Department for Community Based Services

Standards of Practice Online Manual

12.24 Per Diem Rates (Including Specialized Foster Care) 

Cabinet for Health and Family Services

Department for Community Based Services
Division of Protection and Permanency
Standards of Practice Online Manual
Chapter:
Chapter 12-Resource Family Recruitment, Certification and Reimbursement 
Effective:
5/1/2014 
Section:
12.24 Per Diem Rates (Including Specialized Foster Care) 
Version:

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Legal Authority/Introduction

LEGAL AUTHORITY:

The resource home per diem rate structure is designed to give resource parents flexibility and autonomy to decide how to spend money for the children in their homes. R&C worker approval is not necessary for services included in the per diem.

Procedure

  1. The SSW specifies the daily rate (per diem) for care of a child placed in the resource home.
  2. The R&C worker notifies the Director of the Division of Protection and Permanency, within three (3) working days, of any request by a school for DCBS to pay school lunches and breakfasts.  1
  3. The R&C worker or FSOS terminates the resource home’s reimbursement per diem rate for advanced, emergency shelter, medically fragile, and care plus if the resource home fails to meet the ongoing training requirements for their type of home. In these instances, the resource home’s per diem rate reverts to the regular basic per diem rate. 
  4. The R&C worker notifies the appropriate Billing Specialist.

Practice Guidance

 Per Diem Rates 

 

   Basic Advanced Degreed
 Birth to age 11 $22.70  $24.90 N/A
 Age 12+ $24.70 $26.90 N/A
 Emergency Shelter Home $33.00 N/A N/A
 Care Plus Home $40.00 $45.00 N/A
 Medically Fragile $40.00 $45.00 $48.00
 Specialized Med. Fragile N/A  $56.40 $91.55
 Supplemental Services Rate N/A $68.00 N/A

 

  • A basic resource home is reimbursed the specified per diem rate in the above table only for resource parents that have met all requirements of a basic resource home.
  • An advanced resource home is reimbursed the specified per diem rate in the above table only for resource parents that have met all requirements of an advanced resource home as outlined in SOP 12.18.1 Advanced Resource Home Approval.
  • An emergency shelter resource home is reimbursed the specified per diem rate in the above table only for a child whose needs are temporary in nature as described in SOP 12.18.2 Emergency Shelter Home, and the resource parents have met all requirements of an emergency shelter resource home. This per diem rate is payable for a maximum of thirty (30) days with no extensions. 
     
  • Housing expenses, food-related expenses, and school expenses are included in the per diem rate.
  • The child's routine hair care is included in the per diem rate, at an average of $12 per month. 
  • Incidentals such as medicine chest supplies, baby oil and powder, deodorants, sanitary napkins, and other personal toiletries are included in the per diem rate. 
  • The per diem includes money for social and/or school-related activities (e.g. clubs, ballgames, participation in dance class, gymnastics, karate, church, team sports, school supplies, school pictures, band, SAT/ACT testing, etc.). This allows all foster children to participate in normal activities and empowers the foster parent to make these decisions. 2 
  • When a child remains in a resource home less than thirty (30) days, the rate amount for per diem, clothing, incidentals, and allowance is prorated for the number of days the child was in the home.


Specialized Foster Care Per Diem Rates

  • Specialized foster care reimbursements are paid based on the needs of the child, and the training professional licensure of the resource home.  As such:
    • A medically fragile or specialized medically fragile resource home is reimbursed the specified per diem rate in the above table only for a child  designated by the Medical Support Branch of the Division of Protection and Permanency as a medically fragile child; and
    • A care plus resource home is only reimbursed the basic care plus per diem rate for a child designated as a care plus child and has met all requirements of a care plus resource home.
    • An advanced care plus resource home is only reimbursed the advanced care plus per diem rate for a child designated as a care plus child and the resource home parent(s) has:
      • Completed and maintains ongoing training requirements;
      • One year's experience as a care plus resource home parent; and
      • A positive annual re-evaluation.
  • An advanced medically fragile rate is paid to a foster parent who maintains a current license as a licensed practical nurse (in accordance with KRS 314.011(9)) and is caring for a medically fragile child.  The Medical Support Section approves this per diem rate based on the extra professional licensing certification of the resource parent home
  • A degreed medically fragile rate is paid to a foster parent who maintains a current license as a registered nurse (in accordance with KRS 314.011(5)) or is a health care professional and is caring for a medically fragile child.  The Medical Support Section approves this per diem rate based on the extra professional licensing certification of the resource home. 3
  • Specialized medically fragile rates are determined by the medical needs of the medically fragile child.  The decision to assign this rate is determined by the Medical Support Section.
  • An advanced specialized medically fragile rate is paid to a foster parent who maintains a current license as a licensed practical nurse (in accordance with KRS 314.011(9)) and is caring for a child who has been determined by the Medical Support Section to be specialized medically fragile.
  • A degreed specialized medically fragile rate is paid to a foster parent who is a health care professional licensed registered nurse or a physician and is caring for a child who has been determined by the Medical Support Section to be specialized medically fragile.   
  • When it is determined by the child's family team that a child no longer meets determination requirements for a care plus designation, the resource home receives thirty (30) days notification prior to the rate change.  
  • When it is determined by the Medical Support Section that a child no longer meets medically fragile requirements, the resource home receives thirty (30) days notification prior to the rate change.
  • In addition to the Medical Support Section determining whether a child meets medically fragile criteria, this section also assigns the per diem amount to be reimbursed.
  • Back pay for medically fragile and care plus reimbursements can only be received for thirty (30) days prior to designation. 
 

Footnotes

  1. All foster care children are eligible for free lunch programs and may participate upon completion of the appropriate school form.
  2. If the child is under school age, the funds allotted for school activities (dances, clubs, sports, pictures, school supplies, college entrance testing, etc.) should be used toward travel or other expenses that the resource home parent would normally seek approval.
  3. A health care professional is a person actively licensed as a physician, physician's assistant, advanced registered nurse practitioner or registered nurse. 

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