CHILD WELFARE MANUAL

Effective Date:  7-1-2024

 

This subsection describes a variety of payments that are made to or on behalf of children who are in foster care.

12.8.1 – Standard Payment Rates for Foster Family Care

Type of Expenditure	Age Limitation	Amount Payable
Maintenance for licensed resource families caring for Missouri children (includes room and board, clothing and incidentals)	0-5 years 6-12 years 13 and over	$509.00 $577.00 $712.00
Maintenance for unlicensed families seeking Licensure during first 90 days of placement	0-5 years 6-12 years 13 and over	$345.00 $408.00 $455.00
Infant Allowance	0-3 years	$91.00
Annual Clothing Allowance	0-5 years 6-12 years 13 and over	$320.00 $400.00 $700.00
Special Medical Expense	all ages	Contract Unit Rate
Special Non-medical Expense	all ages
Children’s Treatment	all ages	Contract Unit Rate
Residential Treatment (includes room and board)	all ages	Contract Unit Rate
Treatment Foster Care (TFC) Parent Home*	all ages	$2632.26
Level 2 Treatment Foster Care (TFC) Parent Home*	all ages	$3984.89
*These minimum rates are for TFC homes, including relatives, who are fully licensed and have, completed the TFC training requirements. TFC Child Placing Agencies are responsible for these payments to TFC homes. The Children’s Division contracted with Public Consulting Group (PCG) to establish rates for Treatment Foster Care (TFC). The minimum TFC monthly maintenance rates are based on the TFC rate study completed by PCG, which included an analysis of the cost breakdown, associated with the delivery of TFC for both traditional and relative TFC parents serving Level 1 and Level 2 children.
Youth with Elevated Needs-Level A/Medical Foster Care	all ages	$1119.00
Youth with Elevated Needs-Level B Foster Care	all ages	$2034.00
Level B Resource Provider Respite Care	0-12 years   13 and over	$56.00 per 12-24 hours $28.00 per 6-12 hours $63.00 per 12-24 hours $31.50 per 6-12 hours
Traditional Respite Care	0-12 years 13 and over	$31.00 per 12-24 hours $15.50 per 6-12 hours $38.00 per 12-24 hours $19.00 per 6-12 hours
Level B Resource Provider Availability/Transitional Services	all ages	$21.00 per day for up to 90 days
Emergency Foster Family Home (for licensed Foster, Relative, Kinship Providers)	all ages	$37.00 per day for up to 60 days
Independent Living Arrangement (paid to foster youth)	16 plus	$712.00 per month

The maximum rate established for maintenance payment may be exceeded only in special circumstances involving children with exceptional needs. No exception may be made for payment exceeding these standards unless prior approval is received from the Regional Director or the child is authorized to make use of a special alternative care program such as medical foster care or Level A foster care.

• Maintenance payment includes expenses related to the foster child’s daily living needs i.e., room and board, clothing, and incidentals.
• Infant allowance is paid for children from birth up to their third birthday to help defray the additional costs for providing for the specific needs of infants; i.e., formula, diapers, special food, extra clothing, and supplies.
• Maintenance payment and infant allowance, when allowable, and using the following guidelines, may be continued for children who temporarily leave a placement:
  • As provided in the individual case plan and agreed to by the State Agency.  This includes frequent in-home visits, with parents or perspective adoptive parents, hospitalization, or camp, etc., as long as placement remains with foster/relative parents and the plan is for the foster youth to return to the placement home. For residential treatment, this may not exceed a maximum of thirty (30) days during any twelve (12) month period.
  • Up to seven (7) days for each period of time the child is absent for the reasons of runaway, in-patient hospitalization, or detention, or;
  • For children in residential treatment, up to five (5) days per month for the purpose of visiting with birth parents or a “substitute family,” (includes prospective adoptive parents.)

• If a Traditional, Medical or Level A resource family needs a temporary break in child care responsibilities, respite care may be arranged with a contracted Respite provider. The licensed resource home shall continue to receive the regular foster care payment only while the child is in policy defined respite care units; 12 units per year or 14 units plus one weekend a month for elevated needs level B.  On a case by case basis, the worker may request supervisor approval for up to 20 units of respite for a resource provider per foster youth.  Regional Director or designee approval is required for more than 20 units.
  • Documentation of the approval must be maintained by attaching it to the Respite Unit Tracking Log, CD-113, and the Payment Request.

• Maintenance and infant allowance payments begin with the date of the first night the child resides with a provider. It ends effective with the date of the last night the child resides with a provider.
• Level B resource providers are encouraged to use respite care a minimum of one weekend per month plus 14 days per year. Respite Care will be provided for all foster children in the Level B home at the same frequency regardless of Level of Care, i.e., Traditional, Youth with Elevated Needs, etc. Respite care does not have to be provided for all children in the Level B home at the same time. Level B resource providers may determine the actual time(s) to use respite based on the individual needs of the child(ren) in their home, and family. Respite care is to be provided by another trained Level B Resource Parent Respite Care Provider under contract with the Division. Both the Level B resource parent and respite provider will continue to receive their annual reimbursement during periods of respite.

12.8.2 – Emergency Placement Payments

Frequently, children entering alternative care require placement on an emergency basis. The Division operates two primary programs as emergency placement services.

One type of emergency placement is provided by foster families who have elected to make slots available from their licensed capacity, to children who require placement at any time during a twenty-four (24) hour period.

• The emergency placement counts in the resource home’s placement capacity
• Due to its immediacy, this type of placement is paid at a much higher rate than traditional care, $37 dollar per diem
• Once a child has spent 60 days in an emergency foster placement, FACES will automatically change the foster youth’s placement code to reflect a standard level of maintenance payment. If the home has an open Foster Home (FH) license and cooperative agreement. If the home does not have an open FH and corresponding cooperative agreement, FACES will change the foster youth’s placement code to reflect level 3 payment level, no payment.

To process a payment requires the following:

1. An active Cooperative Agreement for the Purchase of Emergency Foster Care Services, CM-11, entered in FACES
2. Open foster youth case management case in FACESTo process a payment requires the following:

The second type of emergency placement is provided by licensed child-caring facilities contracted to provide “emergency residential care”.

1. Open the foster youth case management case in FACES
2. RCST opens appropriate authorization in FACES
3. Invoices for the payment of emergency residential care costs are submitted by the provider directly to the RCST. If there is a question regarding the invoice, the RCST will contact the provider
4. Update FACES as necessary to reflect the child’s movement into other types of alternative care or the child’s return to his own family. 

12.8.3 – Special Expenses Payment

Authority for approval of any of these expenses rests with the Regional Director (of the respective service county) except when delegated or otherwise specified. All other stipulations and the need for supervisory approval should be observed. Special expenses for a Child of a Youth in Alternative Care (CYAC) child must be invoiced using the CYAC parent’s name and Department Client Number (DCN).

Medical and Dental Expenses

These expenses are not covered by the MO Healthnet/Dental Services program. All non-MO HealthNet expenses must be cleared through the Regional Office. CD will not pay any medical expense for children not in agency custody unless specific exceptions are noted in the Child Welfare Manual:

• All necessary medical care, as determined by the county office, will be allowed. Staff must ensure that the Department of Health and Senior Services (DHSS) and the MO HealthNet Division (MHD) resources are explored, as well as any other resources before utilizing HDN funds. Staff should instruct foster parents to request physicians to use MHD approved prescriptive medicine substitutes when possible. No payment will be made for vendor charges which exceed program maximums.
• Any non-subsidy dental (including orthodontia) expense over $500.00 must be sent through supervisory channels with Regional Office approval to CD Central Office. The Program Development Specialist (PDS) responsible for receiving dental requests will review the packet of required information, and if all required documentation has been submitted, will forward the packet to MHD. If the required documents are not enclosed, the packet will be returned to the Regional Office.
• The following information is required for prior authorization and should be included in the packet sent to Central Office.

• • A written statement secured from the orthodontist who provides the following information:
    • A diagnosis and prognosis which includes an itemized listing with the procedural codes and an estimate of the number of months treatment will be required;
    • Orthodontic records which consist of a cephalometric x-ray, panoramic x-ray, or full-mouth survey, in addition to, dental study models, properly occluded and trimmed;
    • The amount of cost for the total treatment program; and
    • A statement from a medical doctor which indicates the treatment is medically necessary for other than cosmetic purposes.
    • NOTE: Orthodontic treatment will be covered when determined medically necessary by the State Orthodontic Consultant.

• The State Orthodontic Consultant will either approve or deny the request and return the packet to the PDS. The PDS will return the information to the Regional Office for approval or disapproval. After the county has received approval from the Regional Office, a letter of agreement, which addresses the following, should be submitted to the orthodontist:

• • The Children’s Division will be responsible for payment only when the Division has care and custody of the child and the child remains in an out-of-home setting. The Division will not pay for any treatment received under this agreement after custody is removed from the Division;
  • The Division does not pay for any services in advance;
  • A lump sum payment will be made to cover the cost of initial diagnosis, consultation, initial banding and treatment; and
  • Any charges covered by Managed Care (SMHK) or MO HealthNet shall be billed to MO Managed Care (SMHK) or MO HealthNet.

• The orthodontist should bill the county office after the initial banding is completed. This usually includes all material and services from the initial diagnostic visit through the placement of bands.  The amount shall be invoiced on a payment request through FACES.

• • Children’s orthopedic shoes and the abduction rotation bar will be paid for as a special expense if it is documented that the service cannot be paid for with MHD funds:

NOTE:  Both items are covered under the Durable Medical Equipment Program if the following conditions are met.

• The recipient is eligible for Missouri Medical/Dental Services
  • The provider is a participant in the program; and
  • The orthopedic shoes are attached with a brace.

Transportation Costs

Resource providers and youth in an Independent Living Arrangement (ILA) or a Transitional Living Advocate (TLA) placement may receive mileage reimbursement for transportation costs as outlined in this section. The resource provider or older youth must complete the Travel Expense Log, CD-106, and submit it to the local CD staff for approval within thirty days (30) of the month that the trip occurred. Transportation costs will be paid at the current state mileage rate as of the date of the trip. A copy of the approved CD-106 shall be provided to the resource provider prior to sending the documents to the FACES Payment Unit. TFC Agency Providers submit the mileage on behalf of their TFC parents and receive the reimbursements, then are responsible for reimbursing the TFC parents. 

Round Trip:  Most transportation reimbursement is based on a round trip. A round trip is leaving from point “A”, traveling to point “B” and returning to point “A” again.

Some round trips may not include the foster child being in the vehicle on the return trip, as the youth is being dropped off to be picked up at a later time. The trip to pick the youth up and return to starting point will be considered a second round trip.

For example:  A resource parent leaves from foster home to take youth to work. The youth is dropped off at the workplace and the resource parent returns home. That is one round trip. The parent later leaves from the foster home to pick up the youth from work and returns back to the foster home. This is a second round trip.

Note: Older youth in an ILA or TLA would not be reimbursed for trips in which they are not in the vehicle.

Child Specific Transportation Costs

Allowable child specific transportation costs for Alternative Care (AC) cooperative agreements, Professional Parent (PP) cooperative agreements, Respite (RS) cooperative agreements, youth in Independent Living Arrangements (ILA), youth in Transitional Living Advocate (TLA) placements, and those who are behavioral and/or medical providers to transport the foster youth include transportation to and from:

• Medical care, TRMD
• Counseling, TRMD
• Family Visits, TRAN
• Family visits, TRAN
• Court and meetings with attorneys to prepare for court activities, TRAN
• Meetings with Guardian Ad Litem, TRAN
• FST and PPR meetings, TRAN
• Respite, TRAN

Allowable child specific transportation also includes trips that are child specific to support the foster youth’s development as approved by the Family Support Team and/or case manager and supervisor.  Identification of the purpose of the trip is entered in field 12 on the CD-106.  When Other Allowable is selected in field 12, an explanation must be entered.   Reimbursement for these transportation needs shall be at a per mile rate for each mile round trip.  This applies to youth in ILA and youth in TLA placements and that are not Level B, which include providers with AC cooperative agreements, PP cooperative agreements, RS cooperative agreements or who are behavioral and/or medical providers.  The payment will be reimbursed on a PR through FACES.  The type of the supporting documentation for other allowable transportation reimbursement is identified by the worker in field 12 on the CD-106.  The location of the supporting documentation is entered in the comments section of the PR.  The name and DCN of the foster youth should be included on the supporting documentation.

Areas that support the child’s development are:

• Life skills development
• Social skills development.

Acceptable child specific transportation also includes education related transportation needs to maintain the foster youth in the school enrolled in to ensure educational stability. The FST members should work with the school to discover and arrange transportation options. All resource parents may receive reimbursement at the current state mileage rate for each mile traveled to and from the child’s school of origin for the day. Level B resource parents also may be fully reimbursed for transporting the child to his/her school of origin, disregarding the mandatory 200-mile deduction. Resource parents, however, are not paid mileage for their commute to or from their place of employment. When transporting youth to or from their school of origin involves a shared route with the resource parent’s commute to work, only the additional mileage incurred transporting the child to the school of origin may be claimed and reimbursed. Full mileage will be reimbursed if the resource parent did not report to work the day being claimed. TRED does not include transportation to school functions. 

Transportation costs for any level of care for child care services is not an allowable cost, even if such services are part of the child’s case plan.

When there is more than one youth being transported for a trip, the trip mileage must be divided between each of the youth who were on the trip.  This is a Federal, IV-E requirement. Refer to CD-106 Instructions and FAQs for examples.

Youth with Elevated Needs-Level B and TFC Reimbursement

In compliance with the Level B Cooperative Agreement, CM-8, the Level B resource provider shall provide ordinary travel which is reasonable and customary including counseling, medical, dental, daily activities and family visits.

• Trips that are over a 200-mile round trip may be reimbursed at a per mile rate for each mile over a 200-mile round trip with Circuit Manager or Circuit Manager Designee in the metro areas approval using the Travel Expense Log for Level B Foster Youth,CD107.
• For cases that require frequent approval, the determination can be made at a Family Support Team meeting that a standing approval is granted for that frequent child specific trip.  The written approval from the Circuit Manager or in the metro areas the Circuit Manager Designee is identified by their signature on the CD-107.  The PR with the CD-107 attached is submitted to the FACES Payment Unit to process for reimbursement.
• A copy of the original approved CD-107 should be attached to the subsequent CD-107 forms for the approved reoccurring trip.

For Example:  A 225-mile round trip would receive reimbursement that is the current state mileage rate x 25 with Circuit Manager Circuit Manager Designee in the metro areas approval.

NOTE: The first 200 miles of any Level B or TFC child specific trip will not be reimbursed.

Non Child Specific Costs:

Non child specific costs are entered in SAM II to generate payment.

• Transportation reimbursement will be paid to resource providers for trips to attend pre-service, after the license is approved and granted, and in-service training.  Transportation costs will be paid at the current state mileage rate as of the date of the trip using the Monthly Expense Report MO 300-1189.
• Transportation reimbursement will be paid to resource providers to attend Regional Foster Parent Advisory Board Meetings.  Transportation costs will be paid at the current state mileage rate as of the date of the trip using the Monthly Expense Report MO 300-1189.
• Transportation reimbursement will be paid to resource providers to attend Missouri State Foster Care and Adoption Board Meetings. Transportation costs will be paid at the current state mileage rate as of the date of the trip using the Monthly Expense Report MO 300-1189.
• Transportation reimbursement will be paid to resource providers to attend other meetings at the request of the Children’s Division. Transportation costs will be paid at the current state mileage rate as of the date of the trip using the Monthly Expense Report MO 300-1189.

Residential Provider Reimbursement

Residential treatment providers may receive mileage reimbursement for transportation costs as outlined in this section. The residential treatment provider will complete the Travel Expense Log, CD-107, and submit it to the local Residential Care Screening Team (RCST) Coordinator for approval within thirty (30) days of the month in which the trip occurred.

Child Specific Travel:

Allowable child specific transportation costs for residential treatment providers include:

• Medical Care
• Visits with caretaker(s), guardian(s), or less restrictive placement providers
• Court
• Family Support Team (FST) and Permanency Planning Review Team (PPRT) meetings

The residential treatment provider may be reimbursed at the standard state rate for child specific transportation over 200 miles round trip with RCST approval. The first 200 miles round trip are not reimbursable per contract and under this policy. Travel reimbursement begins on mile 201 when the single roundtrip child specific transport exceeds 200 miles. For cases that require frequent approval, the determination can be made at a Family Support Team (FST) meeting and a standing approval may be granted for that frequent child specific round trip. The approval in written form from the RCST Coordinator will be attached to the Travel Expense Log, CD-107.

Trips made with multiple foster youth in the vehicle will be reimbursed as a single trip. For example, if a 300 mile trip is made with three eligible foster youth in the same vehicle, the provider will be reimbursed 100 miles. The reimbursement should be divided among all three eligible youth in the vehicle. The provider would identify youth one as traveling 34 miles, youth two as traveling 33 miles, and youth three as traveling 33 miles.

NOTE: All transportation expenses should support the child’s specific treatment plan and have written authorization from the RCST Coordinator

Transporting a Child in Alternative Care via Airplane, Bus or Train:

A round trip is defined as leaving from point “A,” traveling to point “B” and returning to point “A.” Some round trips may not include the foster youth in the vehicle on a return trip, as when a youth is being dropped off and picked up at a later time.

Additional allowable child specific transportation trips that are intended to support the case plan may be made on a case by case situation and as approved by the FST, the RCST, and their supervisor.

All requests for tickets to transport a child in alternative care via airplane, train, or bus, must go through the Payment and Travel Unit in Central Office.  The ‘Airline or Bus Ticket Request’ form, located at Division of Finance and Administration, DFAS, should be completed and faxed to 573-751-6934.

• DCNs, full names and preferred travel dates and times must be listed on the form. All names should be as it appears on his/her photo identification (i.e. driver’s license).

Travel requests for family visits, hearings and other non-emergency situations need to be sent at least ten business days in advance, or as soon as the travel needs are known. All one-way out-of-state ticket requests for children in CD custody must be approved by the ICPC Unit at Central Office.

Emergency travel for disrupted placements also requires a ticket request form to be completed. In addition, the contact names on the form should be available to discuss travel options. Most emergency travel can be completed within an hour if local staff are available to answer questions and approve flight times.

If a caseworker is escorting the child/children, an Out of State Travel Authorization Form, located at DFAS must be completed, signed by a supervisor or Office Manager, and faxed along with the Airline/Bus Ticket Request Form.

Medical Expenses for Infants Released for Adoption at Birth

Costs will be paid if the following conditions are met:

NOTE:  Biological parents are expected, when at all possible, to meet the mother and the newborn’s hospital and medical care costs even though the child is relinquished for adoption.

• The child must be in Children’s Division (CD) custody.
• The natural parents and other resources should be contacted first to assess the ability to meet the cost of care.
• Hospital expenses for time delays between date of birth and date of custody transfer to the Division may be covered.
• The maximum allowable cost is determined by MHD guide-lines for these costs.
• All claims must be sent to the CD Deputy Director, through supervisory channels, for evaluation of cost appropriateness, and payment, if approved.

Child Care Costs for Children in Foster Family Care

• This is an allowable cost if it is deemed as a necessary part of the case plan or the foster parent needs child care due to employment, schooling, or training.
• Costs are to be paid through the use of Protective Service child care funds. Special education costs should be met by the local school district except for tutorial plans which are intended to support a child’s special education plan. Schools should be helped, as needed, to seek the assistance of the Department of Elementary and Secondary Education (DESE) in meeting the cost of a child’s special education needs.

Legal Fees

Agency payment for court costs relating to Termination of Parental Rights (TPR) hearings and adoption proceedings, including attorney fees for the birth parent, according to Administrative Rule, 13 CSR 40-30.020 Attorney Fees in Termination of Parental Rights Cases, allows the following fees:

• Any attorney shall, at the conclusion of representation be compensated at a rate not exceeding one hundred dollars ($100) per hour. Attorneys may be reimbursed, at the conclusion of the representation for expenses reasonably incurred, including the costs of transcripts authorized by court.
• The compensation to be paid for representation at trial shall not exceed one thousand dollars ($1,000) for uncontested matters and seven thousand dollars ($7,000) for contested matters.
• For representation in an appellate court, the compensation shall not exceed three thousand five hundred dollars ($3,500) at one hundred dollars ($100) per hour.
• At any time an attorney believes that the cost of representation will surpass the limits provided, they must provide notice to the Children’s Division that they may exceed the current maximum fee and this amount must be approved by the court.

Approval for payment of these costs must be received from the Regional Director or Designee by submitting the request through supervisory channels. The court must enter an order for the payment of these fees by CD before CD will pay court costs in a TPR or adoption case. Legal expenses in excess of $100 per hour shall be referred through supervisory channels to the Regional Director or Designee, who will then make the decision whether to approve or disapprove or seek consultation from Division of Legal Services (DLS) regarding the expense.

Fees of the attorney for the Juvenile Officer (JO) in a TPR action, and fees of an expert witness subpoenaed by the Juvenile Officer are not an allowable agency expense.

GAL and attorney fees in an abuse/neglect proceeding are not an allowable agency expense.

Missouri Statute, 453.020 states, “the Guardian ad Litem (GAL) may be awarded a reasonable fee for such services to be set by the court. The court, in its discretion, may award such fees as a judgment to be paid by any party to the proceedings or from public funds. Such an award of GAL fees shall constitute a final judgment in favor of the GAL.”

Payment for legal costs for adoption subsidy cases must be approved by the Regional Director after submitting the request through supervisory channels using the CS-SA-2 ATT.

If excessive attorney fees are ordered by the court, the worker is to send the order immediately through normal supervisory channels to the Regional Director or Designee so that a timely decision to pay fees or appeal the order may be made. Upon the decision of the Regional Director or Designee, the worker is to immediately notify DLS if the decision made is to appeal the order as a motion to appeal the order must be filed by DLS within 30 days of the court’s ruling.

Exceptions

Exceptions to any of the above or allowances for any unusual costs for children in alternative care must be approved by the Regional Director and submitted to the CD Deputy Director, for processing.

12.8.4 Children’s Income Disbursement System (KIDS)

The intent of the Children’s Income Disbursement System (KIDS) is to centralize all of a child’s outside income, excluding child support, in order to increase agency efficiency and accountability in the receipt and disbursement of such funds. The KIDS account system is monitored by the FACES Payment Unit. This system provides the county office with all needed information regarding the status of a child’s KIDS account.

A child who is placed in Alternative Care and has an independent source of income (i.e., Social Security Income (SSI), Old Age Survivor Disability Income (OASDI), Veteran’s Affairs benefits (VA),and/or Railroad benefits, (excludes the child’s personal income, inheritance, or settlement income) etc.) will have these funds deposited into the KIDS account. These funds must be applied toward the care of the child prior to authorizing payment from State or Federal funds and are processed through the Children’s Services Income Disbursement system (KIDS). Only a child who has income benefits will have a KIDS account. Child support is placed in a separate fund and is used for the cost of the child’s care.

NOTE:  Inheritance and insurance settlements should not be deposited into the KIDS Account. The Children’s Service Worker should contact the child’s GAL to determine the appropriate type of account to set up for the child.

NOTE: A child who is still in CD custody and receiving support through OASDI must be made the payee when age eighteen (18) is reached, unless found incompetent by the Circuit Court.

NOTE: When a child becomes 16, a savings will accumulate from only SSI/OASDI income up to $999.00 in the KIDS Account to assist the child when released from CD custody.

NOTE: Any child receiving Job Training Partnership Act (JTPA) funds or similar grants including a grant for tuition and books, and weekly need-based payments, does not have to deposit the unearned income in the KIDS account.

How KIDS Accounts are Established

An account is automatically established upon entry of the first CS-KIDS-1 or when the Social Security Administration (SSA) deems CD as representative payee and sends a deposit to Division of Finance and Administrative Services (DFAS). If a paper check for SSI/OASDI income is received in the county office, it should be sent to DFAS at Post Office Box 1082, Jefferson City, Missouri 65102-1082 along with an email to the Cash Receipts Unit indicating a check has been sent. In the event a check is received in the county office for a youth 18 and older, the check is to be given to the youth.

The Social Security Specialist within DFAS completes all necessary forms to apply for benefits and to become representative payee. If granted by the Social Security Administration, then the CD Director shall be listed as the payee of benefits for children in the care and custody of CD. For example, the DFAS Social Security Specialist completes all necessary forms as required by SSI, OASDI, or VA and lists the CD Director as the designated payee. The Designee shall sign the application and add “for the Director of the Children’s Division.” However it is still the SSA’s determination to appoint the appropriate representative payee.

Maintaining and Utilizing the KIDS Account

• Payer(s) (SSI, OASDI, VA, etc.) shall be instructed to send the income directly to DFAS via electronic deposit. However, in the event the county office receives outside income for a child’s KIDS account, they must send the check along with CS-KIDS-1 to the DFAS Cash Receipts Unit.
• The system will automatically debit the KIDS account for maintenance payments and other expenses.

NOTE: The FACES Payment Unit processes fund recoupments on active KIDS accounts for children who exceed or are close to exceeding their resource limit for SSI so they remain eligible for these programs. The fund recoupment process takes money from the child’s account and refunds it to the state for services paid from CD program funds. Fund recoupments are processed for payments made from Alternative Care (AC), Residential Treatment (RT), and Children’s Treatment (CT).

• In order for the child to continue to receive SSI, the Social Security Administration requires that the account balance remains below $2,000.00. It will be necessary to identify needs the child may have that the excess balance may be used for. In consultation with the supervisor, the child’s placement provider, and Family Support Team, it is necessary to decide what needs the child may have that are not otherwise being met.
• Children’s Service Worker’s may request payment for additional expenses not covered by maintenance payments, following policy in the Child Welfare Manual. Back state debt always takes priority over additional expenditures for the child. The Children’s Service Worker should always contact the FACES Payment Unit prior to requesting additional expenditures. If KIDS funds are available, they can be used.
• If the child has a source of income, but for any reason the income is not received during a given month, and there are insufficient funds in the KIDS account, payment for that month will be made from Alternative Care funds by the type of funding source for which the child is eligible (HDN or IV-E). When the income for that month is actually received, it will be deposited in the child’s KIDS account and used to pay maintenance/special expenses for subsequent months. When a child leaves Alternative Care, these funds may be used to pay expenses which should have been paid from the KIDS account, but were paid by CD.
• A statement is available of all transactions involving the funds which have been deposited on the child’s behalf, to include each receipt and disbursement, and may be printed from the KIDS/Dedicated KIDS Account screens to show the most recent 12 months of KIDS Account activity.
• A copy of the CS-KIDS-1 shall be maintained in the business record and a copy of the CS-KIDS-2 shall be maintained in the child’s electronic record in FACES on the KIDS/Dedicated KIDS Account screen.

Rules for Accessing KIDS Account Funds

KIDS Account funds must first be used for the beneficiary’s current maintenance. Maintenance costs include “costs incurred in obtaining food, shelter, clothing, medical care, and personal comfort items”. In addition to maintenance costs, it is important to note that any money accessed from a child’s KIDS Account may only be used for approvable items that will follow that child after the closure of his/her foster care episode. Approvable items are specifically for the recipient and in the recipient’s best interests. Examples of allowable expenditures include:

• school supplies
• medical treatment and education or job skills training;
• if related to a child’s disability, personal needs assistance;
• special equipment;
• therapy or rehabilitation;
• extracurricular activities/items (sport camps, class rings, gymnastics and karate classes);
• funeral expenses;
• pre-paid burial plan,
• other items that support the child’s needs ie: additional clothing, a computer or other electronics, furniture and other household items such as bedding, and tutorial services for a child needing help with school.

NOTE: All purchases must be made, invoiced, and paid prior to adoption, guardianship, returning home, or going on a trial home visit.

Approved items purchase by the placement provider will be reimbursed by submitting a KIDS-2 form along with the proof of purchase. If the vendor is to be paid directly, please submit the KIDS-2 form and an invoice from the vendor.

Rules for Dedicated Account Funds

Money should be accessed for the benefit of the child and only for the following allowable expenses:

• Medical treatment and education or job skills training if related tothe child’s impairment(s),
• personal needs assistance,
• special equipment,
• funeral expenses,
• pre-paid burial plan,
• housing modification
• therapy or rehabilitation
• other items and services related to the child’s impairment(s) that the Social Security Administration determines to be appropriate.

KIDS Account Closure

When a child exits Alternative Care and the child’s case is closed in the Alternative Care screen in FACES, the FACES Payment Unit will determine expenses for five (5) years prior to the date the child left Alternative Care (see Section 516.120 RSMo). The FACES Payment Unit will process prior expenses from the KIDS account through fund recoupments for payments made from Alternative Care (AC); Residential Treatment (RT); and Children’s Treatment (CT).

When a child exits Alternative Care and the child’s case is closed in the Alternative Care Screen in FACES and the child is age 16 or over, the Children’s Service Worker shall check the KIDS/Dedicated KIDS Account screen in FACES or contact the FACES Payment Unit to determine the savings limit due to the youth (up to $999.00). If in excess of $999.00 back state debt shall be recouped or returned to the SSA. Once the amount due to the youth is determined, staff should complete a CS-KIDS-2 form for the person (payee) to whom money is to be released from the child’s KIDS account. This person may be the child’s parent, guardian, adoptive parent or him/herself, if an emancipated minor. It is vital that this occur timely in order for the child to receive funds to the most current address.

NOTE:  If a child age 16 or over has a savings and is being released from CD custody, their savings will not be used to reimburse the state for back state debt

NOTE:  If there is a KIDS account for which a payee cannot be located, after a months’ time, the money will either go to back state debt, be returned to SSA, or both.

SSI and OASDI: County Office staff shall advise a potential “representative payee” or emancipated minor to apply for SSI or OASDI at the local Social Security Office. Two forms are available in e-forms to assist with this:

• CD-271, Older Youth Change of Payee Request Form, for youth who are 18 and will be the payee of their benefits and
• CD-270, Change of Custodian Payee Request Form, for youth who are under age 18 and will not be the payee for benefits.

NOTE:  Any SSI checks deposited in a KIDS account after a child leaves alternative care must be returned to the Social Security Administration (SSA). The FACES Payment Unit will be responsible for returning these checks to the SSA.

Regional Social Security Specialists in Central Office are available if assistance is needed.

County office staff shall advise a potential payee or emancipated minor to apply with the appropriate VA office. It should be noted that VA benefits cease after a child’s adoption is finalized.

12.8.5 – Transitional Services Payments for Youth with Elevated Needs-Level B Resource Providers

Youth with Elevated Needs-Level B resource providers are eligible for reimbursement for transitional services payments of $21.00 a day per child under the specific set of conditions described in the Cooperative Agreement for the Purchase of Elevated Needs Level B Foster Care Services, CM-8.

This contract states the Division agrees to pay the Elevated Needs Level B resource provider at the current apportioned rate for assisting children approved for Individualized Care make the transition to and from their home. Transitional services include, but are not limited to, attending staffing, pre-placement visits, and filing reports. Such payment shall be made for a maximum of ninety (90) consecutive days when the Level B resource provider is not at licensed capacity for children who qualify for Level B care. Payment for transitional services will cease when the Level B resource provider is at licensed capacity for children approved for Individualized Care or is no longer willing to care for additional children approved for Individualized Care, “Level B care”.

To qualify for the transitional payment described above, the Level B resource provider shall:

1. Actively work with the Selection/Screening Team to identify potential children who would be good matches for their home; and
2. Accept children the team agrees are appropriate matches and who fit general profile for the family; and
3. Utilize the FST or Selection/Screening Team to create the specific transitional plan for the child; and
4. Participate in regular staffing with the FST or Selection/Screening Team to assess progress of the transitional plan and to determine if the proposed placement remains a good plan.

Transitional services payments will only be paid for one child at a time at any given time.

Transitional services payments occur over the 90-day transition period only when the Level B resource providers are willing to accept children who fit the profile and are considered by the team as appropriate for placement.

Transitional services payments are child specific. Therefore, the DCN of the Elevated Needs Level B foster youth to whom the transitional services are being provided must be used to generate the payment.

If the provider refuses to accept three (3) consecutive Elevated Needs Level B placements, then the transitional services payments will stop.

Any concerns regarding a Level B resource provider utilizing the transitional services payments should be referred to the appropriate Regional Director or Designee.

12.8.6 – Insurance Claims for Children in Children’s Division (CD) Custody

When insurance companies offer to settle claims for children in CD custody, usually as the result of an accident of some type (automobile, etc.) our agency has no authority to waive the minor child’s rights in a legal cause of action. CD also has no right to settle any potential claim they may have due to the Division’s fiduciary conflict. The juvenile court should be the one to make the final decision on who has authority to settle for the child, possibly by appointing a next friend or setting up a conservatorship. The fiduciary conflict referred to above also involves cases where there may be a Medicaid recovery or KIDS account issues.

If there is such a claim to be settled or offer being made by the insurance company, the following procedure shall be implemented:

• Request the insurance company submit a formal written offer to the local Division of Legal Services (DLS) office.
• The local DLS office should then forward the offer to the juvenile court asking for direction on how to proceed, and forward the offer to the MO HealthNet Division, Third Party Liability Unit.
• The juvenile judge should then issue an order as to how to proceed.

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