Forms for Resource Families
Respite Care Forms
Respite Care Funding Guidelines
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Respite care funding is available for children currently in foster care.
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Each foster youth is eligible for up to 80 hours of respite care per year.
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Reimbursement is available at a rate of $16 per hour, up to a maximum of 4 hours per day (maximum $64 per day).
Example:
If your youth stays with a provider for 3 nights, that equals:
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4 reimbursable hours per day
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12 total reimbursable respite hours
Funds can be used to:
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Pay licensed resource providers (other resource families) directly, or
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Reimburse the cost of a local babysitter.
Important Reminders:
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Please submit the reimbursement form within 30 days of using respite care.
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If you use the same provider multiple times in one month, you may combine those dates on a single form.
This form is to be completed for EVERY medical or dental visit.
When it has been completed, please give it to the social worker/probation officer or return it by mail or fax.
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HERE is additional information to guide you with navigating
Marin Community Clinics. Marin Community Clinics (MCC) phone number is: 415-448-1500 for both medical and dental.
The Caregiver Information Form, also called form JV-290, is intended to provide an easily accessible way for caregivers to provide information about the child to the court.
Rodrigo Dias, one of MFCA's Board Members and a Certified Family Law Specialist, has offered to assist with the filing of your completed JV-290. Email the completed form to Alicia Santos at asantos@tdfamilylaw.com. Please be sure that the case number is on the form. If you are having trouble scanning and sending the form in PDF format, they can scan it for you if you mail or drop it off at their law office. Please note: scanned PDFs are ideal, as opposed to taking a photo of the PDF. They will also take care of the e-filing fee.
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NOTE: Please make sure you email your CASA or lawyer to confirm you submitted the JV-290 form.
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