1120 Assessment of Financial Resources
1130 Application For Potential Benefits
1150 Title IV-E Eligibility Determination for Removed Children
1160 Opening A Social Service Case
1170 Application for a Social Security Number
1172 No Social Security Number
1200 Service Eligibility for Children and Families Not Referred to a CW/CBS provider
1211 Goods and Household Services
1220 Services Listed on Case Plan
1230 Brief
Authorization for Unique Services
1240 Adding Services to the Child Welfare Community-Based Services Handbook
1326 Goods and Household Services
1400 Rank Order of Funding Sources
1412 Making Use of Sliding Scales available through Community Providers
1413 Subsidizing Family Income Through Development of Private Benefits and Entitlements
1430 Government Income Subsidies
1432 Temporary Assistance to Families (TAF)
1433 Explanation of Social Security Administration (SSA) Benefits and
Supplemental Security Income (SSI)
1434 Supplemental Security Income (SSI)
1435 Payee for Benefits When Child Turns 18
1450 Title IV-E and Title IV-A
1510 Client Service Agreement (CSA) Form YA-2833
1514 Goods and Services Not in Handbook
1600 Program Cost Account (PCA) Funding Codes
1700 Placement Agreement Form YA-3302 and YA-3303
1711 Children Not in SRS Custody
1810 Behavior Management Services
1820 Client Service Agreements
To fund services for families who are clients of Children and Family Services (CFS), it is necessary to establish three categories of eligibility: a) customer eligibility, b) service eligibility, and c) provider eligibility.
Services are provided to children and families whether or not they can afford to pay. Individual customer eligibility determines what source of federal funding may be claimed by SRS for services. Families are expected to participate in determining eligibility and paying for services based on their ability. However, needed services are provided regardless of family income or ability to pay.
The intake and assessment process must be initiated before a plan for services can be developed and federal funding eligibility is established.
1120 Assessment of Financial Resources
An assessment of the family's financial resources is
completed prior to SRS paying for services. The assessment will determine
the eligibility or potential eligibility for a specific
federal
funding source, regardless
of whether or not there is an immediate plan to use them to pay for specific
services. This is necessary to give
1130 Application For Potential Benefits
Families requesting assistance from SRS will be asked to apply for all benefits for which they qualify. Exceptions are made for special circumstances. SRS staff shall provide direction in the application process.
1150 Title IV-E Eligibility Determination for Removed Children
For children removed by the court, a basic Title IV-E eligibility determination shall be completed. If a judge has already removed the child from his or her home and placed the child in state custody prior to completion of the intake and assessment process, the fiscal assessment shall ascertain whether the child has basic eligibility for Title IV-E. For detailed information on Title IV-E eligibility, please refer to section 3200 of this manual.
1160 Opening a Social Service Case
When the intake and assessment process concludes that a family or child requires services, a Social Service case is opened, and a case plan completed. The Social Service case shall remain open for the entire period services are purchased or provided through CFS.
1170 Application for a Social Security Number
In order to comply with federal requirements, families receiving federal funding for services (through IV-A, IV-E or Medicaid) are required to obtain a social security number (SSN) for all family members.
If a family has previously received income or medical assistance through SRS, a social security number may have been previously validated.
1172 No Social Security Number
If a family member does not have a SSN, the family shall be referred to the Social Security Administration to complete an SS-5 "Application for Social Security Card."
1200 Service Eligibility for Children and Families Not Referred to a CW/CBS provider
Other than the exceptions described in Section 1211, services eligible for payment through SRS must be listed in the Child Welfare Community-Based Services Handbook (formerly known as "The Handbook of Services, or "The Pink Book"). The Handbook describes each service, lists the preferred funding sources and reimbursement rate, and shows the minimum qualifications for providers (see section 1300).
The Handbook is an inventory of services that can be delivered to families and children referred to CW/CBS providers, to non-referred children and youth, and to JJA youth served by JJA providers.
Each service described in the Child Welfare Community-Based Services
Handbook has a service page that includes:
1. The title of the service and
a procedure/encounter code for reporting the service for federal reimbursement.
2. A description of the service,
3. A listing of who can
purchase/provide the service,
4.
The service definition,
5. Whether a Provider Agreement
or Client Service Agreement is needed for the service,
6. The minimum qualifications to
provide the service,
7. Documentation needed when the
service is delivered;
8. Limitations (e.g. 1 per day,
12 hours per day.)
9. Units of Service (e.g. per
occurrence, per day)
10. Funding Source
A Provider Agreement must be in place before an individual SRS Provider
Placement or Client Service Agreement can be initiated for a placement service
or a service for non-referred children/youth with an open family services case
plan. The exceptions are "hard goods" and other one-time resources purchased as
outlined in the Handbook. Provider Agreements are not needed for hard good purchases, e.g.
description of Clothing Allowance purchases in the Handbook. Reference the Handbook and
the CFS Eligibility and Payment Manual in making such purchases.
The Handbook has been placed on the Web. Please refer to the SRS Net webpage (http://srsnet/) under the Operations tab select Procurement; on the next screen, left hand side, select Provider Agreements. From here you can access the following:
In the Provider Manual column select Appendix B-Youth Services
for the
listing of services contained in the Child Welfare Community-Based Services
Handbook
of Services.
In the
Reports
column select All Providers for a listing of providers, services and rates that replaces the former
Residential Rate Sheet.
The SRS Procurement website contains an SRS template for Provider Agreements which CFS should be
used when developing agreements. The SRS Procurement pathway from the SRS intranet is listed above or
the complete address is listed below. http://www.srsks.sr.state.ks.us/commissions/admin/GC/Provider_Agreements/ProviderAgreementPage.htm
1211 Goods and Household Services
SRS staff may purchase services needed by the family, such as rent, utilities, exterminator service, bus tickets, and so forth. These services are not listed in the Handbook.
1220 Services Listed on Case Plan
When the intake and assessment process determines that a family/child requires services, a Social Service case shall be opened and a case plan completed. Services that the family and child are to receive shall be listed on the case plan. The Social Service case shall remain open for the entire period services are purchased or provided through CFS.
1230 Brief Authorization for Unique Services
When a service is required by the Case Plan which is not included in the Handbook, the service can be provided for a brief initial period as long as the total payment does not exceed $1000 per individual, per service, per year (for more information refer to the Handbook).
1240 Adding Services to the Child Welfare Community-Based Services Handbook
For long term services the unlisted service must be added to the Handbook. Services not listed may be purchased for children and families in consultation with CFS Division to meet families’ needs.
For all services in the Handbook a provider must meet "Minimum Qualifications" as indicated in the Handbook for the specific service being provided. These requirements shall be met even if a Provider Agreement is not required.
To bill for
services delivered to any child or family on behalf of SRS,
a provider agreement is required for all
service providers except contracted CW/CBS
providers. A Provider Agreement is an agreement between the Provider and SRS for
specific services offered to families and children. It is a general agreement,
not specific to any particular family or child.
The development of a Provider Agreement may be initiated either by a service provider, or by the regional SRS office.
The regional SRS office shall assure that the applicant provider meets the minimum requirements for the service(s) they wish to provide based on information furnished by the provider (see section 1310).
A Residential Provider Licensing. All residential facilities have regulatory licensing requirements which shall be met before a Provider Agreement may be issued. KDHE licenses residential facilities.
B. Medicaid Provider Standards. All providers of Behavior Management Services must meet requirements for Medicaid reimbursement and be enrolled with the Medicaid Fiscal Agent.
The Provider Agreement is processed at the regional SRS Office and requires the signature of the Regional Director or designee. Copies must be on file at CFS central office.
Once the Provider Agreement is finalized, the services may be accessed by all SRS offices in the state, at the locations indicated on the Provider Agreement.
A Provider Agreement can not be completed to purchase services from any state employee.
1326 Goods and Household Services
Goods and household services are not listed in the Handbook and do not require a provider agreement. The
Department of Administration has requirements regarding choosing such agents. Coordinate with the Regional Administrative Services Program Administrator regarding procedures or see the Administrative Services manual.
1400 Rank Order of Funding Sources
Within each of the sections in this manual, potential funding sources are presented in the order in which they must be considered. For example, the following is a list of funding options listed in order of general preference:
Insofar as they are able customer payment for services is preferred. There are several forms of direct customer payment. They include but are not limited to:
Staff shall evaluate the family’s ability to pay for needed goods or services. To the extent of their financial ability, families are expected to pay for all or part of the cost of the services they require.
1412 Making Use of Sliding Scales available through community providers.
1413 Subsidizing Family Income Through Development of Private Benefits and Entitlements
Before accessing public funding, staff are asked to assure the family has taken advantage of private income sources. These include:
A. Benefits from the Death of a Family Member. Children who have parents or other family members, recently deceased, may be beneficiary to a life insurance policy or other form of annuity. The individual or organization handling the estate of the deceased should be able to provide additional information. If the deceased family member had a work history, the children may also be eligible for survivor benefits from the Social Security Administration.
B. Benefits from the Retirement of a Family Member. Children who have retired parents or other family members may be eligible for income from a retirement plan or annuity. The children may also be eligible for retirement benefits from the Social Security Administration, based on the work history of the retired parent.
C.
Benefits from the Unemployment of a Wage Earner. Employers in
D. Child Support Payments from an Absent Parent. If both parents are not contributing to the care of a child referred to SRS for services, CFS shall obtain financial assistance from the parent withholding support.
E. Required Referrals to Child Support Enforcement (CSE). For children in SRS custody and placed out of home, a referral to CSE is required.
F. Benefits from the Disability of a Primary Wage Earner. Some employers may carry disability insurance. If a primary wage earner is disabled, CFS staff shall assess whether the family is eligible for disability benefits. These could include payments from the Social Security Administration, based on the work history of the wage earner.
If the child is eligible for private health insurance through the employment of a family member, it can be a useful funding source for a variety of health and mental health services. Explore if a family has private health insurance. Assure they have not exhausted their benefits prior to coming to SRS. This private funding source should always be examined before public (governmental) sources are used. Following the private health insurance claiming process to obtain payment is very important. Private insurance is always primary payor when Medicaid is available.
HealthWave21 is a federally subsidized health
insurance program for uninsured children up to age19, who are members of income
eligible families. Parents pay a monthly premium based on family income.
The benefit level of HealthWave21 is the same as Medicaid in
1430 Government Income Subsidies
Government Income Subsidies may provide a portion of assistance an eligible family requires.
Food Stamps are a federal income subsidy to help families with low income buy food.
1432 Temporary Assistance to Families (TAF)
TAF is a federal income subsidy for families with children. TAF provides a minimal income subsidy to parents or other caretakers of needy children. Families who are eligible for TAF are also eligible for Medicaid.
A. Children Living with Kin. In most circumstances children living with kin are eligible to receive TAF without regard to income. The child is a family group of one. Eligibility determinations for TAF are completed by SRS Economic & Employment Support Specialists.
There are two categories of benefits available to children through the Social Security Administration. The first is generally described as “SSA benefits” and the second category is Supplemental Security Income (SSI).
A. Social Security Administration Benefits (SSA): Benefits may be awarded to children whose parents have made Social Security contributions through their employment and whose parents are disabled, deceased or retired. Eligibility determinations for and the amount of SSA benefits must be completed by the Social Security Administration.
A disabled child can receive both an SSA benefit generated from their parent’s SSA, and SSI for the child’s own disability. The amount of the child’s SSI may decrease when other income increases. Benefits children receive as a result of their parent’s disability or retirement may be used for parental support obligation on file with Child Support Enforcement.
The child remains eligible for the benefit as long as one of the following criteria is met and the child remains unmarried:
· Under age 18.
· Under age 19 and attending full-time school or vocational training.
· Age 18 or older and severely disabled (the disability must have started before age 22)
B. Additional Information Regarding SSA Benefits:
When a child reaches age 19, benefits can continue for a short period. If the child attends a school with enrollment once a year (most common), benefits can continue for 2 months after the month the child becomes19. If a school requires enrollment each quarter or each semester, the benefit would continue until the end of that quarter or semester.
If a child, who is receiving benefits based on a disabled, deceased or retired parent, is disabled prior to age 22, the child can continue to receive benefits as long as the child remains unmarried and continues to be disabled. These types of benefits are called Disabled Adult or Childhood Disability Beneficiary.
For benefits based on a parent’s disability the child would lose their eligibility if the parent’s benefits ended, due to the parent being determined no longer disabled.
When a child is placed for adoption, even after finalization, the child could remain eligible for SSA benefits as long as the criteria explained in Section 1433 are met.
If a natural parent dies after parental rights have been terminated or relinquished, the child may still be eligible for survivors benefits based on the deceased parent.
In some situations a stepchild may be eligible for benefits. Check with the SSA for more information on eligibility criteria.
When a child is receiving benefits based on a retired parent and that parent dies the benefits are automatically switched to survivor’s benefits.
1434 Supplemental Security Income (SSI)
SSI is a federal income support program for low-income aged, blind or disabled individuals. It is considered unearned income. This program is administered by the Social Security Administration and is uniform in every state. These benefits may be received by adults or children. Eligibility is based on an individual’s disability and not based on contributions from employment. A child is not eligible to receive SSI based on a parent’s eligibility for SSI. Financial eligibility for SSI is based on a family or individual’s income and resources. SSI for a child is based on that child’s disability and cannot be used to meet a child support obligation owed by the child’s parents.
To determine a child’s eligibility for SSI the child must be financially needy and blind or disabled. This includes behavioral or emotional disabilities. When a child is living with their parent(s), financial need is based on the family’s income and resources. When a child is placed in the custody of SRS and removed from the home, only the child’s income and resources are counted by the Social Security Administration. Therefore, it is likely that a disabled foster child will be eligible for the full monthly SSI amount. The amount of SSI a child can receive each month is also based on the type of out of home placement.
When an SSI eligible child is adopted and the adoption is finalized, the income and resources of the adoptive family are considered in determining the disabled child's benefit amount.
All
1435 Payee for Benefits When Child Turns Age 18
SSA Benefits: When benefits are based on a disabled, deceased or retired parent, generally the child becomes their own payee at 18 years of age.
SSI Benefits: Social Security Administration will review the child’s situation prior to their 18th birthday. SSA will determine whether the child is able to handle his or her own funds.
If the Social Security Administration determines that the child shall be their own payee and the child is being served by a CFS CW/CBS provider, the payee change shall be reviewed by the SRS Regional CFS Contract Specialist. The CW/CBS provider remains responsible for the child's foster care maintenance. SSI is used for food, clothing, shelter, education and daily supervision. SRS shall assure the youth does not lose their SSI eligibility due to excess accumulation of income. Maintenance payments by the CW/CBS provider will be considered an expense to the child.
Medicaid (Title XIX) is a governmental health care assistance program for families who financially qualify. It is a useful funding source for a variety of health, mental health, and behavior management services. Individuals belonging to the following groups are eligible for a medical card without a spenddown:
∙ SSI recipients;
∙ TAF recipients;
∙ Adoption Subsidy recipients.
Additionally, children who are removed from their homes and placed in the custody of SRS are considered to be a family of one and are eligible for Medicaid, unless their individual income and resources exceed established limits.
1450 Title IV-E and Title IV-A
Title IV-E and Title IV-A are two federal funding streams which are particularly important to CFS. Title IV-E pays 50% to 75% of costs associated with specific services and activities. Title IV-E pays for daily living costs and foster care maintenance for eligible placements. Title IV-E adoption assistance is available to support the extra costs associated with eligible special needs children. Title IV-A pays for in home and out of home services to categorically eligible children and families.
Title IV-A and Title IV-E also pay for administrative costs, based on the number of children who are eligible for these funding sources. It is essential that regional staff identify all children eligible for these funding sources. Administrative costs are reimbursed when children are eligible even if other funding sources are used to pay for the services that are delivered.
State General Funds include General Assistance Foster Care (GA-FC), regular Family Services and state-only Adoption Subsidy. Because these funding sources are all state funds, staff should ensure that all other potential funding sources have been eliminated before using state only funds.
Determine that the child or family, the service, and the provider are all eligible for federal funding through CFS. Document approval prior to the purchase of any service.
1510 Client Service Agreement (CSA) Form YA-2833.
A Client Service Agreement is a three-way contract between the child or family, the provider, and SRS.
A Client Service Agreement is required for all services found in the Child Welfare Handbook of Services. For children not in SRS custody seeking non-Medicaid residential placement services, a CSA shall be approved by the Regional CFS Program Administrator or designee.
The Client Service Agreement shall be based on the Family Based Assessment and/or Case Plan developed for the child or family.
The Client Service Agreement also serves as binder with the provider that SRS will purchase a specific service for a set frequency, rate and length of time. The rate can not exceed the rate indicated in the CW/CBS Handbook.
1514 Goods and Services Not in Handbook
The Client Service Agreement may approve the purchase of goods and household services provided to the family that are not included in the Handbook (see section 1330).
A. When the CSA is used for goods and services not in the handbook, the provider's signature is not required. Do not send a CSA copy to the provider in these cases. This helps to assure customer confidentiality.
The Client Service Agreement shall be completed and signed prior to or at the same time the approved services begin, except for unique goods and services.
A. For unique goods and services such as an interpreter, the provider's signature is not required. When the provider's signature is not required do not send a CSA copy to the provider. This helps to assure customer confidentiality.
All CSA copies shall be distributed as indicated on the form, except as noted in Sections 1514 and 1515.
1600 Program Cost Account (PCA) Funding Codes
As part of the payment process, a PCA funding
code shall be assigned to indicate the funding source for each payment. To
determine the appropriate PCA funding codes, refer to the PCA Funding Table. This is located on the SRS “Intranet” site:
www.srsks.sr.state.ks.us.
Additionally, a listing of service specific
sub-object codes can be located on the web site. The utilization of these codes assists in the
tracking of services provided.
In order to generate payment for services provided to a specific customer, the customer must have an active Case Number and Identification (ID) Number in KAECSES or KANPAY, covering the dates of service.
Inquiry must be made on KAECSES to determine whether the customer already has been assigned a Case Number and Client Identification (ID) Number.
Payments are made with an open KAECSES or KANPAY case number. If the case is open on KAECSES or KANPAY when the CSA is received, use that case number and customer ID number. If no open case is available, open a KANPAY case. If the customer already has an ID number on any system (KAECSES, KANPAY, FACTS, etc.) use that customer ID number when opening the KANPAY case. These numbers are used to generate payments for approved services. Customers receiving CFS services must be entered into the KANPAY system with the following information:
• Status will be coded “IN”.
• Type of Service = SS
• Start Date is found on the CSA.
• The End Date should be no longer than a year from the start date.
Incorrect payments (over-payments/under-payments) shall be corrected promptly, with documentation in the payment file.
1700 Placement Agreement Form YA-3302 and YA-3303
Placement Agreements are required for all out of home placements. The YA-3302 is used for children placed in foster families and the YA-3303 for children placed with residential providers.
Children in SRS Custody and referred to the CW/CBS provider, shall have their Placement Agreement executed between the CW/CBS provider and the placement provider. CW/CBS providers have created their own Placement Agreement forms based on the YA-3302.
1711 Children Not in SRS Custody
Children not in SRS custody and in need of out-of-home placement, shall have a Placement Agreement executed between the placement provider and the parent or guardian of the child. SRS is not a party to parental placement agreements. The placement agreement shall be supplied by the placement provider.
1810 Behavior Management Services
These services are monitored by the Medicaid Fiscal Agent's System Utilization Review Section (SURS).
1820 Client Service Agreements
CSAs shall be monitored by the SRS Social Worker who made the agreement with the customer and a service provider. The SRS social worker assures that services are provided and reports are received as agreed.
The providers' initial and continuing eligibility shall be monitored by the SRS Regional staff. (Refer to the CW/CBS Handbook)
Foster Care Providers are monitored regularly by KDHE and Child Placing Agencies regarding regulatory and licensing issues.