| 100.1 Wayne County Department of Children and Family Services. |
| Exhibit 100.1-A WCDCAFS Organizational Chart |
| 100.2 Mission and Goals of Juvenile Justice Services |
| 100.3 Target Population: Eligible Juveniles |
| 100.4 Juvenile Justice Services System |
| Exhibit 100.4-A Juvenile System Description and Overview |
| 100.5 Organizational Staffing Chart: Juvenile Justice |
| Exhibit 100.5-A Organizational Chart: Juvenile Services |
| 100.6 Emergency Contact Protocol |
| Exhibit 100.6-A CAFS Emergency Contact List |
| Exhibit 100.6-B Addendum 6 Emergency Policy |
| 100.7 Establishment and Maintenance of the JJSH and Communication with Contract Agencies |
| 100.8 Media and Public Relations |
| 100.9 Staff Qualifications: JAC and CMO |
| Exhibit 100.9-A Background Clearance Form |
| 200.1 Juvenile Justice Glossary |
| Exhibit 200.1-A Juvenile Justice Glossary |
| 300.1 Legal Base for Juvenile Justice Services |
| Exhibit 300.1-A Publics Acts 1974- P.A. 150 |
| Exhibit 300.1-B Public Act 518 of 1998 |
| 300.2 Freedom of Information Act Requests |
| 300.3 Office of the Children’s Ombudsman |
| 300.4 Michigan Protection and Advocacy Service, Inc. |
| Exhibit 300.4-A Notice of Access to Youth |
| Exhibit 300.4-B Objection to MPAS Services |
| 401.1 The Third Judicial Circuit Court of Michigan |
| Exhibit 401.1-A Time and Notice Requirements |
| Exhibit 401.1-B Jurisdiction Over Criminal Cases Table |
| Exhibit 401.1-C CM Rule B-28 – Family Division Court |
| 401.2 Petitions |
| Exhibit 401.2-A Petition (JC 04) |
| Exhibit 401.2-B Motion and Notice of Hearing or Commitment Review (RC 76) |
| Exhibit 401.2-C Ready For Trial (MJC 920) |
| 401.3 Preliminary Hearings |
| Exhibit 401.3-A Order After Preliminary Hearing (JC10) |
| Exhibit 401.3-B Wayne County Juvenile Detention Facility – Automatic Admission Offenses |
| 401.4 Trial / Adjudication Phase |
| 401.5 Victim’s Rights |
| 401.6 Dispositional Phase |
| 401.7 Communication With The Court |
| 401.8 Court Orders |
| Exhibit 401.8-A Order of Disposition (JC 25) |
| Exhibit 401.8-B Supplemental Order of Disposition (JC57) |
| Exhibit 401.8-C Order of Delayed Sentence (JC 73) |
| Exhibit 401.8-D Order of Disposition Delinquency Hearing (JA 14) |
| Exhibit 401.8-E Parent/Guardian Letter |
| Exhibit 401.8-F Order of Probation-Designated Case (JC 74) |
| 401.9 Progress Review and Court Report for Juveniles in Commitment Status |
| Exhibit 401.9-A Court Report-Juveniles in Commitment Status with WC-CAFS |
| 401.10 Commitment Review Hearings |
| 401.11 Discharge of Wardship (CAFS and DHS) |
| 401.12 Change of Plan: Escalation and De-escalation |
| Exhibit 401.12-A Escalation Petition Template |
| Exhibit 401.12-B De-escalation Petition Template |
| 401.13 Escaped Youth and Writ of Apprehension |
| Exhibit 401.13-A Order To Take Custody (Writ – JC05) |
| Exhibit 401.13-B Petition and Bench Warrant (MC 229) |
| Exhibit 401.13-C Notice of Cancellation of Writ of Apprehension (MJC 434) |
| 401.14 Waivers |
| Exhibit 401.14-A Order Committing to DHS (CC 236) |
| Exhibit 401.14-B Order of Probation (RC 78) |
| Exhibit 401.14-C Pre-Sentence Investigation Report Outline |
| 401.15 Designated Docket |
| 401.16 Restitution and Reimbursement |
| Exhibit 401.16-A Restitution Verification Form |
| Exhibit 401.16-B Restitution Reimbursement Form |
| 401.17 Delinquency Cases in District Court |
| 401.18 New Criminal Charges During CMO Enrollment |
| 402.1 Medical Assistance (MA) Determination |
| Exhibit 402.1-A MA Clearance Request (Community) |
| Exhibit 402.1-B Request to Close Medicaid |
| Exhibit 401.2-C MA Clearance Request (Out-of-Home Placement |
| 402.2 Title IVE Determination |
| Exhibit 402.2-A Child Placing Agency Case Report (DHS 719) |
| Exhibit 402.2-B Data Code Sheet |
| Exhibit 402.2-C Facsimile of Title IVE Determination Notice |
| Exhibit 402.2-D Cover Sheet for DHS 710 Referrals |
| Exhibit 402.2-E Third Judicial Circuit Court Administrative Review Hearing |
| Exhibit 402.2-F Title IVE Required Language Form |
| Exhibit 402.2-G Court Report Administrative review Hearing |
| 402.4 Bureau of Juvenile Justice (DHS) Programs |
| Exhibit 402.4-A Directory of DHS Juvenile Justice facilities |
| Exhibit 402.4-B Resource Certification (Form Letter) |
| 402.5 DHS PA 150 Contract Cases |
| 402.6 Child Development and Care (CDC) |
| 403.1 Mission of WCJDF |
| Exhibit 403.1-A Automatic Admission Offense List |
| 403.2 Case Management Services |
| 403.3 Health Services |
| Exhibit 403.3-A Female Physical Exam Form |
| Exhibit 403.3-B Male Physical Exam Form |
| Exhibit 403.3-C Health Record Summary |
| Exhibit 403.3-D Initial History / Admission Physical Exam |
| 403.4 Mental Health Services |
| 404.1 Mental Health Pre-Screening Assessment |
| Exhibit 404.1-A Mental Health Pre-Screen Assessment Form |
| 404.2 Mental Health Assessment Instrument |
| Exhibit 404.2-A Mental Health Pre-Screen Assessment |
| 404.3 Accessing DWCCMHA Services |
| Exhibit 404.3-A CMH Child and Adolescent Referral Criteria Worksheet |
| Exhibit 404.3-B CMH Provider List |
| Exhibit 404.3-C Ineligible Services – Memo |
| Exhibit 404.3-D Sample Case Notes |
| Exhibit 404.3-E CMO Request for CMH Services |
| Exhibit 404.3-F Determination of CMH Enrollment and Provider Assignment |
| Exhibit 404.3-G Medicaid Qualified Health Plans |
| 404.4 JAC Psychiatric Services |
| Exhibit 404.4-A JAC Psychiatric Referral Form |
| 404.5 Wraparound Services – A Joint Venture with Detroit-Wayne County Community Mental Health Agency and Wayne County Juvenile Justice |
| Exhibit 404.5-A Memorandum of Understanding |
| Exhibit 404.5-B Wraparound Plan of Care |
| Exhibit 404.5-C Wraparound Flow Chart |
| Exhibit 404.5-D CMO Request for CMH Services |
| Exhibit 404.5-E Wraparound Consent |
| Exhibit 404.5-F Wraparound Crisis Plan |
| Exhibit 404.5-G Wraparound Safety Plan |
| Exhibit 404.5-H Notification (to the Court) of Wraparound Enrollment |
| 404.6 Accommodating Communication, Mobility or Visual Impairments Through the JAC |
| 404.7 Person / Family Centered Planning |
| 404.8 ICBS policy |
| 405.1 CAFS Substance Abuse Providers |
| Exhibit 405.1-A Directory of Wayne County Approved Substance Abuse Providers |
| 407.1 House Arrest Mission FINAL 11.1.24 |
| 407.2 Electronic Monitoring FINAL 12.6.24 |
| 407.3 Alarm Protocols FINAL 11.1.24 |
| 407.4 Court Advocacy FINAL 12.9.24 |
| 407.5 High Risk Youth FINAL 11.1.24 |
| 500.1 JAC: Required Services |
| 500.2 Juvenile Assessment Center Services: Juveniles Placed With CAFS and Probation Cases |
| Exhibit 500.2-A Integrated Planning System – Placed Juveniles |
| Exhibit 500.2-B Integrated Planning System – Probation |
| Exhibit 500.2-C CAFS Acceptance Notice |
| Exhibit 500.2-D Time Frames |
| Exhibit 500.2-E JAC Assessment Units |
| Exhibit 500.2-F JAC Referral Notice |
| Exhibit 500.2-G JAIS Intake Record |
| Exhibit 500.2-I Preliminary Notice of CMO Assignment |
| Exhibit 500.2-J Assessment and Referral Packet Cover Letter |
| Exhibit 500.2-K JAC Parent Appointment Letter |
| Exhibit 500.2-L Individual Service Agreement (DHS 3600) |
| Exhibit 500.2-M Preliminary Notice of Intake Specialist and Psychological Appointment |
| Exhibit 500.2-N Service Description – Probation and At-Risk Cases |
| 500.3 At Risk Juveniles |
| Exhibit 500.3-A JAC At-Risk Referral Notice |
| Exhibit 500.3-B JAC – CMO Data Outcome Sheet |
| Exhibit 500.3-C At-Risk Juvenile Complaint |
| Exhibit 500.3-D Case Control Form (MJC 903) |
| Exhibit 500.3-E Court Memo |
| Exhibit 500.3-F At-Risk Agreement – Consent Form |
| Exhibit 500.3-G Family Division CM Rule B-28 |
| 500.4 Case Acceptance and Referral Packet |
| Exhibit 500.4-A Order of Disposition (JC25) |
| Exhibit 500.4-B Order After Court hearing (MJC 1025) |
| 500.5 CMO Assignment and Juvenile Assessment Packet |
| Exhibit 500.5-A Assessment Packet Receipt |
| Exhibit 500.5-B Authorized to Request/Release of Information |
| Exhibit 500.5-C Authorization for Release of Information |
| 500.6 Detention Services |
| Exhibit 500.6-A CAFS Detention Admission/Preliminary Hearing Request Form |
| Exhibit 500.6-B Detention Placement Policy Grid |
| Exhibit 500.6-C Initial Level of detention Assignment Form |
| Exhibit 500.6-D Excessive Length of Stay Memo Format |
| Exhibit 500.6-E Complaint (JC 01) |
| Exhibit 500.6-F Detention Referral Form |
| Exhibit 500.6-G Procedure for Progressive Sanction/72 Hour Detention |
| Exhibit 500.6-H Youth Release Authorization |
| Exhibit 500.6-I Shelter/Detention Alternative Screening Form |
| 500.7 DHS Eligibility Determination |
| Exhibit 500.7-A DHS Initial Determination of Appropriate Foster Care Funding Source |
| Exhibit 500.7-B DHS Re-determination of Appropriate Foster Care Funding Source |
| 500.8 Governmental Benefits |
| Exhibit 500.8-A Foster Care/Delinquent Ward Benefit Eligibility Record |
| 500.10 Intake Summary and Social History |
| Exhibit 500.10-A Social History Format |
| Exhibit 500.10-B Sample Social History |
| Exhibit 500.10-C Intake History and Social (JAIS Facsimile) |
| 500.11 Clinical Assessment |
| Exhibit 500.11-A Clinical Assessment Appointment Report |
| Exhibit 500.11-B Psychological Evaluation Format |
| 500.12 Care Management Tracks and Utilization Management |
| Exhibit 500.12-A CMT Authorization Request |
| Exhibit 500.12-B CAFS CMT JAIS Code Sheet |
| 500.13 Courtesy Services (Inter County) |
| Exhibit 500.14-A Child and Adolescent Needs and Strengths (CANS) |
| Exhibit 500.14-B CANS Comprehensive Manual |
| Exhibit 500.15-A Family Assessment Report |
| 500.16 Services for DHS Child Welfare Cases |
| Exhibit 500.16-A County Child Care Referral Form |
| Exhibit 500.16-B Adult, Adolescent Parenting Inventory |
| Exhibit 500.16-C Addiction Severity Index Assessment |
| Exhibit 500.16-D Daniel Memorial |
| Exhibit 500.16-G Therapeutic Services Treatment Plan for Child Welfare cases |
| Exhibit 500.16-H Court Report for Child Welfare Cases |
| 500.17 Delinquency Cases in District Court |
| 500.19 Youth Assistance Programs (YAP) and Accessing Child Care Funds |
| 600.1 CMO Service Delivery System |
| 600.2 Interface with Juvenile Assessment Center (JAC) |
| 600.3 CMO Intake Procedures |
| 600.6 Home Based Services |
| 600.9 Out-of-Home Placement Services |
| Exhibit 600.9-A Agency security Level Worksheet |
| Exhibit 600.9-B Unusual Incident Report |
| Exhibit 600.9-C Provider Registration Form |
| 600.10 Educational Requirements |
| 600.11 Reintegration Services |
| 600.12 Security Level Change |
| 600.13 Progressive and Intermediate Sanctions |
| 600.14 Residential Release Plans |
| Exhibit 600.14-A Residential Release Plan Template |
| 600.15 Transportation |
| 600.16 Pre-sentence Investigations |
| 600.17 Michigan Interstate Compact and Out-of-Town Inquiries |
| Exhibit 600.17-A Interstate Compact Placement Request (DHS 4332) |
| Exhibit 600.17-B Interstate Compact Report on Child’s Placement Status (DHS 4333) |
| Exhibit 600.17-C Report of Sending State Parolee or Probationer Being Sent to another Jurisdiction (DHS 3039) |
| Exhibit 600.17-D Violation of Probation or Aftercare Report (DHS 1907) |
| 600.18 Medical/Dental Care and Standards |
| 600.21 Independent Living |
| 600.23 Michigan Protection and Advocacy, Inc (In Development) |
| 700.1 Case Planning, Case Management and Treatment Planning |
| Exhibit 700.1-A Treatment Plan of Care |
| Exhibit 700.1-B Goals, Objectives and Action Step Guide |
| 700.2 Updated Case Planning, Case Management and Treatment Planning |
| Exhibit 700.2-A Updated Plan of Care (UPOC) |
| 700.3 Discharge Planning |
| 700.4 Victim Notification |
| 700.5 Sex Offender Registration |
| Exhibit 700.5-A Michigan Sex Offender registration Form (DD4) |
| 700.6 DNA Sampling Collection |
| Attachment 700.6-A DNA Sampling Confirmation Form |
| 700.7 Escape Reporting |
| Exhibit 700.7-A Notice of Escape from Wayne County Juvenile Detention Facility or Alternative Facility |
| 700.8 Death Reporting |
| Exhibit 700.8-A Report of Death (18 years and Older) |
| Exhibit 700.8-B Report of Minor’s Death |
| Exhibit 700.8-C Request to Terminate Court Jurisdiction |
| 700.9 Neglect, Abuse and Other Complaints |
| Exhibit 700.9-A Report of Actual or Suspected Child Abuse or Neglect (DHS 3200) |
| 700.10 Parent and Juvenile Visitation |
| 700.11 Terms and Conditions of Probation |
| Exhibit 700.11-A Terms and Conditions of Probation |
| Exhibit 700.11-B Terms and Conditions for Commitment |
| Exhibit 700.11-C WC-CAFS / JAC Referral |
| 700.12 Permanency Planning |
| Exhibit 700.12-A Independent Living Agreement |
| 700.13 Authority to Consent |
| EExhibit 700.13-A Consent to Emergency and Routine Medical Treatment |
| Exhibit 700.13-B Special Education Consent Authorization |
| Exhibit 700.13-C Client Information Release Authorization (Sample) |
| Exhibit 700.13-D Family Division – Case Management Rule B-30 |
| 700.14 Standards of Promptness |
| 700.15 Balanced and Restorative Justice (BARJ) |
| 700.16 Termination of Wardship and CMO Disenrollment |
| Exhibit 700.16-A CMO Disenrollment Report |
| Exhibit 700.16-B Termination of Wardship Petition (JC 04) Template |
| Exhibit 700.16-C Administrative Dismissal (JC 36) |
| 700.17 In-Home Services |
| 700.18 Vital Records |
| Exhibit 700.18-A Directory of State Bureaus of Vital Statistics |
| 700.19 Social Security Number |
| 700.20 Involuntary Psychiatric Hospitalization |
| Exhibit 700.20-A Detroit-Wayne County Community Mental Health Agency Crisis Access Centers |
| 700.21 Clothing |
| Exhibit 700.21-A Clothing Inventory Checklist |
| 700.22 Native American Services |
| 700.23 Probation with WC-CAFS |
| Exhibit 700.23-A Probation Tiers |
| Exhibit 700.23-B WC-CAFS – JAC Referral |
| Exhibit 700.23-C Terms and Conditions of Probation |
| Exhibit 700.23-D Probation Risk Assessment Report |
| Exhibit 700.23-E Probation Supervision and Service Plan |
| Exhibit 700.23-F Updated Probation Supervision and Service Plan |
| Exhibit 700.23-G Referrals for Counseling Services Through JAC for Juveniles on WC-CAFS Probation |
| Exhibit 700.23-H Probation Court Review and Termination Report |
| 700.24 Private Training Schools |
| Exhibit 700.24-A Request for Training School Placement |
| 800.1 Introduction to Structured Decision Making (SDM) |
| Exhibit 800.1-A Key Element of an SDM System |
| 800.2 Juvenile Classification and Assignment Report |
| Exhibit 800.2-A Probation Risk Assessment |
| Exhibit 800.2-B Juvenile Classification and Assignment Report |
| Exhibit 800.2-C Offense Codes |
| Exhibit 800.2-D Scoring Guide |
| Exhibit 800.2-E CMO Residential Provider Network by Security Level and Specialization |
| 800.3 Strength and Needs Assessment |
| Exhibit 800.3-A Initial Strengths and Needs Assessment |
| 800.4 Risk Reassessment |
| Exhibit 800.4-A Risk Reassessment for Youth in Residential Placement |
| Exhibit 800.4-B Risk Reassessment Scoring Guide (Residential) |
| Exhibit 800.4-C Risk reassessment for Youth in Community Supervision |
| Exhibit 800.4-D Risk Reassessment Scoring Guide (Community) |
| Exhibit 800.4-E Criteria for De-escalation Grid |
| 800.5 Strength and Needs Reassessment |
| Exhibit 800.5-A Strengths and Needs Reassessment |
| 800.6 Re-offenders Matrix |
| Exhibit 800.6-A Security Level Matrix for Re-Offenders |
| 800.7 Overrides |
| 1000.1 Managing For Results |
| Exhibit 1000.1-A Managing For Results Report |
| 1000.2 Quality Assurance |
| 1000.3 Administrative Complaints |
| Exhibit 1000.3-A Report of Actual of Suspected Child Abuse or Neglect (DHS 3200) |
| Exhibit 1000.3-B Preliminary Report |
| Exhibit 1000.3-C Request for Additional Information |
| Exhibit 1000.3-D Critical Incident Report |
| Exhibit 1000.3-E Instructions for Completing the Preliminary Report |
| Exhibit 1000.3-F Notice of Concern (NOC) Form |
| Exhibit 1000.3-G Notice of Concern (NOC) Monthly Report |
| 1000.4 Audits and Contractor Reporting |
| 1000.5 Training |
| 1000.6 JAC and CMO Reporting |
| 1000.7 Criminal History Checks: Employees and Volunteers |
| Exhibit 1000.7-A Request for Central Registry Clearance |
| Exhibit 1000.7-B Staff Background Clearance Check |
| 1000.8 Consumer Surveys |
| 1100.1 Juvenile Assessment Center (JAC) Case Record Requirements |
| 1100.2 Care Management Organization (CMO) Case Record Requirements |
| Exhibit 1100.2-A Youth Placement and Education Record |
| 1100.3 Retention and Disposal of Case Records |
| 1100.4 Confidentiality of Records |
| 1100.5 Request for Information from the Case Record |
| 1100.6 Digital Prints and Mug Shots |
| 1100.7 Official Case Files |
| 1100.8 Juvenile Justice Forms Index |
| Exhibit 1100.8-A Juvenile Justice Forms Index |
| 1200.1 Care Management Tracks |
| 1200.2 JAC and CMO Payments |
| Exhibit 1200.2-A CMO Invoice Summary |
| Exhibit 1200.2-B JAC Invoice Summary |
| 1200.3 Non-Scheduled Payments |
| Exhibit 1200.3-A Non-Scheduled Authorization Request |
| 1200.4 Child Care Fund |
| Exhibit 1200.4-A Child Care Fund Handbook |
| 1200.5 Processing Calumet Center Payments |
| Policy Release 0100 06 (10-1-2003) |
| CMO -SOP for Invoice Reconiclement 2-1-22 |
| Policy Release 1000.3 Critical Incident |
| Policy Release Critical Incident & Admin Compliant Reporting |
| Memo authorizing policy revisions series 100(8-6-2021) |
