13.45.3 Post Adoptive Placement Stabilization Services (PAPSS)

Introduction

​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​Post-adoptive placement stabilization services (PAPSS) is an optional and supportive service offered to adoptive parents on a voluntary basis. Adoptive parents receiving adoption assistance (subsidy) for a Department for Community Based Services (DCBS) agency adopted child may request services if the placement is close to a disruption. PAPSS is a resource that is included as part of the subsidy services available to adoptive families. If the child meets the criteria established below, additional layers of approval are not necessary and should not be required.

Practice Guidance

  • ​​When an adoptive family becomes involved with DCBS through an investigation or ongoing case, it is important for the caseworker and the recruitment and certification (R&C) worker to communicate regarding the family's needs and any available services to support and prevent disruption. 
  • The managed care organization (MCO) should be contacted and may be able to assist with locating services for the family. For an adopted child(ren) enrolled in an MCO, the worker should contact the MCO case manager to request their assistance with service delivery. ​
  • After the SSW assists the adoptive family in completing referrals for community programs, the appropriate agency works with the family to address the crisis situation to include having the adoptive parent(s) sign a DCBS-1 Informed Consent and Release of Information and Records form​ to allow DCBS to coordinate services. 
  • DCBS may provide PAPSS for out-of-state requests on a case-by-case basis. 
  • Out-of-state inquiries are directed to the Adoption Services Branch at (502) 564-2147. 
  • During the PAPSS period, adoption assistance is temporarily renegotiated to one dollar ($1) and transportation assistance is provided through extraordinary medical expenses as allowed to support the child and family, effective on the date of the child’s placement. 
  • Payments to the private child-caring (PCC) agency are made by the Division of Administration and Financial Management (DAFM) through the special payments TWIST screens in the adoptive/provide case with PCC crisis stabilization selected as the payment type. 
  • Any adoption assistance overpayment made to families must be repaid within ninety (90) calendar days. Overpayment checks are made payable to the Kentucky State Treasurer and are submitted to DAFM at the address below:
    Division of Administration and Financial Management
    275 East Main Street, 3W-C
    Frankfort, KY 40621
    Phone: (502) 564-3427
    Fax: (502) 564-4477 
  • In-home visits with the adoptive parent(s) are not required while PAPSS is being utilized unless requested by the family or as a need arises. 
  • A family team meeting (FTM) may be held more often than every thirty (30) calendar days based on the needs of the child and/or family. 
  • Once the child exits PCC placement and returns to the adoptive home, adoption assistance is resumed to the rate prior to PAPSS and the family signs a new DPP-1258 Adoption Assistance Agreement
  • If appropriate, an aftercare plan is developed with the family.​

Procedure

Designated DCBS staff, (e.g., R&C worker, intake worker, investigative worker, ongoing worker):
  1. Works with the adoptive parent(s) to assist, as needed, with completing referrals for services that support the family and adoptive placement, (i.e., in-home services, respite, additional training/education); 
  2. Works with the adoptive family to contact the MCO case manager of the adoptive child to discuss available services for the child to maintain in the adoptive home, to exhaust all available services through Medicaid, such as: 
    1. Targeted case management (TCM) and other behavioral health services through community; 
    2. In-home services; and 
    3. Crisis stabilization; 
  3. Completes the following tasks when the adoptive parent(s) has cooperated with other preventative services to prevent the adoption dissolution, services are unavailable, or if the services do not effectively improve the child’s behavior/situation and a higher level of care is recommended by a mental health clinician: 
    1. Assists the adoptive parent(s) with completing the DPP-886A Application for Referral and Needs Assessment; 1 
    2. Requests one of the following from the adoptive family: (If the family has several of the below options, use the documentation with the most information.) 
      1. Provider biopsychosocial assessment; 
      2. Admission or discharge summary from psychiatric residential treatment facility (PRTF) or psychiatric hospital; 
      3. PCC discharge summary, or current records; 
      4.  Psychological evaluation; 
      5. Individualized education plan (IEP); 
      6. Medically complex report; 
      7. Individualized health plan; or 
      8. Pre-dispositional report, assessment, etc. from the Department of Juvenile Justice (DJJ); 
    3. Forwards this information to the Adoption Services Branch for review. The Adoption Services Branch reviews the documentation to ensure that the DPP-886A is completed thoroughly prior to submitting to the Children’s Review Program (CRP) for a level of care (LOC) assignment.​
    4. Forwards this information to CRP, at the following email address, so that CRP can assign a LOC for the child: CRPlevels@newvista.org 
    5. Reviews the LOC received from CRP to verify that the child’s level is a qualifying LOC three (3); 2 
    6. Works with the CRP regional placement coordinator (RPC) to make referrals to PCC facilities that offer services to best meet the child's needs. CRP will only send the referral to qualified residential treatment programs (QRTP). Any request for a non-QRTP placement must be staffed with and approved by the Adoption Services Branch; and
    7. Submits a special request through the service region administrator (SRA) to the Division of Protection and Permanency (DPP) director to request an exception if it is determined that a child age ten (10) or under is in need of PCC residential treatment as outlined in SOP 4.51.1 Placement in a Congregate Care (Residential Treatment) Setting​
  4. ​Ensures that the adoptive parent(s) is willing to participate in the child's treatment to support reunification with the child;
  5. Ensures that there is an agreement between the Cabinet for Health and Family Services (Cabinet/CHFS) and the adoptive parent(s) to renegotiate adoption assistance to one dollar ($1) prior to proceeding with the PAPSS referral; 
  6. When necessary, may consult with the Adoption Services Branch if the family refuses PAPSS; 
  7. Consults with the FSOS, as needed, when a family is identified as possibly qualifying for PAPSS; 3 
  8. Completes the following tasks upon concurrence of the adoptive parent(s): 
    1. Provides the adoptive parent(s) written notice using the DPP-154-A Notice of Intended Action ten (10) calendar days prior to the renegotiation of adoption assistance being reduced to one ​​​​​​dollar ($1); 
    2. Documents on the DPP-154A Notice of Intended Action that if the child remains in the PCC placement beyond the PAPSS period and is still in the parents’ custody at the end of PAPSS, that the parent is responsible for payment. 4
    3. Sends a DPP-154 Protection and Permanency Service Appeal with the notification letter; 
    4. Discusses these procedures prior to mailing the notification to the family; and 
    5. Documents the contacts or involvement with the adoptive family events/activities in the service recordings of adoptive/provide case (The child remains in the adoptive/provide case in TWIST); 
  9. Submits the following to DAFM within five (5) working days of the PAPSS placement: 
    1. DPP-114 PCC Level of Care Schedule
    2. New DPP-1258​; 
    3. Child’s name; 
    4. Social Security number;
    5.  Date of birth; and 
    6. TWIST case number; ​
  10. Notifies the Adoption Services Branch within five (5) working days of when a family begins utilizing PAPSS; 
  11. Holds an FTM with the adoptive family, the PCC staff, MCO, and the child to discuss the child’s progress and discharge plan at thirty (30) calendar day intervals after placement; 5 
  12. If it is determined the child will need greater than sixty (60) calendar days of treatment outside the home with PAPSS services: 
    1. Completes an Post Adoptive Placement Stabilization Services (PAPSS) 3O Day Extension Request that provides a summary of the need for continued PAPSS treatment past the sixty (60) calendar days. Please refer to template and submit to the Adoption Services Branch. 6
      1. The extension request cannot exceed thirty (30) additional calendar days, for a total of ninety (90) calendar days. 
  13. At ninety (90) calendar days, with agreement from the adoptive parent(s) and service region administrator assistant (SRAA)/service region clinical associate (SRCA) to continue treatment through voluntary commitment: 
    1. Completes the DPP-167 Consent to Voluntary Commitment
      1. The adoptive parent(s) and the designated authorized DCBS staff sign the DPP-167
    2. Submits a referral to centralized intake that includes: 
      1. The family has exhausted PAPSS ; 
      2. The family is in agreement with voluntary commitment and has been working with DCBS; 
      3. The date of the DPP-167 being in effect needs to be included and must be tracked for ongoing case management; and 
      4.  The case has been staffed with SRAA/SRCA for continued need of out-of-home placement treatment services. 
    3. The R&C worker completes the title IV-E packet at the time the voluntary commitment is signed. The packet is submitted to DAFM as outlined in SOP 31.1 Title IV-E Determination in order to determine title IV-E eligiblity. ​
      1. If the child is placed in a QRTP and DAFM determines that the child is title IV-E eligible, a court review must be held within sixty (60) calendar days. 
      2. If the child is not title IV-E eligible and/or not placed in a QRTP, and it appears the voluntary commitment will exceed one hundred and eighty (180) calendar days, a petition should be filed prior to one hundred twenty (120) calendar days of the voluntary commitment. This should ensure that the case is heard by the court prior to one hundred forty (140) calendar days, so that the case will be eligible for title IV-E funding. The children's benefit worker (CBW) should be advised of the outcome as soon as possible. ​​​
      3. Title IV-E adoption subsidy resumes to amount prior to PAPSS, once voluntary commitment has been signed by completing a new DPP-1258​ contract and all required parties sign, however, state subsidy does not resume until the child is returned to the adoptive home; and 
    4. Sends the DPP-167 and updated DPP-1258 (for title IV-E subsidy) to billing specialist, payment systems change within five (5) working days; 
  14. Notifies the Adoption Services Branch once the child has entered out-of-home care  (OOHC) and is no longer receiving PAPSS services. This is done within five (5) working days to allow the Adoption Services Branch adequate time to notify CRP of the need for a QRTP assessment.
The SRA or designee:
  1. Signs the DPP-114 Level of Care Schedule authorizing payment to the PCC once the child is determined to be eligible for PAPSS and a PCC has accepted the child. 7
The FSOS:
  1. Consults with SRAA/SRCA after a PAPSS case has been identified; and 
  2. Consults at least once monthly on all PAPSS cases and ensures the consult is documented in service recordings.
The SSW with case responsibility:
  1. Notifies the regional billing specialist, the Adoption Services Branch, and DAFM within five (5) working days of the child’s return home.

Footnotes

  1. When an adoptive family requests PAPSS services and the worker determines that PAPSS is appropriate for the case, the SSW should ensure the DPP-886A is completed and submitted to the Adoption Services Branch/CRP within three (3) working days. 
  2. ​ If the child’s needs do not require that LOC, designated regional staff should refer the family to other appropriate resources, as the child would not be eligible for PAPSS. 
  3. The Adoption Services Branch is available for consultation if there are any questions about the PAPSS process or if assistance is needed with referrals or other services.  ​
  4. This is especially important when the parent has not cooperated with the child’s treatment during the PAPSS period, if the PCC doesn’t recommend continued residential treatment, and/or if voluntary commitment is not appropriate but the parent refuses to pick the child up from placement.​
  5. Due to the specific circumstances in these cases, the monthly FTM meets the contact requirement outlined in SOP 3.10 Ongoing Contact with the Child and Family​
  6. The PAPSS extension memo is addressed to the DCBS commissioner, through the Adoption Services Branch, through the SRA or designee. 
  7. PAPSS cannot exceed a ninety (90) calendar day period in any twelve (12) month period.
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Revisions