Ky.gov
Effective: 07/01/2024

5.7 Approval of Subsidized Permanent Custody (SPC) Assistance

Legal Authority

Introduction

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Practice Guidance

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  • The subsidy amount shall not exceed the amount paid for foster care maintenance for the same child or exceed the foster care per diem reimbursement established by the Department for Community Based Services (DCBS) (including medically complex rates and care plus rates). Children who achieve SPC with a level of care (LOC) one (1) shall qualify for up to the advanced rate. Children who achieve SPC with a LOC two (2) or three (3) shall be eligible for up to the care plus or medically complex rate. A private child placing (PCP) caregiver meets the care plus standard for children with a LOC two (2) or three (3). 
  • For a PCP family to receive an advanced rate, they shall be approved for at least one (1) year.
  • A child is eligible for the care plus rate if they have a LOC of two (2) or three (3) and meet at least one of the following criteria (also outlined in SOP 4.10.1 DCBS Care Plus ): 
    • Displays aggressive, destructive, or disruptive behavior; 
    • Has a diagnosed emotional or behavioral problem; 
    • Is scheduled to be released from a treatment facility; 
    • Is at risk of being placed in a more restrictive setting; 
    • Is at risk of institutionalization; or 
    • Has experienced numerous placement disruptions. 
  • Child care services are paid by the caregiver(s) and reimbursed monthly only with a paid receipt as verified by the child care provider. 
  • Child care reimbursements are only available for children under the age of thirteen (13); or thirteen (13) years of age and older if there is an established need due to a physical, emotional, or developmental need of the child, and with documentation provided from a physician or qualified mental health professional (QMHP) as defined in KRS 202A.011 stating the child is physically or mentally incapable of caring for themselves. 1
  •  SPC assistance may be requested for the following: 
    • Reimbursement of child care services for full-time or part-time working permanent caregiver(s) who work a minimum of twenty (20) hours per week and with annual employment verification, or permanent caregiver(s) pursuing higher education. 2
  • A Kentucky medical assistance card is available to all children who have a DPP-1257 Subsidized Permanent Custody Agreement. The Kentucky medical assistance card is approved through the children's benefits worker (CBW) when the SPC order has been signed. 3
  • Respite care is not cumulative; this should be submitted monthly for reimbursement. Respite care is offered to a child approved for: 
    • Medically complex or care plus rates prior to SPC finalization, at two (2) respite dates per child, per month; or
    • Specialized medically complex rate prior to SPC finalization, at three (3) respite days per child, per month.

Families cannot receive the supplemental services rate, or an enhanced rate for SPC subsidy. These rates should be used temporarily during a period of crisis. ​



Procedure

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  1. The recruitment and certification (R&C) or permanency worker discusses with the caregiver(s) non-reoccurring, and child care services. 4 
  2. The R&C/permanency worker submits a request for child care to the service region administrator (SRA), or designee, that includes documentation from a QMHP, or doctor, outlining the therapeutic need for the service for a non-working caregiver(s) home for those children in need of child care who are age thirteen (13) and older. 5 
  3. The SRA or designee conducts a special review of these approved requests every six (6) months. 6 
  4. The R&C/permanency worker informs the caregiver(s) that approved child care co-payments will mirror those established by the Division of Child Care (DCC) in Kentucky Administrative Regulation 922 KAR 2:160 and adjustments in reimbursable amounts can be made at any time as also outlined in the child care section of the DPP-1257 Subsidized Permanent Custody Agreement.
  5. The R&C/permanency worker submits the request for approval of SPC assistance, and non-reoccurring SPC assistance expenses through the R&C/permanency supervisor to the SRA or designee. The packet should include the following: 
    1. Subsidized Permanent Custody (SPC) Approval letter; 
    2. Subsidized Permanent Custody (SPC) Assistance Worksheet;
    3. DPP-1257 Subsidized Permanent Custody (SPC) Agreement ​ for each child; 
    4. DPP 1257N Notification of Subsidized Permanent Custody (SPC)​;
    5. Any other necessary documentation to determine eligibility (LOC, PCP rate, etc.); and
    6. DPP-157 Background Check Request for Foster or Adoptive Applicants and Adolescent Household Members or the KY KARES Final Results registry results. 
  6. Upon approval by the SRA or designee, the DPP-1257 Subsidized Permanent Custody Agreement is signed by all parties, and copies are distributed to the caregiver(s) and CBW, and the regional billing specialist.
  7. The R&C/permanency worker reviews the information and forwards the bill and finalization documentation, along with a copy of the DPP-1257 Subsidized Permanent Custody Agreement to the Division of Administration and Financial Management (DAFM), in central office for payment. 7 

Calculating monthly maintenance for PCP Subsidized Permanent Custody

  1. SSW requests from the PCP agency the current rate that the prospective adoptive parent is receiving, and the current LOC of the child. 
  2. If the child is a LOC one (1) the family shall continue to receive the current daily rate that is received from the PCP. However, the family shall not receive more than the advanced DCBS rate. 
  3. If the child is a LOC two (2) or three (3), the family shall continue to receive the current daily rate that is received from the PCP. However, the family shall not receive more than the DCBS advanced care plus rate. 
  4. If the child is deemed medically complex the family shall continue to receive the current daily rate that is received from the PCP. However, the family shall not receive more than the established DCBS medically complex rate, (i.e., specialized medically complex, degreed medically complex, etc.) 8 
  5. The calculating formula to determine monthly maintenance rate is as follows: daily amount multiplied (x) by 365 divided (÷) by 12 equals (=) monthly maintenance amount (round to nearest dollar). ​​

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​​Contingencies and Clarifications ​​​​​​

  1. If the caregiver(s) requests payment to a private attorney, the attorney shall submit the bill for services and a copy of the permanency judgment​ to the R&C/permanency worker who processed the SPC assistance.​

​​Footnotes​

  1. ​Documentation should include diagnoses and descriptions related to the child’s physical and/or mental incapacity to care for themselves and their need for supervision.
  2. Verification documentation is reviewed during initial and annual contact. Approved childcare rates cannot exceed the rates established by DCC. When possible, adoptive parents are encouraged to utilize public preschool services for children of appropriate ages. 
  3. Discuss with the caregiver(s) the Kentucky Integrated Health Insurance Premium Payment (KI-HIPP) for the SPC child(ren) who is eligible for a medical card. This Medicaid benefit will cover the premium cost for private health insurance when they enroll in this program. Please refer to the KI-HIPP link for enrollment details.
  4. Children approved by the medical review team (MRT) as physically or mentally disabled may be eligible for childcare through age nineteen (19). 
  5. The family must submit documentation every six (6) months to the R&C/subsidy worker. Approved childcare rates cannot exceed the rates established by DCC. When possible, caregiver(s) are encouraged to utilize public preschool services for children of appropriate ages. 
  6. All non-recurring SPC expense reimbursement must be approved before the finalization of SPC and cannot exceed two thousand ($2,000) per child. 
  7. Children can only be deemed specialized medically complex by the Medical Support Section. Please refer to SOP 12.18.3 Medically Complex Home​ for degreed home requirements. 
  8. Examples of calculations: 
  • ​​​​​​The child is a LOC three (3) and the PCP daily rate to the family is $33 per day. $33 multiplied (x) by 365 days equals (=) $12,045 per year. That amount divided (÷) by 12 months equals (=) $1,003.75, which rounds up to $1,004 per month. The family continues to receive the same amount in SPC subsidy because the daily per diem is less than established DCBS rates. 
  • The child is age seven (7), a LOC two (2), and the PCP rate to the family is $60 per day. In this scenario, DCBS staff should utilize the corresponding DCBS rate, which would be $53.42 per day, $19,498 per year, and $1,625 per month. The family cannot receive an SPC subsidy that exceeds established DCBS rates. 
  • The child is age seven (7), a LOC one (1), and the PCP rate to the family is $40 per day. In this scenario, the family would receive $29.57 per day multiplied (x) by 365 days equals (=) $10,793 per year divided (÷) by 12 months equals (=) $902 per month. Because the youth’s LOC is one (1) and the youth is seven (7) years of age, the family will receive the basic advanced rate. The family cannot receive a rate that exceeds established DCBS rates.



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