In the case of Medical or Youth with Elevated Needs-Level A payments, the child must meet the criteria set forth in the same manner as a child in alternative care. The worker shall arrange a team meeting and obtain the required documentation according to policy for children in care. Staff is encouraged to utilize the behavioral consultants to assist in determining eligibility
Children in foster care, who receive Level A or Medical maintenance, are required to have regular six-month reviews. If a regular review is overdue, or if a review is due within 60 days, the review must be completed within one month upon the determination that adoption or guardianship is the goal for the child. The purpose of this staffing is to verify a continued need for above base maintenance. The child must then be staffed every six months until adoption or guardianship is finalized. The subsidy worker must submit the approved staffing results with the request for above base maintenance, in order for the child to be approved for and receive Level A or medical maintenance.
The Medical Foster Care Assessment, CS-10, serves as a referral for medical foster care. Children who are referred for Level A maintenance will follow the local procedures that apply when foster children are referred to this program. These forms are to be completed by the adoptive/guardianship family, with help from staff if needed, and signed by a supervisor. The Division Director will need to approve all above standard maintenance payments via the subsidy Agreement, prior to any payment being authorized.
When children need a Level A maintenance rate to meet their special needs, the adoptive parent(s)/guardian(s) are required to attend Level A foster parenting classes. Training must be completed prior to payment of the above standard rate. No back payments to the date of placement will be approved.
For families who live out of state, 18 hours of equivalent training may be substituted. The family will need to provide the worker with the curriculum from the training they plan to receive. The worker will review this information with their supervisor to determine the appropriateness of the training.
Adoption/guardianship subsidy will reimburse the out-of-state adoptive parent(s)/guardian(s) for training up to $90.00 per hour if there is a charge. This charge must be approved on the subsidy Agreement prior to reimbursement and a receipt provided.
Children receiving above base maintenance rates are not eligible for the incentive payment for charting that is provided through the Youth with Elevated Needs-Level A foster care program.
Families of children receiving the medical maintenance rate must undergo individualized medical training by the child’s health care provider, which is individualized to the child’s specific health care needs. The health care provider who provides the training must provide documentation of this training.
As of July 31, 2002, Youth with Elevated Needs-Level B rates were no longer approved in new subsidy Agreements. Families who are currently receiving Level B maintenance on their subsidy contract as approved prior to July 31, 2002, are not required to undergo yearly reviews, and may be automatically approved to age 18, unless the parent/guardian agrees to reduce the maintenance amount.
Above Base Maintenance may be approved for up to two years at a time or up to the child’s 18th birthday, if it is determined that the child’s condition will not improve and/or that the adoptive/guardianship family will not be in agreement to lowering the maintenance amount as the maintenance rate may not be reduced without the consent of the adoptive parent(s)/guardian(s).
In the case of medical subsidy where the medical condition of the child is permanent as indicated by documentation from medical professionals, medical subsidy should be approved to age 18 as the condition is not expected to improve.
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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