HomeMy WebLinkAbout20170602.tiffRESOLUTION
RE: APPROVE REVISIONS TO OPERATIONS MANUAL SECTION 2.000, HUMAN
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 Various Revisions to Section 2.000,
Human Services Division Policies and Procedures, and
WHEREAS, after review, the Board deems it advisable to approve said revisions, a copy
of which is 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 Human Services, that the Revisions to Section 2.000,
Human Services Division Policies and Procedures, be and hereby are, approved.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 27th day of February, A.D., 2017.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: ddriteiV�
Weld County Clerk to the Board
puty Clerk to the Board
APP' * • AS TO
ounty A t•rney
Date of signature:31G /11
Julie A. Cozad, Chair
Steve Moreno, Pro-Tem
EXCUSED
Sean P. Conway
ke Freeman
CUSED
arbara Kirkmeyer
cc M IS B r ,TG)
3/1/1-7
2017-0602
HR0088
MEMORANDUM
DATE: January 12, 2017
TO: Board of County Commissioners — Pass -Around
FR: Judy A. Griego, Director, Human Services
RE: Weld County Department of Human Services'
Child Welfare Policies and Guideline
Please review and indicate if you would like a work session prior to placing these items on the
Board's agenda.
Request Board Approval of the Revision of Various Department Policies and Guideline
(Attached). The following policies and guideline will be used by Weld County Department of
Human Services Child Welfare staff.
2.320 Out -of -Home Placement with State Licensed Child Placement Agency — Foster
Care Homes
2.321 Out -of -Home Placement with County Certified Foster Care and Kinship Care
Homes
2.322 Needs Based Care Rate Table
2.323 Case Services Payments for Children in Out -of -Home Placements
2.324 Adoption Assistance Reimbursement
2.325 State Licensed Group Home/Group Center
2.326 Residential Child Care Facility (RCCF)
2.330 Monitoring of Purchased Services for Out -of -Home Placements and Remedies
2.802 Core Services Program
Guideline — Adoption Paperwork Process
Policies and Guideline were reviewed by Veronica Cavazos, Child Welfare Resource Manager,
Heather Walker, Child Welfare Division Head, Linda Goff, Assistance County Attorney and Karin
McDougal, Assistant County Attorney.
I do not recommend a Work Session. I recommend approval of the revised policies.
Approve
B I C A enda Work Session
Request
Sean Conway
Steve Moreno
Barbara Kirkmeyer
Mike Freeman
Julie Cozad
Pass -Around Memorandum; January 12, 2017 (Not in CMS)
She r+1-11Y—Pd'Pr
,.
c-i-• r um
2017-0602
Department of Human Services Policies
2.320 Out -of -Home Placement with State Licensed Child Placement Agency —
Foster Care Homes.
A. The Department shall reimburse a State licensed Child Placement Agency
(CPA) provider if such provider meets the State requirements for a State
Licensed Provider as established in Colorado State Rule, Section 7.417.2,
Volume VII, Human 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 that has been approved by the Board of Weld County
Commissioners (BOCC) and the State.
C. The Department will enter into yearly contracts with each State licensed
CPA 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 Placement Contract Coordinator will initiate and mail
out to providers the State prescribed SS -23A, Agreement to Purchase
Service, as outlined in the Colorado State Rules, Section 7.304(G) and
Section 7.304.661 of Volume VII. Exhibits within the SS -23A shall
reflect the daily rate to be paid for each child placed with the contracted
provider for that particular State Fiscal Year. Provider rates reflected
within Exhibits of the SS -23A may consist of State set rates or County
specific negotiated rates approved by the BOCC.
E. Once signed contracts have been received from providers, the State
prescribed SS -23A, Agreement to Purchase Service, with Exhibits, will be
approved and signed by the Department of Human Services Director and
the Board of County Commissioners (BOCC).
F. Upon request, providers will be mailed a fully executed copy of the SS -
23A, Agreement to Purchase Service, for their records.
G. All original contracts will be scanned and stored in the official County
records system maintained by the Clerk to the Board for Weld County
Government. The Child Welfare Financial Unit will notify the Human
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 Child Welfare Financial Unit.
2.320.1 State Licensed Child Placement Agency — Foster Care Reimbursement
A. A child specific Needs Based Care (NBC) assessment shall be used to
determine levels of care for any foster care placement made within a State
licensed Child Placement Agency (CPA).
Department of human Services Policies
B. A 60 day assessment period will be in place for all new placements into
the foster care level. The assessment period will allow the Department
and providers to gather pertinent information on the true needs of the
child. During the 60 day assessment period, the assessment level rate will
be paid to the provider unless otherwise negotiated.
C. After the 60 day assessment period, the Needs Based Care assessment
shall be completed by the Child Welfare Placement Contract Coordinator
based on information obtained from the foster care provider, Department
staff and CPA staff.
D. The levels of care and rates are determined based on the assessment
information and shall be mutually agreed to by both the Department and
the CPA, and documented on the Needs Based Care Addendum signed by
all parties.
E. The Needs Based Care rate table, as outlined in Section 2.322, shall be
used to reimburse providers within the available appropriation and may be
made up of the following components:
1. Child Maintenance — is a reimbursement for the basic needs of a
child placed in any foster care facility. Basic child maintenance
needs include but are not limited to: food, clothing, shelter,
education, personal supplies and allowance. An additional
difficulty of care and/or medical needs component, as determined
by the assessment, may be added within the child maintenance rate.
2. Respite Care — is a reimbursement for costs associated with the
temporary supervision of foster care children in the foster care
home. Respite care is reimbursed at $.66/day, unless otherwise
negotiated.
3. Administrative Maintenance — is a reimbursement to the
placement agency for general and administrative overhead, and
case management services provided to the children in foster care.
4. Administrative Services — is a reimbursement for therapeutic
services not covered by Medicaid.
F. Children who are eligible for the Children's Habilitation Residential
Program (CHRP) waiver, will be reimbursed at the current Social Security
Disability rate by the County and all other services costs shall be the
responsibility of the provider to bill through the MMIS State Medicaid
system.
Department of Human Services Policies
G. Children placed within a State Licensed Child Placement Agency (CPA)
foster care home are not eligible to receive a clothing allowance as this
expense is included within the child maintenance portion of the
reimbursement noted in Section F.
H. Medicaid co -pays may be reimbursed to CPA foster care providers for
youth in placement from the age of 19 to 21, if:
1. an original receipt is submitted to the Department listing the co -pay
amount(s) and child's name; and
2. the receipt is turned in within 60 days after the co -pay was made.
Medical expenses may be reimbursed to CPA foster care providers if:
1. the foster care child is not eligible for Medicaid; and
2. an original receipt is submitted to the Department listing the
child's name, medical expense amount(s) and service; and
3. the receipt is turned in within 60 days after the expense was
incurred.
2.320.2 Rate Re -Evaluation and Adjustment
A. All rates/services may be re -negotiated at anytime based upon the
changing needs of the child.
B. Rates/services may be re-evaluated a minimum of every six months by the
Child Welfare Placement Contract Coordinator and the Financial
Supervisor, in collaboration with Department staff, foster care providers,
and CPA staff.
2.320.3 Temporary Absence
A. Bed hold payments for a child's temporary absence from a provider,
including hospitalization, are limited to a maximum of 7 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 Child Welfare
Placement Contract Coordinator will contact the provider to negotiate a
daily rate for the approved bed hold if needed.
Department of Human Services Policies
2.321 Out -of -Home Placement with County Certified Foster Care and Kinship
Care Homes
A. The Department shall reimburse a County certified foster care provider or
kinship foster care provider if such provider meets the State requirements
for County Certified Providers as established in Colorado State Rule,
Section 7.417.1, Volume VII, Human 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 that has been approved by the Board of County
Commissioners (BOCC) and the State.
C. 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. The Child Welfare Placement Contract Coordinator will initiate and mail
out to providers, the State prescribed CWS-7A, Individual Provider
Contract, as outlined in Colorado State Rules, Section 7.304(G) and
Section 7.304.661 of Volume VII. The exhibit within the CWS-7A shall
reflect the daily rate to be paid for each child placed with the contracted
provider for that particular State Fiscal Year. Provider rates reflected
within the exhibit of the CWS-7A may consist of State set rates or County
specific negotiated rates approved by the BOCC.
E. Once signed contracts have been received from providers, the State
prescribed CWS-7A, Individual Provider Contract, with the exhibit, will
be approved and signed by the Director and the BOCC.
F. Providers will be mailed a fully executed copy of the CWS-7A, Individual
Provider Contract, for their records upon request.
G. All original contracts will be scanned and stored in the official County
records system maintained by the Clerk to the Board of the BOCC. The
Child Welfare Financial Unit will notify the Human Services Director, 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 Child Welfare Financial Unit.
Department of Human Services Policies
2.321.1 County Certified Foster Care and Kinship Care Reimbursement
A. A child specific needs based care assessment shall be used to determine
levels of care for foster care placements made within County certified
foster care homes.
B. A 60 day assessment period shall be in place for new placements into
the foster care level. The assessment period will allow the Department
and provider to gather pertinent information on the true needs of the
child. During the 60 day assessment period, the assessment level rate will
be paid to the provider unless otherwise negotiated.
C. After the 60 day assessment period, the Needs Based Care assessment shall
be completed by the Child Welfare Placement Contract Coordinator based
on information obtained from the foster care provider and Department
staff.
D. The levels of care and rates are determined based on the assessment
information and shall be mutually agreed to by both the Department and
the County certified foster care provider and documented on the Needs
Based Care Addendum signed by all parties.
E. The Needs Based Care rate table, as outlined in Section 2.322, shall be
used to reimburse providers within the available appropriation and may be
made up of the following components:
1. Child Maintenance — is a reimbursement for the basic needs of a
child placed in any foster care facility. Basic child maintenance
needs include but are not limited to: food, clothing, shelter,
education, personal supplies and allowance. An additional
difficulty of care and/or medical needs component, as determined
by the assessment, may be added within the child maintenance rate.
2. Respite Care — is a reimbursement for costs associated with the
temporary supervision of foster care children in the foster care
home. Respite care is reimbursed at $.66/day, unless otherwise
negotiated.
F. An initial clothing allowance may be reimbursed to County Foster
Care/Kinship Care providers of up to $200.00 per year (August Pt to July
31St) to ensure that the child has an adequate wardrobe. Clothing
reimbursement shall be submitted on the Department approved clothing
allowance form available on the Foster Parents Internet Database and On-
line System (FIDOS). Original receipts must accompany the clothing
allowance form for reimbursement. The clothing reimbursed under the
clothing allowance shall become the property of that specific child and
Department of Human Services Policies
must follow the child upon discharge from the foster care/kinship foster
care home. Admission and discharge clothing inventories shall be
required by the Department to track the clothing of each child in care. If a
child's wardrobe is lost, stolen, or destroyed, the Department may approve
an additional clothing allowance, the reason for which shall be thoroughly
documented in the child's record.
G. Transportation reimbursement is available to County Foster
Care/Kinship Care providers. Mileage reimbursement must be:
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. For in -county travel, as approved for special circumstances, with
prior approval of the Foster and Kinship 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 mileage reimbursements must be received by the
Department within 60 days of the expenditure occurring. If the
request is made over 60 days the expense will become non -
reimbursable.
7. Mileage reimbursement requests must be completed using the
approved County Foster Parent Mileage Expense Account Sheet
available on FIDOS.
H. Medicaid co -pays may be reimbursed to County Foster Care/Kinship Care
providers for youth in placement, from the age of 19 to 21, if:
1. an original receipt is submitted to the Department listing the co -pay
amount(s) and child's name; and
2. the receipt is turned in within 60 days after the co -pay was made.
I. Medical expenses may be reimbursed to County Foster Care/Kinship
Foster Care providers if:
1. the foster care child is not eligible for Medicaid; and
Department of Human Services Policies
an original receipt is submitted to the Department listing the
child's name, medical expense amount(s) and service; and
3. the receipt is turned in within 60 days after the expense was
incurred.
2.321.2 Rate Re -Evaluation and Adjustment
A. All rates/services may be re -negotiated at anytime based upon the
changing needs of the child.
B. Rates/services may be re-evaluated a minimum of every six months by the
Department Rate Negotiator and the Financial Supervisor, in collaboration
with Department staff, and the foster care provider.
2.321.3 Temporary Absence
A. Bed hold payments for a child's temporary absence from a provider,
including hospitalization, are limited to a maximum of 7 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 Placement Contract
Coordinator will contact the provider to negotiate a daily rate for the
approved bed hold if needed.
Department of Human Services Policies
2.322 Needs Based Care Rate Table (Effective 7/01/2015)
LEVEL OF
SERVICE
CHILD
MAINTENANCE
RESPITE
ADMINISTRATIVE
MAINTENANCE
ADMINISTRATIVE
SERVICES
MEDICAL
NEEDS
Level
Daily Rate
iiii
Daily Rate
a
Daily Rate
Daily Rate
Daily Rate
County Basic
I�laintenance
Rate
Age 0-10...$17.01
Age I I-14...$18.81
Age 15-21...$20.09
x.66
$12.35
No crisis intervention, minimal
CPA involvement, one face -to-
face visit with child per month.
$0.00
Not needed or covered
under Medicaid.
$20.56
$.66
$15.77
Minimal crisis intervention as
needed, one face-to-face visit per
month with child, 2-3 contacts
per month.
$5.14
Regularly Scheduled
therapy up to 4
hours/month.
$3.45
1 'i
$23.99
5.66
$17.48
----_-----
2
527.42
11
> "`'
$19.20
Occasional crisis intervention as
needed, two face-to-face visits
with child, 2-3 contacts per
month.
$10.28
Weekly scheduled
therapy 5-8 hours a
month with 4 hours of
group therapy.
't,.1 9'
2 '/z
$30.85
$.66
$20.91
3
$34.27
$ ,,,,
$22.62
Ongoing crisis intervention as
needed, weekly face-to-face
visits with child, and intensive
coordination of multiple
services.
,
$15.42
Regularly scheduled
weekly, multiple
sessions, can include
more than I person,
i.e. family therapy, for
9-12 hours/monthly.
it
$6.50
3 1/2
$ 3 7.69
y.6 r,
$24.34
4
Congregate
Care
Drop Down
$-t 1.13
$ (,.'
$26.05
Ongoing crisis intervention as
needed, which includes high
level of case management and
CPA involvement with child and
provider and 2-3 face -to face
contacts per week minimum.
Negotiated
Negotiated
Assessment/
Emergency
Level Rate
$27.42
$.66
$19.20
Department of Human Services Policies
2.323 Case Services Payments for Children in Out -of -Home Placements
A. The State Department of Human Services has made child welfare funds
available to purchase program services that support a case plan for
children in out -of -home placements, Adoption Assistance or a Relative
Guardianship Assistance.
B. Allowable purchased services are outlined in Colorado State Rule, Section
7.410, Volume VII.
Department of Human Services Policies
2.324 Adoption Assistance Program
2.324.1 Adoption Assistance
A. Available public programs for which the child is eligible for shall be used
first to address the child's needs before an adoption assistance agreement
is negotiated.
B. The Department shall utilize financial information regarding the family
including assets, liabilities and insurance benefits in negotiating initial
agreements and any subsequent increases in adoption assistance.
C. The Adoption Assistance Review team, which consists of the Resource
Manager, Financial Supervisor, Adoption Supervisor and County Attorney
shall review and draft proposals for all adoption assistance requests
submitted by the Adoption Assistance Specialist.
D. The Department determines the amount and kind of assistance based on
the following:
1. The child's documented special needs at the time of the adoptive
placement. (Please refer to the Colorado Department of Human Services, Volume
VII, Section 7.306.4 A (d) for qualifying special needs factors and conditions.)
2. The adoptive family's circumstances.
3. Available public programs for which the child is eligible for shall
be used first to address the child's needs.
E. Adoption assistance payments may be made directly to the family to
partially assist with expenses related to the child given the circumstances
of the adoptive parent(s). The adoptive parents are not required to account
for how the money is spent.
F. The maximum adoption assistance payment to adoptive parents shall be
the County Basic Maintenance rate, referenced in Section 2.322 and is
based on the age of the child at the time the adoption assistance agreement
is signed.
Note: The monthly respite care payment that is provided under the
foster care program is not a benefit under the adoption assistance
program. Once a monetary adoption assistance 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)
Department of Human Services Policies
G. In addition to the adoption assistance payment, the Department may also
provide adoption assistance Case services on behalf of the child. Please
refer to Colorado Department of Human Services, Volume VII, Section
7.306.52 for allowable Case services. The Department shall consider the
monetary value of these services when negotiating the amount it will pay
in adoption assistance payments to adoptive parents.
2.324.2 Reviews
A. Adoption assistance shall be reviewed every three years. The Department
shall initiate the Adoption Assistance Review form, CWSA-4, as a written
notice of the review sixty (60) days prior to the three-year anniversary of
the agreement. The Department may renegotiate the current rate at the
time of each review. Any changes in the needs of the child shall relate to
the original barrier(s), identified at the time the decision was made that
adoption assistance was needed. If it is determined that there is no current
need for a cash payment for a special needs child, a dormant assistance
will be established. This review is to determine if the amount and/or kind
of adoption assistance is still appropriate given the child's needs and the
circumstances of the parents. Documentation of any change of
circumstance shall be required.
B. The adoptive family may request a review of the agreement prior to the
three-year review if changes in the needs of the child or family
circumstances occur.
C. The Adoption Assistance Review team, shall review and draft proposals
for all adoption assistance renegotiation requests submitted by the
Adoption Assistance Specialist.
2.324.3 Termination
A. Weld County DHS will terminate adoption assistance payments 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 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.
Department of Human Services Policies
Please refer to the Colorado Department of Human Services Volume VII, Section
7.306.59 (B) on termination procedures for adoption assistance payments,
adoption Case services and Medicaid adoption assistance agreements.
2.324.4 Continuing Adoption Assistance Agreements Beyond Age Eighteen
A. If a child is 18 years of age and has not graduated with a high school
equivalency, the county may continue the assistance under the
State/County-only program until the child finishes high school or is 19
years of age. At 19 years of age, the assistance 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 an adoption
assistance. 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 assistance may depend on available county
funds. A new non -Title IV -E agreement must be signed by all parties
prior to the child's 18th birthday reflecting the continuance until the child
graduates from high school or is 19 years of age.
B. A child who is identified in the original adoption assistance agreement as
being developmentally disabled or physically handicapped, is between the
ages of 18-21, and continues to live at home, may continue to be eligible
for the assistance program.
2.324.5 Right to appeal
Please refer to the Colorado Department of Human Service Volume VII,
Section 7.306.6, regarding the appeal guidelines.
2.324.6 Adoption Assistance Negotiations
2.324.7 Initial Adoption Assistance Negotiations
A. The Adoption Caseworkers will submit an Adoption Assistance Referral
Form to the Adoption Assistance Specialist to start adoption assistance
negotiations. The Adoption Caseworkers shall ensure that all supporting
documentation of the child's qualifications for an adoption assistance are
scanned into the electronic case file for review by the Adoption Assistance
Specialist. All negotiations will occur with the Adoption Assistance
Specialist rather than the Adoption Caseworker.
B. The Adoption Assistance Specialist shall promptly mail a letter to the
prospective adoptive parent(s). The letter will include:
1. Statements advising the following: adoption assistance is available
under certain circumstances; any adoption assistance must be
Department of Human Services Policies
agreed upon before the Director of Human Services will sign a
Consent to Adopt; and the Director of Human Services has the
final approval on the amount and kind of adoption assistance.
2. A procedure for setting up a time to start adoption assistance
negotiations with the Adoption Assistance Specialist and a
deadline by which to respond. Failure to respond and set up a
meeting or phone conference by that time will result in the case
being put on hold. Cases where there are meetings scheduled will
take priority over cases on hold. If a case is put on hold, the
Adoption Assistance Specialist 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 Weld County Adoption Assistance Information form, WC -A-1,
(Exhibit A) explaining the possible assistance that may be
available to families.
4. A Special Needs Assessment Worksheet, WC -A-3, (Exhibit C) for
the adoptive parent(s) to complete and bring to the adoption
assistance meeting. This worksheet will outline the special needs
of the child that might pose a barrier for the adoption. The
worksheet will contain 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.
5. An Adoptive Family Resource Questionnaire, WC -A-4, (Exhibit
D) for the adoptive parent(s) to complete and bring to the adoption
assistance meeting with their most current Federal tax return.
6. An Adoption Assistance Refusal form which the adoptive parents
may sign before a notary indicating that they are declining any
assistance.
7. Tax credit information.
8. School Attendance form for the adoptive parents to complete and
bring to the adoption assistance meeting.
9. An advisement that the adoptive parents may be represented by an
attorney at the meeting at their own cost if they so desire.
Department of Human Services Policies
C. The Adoption Assistance Specialist will meet with the parent(s) at the
scheduled time. The Adoption Assistance Specialist will do the following:
1. Review the Weld County Adoption Assistance Information form,
WC -A-1, (Exhibit A) with adoptive parents.
2. Inform parents of the general maximum monthly maintenance
assistance amounts and services available if a child qualifies.
3. Review the Adoptive Family Resource Questionnaire, WC -A-4,
(Exhibit D) with the adoptive parents.
4. Review the Special Needs Assessment form, WC -A-3, (Exhibit C)
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 Adoption Assistance
Specialist until that material is provided by the adoptive parents.
5. The Adoption Assistance Specialist will match the special needs
identified for the child or children according to Rule 2.324 of the
Weld County Department of Human Services Manual and Volume
VII of the Colorado Department of Human Services. The
Adoption Assistance Specialist will develop a proposal to be
staffed with the Adoption Assistance Review Team regarding the
type and/or amount of assistance that could be offered by the
Department based on information submitted. Once staffed and an
adoption assistance proposal is agreed upon by the team, the
Adoption Assistance Specialist will send out a completed Adoption
Assistance Acknowledgment form (WC -A-2) to the adoptive
parents outlining the assistance that is being proposed. Note that
this offer is not binding on the Department until it is approved by
the Director of Human Services or designee.
D. If there is an agreement, the adoptive parents will indicate this on the
Adoption Assistance Acknowledgment form, WC -A-2, (Exhibit B) by
circling "agreed", signing and returning the form to the Adoption
Assistance Specialist. The Adoption Assistance Specialist will prepare the
CW-SA-3 for an initial adoption assistance or the CW-SA-4 form for
renewal of adoption assistance, based on the agreement and submit this to
the adoptive parent(s) for their signature. The signed Adoption Assistance
Acknowledgment form will be filed in the electronic adoption assistance
file for documentation purposes.
E. If no agreement is reached, the Adoption Assistance Specialist will present
his/her recommendations to the Adoption Assistance Review Team for
review. A determination of whether to attempt to renegotiate or to refer
the matter to the Director of Human Services will be made promptly by
the review team in consultation with the Human Services Administrator.
Department of Human Services Policies
This decision will be made within 14 days of the date the Adoption
Assistance Specialist refers the matter to the Adoption Assistance Review
Team. The adoptive parents shall be notified by letter from the Adoption
Assistance Specialist if the decision is to continue negotiations.
F. 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 Human Services. The Adoption Assistance
Acknowledgment form, WC -A-2, (Exhibit B) reflecting the final offer,
will be sent with the advisement letter informing the adoptive family of
their appeal rights and the process for appealing to an administrative law
judge (AU) at the Colorado Department of Human Services. If the
Adoption Assistance Acknowledgment form is received back signed and
in agreement, the Adoption Assistance Specialist will proceed as in Step
D.
G. If, at any time, the parents request the presence of an attorney at
negotiations, the Adoption Assistance Specialist may request that an
Assistant County Attorney be present.
H. Adoption assistance applications and renewal forms are not considered
final until signed by the Weld County Director of Human Services or
designee.
2.324.22 Adoption Assistance Renewal Negotiations
A. The Adoption Assistance Specialist and the Adoption Resource Specialist
shall review all adoption cases every three years. The adoptive parents
may 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 Assistance Specialist and the Adoption Resource
Specialist determine that there may be change in circumstance, procedures
will be followed as set out in the initial adoption assistance negotiations to
determine the amount of assistance. Documentation shall consist of
reports or evaluations by independent professionals.
D. Adoption assistance applications, agreements, and renewal forms are not
considered final until signed by the Weld County Director of Human
Services or designee.
E. Appeal procedures are as set out for initial adoption assistance
negotiations.
Department of human Services Policies
Exhibit A
rf&C:frel
111Ile
COLORADO
DEPARTMENT OF HUMAN SERVICES
PO BOX A
GREELEY, CO 80632
WEBSITE: www.co.weld.co.us
Administration and Public Assistance (970) 352-1551
Child Support (970) 352-6933
WC -A-1 (Revised 8/2016)
WELD COUNTY ADOPTION ASSISTANCE INFORMATION
This document is intended to answer "Frequently Asked Questions" about the Adoption Assistance program.
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.
Colorado operates two adoption assistance programs:
1. Title IV -E program - The Federal government participates in adoption assistance
agreements on behalf of children who meet the eligibility criteria for the Title IV -
E adoption assistance program.
2. State and County -only (non -IV -E) program - The State and County participate in
adoption assistance agreements on behalf of children who are not eligible for the
Title IV -E program.
A child can only be eligible for one type of assistance program. If a child is eligible for adoption
assistance, 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 assistance 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.
Adoption assistance is a program that provides assistance to adoptive parent(s) in certain defined
and limited ways to provide for the needs of an eligible adopted child. Adoption assistance is
intended to help or remove financial or other barriers to the adoption of Colorado children with
special needs by providing assistance to the parent(s) in caring for and raising the child.
Department of Human Services Policies
Exhibit A
Special needs classification
A "special need" is one or more of the following special, unusual, or significant factors that act
as a barrier to the child's adoption:
1) Physical disability (such as hearing, vision, or physical impairment; neurological
conditions; disfiguring defects; and, heart defects).
2) Mental disability (such as developmental delay or mental retardation, perceptual or
speech/language disability, or a metabolic disorder).
3) Developmental disability resulting in educational delays or significant learning
processing difficulties.
4) Educational disability that qualifies for Section 504 of the Rehabilitation Act of 1973
or special education services.
5) Emotional disturbance (such as post -traumatic stress disorder, bi-polar disorder and
other diagnoses).
6) Hereditary factors that have been documented by a physician or psychologist.
7) High risk children (such as HIV positive, drug -exposed, or alcohol -exposed in utero).
8) 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.
9) Ethnic background or membership in a minority group which may be difficult to
place.
Weld County DHS determines the amount and kind of assistance 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) Available public programs for which the child is eligible for shall be used first to
address the child's needs.
The Department shall utilize financial information regarding the family including assets,
liabilities and insurance benefits in negotiating initial agreements and any subsequent
increases in adoption assistance.
Department of Human Services Policies
Adoption Assistance Service Available
1. Medicaid
a. IV -E eligible children with an effective adoption assistance 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.
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 — Reimbursement for the following non -recurring
adoption expenses, not to exceed $800.00 per child, is available to parents adopting
children with special needs:
a. Legal fees.
b. Adoption fees.
c. Other expenses related to the legal adoption of the child(ren).
3. Adoption Assistance - The county department may authorize the following types of
adoption assistance agreements:
a. Long -Term Adoption Assistance Agreement - To partially meet a child's daily
needs on an indefinite basis. A long-term agreement 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 or child's
circumstances change, or the agreement terminates as outlined in Termination of
Adoption Assistance, Section 7.306.59, of the Adoption Assistance Agreement
rules.
The maximum monetary assistance that can be negotiated is as follows:
(1) Ages 0-10 $17.01 /daily*
(2) Ages 11-14 $18.81/daily*
(3) Ages 15-21 $20.09 daily*
* Additional monetary assistance for Physical/Developmental disability
can be negotiated if disability criteria is met.
(a) Level 1 - $3.45/daily
(b) Level 2 - $4.97/daily
Department of Fluman Services Policies
(c) Level 3 - $6.50/daily
b. Time -Limited Adoption Assistance Agreement - 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.
Agreement partially covers unmet needs that are time limited and non-renewable.
The maximum monetary assistance that can be negotiated is as follows:
(1) Ages 0-10 $17.01/daily*
(2) Ages 11-14 $18.81/daily*
(3) Ages 15-21 $20.09 daily*
* Additional monetary assistance for Physical/Developmental disability
can be negotiated if disability criteria is met.
(a) Level 1 - $3.45/daily
(b) Level 2 - $4.97/daily
(c) Level 3 - $6.50/daily
c. "Dormant" or "Medicaid -Only" Adoption Assistance Agreement - means
there is no adoption assistance payment provided at this time. County departments
shall document special needs for the child in the services record and in the State
Department's automated system that the potential need for financial adoption
assistance exists and may need to be activated at a future time.
4. Medical Assistance
a. Medical adoption assistance agreements payments are made directly to adoptive
parents for a service already received or to a vendor for treatment of a physical or
developmental disabilities or an emotional disturbance. A medical adoption
assistance agreement shall relate directly to the barrier or barriers identified at the
time the initial agreement is approved.
b. Medical adoption assistance agreements are not available for treatment of any
physical or developmental disability or emotional disturbance diagnosed after
finalization of the adoption.
c. Medical adoption assistance agreements 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. Medical adoption assistance agreements can only be used for Medicaid cases if
the service requested is something that would not be covered under the State
Medicaid Plan and relates to the direct barrier/need identified at the time the child
is placed for adoption.
e. Adoption assistance payments for medical services shall reflect the reasonable
costs of those services in the child's community.
5. Reimbursable and Non -Reimbursable Adoption Assistance Case Services
Department of Human Services Policies
Case services are a type of purchased program services that support a case plan for
children in out -of -home placement or an adoption assistance agreement. These 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 assistance
agreements. 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
Eye glasses are not reimbursable using case services dollars as Medicaid
pays for one pair of glasses per year. Payment for additional eye glasses in
a year or contacts related to the child's special needs identified at the time
of the initial adoption assistance agreement are reimbursable.
3) Medication
a. Routine that is not related to the child's special needs - not reimbursable.
b. If related to child's 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 adoption assistance.
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.
5) Special Equipment
Special medical needs/equipment, as prescribed by a physician may be
reimbursable. For severely physically -challenged children, special
exceptions should not exceed $2,000 without a supervisor's written
authorization.
B. Psychological Services
1) 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.
Department of Human Services Policies
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 service.
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 assistance 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.
2) Day Care - not reimbursable except 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 Adoption Assistance Case Services
Adoption assistance case services for either IV -E or non -IV -E may be provided
for a specified time to provide needed services, such as, but not limited to,
transportation to facilitate adoptive placement. It is required that these time -
limited services/funds are clearly provided on a case -by -case basis. This
requirement must be clearly documented in the agreement.
6. Termination of adoption assistance agreement
The county department shall terminate adoption assistance agreements 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 a
developmental or physical disability which warrants continuation of assistance; or,
Department of Human Services Policies
3) Adoptive parent(s) are no longer legally responsible for the support of the child; or,
4) Child is no longer receiving any support from the adoptive family; or,
5) County of responsibility verifies the child's death, or marriage.
7. Continuing adoption assistance beyond age eighteen
1) If a child is 18 years of age and has not graduated with a high school equivalency, the
county may continue the assistance under the State /County -only program until the
child finishes high school or is 19 years of age. At 19 years of age, the assistance
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 an
assistance. 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 assistance may depend on available county funds.
2) If the child is eligible for a Title IV -E adoption assistance until the age of eighteen
(18), that agreement shall be terminated. Any new non -Title IV -E agreement must be
signed by all parties prior to the child's 18th birthday.
3) A child who is identified in the original assistance 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.
4) Children who have emancipated from an adoption assistance agreement are eligible to
continue Medicaid until the age of 21. Once emancipated, the child's adoption
assistance agreement will be terminated and emancipation Medicaid will be opened
until the child reaches 21.
8. Review of eligibility for all ongoing adoption assistance agreements
1) The County shall initiate the written notice of the review for adoption assistance sixty
(60) days prior to the three year anniversary of the agreement.
2) The adoptive family may request a review of the agreement 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 adoption assistance was needed. The County
shall not add additional needs for adoption assistance payments after the adoption
decree has been issued unless genetic in nature.
Department of Human Services Policies
9. Reinstatement of adoption assistance
1) Non -Title IV adoption assistance agreements may be reinstated if the services
requested relate to the child's special needs which were identified at the time of the
original adoption assistance.
2) Reinstatement of adoption assistance agreements 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 eligibility for reinstatement of the adoption assistance agreement in
his/her new adoptive placement.
10. Right to appeal
1) When the county department denies an application for adoption assistance, or reduces
or terminates the adoption assistance, the applicant or recipient shall have a right to
appeal. See Section 3.850 of the Income Maintenance Staff manual on Appeal and
State Hearing (9 CCR 2503-1)
2) When a family who has been denied Title IV -E Adoption Assistance 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 assistance was determined correctly. (See Colorado
Department of Human Services Vol. 7, Section 7.306.41, E, for fair hearing
circumstances)
3) The adoptive parents have the burden of proving extenuating circumstances and
adoption assistance eligibility at a state level Fair Hearing. The State and/or its
designee can provide factual information to assist the family in establishing eligibility
for Title IV -E adoption assistance.
4) When either State or Federal law requires or results in a reduction or deletion of
services, a hearing need not be granted.
11. Post adoption programs/tax credit
Children adopted through the child welfare system and are determined to have special
needs may qualify for:
1) Post adoption programs through other resources. (e.g. Colorado Post -Adoption
Resource Center)
2) Federal adoption tax credit. (Please consult your tax accountant regarding eligibility
guidelines)
Department of Human Services Policies
For additional information on post adoption programs please contact:
Lisa Travis
Weld County Department of Human Services
Adoption Resource Specialist
(970) 352-1551 Ext. 6257
By signing below, I attest that I have read and initialed each page and understand
the Weld County Department of Human Services Adoption Assistance Policy.
Adoptive Parent Signature Date Adoptive Parent Signature [)ate
Adoption Assistance Specialist Date
Department of Human Services Policies
Exhibit B
Weld County Department of Human Services
Adoption Subsidy Information Acknowledgment
WC -A-2 (8/2016)
Identified below are the proposed Adoption Assistance benefits for your child. Please review each of
the possible benefit categories being offered. At the bottom of this form you will need to CHECK
Agree or Disagree, sign and date before returning the form to the County Adoption Assistance
Negotiator. If you do not agree with the following proposal you will need to attach a letter
documenting the exact benefits you are requesting, including a specific dollar amount if applicable,
how the requested benefits will be used to address your child's special needs, and any other relevant
information that will need to be taken into consideration for negotiations.
Please be advised that per Human Services Division Policies and Procedures 2.324.7 (C)(4) this
initial proposal is not binding and is subject to final approval by the Director of Human Services.
Once an agreement has been reached, the formal state Adoption Assistance Agreement forms will
be generated and processed for all required signatures and approval.
1. Adoption Expenses - ❑ Eligible ❑ Ineligible
Non -Recurring Adoption Expenses (applicable for initial agreement only). There is an
$800 ceiling for non -recurring adoption expenses for legal and adoption fees.
2. Medicaid - ❑ Eligible ❑ Ineligible
Program Type: ❑ Title IV -E Assistance n State/County Adoption Assistance
3. Maintenance -
Program Type: n Title IV -E Assistance ❑ State/County Adoption Assistance
Maintenance Type: (Select one)
A. Medicaid Only (Dormant) ❑
Medicaid only adoption assistance 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 this is a Medicaid
only adoption assistance agreement, it will be reviewed as the child ages
or the family circumstances change.
B. Time -Limited — Duration/Stipulations: *Monthly Rate $
C. Long -Term (ongoing) *Monthly Rate $
*Assistance payments are paid based on a daily rate (as reflected below);
monthly rates shown are approximate amounts only and may vary from
month to month.
Total Daily Rate: $
Department of Human Services Policies
4. Adoption Case Services Not applicable at this time One -Time Ongoing
(Description):
5. Other (Description):
I/We do hereby acknowledge receipt of the information pertaining to the
Adoption Assistance Program and have discussed an adoption subsidy with the county
negotiator.
I/We do hereby, AGREE ❑ DISAGREE ❑, on the above proposed adoption assistance
benefits, relative to adopting
Adoptive Parent Signature
Date Adoptive Parent Signature Date
County Negotiator Signature Date
The offer contained on this acknowledgment form is not considered final until the CWSA-1& 2
and CW-SA 3 are approved and signed by the Weld County Director of Human Services.
Department of Human Services Policies
Exhibit C
SPECIAL NEEDS ASSESSMENT WORKSHEET
FOR ADOPTION ASSISTANCE
WC -A-3 (8/2016)
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 assistance ? If yes, please
explain.
* * * Please include professional documentation on questions answered "Yes". (i.e. letters
from doctors, therapist, etc.)
Department of Human Services Policies
Exhibit D
ADOPTIVE FAMILY
RESOURCE
QUESTIONNAIRE
WC -A-4 (Revised 8/2016)
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 adoption assistance
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.):
5) Does anyone in your family have unusual costs, such as medical or educational? If yes, please explain
and identify the amount:
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 the kind 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 assistance/or services are being requested please indicate the reason and
provide documentation for the request) Attach additional pages if 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:
Address (street, city, state, zip):
Name of Policy Holder:
Department of Human Services Policies
Social Security Number:
Group/Plan #:
Policy ID#:
10) Are you capable of providing for and meeting your child's special needs without adoption assistance? No
Optional Comments:
1) Do you feel finances are a barrier to your ability to meet the special needs of your child? (Not including basic
needs or expected parental responsibilities, such as food, shelter, clothing, child care, extracurricular activities,
education expenses. etc.) No
Optional Comments:
12) If a monetary payment is being requested please indicate the exact amount, the reason for the request, and
details of how the money will be spent.
Please provide supporting documentation that the assistance you are requesting is required to address
your child's special needs and that Medicaid and/or other community resources have been exhausted.
(Attach additional page if needed.)
13) Do you require a specific service to be provided and/or paid for to meet your child's special needs on a short
term basis and for a limited period of time? No
If yes, please indicate the exact cost of the service, the provider, company or organization being used, and the
length of time the service is needed.
Please provide supporting documentation that the service provided is required to address your child's
special needs. (Attach additional page if needed.)
Department of Human Services Policies
Exhibit E
REFUSAL OF ADOPTION ASSISTANCE
fie, do affirm that on this day
Name of Adoptive Parents Date
The Weld County Department of Human Services has informed me of the availability of an
adoption assistance in the adoption of . I have
Child/Children's Name
conferred with my legal council and I do acknowledge that adoption assistance is optional.
At this time, I am informing you of my refusal of any adoption assistance that the Weld County
Department Human Services has advised me of.
Adoptive Parent Signature Date
Notary Signature Date
Notary Seal
My commission Expires:
Adoptive Parent Signature Date
Department Signature Date
Department of Human Services Policies
2.325 State Licensed Group Home/Group Center
A. State licensed Specialized Group Homes will serve as alternative
placements, as well as step down placements to Therapeutic Residential
Treatment Facilities, for difficult children/adolescents.
B. The department will contract with State licensed specialized group home
providers as indicated in Colorado State Rule, Volume VII.
2.325.1 Group Home/Group Center Provider
A. The Department shall reimburse a State licensed Group Home/Group
Center provider if such provider meets the State requirements as set forth
and established in Colorado State Rule, Volume VII.
B. Reimbursement for a State licensed Group Home/Group Center will be
individually negotiated based on market trends.
2.325.2 Evaluation of Group Homes
A. The Department may evaluate the group home/group center after the first
six months of operation. Thereafter, an evaluation shall be conducted at
least annually.
B. A group home/group center having an unsatisfactory evaluation will
require reevaluation for continuing use. If it is determined that the use of
the home/center should be continued, the Department will contract for
improved performance. If after 50 calendar days the unsatisfactory
components have continued, the Department shall terminate use of the
home/center.
C. The Department may conduct announced or unannounced home visits for
evaluating/monitoring purposes.
Department of Human Services Policies
2.326 Residential Child Care Facility (RCCF)
The Department shall reimburse a State licensed RCCF provider, if such provider
meets the State requirements as set forth and established in Colorado State Rule,
Volume VII.
2.326.1 RCCF Reimbursement Rate
The service rates will be based on the State determined rates that are entered as
base rates in the State automated tracking system. Rates may also be negotiated
to reflect additional services that the Department has approved.
Admlmanss58.jag
Department of Human Services Guidelines
Steps for Completing Adoption Paperwork
1. Upon case transfer, the Adoption Caseworker will review the Adoption Placement Process and
proceeds based on the placement status of the child.
2. Check for a Child -Specific Home Study (if the child is already placed in an adoptive home). If still
needed, make referral.
3. Check for recent fingerprints/CBI/FBI background checks. Obtain if needed.
4. Schedule a Pre -Finalization Information Sharing meeting and complete the CWS-18 and CWS-19.
5. Have the family complete the CDHS Original Application to care for Children - CWS-61.
6. Submit the Adoption Assistance Referral Form to HS-AdoptAssist as soon as the Adoption
Caseworker, GAL and Adoptive family have determined that they are ready to proceed. The SS -11 is
then completed in the IV -E Module by the Eligibility Clerk prior to or during the month the Adoption
Petition will be filed.
7. Scan all supporting documentation and attach to the Adoption Assistance Referral email.
8. The Adoption Assistance Specialist will contact the adoptive family about beginning the negotiation
process (see Adoption Assistance Policy).
9. The Adoption Assistance Specialist will meet with the review team which consists of the Financial
Supervisor, Resource Manager, Adoption Supervisor and County Attorney to review the requested
adoption assistance.
10. Once the negotiation is complete and the adoptive parents sign the Adoption Subsidy Information
Acknowledgement form, the Adoption Assistance Specialist will prepare the contracts.
11. Once the contracts are approved by the Financial Supervisor, the Adoption Assistance Specialist will
email the contracts to the Adoption Supervisor and the Adoption Caseworker.
12. The Adoption Caseworker will insert the special needs summary required for the adoption
assistance contracts.
Page 1 of 3
Department of Human Services Guidelines
13. The Adoption Caseworker will prepare the County Consent to Adopt Checklist and will submit to
Legal for review and signature.
14. Once the contracts have been signed (digitally) by the Adoption Supervisor and Adoption
Caseworker, the Adoption Caseworker will gather the following paperwork and will email to the
Child Welfare Administrator: County Consent to Adopt Checklist, Agency Consent to Adopt, Child
Social History and the Adoption Assistance Agreement Contracts.
15. The Adoption Caseworker will schedule a meeting with the Child Welfare Administrator, within a
week of receiving the completed contracts.
16. The Child Welfare Administrator will then meet with the Director of Human Services to present the
consent and the contracts. If approved, the Director will sign the consent and the contracts and
send back to the Child Welfare Administrator, who will then forward them to the Adoption
Supervisor and Adoption Caseworker.
17. Once the consent and the contracts have been signed, the Adoption Caseworker will expedite
submitting all the required paperwork (see Attorney Receipt of Information checklist) to the
attorney for filing with the Court.
18. The Adoption Caseworker will ensure that the contracts are signed (signatures need to be obtained
and dated prior to the effective date/date of the adoption finalization).
19. Once the Adoption has been finalized in Court, the Adoption Caseworker will complete all required
TRAILS paperwork, including opening the Adoption Case and Service in TRAILS.
20. The Adoption Caseworker will complete the Adoption Placement Information Form and submit to
HS-AdoptAssist within 7 days of the date of the adoption hearing.
21. The Adoption Caseworker will scan the remaining paperwork (see Adoption Scanning Process).
22. Once all the above is complete (including scanning), the Adoption Caseworker will prepare the
checklist for transfer to the Adoption Resource Specialist.
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Department of Human Services Guidelines
23. The Adoption Resource Specialist will prepare the Sealed File in On Base (see Sealed Adoption
Records Checklist).
24. The Adoption Supervisor will maintain the adoption assistance TRAILS cases on the Supervisor's
TRAILS workload.
Page 3 of 3
Department of Human Services Policies
2.330 Monitoring of Purchased Services for Out -of -Home Placements and
Remedies
Weld County shall monitor out -of -home placements as outlined in Section
7.304.66, Colorado State Rules, Social Services Program, Volume 7.
2.330.1 Monitoring Procedures
A. The caseworker will be provided with information regarding the services
that the out -of -home provider has agreed to provide as outlined in the
initial Placement Contract. This information should assist the worker in
conducting a review during monthly routine visits.
B. The caseworker will document any problems or concerns that are noted
within the routine visit. The documentation will be given to their
immediate supervisor for review.
C. If problems or complaints are deemed serious, the supervisor and
caseworker will staff the findings with the Resource Manager.
D. The Resource Manager may then recommend the following:
1. Initiation of a follow-up phone call to the facility regarding the
concerns that were noted within the review. These concerns will
then be monitored and re-evaluated monthly by routine visits by
department staff.
2. Recommend to the Child Welfare Division Head to activate a
review team that will be comprised of appropriate
Resource/Permanency unit staff, and a county financial
representative. The review team will conduct an on -site audit of
the facility that is in question.
3. Recommend that the Supervisor/Administrator report these
findings to the State Licensing Division and/or the certifying
authority for investigation.
2.330.2 Monitoring Remedies
A. If the review team finds the provider to be in non-compliance of the
placement contract and/or in violation of State/County policy, the
Administrator shall meet with the Director to communicate these findings.
At that time, possible remedies discussed may include the following:
Department of Human Services Policies
1. Written warning regarding documented findings sent to the facility
under investigation. Copies may be forwarded to the State
Department of Licensing and the provider's county file, and/or
2. Fiscal sanctions imposed on the facility, and/or
3. Removal of child from the facility, and/or
4. Communication to other counties that are using the facility. This
communication will notify counties that an audit was performed
and what the documented violations were.
Department of Human Services Policies
2.802 Core Services Program
The Department provides services under its Core Services Program in accordance
with Volume VII, Section 7.303, Colorado Department of Human Services. The
Department's Core Services Program is approved each year for a period beginning
June 1 through May 31 of the following year.
2.802.1 Definitions
Core Services Program consists of services as defined in Volume VII, Section
7.303.1, Colorado Department of Human Services as follows:
A. Home Based Intervention: Services provided primarily in the home of
the client and includes a variety of services that can include therapeutic
services, concrete services, collateral services and crisis intervention
directed to meet the needs of the child and family. Service elements of
therapeutic, concrete, collateral and crisis intervention services are defined
in Volume VII, Section 7.303.14, Colorado Department of Human
Services.
B. Intensive Family Therapy: Therapeutic intervention, typically with all
family members, to improve family communication, functioning, and
relationships.
C. Life Skills: Services provided primarily in the home that teach household
management, effectively accessing community resources, parenting
techniques and family conflict management.
D. Day Treatment: Comprehensive, highly structured services that provide
education to children and therapy to children and their families.
E. Sexual Abuse Treatment: Therapeutic intervention designed to address
issues and behaviors related to sexual abuse victimization, sexual
dysfunction, sexual perpetration, and to prevent future sexual abuse and
victimization.
F. Special Economic Assistance: Emergency financial assistance of not
more than $2,000.00 per family per rolling year in the form of cash and/or
vendor payment to purchase hard services. Services elements for hard
services are defined in Volume VII, Section 7.303.14, Colorado
Department of Human Services.
Department of Human Services Policies
G. Mental Health Services: Diagnostic and/or therapeutic services to assist in
the development of the family services plan, to assess and/or improve family
communication, functioning, and relationships.
H. Substance Abuse Treatment Services: Diagnostic and/or therapeutic
services to assist in the development of the family service plan, to assess
and/or improve family communication, functioning and relationships, and to
prevent further abuse of drugs or alcohol.
I. Aftercare Services: Any of the Core services provided to prepare a child
for reunification with his or her family or other permanent placement and to
prevent future out -of -home placement of the child.
J. County Designed Services: Innovative and/or otherwise unavailable
services proposed by a county that meet the goals of the Core Services
Program.
2.802.2 Program Eligibility
Program eligibility for the program is defined in Volume VII, Section 7.303.13,
Colorado Department of Human Services.
2.802.3 Procedures to Access Services
A. According to Volume VII, Section 7.303.12, Colorado Department of
Human Services, the Department must make all of the Core Services, except
for county designed services, available to any client who meets the criteria
for the service as documented in the Family Services Plan.
B. Each program year, the Department provides a provider directory to
caseworkers for each Core Services Program area as defined in Section
2.802.1 (A) through (H). The directory will include a description of the
population best served by the vendor and services to be provided.
C. The caseworker will make a referral to a provider on behalf of a family.
The referral must be documented in the Family Services Plan and meet the
requirement of Section 2.802.3 (A). The minimum requirements of the
referral include: the recommended beginning and ending dates of service
from the vendor, the family's household number, and reasons for the referral
to the vendor.
D. Referrals are submitted to the e-mail distribution list "HS-CW Service
Department of Human Services Policies
referral" for processing. Referrals may also be reviewed by the
Department's Mental Health Professional for further evaluation.
E. Approved Core services are entered into Trails by the Service Utilization
Clerk.
2.802.4 Reserved.
2.8023 Substance Abuse Procedures
2.802.51 Substance Abuse Referral for D&N and Voluntary Child Protection
Cases
A referral to substance abuse services must meet the Core Services definition
identified in Section 2.802.1, H, and eligibility criteria identified in Section 2.802.2
of the Department's Policies and Guidelines Manual.
2.802.52 Immediate Testing to Monitor Sobriety
A. In certain cases, a caseworker may not have sufficient information to refer a
parent for a substance abuse evaluation or is ordered by the Court to have
the parent immediately tested. In such cases, the caseworker may refer the
parent for immediate testing to monitor sobriety with contracted providers.
2.802.521 Non -Immediate Monitored Sobriety Procedures
A. Caseworkers may refer a client up to the approved time limit set forth by the
Department's Substance Abuse Professional, for monitored sobriety, if a
parent is required to be clean and sober as a condition of visits. This allows
the client to get into see an evaluator and to visit with their children while
the evaluation procedure is in process.
2.802.53 Substance Abuse Treatment Plan Procedures
A. The caseworker will refer the parent to a substance abuse evaluation by
using the appropriate Core Services Program referral form.
B. This evaluation will identify treatment recommendations for the parent.
C. The evaluator must:
1. Complete the type of testing to monitor sobriety as chosen by the
Department of Human Services Policies
Department the day of the evaluation with the parent, and
2. Make at least two collateral contacts.
D. Based on the results of the evaluation, the caseworker will meet with the
client and review the treatment recommendations.
2.802.54 Payment of Substance Abuse Testing, Assessment, and Treatment
The Department, through appropriate Court motions, will pursue, by priority,
payment of treatment services through the parent's private insurance policy,
through other community resources and through Core Services Program funding.
A. Through appropriate Court motions and as part of the treatment plan, the
Department may seek orders that the parent be responsible for payment of an
evaluation if the parent:
1. Does not complete an evaluation within 30 days of the court order
for such evaluation.
2. Has tested positive while in treatment or if the parent is non-
compliant and does not consistently attend their treatment program.
3. Has been previously ordered through another court action to comply
with monitored sobriety.
B. Core Services Program funding should only be used for each level of care
needed on a one-time basis, unless specifically approved by the Department.
C. Any residential treatment recommended by the substance abuse evaluator
shall be staffed with the Department's Substance Abuse Professional.
2.810 Core Services Provider Billing and Request For Reimbursement
Requirements
A. Requests for payment must be submitted in complete form to the Fiscal
Clerk and date stamped no later than the 7t' day of the month following the
service month. Any requests for payment received after the 7th of the month
following the service month will not be honored. A complete form is
considered by the Department to be, but not limited to:
1. Request for Reimbursement form(s) must have all sections completed
Department of Human Services Policies
with each client's complete information from the referral form,
showing clients receiving services and not receiving services. All
client names, household numbers, referral numbers, approved entry
date and approved exit date must be taken off the referral in complete
form.
2. Client verification form(s) must be completed entirely for clients that
are receiving services for that month. Client signatures must be done
at the time of service. Any Client Verification form received with
services, but without a client's signature, will not be paid. All
participants in attendance must sign the Verification form(s). If there
are children that are unable to sign, the parent can sign for the child.
Original signatures are required.
3. A Monthly Progress Report must be completed for each client that
reflects presenting problem(s) of the client/family, specific services
provided, extent of client(s) participation and commitment to the
program, client(s) progress to date and anticipated discharge date.
4. All renewal requests are the responsibility of the provider. Renewal
requests must be submitted via e-mail, reflect cause for renewal and
must be submitted prior to the current end date. Human Services
will reserve the right to request a meeting on any request the
Department deems needs clarification.
B. Requests for payments that are submitted by the 7`h day of the month
following the service month, will have an initial review process for any
missing or incorrect information. After the initial review process, if there is
any missing or incorrect information, the provider will be contacted the day
the initial review is completed. The provider will have the option to correct
the billing within a timeframe set forth by the Department.
Department of Human Services Policies
2.802 Core Services Program
The Department provides services under its Core Services Program in accordance
with Volume VII, Section 7.303, Colorado Department of Human Services. The
Department's Core Services Program is approved each year for a period beginning
June 1 through May 31 of the following year.
2.802.1 Definitions
Core Services Program consists of services as defined in Volume VII, Section
7.303.1, Colorado Department of Human Services as follows:
A. Home Based Intervention: Services provided primarily in the home of
the client and includes a variety of services that can include therapeutic
services, concrete services, collateral services and crisis intervention
directed to meet the needs of the child and family. Service elements of
therapeutic, concrete, collateral and crisis intervention services are defined
in Volume VII, Section 7.303.14, Colorado Department of Human
Services.
B. Intensive Family Therapy: Therapeutic intervention, typically with all
family members, to improve family communication, functioning, and
relationships.
C. Life Skills: Services provided primarily in the home that teach household
management, effectively accessing community resources, parenting
techniques and family conflict management.
D. Day Treatment: Comprehensive, highly structured services that provide
education to children and therapy to children and their families.
E. Sexual Abuse Treatment: Therapeutic intervention designed to address
issues and behaviors related to sexual abuse victimization, sexual
dysfunction, sexual perpetration, and to prevent future sexual abuse and
victimization.
F. Special Economic Assistance: Emergency financial assistance of not
more than $2,000.00 per family per rolling year in the form of cash and/or
vendor payment to purchase hard services. Services elements for hard
services are defined in Volume VII, Section 7.303.14, Colorado
Department of Human Services.
Department of Human Services Policies
G. Mental Health Services: Diagnostic and/or therapeutic services to assist in
the development of the family services plan, to assess and/or improve family
communication, functioning, and relationships.
H. Substance Abuse Treatment Services: Diagnostic and/or therapeutic
services to assist in the development of the family service plan, to assess
and/or improve family communication, functioning and relationships, and to
prevent further abuse of drugs or alcohol.
I. Aftercare Services: Any of the Core services provided to prepare a child
for reunification with his or her family or other permanent placement and to
prevent future out -of -home placement of the child.
J. County Designed Services: Innovative and/or otherwise unavailable
services proposed by a county that meet the goals of the Core Services
Program.
2.802.2 Program Eligibility
Program eligibility for the program is defined in Volume VII, Section 7.303.13,
Colorado Department of Human Services.
2.802.3 Procedures to Access Services
A. According to Volume VII, Section 7.303.12, Colorado Department of
Human Services, the Department must make all of the Core Services, except
for county designed services, available to any client who meets the criteria
for the service as documented in the Family Services Plan.
B. Each program year, the Department provides a provider directory to
caseworkers for each Core Services Program area as defined in Section
2.802.1 (A) through (H). The directory will include a description of the
population best served by the vendor and services to be provided.
C. The caseworker will make a referral to a provider on behalf of a family.
The referral must be documented in the Family Services Plan and meet the
requirement of Section 2.802.3 (A). The minimum requirements of the
referral include: the recommended beginning and ending dates of service
from the vendor, the family's household number, and reasons for the referral
to the vendor.
D. Referrals are submitted to the e-mail distribution list "HS-CW Service
Department of Human Services Policies
referral" for processing. Referrals may also be reviewed by the
Department's Mental Health Professional for further evaluation.
E. Approved Core services are entered into Trails by the Service Utilization
Clerk.
2.802.4 Reserved.
2.8023 Substance Abuse Procedures
2.802.51 Substance Abuse Referral for D&N and Voluntary Child Protection
Cases
A referral to substance abuse services must meet the Core Services definition
identified in Section 2.802.1, H, and eligibility criteria identified in Section 2.802.2
of the Department's Policies and Guidelines Manual.
2.802.52 Immediate Testing to Monitor Sobriety
A. In certain cases, a caseworker may not have sufficient information to refer a
parent for a substance abuse evaluation or is ordered by the Court to have
the parent immediately tested. In such cases, the caseworker may refer the
parent for immediate testing to monitor sobriety with contracted providers.
2.802.521 No n -I m mediate Monitored Sobriety Procedures
A. Caseworkers may refer a client up to the approved time limit set forth by the
Department's Substance Abuse Professional, for monitored sobriety, if a
parent is required to be clean and sober as a condition of visits. This allows
the client to get into see an evaluator and to visit with their children while
the evaluation procedure is in process.
2.802.53 Substance Abuse Treatment Plan Procedures
A. The caseworker will refer the parent to a substance abuse evaluation by
using the appropriate Core Services Program referral form.
B. This evaluation will identify treatment recommendations for the parent.
C. The evaluator must:
1. Complete the type of testing to monitor sobriety as chosen by the
Department of Human Services Policies
Department the day of the evaluation with the parent, and
2. Make at least two collateral contacts.
D. Based on the results of the evaluation, the caseworker will meet with the
client and review the treatment recommendations.
2.80234 Payment of Substance Abuse Testing, Assessment, and Treatment
The Department, through appropriate Court motions, will pursue, by priority,
payment of treatment services through the parent's private insurance policy,
through other community resources and through Core Services Program funding.
A. Through appropriate Court motions and as part of the treatment plan, the
Department may seek orders that the parent be responsible for payment of an
evaluation if the parent:
1. Does not complete an evaluation within 30 days of the court order
for such evaluation.
2. Has tested positive while in treatment or if the parent is non-
compliant and does not consistently attend their treatment program.
3. Has been previously ordered through another court action to comply
with monitored sobriety.
B. Core Services Program funding should only be used for each level of care
needed on a one-time basis, unless specifically approved by the Department.
C. Any residential treatment recommended by the substance abuse evaluator
shall be staffed with the Department's Substance Abuse Professional.
2.810 Core Services Provider Billing and Request For Reimbursement
Requirements
A. Requests for payment must be submitted in complete form to the Fiscal
Clerk and date stamped no later than the 7th day of the month following the
service month. Any requests for payment received after the 7th of the month
following the service month will not be honored. A complete form is
considered by the Department to be, but not limited to:
1. Request for Reimbursement form(s) must have all sections completed
Department of Human Services Policies
with each client's complete information from the referral form,
showing clients receiving services and not receiving services. All
client names, household numbers, referral numbers, approved entry
date and approved exit date must be taken off the referral in complete
form.
2. Client verification form(s) must be completed entirely for clients that
are receiving services for that month. Client signatures must be done
at the time of service. Any Client Verification form received with
services, but without a client's signature, will not be paid. All
participants in attendance must sign the Verification form(s). If there
are children that are unable to sign, the parent can sign for the child.
Original signatures are required.
3. A Monthly Progress Report must be completed for each client that
reflects presenting problem(s) of the client/family, specific services
provided, extent of client(s) participation and commitment to the
program, client(s) progress to date and anticipated discharge date.
4. All renewal requests are the responsibility of the provider. Renewal
requests must be submitted via e-mail, reflect cause for renewal and
must be submitted prior to the current end date. Human Services
will reserve the right to request a meeting on any request the
Department deems needs clarification.
B. Requests for payments that are submitted by the 7th day of the month
following the service month, will have an initial review process for any
missing or incorrect information. After the initial review process, if there is
any missing or incorrect information, the provider will be contacted the day
the initial review is completed. The provider will have the option to correct
the billing within a timeframe set forth by the Department.
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