IV-A. A. Decision Making and Service Authorization

Effective 9/9/16

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IV-A. A. Decision Making and Service Authorization

Effective 9/9/16

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I.SUBJECT

 

This policy outlines the different decision levels, who can authorize a decision or service, and the rate of pay that is authorized for the different services provided.

 

II.PHILOSOPHY

 

OCFS believes that the needs of families should be met in a way to provide them with appropriate and timely decisions and services to ensure the safety, permanency, and well-being of all family members.

 

III.PURPOSE

 

Decisions are made on a daily basis regarding child safety, permanency, and well-being.  Decisions are also made regarding payment authorization for services, tangible items, and activities.  The Decision Making and Service Authorization policy outlines the levels at which authorization must occur and the payment rates allowed.  These include decisions regarding services to:  alleviate or reduce child abuse or neglect; work toward family reunification or another permanency plan for children; build independent living skills for older youth; and support relative placements.  

 

IV.PRACTICE MODEL

 

All planning for children focuses on the goal of preserving the family, reunifying the family, or achieving permanent placement for the child in another family.

 

Our organization is focused on providing high quality, timely, efficient, and effective services.

 

As we work with children, families, and their teams, we clearly share our purpose, role, concerns, decisions, and responsibility.

 

V.LEGAL BASE

 

22 M.R.S. §4041 and §4061 – 4068.

 

VI.PROCEDURE STATEMENT

 

Client Rights:

All clients/recipients, including children and youth, have the right to participate in all service decisions; review their treatment, case, or service plan; refuse any service unless mandated by law or court order; and be informed about the consequences of refusal or disengagement with services. Clients/recipients must be informed of their right to choice in the selection of a service provider qualified to meet the assessed service or treatment need. Services are to be provided to meet the assessed need and should not go beyond the scope of that need unless requested by the client/recipient. Services recommended for clients/recipients should be done within the context of case planning.  Prior to any engagement of services the client/recipient is to be informed, by the provider agency of their rights regarding confidentiality and privacy protections. Any client/recipient denied or discharged from services or treatment must be informed of the provider agency’s mechanisms for expressing and resolving grievances.  

 

Levels of Approval:

Case decisions and expenditures vary in type of decision and rates for services.  Therefore different levels of approvals are required. These levels include but are not limited to:

Caseworker: decisions in day-to-day social work following the case plan and court orders for the case.

Parents: for children in care whose parents’ rights have not been terminated, their parents must be consulted for certain decisions, i.e. immunizations, circumcision, medical procedures, haircuts, and piercings.  However, any decisions that cannot be reversed, such as immunizations, circumcision, piercings (except ear piercing), etc. must be discussed with and receive approval from the Office Director.

Supervisor: must approve the payment for client services; these are either approved within MaineCare rates or within established contract rates.  Supervisors also oversee the case decisions made by the caseworker.

Program Administrator/Assistant Program Administrator: service authorization not specifically covered by MaineCare or an already established rate approved by Child Welfare Service, a second level approval is required.  These include: any bill over $500; purchase orders totaling over $500; or a rate higher than a rate already approved by Child Welfare Services such as a CODE (Court Ordered Diagnostic Evaluation); or hours of service exceeding established hours.  The Program Administrator/Assistant Program Administrator must also give secondary approval for any evaluation in the Evaluations and Therapies section of this policy.

Associate Director/Regional Associate Director: any bill over $1,000; exceptional medical services to an adult client or child not in DHHS custody when intended to meet established safety, permanency or well-being goals of the case; ongoing treatment above the established rate; or a new type of evaluation.

Office Director: any inpatient substance abuse services; residential or mental health hospitalization when not approved by APS; and names and placements for Safe Haven infants.  Any decision that cannot be reversed such as circumcision or immunizations if the parents are in disagreement with OCFS.

Commissioner: Adoptions; Do Not Intubate Orders; Do Not Resuscitate (DNR) Orders; other end of life measures and marriages for youth in care.

Note: Services that are not paid for by MaineCare, but are paid for by OCFS, may only be authorized at the MaineCare rate unless specifically stated in the Rate section of this policy for that specific service.

 

Evaluations and Therapies:

Batterer’s Intervention Program

A Batterer’s Intervention Program is a therapeutic intervention to hold batterers of Domestic Violence accountable and works to change behaviors.  The Batterer’s Intervention Program must be certified by the Department of Corrections.

Authorization: Supervisor

Rate:  OCFS only pays for the first assessment then payment is the responsibility of the batterer as this is part of the therapeutic program.

Case Management Services:

There are children in care who may benefit from having case management services.  The caseworker can make a referral for these services.  We cannot pay for case management services for adult clients.  

Authorization:  Supervisor

Rate:  MaineCare approved rate

Clinical Consultation:

There are times when a clinical consultation is needed outside the treatment of the parent or child.  These are unusual circumstances that may arise in a difficult case situation or, for example, to support staff after a child death.

Authorization:  Program Administrator  

Rate:  Determination to be made on a case by case basis but MaineCare rates will be considered.

CODE (Court Ordered Diagnostic Evaluation)

The court-ordered diagnostic evaluation program provides forensic child maltreatment risk and need assessments of parents, guardians, other caregivers, children, and their families.  

Authorization:  Administrative Hearing Program Specialist will, once the evaluation has been court ordered, approve the evaluation and enter the rate for approval and select the evaluator from an approved network of providers.  The supervisor will then approve the rate entered.

Rate:  The approved rate is entered by the Administrative Hearing Program Specialist

FFT (Functional Family Therapy):

To be used for youth who lack problem solving skills and have poor frustration tolerance.  Providers work with families to make incremental, positive changes that lead to reduced risk. Appropriate referrals include conduct problems, truancy, other school related behaviors, delinquency, running away and substance abuse.  

Authorization:  Supervisor

Rate:  MaineCare approved rate

 

HCT (Home and Community Therapy):

Provides individual and family therapy, support, parenting education, and behavior management in the home.   Used to assist parents to develop strategies to manage their children’s emotional and/or disruptive behaviors within the context of the family.

Authorization:  Supervisor

Rate:  MaineCare approved rate

Individual Therapy:

To be used to address issues that contribute to child abuse and neglect, or for children and youth to address issues resulting from their family or current life situation.

Authorization:  A supervisor can authorize twelve (12) sessions at one time.  Reauthorization will be done after verification that OCFS has received a written treatment plan with clearly defined and measurable goals and at least quarterly progress reports from the clinician/provider outlining the progress a client has made as well as goals that have been met.

Rate:  MaineCare approved rate

MST (Multisystemic therapy):

To be used for youth who are chronic juvenile offenders, have substance abuse issues, are violent, or have severe emotional disturbance.  The service involves intensive family and community based treatment to address externalizing behaviors of youth displaying emotional and behavioral disturbances through antisocial behaviors.

Authorization:  Supervisor

Rate:  MaineCare approved rate

Neuropsychological Evaluation:

This type of evaluation should only be considered if there are organic indicators and the following applies:  medical or CPS assessment information that indicates the child may have suffered a brain injury; information is needed  to determine services for special education or vocational rehabilitation for adults; there is a need for more current neuropsychological information to determine eligibility for adult services; or to determine whether or not a child needs a legally appointed guardian when they reach adulthood.

Authorization: Must be approved by the Program Administrator/Assistant Program Administrator

Rate:  MaineCare approved rate

No-Show Fees:

When clients do not show for an appointment or do not give a twenty-four (24) hour cancellation notice the caseworker may be asked to pay a no-show fee.  The Department does not pay no-show fees.  Caseworkers should be making providers aware of this fact as well as letting parents know it is their responsibility to cancel appointments if they are unable to attend.

Exception: no-show fees are paid for CODE evaluations for up to three (3) hours to cover the evaluator’s prep work.

Authorization:  Supervisor

Rate:  For CODE no-shows only, $88/hour and is entered in MACWIS using the authorization for the CODE

Psychiatric Evaluation:

Parents: To determine if there is an undiagnosed psychiatric condition impairing their ability to safely parent their child.

Children:  To determine if the child has an undiagnosed condition that would benefit from treatment; to monitor the effects of prescribed medications; or when information is needed to determine eligibility for child or adult services.

Authorization:   Supervisor

Rate: MaineCare approved rate

Psychological Evaluation

To determine what services are appropriate and if the client has a mental health diagnosis, learning disability, or the need for special educational services.

Authorization: Supervisor

Rate: MaineCare approved rate

RCS (Rehabilitative Community Services):

To be used for children with cognitive impairments and functional limitations (i.e. Autism Spectrum Disorders, Down Syndrome, etc.).  Services focus on skill building in activities of daily living and behavior management by working with the child in the home and community.  

Authorization:  Supervisor

Rate:  MaineCare approved rate

Sexual Offender Risk Assessment Evaluation:

To determine level of risk posed by an alleged or convicted sexual offender.

Authorization: Program Administrator/Assistant Program Administrator approval and must be court ordered. If it is not court ordered it must have the approval of the Program Administrator/Assistant Program Administrator.

Rate: Forensic evaluation rate as is used for the CODE

VRP (Virtual Residential Program):

To be used for children with mental illness and those with emotional disturbance so severe they are at imminent risk of out-of-home placement.  Intervention begins intensely at thirty-five (35) hours per/week and then tapers off.

Authorization: Supervisor

Rate:  MaineCare approved rate

 

Substance Use/Abuse Evaluations and Services

Drug Replacement Therapies:

These are prescribed medications such as Suboxone, Subutex and Methadone.

Authorization: Supervisor and must be part of the reunification plan and directly related to the reasons we are involved with the family.

Rate:  The Prescription Medication and Pharmacy Conditions Contract must be used and MaineCare rates apply.  (See Appendix 1)

Drug Testing:

Drug testing is used in assessments and cases to obtain information regarding a client’s substance use/abuse.  The only type of drug testing that may be used is urine testing.  Drug testing should not be the only determination regarding a client’s drug use/abuse and should be done in conjunction with a thorough assessment or substance abuse treatment.  

Authorization:  Supervisor

Rate:  Established by the agency conducting the testing.

In-Patient Substance Abuse Services:

There are times when outpatient substance abuse therapy is not successful and a higher level of treatment is recommended.  In those circumstances you must gather the information needed for approval from the Office Director.

Authorization: Office Director

Rate:  Determined by Central Office

Substance Abuse Treatment including IOP (Intensive Outpatient Treatment):

To be used to address substance abuse issues on an out-patient basis.

Authorization: Program Administrator/Assistant Program Administrator and the Request for Intensive Outpatient Services (IOP) for Parents Checklist must be used.  (See Appendix 2)

Rate:  MaineCare approved rate

 

Contracted Services:

Alternative Response Program (ARP):

Each district has the ARP service which provides assessment and post assessment case management for reports/assessment deemed low to moderate risk.

Authorization:  Supervisor

Rate:  Billed to the contract by the ARP agency at the contracted rate

Contracted Mental Health Services:

DHHS contracts with mental health agencies throughout the state to provide services to clients who do not have MaineCare.  These services are used in assessments and cases to reduce the risk to children placed in the home and/or to work toward family reunification.  

Authorization:  Supervisor

Rate:  MaineCare rates apply

Contracted Substance Abuse Services:

DHHS contracts with substance abuse agencies throughout the state to provide services to clients who do not have MaineCare.  These services are used in assessments and cases to reduce the risk to children placed in the home and/or to work toward family reunification.  

Authorization:  Supervisor

Rate:  MaineCare rates apply

Interpreters:  

In situations where a parent and/or child needs an interpreter these services are arranged for by the Department and are paid for through a contract.   Examples include individuals who are hearing impaired or for whom English is not their primary language.  There are contracts for the following services:  American Sign Language (ASL); In Person Spoken Language Interpreting; Telephonic Interpreting Services; and Video Remote Interpreting Services.  The agencies with established contracts can be located at http://www.maine.gov/purchases/contracts/index.shtml under Services.

Authorization:  Caseworker

Rate:  Established contract rate

Services in Closed Assessments/Cases:

Contracted services (except supported visitation and drug testing) can be extended to families for ninety (90) day post assessment/case closure if providing those services will continue to reduce the level of risk in a family.  A new referral form for the service must be completed using the code PX99.  

Authorization:  Supervisor

Rate:  Billed to contract by the agency at the contracted rate

Supported Visitation:

Each District has a supported visitation service they are contracted with which should be used to provide visits between parents and children in custody.  Before a referral is made to the supported visitation service, the caseworker should discuss the need for supervision.  If it is determined that the visit should be supervised then other resources, such as the resource/kinship family or other family member, should be approached first to determine if they can supervise the contact between the parent and child.

Authorization:  Caseworker

Rate:  Billed to contract by the visitation agency at the contracted rate

Transportation:

Each District has a transportation service they are contracted with which should be used to transport parents and children in custody age seven (7) and older who do not have another mode of transportation.  The referral form must be filled out and faxed to the appropriate contracted agency.  The transportation agency is to follow its own contract.

Authorization:  Caseworker

Rate:  Billed to contract by transportation agency at the contracted rate

 

Court/Legal Services:

Attorney for Child/Youth:

If a child/youth in DHHS custody is charged with an offense we may pay for an attorney if the court will not appoint an attorney to represent them.  This varies by court jurisdiction.  If law enforcement wants to question a child/youth in DHHS care or custody with regard to an offense they may be charged with, the Department must hire an attorney to represent the child/youth.

Authorization:  Attorney General’s office must approve.  If approved the Attorney General’s office will locate an attorney.

Rate:  Determined by the Attorney General’s office once service is approved

 

 

Children’s Advocacy Centers (CAC):

CACs conduct interviews in coordination with law enforcement regarding child sexual abuse cases.  The CACs partner with the Department and law enforcement so children do not have to be interviewed multiple times.

Authorization:  Supervisor

Rate: There is no fee for the CAC

Expert Witness Court Testimony and Preparation:

Expert witnesses submit bills for court preparation and testimony.  It is allowable for them to include preparation time with DHHS staff and the Assistant Attorney General, record review time, and time spent at the courthouse.

Authorization:  Assistant Attorney General and Supervisor must authorize the use of an expert witness.  The Supervisor will authorize payment.

Rate:  MaineCare approved rate or pre-established rate for service, i.e. testimony regarding a CODE would be at the rate approved for that service.

Qualified Expert Witness in ICWA cases:

In ICWA cases a Qualified Expert Witness must testify regarding the removal and active remedial efforts and provide cultural and historical context specific to the child’s tribe.  (Please see policy III A. Indian Child Welfare Policy)   This expert witness may bill for the time needed to assess the situation including attendance at meetings, home visits and report writing, court preparation, and time spent at the courthouse.  This witness may also bill for mileage used to complete the assessment.

Authorization:  Assistant Attorney General and Supervisor must authorize the use of an expert witness.  The Supervisor will authorize payment.

Rate:  $65/hour

 

Medical/Dental Services:

Abortion:

There may be situations in which a youth in care becomes pregnant and decides they do not want to continue with the pregnancy.  

Authorization:  Office Director and Commissioner

Alternative, Experimental or High Risk Treatment:

Alternative, Experimental or high risk treatment are those treatments that are either in the experimental stage, are typically used for another condition or whose risk of complications is high.

Authorization:  Commissioner through a memo from the Office Director

Anesthesia:

Anesthesia can pose its own medical risks so the caseworker should be fully informed before consenting.

Authorization:  Caseworker

Circumcision:

Circumcision is a procedure that usually occurs within the first few days of birth; however, there are occasions where it is recommended for older children based on a medical need.  In these cases the medical reasons should be discussed with the medical professional who is recommending that the procedure be done.  This discussion should include the parents of children in custody whose parental rights have not been terminated.

Authorization:  At time of birth:  Caseworker and parents, if parental rights have not been terminated.  For an infant already discharged from the hospital:  Supervisor and parents, if parental rights have not been terminated.  For Safe Haven Infants:  Office Director.

Rate:  MaineCare covers this procedure if done at birth prior to the child being discharged from the hospital.  If done after a child has been discharge from the hospital at birth MaineCare approved rates will be used.

Comprehensive Health Assessment:

All children entering care must have a comprehensive health assessment and some districts have a contracted provider who provides this service.  The provider conducts a medical and psychosocial evaluation on the child and gathers all medical records to make recommendations for services.  The comprehensive health assessment should follow Child Health Assessment (CHA) practice.  

Authorization:  Caseworker

Rate:  MaineCare rate

Dental and Orthodontic Services:

There is a scarcity of dentists who provide both regular dental care and orthodontic care at MaineCare rates.  If a caseworker is unable to locate a dentist who accepts MaineCare rates within fifty (50) miles of the placement of a child in care estimates of the work shall be sought from a provider closer to the child’s placement and a memo requesting authorization of payment shall be created.  In addition, there are circumstances where MaineCare will not approve orthodontia for children in care yet the service is recommended for the child’s well-being.  In such cases the caseworker will seek estimates for the cost of the work needed and create a memo to the Program Administrator.

Authorization:  Program Administrator/Assistant Program Administrator

Rate:  Determined on a case by case basis

Do Not Resuscitate Orders:

Authorization:  The Office Director will receive a memo from the District outlining the situation.  Final decision is with the Commissioner; please see the policy V. I-5 Consent for Non-Routine Health Care Procedures.

Emergency Medical Treatment:

Emergency medical treatment includes not only a child/youth presenting at the hospital needing to be treated for a medical situation, but it also includes those situations when a child/youth is at an Emergency Department waiting for a mental health bed.

Authorization:  Caseworker or ACES staff after hours.  The parents, if parental rights have not been terminated, should be notified as soon as possible.

Hospital Admissions:

Hospital admissions are those times when a child/youth is actually admitted, as opposed to those times a child/youth is in the Emergency Department waiting for admission.

Authorization:  Caseworker.  The parents, if parental rights have not been terminated, should be notified as soon as possible.

Immunizations:

Immunizations are recommended by the medical profession to be administered at specified ages to prevent certain diseases; however, in Maine parents have the right to choose not to have their child immunized.

Authorization:  Caseworker and parents, if parents are in agreement that the child should be immunized.  Office Director if the parents do not want the child immunized.

Routine Checkups for Children in Care:

Routine medical care for children in care includes well-child checks, examination by the child’s primary care physician when the child is ill, examinations for sports activities, etc. Authorization:  These appointments may be made by the child’s caregiver/resource parent with notification to the caseworker.  Parents in reunification cases should be encouraged to attend these appointments.  

Rate:  MaineCare pays for this service

Second Opinions:

In cases in which a second opinion is requested for a serious diagnosis or for special treatment considerations the caseworker should assure that their questions, as well as those of the child, resource parent and parent, are answered.  

Authorization:  Program Administrator/Assistant Program Administrator and Office Director

Rate: MaineCare if they will approve payment for the second opinion, if not, MaineCare rates apply.

Selection of Provider:

When a child enters custody OCFS tries to assure the least amount of disruptions; therefore, a child’s Primary Care Physician should be maintained.  However, there are situations, due to distance between the child’s placement and the PCP, when this is not possible and the resource parent may change providers.

Authorization:  The parents, whose parental rights have not been terminated, should be informed of the decision.

Rate:  The PCP selected must accept MaineCare.

Spurwink Child Abuse Program:

The Spurwink Child Abuse Program works closely with the Department and consults on child sexual abuse cases, failure to thrive cases, and serious injury assessments and cases providing a diagnostic medical examination.  

Authorization: Caseworker

Rate: Contracted rate  

Surgery:

Surgery should only be authorized when a child’s medical team recommends surgical treatment for a diagnosis and the level of risk has been balanced against the diagnosis/prognosis and other management options.

Authorization:  Program Administrator/Assistant Program Administrator.  If the parents’ rights have not been terminated, the parents should be informed of the surgery and DHHS should facilitate the opportunity for the parents to consult with the medical team concerning the proposed treatment and risks.   The parents should be informed of the surgery before it occurs and they should have the opportunity to talk to the physician if they choose.  

Tattoo Removal:

If a child in care wants a tattoo removed that is the result of gang activity or human trafficking, the Department will pay for the removal.

Authorization:  Program Administrator/Assistant Program Administrator

Rate:  Determined on a case-by-case basis

 

Payments for Parents in Assessments, Service Cases and Reunifications Cases:

Board Rate for Parents during the Trial Home Placement:  

When a child in care returns home for a trial placement, the parent is not eligible for TANF as they do not yet have custody of their child.  The unlicensed board rate may be paid to the parent during this phase of the case if the parent would be eligible for TANF if they had custody of their child.  

Authorization:  Supervisor

Rate:  $10/day per child

Child Care in Service Cases:

There are times in service cases in which, after an FFTM, a child has been planned to an out-of-home placement.  In these situations, if the caregiver is working, they may require child care in order to be able to provide placement for the child.  If this payment is deemed necessary it should be part of the case plan.

Authorization:  Supervisor

Rate:  Child Care market rates

Food:  

There are occasions that the Department may be asked to help with food/groceries for a family.  Before this is done other options, such as food pantries must be explored.

Authorization:  Supervisor

Rate:   To be determined on a case-by-case basis

Hotel Rooms:

There are situations when we may need to pay for a hotel room for a parent.  These situations include help in a domestic violence situation when shelters are full and when a parent is coming from out of state to visit with a child as part of the ICPC process.  In these situations we only pay if there is clear evidence that the parent is unable to pay and it is part of the case plan.

Authorization:  Program Administrator/Assistant Program Administrator

Rate:  Government rate

Medications for Parents in Reunification Cases:

When a parent is receiving MaineCare, they lose coverage when their child enters Department custody unless they have a medical condition or disability qualifying them for the benefit on their own.  In the case of a parent who has lost this benefit the Department covers a parent’s mental health medications during the reunification process as long as use of the medication has been court ordered, is a part of the reunification plan, is directly related to the reasons we are involved with the family, and alternative sources to pay for the medication have been explored.  The parents must sign the prescription medication form in order for us to authorize payment.  

Authorizations:  Supervisor approval is required for mental health medications that are part of the court ordered reunification plan.

Rate:  MaineCare approved rates apply

Security Deposit/Rent:

There are situations in which the Department will consider assisting a parent with a security deposit or rent.  In an assessment or service case it can be considered if proper housing is the only barrier for children remaining in their parents’ custody.  In a reunification case, it may be considered if it is the only barrier to placing the children home for a trial placement.  The parent must be able to demonstrate that, if the Department assists with a security deposit or one month of rent, they have a viable plan to maintain the residence by being able to afford future rent payments.

Authorization:  Program Administrator/Assistant Program Administrator

Rate:  To be determined on a case by case basis

Taxis:

The Department has contracts with transportation agencies; therefore, taxis should only be used in after hours or unusual situations.  Children/youth should not be transported by taxi.

Authorization:  Supervisor

Rate:  Determined by the taxi company

Utility Bills:

There are situations where a parent may be struggling to pay a utility bill, such as electricity or oil.  In these situations, the Department may consider a one-time payment for the family to get them back on track if this is the barrier for children remaining in their parents’ custody or for a child in care to be returned home.  In both situations the parents must have a viable plan to continue to pay for the utility.

Authorization:  Supervisor if under $500 and Program Administrator/Assistant Program Administrator if over $500.

Rate:  To be determined on a case by case basis.

 

 

Decisions and Payments for Children in Care:

Bed/Cribs:

A licensed resource family, licensed for the specific age of child being placed, should have the appropriate sleeping arrangements for a foster child.  Kinship/fictive kin families may not have been expecting a placement and may need help purchasing a crib or bed.  Other resources such as the family and Adoptive & Foster Families of Maine should be explored first.  The caseworker should make sure any crib used meets current safety standards.

Authorization:  Supervisor

Rate:  Up to $300

Bikes/helmets:

Foster child should have the same advantages as other children in a foster home; therefore, the Department will purchase bikes and helmets for children in care.

Authorization:  Supervisor

Rate:  Up to $200 when purchasing both the bike and helmet together.

Car Seats:

All children in care must be securely fastened into a vehicle according to state law.  The Department will buy car seats for resource families but should first ask the parents if the child’s car seat can go with them upon entering care.  Other resources, such as Maine Families, should also be explored prior to the Department purchasing a car seat. Authorization:  Supervisor

Rate:  Up to $150

Child Care at Market Rates:

Resource families including kinship, regular family resource home, and treatment homes may require child care for the children placed with them. The Department pays for child care for resource parents in the following circumstances: both resource parents are working, the child has special needs which can only be met in a structured, licensed child care setting, or because of the age/illness of a resource parent.

Authorization:  Supervisor

Rate:  Child Care Market Rates.  Reimbursement will be made directly to the provider unless circumstances beyond the provider’s control prevent direct payment.

Child Care above Market Rates:

There are times when an available child care provider will not accept the child care market rates.  Possible exceptions to the market rate are based on the best interest of the child and a lack of other viable options for:  Age/illness of Foster Parent; child has Special Needs which can only be met in a structured, licensed child care facility; child is already attending an appropriate child care provider and the provider does not accept market rates; Foster Parent cannot locate child care provider in the area who accepts market rate for that county AND has openings; or Foster Parent is currently using a child care provider for children already in their home and the provider does not accept market rate but has openings.  If there is no other provider in the area able to take the child at the approved rate, or if the child’s situation warrants an in-home daycare provider, the request to pay over the allowed rates will be given to the Program Administrator/Assistant Program Administrator.  The request should outline the reasons and why it is in the child’s best interest.

Authorization:  Program Administrator/Assistant Program Administrator

Rate:  To be negotiated on a case by case basis to meet the child’s best interest.  Reimbursement should be made directly to the provider.

Clothing:

The daily clothing rate shall be entered when a child is placed in a kinship or resource home.  A purchase order may be given if a child is entering custody or changing placements and does not have sufficient clothing, or if the child has experienced a significant weight loss or gain.

Authorization:  Supervisor under $500 and anything exceeding $500 needs Program Administrator/Assistant Program Administrator approval.

Rate:  As entered under per-diem in MACWIS: ages 0-3 $1.52/day; ages 4-10 $2.47/day; ages 11-20 $3.67/day.   The diaper allowance is $0.99/day.  For a purchase order the amount needed should be discussed and negotiated with the resource parent.

Extra-Curricular School Activities:

Foster children should be allowed to participate in activities that their peers participate in.  Therefore the caseworker will sign the permission slip for the school at the beginning of the school year which allows for foster parents to give permission for these activities.

Authorization:  Caseworker

Field Trips:

Foster children should be able to participate in activities that other children are able to participate in and should not be denied for the sole reason that they are foster children.  At the beginning of the school year the caseworker is to sign the permission form for the school that allows the foster parent to sign for class field trips.

Authorization:  Caseworker

Hunting License:

State statute prohibits anyone under the age of 10 from hunting at any time.  A Junior License is required for persons at least 10 years of age and under 16 years of age.  In addition hunters between the ages of 10 and 16 must be accompanied at all times while hunting either by a parent or approved adult who is at least 18 years of age. This person must have a valid hunting license. The State of Maine’s statutes pertaining to hunting will be followed at all times.

Authorization: The decision regarding hunting shall be determined by the team within the context of an FTM.  If the decision is that the child may hunt then the FTM will address who is responsible for supervision, hunting classes, licensing obtainment and other activities that allow for hunting. 

Note:  The Penobscot Nation and the Passamaquoddy Tribe, within their respective Indian territories, have exclusive authority to regulate hunting and trapping.  The supervising adult and child who hunt within these territories are to comply with the rules set by the Penobscot Nation and the Passamaquoddy Tribe.

Joining the Military:

If a child in care under the age of 18 wishes to enlist in the military the caseworker should have a conversation with him or her regarding the implications but the decision to join is the youth’s decision.  

Authorization:  Program Administrator/Assistant Program Administrator in conjunction with parents, if parental rights have not been terminated.  

Marriage:

There are times when a child in care under the age of 18 wants to be married.  In such situations the caseworker will discuss the issue with the youth, the youth’s caregivers and the parents if parental rights have not been terminated.

Authorization:  Commissioner

Media Coverage:

The names or images of children in care are not to be used in the media if it identifies them as a foster child.  Children’s pictures may be in the paper for activities, for example if a child is on a basketball team and the team’s picture is in the paper but the foster child is not identified as being in care.  

Authorization:  When a child is going to be identified as a foster child or the story is about foster care, permission must be received from the Office Director.

Mileage for Resource Parents to transport to Child Care or School:

The Department recognizes that resource parents may be going out of their way to transport a child to child care.  In addition, the Department wants to promote school continuity.  Therefore, if a foster parent needs to transport a child to a school outside the school district the child is residing in, the Department will pay mileage.

Authorization:  Supervisor

Rate:  The approved mileage rate for the distance the resource parent is traveling outside a reasonable area.

Name Changes:

There may be times when a child in care wants to change his or her name or it is recommended by a mental health professional that changing a child’s name is in their best interest.  These are decisions that require a great deal of thought and discussion regarding the reasons why and if it is in the child’s best interest.

Authorization:  Office Director

Naming a Safe Haven Baby:

When parent(s) deliver a child less than thirty-one (31) days of age to a safe haven site with no intent of returning for the child, the Safe Haven law is followed, see policy IV-C-3 Procedural Guidelines to Assist Safe Haven Providers.  In these cases the child may need to be named so a birth certificate can be generated.  

Authorization:  The Office Director will be included in these situations and will be the decision maker regarding the child’s name.

Non-Public School Education:

The Department believes that children in care should be educated through the public school system; however, there are times when the resource parent or a child in care requests to attend a private school or to be home-schooled. For guidelines and information needed for approval, see policy V. D-5 Education Policy.

Authorization:  Program Administrator/Assistant Program Administrator if no funding is involved; Office Director if funding is needed

Rate:  Determined by the school

Overnight/Specialized Camps:

Children in care often want to attend either day camp or overnight camp.  When making the determination the caseworker should take into account the child’s developmental level as well as any special needs, including behavioral needs.

Authorization:  Supervisor

Rate:  Up to 2 weeks for up to $500/week but camp scholarships should be attempted before payment approval.

Participation in certain School Courses:

There are certain school programs which require the legal guardian’s consent to participate in certain classes, such as advanced placement courses and sexual education.  Participation in these classes should be discussed with those that know the child best, including the resource parent and parent, to determine if it is in the child’s best interest.

Authorization:  Caseworker and parent, if parental rights have not been terminated.

Recreational Activities:

Foster children may wish to participate in recreational activities such as karate lessons, dance, swimming lessons, etc.  It is recognized that these activities can be beneficial to children; however, the cost and duration must also be considered.  The activities should be connected to the child’s needs as well as their development.

Authorization:  Program Administrator/Assistant Program Administrator

Rate:  Determined by the agency/business sponsoring the activity

Rent:

Older youth in care on a V-9 agreement may be appropriate for apartment living.  If this has been determined to be appropriate, the amount paid is to be determined on a case by case basis.  Please see policy V. T. Youth Transition Policy for apartment living considerations.

Authorization:  Supervisor

Rate:  Determined on a case by case basis (see policy V. T. Youth Transition Policy).

Snowmobile/ATV and motorized equipment use by a Child in Care:

Recreational motor vehicles, such as snowmobiles and ATVs, are a large part of some family’s culture.  Foster children placed in these families should be made to feel as much a part of the family as possible.  However safety measures should always be taken and parent wishes should also be taken into consideration.  

Authorization:  Licensing rules state, “Use of snowmobiles, ATV’s and other motorized equipment by foster children must be approved by the Department caseworker.  Appropriate safety equipment must be work at all times.”  

 

Tattoos/Piercing:

The Department does not give permission or pay for either tattoos or piercings.

Therapeutic Horse Back Riding:

Therapeutic horseback riding is the use of horses and equine-assisted activities in order to achieve goals that enhance physical, emotional, social, cognitive, behavioral and educational skills for people who have disabilities.

Authorization: OCFS does not pay for this service.

Tutoring/Summer School:

If a child in care needs either summer school or tutoring to help them obtain or maintain work at grade level, the Department should discuss this need with the school and make the decision based on the child’s educational needs.

Authorization:  Caseworker if it is being provided by the school at no cost and the supervisor if payment is required.

Rate:  To be determined on a case by case basis with input from the school regarding fair market rates

Vehicle Ownership:

Children in Department custody, under the age of 18, are not allowed to own vehicles.  Please see policy V. T.  Youth Transition Policy.  

 

 

 

 

APPENDIX 1

 

OCFS-PAID PRESCRIBED MEDICATION AGREEMENT

Please initial each paragraph, indicating you understand and agree to these provisions.

 

 

________Payment for medications is not automatic.  Before OCFS will pay for any medication, parent must request approval. This applies to any new medications after this agreement has been signed.

 

________Payment for medications must be necessary to facilitate family reunification services.  

 

________        Medication shall be used only as directed by prescriber and/or manufacturer.  

 

________OCFS may seek to suspend payment for medication if it believes parent is engaging in drug diversion or other inappropriate activity.

 

________Parent shall give OCFS the names and contact information for all professionals prescribing their medications.  

 

________For any emergency medical treatment, the parent shall inform the emergency treatment provider of their medication and substance abuse history.  

 

________OCFS may suspend payment for medications if parent is non-compliant with reunification services and planning.   OCFS will give 10 days-notice prior to suspension. A Family Team Meeting should be held before payment is reinstated.  

 

 

 

 

DATED: ____________________                        ________________________________

                                                 Parent signature

 

DATED: ____________________                        ________________________________

                                                 Authorized OCFS Social Worker

 

 

 

 

APPENDIX 2

 

 

Checklist and Request for Intensive Outpatient Services (IOP) for Parents

 

In order to be eligible for this service a family must have at least one child who either at risk of entering custody or entered state custody and a recent substance abuse assessment that recommends Intensive Outpatient Service (IOP) as the appropriate level of care for treatment.    

 

Steps for requesting IOP Services for parents:

☐        The caseworker will talk to their supervisor about the appropriateness of this service for the parent.

☐        The caseworker will share information about the program and services available with the parent.        

The caseworker will complete the UNCOPE with the parent and document the results in MACWIS.  

If the parent scores positive on two or more items they qualify for a referral for a substance abuse assessment.

A Family Team Meeting has been held and the parent has agreed they have a substance abuse problem and is willing to enter into treatment including IOP if recommended.
A referral was made for a substance abuse assessment (an assessment utilizing ASAM criteria is preferred).
The evaluation (by someone other than the admitting provider whenever possible) indicates that outpatient intensive treatment is the appropriate level of care for this individual.
When the child has come into care, there is a signed Rehabilitation and Reunification Plan outlining treatment goals and services that has been filed with the court.

☐         The caseworker will have at least monthly contact with the parent receiving IVE Waiver Services.    

☐        The caseworker will have at least monthly contact with the treatment facility Provider.    

Client name:                                                MACWIS case ID:                

 

Client DOB:                                                A#:                                

 

Caseworker contact:                                        OCFS office:                        

 

Treatment Agency:                                        Supervisor’s Initials:__________