Ohio Administrative Code
Title 5101:2 - Division of Social Services
Chapter 5101:2-47 - Title IV-E Foster Care Maintenance
Section 5101:2-47-18 - Title IV-E foster care maintenance (FCM) program reimbursability: Reimbursements related to the difficulty of care needs of a child placed in a foster home, relative home, or pre-finalized adoptive home
Current through all regulations passed and filed through December 11, 2023
(A) A child with special, exceptional, or intensive needs, as defined in this rule, receiving FCM reimbursements may be eligible for a supplemental difficulty of care reimbursement. This reimbursement shall be available for a child who has been determined by the Title IV-E agency to have special, exceptional or intensive needs that require special parenting attention and care.
(B) Child characteristics describing the child's special, exceptional or intensive placement services shall be entered into the statewide automated child welfare information system (SACWIS) within thirty days of the Title IV-E agency receiving custody.
(C) Difficulty of care reimbursements shall be updated annually by the issuance of a "Family, Children and Adult Services Procedure Letter" and may be offered at one of the following three levels of intensity depending upon the needs of the child and qualifications of the substitute caregiver:
(D) A child is eligible for special needs difficulty of care reimbursements when a child is placed in a foster home or, on or after April 1, 2005, in a treatment foster home, as defined in rule 5101:2-1-01 of the Administrative Code, and who presents:
(E) The Title IV-E agency shall provide special needs difficulty of care reimbursements only to a foster caregiver or, for eligible children placed on or after April 1, 2005, to a treatment foster caregiver certified pursuant to Chapters 5101:2-5 and 5101:2-7 of the Administrative Code. The care and supervision that shall be given by the substitute caregiver of a special needs child shall include, at a minimum:
(F) A child is eligible for exceptional needs difficulty of care reimbursements when a child is placed in a treatment foster home, as defined in rule 5101:2-1-01 of the Administrative Code, if one of the following applies:
(G) The Title IV-E agency shall provide exceptional needs difficulty of care reimbursements only to a foster caregiver or, for eligible children placed in a treatment foster caregiver certified pursuant to Chapters 5101:2-5 and 5101:2-7 of the Administrative Code and who has successfully completed, or is currently participating in, a behavior management training course provided or recognized by the Title IV-E agency. The care and supervision that shall be provided by the caregiver of an exceptional needs child shall include, at a minimum:
(H) A child eligible for an intensive needs difficulty of care reimbursement is a child with intensive health care needs who is placed in a medically fragile foster home, as defined in rule 5101:2-1-01 of the Administrative Code, and who meets all of the following criteria:
(I) The Title IV-E agency shall only provide intensive needs difficulty of care reimbursements to a foster caregiver or, for eligible children placed in a medically fragile foster caregiver certified pursuant to Chapters 5101:2-5 and 5101:2-7 of the Administrative Code. A caregiver providing intensive needs services shall not have more than two intensive needs children who are not the caregiver's own children and a maximum of five children placed in his/her home at one time, including other foster children and his/her own children. The care and supervision that shall be provided by the caregiver of an intensive needs child shall include, at a minimum:
(J) When a substitute caregiver is receiving a special, exceptional or intensive needs difficulty of care payment on behalf of a child, the Title IV-E agency shall ensure the foster caregiver is certified to operate a treatment or medically fragile foster home, as applicable.
(K) Difficulty of care reimbursement may also be available for a special, exceptional or intensive needs child who is placed in an emergency foster home. "Emergency foster home" as used in this rule means a licensed, certified or approved foster home which has been designated by a Title IV-E agency as an emergency foster home to provide temporary care, not to exceed thirty days, for children requiring immediate out-of-home placement or immediate placement because of a placement disruption. The emergency foster home must be available to provide care to children at any time of the day or night, with little or no notice, and be able to meet immediate physical and emotional needs of children. The Title IV-E agency may also impose restrictions regarding the number of children served or additional training requirements before designating a foster home as an emergency foster home. An emergency foster home for special, or exceptional needs children shall be certified as a treatment foster home. An emergency foster home for intensive needs children shall be certified as a medically fragile foster home.
(L) The difficulty of care reimbursement for an emergency foster home shall not be affected by the age of the child. Difficulty of care reimbursements related to the special, exceptional or intensive needs of the child may be made in addition to the payment for an emergency foster home when the emergency foster home meets the provisions of paragraphs (D), (F), (H), and (J) of this rule.
(M) Reimbursement for emergency foster home placement is limited to thirty days for each placement. Reimbursement shall not be available as a retainer to a caregiver for maintaining a space for emergency placements.
(N) Difficulty of care reimbursements shall be reimbursed at the FCM program rate of federal financial participation. Authorization for difficulty of care payments shall be made pursuant to rule 5101:2-47-15 of the Administrative Code.
(O) For difficulty of care payments, the following documentation shall be maintained in the FCM case record to support such payments:
(P) The uniform statewide standards for FCM payment amounts for public foster homes, relative homes licensed as a foster home and pre-finalized adoptive homes that are established by the ODJFS shall set the maximum amounts for exceptional needs difficulty of care reimbursements and intensive needs difficulty of care reimbursements at the same amount.
(Q) ODJFS reimbursement amounts for a child placed in a foster home on the effective date of rules 5101:2-5-25, 5101:2-5-36, 5101:2-5-37, 5101:2-7-16 and 5101:2-7-17 of the Administrative Code shall not be changed solely as the result of the enactment of those rules or placement of the child into one of the new categories of foster homes created by those rules.
(R) A child with special, exceptional or intensive needs as described in this rule who is placed in a foster home prior to April 1, 2005 and on whose behalf a difficulty of care payment is made shall continue to be eligible to receive the difficulty of care payment as long as the child remains placed in the same family foster home.
Effective:
5/1/2019
Five Year Review (FYR) Dates:
1/31/2019 and
05/01/2024
Promulgated
Under: 119.03
Statutory
Authority: 5103.03,
5101.141
Rule
Amplifies: 5103.03,
5153.16,
5101.141
Prior
Effective Dates: 04/01/1986 (Emer.), 07/01/1986, 07/02/1987, 09/30/1987
(Emer.), 12/27/1987, 09/01/1988, 09/01/1989 (Emer.), 11/30/1989, 09/30/1990,
09/30/1991, 09/01/1993, 12/17/1994, 01/01/1996, 05/01/1998, 01/01/2003,
12/01/2003, 08/25/2008, 05/01/2014