Section 55.06. Subsidized guardianship agreement.

 

(1)  An agency shall enter into a written, signed subsidized guardianship agreement with a prospective guardian before guardianship is established under s. 48.977 , Stats., or under a substantially similar Wisconsin tribal law and an agreement specified in s. DCF 55.01 (2) , and before providing subsidized guardianship payments to the guardian. The agency shall provide the prospective guardian with a copy of the signed agreement.

(2)  The subsidized guardianship agreement shall be on a form prescribed by the department and specify all of the following:

(a) The amount of the monthly subsidized guardianship payments that will be provided under the agreement.

(b) The manner in which subsidized guardianship payments may be adjusted periodically based on the circumstances of the guardian and needs of the child, in consultation with the guardian.

(c) A description of any additional services and assistance that the child or guardian will be eligible for under the agreement and the procedures by which the guardian may apply for the additional services and assistance as needed.

(d) That the agency will pay or reimburse the total cost of nonrecurring expenses directly related to obtaining guardianship of the child, not to exceed $2,000, including court costs, attorney fees, and other reasonable and necessary expenses.

(e) That the agreement will remain in effect without regard to the state of residence of the guardian.

(f) That medical assistance provided under Title XIX of the Social Security Act of 1935, as amended, is available to the child as follows:

1. Medical assistance will be provided in accordance with the procedures of the state in which the child resides, except if a child receiving subsidized guardianship payments from an agency in Wisconsin is not eligible for medical assistance in the child's state of residence, the child is eligible for Wisconsin's medical assistance program under ss. 49.43 to 49.497 , Stats.

2. Medical assistance may not be used as primary insurance coverage for care of a child that is covered by a guardian's private health insurance. A prospective guardian shall complete a form prescribed by the department of health services to provide information on any private health insurance coverage before guardianship is established under s. 48.977 , Stats., or a substantially similar Wisconsin tribal law.

(g) The agency's responsibility to release medical, educational, and other historical information the agency has about the child to the prospective guardian, in accordance with applicable law.

(h) That if any of the following occur, the guardian shall notify the agency within 10 calendar days of the effective date:

1. The guardian's address changes.

2. There is a change in the child's guardian.

3. The child enters the military.

4. The child gets married.

5. The child is no longer living in the home of the guardian.

6. The child is deceased.

7. The child completes high school or an equivalent educational program after reaching 18 years of age.

8. If the child is covered by the guardian's health insurance and the guardian's health insurance benefits change or if the child was not covered by the guardian's health insurance and becomes covered.

9. The guardian is no longer supporting the child or is no longer legally responsible for supporting the child.

10. The child is placed outside the guardian's home at public expense.

(i) The guardian's responsibility to complete and return to the agency the annual review questionnaire under s. DCF 55.10 (3) in a timely manner to allow the agency to determine whether the child and guardian remain eligible for subsidized guardianship payments.

(j) A description of the terms upon which the subsidized guardianship agreement may terminate under s. DCF 55.10 (5) (d) .

(k) That an agency may recover any overpayment of subsidized guardianship payments from a current or former guardian by any legal means as determined by the agency. An overpayment to a guardian who continues to receive subsidized guardianship payments may be recovered by reducing the amount of the person's monthly payment.

(L) That the guardian may be eligible for adoption assistance under s. 48.975 , Stats., and 42 USC 673 for care of the child if the guardian later decides to adopt the child. In determining eligibility for adoption assistance, the placement of the child in the home of the guardian and any subsidized guardianship payments will be considered to have never been made.

CR: 12-045: cr. Register May 2013 No. 689 , eff. 6-1-13.

Note

Form HCF-10115, BadgerCare Plus/Medicaid Health Insurance Information , is available in the forms section of the Department of Health Services website, http://www.dhs.wisconsin.gov , or from the Division of Health Care Access and Accountability, P.O. Box 309 Madison, WI 53701-0309. Microsoft Windows NT 6.1.7601 Service Pack 1 Form DCF-F-CFS2365, Subsidized Guardianship Agreement , is available in eWiSACWIS, the child welfare automation system, or by writing to the Division of Safety and Permanence, P.O. Box 8916, Madison WI 53708-8916. Microsoft Windows NT 6.1.7601 Service Pack 1