Legal Authority/Introduction

LEGAL AUTHORITY:

• KRS 314.011(5) and (6) Definitions for chapter
• 922 KAR 1:350 Requirements for public child welfare agency foster parents, adoptive parents, and respite care providers
• 922 KAR 1:495 Training requirements for foster parents, adoptive parents, and respite care providers for children in the custody of the cabinet

The foster or adoptive home per diem rate structure is designed to give foster or adoptive 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 foster or adoptive home.
2. The R&C worker notifies the OOHC branch manager, 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 foster or adoptive home’s reimbursement per diem rate for advanced, emergency shelter, medically fragile, and care plus if the foster or adoptive home fails to meet the ongoing training requirements for their type of home. In these instances, the foster or adoptive 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
Child specific	$11.51	N/A	N/A
Birth to age 11	$24.10	$26.40	N/A
Age 12+	$26.20	$28.50	N/A
Care Plus Home	$42.40	$47.70	N/A
Medically Complex	$42.40	$47.70	$50.90
Specialized Med. Complex	N/A	$59.80	$97.00
Supplemental Services Rate	N/A	$72.10	N/A

• Foster and adoptive homes are reimbursed the per-diem rate based on their approval level. 
• 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. 
• Incidentals such as first aid 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.  
• When a child remains in a foster or adoptive 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 professional licensure of the foster or adoptive home.  As such:
• A medically fragile or specialized medically complex foster or adoptive 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 complex child; and
• A care plus foster or adoptive 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 foster or adoptive home.
• An advanced care plus foster or adoptive home is only reimbursed the advanced care plus per diem rate for a child designated as a care plus child and
• The home has been approved for two (2) years; and
• Completed all training requirements.
• An advanced medically complex rate is paid to a foster parent who has been approved for two (2) years and is approved to care for a child who is determined to be medically complex by the Medical Support Section.
• A degreed specialized medically complex rate is paid to a foster parent who maintains a current license as a health care professional and is caring for a specialized medically complex child.  The Medical Support Section approves this per diem rate based on the needs of the child. 2
• When it is determined by the child's family team that a child no longer meets determination requirements for a care plus designation, the foster or adoptive 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 complex requirements, the foster or adoptive home receives thirty (30) days notification prior to the rate change.
• In addition to the Medical Support Section determining whether a child meets medically  complex criteria, this section also assigns the per diem amount to be reimbursed.
• Back pay for medically complex 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. A health care professional is a person actively licensed as a physician, physician's assistant, advanced registered nurse practitioner or registered nurse.