Practices and Procedures Guide

4430. Courtesy Supervision

The DCFS Regional Administrator must establish procedures for the provision of Courtesy Supervision between offices and between regions, as well as Interstate Compact on the Placement of Children (ICPC), consistent with the provisions below and the remainder of this section.
1. The supervisor of the assigned social worker in the sending office must provide notice of the impending case transfer and request and receive an approved home study before the child actually moves to the new placement.
  1. If a court of competent jurisdiction has ordered placement within a timeframe that prevents receipt of acceptance or a home study prior to the placement, the sending office must notify the receiving office of the placement of the child within 30 days of the placement and request the home study.
  2. The sending office social worker must include a copy of the court order in the child’s file.
2. The receiving office supervisor must not decline to accept nor delay assignment of a case being transferred from another office if:
  1. The transfer is consistent with the child’s case plan;
  2. The transfer is in the best interests of the child; and
  3. The proposed or actual placement is licensed to provide care under the provisions of chapter 74.15 RCW or, if not required to be licensed, has an approved home study.
3. The sending and receiving office supervisors must document agreement by the receiving office of acceptance of Courtesy Supervision within 30 days of the request.
4. The receiving office supervisor must ensure that transferred cases, including ICPC, receive the same levels of support and supervision as other cases, as required by the Case Services Policy Manual and this manual.
For courtesy supervision, at a minimum, the receiving office’s service activity must include 30-day social worker visits (see Practice and Procedure Guide Chapter 4000 – section 4420) however, one visit within every 90 calendar days must be conducted in the home where the child resides.

These contacts are intended to ensure the health and safety of the child, to assess the child’s adjustment to placement, to assess services needed by the child or placement resource, to provide casework support, and to facilitate the child’s service plan on behalf of the sending social worker. The worker must document these activities in the case SER.
1. The sending social worker retains primary responsibility for the child and the plan. The social worker providing courtesy supervision does not make case decisions.
2. For the child in behavior rehabilitation services/ group care placement, the sending social worker and the worker providing courtesy supervision will mutually decide who will participate in the regularly scheduled treatment conferences with the provider. Normally, such activity remains the responsibility of the sending worker.

4431. Placement Out of Area - Family Foster Care or Relative Placement

Inter and Intra-County
1. Placement of a child in another DCFS office's service area may be necessary. However, before making a request to the court or placing the child on its own authority in the other service area, the placing DCFS office social worker or supervisor must notify the DCFS office serving the area of the proposed placement and obtain from that office a positive home study and/or assessment of the proposed placement.
2. The assigned receiving office social worker or the placing worker, with the agreement of the receiving office, must conduct the home study in accordance with chapter 5000, section 5231. Such placements may be necessary when:
  1. The child's family or alternate family has moved.
  2. A permanent or other relative placement has been located in another DCFS service area.
  3. There is a specific need for specialized medical, emotional, and/or educational services/facilities not available near the child's family.
  4. The child needs placement outside his/her home community due to the child's behavior and/or the family's situation.
  5. There are no suitable homes available for a child in the original DCFS service area.
Originating Office Duties
1. The social worker, through the worker's supervisor, requests a foster placement/relative home study from the appropriate supervisor in the receiving DCFS office. The worker or supervisor may make the initial request by telephone to the supervisor in the receiving office, but the social worker sends a written request and the most recent ISSP and court order, on the child within five working days of the initial request.
2. If the social worker makes a placement following location of a suitable foster home or a positive relative home study, the originating office retains responsibility for case planning, including approval of medical treatment, medication notifications, and confirming acceptance of the child into special education in the new school district if an eligible handicapped child, and maintains the case file and CAMIS data.
3. Legal jurisdiction remains with the originating area's court, if either parent continues to reside in the original area unless the parent with whom the social worker plans reunification resides in the receiving county.
4. If neither parent lives in the originating county, the original office may request that the court transfer jurisdiction three months after the parent has established residence of some permanence in the new county. The procedures are:
  1. Prior to requesting transfer of jurisdiction from the originating county, consult with the DCFS local office supervisor for the area in which the parent resides to request permission to transfer jurisdiction and case responsibility. The originating office supervisor does not request transfer of jurisdiction until permission has been obtained from the receiving office supervisor. If there is a disagreement between offices, it is resolved at the lowest possible level through the chain of command in the region(s).
  2. Consult with and advise the AAG/Prosecutor in the sending and receiving areas of the desire/plan to request jurisdiction transfer. An official request for the legal case to transfer shall not be made until the local office supervisor and the AAG in the receiving area have agreed to accept the case.
  3. When the court with original jurisdiction enters an order to transfer jurisdiction, the case must be transferred to the receiving office within five working days.
  4. The receiving office requests that the court schedule a hearing to determine if the receiving county will accept legal jurisdiction.
  5. If the receiving county's court refuses to accept jurisdiction, the case file is returned to the original office. The original office requests that the original court resume reviews and planning for the child.
Receiving Office Duties
1. Refers suitable licensed homes to the original DCFS office or notifies the original office that there are no suitable homes available.
2. Contacts the prospective family to complete a relative home study.
3. Completes the home study within 60 working days of receipt of the request for the study and then immediately notifies the referring DCFS office of findings. Exception: When fingerprint checks through the Federal Bureau of Investigation (FBI) are required prior to completion of the home study, the study shall be completed within 10 days of receipt of satisfactory criminal history reports from the FBI.
4. Helps coordinate actual placement with the originating office and prospective home, if requested.
5. Provides courtesy supervision of the placement, including monitoring health and safety, and provides written reports once every six months of the child's progress. The sending office needs to make a written request one month prior to a scheduled court hearing, if the office wants the report for court. Maintains a courtesy supervision file in CAMIS per current standards.
6. Immediately notifies the initiating DCFS office for additional planning if the placement fails.
Other Considerations
1. When a child in a DCFS foster family placement runs away and is found in the catchment area of another DCFS office, the social worker in the DCFS office where the child is found:
  1. Arranges for the appropriate office to notify or directly notifies, if possible, the child's parents of the child's whereabouts;
  2. Arranges shelter care for the child, if necessary;
  3. Contacts the assigned social worker in the original office to request payment to the temporary care provider for that care;
  4. Arranges for transportation to return the child to the catchment area of the originating DCFS office and requests that the assigned worker establish payment, using the appropriate SSPS code;
  5. Does not open a new case file or assign a new case number;
  6. Forwards documentation of service activity, provided to the child to the office in which the case is assigned for placement in the case file. Such documentation includes the assigned worker's identity and activities, recorded in CAMIS.
2. The originating office retains responsibility for planning and payment in behalf of the child.
3. When a child in a foster home placement moves with the foster family to another area, the original DCFS office coordinates with DLR and the receiving DCFS office for licensing, continuation of payment, and courtesy supervision of the child.
4. If the originating office and the receiving office are within the same region, the Regional Administrator may determine that the case will not be transferred from one office to the other.

4432. Placement Out of Area - Group Care

The Group Care Coordinator, in conjunction with the child's social worker, makes the decision to place a child in group care out of area. Factors to be considered in the decision include the treatment and support needs of the child and family, the permanency plan, and the availability of in-region resources to meet identified needs.
The originating Group Care Coordinator provides courtesy notification of the child's placement to the Group Care Coordinator and DLR Regional Manager in the region where the child will be temporarily residing.
When youth are placed in contiguous states in out-of-care facilities with which CA has a contract, the placing social worker shall contact the CA Interstate Compact on the Placement of Children (ICPC) program manager and provided needed information. The program manager will then complete required paperwork to complete ICPC notification to the receiving state.
Responsibilities of the receiving region include:
1. CA Intake screens and refers to appropriate resources any report of neglect or abuse involving the child;
2. Appropriate DLR staff will conduct any investigation of alleged abuse or neglect of the child or of alleged licensing violations involving the facility;
3. Regional DLR staff will conduct the comprehensive biennial facility review.

Case management includes providing an assessment for eligibility for services, assessing risk of abuse/neglect, family conflict or placement, developing permanency plans, advocating for families in brokering services, ensuring that families understand how to access services, monitoring the progress of services/permanency plans, and making recommendations to juvenile courts and other reviewing bodies about the case plan and completing administrative requirements.

45012. Eligibility

Each family opened for DCFS services shall have an assigned DCFS social worker.

45013. Procedures for Access

Social workers refer families for case management by following established CPS, FRS, and CWS intake procedures.
Social workers are assigned by a local office supervisor following intake.
1. The entry point for case assignment for CPS is a referral alleging abuse and/or neglect. See chapter 2000.
2. For FRS the entry point is a family's request for services to resolve family conflict. See chapter 3000.
3. The entry point for CWS is a family's request for such mnl_PnPg/hdrPnPgassessment services. See chapter 4000, sections 4100 and 4200.

45014. Other Sources

Case management services may be available through mental health, DDD, private child placing agencies, and schools in some communities.

4502. Intensive Family Preservation Services (IFPS), Family Preservation Services (FPS)

45021. Service Definition

IFPS, authorized and described in RCW 74.14C.040, and FPS, authorized and described in RCW 74.14C.050, are family-focused, behavior-oriented, in-home counseling, and support programs available in most counties. The services of both programs may be utilized when youth are, for IFPS, at imminent, or for FPS at substantial, risk of placement or for children returning to the home from out-of-home care. See section 45023, below, for procedures to access IFPS and FPS.

For IFPS, services begin within 24 hours of referral, are available 24 hours a day, are short-term, limited to a maximum of 40 days, unless paraprofessionals are used, in which case service is limited to a maximum of 90 days. The service can be up to 80 hours in a 30-40 day intervention or up to 100 hours in a 90 day intervention. Services include both clinical assistance (counseling, case management, parent education) and concrete help (financial, housing, utilities, clothing, food). IFPS services are provided by contracted vendors and are available statewide.
FPS begin within 48 hours of referral, are available 24 hours a day, and can be up to six months in duration. FPS is designed to be less intensive that IFPS, and interventions are focused on improving family functioning and assisting families with getting connected to local community resources. FPS are provided by contracted vendors and are available statewide.

45022. Eligibility

Families and children are eligible for IFPS and/or FPS when a child is in out-of-home placement and can be reunited within 30 days or the social worker has determined that, without intervention, the child, for IFPS, is at imminent risk of out-of-home placement or, for FPS, at substantial likelihood of being placed out-of-home due to at least one of the following:
1. Child abuse or neglect.
2. A serious threat of substantial harm to the child's health, safety, or welfare.
3. Family conflict.
The social worker need not refer otherwise eligible families and family preservation services need not be provided if at least one of the following conditions is met:
1. The services are not available in the community in which the family resides.
2. The services cannot be provided because the program is filled to capacity.
3. The family refuses services. or
4. The social worker or the service provider determines that the safety of a child, a family member, or persons providing the services would be unduly threatened.
IFPS/FPS may not be used for families in need of an in-home crisis resolution or therapeutic service to avoid possible family disruption or foster care placement at some unspecified time in the future and is not to be used as an interim measure until a planned placement resource is secured.
The family has a case open for service with CPS, FRS, or CWS. The child must be either residing in the family home or be able to go home immediately, within 30 days, with either IFPS or FPS.
The child, for IFPS, has been assessed by the assigned social worker as needing immediate placement or, for FPS, will need placement in the future if family dynamics do not change or is already in placement but could return home immediately with either IFPS or FPS.
For IFPS, immediate placement means that the social worker is planning to file a petition with the juvenile court to remove the child from the family home within 72 hours or is planning to obtain a voluntary placement authorization from the child's parents within 72 hours.
For FPS, substantial likelihood of placement means the assigned social worker has determined, through assessment, that there is a strong possibility that another injury or crisis will occur in the near future, resulting in the placement of the child, or the child is already in placement but could return home sooner with FPS.
The Regional Administrator may limit the provision of IFPS or FPS to families where children would be receiving paid DCFS placement services.
The social worker has determined that there are no less intensive services available that can meet the family need.
An immediate opening with the contracted IFPS and/or FPS agency is available.

45023. Procedures for Access

Referrals for IFPS or FPS must come through DCFS. Contractors shall not accept referrals directly from families or other sources.
The Regional Administrator or designee:
1. Appoints a Gatekeeper for each office served by an IFPS or FPS provider. The IFPS/FPS Gatekeeper:
  1. Participates in a review or reviews all IFPS/FPS referrals to ensure conformance with eligibility requirements and the best use of the resource.
  2. Makes final department determinations of family eligibility for IFPS/FPS prior to referral to and intake by the service provider, rejecting all families for whom placement is not imminent or substantially likely.
  3. Facilitates the departmental review of all families entering placement for possible eligibility and referral to IFPS.
2. Develops a written protocol with IFPS and FPS contractors governing the assessment of client eligibility, procedures for service referrals, approval of service extensions, and utilization of IFPS - Assessment and Aftercare Services.
3. Distributes copies of the written protocol to IFPS/FPS Gatekeepers, Area Managers, supervisors, and all case carrying DCFS social workers.
4. Works to ensure that IFPS and FPS eligibility determination and case referral practices in local offices are consistent with statutory and protocol requirements.
5. Reports to the Assistant Secretary quarterly on the provision of IFPS and FPS in the region.
6. Monitors payments against allotment and contract dollar limits.
7. Monitors performance of contractors against standards set by the statement of work.
8. Notifies contractors when there is a rate change and amend contracts as needed.
The DCFS social worker:
1. Identifies families who may be eligible for the service in accordance with regional procedures, including consultation with an internal or external team, a supervisor, or a designated IFPS/FPS Gatekeeper.
2. Following referral, orally or in writing, per contract and regional procedure, supplies the contractor with referral information, release of which is permitted under RCW 13.50.100(3), that is as complete as possible and includes:
  1. Name and case numbers of family caretaker(s).
  2. Names, birth dates, Social Security numbers, and case numbers (if different) for all children at imminent risk of placement;
3. File a written report with his/her supervisor stating the names of families referred and reasons for which the client was referred. The social worker's supervisor verifies in writing his/her belief that the family referred meets the eligibility criteria in section 45022(A), above. The supervisor reports monthly, through the Area Manager, to the Regional Administrator on the provision of these services. The Regional Administrator reports to the Assistant Secretary quarterly on the provision of these services for the entire region.
4. Immediately opens payment on the Social Service Authorization, DSHS 14-154(A), utilizing SSPS codes at the time of authorization and sends a copy of the service authorization to the provider. The service termination date will not be entered until receipt of the service termination summary from the contractor.
5. For FPS, receives a monthly statement from the provider and immediately processes the statement to generate a payment for services provided that month.
6. During the delivery of contracted service, regularly consults with the IFPS or FPS contractor regarding the progress of the family.
7. Immediately notifies the contractor if CPS referrals are received on the family.
8. Participates in exit interviews with the IFPS/FPS therapist.
9. Enters the service termination date on the Social Service Authorization upon receipt of the contractor's termination report, using the last date of client contact as the termination date. The authorization is immediately processed to generate a payment for services provided by the IFPS or FPS contractor.

45024. Other Sources

Components of DCFS funded IFPS/FPS exist in other service delivery systems in some communities, including the Regional Support Network (RSN) and DDD.

4503. Child Protective Services Child Care

45031. Program Description

The Child Protective Services (CPS) child care subsidy program provides short-term, time-limited subsidized child care for families that are currently involved in a CPS investigation by Children's Administration (CA). CPS child care subsidy must end when the case is no longer classified as a CPS or is transferred to another program.

45032. Eligibility

The CA social worker may authorize child care for a family with an open CPS case when the family is:
1. Under stress and in need of respite care; or
2. Working to complete a service plan.
To be eligible for CPS child care subsidy program the family must have:
1. An open CPS case; and
2. An income at or below 225% of Federal Poverty Level (FPL) adjusted for family size. See the CA Operations Manual, chapter 9000, section 91300.
The social worker may waive income eligibility and co-payment requirements on a case-by-case basis. See the Operations Manual, chapter 9000, section 91300, for information regarding income eligibility and co-payments.
When the CPS social worker places a child with a relative who is employed, the social worker may authorize Employed Foster Parent Child Care subsidies for the time the relative is at work.
When the family needs child care, the social worker determines if other resources are available to the family before authorizing CPS child care. For example, family members may be available to provide or pay for privately arranged child care. If the social worker determines there are no other resources available, CA may pay for care through the CPS Child Care Subsidy Program.

45033. Procedures for Access

The family's CPS social worker authorizes CPS child care through CAMIS and SSPS.
For more information regarding program requirements and eligibility standards, contact the CPS Child Care Program Manager at (360) 902-8046.

45034. Other Sources

The Division of Child Care Early Learning (DCCEL) maintains an information and referral service for parents who are seeking child care providers. Information on other sources of payment for child care is available through(DCCEL).
Head Start is a federally funded parent-participation pre-school program for low-income children.
The Early Childhood Education Assistance Program (ECEAP) is a state-funded pre-school program for low-income children.
Cooperative Pre-school and Crisis Nursery Services may be available in local communities to provide child care at low fee to parents.

4503. [A] Child Welfare Services Child Care

4503. [A1] Program Description

Child Welfare Services (CWS) child care subsidy program provides short-term, time-limited subsidized child care for families to avoid out-of-home placement or other state intervention.

4503. [A2] Eligibility

If the case was formerly a CPS case, the social worker must close CPS child care and open for CWS child care, using CWS child care eligibility requirements.
CA may authorize CWS child care for a family that:
1. Has been through a CPS investigation and continues to participate with voluntary services; or
2. Is in crisis and needs care to avoid out-of-home placement of the child or other state intervention.
To be eligible for CWS child care subsidy program, the family must have:
1. Documented need for the service; and
2. An income at or below 225% of Federal Poverty Level (FPL) adjusted for family size.
CWS authorizing workers must use co-payment and income eligibility guidelines. See the Operations Manual, chapter 9000, section 91300, for information regarding income eligibility and co-payments.
When the family needs child care, the social worker determines if other resources are available to the family before authorizing CWS child care. For example, family members may be available to provide or pay for privately arranged child care. If the social worker determines there are no other resources available, CA may pay for care through the CWS Child Care Subsidy Program.

4503. [A3] Procedures for Access

The family's CWS social worker authorizes CWS child care through CAMIS and SSPS.
For more information regarding program requirements and eligibility standards, contact the CPS Child Care Program Manager at (360) 902-8046.

4503. [A4] Other Sources

The Division of Child Care early Learning (DCCEL)maintains an information and referral service for parents who are seeking child care providers. Information on other sources of payment for child care is available through DCCEL.
Head Start is a federally funded parent-participation pre-school program for low-income children.
The Early Childhood Education Assistance Program (ECEAP) is a state-funded pre-school program for low-income children.
Cooperative Pre-school and Crisis Nursery Services may be available in local communities to provide child care at low fee to parents.

4504. Therapeutic Child Development

45041. Service Definition

Therapeutic Child Development (TCD) is child development and family service provided in a licensed child care setting to families of children at risk for maltreatment. Both children and parents receive treatment to reduce the risk of child maltreatment, strengthen the family, and enhance continuity and consistency in the child's environment. Contractors provide a daily day care program during which they monitor the child's welfare, complete regular assessments, and provide remediation activities. Services include home visits by TCD social workers, transportation to and from day care, and parenting education.
TCD provides four hours of service daily, in the child care setting, excluding transportation time.
TCD-enrolled children may require a full day of care due to the schedule of the parent or foster parent. The social worker may authorize payment for a ½ day of care to the same or other facility, in addition to the TCD payment, if it is appropriate for DCFS to be supporting a full day of care. The additional authorization would be at the standard half-day rate for that area. In no circumstances should the facility be expected to keep the child for a full day without additional reimbursement.

45042. Eligibility

TCD is available to children who are at risk of CA/N and their families who have open cases with CPS or CWS, including children in out-of-home placement. CA uses the program to support the ISSP or family service plan. Since this is a daily weekday program, the program is generally structured to serve children who have not yet entered school. The provider's contract with the department further defines the eligible population.
The child's CPS/CWS social worker determines eligibility. The social worker consults regional procedures to determine current availability of slots and other limitations.
The DCFS social worker and the TCD provider must negotiate the estimated length of enrollment at the time of enrollment, based on the ISSP, the family service plan, and/or available intake or assessment information, consistent with the contract.

45043. Procedures for Access

To use TCD, social workers must include TCD as part of the overall ISSP for the child, as appropriate.
When interviewing the family, the social worker inquires about the family's financial and family resources.
The child's social worker sees that the child's full legal name, birth date, and Social Security number are entered into CAMIS so that the information is available to the DCFS federal funding specialist.
The federal funding specialist verifies that the TCD providers have obtained the following information:
1. Client income. If the family is not receiving Medicaid benefits and their income is above $60,000, the TCD provider collects a one-time co-payment of $100.00 from the family and reports the collection to the social worker.
2. Medical necessity. Providers complete a statement of medical necessity during the initial physical assessment (EPSDT screening) and for each on-going physical examination, signed by a licensed practitioner of the healing arts. Providers forward this information to the CA federal funding specialist.
After receipt of the required information from the TCD provider, or after searching CAMIS to determine the child's enrollment in TCD, the federal funding specialist completes an Automated Client Eligibility System (ACES) search to determine Medicaid eligibility. The federal funding specialist makes a screen print of Medicaid eligibility.
The social worker completes an SSPS authorization for payment at the time he/she approves the service for the child, before the child's first day of attendance.
CAMIS will automatically generate the source of funds code "6," Categorically Needy-Title XIX eligible. If the child is not on Medicaid, the federal funding specialist must determine if the client is eligible for AFDC-FC. If the child is ineligible, the federal funding specialist updates the SSPS authorization with a source of funds code "5" and informs the social worker so that appropriate Medicaid application can be made.

45044. Social Worker Ongoing Responsibilities

The DCFS social worker must:

Receive and incorporate information from the service provider's quarterly reports into case planning.
Attend staffings regarding the child/ family as scheduled by the service provider.
Include provider staff, as appropriate, in department-initiated staffings regarding the child/family.

4505. Employed Foster Parent Child Care

45051. Program Description

The Employed Foster Parent Child Care Program pays for child care for the child in the out-of-home care setting to support the foster parent or non-needy relative caretaker's employment.

45052. Eligibility

The social worker for the child may authorize child care to the Children's Administration (CA) foster parent or relative caretaker for children placed by CA or a CA certified agency:
1. Without regard to the foster parent's or non-needy relative's income;
2. When the foster parent or non-needy relative needs child care to maintain the foster parent or relative caretaker's employment; and
The Employed Foster Parent Child Care program must not pay foster parents and non-needy relative caretakers for providing child care to their own foster children who live with them.
Children living with non-needy relatives not placed by CA or a CA certified agency do not qualify for Employed Foster Parent Child Care subsidies. The child may qualify for child care subsidies through the Working Connections Child Care Program (WCCC) offered through Economic Services Administration.

45053. Procedures for Access

The child's CA social worker authorizes the Employed Foster Parent Child Care program for foster parents and non-needy relative care takers.
For more information contact the Employed Foster Parent Child Care Program Manager at (360) 902-8046.

45054. Other Sources

See the Operations Manual, chapter 9000, section 91300, for additional information.

4509. Respite For Parents

Respite care offers time limited relief for substitute parenting or care giving of a child. For the purposes of this section, respite care is available for parents whose children are dependent and who are in the custody and control of CA.

Respite care to prevent out of home placement or re-entry into out of home care is:

Based on the child's special needs.
Available on an emergent basis to prevent placement disruption; or,
A planned event as part of the child's safety plan to remain in the home or the child's safety and transition plan during a trial return home.

The respite provider must have experience and/or training to deal with the particular special needs of the child in care.
Social worker responsibilities:

Explore other available resources to assist in providing respite including:

Family resources
Other DSHS divisions, for example, the Division of Developmental Disabilities (DDD)
The Regional Support Networks (RSN) for emergency respite care for mental health clients to prevent hospitalization. Multi-disciplinary "wrap-around" service planning groups may also occasionally authorize respite care in the context of a plan that prevents a child from entering out-of-home care.

Complete the criminal/background check process prior to approval of the services, if not previously completed,
Authorize payment for respite only when utilizing a licensed out-of-home provider or approved provider in home where the child resides.

4510. Respite for Licensed Foster Parents, Unlicensed Relative Caregivers and Other Suitable Persons

Respite services can play an important role in preventing placement disruption. These services are available for licensed foster parents, unlicensed relative caregivers and other suitable persons with placement of children in CA or Tribal custody. Caregivers should be encouraged to access respite care services in emergent situations and to prevent disruption of the child from their home.

45101. Service Definition

Respite care service pursuant to this section (4510) is the temporary, time limited relief for substitute parenting or caregiving of a child. Respite care can be arranged in advance or on an emergency basis.
Respite care services for licensed caregivers, are intended to meet the following needs:

To offer relief from parenting and caregiving responsibilities;
To allow the caregiver personal time away from home;
To provide substitute care in the absence of the caregiver;
To provide opportunities to attend overnight training.
To allow caregivers access to substitute caregiving to meet emergent situations for the caregiver;
To prevent placement disruption.

Respite care services for unlicensed relative caregivers or other suitable persons (See Practices and Procedures Guide Section 4261) are intended to meet the needs of children and families in emergency situations and when the placement is at risk of disruption.
Payment for respite services is not available to individuals who reside or live in the caregiver's residence. Respite services may be provided by a relative of the child or caregiver, only when the respite care provider resides outside the child's current placement.
Respite care that is provided outside the child's caregiver's home must be provided by individuals who are licensed foster parents or licensed child care providers.
Unlicensed respite providers can provide paid respite services only in the child's caregiver's home. Unlicensed respite providers must (1) successfully complete a CAMIS background clearance and Washington State Criminal check and (2) meet the standards identified in WAC 388-148-0040 and 388-148-0045. Background checks for unlicensed respite providers providing respite in licensed foster homes will be completed by Division of Licensed Resources (DLR) staff, or in the case of respite services for unlicensed relative caregivers, background checks will be completed by the assigned CA social worker.
The social worker or licensor will verify that the respite provider has experience and/or training to deal with the particular special needs of the child in care such as dealing with children who are medically fragile, children who have been sexually and/or physically aggressive or assaultive.
Licensed child care providers may be used to provide respite care services for respite that is less than 24-hour duration. Respite payment to licensed child care providers is paid at the regional child care rates using the appropriate SSPS respite payment code. SSPS child care codes in the 2800 series are not used to authorize respite payment.
Licensed providers for respite service must not exceed their licensed capacity and must meet Minimum Licensing Requirements (MLRs) while providing respite.
Licensed caregivers using paid respite services, may not provide respite to other children (paid or exchange), during the period of paid respite.
Child-specific respite care plans are an element of the child's case plan. As appropriate, the need for continued respite service is reviewed at service re-authorization and/or during multidisciplinary staffings.
Respite care payments remain the fiscal responsibility of the originating region and office during courtesy supervision activities.

45102. Respite Care Category Descriptions

Retention Respite provides licensed CA caregivers, licensed Tribal foster parents, and licensed Private Child-Placing Agency foster parents providing care for CA-placed children, with regular "time off" from the demands of caregiving responsibilities. Retention Respite guidelines are:

Retention respite is intended to provide regular, monthly breaks from the demands of foster parenting and can also be used to meet emergent needs of licensed caregivers.
Retention respite is awarded on a monthly basis per CA, Tribal, or Private Agency foster home caring for CA children.
Retention respite is earned by eligible licensed caregivers at a rate of two (2) days per month.
Retention respite is authorized in daily units only.
The licensed caregiver home may accumulate or 'bank' a maximum of fourteen (14) days of retention respite days to be used at one time. Licensed caregivers should be encouraged to use retention respite as it is earned.
Newly licensed caregivers will have a 30-day waiting period from the first eligible child placement before accruing retention respite.
A licensed caregiver must provide foster care to one or more children at least twenty (20) days in a month to earn retention respite for that month.
When a day of retention respite is authorized, respite is normally paid for each eligible foster child in the home, regardless of how long the child has been in placement in the home. However, a licensed caregiver can elect to use retention respite for only one child, even though more than one child is in the placement. Whether retention respite is used to meet the needs of one or more children, the time used will be deducted from accrued retention respite days.
Licensed caregivers and social workers should be aware of pending respite plans in the caregiver's home when a child is placed. Efforts should be made to avoid changes in caretakers for a child shortly after placement.
The respite provider must have experience and/or training to deal with the particular special needs of the child in care such as dealing with children who are medically fragile or children who have been sexually and/or physically aggressive or assaultive.
Regions will develop a process to authorize and monitor retention respite eligibility and utilization for CA foster homes.
Tribal and Private Agencies shall monitor retention respite eligibility and utilization for their licensed homes, and will coordinate with CA regional management to develop a process to access and report retention respite usage.

Child-Specific Respite (CSR) provides unlicensed relative caregivers, other suitable persons, licensed CA caregivers, licensed Tribal foster parents, and licensed Private Child-Placing Agency foster parents providing care for children placed by CA, with the opportunity for relief from the caregiving responsibilities that are linked to the medical, behavioral or special needs of an individual child. The CSR guidelines are:

CSR is authorized on a case-by-case basis consistent with the written service plan for the child.
CSR is authorized in half-day or daily increments. Half-day will be authorized for respite services 0 - 5 hours and daily respite will be authorized for respite services greater than 5 hours.
CSR is part of a child's unique service plan. The need for continued service is reviewed at service re-authorization and during multidisciplinary staffing.
CSR for more than 1 week must have Area Administrator approval.
CSR may be discontinued based on an updated assessment of the needs of the child.
In calculating CSR, the worker should consider the availability of relief from caregiving responsibilities provided through retention respite, school, other relatives, visitation schedules, etc.

Exchange Respite is the relief from parenting responsibilities, which is negotiated and arranged between licensed caregivers and does not include payment of CA funds. Exchange respite guidelines are:

Licensed caregivers must remain within their licensing requirements (i.e. capacity, age, gender, etc.).
Licensed caregivers must notify the child's social worker(s) of exchange respite services prior to the respite occurring.
The social worker will verify that there are no licensing complaints pending which would preclude the respite provider from caring for the child.
The social worker will inform the respite provider of any special needs of the child, supervision requirements and safety issues prior to initiating respite.

45103. Procedures for Access

Retention Respite is authorized through SSPS by the regional designee responsible for monitoring the accrual and utilization of retention respite for foster families.
The assigned social worker for each child in a licensed home shall be notified that retention respite is being authorized.
Child-Specific Respite (CSR) is authorized through SSPS by the assigned social worker for the child.
For unlicensed relative caregivers and other suitable persons, the assigned social worker shall explore other family support options prior to requesting respite services.

45104. Respite Care Payment

Child-Specific Respite (CSR) services, from 0 - 5 hours will be reimbursed at the half-day rate posted in the SSPS Manual.
CSR services more than 5 hours will be reimbursed at the daily rate posted in the SSPS Manual.
Retention respite is authorized in daily units only and reimbursed at the daily rate posted in the SSPS Manual.

45105. Respite Care Rates

Respite rates for licensed CA relative and foster homes, licensed Tribal foster homes, and licensed Private Child-Placing Agency foster homes providing care for CA-placed children are determined by the child's assessed foster care rate level and are listed in the SSPS manual. Exceptions to the maximum respite care rate may be authorized only with administrative approval.
Respite rates for unlicensed relative caregivers or other suitable persons would be authorized at the Basic Respite rate listed in the SSPS manual for children in level 1 or 2 foster care.
For unlicensed relative caregivers or other suitable persons, respite rates above the respite rate for a child in level 1 or 2 foster care requires the completion of an Exception request (DSHS form 05-210). The exception request should include an assessment of the supervision needs of the child, behavioral, medical, developmental and social needs of the child, and any special needs that would indicate a higher rate, The exception request will require supervisory and area administrator approval.
Respite for unlicensed relative caregivers or other suitable persons may be authorized for up to 7 days per month. Any respite beyond the 7 days will require area administrator approval.
Payment for respite provided by licensed child care facilities is paid at the Region's established child care rate, using SSPS 3220 or 3221 payment codes. SSPS chapter 2800 Child Care payment codes are not used to authorize respite payment.
Regional management may establish payment rates below the maximum rate listed in the SSPS Manual.

4511. Foster Parent Consultation

45111. Service Definition

Consultation is a contracted service to individual homes or to a group of homes directed toward skill building and networking. Typical activities include home visits to foster homes and telephone consultation, advice in a crisis or skill building information, individual and group consultation, assistance in obtaining resources, and participation in case staffing.

45112. Eligibility

DCFS licensed foster parents are eligible for the service upon authorization by the social worker. Such services are not an entitlement and may be discontinued at the discretion of the social worker.

45113. Procedures for Access

The social worker utilizes regional procedures for authorization of contracted consultation. Social workers may consult with Home Finders to determine the regional availability of this service. See chapter 5000, section 5182.

4512. Foster Parent (Licensed Family Foster Home) Training

45121. Required Training

Foster Parent (Licensed Family Foster Home) Training

Orientation
Pre-service Training
First Aid/CPR
HIV/BBP

All licensed family foster homes are required to complete 36 hours of ongoing training during each three year licensing period prior to renewal. This training requirement can be fulfilled through:

Resource Family Training Institute (RFTI) training courses;
Conferences and trainings related to child welfare and/or other human services relevant to the foster parent's scope of duties;
Other relevant training offered by the Office of Training and Development, Children's Administration;
Certification programs offered by Pierce or Seattle Central Community College;
CA on-line or video training courses offered on the Resource Family Institute's webpage;
CA approved private agency training courses;
Other training as approved by the licensor.

The 36 hour training requirement may be met by one or both parties on a license, in any combination. That is, one party on a two parent license may complete all 36 hours or two people on a two parent license may complete part of the 36 hours as long as a total of 36 hours is completed.
If the licensed family foster home reaches re-licensing without completing the training requirement of 36 hours in 3 years, the licensor will

create a compliance plan for not more than 6 months with the licensee(s) for completion of the requirement, and
if the compliance plan is not met, issue a stop placement until the training requirement is met.

Revocation may occur if the compliance plan is not met.

The "36 hours in 3 years" refers to the licensing period.
All mandatory training requirements will be entered into CAMIS. The RFTI training manager will enter training completion for RFTI inperson classes into CAMIS and the DLR licensor for the home will enter completion data for all other training.
Licensees will complete the yearly Self-Assessment for Licensed Caregivers (DSHS10-399) which includes the training completed in the past 12 months and asks what training would be helpful.
Specific and additional training may be required as part of a compliance plan.

45122. Access to Training

DCFS licensed family foster homes, private agency licensed family foster home, and relative caregivers are eligible to participate in department sponsored training.

45123. Procedures for Accessing Training

The licensed family foster home consults the licensor, private agency and/or regional training manager for class announcements and procedures to access to this service. The web site also maintains a training calendar available to all foster parents, relative caregivers and agency staff.

4513. Foster Parents - Ancillary Support Services

45131. Service Definition

Ancillary supports allow for the purchase of specific goods or services that contribute to effective quality care in foster care.
Ancillary supports can include, but are not limited to:
1. Purchased recreation activities for children in care.
2. Recreational and craft supplies.
3. Other equipment that enhances safe, quality care.

45132. Eligibility

Licensed foster parents are eligible upon authorization by the social worker. Such services are not an entitlement and may be discontinued at the discretion of the social worker, based upon availability of funds and/or an assessment of the needs of the child, the family, and the foster family.

45133. Procedures for Access

The social worker consults regional procedures to access ancillary support services for foster parents. Home Finders are a resource to provide information on regional availability of this service.

4514. Family Support Networks

45141. Service Definition

Each individual family's extended family, tribe, friends, and other lay or professional helpers who help resolve current issues of concern constitute a support network. Informal support networks reduce social isolation that may contribute to CA/N and may provide the resources to assist in reduction of family conflict. Supportive networks may be more helpful than professional services because they are generally a life-long part of the client's life.

45142. Eligibility

All DCFS clients are eligible for the service.

45143. Procedures for Access

The social worker uses "reasonable efforts" in locating and contacting extended family members, friends, and lay helpers for potential support and/or placement resources.
The social worker is encouraged to develop informal family support network alternatives to professionally provided services when possible.
The social worker provides the family support network consistent information and support, within the limits of laws on confidentiality.

45144. Other Sources

The RSN, DDD, and local schools may have projects in some communities to facilitate the development/maintenance of family support networks. The social worker is encouraged to explore those systems for help in coordinating a family support network.
Participation in an organization that has culturally-specific ties may reduce isolation for some individuals.
Families may have support available to them through their church. Churches support many social service and recreational programs.
Special interest support groups, including support groups for parents who have experienced a SIDS death or parents with developmentally disabled or medically fragile children, can be helpful and supportive to parents.
Recreational activities can be especially valuable to families needing support. Many non-profit recreational organizations provide scholarships or reduced tuition.

4515. Family Home Support Services

45151. Service Definition

Family Home Support Services (FHSS) provides supportive, culturally appropriate, in-home, skill-building services in partnership with DCFS client families. Services are provided as part of a comprehensive case plan to clients of DCFS. Services may be offered on weekends and beyond normal working hours. Overnight service may be provided in emergent cases where all other appropriate placement options have been determined to be inappropriate.
Services provided by Home Support Specialists (HSS) include:
1. Teaching and demonstrating basic physical and emotional care of children, including child development and developmentally appropriate child discipline.
2. Teaching homemaking and other life skills, including housekeeping, economical shopping, nutrition and food preparation, personal hygiene, financial budgeting, time management and home organization, with consideration given to the family's cultural environment.
3. Helping families obtain basic needs. Networking families with appropriate supportive community resources; e.g., housing, clothing and food banks, health care services, and educational and employment services.
4. Providing emotional support to families and building self-esteem in family members; aiding family members in developing appropriate interpersonal and social skills.
5. Providing client transportation/supervision of visits on a time-limited basis.
6. Observing family functioning, assisting the social worker in identifying family strengths as well as areas needing intervention or remediation, reporting to the social worker on the family's progress in skill-building, family functioning and other areas defined in the case plan.
7. Providing individual care services, including child care and household management on an emergent, time-limited basis when necessary to maintain a family that is in crisis.
FHSS is not intended to provide long-term maintenance for a family, is not a housekeeping service, and is not interchangeable with CHORE Services. Requests for on-going or repetitive child care or household maintenance are not appropriate for FHSS.

45152. Eligibility

The following criteria determine eligibility, contingent upon available funding, for FHSS:

The family must be a current DCFS client.
The case plan must document the need for teaching, skill-building, or community networking.
Alternatively, an emergent need exists in which the temporary use of an HSS will prevent out-of-home placement. Such situations include:
1. The temporary absence or incapacity of the primary caretaker, when it is anticipated that other suitable substitute care will be found within 72 hours.
2. The one-time provision of household chores when the condition of the home may necessitate out-of-home placement.
Families with adolescents are eligible for this service.

45153. Procedures for Access

The social worker initiates the referral and gives it to the FHSS supervisor/coordinator. Referrals for FHSS shall list specific areas for HSS intervention with a family.
The FHSS supervisor/coordinator evaluates the request for service eligibility and determines priority for service within available full time equivalent (FTE) staff resources.
The FHSS supervisor/coordinator gives service priority to cases where the service is in support of time-limited objectives to improve family functioning or to maintain a family in crisis. Priority cases have one or more of the following characteristics:
1. There is high risk of out-of-home placement and indication that HSS intervention will reduce that risk. This may include planned skill-building services or emergent, one-time provision of household chores, material resources, or child care, including overnight services. The purpose is to maintain a family having a crisis.
2. There is probability of continued out-of-home placement and indication that HSS intervention will enhance family reunification.
3. There is need to provide supportive services to a family when a child returns home from out-of-home placement.
4. There is need to provide support services to foster parents or relative care providers in order to stabilize and maintain placement.
Except in case of emergency provision of service, the social worker initiates a case planning staffing with the HSS and other appropriate individuals prior to initiation of services to set FHSS service planning goals and expectations and to discuss any issues the HSS should be aware of in dealing with the family. The social worker informs the HSS of any known or suspected issues affecting personal safety prior to contact with the family.
On-going case consultation between the HSS and the assigned social worker shall occur on a regular basis. As part of regular supervisory conferences, review of the need for continued FHSS shall occur.

4516. Health Services For Mothers And Children

45161. Service Definition

Services available to detect risk factors that might affect the health or growth of the baby early in the pregnancy. Health related services designed to assist parents with infants and young children. Programs offering health screening, assessment, and treatment for children. Health services provided through the Early and Periodic Diagnosis and Treatment (EPSDT) or Healthy Kids Program and Women, Infants, and Children (WIC) program.
DCFS also contracts with local health departments to provide public health nursing services in-home for families who need them.

45162. Eligibility

Parents with infants and young children who are eligible for the Medicaid program are generally eligible for Healthy Kids services. The family's social worker determines eligibility for DCFS contracted public health services.

4517. Medical/Dental Services For Children In Out-Of-Home Care Or Receiving Other Services

45171. Service Definition

The Early and Periodic Screening, Diagnosis and Treatment (EPSDT), program is a federal preventative health care benefit. The purpose of this program is to screen children and youth 20 years of age and younger in order to identify physical and/or mental health problems.
The Medicaid periodicity schedule for EPSDT examinations for children in out-of-home care is:

The initial EPSDT examination will occur within the first 30 days of placement whenever possible.

Five EPSDT screening examinations during the first year of life.
Three EPSDT screening examinations between one and two years of age.
One EPSDT screening examination for each 12 month period between ages two and 20.

Initial EPSDT examinations for children entering foster care are to be obtained prior to placement or scheduled within 30 days of OPD.
Children may receive additional EPSDT examinations beyond the periodicity schedule if it is determined that such an examinations are needed (i.e. after being on the run or has re-entered foster care). These are called inter-periodic EPSDT examinations.
The child's social worker is expected to assist the child's caregiver in engaging the child with identified services on all referrals made as a result of the EPSDT examination.
All children in foster care should be screened for mental health concerns as part of their initial and subsequent annual EPSDT examinations.
The child's well-being status will be reviewed at all Shared Planning Meetings. Well-being information will be included in the child's ISSP.
CHET Screeners will record the initial EPSDT examination date in the PrePassport Module of CAMIS for children who receive a CHET screening.
The assigned social worker will record the date of all EPSDT examinations in the Shared Planning Meeting minutes.

45172. Eligibility

All children in CA-paid, licensed out-of-home placements are eligible for medical services. A child in out-of-home care or receiving Adoption Support is eligible for Medical ID Cards until the child graduates high school or completes an approved equivalent vocational program or the child's 21st birthday, whichever occurs first. The CA social worker must verify that child is enrolled in school or an approved vocational program. Some children receiving other services may also be eligible for Medicaid.

Children placed from non-Medicaid recipient homes are immediately eligible for Medicaid on a fee-for-service basis, issued by the Foster Care Medicaid Unit (FCMU), upon entry of information into the CAMIS placement module.
Children being placed from Medicaid-covered households must be served by the family's assigned health plan until the child is terminated from that coverage.
1. Staff may obtain information about the existence or identity of an assigned health care plan through ACES or by calling the FCMU.
2. If the location of the child's placement makes seeing the assigned medical provider difficult, the social worker must call the customer service number for the plan (listed on the Medicaid ID card or the ACES screen) to negotiate a change in provider.
3. Coverage on the family's plan may take from 15 to 45 days to be terminated and continue for up to 90 days in cases where the child is expected to return home within that time-frame.
Children receiving Medicaid services at the time of placement may not be authorized for medical through CA until their managed care medical coverage through the TANF grant or the medical-only program is terminated in the CSO. Once a child is determined not to be/no longer included on their family's Medicaid managed care plan (Healthy Options), the FCMU must complete the authorization.
Social workers may facilitate access to health care for foster children and clarify the foster parents' role to health care providers by providing a Healthy Kids Card, DSHS 03-338, to the foster parents for each child in placement.
Children being served through intensive services plans (i. e., CHAP) contracts must be in licensed care at least one day per month to be eligible for Medicaid. For all private agency placements, the CA social worker must receive documentation of the placement from the private agency and must enter the placement information in the CAMIS placement module as soon as possible. The FCMU will issue the Medical ID Card at the time of placement and will send a copy to the private agency if requested.
When children enter mental health or substance abuse treatment from foster care, social workers will indicate the reason and the location of the child in the CAMIS placement module. These children will remain on "D Medical" for 90 days. The FCMU will initiate an alert to trigger at the end of 90 days. The CA social worker and the FCMU will make a determination at that time whether the child will be returning to foster care or home.
Infants of Minor Mothers
Newborns of Mothers Enrolled in Healthy Options
1. Newborns whose mothers are Healthy Options members are deemed members and enrolled in Healthy Options beginning from the newborn's date of birth or the mother's date of enrollment, whichever is later. DSHS will pay supplemental premiums to the Healthy Options plan through the end of the month in which the 60th day of life occurs. The FCMU will issue the child's Medical ID Card with the mother's Healthy Options plan.
2. Children born to minor mothers enrolled in Healthy Options are considered to belong to the mother's household while the child is in the hospital and/or transferred to Pediatric Interim Care Center (PICC) the month of birth. If a legal dependency is filed, the child will be changed to “D medical” the following month, and the financial worker notified. If the child is expected to return home within 90 days, the child is considered to be in the mother's household, and the financial worker should be notified so a 90-day tickler can be initiated. In this case, the newborn is converted to "D medical" and remains in the child's Healthy Options plan.
Adoption Support Program
1. When the adoption is finalized for a child in care and service through Adoption Support begins, the social worker's or the Adoption Support program manager's change in the placement module must indicate the new adoption status, which will electronically alert the FCMU to make the appropriate changes in the authorization.
  1. The FCMU will issue a Medical ID Card in the child's new name once the adoption is finalized.
  2. The CA social worker or Adoption Support program manager must provide to FCMU the child's previous name and case number along with the new name so that the unit can close the previous Medical ID Card.
2. The FCMU, via CA, will issue the Medicaid ID Card for children eligible for Medicaid through the Adoption Support program, with the following exceptions:
  1. If the adoptive family applies for TANF, Basic Health Plan (BHP), or other Medicaid programs as a family unit that includes the adoptive child, the CA-issued Medicaid will be suspended for the duration of the family's enrollment.
  2. The Community Services Office (CSO) will issue the Medicaid ID Card for children on Adoption Support who are receiving Supplemental Security Income (SSI) or whose family qualifies for TANF or the Children's Medical Program (H medical). Children who are on SSI will remain on SSI and will not be opened for “D medical.”
3. Children who are not income eligible for the H medical program or the BHP and receive Adoption Support are eligible for foster care “D medical.”
4. Children who are receiving Adoption Support from another state and move into Washington are eligible for “D medical.” The regional Adoption Support program manager needs to obtain the out-of-state information and create a case number for the child. This information is then sent to the FCMU to issue a Medical ID Card.
5. The FCMU supervisor grants Adoption Support exception requests by the family on cases with “D medical” on a case-by-case basis.
For children in out-of-home care and who are eligible for SSI, the FCMU will issue the Medicaid ID Card on behalf of CA.
Medicaid for Children Placed from Other States
1. All children who are living in Washington State, but not with an adult who is financially responsible for them, are eligible for Medicaid. For those in licensed care or on Adoption Support, the assigned CA worker initiates the application. Others apply through the Medical Eligibility Determination Services (MEDS) unit (P. O. Box 45521, Olympia, WA 98504-5531; telephone toll-free 1-800-562-3022) or at the CSO.
2. CA and FCMU will issue Medicaid when there is reason to open a CA case, to assign a worker, and the child is placed in a licensed home or eligible adoptive home, according to the Consolidated Omnibus Budget Reconciliation Act (COBRA) or Interstate Compact for Adoption and Medical Assistance (ICAMA) regulations. In cases where a worker is assigned but no entry in the CAMIS placement module is required, the social worker must initiate the application by notifying the FCMU by telephone or e-mail. The social worker must also ensure that the department issues a provider number for the home.
  1. Private agencies must initiate application themselves in cases where DCFS is not providing services. If asked, the CA social worker refers the agency to MEDS.
  2. Unlicensed relatives of a specified degree must also initiate the application themselves. If asked, the CA social worker refers the relatives to MEDS or to the local CSO.
3. FCMU will issue Medicaid directly for children on COBRA. CA does not need to take any action.
4. Children from other states who are not Title IV-E eligible and who are on SSI apply through the CSO for SSI Medicaid.
Children Who Are Undocumented Aliens
1. Children who are undocumented aliens are eligible for “D Medical” state funds only. The CA social worker must code these children correctly in CAMIS.
2. Undocumented aliens are:
  1. Non-immigrant; i. e., visitor from other countries, child with a student visa, or undocumented; or
  2. Immigrant with Immigration and Naturalization Service (INS) status of parolee, conditioned entrant, or lawful Permanent resident and who arrived in the U. S. after August 22, 1996, but has not been in the country seven years.
In addition to the Medicaid ID Card, the following documents are acceptable verification of Medicaid coverage:
1. A stamped, initialed ACES print screen of the medical ID card;
2. A yellow medical ID card, issued by the FCMU;
3. Information issued through a Medical Eligibility Verification System (MEVS); and
4. Verbal or written verification from the FCMU to the medical provider.
With the approval of the Regional Administrator or designee and within limited funds available, the social worker may authorize elective medical services, such as orthodontics or corrective surgery to correct a disfiguring condition, not covered by Medicaid. The social worker must accompany each request for such medical services with verification of denial of payment by the Medical Assistance Administration, including following administrative appeal. Social workers must obtain parental consent, or a court order authorizing the department to consent, to provision of any medical or dental services, including surgery, that are neither routine nor emergency services.

45173. Procedures for Access

CA social workers or other assigned staff must do the following to facilitate eligibility determination and issuance of Medicaid ID Cards:
1. CA staff must enter the placement information into the CAMIS placement module in accordance with the CA Operations Manual, chapter 15000, section 152222. This information will electronically alert the FCMU to authorize, change, or close Medicaid. The FCMU sends the Medicaid ID Card to the physical location of the child. If there is reason to send a copy of the card to another location, the FCMU can arrange to produce more than one card.
2. If there is a medical emergency, CA staff must call or e-mail the FCMU following entry of the placement information. This will enable the FCMU staff to check for an assigned provider and/or immediately process the Medicaid eligibility and fax or telephone the necessary eligibility information to the health care provider. The social worker can reach FCMU by e-mail, direct telephone, or the foster care Medicaid hotline at 1-800-547-3109. The social worker may advise the foster parent to contact FCMU if the child experiences a medical emergency before receipt of the medical ID card.
3. If the medical emergency occurs after-hours, the care provider or CA staff needs to take the child for services to the local hospital emergency room. CA staff must contact the FCMU the next business day with treatment provider information.
The CA social worker, for CA children, and private child placing agency staff, for CA-funded children for whom those agencies are responsible, must make every effort to determine if each child has a Social Security number.
1. If the child does not have a Social Security number, the CA social worker refers the matter to the Federal Funding Specialist, who will apply or cause an application to be made for a Social Security number during the month the child begins to receive services, including but not necessarily limited to out-of-home care, that may be Medicaid-eligible.
2. For a child without a Social Security number being served by a child placing agency and funded by DCFS, the private agency staff must apply or cause an application to be made for a Social Security number during the month the child comes into care or begins to receive services that may be Medicaid-eligible.
3. When the social worker or other assigned staff receives the Social Security number, the staff enters the number in CAMIS and notifies the FCMU of the action by telephone or e-mail.

45174. Other Sources

Medical/behavioral services required for a child to maintain in school may be eligible for payment through school district sources. The social worker may request, or advise the parents of the child to request, an evaluation for special education. Required services are authorized after assessment and the development by the school of an Individualized Education Plan (IEP) for the child.
Civic groups such as the Shriners, Crippled Children's Service, Kiwanis, and the Lions Club often provide funding for special needs services.
See section 4526 for information regarding Medicaid Personal Care (MPC) Services.

45175. Record Keeping

The social worker must file and/or record all information gathered through the EPSDT/Healthy Kids examination and other medical/dental/behavioral services in the Health and Education Record. See sections 43092 and 4517 of this manual and the Operations Manual, chapter 13000, section 13410.
The social worker must file any historical medical/dental/behavioral services information gathered through ACES or contact with previous providers in the Health and Education Record of the child's file. See the Operations Manual, chapter 13000, section 13410.

4518. Drug/Alcohol Services

45181. Service Definition

Assessment, treatment or monitoring services provided to an individual or family to assist a client in maintaining sobriety.
These may include both in-patient and outpatient services. DCFS contracts or pays for substance abuse services in a variety of ways depending on the availability of state and federal funding. Most adults without income are referred to ADATSA programs contracted through the Division of Alcohol and Substance Abuse (DASA). Several DCFS regional offices contract for urinalysis monitoring. Substance abuse treatment components exist within many DCFS contracted rehabilitative/residential care programs for adolescents. Specific services needed are determined through a drug and alcohol assessment provided by a qualified professional.

45182. Eligibility

DCFS clients where drug and/or alcohol abuse is suspected are eligible for available services.

45183. Procedures for Access

The social worker consults regional procedures for utilization of local drug and alcohol abuse programs within their communities. Obtaining information from the client regarding the availability of insurance coverage is essential to determining the range of resources that are available for any individual client.
The social worker refers clients without resources to the local DSHS Community Service Office (CSO) to determine if they are eligible for state and/or federally funded assessment and treatment services.
Controlled Substance Testing
1. Children's Administration staff shall not collect urine samples for urinalysis or other tissues from children, their families, or other involved parties for drug testing.
2. If a court of competent jurisdiction orders that a party to a dependency, Child in Need of Services (CHINS), or At-Risk Youth (ARY) action submit to testing for use of controlled substances, the assigned social worker shall arrange for such testing to be done independently by a qualified drug and alcohol program or laboratory.
3. If the social worker and the care provider, usually a parent, negotiate an agreement for controlled substance testing of the parent/provider, the social worker shall arrange for such testing to be done independently by a qualified drug and alcohol program or laboratory, in accordance with conditions of paragraph 4, below.
4. If the department is to pay for the cost of the testing, the social worker shall arrange for the testing to be conducted by an organization or laboratory contracting with the department for such services.
5. The Regional Administrator, through the Regional Contracts Manager, shall make available to staff the names and contract terms and conditions of entities available for such substance abuse testing.
6. The social worker authorizes payment for those tests for which the department is financially responsible in accordance with the service provider's contract.

45184. Other Sources

Alcoholics Anonymous, Narcotics Anonymous, Alateen, and Alanon are self-help organizations that are free and available in most communities in Washington State.
Many communities fund specialized programs to meet the needs of particular populations or groups.
Division of Alcohol and Substance Abuse (DASA) Child Care is available to parents who are in a DASA-approved treatment facility. Substance abuse treatment staff are designated to approve child care services.
1. DASA Child Care is authorized by staff in counties or treatment facilities. DASA Child Care is not authorized by DSHS offices. For information, contact the county alcohol and drug coordinator or the DASA Child Care Program Manager at (360) 438-8068.
2. Participation of a parent in substance abuse treatment is confidential. Participation may not be disclosed unless a release has been signed by the person in treatment.

4519. Home Based Services

45191. Service Definition

Home Based Services (HBS) are designed to prevent or remediate problems that may result in out-of-home placement.
Such services are provided in the context of a comprehensive permanency plan and may include:
1. Basic goods and services; e.g., food, clothing, shelter, furniture, health, utilities, transportation.
2. Paraprofessional services; e.g., parent aides.
3. Parent training.
4. In-home counseling to prevent out-of-home placement.
5. Services may be provided by contract in some DCFS regions.

45192. Eligibility

For a family or individual to receive HBS, the following conditions must be met:
1. The client has a case open for CPS, CWS, or FRS services.
2. Services may be provided to the family of origin, relatives, or foster families when the intent of HBS is to maintain or reunify a permanent or long-term stable home for the child.
3. The family is willing and able to cooperate with HBS services.
4. In the social worker's judgment, the child can be safely maintained in the home or be safely returned to the home within the next three months with HBS services.
5. There is funding available through the HBS budget to provide HBS services.

45193. Procedures for Access

The social worker follows regional procedures to authorize services.
The worker opens the appropriate SSPS payment code and sends a copy authorizing services to the provider.
During the course of the service, the worker is encouraged to maintain contact with the HBS provider to review the progress of services. The worker shall immediately notify the HBS contractor if a CPS referral on the family has been received.
Following completion of service, the worker receives a closing summary from the contractor and then terminates payment through SSPS.

45194. Other Sources

Some of the components of service provided by HBS are available from other sources in some communities. Workers may explore private charitable and religious organizations for help with the provision of concrete services, the RSN for availability within "wrap-around" funds, and DDD for parent education for developmentally disabled parents. Community Public Health and Safety Networks are another possible resource.

Continue to sections 4520 - 4529