Fill and Sign the Consent Decree Out of Home Placement Only Wisconsin Form

STATE OF WISCONSIN, CIRCUIT COURT,       COUNTY For Official Use IN THE INTEREST OF       Name Consent Decree (Out of Home Placement Only)       Date of Birth Case No.       The parties stipulate and agree that the court may enter a consent decree, placing the child/juvenile under supervision, consistent with these terms and conditions. 1. The case shall be held open for       days/       months. [Chapter 48, up to six months; Chapter 938, up to one year] 2. Placement shall be in:       3. No referrals to intake and/or violations of federal, state, or local laws. 4. Restitution: $       (under age 14, $250 limit), payable to:       Payment terms:       Make repairs or provide services agreeable to the victim (under age 14, 40 hour limit): See attached.       5. Community service/supervised work program (under age 14, 40 hour limit) Amount:       hours. Terms:       6. Counseling:       7. Other (include payment for services under §§48.36, 938.36, 938.361): See attached.       8. The court may extend this decree for an additional 6 months (1 year if a youth village placement) upon notice and motion. Unless an objection is made, no hearing will be held. SIGNED BY DATE SIGNED BY DATE Child/Juvenile       Child’s/Juvenile’s Attorney/GAL       Mother             Father             Prosecuting Attorney       Social Worker       Notice: During the period of this consent decree, the child/juvenile may object to its continuation and the hearing under which the child/juvenile was placed on supervision may be continued as if the consent decree had never been entered. THE COURT FINDS: 1. The victim/family has been given an opportunity to make a statement. 2. If restitution/repairs are ordered, the child/juvenile alone is financially able to pay or the custodial parent is financially able to pay. 3. If the juvenile is providing services for the victim, the child/juvenile is physically able to perform services for the victim (under age 14, 40 hour limit) and the victim agrees to accept such services. JD-1785, 06/03 Consent Decree (Out of Home Placement Only) §§48.32 and 938.32, Wisconsin Statutes . This form shall not be modified. It may be supplemented with additional material. Page 1 of 3 Consent Decree (Out of Home Placement Only) Page 2 of 3 Case No. 4. The consent decree is in the child’s/juvenile’s best interest and is approved. 5. The child’s/juvenile’s placement out of the home is maintained. a. Placement in the home at this time is contrary to the child’s/juvenile’s welfare because:       b. Reasonable efforts to prevent removal were: (Complete one of the following.) made by the department or agency responsible for providing services in the following manner:       not possible due to the following emergency situation:       not required under §48.355(2d) and 938.355(2d) because:       required, but good cause has been shown why sufficient information is not available to enable the court to make the necessary findings. This hearing is continued until (date):       . not to exceed 5 days required, but the department or agency responsible for providing services failed to make reasonable efforts. c. Permanency plan has not been filed. has been filed and reasonable efforts to achieve the goal(s) of the permanency plan were: (Complete one of the following only if a permanency plan has been filed.) made by the department or agency responsible for providing services in the following manner:       not made by the department or agency responsible for providing services. 6. As to the department or agency recommendation: a. The placement location recommended by the department or agency is adopted. OR b. After giving bona fide consideration to the recommendations of the department or agency and all parties, the placement location recommended is not adopted. THE COURT ORDERS: 1. The child/juvenile is placed at       2. The parties must comply with all terms and conditions of the consent decree. 3. Failure to comply with this consent decree may result in reinstatement of these proceedings. If not reinstated, the original petition is dismissed at the end of the appropriate period without further order of the court. JD-1785, 06/03 Consent Decree (Out of Home Placement Only) §§48.32 and 938.32, Wisconsin Statutes . This form shall not be modified. It may be supplemented with additional material. Page 2 of 3 Consent Decree (Out of Home Placement Only) Page 3 of 3 Case No. Expiration Date:       BY THE COURT: Distribution: 1. Original - Court 2. All Signers 3. Service Providers Signature of Circuit Judge/Circuit Court Commissioner       Name Printed or Typed       Date JD-1785, 06/03 Consent Decree (Out of Home Placement Only) §§48.32 and 938.32, Wisconsin Statutes . This form shall not be modified. It may be supplemented with additional material. Page 3 of 3