CODES/REFERENCES  

Title 45 Code of Federal Regulations (CFR) Part 1356.21(e)

REQUIREMENTS

The Department of Family and Children Services (DFCS) shall:

1. Notify the Revenue Maximization (RevMax) Specialist (RMS) via the Notification of Change (NOC) in Georgia SHINES anytime a child in foster care is placed on a trial home visit, runs away or has a child.
2. Ensure that a trial home visit does not exceed six months in duration, unless the court orders a longer trial home visit (see policy 10.24 Foster Care: Trial Home Visits). NOTE: If a trial home visit extends beyond six months without authorization by the court, or exceeds the time authorized by the court, and the child subsequently returns to foster care, the placement must be considered a new placement. IV-E eligibility must be newly established including judicial determinations regarding contrary to the welfare and reasonable efforts to prevent removal.
3. Provide foster care maintenance payments for a child, who is not in DFCS custody, but is placed together with their parenting youth in foster care.
4. Maintain responsibility for initial and ongoing IV-E determinations for any Georgia child placed outside the state. NOTE: Any IV-E eligible child in foster care in Georgia who is placed in another state shall be eligible for medical coverage in that state.
5. Provide medical coverage for any IV-E eligible child placed in Georgia from another state.
6. Retain responsibility for medical coverage of any child not IV-E eligible placed outside of Georgia. NOTE: The sending state shall retain responsibility for medical coverage for a child not IV-E eligible in foster care placed into Georgia from another state.

PROCEDURES

Trial Home Visits or Runaways

The Social Services Case Manager (SSCM) will:

1. Track the length of time a child is on a trial home visit or runaway status.
2. Notify the RMS via a NOC in Georgia SHINES of the trial home visit or runaway episode. NOTE: The RMS will terminate IV-E reimbursability for a IV-E eligible child.
3. Submit a new IV-E application if a child returns to foster care from a trial home visit or runaway episode.
   1. New eligibility determinations are not required if the child returns to foster care within six months or prior to any court authorized extension of a trial home visit.
   2. New determinations of all eligibility factors, including judicial determinations of “contrary to the welfare” and “reasonable efforts”, are required if the child returns to foster care after six months or after the court authorized period for a trial home visit as this is considered a new placement episode.

Parenting Youth in Foster Care

The SSCM will:

1. Notify the RMS via the NOC in Georgia SHINES when a youth in foster care gives birth, indicating whether the youth and child are in the same placement and whether DFCS obtained custody of the child.
2. Request a Payment of Care waiver to add the child to the minor parent’s foster care per diem, if the child is placed with the minor parent and is not in DFCS custody.
3. Assist the parenting youth with applying for medical assistance for the newborn child, if DFCS does not obtain custody of the newborn child.
   
    
   1. Fax the Medical Assistance Application to the appropriate RMS.
   2. Notify the RMS that the Medical Assistance Application is for the child of a parenting youth in DFCS custody.
   3. Complete the Person Detail for the child in the parenting youth’s case in Georgia SHINES.
4. Complete an initial Medicaid and IV-E Foster Care Application on behalf of the child, if DFCS obtains custody of the child (see policy 9.2 Eligibility: Applying for Medical Services at Initial Entry and Exit and policy 9.3 Eligibility: Applying for Initial Funding).

Out-of-State IV-E Foster Care

The SSCM will:

1. For a Georgia IV-E child placed out-of-state through the Interstate Compact on the Placement of Children (ICPC) (see policy 15.2: Interstate Compact on the Placement of Children: Placement of Georgia Children into Other States):
   
    
   1. Complete all required information in Georgia SHINES.
   2. Notify the RMS via the NOC in Georgia SHINES of the child’s placement out-of- state.
   3. Obtain verification from the RMS of the child’s continuing IV-E eligibility. The RMS will update the placement in Georgia Gateway and close the Georgia Medicaid case.
   4. Notify and provide verification to the receiving state of the child’s IV-E foster care status.
   5. Provide instructions to the out-of-state placement provider for obtaining Medicaid in the receiving state.
2. For an out-of-state IV-E child placed in Georgia through ICPC (see policy 15.3 Interstate Compact on the Placement of Children: Placement of Children from Other States into Georgia/Georgia Receiving State):
   
    
   1. Complete a Medicaid Application in a Non-Incident Foster Care Child (FCC) stage for the ICPC IV-E foster child (determined IV-E by the sending state).
   2. Submit the Medicaid Application to RevMax for processing in Georgia Gateway.
   3. Provide RevMax the following verifications:
      
       
      1. Child is receiving IV-E foster care per diem from the sending state.
      2. Child is currently in Georgia in an approved foster care placement.
      3. Child is under the age of 18.
      4. Child’s social security number.
      5. Child’s foster home address.
3. For a Georgia child not eligible for IV-E and placed out-of-state through ICPC:
   1. Complete all required information and updates in Georgia SHINES.
   2. Send a NOC via Georgia SHINES to the RMS to notify them of the child’s placement out-of-state.
   3. Notify the receiving state that the child is not IV-E eligible.
   4. Discuss medical options with the child’s placement provider and determine if there is an out-of-state medical provider willing to become a Georgia Medicaid provider. NOTE: The legal state of the child in foster care is responsible for any costs for a child that is determined to be not IV-E eligible.

The Social Services Supervisor (SSS) will:

1. Review the case record in Georgia SHINES to ensure:
   
    
   1. Compliance with trial home visit timeframes.
   2. Diligent efforts are being made to locate a runaway child (see policy 19.22 Case Management: Missing Child).
   3. Notification to RevMax via the NOC in Georgia SHINES of the trial home visit, runaway status, birth of a child by a youth in foster care or placement of a child out- of-state.
   4. Submission of a Medicaid Application for an out-of-state IV-E child placed in Georgia.
2. Provide guidance to the SSCM, as needed.

PRACTICE GUIDANCE

Trial Home Visit

A trial home visit refers to the circumstance when a child in DFCS custody returns to the home from which he or she was removed for a time period designated by the juvenile court. A trial home visit should be less than six months unless extended by the court, in order not to adversely affect a child’s IV-E eligibility/reimbursability. DFCS retains legal custody for the duration of a trial home visit. Although a IV-E eligible child retains medical assistance during a trial home visit, the child is not eligible to receive IV-E payments. Parents cannot be paid a per diem for caring for their own children.

Parenting Youth in Foster Care

The Title IV-E program allows for states to claim reimbursement for the cost of an infant living in the same placement of the parenting youth in foster care without requiring DFCS to obtain custody of the infant (see policy 9.1 Eligibility: Foster Care Maintenance Payments). The added cost of care for the infant is reimbursed through the parenting youth’s IV-E status. Only one payment is made to the placement provider. State funds may be used if the child remains in the custody of a parenting youth in foster care who is not IV-E eligible.

If the child of a parenting youth in foster care is ever removed and placed apart from his or her parent, judicial placement authority must be obtained by DFCS. The infant would be entered into Georgia SHINES as a foster child and a Medicaid Application and IV-E Application for Foster Care would have to be submitted to RevMax. If the issues requiring the removal from

the parenting youth in foster care are addressed and the court sanctions reunification, the child may be placed in the same placement as the parenting youth and not lose IV-E eligibility or reimbursability.