Resources and Forms

The following is a non-exhaustive list of resources to civil rights and ADA/Section 504 notices, policies, manuals, forms, and other tools applicable to DHS/DFCS programs and Providers. Generally, policies and procedures are available on the DHS Policy and Manual Management System ( PAMMS ).

Policies, Manuals, and Forms (applies to all DHS/DFCS programs, activities, and services) DFCS Policy 3601 - Americans with Disabilities Act and Section 504 of the Rehabilitation Act DHS Policy 2001 - DHS Limited English Proficiency/Sensory Impairment (LEP/SI) Policy DHS Manual 2001 - Access Plan for Constituents with Limited English Proficiency (LEP) and Sensory Impairments (SI) DFCS Civil Rights and ADA/Section 504 Complaint Process (available in English and Spanish ) DFCS Civil Rights, ADA/Section 504 Complaint Form 724 (available in English and Spanish ) DFCS Reasonable Modification and Communication Assistance Request Form for Persons with Disabilities Form 101 (available in English , English large print , Spanish , Spanish large print ) ADA Reasonable Modification Form 101 and 102 Instructions DFCS Reasonable Modifications (RM) and Communication Assistance (CA) Tracking Form 102 ADA Reasonable Modification Form 101 and 102 Manual Tracking Log

Training DHS 1100 - Civil Rights and LEP/SI (applies to all DFCS and OFI Community Partners, required annually and within 30-days of hire) Training materials available on DHS IOTIS training site

Required Signage and Posters DFCS “Notice of ADA/Section 504 Rights” DFCS U.S. Department of Agriculture’s and U.S. Department of Health and Human Services’ Joint Nondiscrimination Statement Georgia Department of Human Services Notice of Free Interpretation Services “AND JUSTICE FOR ALL” Posters TEFAP and CSFP (FNS Form AD-475A) SNAP (FNS Form AD-475B) DFCS programs, services and activities funded by the USDA (e.g., SNAP) must follow applicable “Public Notification” requirements (e.g., FNS Instruction 113-1).

DHS/DFCS Webpage Links DFCS Nondiscrimination and Disability ( dfcs.georgia.gov/adasection-504-and-civil-rights ) ADA/Section 504 documents and forms ( dfcs.georgia.gov/adasection-504-and-civil-rights ) LEP/SI ( dhs.georgia.gov/organization/about/language-access )

Office of Family Independence (OFI) Policies, procedures, and forms (applies to all OFI programs) DFCS’ “Duties of the Office of Family Independence District ADA/Section 504 Coordinators” (See POL 3601 Americans with Disabilities Act and Section 504 of the Rehabilitation Act-Attachment 1) DFCS OFI “ADA/Section 504 District Coordinator List” DFCS “Quality Assurance Unit’s Plan for Periodic Random Sampling of Fair Hearing Requests and ADA/Section 504 DFCS County” (DFCS Management Evaluation (ME) Plan) DFCS “County Department Civil Rights/ADA Reasonable Modifications Compliance Review Guide” (Form 723) SNAP Policies Policy 3025 Americans with Disabilities Act (ADA) and Section 504 Policy 3030 Civil Rights Medicaid Policies Policy 2020 Americans with Disabilities Act (ADA) and Section 504 Policy 2025 Civil Rights TANF Policies Policy 1003 Civil Rights Policy 1004 Americans with Disabilities Act (ADA) and Section 504 Energy Assistance Program (LIHEAP) Policies Policy 800 Americans with Disabilities Act and Section 504 Community Services Block Grant (CSBG) Program Policies Policy 800 Americans with Disabilities Act (ADA) and Section 504 Training (Available on DHS IOTIS training site): DHS 1100 - Civil Rights and LEP/SI (All DFCS and Gateway Community Partners, required annually and within 30-days of hire) ADA 204 - ADA Section 504 Training (OFI and Gateway Community Partners only) WEX 242: ADA Training Updates (OFI only, Gateway training) WEX 243: CR 675021 Civil Rights Updates (OFI only, Gateway training) ADA/Section 504 DFCS District Coordinator Training (OFI only) DHS 3000: Customer Service and Communication R.H. et al. v. Rawlings et al., CAFN: 1:17-CV-01434-TWT (N.D. Ga. 2019) (Consent Order filed on June 4, 2019)

Child Welfare Policies, procedures, and forms (applies to all child welfare programs) Policy 1.4 Non-Discriminatory Child Welfare Practices Policy 1.5 Americans with Disabilities Act (ADA)/Section 504 and Reasonable Modifications Policy 1.6 Indian Child Welfare Act (ICWA) and Transfer of Responsibility for Placement and Care to a Tribal Agency Policy 1.16 Civil Rights Complaint Process DFCS Child Welfare “ADA/Section 504 Regional Coordinator List” Foster care and adoption Policy 14.11 Individualized Assessment Individualized Assessment Tool for Prospective and Existing Caregivers Training (Available on DHS IOTIS training site): DHS 1100 - Civil Rights and LEP/SI (All DFCS, required annually and within 30-days of hire) OCP 833 – ADA/504 Individualized Assessment ADA/Section 504 DFCS Regional Coordinator Training –“WEB 153: Regional FC/Ado ADA Coordinator Training” (Foster care & adoption) OCP 777 - Indian Child Welfare Act (ICWA) OCP 131 – Multi-Ethnic Placement Act (MEPA)/Inter-Ethnic Adoption Provisions Act (IEPA) ADA 205 - Part 2: Civil Rights Protections for Individuals with Opioid Use Disorder