Miss. Code. tit. 18, pt. 6, ch. 1, 18-6-1-C, 18-6-1-C-III, app 18-6-1-C-III-A
Form DFCS 516
Revised 02/2011
You have rights and responsibilities while you are involved with the Division of Family and Children's Services (DFCS) and have an open case. The normal hours of operation for the DFCS are 8:00 a.m. until 5:00 p.m. Monday through Friday, excluding state holidays. In case of emergencies, contact may be made after hours, weekends, and/or on state holidays at 1-800-222-8000.
YOU HAVE THE RIGHT TO:
1. Participate in decisions affecting your family.
2. Identify and discuss your family's strengths and areas needing improvement with your worker to develop your Individual Service Plan.
3. Have office phone numbers and office addresses for your worker and your worker's supervisor.
4. Participate in any court hearings held in your case.
5. Refuse any service or treatment recommended by DFCS unless court ordered.
6. Know when services are about to end.
7. Have your Native American (Indian) ancestry recognized and respected. We will tell the Bureau of Indian Affairs about our involvement with your family and follow the tribe's decisions for handling your case.
8. Be treated with dignity and respect and receive services without regard to age, race, color, creed, religion, national origin, sex, disability, or political affiliation.
_______ / _________________
Client(s) initialsWorker initials
YOU HAVE THE RESPONSIBILITY TO:
1. Provide full names, dates of birth, social security numbers for household members and other necessary information requested by your worker.
2. Cooperate with your worker and participate in service decisions.
3. Complete your Individual Service Plan . This may include paying for the cost or part of the cost of a task.
4. Ask for and be a part of all Family Team Meetings.
5. Give to your worker the names, phone numbers, and addresses of your relatives who may be able to care for your child if necessary.
6. Give your worker all requested medical and educational information about your child.
_______ / _________________
Client(s) initialsWorker initials
CONFIDENTIALITY:
Your family's information is confidential and private. We will not disclose any information without your written permission or by order of the court. However, information may be shared with law enforcement or the Office of the District Attorney without your written permission. We may contact other people to assess the safety of your child.
Confidentiality laws additionally limit the information we can share with you. We are not able to name the reporter in any investigation, tell you what anyone else said, or give you a copy of any investigation.
_______ / _________________
Client(s) initialsWorker initials
The court of your county has the authority to modify any of the statements above.
Client(s): ____ / ____Date: ____
Worker: _________________
Miss. Code. tit. 18, pt. 6, ch. 1, 18-6-1-C, 18-6-1-C-III, app 18-6-1-C-III-A