian(s)’s Full Name(s) Successor Guardian(s)’s Address Successor Guardian(s)’s Email Address Successor Guardian(s)’s Phone Number SIGNATURES: FOR AMENDED, RENEWAL, OR REVISION AGREEMENTS ONLY For each box checked, the appropriate documentation must be submitted to the Agency. Check all that apply: Documentation We/I certify that our/my child is a full time student. Verification of school attendance We/I certify that our/my child is currently employed. Proof of employment and documentation of income. We/I certify that our/my child is currently a recipient of SSA, SSI, or VA benefits. Verification of the type and amount of the benefit. We/I certify that our/my child has financial resources such as a checking/savings/trust account, or vehicle(s). Verification or proof of the value of each financial resource. We/I certify that our/my child has unpaid medical bills. Verification of the unpaid medical bills. SIGNATURES FOR INITIAL OR TERMINATION: Permanent Guardian: Date: Permanent Guardian: Date: NOTARIZED SIGNATURES FOR AMENDED, RENEWAL OR REVISION: By signing below, I/we certify that I/we am/are still legally responsible for the support of the child and providing financial support for the child. Permanent Guardian: Date: Sworn to and subscribed before me this____________ day of __________________, 20______________ My commission expires_____________________________ _____________________________________ Notary Public Notary Public Seal Permanent Guardian: Date: Sworn to and subscribed before me this____________ day of __________________, 20______________ My commission expires_____________________________ _____________________________________ Notary Public Notary Public Seal Permanency/Subsidy Specialist Signature: Date DCS Supervisor Signature: Date Check the “Forms” Webpage for the current version and disregard previous versions. This form may not be altered without prior approval.
Successor Guardian. In the event that the Guardian becomes incapacitated or dies, a Successor to the Guardianship Subsidy payment can be identified. If a Successor is not identified on this agreement, a person can be identified during future renewals or revisions. (Successor Guardian’s full name(s)) (Successor Guardian(s)’s Address) (Successor Guardian(s)’s Email Address (Successor Guardian(s)’s telephone number) Medical, Psychological/Psychiatric, Dental, Hospitalization, Residential Care and Other Expenses.
