Department for Community Based Services

Standards of Practice Online Manual

31.4 Reimbursability and Annual Redetermination Under Title IV-E 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 31-Standards of Practice Regarding Title IV-E, Medicaid and Other Applicable Benefits
Effective:
1/29/2021
Section:
31.4 Reimbursability and Annual Redetermination Under Title IV-E Foster Care
Version:
3

When a section of SOP has been revised users will see the following: Added {This is added material}, Deleted {This is deleted material}. The bold and strikethroughs will appear on the site for fifteen (15) days after a modification and will then be removed.

Legal Authority/Introduction

LEGAL AUTHORITY:


Practice Guidance

  • Once eligibility is established, the Cabinet determines for every month that a child is in foster care whether the child’s care was reimbursable by the federal government.
  • A child may lose and regain reimbursability on a frequent basis depending on changes in the child’s circumstances. Conditions of reimbursability may vary from month to month.
  • A redetermination occurs every twelve (12) months to establish whether the seven (7) reimbursability criterions are met on a month to month basis.
  • The procedures for eligibility and reimbursability may occur simultaneously.
  • The agency 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 sections 472(j) and 472(a)(2)(C) of the Act.  The agency 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 agency may not include the costs of administration and operation of the facility in the child’s title IV-E FCMP. 
  • For every qualified residential treatment program (QRTP) where a child is placed for more than twelve (12) consecutive months or eighteen (18) nonconsecutive months (or, in the case of a child who has not attained age thirteen (13), for more than six (6) consecutive or nonconsecutive months), the title IV-E agency must maintain the following documentation in the child’s case plan:
    • The most recent versions of the evidence and documentation specified in section 475A(c)(4) of the Act submitted at each status review and permanency hearing, (e.g., demonstrating that the assessments of the child support a continued QRTP, documenting treatment or service needs, and preparation for return home or other placement);
    • The signed approval of the DCBS commissioner for the continued placement of the child in that setting (section 475A(c)(5) of the Act); 
    • The agency must document in the child’s case plan that the commissioner approved the child’s continued placement in the QRTP to claim title IV-E FCMPs after the first twelve (12) consecutive months or eighteen (18) nonconsecutive months of the placement (or, in the case of a child who has not attained age thirteen (13), the first six (6) consecutive or nonconsecutive months) (section 472(k)(1)(B) of the Act).

Procedure

The CBW:

  1. Determines whether the initial placement and all subsequent placements are reimbursable upon redetermination as described in SOP 31.5 Legal Responsibility;
  2. Makes the reimbursability determination for each month in the twelve (12) month period and completes OOHC 1262 IV-E Redetermination form;
  3. Completes a 'look-back' every twelve (12) months for redetermination to determine that the following seven (7) criterion were met on a month to month basis:
    1. Legal responsibility for the child is with the title IV-E agency;
    2. Court certification within the last twelve (12) months that reasonable efforts are being made to finalize a permanency plan or that reasonable efforts to reunify the child and family are not required as described in SOP;
    3. A court order, which contains the appropriate judicial determination, obtained within one-hundred, eighty (180) days for children removed as a result of a voluntary commitment agreement;
    4. Reimbursable placement; 1
    5. Need;
    6. Deprivation; and
    7. Under age twenty-one (21) or meets any of the following conditions: 
      1. Is completing secondary education or a program leading to an equivalent credential;
      2. Is enrolled in an institution which provides post-secondary or vocational education;
      3. Is participating in a program or activity designed to promote, or remove barriers to, employment;
      4. Is employed for at least eighty (80) hours per month; or
      5. Is incapable of doing any of the above described activities due to a medical condition, which incapability is supported by regularly updated information in the case plan of the child.
 

Footnotes

  1. There are six (6) types of out-of-home placements that are title IV-E reimbursable:
    • An approved foster family home (includes an approved relative foster home);
    • A private non-medical group home licensed by the state (a PCC);
    • A public non-medical group home or child-care facility which has a licensed capacity of less than twenty-six (26) beds;
    • A licensed private child placing (PCP) provider; 
    • An approved pre-adoptive placement; or
    • A supervised independent living setting (when the child is eligible as described in procedure 3 (G) in this chapter and section).

Communicate

Sign In (Editor Access Only)
Copyright © 2011 Commonwealth of Kentucky - All Rights Reserved
Kentucky Unbridled Spirit