12 Colo. Code Regs. § 2509-5-7.417

Current through Register Vol. 47, No. 22, November 25, 2024

Section 12 CCR 2509-5-7.417 - REIMBURSEMENT REQUIREMENTS

7.417.1COUNTY FOSTER CARE HOME PROVIDER REQUIREMENTS [Rev. eff. 1/1/16]

County providers include foster care homes, receiving homes, and kinship foster care homes. County providers are reimbursed by the county department of human or social services according to the procedures in this manual.

A. Facilities must be certified in order for the county department to be reimbursed by the state.

B. The pay period for foster care is the calendar month. The foster facilities are reimbursed for the day in which the child is placed in the home, but are not reimbursed for the day the child leaves it, unless the child was placed and removed on the same day.

C. All certified facilities shall sign and use the relevant provider contract when they are certified and recertified.

D. When a child is placed, the information shall be entered on the child placement log by the county department and the provider, and copies of the updated log shall be maintained in the provider file and by the provider in the facility.

E. County departments shall evaluate receiving homes. Homes shall be evaluated after the first six months of operation and annually thereafter.

1. An evaluation shall include, but not be limited to, the following information:

a. Date of evaluation;

b. Name of home;

c. County department identification number;

d. Licensed capacity;

e. Average number of children in residence for the last six (6) months;

f. Personnel, including the number of full time staff;

g. Direct care services.

2. The evaluator shall review an operating statement and financial records to determine if the home is maintaining records and files of revenue and expenditures. The operating statement shall be used to justify payments.

3. Any incorrect payments to the home due to omission, error, fraud, or embezzlement shall be recovered from the home by deduction from subsequent payments.

4. The evaluator shall discuss and review the evaluation with the home staff and obtain the signature of the operators.

5. A home having an unsatisfactory evaluation will require re-evaluation for continuing use. If it is determined that the use of the home should be continued, the supervising agency will contract for improved performance. If after sixty (60) calendar days the unsatisfactory components have continued, the supervising agency shall terminate use of the home.

6. If the staff of the home does not agree with the evaluation, an attempt shall be made to resolve the dispute within fifteen (15) working days by informal county grievance procedures, as determined by each county.

7.417.2STATE LICENSED PROVIDER REQUIREMENTS

The State licenses providers including Child Placement Agencies and Residential Child Care Facilities. State licensed providers are reimbursed by the county department according to procedures in this manual.

A. In addition to the minimum standards required by licensing, Residential Child Care Facilities and Child Placement Agencies must be included on state department established approved vendor lists in order for the county department to receive state reimbursement for purchased residential care and treatment services from such providers. These lists contain the names of providers who have requested approval and have been approved by the state department to enter into purchase agreements for care and treatment of children placed in a Residential Child Care Facility or Child Placement Agency by a county department.

B. Providers may request to be added to the approved vendor lists by following the review process as published by the Child Welfare Division. In the event that a provider adds a new population to be served or a new program to the current menu of service, the provider may request to have the new program added to the provider list by following the review process.

C. If the facility provides its own educational program, that program must be approved by the Colorado Department of Education and documentation of such approval must be provided.

D. The pay period for foster care is the calendar month. See Section 7.417.1, B.

E. Each provider shall allow representatives of the state or federal agencies who have an interest in monitoring and evaluating a program to have access to such records and information as may be necessary to achieve those purposes authorized by state or federal law.

F. The reimbursement rate agreed upon by provider and the county department shall be neither retroactively increased to reflect unforeseen service costs nor retroactively decreased.

G. The reimbursement rate for child maintenance agreed upon between the CPA and the county department shall be paid to the CPA foster parents for the care of the child.

7.417.3EMERGENCY SHELTER REIMBURSEMENT REQUIREMENTS [Rev. eff. 4/1/12]

Reimbursement restrictions exist for facilities such as foster home, receiving homes and shelter facilities used as emergency shelter.

A. Reimbursement for care is limited to ninety (90) consecutive days.

B. For stays in care beyond sixty (60) calendar days, the county department shall document in the child's record information which:

1. Indicates the county department has a specific plan for the child's living arrangements;

2. Specifies the reasons for the extension from 60 to a maximum of 90 calendar days; and,

3. Verifies that the extension will prevent additional temporary foster care placements until the plan can be implemented.

7.417.4KINSHIP FOSTER CARE HOME PROVIDER REIMBURSEMENT REQUIREMENTS [Rev. eff. 1/1/16]

A. Kinship foster care providers for Title IV-E eligible children shall receive the same reimbursement as non-relative foster care providers.

B. Kinship foster care providers may elect not to receive a money payment and may follow the grievance process for foster care providers when there is disagreement about such reimbursement rate.

C. A child in the care of his/her parents is not considered to be living in a foster home and, therefore, is ineligible for foster care maintenance payments, including kinship care payments.

D. Title IV-E reimbursable foster care payments may only be made to kin who are defined as an adult who is not a parent, but who is in one of the following groups:

1. Any blood relative, including those of half- blood, and including first cousins, nephews or nieces, and persons of preceding generations as denoted by prefixes of grand, great, or great- great.

2. Stepfather, stepmother, stepbrother, and stepsister.

3. Persons who legally adopt a child or his/her parent, as well as the natural and other legally adopted children of such persons, and other relatives of the adoptive parents in accordance with state law.

4. Spouses of any persons named in the above groups even after the marriage is terminated by death or divorce.

7.417.6MONTHLY PROVIDER BILLING [Eff. 5/1/12]

A certification shall be prepared and signed by the provider monthly and used by the county business office to verify the days the children are in the facility. This shall be done using the Colorado Department of Human Services prescribed form. These forms are due in the county departments of social/human services by the end of the month in which care was given. These forms shall be kept on file and available for audit.

12 CCR 2509-5-7.417

38 CR 23, December 10, 2015, effective 1/1/2016

40 CR 17, September 10, 2017, effective 10/1/2017

40 CR 21, November 10, 2017, effective 12/1/2017

41 CR 21, November 10, 2018, effective 12/1/2018

42 CR 17, September 10, 2019, effective 10/1/2019

42 CR 23, December 10, 2019, effective 1/1/2020

43 CR 21, November 10, 2020, effective 12/1/2020

44 CR 21, November 10, 2021, effective 11/1/2021

44 CR 23, December 10, 2021, effective 12/30/2021

46 CR 09, May 10, 2023, effective 6/1/2023