Department for Community Based Services

Standards of Practice Online Manual

31.2 Title IV-E Eligibility and Reimbursability

Cabinet for Health and Family Services

Department for Community Based Services
Division of Protection and Permanency
Standards of Practice Online Manual
Chapter:
Chapter 31-Standards of Practice Regarding Title IV-E, Medicaid and Other Applicable Benefits
Effective:
9/14/2018
Section:
31.2 Title IV-E Eligibility and Reimbursability
Version:
2

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Legal Authority/Introduction

LEGAL AUTHORITY:

Title IV-E provides for federal payments to the states for foster care maintenance and adoption assistance payments made on behalf of eligible children. The objective is:

  • To improve the quality of care provided to children in substitute care;
  • To reduce the number of children who are removed from their own homes for placement in substitute care. Substitute care includes foster family, group home and institutional care;
  • To return children from substitute care to their homes as soon as conditions in the home permit; and
  • To facilitate the adoption or other permanent placement for those children who cannot be returned to their own homes.

There are two (2) major components of title IV-E: eligibility and reimbursability. Eligibility does not automatically confer federal benefits. The reimbursability criterion must be met for the state to receive federal support for the child.
Title IV-E eligibility is determined by the Children’s Benefits Worker (CBW) based upon information provided by the SSW.  SOP Procedures for the SSW are located in SOP 31.1 Title IV-E Determination.

  • The Department for Community Based Services is responsible for:
  • Determining eligibility;
  • Determining reimbursability;
  • Maintaining compliance with Medicaid regulations pursuant to  KRS 205 §§ 510-630;
  • Monitoring the case to ensure that IV-E foster care maintenance payments are being made correctly on the child’s behalf.

The CBW case assignment is determined using all factors to attain equitable caseloads as determined by the DCBS Division of Administrative and Financial Management (DAFM).
 
Title IV-E provides for federal payments to the states for foster care maintenance and adoption assistance payments made on behalf of certain eligible children.  

Procedure

The SSW:

  1. Notifies the CBW on the day that the agency assumes legal responsibility for the supervision and care of a child;
  2. Within ten (10) working days:
    1. Completes the DSS-1260 Title IV-E and Child Support Referral in TWIST;
    2. Submits the DSS-1259 Benefits Action Transmittal and all documents listed on it to the Children’s Benefits Worker;
  3. Notifies the Children’s Benefits Worker within ten (10) working days of any changes in:
    1. Placement;
    2. Custody status;
    3. TPR status; or
    4. AFDC relatedness, including:
      1. Deprivation of the care and support of one or both parents;
      2. Need (resources and income, including receipt of SSI benefits); or
      3. Age (A child loses eligibility and reimbursability at the beginning of the month following his eighteenth (18th) birthday, unless he is enrolled full-time in high school, or any equivalent course of study, and can be reasonably expected to graduate prior to the his nineteenth(19th) birthday. When the child meets this expectation, reimbursement may continue until the beginning of the month following the child’s graduation);
  4. Ensures that:
    1. The wording of the court order states that continuation in the home is contrary to the welfare of the child.  This wording is required for the child to be title IV-E eligible as outlined in SOP 31.1 Title IV-E Determination.  The judicial determination for IV-E eligibility requires that the results in the child's removal coincide with (i.e. occur at the same time as) the Cabinet's action to physically or constructively remove the child, unless the court order specifies an alternative timeframe for removal.  If a court makes a judicial determination that it is contrary to the child's welfare to remain at home (without specifying an alternative timeframe) and the child does, in fact, remain at home and no removal occurs, the requirement for removal is not met and the child is ineligible for title IV-E.
    2. The court certifies that, within the last twelve (12) months, reasonable efforts are being made to finalize a permanency plan or that reasonable efforts to reunify the child and family are not required (must be made at least every twelve months or eligibility will cease); or
    3. The court that orders voluntary commitment contains the appropriate judicial determination within one-hundred, eighty (180) days from when the children were removed.

Practice Guidance 

 

  • Agencies may claim title IV-E foster care maintenance payments (FCMPs) for a child placed with a parent in a licensed residential family-based treatment facility for substance abuse for up to twelve (12) months in accordance with requirements in section 472(j) and 472(a)(2)(C) of the Act.  Agencies may also claim administrative costs during the twelve (12) month period consistent with 45 CFR 1356.60(c) for the administration of the title IV-E program, which includes such things as case management.  A licensed residential family-based treatment facility for substance abuse is not a child care institution (CCI) as defined in section 472(c) of the Act.  While the facility must be licensed, there is no requirement that it meet the title IV-E licensing and background check requirements for a CCI.
  • The agency may claim FCMPs in accordance with the definition in section 475(4)(A) of the Act, which includes such things as the cost of providing food, clothing, shelter, and daily supervision.  However, because a licensed residential family-based treatment facility for substance abuse is not a CCI, the title IV-E agency may not include the costs of administration and operation of the facility in the child's title IV-E FCMP. Also see section 472(k)(1)(A) of the Act.

AFDC RELATEDNESS TEST

  • To be eligible for title IV-E (per section 472(a)), a child is required to have been removed from the home of a specified relative and to have met technical and financial AFDC eligibility that was in effect on July 16, 1996.  However, if a child is placed with a parent who is residing in a licensed residential family-based substance abuse treatment facility, it is not required that a child meet the AFDC eligibility requirements if the child would otherwise be eligible for title IV-E foster care maintenance payments.  (472 (j)(1) of the Social Security Act)
  • For the purposes of IV-E eligibility, a specified relative as defined by title IV-E, section 406(a) of the Social Security Act as:
    • A child’s natural or adoptive parent;
    • A blood relative of the child including a relative of the half-blood;
    • Legally adopted or natural children of the adoptive parent and other relatives of such parents;
    • The alleged parent or a relative of the alleged parent may be determined a blood relative through the administrative establishment of paternity; or
    • A relative by marriage of any persons listed in bullet points 2-4 above even if the marriage has ended.  This is true as long as the marriage ended after the child’s birth.

  • The eligibility month is the month during which the child meets the IV-E AFDC-relatedness test.  That is:
    • The month during which a voluntary commitment agreement was signed by the parent(s); or
    • The month during which the petition that led to the child’s removal from the home was signed by an agency official.
  • The date that the child entered care does not necessarily define the time for which the child meets the AFDC relatedness test. Rather, it is the petition that directly led to the custody or supervision that defines the petition date for purposes of determining whether the child meets the AFDC relatedness test. 
  • A temporary custody petition may lead to temporary placement, which is then followed by a petition for continued placement. Assuming the child remained in a placement supervised by the department during the time between the temporary custody placement and the date of the court order granting continued placement, it is the temporary custody petition that determines the eligibility month.
  • If the petition leading to the removal is not filed within six (6) months of the commitment or custody order, the month of the commitment or custody order is the "removal month" for eligibility determination.
  • A child meets AFDC relatedness when one of the following two tests is met:
    • The child was eligible for AFDC, as in effect on July 16, 1996, in the removal home in which the child lived during the removal month; or
    • The child did not live with a specified relative in the removal month, but did live with such a relative in any of the preceding six (6) months, and the child would have been eligible for AFDC as in effect on July 16, 1996, in that relative’s home during that month had an application been made.
  • The AFDC relatedness test requires identification of the removal home.
  • Normally the removal home is the home from which the child is both physically and legally removed by court action. However, in cases where at the time of the court order the child is living in a home other than the one from which the court orders the child to be removed, determination of the removal home must be made for eligibility purposes.
  • If the removal home is other than a parent’s or adoptive parent’s home, only the child’s income and resources are used to determine AFDC need.
  • The circumstances that define AFDC related test for title IV-E eligibility are:
    • Living with a specified relative;
    • Deprived of support of one or both parents;
    • Need, which is an income and resources test;
    • U.S. citizen or legal alien; and
    • Age.

DEPRIVATION- NEED- AGE

  • Deprivation:
    • To maintain IV-E reimbursability, a child in foster care must continually be deprived of the care and support of one or both parents.
    • As with the eligibility determination described in this SOP, this means that one or both parents are absent from the removal home, unemployed, disabled or deceased. It is possible that the deprivation may change at any time between redeterminations.
    • When termination of parental rights (TPR) has occurred during the last six (6) months, the deprivation factor is to be changed to absence.
    • The status of the parent does not have to be verified after TPR. 
    • The CBW determines whether the child’s income and resources meet reimbursability criteria and notifies the Social Service Worker (SSW) within ninety (90) calendar days of the date the redetermination is due.
  • Need:
    • The child is required to have a financial "need" in AFDC terms to maintain reimbursability.
    • "Need" has two elements:
      • When a child’s resources exceed $10,000 in any month, the child is not reimbursable, until the balance is spent down below $10,000.
      • Child’s income. The income available to the child is required to be less than the costs of the monthly maintenance in foster care. In any month where the child’s income after deductions exceeds this amount, the child is not reimbursable.
    • In a "Need" determination for continuing reimbursability, it is only the child’s income and resources that are considered. 
    • In the test of "Need" in a reimbursability determination, the income and resources of the child’s parents are not considered unless the parents are contributing funds to the Cabinet for the care of the child. When the parents are contributing toward the care of the child (child support), the contribution is considered unearned income of the child to be counted in the "Need" determination.
    • Survivor’s benefits and other resources may accumulate in the child’s trust fund.
  • Age: 
    • A child loses IV-E eligibility and reimbursability at the beginning of the month following the child’s eighteenth (18th) birthday, unless the child is enrolled full-time in high school, or any equivalent course of study, and can be reasonably expected to graduate prior to the child’s nineteenth (19th) birthday.
    • When the child meets this expectation, reimbursement may continue until the beginning of the month following the child’s graduation but no later than the month following the child's nineteenth (19th) birthday. 
    • The CBW discontinues IV-E when the child no longer meets the age requirements and notifies the SSW when the child is discontinued.
  • When a child has been placed in out of home care by voluntary commitment, if the parents or guardians request the child be returned to their home or the home of a relative, the child is no longer eligible for title IV-E assistance; unless the agency obtains a judicial determination that the child’s return would not be in his/her best interests.
 

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