Process the completed subsidy forms. When exceptions to the basic subsidy package are involved, route them through supervisory lines: the Circuit Manager/Program Manager, or his/her designee, and Regional Office for review, as indicated in this section and according to the forms instructions. If the basic package is requested, send directly to Central Office.
Staff should maintain a copy of the completed subsidy forms with family signatures in their local file. Staff should also maintain copies of all associated documentation for above standard services as well as a copy of the Subsidy Application in the local file.
Contract Management Unit (CMU) will return a copy of the signed Agreement to the managing county/circuit indicated on the Agreement. Upon receipt of the signed copies back from the CMU, Children’s Service/Performance Based Contract (PBC) staff are to forward one (1) copy signed by the Department of Social Services/Children’s Division Director to the adoptive parent(s)/guardian(s) with a cover letter which includes the following information:
- While not required of adoptive parent(s) or guardian(s), if a family carries private insurance for the child, the physician must first use the family’s own private medical/dental insurance as primary, using MO HealthNet as the secondary insurance. The Division will not supplement the payment made by private insurance. Any exceptional services not covered by private insurance or MO HealthNet must be requested and approved before payment may be made. Appropriate documentation is required with the request. Payment for emergency care not covered by MO HealthNet may be authorized, if necessary, at the discretion of the Division after the service has been provided as indicated in the Agreement.
- Prices of services specified in the Agreement attachment are fixed. Changes in the Agreement attachment may be requested by adoptive parent(s)/guardian(s), but will require the renegotiation through an amendment to the contract.
- The right to appeal the terms of the Agreement as specified in the Agreement. The following statement should be included;
“If you disagree with this decision to reject, reduce benefits or to close your case, you have the right to request a hearing within 10 days of this letter. If you request a hearing, you may present your information yourself or you may be represented by your own attorney or by other persons who have knowledge of your situation. You have the right to present witnesses on your own behalf and to question witnesses who appear at the request of the Children’s Division.”
- Responsibility to keep the Division informed of changes in circumstances of the adoptive parent(s) or guardian(s) or the child(ren) as listed in the contract and relating to the receipt of a subsidy;
- Encouragement and support for the continued success of the placement.
- The Division’s willingness to assist them in renegotiating via amendment to the Agreement as necessary and at their request; and
- The Division’s availability to answer any questions regarding the subsidy.
Update the Alternative Care Client Information screen and Vendor Licensure/Approval and Renewal FACES screens, consistent with the subsidy Agreement, to begin payment for maintenance and other services effective with the effective date of the Agreement/date of Director’s signature.
Report availability of third-party medical/dental insurance via use of the Third Party Resource Form, TPL-1, if the child is covered through the family’s policy. The TPL-1 is to be sent to the MO HealthNet Division by the adoption/guardianship worker with a copy placed in the subsidy file.
Related Practice Alerts and Memos:
7-1-19 – CD19-52 – FY20 Rate Increases
12-4-19 – PA19-AD-06 – Transitional Living Placements and Subsidy Agreements
1-10-20 – PA20-AD-01 – Legal Fees for AD and LG Subsidies
10-29-2020 – PA20-AD-06 – Child Summary
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