Ky.gov
Effective: 7/01/2024

12.24 Per Diem Rates (Including Specialized Foster Care)

Legal Authority

Introduction

​​​​​​​​​​​​The foster or adoptive home per diem rate structure is designed to give the foster or adoptive parent(s) flexibility and autonomy to decide how to spend money for the child(ren) in their home.  Recruitment and certification (R&C) worker approval is not necessary for services included in the per diem.​​​

Practice Guidance

Per Diem Rates 








 Birth to age 11
Basic​​
$27.00
Advanced
$29.57
Degreed
N/A
 Age 12+
$29.34
$31.92
N/A
 Care Plus Home$47.49
$53.42
N/A
 Medically Complex$47.49
$53.42
$57.00
 Specialized Medically ComplexN/A​$67.00
$108.64
 Supplemental Services RateN/A$80.75
N/A


  • Non-familiar foster and adoptive homes and relative and fictive foster and adoptive homes are reimbursed the per-diem rate based on their approval level. 
  • Effective January 1, 2024 child-specific rates were evaluated and updated in TWIST and are now equal to the basic rate. In addition, KRS 605.120 will be used as the agency’s periodic review to ensure that children receive the same amount of foster care maintenance payment, whether placed in a licensed approved foster family home, relative, or fictive foster home.
  • Housing expenses, food-related expenses, and school expenses are included in the per diem rate.
  • The child's routine hair care is included in the per diem rate. 
  • Incidentals such as first aid supplies, baby oil and powder, deodorants, sanitary products, and other personal toiletries are included in the per diem rate. 
  • The per diem includes money for social and/or school-related activities, (e.g., clubs, ballgames, participation in dance class, gymnastics, karate, church, team sports, school supplies, school pictures, band, SAT/ACT testing, etc.).  This allows all foster children to participate in normal activities and empowers the foster parent to make these decisions.  
  • When a child remains in a foster or adoptive home less than thirty (30) calendar days, the rate amount for per diem, clothing, incidentals, and allowance is prorated for the number of days the child was in the home.

Specialized Foster Care Per Diem Rates
  • Specialized foster care reimbursements are paid based on the needs of the child and the professional licensure of the foster or adoptive home.  As such:
    • A medically complex or specialized medically complex foster or adoptive home is reimbursed the specified per diem rate in the above table only for a child designated by the Medical Support Section of the Division of Protection and Permanency (DPP) as a medically complex child;
    • A care plus foster or adoptive home is only reimbursed the basic care plus per diem rate for a child designated as a care plus child and has met all requirements of a care plus foster or adoptive home;
    • An advanced care plus foster or adoptive home is only reimbursed the advanced care plus per diem rate for a child designated as a care plus child;
    • The home has been approved for one (1) year as a care plus foster or adoptive parent; and
    • The foster parent(s) has completed all training requirements.
  • An advanced medically complex rate is paid to a foster parent who has been approved for one (1) year as a medically complex foster or adoptive parent and is approved to car​e for a child who is determined to be medically complex by the Medical Support Section.
  • A degreed specialized medically complex rate is paid to a foster parent who maintains a current license as a health care professional and is caring for a specialized medically complex child.  The Medical Support Section approves this per diem rate based on the needs of the child. 1
  • When it is determined by the child's family team that a child no longer meets the determination requirements for a care plus designation, the foster or adoptive home receives thirty (30) calendar days notification prior to the rate change.  
  • When it is determined by the Medical Support Section that a child no longer meets medically complex requirements, the foster or adoptive home receives thirty (30) calendar days notification prior to the rate change.
  • In addition to the Medical Support Section determining whether a child meets medically complex criteria, this section also assigns the per diem amount to be reimbursed.
  • Back pay for medically complex and care plus reimbursements can only be received for thirty (30) calendar days prior to designation. 



Procedure

  1. The SSW specifies the daily rate (per diem) for care of a child placed in the foster or adoptive home.
  2. The R&C worker notifies the Out-of-Home Care (OOHC) branch manager, within three (3) working days, of any request by a school, for the Department for Community Based Services (DCBS) to pay for school lunches and breakfasts. 2
  3. The R&C worker or family services office supervisor (FSOS) reduces the foster or adoptive home’s reimbursement per diem rate for medically complex or care plus homes if the foster or adoptive home fails to meet the ongoing training requirements for their type of home.  Prior to reducing the per diem rate, a corrective action plan is completed with the foster or adoptive home to address the training deficiency.  In these instances, the foster or adoptive home’s per diem rate reverts to the advanced or basic per diem rate.  3
  4. The R&C worker notifies the appropriate billing specialist.​


​Footnotes

  1. ​​A health care professional is a person actively licensed as a physician, physician's assistant, advanced registered nurse practitioner, or registered nurse.​
  2. All foster care children are eligible for free lunch programs and may participate upon completion of the appropriate school form.
  3. When assessing the family and developing the corrective action plan for completion of training hours, the R&C worker should consider the following:  
    • The family’s circumstances that led to the deficiency;
    • The family's partnership with the agency;
    • If this is a pattern;
    • How many hours are needed; and
    • The availability of the training in their area.​​
​​​​​​If the family fails to resolve the deficient training hours the family is provided with written notice via a DPP-154A of their foster/adoptive home type changing.   A new DPP-111 is completed and the ongoing recommendation screen is updated in TWIST to match the change in home type. 
​


Documents

Revisions

​6/14/2023 Addition: 

  • The home has been approved for one (1) year as a care plus foster and adoptive parent; and  two (2) years; and​


  • An advanced medically complex rate is paid to a foster parent who has been approved for one (1) year as a medically complex foster or adoptive parent two (2) years and is approved to car​e for a child who is determined to be medically complex by the Medical Support Section.


1/16/2024

Rate update from 12/2023

2/15/2024

Addition: 

Effective January 1, 2024 child specific rates were evaluated and updated in TWIST and are now equal to the basic rate. ​


7/1/2024

Rate update