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HomeMy WebLinkAbout20072771.tiff RESOLUTION RE: APPROVE REVISIONS TO OPERATIONS MANUAL, SECTION 2.000, SOCIAL SERVICES DIVISION POLICIES AND PROCEDURES WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS,the Board has been presented with revisions to Section 2.000, Social Services Division Policies and Procedures, for the Department of Social Services Operations Manual, and WHEREAS, after review, the Board deems it advisable to approve said revisions, a copy of which are attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, ex-officio Board of Social Services, that the revisions to Section 2.000, Social Services Division Policies and Procedures, for the Department of Social Services Operations Manual, be, and hereby are, approved. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 29th day of August, A.D., 2007. 1ELk BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: =%V ) EXCUSED David E. Long, Chair Weld County Clerk to th,`.ijJ. BY: William H n-Tem Dep Cler'o the Board William F. Garcia APP D AS • EXCUSED Robert D. Masden ounty A torney Douglas ademacher Date of signature: 9 h 107 2007-2771 SS0034 O sS o9-/a -o7 1;;;;;\\ DEPARTMENT OF SOCIAL SERVICES A OX B P.O.GREELEY, CO. BOX 2Webstte: www.co.weld.co.us 'rs Administration and Public Assistance(970)352-1551 Child Support(970)352-6933 O COLORADO MEMORANDUM TO: David E. Long, Chair Date: August 24, 2007 Board of County Commissioners FR: Judy A. Griego, Director, Social Services/t �Q. C RE: Revisions to Section 2.000, Social Service s Division ° p Policies and Procedures, Weld County Department of Social Services Operations Manual Enclosed for Board approval are revisions to Section 2.000, Social Services Division Policies and Procedures, Weld County Department of Social Services Operations Manual. These revisions were reviewed at the Board's Work Session held on July 23, 2007, and August 20, 2007. The purpose of the revisions is to convert all County Certified Foster Care/Kinship Homes to a similar rate structure that is currently applied to Child Placement Agencies. Rates to County Certified Foster Care/Kinship Homes will be based on the Needs Based Care Assessment tool. Any cost of living increases will be provided at the start of State Fiscal Years and the same level provided for Child Placement Agencies. The County Certified Foster Care/Kinship Homes will be required to enter into Agreements with the Department to outline responsibilities and the new rate methodology. The major revisions will become effective January 1, 2008. Minor re-organization changes to the manual will become effective August 2007. Section Citation Title of Section 2.320.1 State Licensed Provider Reimbursement 2.320.2 County Certified Provider Reimbursement 2.321.1 County Foster Care,Kinship Care and Foster/Adoption Home Reimbursement Rate 2.321.11 Reimbursement Details for All County Foster Care Providers 2.324 Subsidized Adoption Reimbursement 2.324 Reimbursement Rate(Child Placement Agencies) Form WC-A-1 Weld County Subsidized Adoption Information If you have any questions,please telephone me at extension 6510. 2007-2771 Social Services Division Policies and Procedures 2.320 Out-of-Home Placement Reimbursement Effective 1/1/01 The Department establishes rates to be paid to providers for out-of-home Revised 6/02 placements at the beginning of every state fiscal year. These rates are similar to the State determined reimbursement for specific types of facilities. 2.320.1 State Licensed Provider Reimbursement Added 6/02 Revised 6/06 A. The Department will reimburse a state licensed provider if such provider Revised 8/06 meets the State reimbursement requirements of Colorado State Rules, Revised 8/07 Section 7.405, Volume VII, Social Services Programs, and the State requirements for State Licensed Providers of Colorado State Rules, Section 7.417.2, Volume VII, Social Services Programs. B. As required by C.R.S. 26-5-104, the Department will negotiate rates, services, and outcomes with providers as outlined in the submitted Rate Setting Methodology, Exhibit A, that has been approved by the State. C. The Department will enter into yearly contracts with each State Licensed Provider that the Department utilizes. The Contracts will be in force from July 1, the start of the state fiscal year, to June 30, the end of the state fiscal year. D. The Child Welfare Rate Negotiator will initiate and mail out to providers, both the State prescribed SS-23A, Agreement to Purchase, contract Exhibit B, for Providers as outlined in Colorado State Rules, Section 7.304 and Section 7.304.661 of Volume VII, and the Weld County Addendum to the Agreement to Purchase SS-23A, Exhibits C-G. The county specific addendum will reflect the daily rate to be paid for each child placed with the contracted provider for the state fiscal year, as outlined in paragraph B. Rates reflected within the yearly contracts, will be determined by the State and may include a cost-of-living increase the county has approved. Rates may also be negotiated to reflect additional services that the department has approved. E. Once signed contracts have been received from providers, the State prescribed SS-23A Agreement to Purchase contracts will be approved and signed by the Director and All Weld County Addendums to the State prescribed SS-23A will be approved and signed by the Director and the Board of County Commissioners, Weld County, sitting as the Weld County Board of Social Services. F. Once Placement Contracts are approved and signed by the Director and/or the Board of County Commissioners, each provider will be mailed fully Social Services Division Policies and Procedures executed copies of the Agreement to Purchase Services, SS-23A and Weld County Addendum for their records. Revised 8/07 G. All original contracts will be filed in the Service Utilization Unit. The Service Utilization Unit will notify the Social Services Administrator, or designee, if a provider is requesting reimbursement and does not have a current signed contract. Payment cannot be authorized to the provider until the required contract is provided to the Service Utilization Unit. Revised 8/07 H. Bed hold payments for a child's temporary absence from a provider, including hospitalization, are limited to a maximum of 3 days unless otherwise negotiation as allowed in Volume VII.. All bed hold authorizations need to be approved, in writing within 2 working days, by the Administrator. Once a bed hold is authorized, the Negotiator will contact the provider to negotiate a daily rate for the approved bed hold. 2.320.2 County Certified Provider Reimbursement Added 8/07 A. The Department will reimburse a county certified foster care provider if such provider meets the State reimbursement requirements of Colorado State Rules, Section 7.405,Volume VII, Social Services Programs, and the State requirements for County Certified Providers of Colorado State Rules, Section 7.417.1, Volume VII, Social Services Programs. B. As required by C.R.S. 26-5-104, the Department will negotiate rates, services, and outcomes with providers as outlined in the submitted Rate Setting Methodology, Exhibit A, that has been approved by the State. C. Effective January 1, 2008,the Department will enter into yearly contracts with each County Certified Provider that the Department utilizes. The Contracts will be in force from July 1, the start of the state fiscal year, to June 30,the end of the state fiscal year. D. Effective January 1, 2008, the Child Welfare Rate Negotiator will initiate and mail out to providers, both the State prescribed SS-23A, Agreement to Purchase, contract Exhibit B, for Providers as outlined in Colorado State Rules, Section 7.304 and Section 7.304.661 of Volume VII, and the Weld County Addendum to the Agreement to Purchase SS-23A, Exhibits C-G. The county specific addendum will reflect the daily rate to be paid for each child placed with the contracted provider for the state fiscal year, as outlined in paragraph B. Rates reflected within the yearly contracts, will be determined by the State and may include a cost-of-living increase the county has approved. Rates may also be negotiated to reflect additional services that the department has approved. Social Services Division Policies and Procedures E. Once signed contracts have been received from providers, the State prescribed SS-23A Agreement to Purchase contracts will be approved and signed by the Director and All Weld County Addendums to the State prescribed SS-23A will be approved and signed by the Director and the Board of County Commissioners, Weld County, sitting as the Weld County Board of Social Services. F. Once Placement Contracts are approved and signed by the Director and/or the Board of County Commissioners, each provider will be mailed fully executed copies of the Agreement to Purchase Services, SS-23A and Weld County Addendum for their records. G. All original contracts will be filed in the Service Utilization Unit. The Service Utilization Unit will notify the Social Services Administrator, or designee, if a provider is requesting reimbursement and does not have a current signed contract. Payment cannot be authorized to the provider until the required contract is provided to the Service Utilization Unit. H. Bed hold payments for a child's temporary absence from a facility, including hospitalization, are limited to a maximum of 3 days unless otherwise negotiated as allowed in Volume VII. All bed hold authorizations need to be approved, in writing within 2 working days, by the Administrator. Once a bed hold is authorized, the Negotiator will contact the provider to negotiate a daily rate for the approved bed hold. Social Services Division Policies and Procedures 2.321 Reimbursement for County Certified Foster Care Provider Effective 1/1/99 The Department will reimburse a county certified foster care provider if such foster care provider meets the State reimbursement requirements of Colorado State Rules, Section 7.405, Volume VII, Social Services Programs, and the State requirements for County Certified Providers of Colorado State Rules, Section 7.417.1, Volume VII, Social Services Programs. 2.321.1 County Foster Care, Kinship Care and Foster/Adoption Home Reimbursement Rate Revised 1/01/02 Revised 6/02 According to Table 1, the Department will reimburse for the care provided by Revised 8/5/02 County Certified foster care parents upon submittal in a timely fashion on a form Revised 10/29/02 showing the number of days the child/ren were in care. Revised 12/03 Revised 12/04 Revised 12/05 Revised 1/07 Table 1 Age Daily Respite Care of Maintenance Daily Child Rate Allowance 0 months 16.12 to $.66 10 years 11 years to 14 years $17.85 $.66 15 years to 21 years $19.07 $.66 1. The rates established by the Department will be reimbursed within the available appropriation. The rates effective January 1, 2007, reflect an approximate 3.0% cost of living increase. 2. If the child's birthday occurs during the month, placing him in a higher age grouping, the payment for that month is made on the basis of the higher grouping rate. 3. County Certified foster homes are paid the basic rate, plus an additional Respite Care Allowance of$.66 per day. Revised 1/1/08 A. Effective January 1, 2008, the above rate structure will no longer be used and a child specific Needs Based Care Assessment half tiered system, designated as Exhibit B shall be used to determine levels of care for each adm\manss.jag Social Services Division Policies and Procedures child placed within a County Certified foster care home. The assessment will be completed by the County caseworker with assistance from the Service Utilization Unit. The specific rate of payment will be paid each level of service as recorded by the Needs Based Care Assessment. The reimbursement rate for these levels will be indicated by the Needs Based Care Rate Table, designated as Exhibit C. Once rates have been established, the Needs Based Care Addendum, designated as Exhibit D, will be completed by the County Rate Negotiator to outline the total rate of reimbursement for the out-of-home care of the child. This addendum will be effective from the time of placement until the end of the Colorado fiscal year, June 30, unless otherwise negotiated. The Needs Based Care forms have been adopted from the Northern Consortium of Counties. Effective October 1, 2001, all providers received a 2.5% increase in administrative overhead rate. Effective July 1, 2006, providers received a 3.25% COLA to the administrative overhead rate. Effective July 1, 2007, providers received a 2.5% increase to the Child Maintenance rate and the use of the new half tiered Needs Based Care Assessment tool and Rate Table was established. Revised 1/1/99 B. The Department shall negotiate rates with certified kinship care providers based on the child's needs and within the County Certified Foster Care Rate. The range shall be upward from the prevailing federal TANF payments and is to be based on the needs of the child, plus the $.66 per day additional respite care allowance. Revised 1/1/08 Effective January 1, 2008, children that are placed in County certified kinship foster care homes or a County foster/adoption home as a pre- adoption placement, will be reimbursed at the County Basic Maintenance level on the Needs Based Care rate table, as broken out by age, regardless of the child's level of need. (Refer to Exhibit C) Certified kinship care providers may elect not to receive a money payment and may follow the grievance process for foster care providers when there is disagreement about such reimbursement rate. A child in the care of his or her parents is not considered living in a foster home, and, therefore, is ineligible for foster care payments, including kinship care payments. IV-E reimbursable foster care payments may only be made to kin who are defined as an adult who is not a parent, but who is in one of the following groups: 1. Any blood relative, including those of half-blood, and including first cousins, nephews or nieces, and persons of preceding generations as denoted by prefixes of grand, great, or great-great. 2. Stepfather, stepmother, stepbrother, and stepsister. adm\tnanss.jag Social Services Division Policies and Procedures 3. Persons who legally adopt a child or his or her parent, as well as the natural and other legally adopted children of such persons, and other relatives of the adoptive parents in accordance with State law. 4. Spouses of any persons named in the above groups even after the marriage is terminated by death or divorce. C. The Department will not provide nonreimbursable IV-E foster care payments to certified kinship care providers who do not meet IV requirements for payment. Effective 1/1/99 D. The Department, under contract with a physician or health department, Revised 9/18/02 will pay for annual physicals for County Certified Foster Care Home providers and other residents of the County Certified Foster Care Home. The County Certified Foster Care Home may obtain their own annual physicals; however, the Department will pay for co-payments, not to exceed $60 per person and excluding foster children. Effective January 1, 2003, the contract with a physician for a physical and tuberculosis testing is at a cost of$60 per person or less in the County Certified Foster Care Home, excluding the foster children. The maximum reimbursable amount under the contract for a calendar year is $7,000. 2.321.11 Reimbursement Details for All County Foster Care Providers. Effective 1/1/99 A. The County Certified Foster Care Rate is a flat grant that pays for the basic maintenance needs for a child placed in any foster care facility. The basic maintenance needs include food, clothing, shelter, education, personal supplies and allowance. Effective 1/1/08 Effective January 1, 2008, the provider rate, as outlined in Exhibit C, consists of the Basic Child Maintenance rate, as set by the State and modified by the County with cost of living increases since 1999. (Referred to as "County Basic Maint." on Exhibit C) This reimbursement includes, but is not limited to: Food, clothing, shelter, education, personal supplies and allowance for children placed in any foster care home. In addition to the County Basic Child Maintenance reimbursement, a foster care provider may also be eligible to receive an increase in this rate due to the difficulty of care, as assessed by the Needs Based Care Assessment tool. (As reflected in Exhibit C, Level 1 to Level 4) Effective 1/1/99 B. A Respite Care Allowance is paid for each child placed in a County Certified Foster Care Home or a Child Placement Agency, and in certified adm\manss.jag Social Services Division Policies and Procedures kinship care homes. It is not paid to a Specialized Group Home or Center, or for Independent Living. Effective 1/1/99 C. The County Certified Foster Care Rate is used as the basic maintenance rate (flat grant portion) when computing the rate in Receiving Homes, Group Homes/Centers, Independent Living and Subsidized Adoption Homes. Effective 1/1/08 Effective January 1, 2008, the County Basic Maintenance Rate is used as the base rate when computing the rates for Group Homes/Centers, Independent Living and Subsidized Adoption Homes. Effective 1/1/99 D. Foster Care facilities are reimbursed by the Department as stated in Colorado State Rules, Volume VII, and according to this Weld County Manual. Facilities must be licensed or certified in order for the Department to be reimbursed by the State. The foster care facilities are reimbursed for the day in which the child is placed in the home, but are not reimbursed for the day the child leaves it, unless the child was placed and removed on the same day. Effective 1/1/99 E. All certified foster care facilities will sign and use the relevant provider contract when they are certified and recertified. Effective 1/1/08 Effective January 1, 2008, all certified foster care providers will sign the State prescribed provider contract and the Weld County Addendum. This contract will be effective from the time of certification or the beginning of the Colorado State fiscal year until the end of the Colorado fiscal year, June 30, unless otherwise indicated. Effective 1/1/99 F. When a child is placed, the information shall be entered on the CWS-7B Child Placement Log by the Department caseworker and the provider and copies of the updated log shall be maintained in the provider file and by the provider of the facility. Revised 8/01 G. An annual clothing allowance of$200 may be made at the time of placement out of the home to ensure that the child has an adequate beginning wardrobe and annually thereafter for the primary purpose of preparing the child for the initial start of the school year. A clothing allowance is the property of a specific child who is in the custody of the Department and is to be spend for the benefit of that child only. All clothing purchased with these funds must follow the child upon discharge from the foster home. Admission and discharge clothing inventories, with the exception of expendable items, e.g. diapers, may be requested by the adm\manss.jag Social Services Division Policies and Procedures Department. Original receipts must accompany any claims for reimbursement. If a child's wardrobe is lost, stolen, or destroyed. the Department may again approve an additional clothing allowance, the reason for which shall be thoroughly documented in the child's record. The clothing allowance may be made for children in County certified foster care homes, when the Department has legal authority for placement, and expressly pre-approved in writing by the Director. Added 5/00 H. Transportation reimbursement is available to foster parents as mileage Revised 1/1/02 reimbursement. The mileage reimbursement for visitation must be: Revised 3/04 1. For mileage not covered by other resources. 2. For non-Medicaid mileage when the foster parents are not involved in family counseling. 3. Limited to out-of-county travel. 4. In-county travel as approved for special circumstances with prior approval of the casework's supervisor. 5. Reimbursed at two cents per mile below the standard mileage rate allowed, pursuant to 26, U.S.C. 162 of the IRS regulations as amended. 6. All requests for mileag.e reimbursements must be received in the Department by the 25th calendar day following the month the expenditure occurred, for the expenditure to be considered for reimbursement. If the 25th falls on a weekend or holiday, then the following work day. 7. All mileage reimbursement requests must be done on Form S315 County Expense Account sheet. Added 7/2004 I. County certified Foster Care Providers will be reimbursed for any Revised 8/1/07 Medicaid co-pay for developmentally delayed children from the age of 19 to the last day of his or her 20th birthday or for children who are deemed ineligible for Medicaid due to non-citizenship. This co-pay will be reimbursed the following month after the provider pays the co-pay if the following terms are met: 1. An original receipt is turned in listing the co-pay amount(s) and child's name; and 2. The receipt was turned in the 4`h calendar day of the month after the co-pay was paid, along with the provider roster. Added 7/2004 J. County certified Foster Care Providers will be reimbursed the following month after the service was provided for the last day the child or adolescent was in the home if the following terms are met: adm\manss.jag Social Services Division Policies and Procedures 1. The child or adolescent was in the care of the provider until 11:00 a.m.; and 2. The child was placed in his or her permanent placement. 2.321.12 Temporary Absence Effective 8/1/07 A. Bed hold payments for a child's temporary absence from a provider, including hospitalization, are limited to a maximum of 3 days unless otherwise negotiated as allowed in Volume VII. All bed hold authorizations need to be approved, in writing within 2 working days, by the Administrator. Once a bed hold is authorized, the Negotiator will contact the provider to negotiate a daily rate for the approved bed hold. adm\manss.jag Social Services Division Policies and Procedures NORTHERN CONSORTIUM OF COUNTIES NEEDS BASED CARE ASSESSMENT (Exhibit B) IDENTIFYING INFORMATION CHILD'S NAME STATE ID# SEX X TRAILS CASE ID jDOB F WORKER COMPLETING ASSESSMENT 1HH# I 'DATE OF ASSESSMENT AGENCY NAME 'PROVIDER NAME I PROVIDER TRAILS ID ANSWERS TO THE FOLLOWING QUESTIONS WILL DETERMINE THE NEEDS BASED CARE PAYMENT • For each question below,please select the response which most closely applies to this child. THE FOLLOWING SEVEN QUESTIONS ARE MUTUALLY EXCLUSIVE: P 1. How often does the child require transportation by the foster care provider for the following: Therapy; Medical Treatment; Family Visitation; Extraordinary Educational Needs; etc.,as outlined in the treatment plan? ['Basic Maint.)Less than one round trip a week ❑I)One round trip a week ❑1'/x)2 round trips a week 02)3-4 round trips a week. 02%)5 round trips a week 03)6 round trips a week 03%)7 round trips or more P 2. How often is the foster care provider required to participate in child's therapy or counseling sessions? ❑ Basic Maint.)No participation required 01)Once a month 02)Three times a month 011/2)Two times month ❑2/:)Once a week 03)Two times a week 03%)Three times a week or more P 3. How much time is the provider required to intervene at home and/or at school with the child in conjunction with a regular or special education plan? ❑ Basic Maint.)No educational requirements ❑1)Less than a ''/3 hour per day ❑1'A) '/,hour a day ❑2) 1 hour a day ❑2 %) 11/2-2 hours per day 03)2'/r3 hours per day 03%)More that 3 hours per day P 4. How often does the child require special and extensive involvement by the provider in scheduling and monitoring of time and/or activities and/or crisis management? ❑ Basic Maint.)No special involvement needed 01)Less than 5 hours per week 01%)5 to 7 hours per week 02) 8 to 10 hours per week ❑2%:) 11 to 14 hours per week 0 3)Constant basis during awake hours 03%)Nighttime hours P 5. How much time is the provider required to assist the child because of impairments beyond age appropriate needs with feeding, bathing,grooming, physical,and/or occupational therapy? ❑ Basic Maint.)0-2 hours per week ❑1)3 to 4 hours per week 01%)5 to 7 hours per week ❑2)8 to 10 hours per week 02%) 11 to 15 hours per week ❑3) 16 to 20 per week 03%)21 or more hours per week adm\manss.jag Social Services Division Policies and Procedures NORTHERN CONSORTIUM OF COUNTIES NEEDS BASED CARE ASSESSMENT (Exhibit B Continued) A 1. How often is CPA/County case management required?(Does not include therapy) ['Basic Maint.)Face-to-face contact one time net month with child and no crisis intervention. (i.e.mutual care placements.) ❑1)Face-to-face contact one time per month with child and minimal crisis intervention. ❑I'/)Face-to-face contact one time per month with child and occasional crisis intervention. O2)Face-to-face contact two times Der month with child and occasional crisis intervention. OVA)Face-to-face contact three times per month with child and occasional crisis intervention. O3)Face-to-face contact weekly with child and occasional crisis intervention. O3'/z)Face-to-face contact weekly with child and ongoing crisis intervention which may include intensive coordination of multiple services. **Please Note: The Case Management level may be assessed on a combined basis if a sibling group,or more than one County foster child is with the same provider. T 1. How often are therapy services needed to address child's individual needs per NBC assessment? ❑0)Not needed or provided by another source(i.e.Medicaid) ❑1)Less than 4 hours per month ❑2)4-8 hours per month ❑3)9-12 hours per month adm\manss.jag Social Services Division Policies and Procedures WELD COUNTY DSS NEEDS BASED CARE ASSESSMENT (Exhibit B) BEHAVIOR ASSESSMENT Please rate the behavior/intensi oof conditigoons which create the need for services that apply to this child.051 04' 4 x . ° }fit, s -: 6 ' f 'MN:. „n }d i “ 6.1. � �� y a pt �' t't` , .. a.�� �' � 411W; � � . y4r't "�.' � t. ° £r � �` -� r z F 5e Y k` "'i, - t e: 11'4 bo , 31 M1 yYVc O ., }vuz iFi 3•r iii 1 a . + tf r-gg,,...::,,±-4.2_...,..,—.0.....1.' ev '? C3o x ax. AE M1r,1 i "*a' dei,t i, ,Fr..- -i-- it k +<.t 1 1, (6.e .yff4 r' e t t'tkj ri ,',.h •ir, 4f k ad.-S.2:1;4- .} 1 a 'd v. �, .. s t.: Aggression/Cruelty to ❑ ❑ 0 ❑ Animals Verbal or Physical ❑ ❑ ❑ ❑ Threatening Destructive of Property/Fire Setting ❑ Stealing ❑ 0 ❑ ❑ Self-injurious Behavior ❑ ❑ ❑ ❑ Substance Abuse 0 ❑ ❑ ❑ Presence of Psychiatric ❑ ❑ ❑ 0 Symptoms/Conditions Enuresis/Encopresis ❑ ❑ ❑ ❑ Runaway ❑ ❑ ❑ ❑ Sexual Offenses ❑ ❑ 0 ❑ adm\manss.jag Social Services Division Policies and Procedures BEHAVIOR ASSESSMENT CONTINUED (Exhibit B) Please rate the behavior/intense of conditions which create the need for services that appl 'to this child. 7u �,° `i �9 9 } ® fi r f t .'yt x . ` I,t,,,. '` : �,k-' t i ' I t tpj 5b€ '"..-...r °"`&'" a _ _ " ., ₹ c � x k I s —r as xy,,,st� Ri i" nuf,i>1;041--L �v ,� }! T ct 5r" Es_. r a-! Y'-44. r 's.'fy° ,. • :its t 3"t dU�. y s4 a.� s' ditilf% !� t 'za n„n-r v t *t . _r-., w p-jy Sey .y, � " tt&r ^E .fi! 4 . ..lz......r. -2:11121n. Inappropriate Sexual Behavior ❑ ❑ ❑ ❑ Disruptive Behavior ❑ ❑ ❑ ❑ Delinquent Behavior ❑ ❑ ❑ ❑ Depressive-like Behavior ❑ ❑ ❑ ❑ Medical Needs (If condition is rated"severe",please complete ❑ ❑ ❑ ❑ the Medically fragile NBC) Emancipation ❑ ❑ ❑ ❑ Eating Problems ❑ ❑ ❑ ❑ Boundary Issues ❑ ❑ ❑ ❑ Requires Night Care ❑ ❑ ❑ ❑ Education ❑ ❑ ❑ ❑ Involvement with Child's ❑ ❑ ❑ ❑ Family CHILD'S OVERALL LEVEL OF NEED FROM BEHAVIOR ASSESSMENT: (check level of need) D o ❑ 1 0 2 0 3 adm\manss.jag Social Services Division Policies and Procedures WELD COUNTY DEPARTMENT OF SOCIAL SERVICES NEEDS BASED CARE RATE TABLE �_t�v (Exhibit C) !≤ f+ ,9` i— ao a 1 : t 1: y b' ; 77 § '3R { r e' "' N�` r '`S.k_ ttp •., a:=;3. ,,,,bF s it F 74-1- i x,a s .y�c�' ( _ 1 m'�ri. ui,E it fr $ MEDICAAL$ ", ' , r rr`P3 a *4 _: v s !.4, c-{ ' s EEDSr','x S _ E ,h {,v... _ T, h� . zit Y *.+''Tp.frst'"3`' pUM ''Eater,i WSt' ,�,+te f x �N,p r` # t=w "+ c , 4',+1¢ fi .. r,. Leve 6 .r T A v r `t�*q*.:' " '-f . q, At#.'if ty 1°L"r, T '� l ... ,, -max .:42:.5":2v,5".4: :. t; .:,k fit" r° °. . ,Level x . . ._.. .__ inn. t � �..-:.i �---,_. ar �>d/*R!' �" `�"` z �' - Age 0-10...$16.32($496) Basic Maint $4.93 day/$150mo - Level 0 $0 4x;.,:. County Age 11-14...$18.05 .4, Therapy not needed or provided Basic ($549) k - No crisis intervention, Minimal CPA by Level 0...$0 Maint. Age 15-21...$19.27 (None) .; ($586) , . involvement, one face-to-face visit another source, i.e.mental health. ' +$.66 Respite Care •` ($20) �' with child per month. + k.`- $19.73 Level 1 $8.22 day/$250 mo - Level 1 $4.93/$150 mo , t ; +$.66 Respite Care t Minimal crisis interention as needed, Regularly scheduled therapy, T. - one face-to-face visit per month with Level 1 ...$2.99 ($20.39 day/$620 mo) child, = up to 4 hours/month. r 2-3 contacts .er month ..r $23.01 a w.. s 1 1/2 r +$.66 Respite Care =3 Level 1 1/2 $9.86 day/$300 mo ------ ($23.67 day/$720 mo) :i) .,,�. $26.30 Level 2 $11.51 day/$350 mo `-° Level 2 $9.86/$300 mo 2 +$.66 Respite Care i erapy,$ Occasional crisis intervention as needed, Weekly scheduled th c 3 Level 2..$4.47 ¢>=�< two face-to-face visits with child, 5-8 hours a month with 4 hours of ($26.96 day/$820 mo) n a- s3,, 2-3 contacts per month group therapy. $29.59 t':,:.;7 2 1/2 4 +$.66 Respite Care '4.1 Level 2 1/2 $13.15 day/$400 mo ---.._____ _.___ "` _______ Tr ($30.25 day/$920 mo) C $32.88 5 Level 3 $14.79 day/$450 mo Level 3 $14.79/$450 mo g +$.66 Respite Care :$ Ongoing crisis intervention as needed, Regularly scheduled weekly . p 3 multiple sessions,can include Level 3..$6.02 weekly face-to-face visits with child, t more ($33.54day/$1020 mo) and intensive coordination of than 1 person,i.e.family therapy, r multiple services. Th-, for 9-12 hours/monthly. 04 $36.16 ` -ll ''`" Ri 31/2 +$.66 Respite Care 3;71 Level 31/2 $16.44 day/$500 mop; _— ($36.82 day/$1,120 mo) +7.1 $39.45 :; A Level 4 $18.08 day/$550 mo Level 4 $14.79/$450 mo +$.66 Respite Care ;- Ongoing crisis intervention as needed, Regularly scheduled weekly x 4 multiple sessions,can include RTC _ ,S-3 which includes high level of case more Drop p Level 4....Neg. �. Down au ($40.77 day/$1220 mo) management and CPA involvement with than 1 person,i.e.family therapy, - 51 child and provider and 2-3 face-to-face for 9-12 hours/monthly. contacts .er week minimum. w ;y ft Assess o:. $26.96 day/$820 mo :7'141 Assess Rate k; .., .. (Includes Respite) .}.-( $11.51 day/$350 mo ----- �, TV Admin.Overhead Rate: As of 7/01/07 $6.25 day/$190.00 month adm\manss.jag Social Services Division Policies and Procedures WELD COUNTY DEPARTMENT OF SOCIAL SERVICES NEEDS BASED CARE ADDENDUM (Exhibit D) This addendum supplements the Placement Agreement Form SS-23A dated between the above County Department of Social Services and_,provider# . The provider(s)hold(s)a valid and current full certificate as a certified provider. This Addendum is effective from to_, unless otherwise negotiated. I. THE ABOVE COUNTY AGREES TO: • Pay the provider a rate of$ per day, prorated for the days in care, for the care of child , State ID#_, Case ID#_ The agreed upon rate is based upon the following : SERVICES LEVEL DAILY RATE Provider Services $ (Child Maintenance) Case Management Services $_ (Admin.Maintenance) Therapy Services $ (Admin.Services) Special Medical Needs $_ (Child Maintenance) Administrative Overhead $ (Admin.Maintenance) Total $_ • Provide support and supervision to such placement as specified in the Family Service Plan and Needs Based Care Assessment. Involve the provider in case planning, staffing or other meetings concerning the child, and service delivery as specified in this child's Family Service Plan and Needs Based Care Assessment. II. THE PROVIDER HAS MET THE PLACEMENT REQUIREMENTS OF: n Family Foster Care n Gateway n Child Placement Agency Group Care n Specialized Group Care n Child Placement Agency Foster Care III. THE PROVIDER AGREES TO: Meet the service needs as identified by the Needs Based Care Assessment and Family Service Plan. Keep weekly records of this child's behavior and progress, submit monthly written reports to the county department, and retain copies for own files. Submit the required forms for payment in a timely manner. The provider's signature on the monthly payment form signifies that the above services have been provided for this child during the month. Provide the services identified by the Needs Based Care Assessment and Individual Plan. Meet additional requirements: IV. This addendum shall be reviewed at least every six months in conjunction with the review of the Family Service Plan or Needs Based Care Assessment. It shall be revised if there are agreed upon changes in the child's service plan. It shall expire the date the child is removed, upon the renegotiation of a new addendum, or upon the termination of the SS-23A Placement Agreement. The conditions of this contract may be renegotiated at any time during the term of the contract based upon the changing service needs of the child. adm\manss.jag Social Services Division Policies and Procedures rovider Signature/Date Negotiator Signature/Date rovider Signature/Date Other Signature/Title/Date adm\manss.jag Social Services Division Policies and Procedures 2.324 Subsidized Adoption Reimbursement Revised1/05 The Department determines the amount and kind of subsidy based on the following: 1. The child's documented special needs at the time of the adoptive placement. 2. The adoptive family's circumstances. 3. The need to purchase services that are not available in the community free of charge. Revised 9/24/01 A. The maximum subsidized adoption reimbursement that the Department Revised 6/03 will pay, in monetary reimbursement; to adoptive parents is the County Revised 1/05 Certified Foster Care basic maintenance rate. (Referenced in Section 2.321.1) Effective 1/1/08 Effective January 1, 2008, the subsidized adoption reimbursement that the Department will pay, in monetary reimbursement; to adoptive parents is the County Basic Maintenance rate. (Referenced in Section 2.321.1 Exhibit C) Revised 8/07 Note: The monthly respite care payment that is provided under the foster care program is not a benefit under the subsidy program. Once a monetary adoption subsidy rate is established, this rate is not eligible for cost of living increases. The Department may consider the additional needs of the child to determine if the Special Needs Rate for the Developmentally Disabled and Physically disabled apply. (Referenced in Section 2.322) B. Available public programs and insurance benefits for which the child is eligible shall be used first to address the child's needs before subsidized adoption payments are used. Revised 8/07 C. In addition to the monetary reimbursement, paid to the adoptive parents as an adoption subsidy, the Department may also purchase services on behalf of the child. This assistance will include any assistance, excluding Medicaid, intended to help, or remove barriers to, the adoption of children with special needs. The Department will consider the monetary value of these services when negotiating the amount it will pay, in monetary reimbursement, to adoptive parents as an adoption subsidy. The services that may be considered for this purpose include Case Services reimbursement.. D. A special needs child is defined in Colorado Department of Human Services, Volume VII, Section 7.203.22(E) and C.R.S. § 26-7-101(2). E. Adoption subsidies will be reviewed every three years. The Department may renegotiate the current rate at the time of each review. If it is determined that there is no current need for a cash payment for a special Adm\manss46.jag Social Services Division Policies and Procedures needs child, a dormant subsidy will be established. This review is to determine if the amount and/or kind of subsidy is still appropriate given the child's needs and the circumstances of the parents. Documentation of any change of circumstance will be required. 1. If a child is receiving a IV-E subsidy and is 18 years of age and has not graduated with a high school equivalency, the county may continue to subsidy funded by State/County-only until the child finishes high school or is 19 years of age. At 19 years of age, the subsidy terminates regardless if the child is still in high school.. Post-high school voc- ational schools or college classes do not qualify for the continuance of a subsidy. The adoptive parents shall provide documentation that the child is enrolled full-time in high school and making progress in the program. Continuation of the subsidy may depend on available county funds. 2. If a child is receiving a State/County-only subsidy and is 18 years of age and has not graduated with a high school equivalency, the county may continue the subsidy until the child finished high school or is 19 years of age. At 19 years of age, the subsidy terminates regardless if the child is still in high school. Post-high school vocational schools or college classes do not qualify for the continuance of a subsidy. The adoptive parents shall provide documentation that the child is enrolled full-time in high school and making progress in the program. Continuation of the subsidy may depend on available county funds. 3. A child who is identified in the original subsidy agreement as being developmentally disabled or physically handicapped, is between the ages of 18-21, and continues to live a home, may continue to be eligible for the adoption assistance program. F. The adoption assistance subsidy is a payment made directly to the family to partially assist with expenses related to the child given the circumstances of the adoptive parents. The adoptive parents are not required to account for how the money was spent. G. Weld County DSS will terminate adoption assistance payments for subsidized adoption when: 1. The family requests payments end; or, 2. Child reaches age 18 or age 21, if the county has determined that the child has a developmental or physical disability which warrants continuation of assistance; or, 3. The adoptive parent(s) are no longer legally responsible for the Adm\rnanss46.jag Social Services Division Policies and Procedures support of the child; or, 4. The child is no longer receiving any support from the adoptive family; or, 5. The county of responsibility verifies the child's death, or marriage; or, 6. The child is removed from the adoptive home because of abuse or neglect. H. If the adoptive parents are receiving state/county adoption assistance payments and the child is placed into the custody of the Department for an out of home placement for a duration of over 30 calendar days, the state/county adoption assistance payment will be discontinued to the adoptive parents. The state/county adoption assistance payment will not be reinstated to the adoptive parents because the child returns to the home of the adoptive parents for holidays or visits while in the child is in the custody of the Department. If the adoptive parents have an approved IV-E adoption assistance payment and the child is placed into the custody of the Department for an out-of-home placement for duration longer than 30 calendar days, the Department will assess a parental share fee not to exceed the amount of the approved adoption assistance payment. The parental share fee will not be discontinued and the IV-E adoption assistance payment will not be reinstated because the child returns to the home of the adoptive parents for holidays or visits while the child is in the custody of the Department. J. Right to appeal a denial, a termination or a reduction of subsidy 1. When the county department denies an application for adoption subsidy, or reduces or terminates the subsidy grant, the applicant or recipient has a right to appeal to a state administrative law judge and may be represented by counsel at their own expense for such an appeal. C.R.S. § 26-7-107, Vol. VII, § 7.306.4 and the Code of Federal Regulations. See Section 3.324.31 (E)(1) below for more information on what constitutes a decision or denial by the Department. 2. When either state or federal law requires or results in a reduction or deletion of services, no hearing is required. 2.324.1 Medical Resources Revised 3/29/99 Subject to certain income and resource limitations, medical assistance through the Colorado Medicaid program must be provided to certain children receiving child Adm\manss46.jag Social Services Division Policies and Procedures welfare services including children who have a current, signed subsidized adoption agreement and children in subsidized adoption. Children in subsidized adoptions, including adoption placements out-of-state, who are IV-E eligible or where the state option is in effect are eligible until the receiving state can provide Medicaid. The Department is responsible for determining eligibility for Colorado Medicaid in the manner prescribed by the State Department of Human Services and according to State Regulations described in Volume VII. 2.324.2 Subsidized Adoption Reimbursement Negotiations Added 5/00 2.324.21 Initial Subsidy Negotiations A. The Adoption Caseworkers will inform the County Negotiator of all cases ready for subsidy negotiations. The Adoption Caseworkers will advise the County Negotiator of their assessment of whether the child will qualify for a subsidy and the reasons for that belief. All negotiations will occur with the County Negotiator rather than the Adoption Caseworker. B. The adoption negotiator will promptly mail a letter to the prospective adoptive parent(s). The letter will include: 1. An advisement that adoption subsidies are available under certain circumstances. An advisement that the subsidy issue must be resolved before the Director of Social Services will sign a Consent to Adopt an advisement that the Director of Social Services has the final say on the amount and kind of subsidy. 2. A procedure for setting up a time to start subsidy negotiations with the County Negotiator and a deadline by which to respond. A notice that failure to respond and set up a meeting or phone conference by that time will result on the case being put on hold - which means that other cases where there are meetings scheduled will be worked on ahead of any case on hold. If a case is put on hold,the County Negotiator will provide the Adoption Caseworker with a letter to be attached to any court letter so that the court will know the reason for the delay in finalizing the adoption. 3. A form which the adoptive parents may sign before a notary indicating that they are declining any subsidy. 4. A Special Needs Assessment Worksheet for the adoptive parent(s) to fill out and bring to the negotiations. This worksheet will outline the special needs of the child that might pose a barrier for Adm\manss46.jag Social Services Division Policies and Procedures the adoption. 5. An advisement that there must be written documentation from professionals regarding any concerns or issues with the child or children and that this documentation must be submitted to the negotiator at the time of negotiations. This documentation may take the form of letters from doctors, therapists, or other professionals. The letter will also advise that any negotiations will be postponed until this documentation is available. 6. An advisement that the adoptive parents may be represented at the meeting at their own cost if they so desire. C. The County Negotiator will meet with the parent(s) at the scheduled time. The County Negotiator will do the following: 1. Review the Weld county Subsidized Adoption Information Form (WC-A-1)with adoptive parents. 2. Inform parents of the general maximum monthly maintenance subsidy amounts and services available if a child qualifies. 3. Go over the special needs assessment form with the adoptive parents. Unless the form is filled out completely and/or all professional documentation is provided, the meeting may be stopped and rescheduled by the County Negotiator until that material is provided by the adoptive parents. 4. The County Negotiator will match the special needs identified for the child or children according to Rule 2.324 of the Weld County Department of Social Services Manual and Volume VII of the Colorado Department of Human Services and will determine the type and/or amount of subsidy which the Department will offer. Depending on how complicated the issues are, this determination may occur at the meeting or by letter after the meeting. In either case, the County Negotiator will offer or mail an Adoption Subsidy Information Acknowledgment form WC-A-2 outlining the subsidy offer. Note that this offer is not binding on the Department until it is approved by the Director of Social Services. D. If there is agreement, the adoptive parents will indicate their agreement with the subsidy offered by signing the Adoption Subsidy Information Acknowledgment form and returning it to the County Negotiator. The signed Adoption Subsidy Information Acknowledgment form will be given to the Adoption Caseworker. The adoption caseworker will prepare the CW-SA-3 for an initial adoption subsidy or the CW-SA-4 form for Adm\manss46.jag Social Services Division Policies and Procedures renewal of adoption subsidy based on the agreement and mail this to the adoptive parent(s) for their signature. E. If no agreement is reached, the County Negotiator will present his/her recommendations to the Resources Services Manager. A determination of whether to attempt to renegotiate or to refer the matter will be made promptly by the Resources Services Manager in consultation with the Social Services Administrator. This decision will be made within 14 days of the date the County Negotiator refers the matter to the Resource Services Manager. The adoptive parents shall be notified by letter from the Resource Services Manager if the decision is to continue negotiations. 1. When the determination is made that no further negotiations will take place, the adoptive parents shall be advised of the Department's final offer in a letter from the Director of Social Services. Their appeal rights and the process for appeal to an administrative law judge (AU ) working for the Colorado Department of Human Services shall also be set out in the letter. A copy of the Adoption Subsidy Information Acknowledgment form will also be attached. If it is returned with signatures, the County Negotiator will proceed as in Step D. F. If, at any time, the parents request the presence of an attorney at negotiations, the County Negotiator may request that an Assistant County Attorney be present. G. Subsidy applications and renewal forms are not considered final until signed by the Weld County Director of Social Services. 2.324.22 Subsidy Renewal Negotiations Revised 6/03 A. The Adoption Caseworker shall review all adoption cases every three years. The adoptive parents shall be asked to submit documentation of current special needs. Documentation shall consist of reports or evaluations by independent professionals. B. All adoption cases will be reviewed annually for Medicaid eligibility as outlined in the Colorado Department of Human Services Volume VII. C. If the adoption caseworker determines that there may be a change in circumstance, the case shall be referred to the County Negotiator. D. The County Negotiator shall then follow the procedures as set out in the initial subsidy negotiations to determine the amount of subsidy. Documentation shall consist of reports or evaluations by independent professionals. Adm\manss46.jag Social Services Division Policies and Procedures E. Subsidy applications and renewal forms are not considered final until signed by the Weld County Director of Social Services. F. Appeal procedures are as set out for initial subsidy negotiations. Adm\manss46.jag Social Services Division Policies and Procedures WELD COUNTY SUBSIDIZED ADOPTION INFORMATION WC-A-1 (8/07) This document is intended to answer"Frequently Asked Questions" about Subsidized Adoption. It is not intended to be a substitute for legal advice. If you have specific questions about an issue, the caseworker or county negotiator may be able to explain further but it is recommended that you seek legal advice from your own attorney if questions remain. SUBSIDIZED ADOPTION Colorado operates two subsidized adoption programs: The Title IV-E program (IV-E) and the state and county—only program. The federal government participates in adoption assistance payments on behalf of children who meet the eligibility criteria for the Title IV-E program. The state and county participate in adoption assistance payments on behalf of children who do not qualify for the IV-E program. A child can only be eligible for one type of subsidy program. If a child is eligible for the Title IV-E program, the child is considered ineligible for the state and county—only program. Under the IV-E program, if a child is eligible, the state (through the county department) is required to enter into an adoption assistance agreement with the adoptive parents of a child with special needs (as defined in section 473(c) of the Foster Care Independence Act of 1999). All parties must sign this agreement before an adoption takes place. The adoptive parents can waive the assistance but they must do so in writing. If an agreement cannot be reached (including whether the child is IV-E eligible), the agency determines the amount of subsidy and the adoptive parents are entitled to a"fair hearing" in front of an administrative law judge if they continue to dispute the amount. There are time limits and other requirements for that appeal and adoptive parents should consult with an attorney if they have questions. Weld County DSS determines the amount and kind of subsidy based on the following: 1. The child's documented special needs at the time of the adoptive placement. 2. The adoptive family's circumstances. 3. The need to purchase services that are not available in the community free of charge. ELIGIBILITY REQUIREMENTS In order for a child to be eligible for subsidized adoption,all of the following factors must be present at the time the child is placed for adoption: 1. The goal for the child is adoption and the court has determined that the child cannot or should not be returned to the home of his/her parents and all parent-child legal relationships are terminated. 2. The county department, agency, or relative requesting the adoption subsidy is financially responsible for the care of the child. Adm\manss46.jag Social Services Division Policies and Procedures 3. The county must determine that in each case a reasonable, but unsuccessful, effort to place the child for adoption has been made before providing a subsidy, unless the best interests of the child would not be served by such an effort. 4. Children who are in the custody of licensed non-profit private agencies or who are living with relatives must meet federal IV-E eligibility requirements. 5. The child is one with "special needs." a) Physical disability (such as hearing, vision, or physical impairment; neurological conditions; disfiguring defects; and heart defects). b) Mental retardation (such as developmental delay or disability, perceptual or speech/language disability, or a metabolic disorder). c) Developmental disability resulting in educational delays or significant learning processing difficulties. d) Educational disability,which qualifies for Section 504 of Rehabilitation Act of 1973 or special educational services. e) Emotional disturbance. f) Hereditary factors that have been documented by a physician or psychologist. g) High-risk children(such as HIV-positive,drug-exposed,or alcohol-exposed in utero). h) Other conditions that act as a serious barrier to the child's adoption. Conditions may include but are not limited to a healthy child over the age of seven or a sibling group that should remain intact and medical conditions likely to require further treatment. SUBSIDIZED ADOPTION SERVICES AVAILABLE 1. Medicaid a) IV-E eligible children with an effective subsidized adoption agreement are eligible for Medicaid in the state they reside. b) An adoption assistance is not required to extend Medicaid coverage. c) Colorado is a member of the Interstate Compact on Adoption and Medical Assistance. d) Medicaid eligibility shall be continued for IV-E eligible children who are out of the home for more than 30 calendar days unless it is determined that they are eligible for Medicaid under another program by completing the SS-1A. Adm\manss46.jag Social Services Division Policies and Procedures e) Medicaid eligibility for all children receiving Medicaid shall be re-determined yearly only if the child continues to be eligible for Medicaid. This can be done by completing the State prescribed form or completing a form letter that the child(ren) continues to be eligible for Medicaid. This form letter shall be sent to other states by the county department to ensure continuation of Medicaid for a child who is residing out of state. 2. Non-recurring Adoption Expenses—The department may reimburse the adoptive parent(s) for expenses that are reasonable and necessary for the adoption to occur, subject to a maximum of$800.00. The expenses must; a) directly relate to the legal adoption; and b) not be in violation of state or federal law; and c) not have been reimbursed from other sources of funds. Reimbursement may only be requested after adoption finalization. The request for reimbursement must be submitted within (1) year after the date of the finalization. 3. Adoption Assistance—The county department may authorize the following types of adoption assistance subsidies: A. Long-Term Subsidy(Available for IV-E and State/County subsidies)—To partially meet child's daily needs on an indefinite basis. A long-term subsidy is made when the family's financial situation precludes adoption and is unlikely to change or when a child's needs take an excessive toll on the family's financial and emotional resources. This sort of monthly payment may continue until the family's financial circumstances improve, the child's circumstances change, or the subsidy terminates as outlined in Termination of Subsidy, C.R.S. § 26-7-107, Vol. VII, § 7.306.58 of the Subsidized Adoption rules. B. Time-Limited Subsidy (Available for State/County-only subsidies)—To partially meet the everyday needs of the child for a specified period. These are start-up costs for those things that children placed for adoption do not always have, such as sufficient clothing. This subsidy partially covers unmet needs that are time limited and non-renewable. C. Dormant Subsidy (Available for State/County-only subsidies)—No adoption assistance is provided at this time. Weld DSS will document special needs for the child in the services record and in the automated system, that the potential need for a financial subsidy exists and may need be activated at a future time. Documentation will have to be provided before a dormant subsidy is activated. 4. Medical Subsidy a) Medical subsidies are payments made directly to adoptive parents for a service already received or to a vendor for treatment of physical or developmental disabilities or an emotional disturbance. A medical subsidy shall relate directly to Adm\manss46.jag Social Services Division Policies and Procedures the barrier or barriers identified at the time the initial subsidy is approved. b) Medical subsidies are not available for treatment of any physical or developmental disability or emotional disturbance diagnosed after finalization of the adoption. c) Medical subsidies may be used to supplement any other available resource such as an adoptive family's private insurance that pays part but not all for the child's treatment (physical, mental, and emotional). d) Subsidized adoption payments for medical services shall reflect the reasonable costs of those services in the child's community. 5. Reimbursable and Non-Reimbursable Subsidized Adoption Case Services—Case Services are a type of purchased program services that support a case plan for children in a subsidized adoption. Case services are provided to meet a child's special needs identified when the child is placed for adoption and which are not covered by the adoption assistance or Medicaid subsidies. The following are examples of reimbursable and non- reimbursable expenses allowed under Case Services: A. Medical 1) Orthodontia a. Cosmetic reasons—not reimbursable. b. Special needs directly related to the reason for which the child was classified as special needs, e.g. cleft palate or injury related to an abuse will be reimbursable. 2) Eye Glasses a. Eye glasses are not reimbursable using case services dollars as Medicaid pays for one pair of glasses per year. b. Payment for additional eye glasses in a year or contacts related to the child's special needs identified at the time of the initial subsidized adoption agreement are reimbursable. 3) Medication a. Routine that is not related to the child's special needs—not reimbursable. b. If related to the child special needs—reimbursable. The medication must be prescribed by a licensed physician and related to the special need identified at the time the child was approved for subsidized adoption. 4) Special Therapies—Speech, Occupational, and Physical a. If not available through other community and family resources—reimbursable. School-age children should receive these services through the school system. b. When these services are available in hospitals and clinics - not reimbursable as Medicaid covers these costs. Adm\manss46.jag Social Services Division Policies and Procedures 5) Special Equipment—Special medical need/equipment, as prescribed by a physician may be reimbursable. For severely physically challenged children, special exceptions should not exceed $2,000 without supervisors written authorization. B. Psychological Services I) Time-limited out-patient therapy for children living in states that do not accept Medicaid for this service—reimbursable, if related to the child's special needs and a written plan is obtained from the service provider which contains: a. Diagnosis. b. Prognosis. c. Length of service. d. Individuals who will be seen in therapy. e. A cap on the amount of money to be spent for the psychological exam or therapy. f. Frequency of contact(i.e., once a week, twice a month, etc.). g. Type of therapy being provided (i.e. individual, group, family, etc.) 2) If time-limited out-patient therapy is available using Medicaid—not reimbursable. 3) Day treatment- not reimbursable as Medicaid provides for this service. 4) Residential Child Care Facility- not reimbursable as Medicaid provides for this services. 5) In-patient psychiatric hospitalization- not reimbursable as Medicaid provides for this service. (Children who are Medicaid eligible may receive some in-patient psychiatric services under the Medicaid Program.) C. Educational Costs 1) Tutoring—not reimbursable. School systems are mandated to provide all children with special needs a free appropriate public education. 2) School tuition—not reimbursable. There will be no reimbursement for tuition expenses through the adoption subsidy program. If the family wants the child to remain in his/her current private school placement, this is an expense for which they are responsible. D. Respite and Day Care 1. Respite Care- reimbursable. Adm\manss46.jag Social Services Division Policies and Procedures 2. Day Care-Not reimbursable expect for IV-E children. If day care services are needed and the child is IV-E eligible at the time of adoption, the family should be referred for day care services, as they are eligible for Title XX services. E. Other Subsidies A subsidy may be provided for a specified time to provide needed services, such as transportation to facilitate adoptive placement. TERMINATION OF A SUBSIDY Weld County DSS will terminate adoption assistance payments for subsidized adoption when the: 1. Family requests payments end; or, 2. Child reaches age 18 or until age 21, if the county has determined that the child has developmental or physical disability which warrants continuation of assistance; or, 3. Adoptive parents(s) are no longer legally responsible for the support of the child; or, 4. Child is not longer receiving any support from the adoptive family; or, 5. County of responsibility verifies the child's death, or marriage; or, 6. Child is removed from the adoptive home because of abuse or neglect. CONTINUING SUBSIDIES BEYOND AGE EIGHTEEN 1. If a child is receiving a IV-E subsidy and is 18 years of age and has not graduated with a high school equivalency, the county may continue the subsidy funded by State/County- only until the child finishes high school or is 19 years of age. At 19 years of age, the subsidy terminates regardless if the child is still in high school. Post-high school vocational schools or college classes do not qualify for the continuance of a subsidy. The adoptive parents shall provide documentation that the child is enrolled full-time in high school and making progress in the program. Continuation of the subsidy may depend on available county funds. 2. If a child is receiving a State/County-only subsidy and is 18 years of age and has not graduated with a high school equivalency, the county may continue the subsidy until the child finishes high school or is 19 years of age. At 19 years of age, the subsidy terminates regardless if the child is still in high school. Post-high school vocational schools or college classes do not qualify for the continuance of a subsidy. The adoptive parents shall provide documentation that the child is enrolled full-time in high school and making Adm\manss46.jag Social Services Division Policies and Procedures progress in the program. Continuation of the subsidy may depend on available county funds. 3. A child who is identified in the original subsidy agreement as being developmentally disabled or physically handicapped, is between the age of 18-21, and continues to live at home, may continue to be eligible for the adoption assistance program. REDUCTION OR DISCONTINUANCE OF ADOPTION SUBSIDY 1. When the child is receiving a state/county only subsidy and the child is absent from the home for over 30 calendar days, the adoption assistance payment and adoption case services subsidy will be discontinued. (See C.R.S. § 26-7-107, Vol. VII, § 7.404, regarding Placement Fees for out-of-home care.) If the child is in placement in a facility where he/she comes home for holidays or visits, this is not to be used as justification for continuing the state/county subsidy. A state/county subsidy can only be resumed when the child is returned home and the out-of-home placement has been discontinued on the Department's automated reporting system. 2. Children with a Title IV-E adoption assistance subsidy who are out of the home for more than 30 calendar days will continue to receive an adoption assistance payment if it is a part of the child's subsidized adoption agreement, unless the child is removed from the home because of abuse or neglect. (See C.R.S. § 26-7-107, Vol. VII, § 7.404, regarding Placement Fees for out-of-home care.) 3. Medicaid eligibility shall continue for Title IV-E eligible children who are out of the home for more than 30 calendar days unless it is determined that they are eligible for Medicaid under another program by completing the SS-1A. REVIEW OF ELIGIBILITY FOR ALL ONGOING SUBSIDIES 1. The county shall review the current subsidy agreement every three years. You will be contacted by the department prior to the tri-annual due date. The subsidy renewal form, along with proper documentation regarding current/ongoing special needs of the child must be submitted to the department in order for the subsidy to continue. If a renewal is not received prior to the tri-annual due date, please contact your current adoption caseworker so that no disruption in the adoption subsidy will take place. 2. The adoptive family may request a review of the subsidy prior to the three-year review if changes in the needs of the child or family circumstances occur. 3. Any changes in the needs of the child shall relate to the original barrier(s), identified at the time the decision was made that a subsidy was needed. REINSTATEMENT OF SUBSIDY Adm\manss46.jag Social Services Division Policies and Procedures 1. State/county subsidies may be reinstated if the services requested relate to the child's special needs which were identified at the time of the original subsidy. 2. Reinstatement of subsidy is not possible if the original adoptive parents no longer have legal custody of the child. 3. When adoptive parents have relinquished, have had their parental rights terminated, or have died and the child is placed in a subsequent adoptive placement, then the child retains IV-E eligibility for reinstatement of the subsidy in his/her new adoptive placement. RIGHT TO APPEAL 1. When the county department denies an application for adoption subsidy, or reduces or terminates the subsidy grant, the applicant or recipient shall have a right to appeal and may be represented by counsel. When either state or federal law requires or results in a reduction or deletion of services, no hearing is required. See C.R.S. § 26-7-107 and Code of Federal Regulations for more information. 2. Examples of issues which may be appealed: A. Relevant facts regarding the child were known by Weld County DSS and were not presented to the adoptive parents prior to finalization of the adoption. B. Denial of assistance based on a means test of an adoptive family. C. Disagreement with the determination on whether the state is eligible for adoption assistance. D. Failure to advise the adoptive parents that adoption assistance is available. E. Decrease in the amount of adoptive assistance without the agreement of the adoptive parents. F. Denial of a request for change in payment level due to a change in the adoptive parents circumstances. 3. When a family who has been denied Title IV-E Subsidized Adoption benefits requests a state level Fair Hearing, it is the responsibility of the Administrative Law Judge to determine whether the applicant or recipient was wrongly denied eligibility or whether the amount of the subsidy was determined correctly. (See Section 7.203.24, C, for fair hearing circumstances.) The adoptive parents have the burden of proving extenuating circumstances and adoption assistance eligibility at a state level Fair Hearing. The state or/its designee can provide Adm\manss46.jag Social Services Division Policies and Procedures factual information to assist the family in establishing eligibility for Title IV-E Subsidized Adoption. 4. A successful appeal can reverse the decision and if the child meets all eligibility criteria, IV-E subsidies are available starting with the earliest date the child became eligible. Adm\manss46.jag Social Services Division Policies and Procedures Weld County Department of Social Services Adoption Subsidy Information Acknowledgment WC-A-2(4/03) 1. Adoption Expenses - (Check One) n Eligible n Ineligible Non-Recurring Adoption Expenses (applicable for initial agreement only). There is an $800 ceiling for non-recurring adoption expenses for legal fees, and adoption fees. 2. Medicaid - (Check One) n Eligible n Ineligible Type: Title IV-E Medicaid n State/County Only Medicaid n 4. Maintenance- (Check One) n Eligible n Ineligible (Select one Adoption Assistance below) Title IV-E Assistance In A. Medicaid Only ❑ B. Long-Term (ongoing) $ Daily Rate: $ State/County Only Adoption Assistance Program n A. Medicaid Only B. Time-Limited - Number of years $ C. Long-Term (ongoing) $ D. Dormant: (Type Dormant on line) $ Dormant means, no adoption assistance payment is provided at this time; however, due to the previously described special needs, there exists the potential need for services. If there is a dormant financial subsidy, it will be reviewed as the child ages or the family circumstance changes. Daily Rate: $ 5. Adoption Case Services n Not applicable n One-Time In Ongoing {Description) 6. Other(Description) I/We do hereby acknowledge receipt of the following information on an adoption subsidy and agree that we discussed an adoption subsidy with the county negotiator and have AGREED/DISAGREED on the above information, relative to adopting Adoptive Parent Signature Date Adoptive Parent Signature Date County Negotiator Signature Date Adm\tnanss46.jag Social Services Division Policies and Procedures SPECIAL NEEDS ASSESSMENT WORKSHEET FOR SUBSIDIZED ADOPTIONS WC-A-3 (4/03) 1. BEHAVIOR MANAGEMENT - Does the child have emotional impairment and/or behaviors which require special or extensive involvement by the adoptive parent(s) in scheduling and monitoring of time and/or activities and/or crisis management? If yes, please explain. 2. THERAPY/ COUNSELING - Does the child attend therapy/counseling sessions? If yes, what is the reason and how often does the child go? 3. EDUCATION - Does the child have any special educational requirements? If yes, please explain. 4. PHYSICAL OR MEDICAL IMPAIRMENTS - Does the child have any physical or medical impairments requiring daily medically prescribed therapy or procedures (i.e. daily medication, etc.) If yes, please explain. 5. OTHER NEEDS TO CONSIDER - Does the child have any other special needs that should be considered for adoption subsidy? If yes, please explain. *** Please include professional documentation on questions answered "Yes". (i.e. letters from doctors, therapist, etc.) Adm\manss46.jag Social Services Division Policies and Procedures ADOPTIVE FAMILY RESOURCE QUESTIONNAIRE WC-A-4(12/04) Adoptive child's name: Date: Please complete the following questions regarding your family resources. 1) What is your family's gross monthly income?(Do not include foster or subsidy payments)$ 2) Number of persons supported by that income: 3) Total of persons in home: 4)List additional financial sources and amounts available to members of the household(i.e. foster care,guardian assistance,child support, social security,rental property,etc.): Business Office Use Only Current Foster Care Rate without respite: Current Foster Care Rate with respite: 5)Does anyone in your family have unusual costs,such as medical or educational? If yes,please explain: 6)What financial resources,other than your income, are available to meet the child's needs? (Indicate amount by appropriate category) $ SSD(disability of parent) include a copy of letter from Social Security Admin. (SSA) $ SSA(survivor's/death of birth parent) include copy of the letter from SSA. $ SSI(child's disability)include a copy of the letter from SSA. $ Child Support(being received by adoptive family) $ Other(Specify) 7)Will the child become eligible for additional benefits based on adoption by you? (Indicate kid of benefits and amounts) 8)In thinking about the needs of this child and the resources(financial,extended family,community services,etc.) available to your family,what will be REQUIRED in addition to those resources to continue support of this child in your household? (If a monetary subsidy/or services are being requested please indicate the reason and provide documentation for the request)Attach additional page of needed. 9)Will the child being adopted be added to your medical insurance policy? Yes No If yes,please complete the following: Effective Date of Child' Coverage: Name of the Insurance Company: Adm\tnanss46.jag Social Services Division Policies and Procedures Address(street, city,state,zip): Name of Policy Holder: Social Security Number: Group/Plan#: Policy ID#: 10)Attach a copy of your last tax return. (This is required information in order to complete the adoption.) Adm\manss46.jag Social Services Division Policies and Procedures REFUSAL OF ADOPTION SUBSIDY I/We, do affirm that on this day Name of Adoptive Parents Date the Weld County Department of Social Services has informed me of the availability of an adoption subsidy in the adoption of . I have Child/Children's Name conferred with my legal council and I do acknowledge that adoption subsidies are optional. At this time, I am informing you of my refusal of any adoption subsidy that the Weld County Department Social Services has advised me of Adoptive Parent Signature Date Adoptive Parent Signature Date Notary Signature Date Department Signature Date Notary Seal My commission Expires: Adm\manss46.jag Social Services Division Policies and Procedures 2.327 Child Placement Agencies Added 1/02 Revised 10/29/02 The Department has established and will reimburse the Child Placement Agencies (CPA) by the method in this manual as outlined in Section 2.320.1. 2.327.1 Reimbursement Rate Revised 10/29/02 A child specific Needs Based Care Assessment half tiered system Revised 6/06 designated as Exhibit B in Section 2.321.1, shall be used to determine Revised 8/06 levels of care for each child placed within a CPA. The assessment will be Revised 7/07 completed by the county caseworker with assistance from the Service Revised 8/07 Utilization Unit. The specific rate of payment will be paid for each level of service as recorded by the Needs Based Care Assessment. The reimbursement rate for these levels will be indicated by the Needs Based Care Rate Table, designated as Exhibit C in Section 2.321.1. Once rates have been established, the Needs Based Care Addendum, designated as Exhibit D in Section 2.321.1, will be completed by the County Rate Negotiator to outline the total rate of reimbursement for the out-of-home care of the child. This addendum will be effective from the time of placement until the end of the Colorado fiscal year, June 30, unless otherwise negotiated. The Needs Based Care forms have been adopted from the Northern Consortium of Counties. Effective October 1, 2001, all providers received a 2.5% increase in administrative overhead rate. Effective July 1, 2006, providers received a 3.25% COLA to the administrative overhead rate. Effective July 1, 2007, providers received a 2.5% increase to the Child Maintenance rate and the use of the new half tiered Needs Based Care Assessment tool and Rate Table was established. 2.327.2 Rate Re-Evaluations and Adjustments Added 10/29/02 A. The rates that are established in the Needs Based Care addendum will be re-evaluated and/or adjusted as outlined in the Department's Operations Manual, Section 2.902.2, or B. The rates may be negotiated at any time based upon the changing service needs of the child. Hello