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
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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.
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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
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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
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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:
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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.
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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
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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
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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.
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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 ❑
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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
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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
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Social Services Division Policies and Procedures
WELD COUNTY DEPARTMENT OF SOCIAL SERVICES
NEEDS BASED CARE
RATE TABLE
�_t�v (Exhibit C)
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''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
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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
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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
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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
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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
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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
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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.
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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.
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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
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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
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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
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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.
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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
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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.)
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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:
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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.)
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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:
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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.
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