I. PURPOSE

The purposes of this Policy Guide are to clarify the circumstances under which the Department will approve and make payment to a Purchase of Service (POS) agency for Case Management Only Services (Type of Service Code 0118) and to replace Policy Guide 2002.15. Children placed in Independent Living situations and Transitional Living Programs (TLP) are covered by the Bed Hold Payments When Children are Absent from a Living Arrangement Policy Guide.

II. PRIMARY USERS

The primary users of this Policy Guide are DCFS and POS agency child welfare staff, DCFS regional contract staff, and DCFS financial payment staff.

III. PAYMENT OF CASE MANAGEMENT ONLY SERVICES (Type of Service Code 0118)

The Department of Children and Family Services only pays one agency at a time to provide case management services to a child for whom the agency is assigned case management responsibility. A case management only payment ($413.58 to a maximum of $516.98 depending on type of contract under which a child is being served) may be authorized to a private agency. The case management payment should be billed on a CFS 1042, Billing Summary, using Type of Service Code 0118.

Children placed in residential care, a group home, Transitional Living, or Independent Living programs are not covered by this Policy Guide. Existing Department policy and procedures governing the request and approval of bed holds should be followed for these types of placements.

The situations in which a case management payment may be authorized are as follows:

1. A child receiving specialized services who is placed with a caregiver who is receiving specialized payments directly from the Department (0114/0144 type service code) - The case management payment would be $516.98 prorated on a daily basis. Inclusion of this situation is intended primarily to address current arrangements. The Department expects in the future a limited number of situations in which a child receiving specialized services is placed with a caregiver who is receiving specialized payments directly from the Department and case management is assigned to a POS agency.
2. A child absent from placement for reason of “whereabouts unknown” or “abduction”, who previously was in foster care assigned to a POS agency in a Downstate Performance Contract, Small Cook County Performance Contract, or Specialized Contract - Payment may be authorized for a maximum of 90 consecutive days, beginning the effective date of the absence from placement as entered on the CFS 906-1, Placement/Payment Authorization, at the applicable payment amount in note #1 based on the contract in which the child was being served prior to the absence from placement. The agency will continue aggressive efforts to locate the child under DCFS Procedures 329, Locating and Returning Missing, Runaway and Abducted Children and reporting to the Child Location Unit within an hour. Once located, even if beyond 90 days, the child will be assessed to determine if it’s in the child’s best interest to return to that agency.
3. A child hospitalized for medical reasons who, prior to hospitalization, was served in foster care assigned to a POS agency in a Downstate Performance Contract, Small Cook County Performance Contract or Specialized Contract - Payment may be authorized for all days of the hospital stay, beginning the effective date of the hospitalization as entered on the CFS 906-1 at the applicable payment amount in note # 1 based on the contract in which the child was being served prior to the child’s admission to the hospital.
4. A child in a county – operated juvenile detention facility, a jail or committed to the Illinois Department of Corrections for less than 90 days who previously was in foster care assigned to an agency in a Downstate Performance Contract, Small Cook County Performance Contract or Specialized Contract - Payment may be authorized for all days of the detention stay up to 90 days, beginning with the effective date of the detention as entered on the CFS 906-1 at the applicable payment amount in note # 1 in which the child was being served prior to the child’s placement in detention.
5. A child sentenced in a county-operated juvenile detention facility, a jail or committed to the Illinois Department of Corrections more than 90 days who previously was in foster care assigned to an agency in a Downstate Performance Contract, Small Cook County Performance Contract, or Specialized Contract - The child should be transferred back to the Department and payment will not be authorized for any days beyond 90. The POS agency must submit a copy of the CFS 1425 with the CFS 1042 to the Central Office Client Payment Unit (CPU), which demonstrates notification oftransfer to the Department has occurred. The CPU will notify the appropriate Downstate APT Supervisor or the Division of Monitoring/Quality Assurance when CYCIS reflects that a case has not been transferred back to the appropriate DCFS region according to the protocol described.
6. A child admitted to a hospital for psychiatric reasons and the child was served prior to admission in foster care by a POS agency in a Downstate Performance Contract, Small Cook County Performance Contract or Specialized Contract - Payment may be authorized for a maximum of 30 consecutive days, beginning the effective date of the psychiatric hospitalization as entered on the CFS 906-1 at the applicable payment amount in note #1 for the contract in which the child was being served prior to the child’s admission to the hospital. The child’s case will NOT be transferred back to the Department even if the hospitalization is beyond 30 days.

7. A child admitted to a short-term residential drug or alcohol treatment facility who was served prior to admission in foster care by a POS agency in a Downstate Performance Contract, Small Cook County Performance Contract, or Specialized Contract - Payment may be authorized for a child in drug or alcohol treatment for a maximum of 90 consecutive days and the POS agency will maintain case responsibility, beginning the effective date of the short-term residential drug or alcohol treatment placement as entered on the CFS 906-1 at the applicable payment amount in note # 1 for the contract in which the child was being served
   prior to the child’s admission to the drug or alcohol treatment facility. The reason for placement “SAB” (child was placed in this setting because of his or her abuse of alcohol or drugs) should be used on the CFS 906 when children are placed in these types of living arrangements. 

   If the drug or alcohol treatment stay is for more than 90 consecutive days, the child’s case should be transferred to the appropriate DCFS region. The POS agency shall retain case management responsibility until the case is transferred to the Department. The POS agency must submit a copy of the CFS 1425 with the CFS 1042 to the Central Office Client Payment Unit (CPU), which demonstrates notification of transfer to the Department has occurred. The CPU will notify the appropriate Downstate APT Supervisor or the Division of Monitoring/Quality Assurance when CYCIS reflects that a case has not been transferred back to the appropriate DCFS region according to the protocol described. The POS agency will be compensated for case management until the Department accepts the transfer.

8. Child in a foster home where the foster parents have requested no monthly foster care payments: payment to the POS agency should be authorized at a maximum rate of $413.58 per month prorated on a daily basis if the child is served in a Cook County contract or $516.98 per month prorated on a daily basis if the child is served under a downstate contract.
9. A youth 18 and over that has selected their own placement (see Procedures 301.60(d), Self-Selected Placements), should be transferred back to the Department with a current CFS 497, Client Service Plan, for emancipation of the youth and the status of the plan. Additionally, if the youth has a court hearing or Administrative Case Review (ACR) scheduled within 30 days of the case transfer, both the transferring worker and the receiving worker shall attend the court hearing and/or the ACR. The POS agency shall retain case management responsibility until the case is transferred to the Department. Payment may be authorized for all of the days of case management prior to the date on which the case is actually transferred in CYCIS at a maximum rate of $413.58 per month prorated on a daily basis. The POS agency must submit a copy of the CFS 1425 with the CFS 1042 to the Central Office Client Payment Unit (CPU) which demonstrates notification of transfer to the Department has occurred. The CPU will notify the appropriate Downstate APT Supervisor or the Division of Monitoring/Quality Assurance when CYCIS reflects that a case has not been transferred back to the appropriate DCFS region according to the protocol described.

Note # 1: Following is a listing of the monthly rates that will be used to determine the per diem payment for “case management only” under each of the listed types of contracts. These rates are subject to change if the contract rate changes in any given fiscal year:

• Specialized Care Contracts	$516.98
  Small Cook County Contract (PCS)	$413.58
  Downstate Performance Contract (PCD)	$516.98

Case Management Only services (Type of Service 0118) will NOT be approved for a child served under a Cook County Relative/Traditional Performance contract in any of the situations described above as the BAFC payment includes payment for case management services in the above described situations.

Note #2: A child admitted and sentenced for more than 90 days to the Illinois Department of Corrections (IDOC) and placed in an IDOC juvenile or adult correctional facility who previously was in foster care assigned to an agency in their Downstate Performance Contract, Small Cook County Performance Contract, Specialized Contract, Independent Living Contract or Transitional Living Contract should be transferred to the appropriate DCFS region immediately and will not receive any reimbursement.

Note #3: Availability of case management only services (type service code 0118) for youth participating in the Youth in College Program, the Scholarship program, the Youth in Employment or the Youth in Vocation program will be clarified at a later date. The agency should immediately initiate steps to transfer the child’s case to DCFS.

IV. EXCEPTIONS

Payment for exceptions to this Policy Guide will be considered if appropriate documentation of the reason for the exception is sent to the Central Office Client Payment Unit.

V. BILLING PROCEDURES

Approval and entry of valid 0118 bills should follow this process:

1. The regional contract office receives a CFS 1042 billing from the provider. The region determines that the bill is a valid bill and that the services listed have been delivered. The appropriate staff sign off on the billing as receiving officer.
2. The regional staff attaches a cover sheet to the CFS 1042 indicating the name, address and phone number of the regional staff person to be contacted with any questions regarding the billing.
3. The regional office staff sends the billing to Central Office Client Payment Unit (CPU), Department of Children and Family Services, 406 East Monroe Street – Station #438, Springfield, Illinois 62701 for further review of the billings.
4. The Central Office Client Payment Unit approves or denies the bill.
   1. Approved – CPU initials the bill (partial or entire) and verifies that the 0118 type service code and rate is in the provider’s contract. If not, CPU notifies the Office of Contract Administration (OCA) to complete the process for adding the need for the rate to be included in the appropriate contract.
   2. Denied – CPU sends the bill (partial or entire) back to the region with notification regarding the reason for denial.
5. OCA completes entry of rates and funding to the appropriate contract and notifies CPU when completed. CPU forwards the CFS 1042 billings to the Client Payment Vouchering Unit for entry.
6. The Client Payment Vouchering Unit submits the bill to the Audit and Approval Unit for final auditing and approval. The Audit and Approval Unit will review the billing for the Client Payment Unit initials. If not initialed, the billing will be rejected back to CPU for review.
7. Approved billings will be processed to the Comptroller’s Office for payment.

VI. QUESTIONS

Questions about this Policy Guide should be directed by telephone to the Department’s Central Office Payment Unit in Springfield at 217-782-7043 or by fax at 217-557-0639.

VII. FILING INSTRUCTIONS

Remove Policy Guide 2002.15 in its entirety from behind Procedures 359.40 – 359.46 (10) and replace with this Policy Guide.