Transitional Housing Placement - Non Minor Dependent (THP-NMD) (formerly Plus Foster Care (THP+FC)
THP-NMD Rate Application
Program background and process:
- All-County Letter (ACL) 12-44: Transitional Housing Placement-Plus-Foster Care and Changes to Transitional Housing Placement Program and Transitional Housing Program-Plus (dated September 11, 2012)
THP-NMD New Provider and New Program
Required rate application form:
- SOC 179
List of case manager names
Type of case manager degrees
A case manager is required for the single site and remote site models to guide and support participants. The provider is required to submit this case manager information as part of the rate application process.
Other required documents:
- CCL License – transitional housing placement provider license, or application for a license, to serve non-minor dependents
- County certification of THP-NMD program
- Articles of Incorporation (Secretary of State)
- Internal Revenue Service (or Franchise Tax Board) Tax Exempt Letter
- Job titles/descriptions
- Organization chart
- List of Board members
- Non-Profit Declaration Statement – non-profit declaration signed by the Board of Directors: requires that the organization will operate during the fiscal year in the public interest for scientific, education, service or charitable purposes; is not organized for profit making purposes; and uses its net proceeds to maintain, improve, or expand its operations. (Please email Fosterca@dss.ca.gov for a sample)
- Lease agreement(s) in effect at the time of the application: must be submitted with biennial rate applications for ongoing programs, as well as with rate applications for new THP-NMD programs. Note: The Foster Care Rates unit does not need addendums or terms and conditions.
- Statement of Information 100 (SI100)
- Program statement – an approved program statement must be sent from Community Care Licensing
For Additional Information:
Foster Care Rates Bureau
744 P Street, MS 8-3-570
Sacramento, CA 95814
Fosterca@dss.ca.gov