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Casey Child Welfare Financing Survey: Family Foster Care Provider Classifications and Rates

Section3:Statefamilyfostercarerateprofiles


Alabama Profile

Family Foster Care Rates Table (Rates implemented in 2007) Service type/level Age ranges Per Diem % of family foster care

caseload in this category

Basic Foster Care 0‐2 $14.20

77‐78.5% 3‐5 $14.63

6‐12 $14.99

13‐18 $15.39

Therapeutic Foster Care 0‐2 $35.06

18%

3‐5 $35.49

6‐12 $35.85

13‐18 $36.25

18‐21 $36.25

Medically Fragile All ages $35.51 3.5‐5%

NOTES:

(1) Percentages listed are statistical estimates based on the ages of the young people currently in care. State is not currently able to access reliable cohort data through their new SACWIS. State is currently working with Casey Family Programs to restore their ability to track that data set.

Payment or reimbursement for incidentals (other than the daily rate): Type of payment/reimbursement Maximum $ provided

Emergency clothing School clothes

All of these items could be allowed as needed and are determined through Individual Planning. There are no noted caps with regard to reimbursement for incidentals as long as the reimbursement is not prohibited by State and/or Federal law. All determinations regarding spending are addressed in the Individuals Service Plans and supporting documentation and receipts are required. Any costs/purchases above $500 have to be approved by the Department’s Finance Review Committee.

Allowance for children Book/school supplies Camp Diaper Family vacation Graduation expenses Holidays/birthdays School clothes Sibling visits Supplemental school fees in year‐round schools

NOTES:

(1) An initial clothing allowance of $200 is sometimes given. This determination is based on the specific needs of the child. If parents or guardians provide sufficient clothing at the time of removal, those funds are not expended. The clothing allowance is most often used to provide start up supplies and clothing for newborns. Many counties, however, have tremendous community support and clothing and supplies are collected and donated to the counties from community organization to support youth in foster care. The initial clothing allowance is provided on an individual needs basis. Extra‐ordinary expenses can be reimbursed if agreed on in advance. (2) Additional detail on clothing (excerpts from TFC Policy (See Appendix for a copy of this document.): If the parents are unable to provide an adequate initial supply of clothing or if the Department is unable to provide this through some other source, the foster parents should be authorized to purchase an initial specified amount of clothing to be paid for from local public or private funds when such is available. Workers and foster families can assist accordingly.

(3) Eight percent (8%) of the board payment should be allotted each month for clothing expenses. This may not always meet the ongoing need for clothing as children outgrow or clothes need to be replaced; therefore, counties are allowed through Local Fund

Polices to spend up to $500.00 per year for clothing. (Refer to Local Funds Policy) The foster care facility (foster family boarding home, therapeutic foster home) is expected to provide clothes for the child from the board payment as long as the child remains in foster care.

Description of Service Types/Rate Levels Source: Excerpts below from Alabama Department of Human Resources Foster Care Board Rates. See Appendix for a copy of this document.

The medically fragile rate is for children with medical conditions that require special training for the foster parents in order to care for the child. Therapeutic board rate is for children with serious mental or emotional problems that require specialized training and additional interventions to deal with. Child must have a DSM‐IV diagnosis. Source: Excerpts below from TFC Policy. See Appendix for a copy of this document. A link to the Therapeutic Foster Care Manual is: http://dhr.alabama.gov/documents/TFC_Manual.pdf

Therapeutic foster care (TFC) exists to serve children and youth whose special emotional needs lead to behaviors, that in the absence of such programs, they would be at risk of placement into restrictive settings, e.g. hospitals, psychiatric centers, correctional facilities, or residential treatment programs. A DSM‐IV Axis I diagnosis as documented by a current psychological or psychiatric evaluation within 24 months without the associated behaviors is not necessarily an entrance criterion into the TFC placements. A child may not be placed in TFC or moderate residential care with an IQ below 65. Children with IQ’s below 65 should be referred to mental retardation developmentally delayed placements. TFC also aims to serve the families of the children that are placed within the program, supporting child‐family relationships consistent with the permanency goals outlined in the family’s ISP.

There are two levels of TFC services. All children who meet the criteria for TFC will enter at the Comprehensive TFC level. Children in TFC placements will be assessed semi‐annually by the Multi‐dimensional Assessment Tool (MAT) to determine their continued need for TFC services. Step‐down TFC is a reduced level of service need identified by the MAT. This level is identified for children who no longer need comprehensive TFC services but may require more services than offered in a traditional foster home setting. For step‐down procedures refer to the Therapeutic Foster Care Manual Core Services section.

Out‐of‐Region TFC placements are approved by the county consultant in the Office of Child Welfare Consultation, if the assigned consultant cannot be contacted, intake in the Office of Child Welfare Consultation gives approval. The Office of Permanency must be contacted for approval for placement under the age of six (6) in TFC. Refer to Therapeutic Foster Care Manual Revised October 2005 for further information. The manual is located on the web‐site.

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: Multi‐systemic Assessment Tool

Information on rate‐setting process/frequency: Rates are driven by legislative approval. The changes in foster care rates are generally driven by an introduction of a bill by a legislator which is generally spurred by constituent concerns or advocacy groups lobbying for an increase. There has been no such successful action since 2007. Rates are not revised to reflect rates of inflation.


Alaska Profile



Foster Care Base Rate: Basic Rate* 0‐29 mos Min: $27.67; Max: $39.29

94.34% 30 mos‐11 yrs Min: $24.59; Max: $34.91

Fostering Independence Assistance: Basic Rate*

12‐1819‐20

Min: $29.20; Max: $41.46 Min: $29.20; Max: $41.46

Foster Care Base Rate: Specialized* 0‐29 mos Min:$35.17; Max:$46.79

2.64% 30 mos‐11 yrs Min:$32.09; Max:$42.41

Fostering Independence Assistance: Specialized*

12‐1819‐20

Min:$36.70; Max:$48.96 Min:$36.70; Max:$48.96

Foster Care Base Rate: Structured* 0‐29 mos Min:$42.67; Max:$54.29

2.5% 30 mos‐11 yrs Min:$39.59; Max:$49.91

Fostering Independence Assistance: Structured*

12‐1819‐20

Min:$44.20; Max:$56.46 Min:$44.20; Max:$56.46

Medically Fragile All ages Rate TBD based on assessment/XIX waiver

0.22%

Teen w/ Baby All ages Rate TBD using non‐custody child’s age

0.29%

Emergency Foster Home Care * Less than 24 hrs notice/Cannot exceed 30 days

All ages Min: $36.89; Max: $52.38

Emergency Foster Group Home Care* Less than 24 hrs notice/Cannot exceed 30 days

Min: $76.89; Max: $109.18

NOTES: (1) *Geographical difference multipliers applied. Rates in Alaskan villages across the state vary. Multipliers range from 1.00% to 1.42%. See State of Alaska‐Department of Health and Social Services, Orca Foster Care Rate Schedule, Effective July 1, 2008 in Appendix. (2) Percent of caseload averages are based on payments issued during the month of November 2011


Assessed on an as‐needed basis within regulation and policy. Incidentals have various spending limitations based on several criteria – need, age, funding availability from other resources, placement type (in home, licensed out of home, unlicensed relative, institutional, etc.) and legislative appropriation of funds. For detailed information on incidental payments/reimbursements, see Appendix for Office of Children’s Services Special Needs Spending Matrix.

Description of Service Types/Rate Levels Source: Excerpts below from 6.2.2.3.A. Augmented/Difficulty of Care Rates for Children in Foster Care or Fostering Independence Assistance. See Appendix for a copy of this document.

Specialized Care: Children who qualify for the specialized care rate have identified special needs that require more intensive care and supervision from the foster parent.

Structured Care: Children who qualify for the structured care rate have identified severe problems that require specialized training by the care provider and a structured environment and their needs are more than can be provided through basic or specialized care, but residential care placements are not required to meet their needs.

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: Alaska Difficulty of Care Assessment

Information on rate‐setting process/frequency: Revisions to foster care rates vary. The most recent increase, effective July 1, 2008, increased rates 28.9% from the rates that had last been increased in 1999. All increases are subject to legislative appropriation of supplemental funds. Rates are revised to reflect rates of inflation as determined by the state legislative process. The standard rate for the foster care maintenance payment is the US Health and Human Services Federal Poverty Guideline for a household of one person for the State of Alaska, which includes a 24.8% cost of living differential as determined by the federal government. The standard daily rate may be increased by a geographical differential up to 42% over standard rate as defined by state regulation (7 AAC 53.030 (b) and emergency foster care rates are calculated as 120% over standard rate in addition to a geographical differential. The standard rate is also adjusted by the child's age with ages less than 30 months decreased by 10%; ages 30 months to 11 years decreased by 20%; and ages over 12 years decreased by 5%. The emergency foster care rate is not adjusted by a child's age, however, eligibility exists only when a child is placed with less than 24 hour notice and may not exceed 30 days.


Arizona Profile



Foster Care Basic 0‐11 $19.6882.6%

12‐18+ $21.72

Foster Care Special level 2 0‐18+ $23.52 8.7%

Foster Care Special level 3 0‐18+ $29.94 7.2%

Foster Care Medically Fragile 0‐18+ $35.75 1.5%

NOTES: (1) Rates are what the foster homes are paid directly. The rates do not include Home Recruitment Study and Supervision (HRSS) services which are paid to private providers responsible for recruitment and supervision of foster homes. (2) Rates do not include daily clothing and personal allowances. These payments are included in the table below.


Emergency clothing/Emergency clothing‐EXTRA

Emergency clothing allowance: $150.00 per state fiscal year Emergency clothing‐EXTRA: $100 per state fiscal year (e.g., Fire, Flood, Theft)

Clothing Daily allowance

0‐12 mos: $0.53

1‐2 yrs: $0.53

3‐5 yrs: $0.53

6‐11 yrs: $0.79 12‐18+ yrs: $1.02

Personal allowance Daily allowance

0‐12 mos: $2.10*

1‐2 yrs: $0.95**

3‐5 yrs: $0.10

6‐11 yrs: $0.33

12‐18+ yrs: $0.72 *For diapers and formula **For diapers

Books Education Expenses $82.50 max per school year. For books, supplies, course fees, student services and physical education. May be approved for special pre‐school and college level, technical and vocational classes.

Diapers (Special) $62.50 per month. This allowance must be authorized monthly. Available with medical documentation for children who require additional funds for diapers.

Supplemental extra school tuition and fees $165 per session. For use during summer sessions or interim sessions at year round schools.

Graduation expenses $220.00 maximum. Available for High School only for cap, gown, ring, yearbook, and other graduation related fees.

Special needs $22.50 per state fiscal year. Available to assist foster parents with expenses such as holidays, birthdays, and special

occasions.

Passport allowance Reimbursement for the actual cost of obtaining a passport book or card. Receipts are required. One time reimbursement per child.

NOTES: (1) Excerpts above from State of Arizona Administration for Children, Youth & Families, Family Foster Home Care Rates and Fees Schedule, Rates effective March 1, 2009. Please see Appendix for a copy of this document.

Description of Service Types/Rate Levels Assignment of children to various rate levels is determined by the unique needs of each assessed case. In order for the CPS Specialist (case manager) to recommend to the CPS Unit Supervisor that a foster parent should receive a higher foster care rate than the basic rate for a specific child, the case manager must complete several assessment windows in CHILDS. The information in these windows pertains to the child's special needs, medical/dental conditions, psychological and behavioral health conditions, educational needs, and etc. This is not a diagnostic tool. It is a guide to assist case managers in their decision to recommend to their supervisor that the daily 24/7 care for a specific child merits a foster care rate over and above the basic daily rate. Any rate above the basic rate requires the approval of the CPS Unit Supervisor.

Information on rate‐setting process/frequency: The Foster Home rate schedule adjusts when the Division of Children Youth and Families receives an increased appropriation from the legislature for Foster Care rates. Rates are not revised to reflect rates of inflation.


Arkansas Profile



Basic rate 0‐5 $13.48

‐‐ 6‐11 $14.47

12‐14 $15.45

15‐17 $16.44

Special Board Rate Based on nature and extent of child’s special needs; cannot

exceed $460/mo above standard board rate for child’s age group. If child is eligible for SSI, rate can

be $460 above SSI rate.

‐‐

NOTES: (1) Special board rates can be provided when foster parents are caring for a child with special needs and the child’s needs cannot be met with the regular board payment. Although they use the PACE Exam, it is not the only thing used to determine the child’s needs/level of care. They utilize the tools or medical record and psych evaluations as well as foster parent daily accommodations to determine special board per policy.


Emergency clothing $135 initial

Clothing Special payment (on an as‐needed basis; not a regular clothing allowance): $400 per quarter

Allowance for children $35 per month

Books/school supplies No maximum

Camp No maximum

Graduation expenses $500 per year

Holidays/birthdays $30 per year

Parent/sibling visits (transportation or food reimbursement)

No maximum

Description of Service Types/Rate Levels For “Special Board Rate” policy and descriptions of various rate levels, see Appendix for copies of: Instructions, Justification for Levels of Care Special Board Rate Form CFS‐304 and Justification for Special Board Rate Form.

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: PACE (Project for Adolescent and Child Evaluation) Exam, Special Board Rate

Information on rate‐setting process/frequency: State reviews the board rate every 5 years which aligns with the Child and Family Services Plan development. The next review will be in 2014. However, rates might not change when they are reviewed. Rates are not revised to reflect rates of inflation.


California Profile Family Foster Care Rates Table (Basic rates implemented in 2012; specialized care rates implemented in 2008) Service type/level Age ranges Per Diem % of family foster care

caseload in this category Basic 0‐4 $21.04

‐‐

5‐8 $22.78

9‐11 $23.97

12‐14 $25.08

15‐19 $26.27

Specialized Care Varies by county ‐‐

NOTES: (1) There are 54 participating counties responsible for maintaining and administering county‐specific specialized care systems. Each county has its own rate system, criteria and methodology. Caseload unknown. Not all counties have a specialized care system. (2) All of California’s licensed foster family homes receive the minimum of the rates reflected above. The California Department of Social Services sets the rates that counties pay their foster family homes across the state. California pays providers monthly set rates rather than per diem rates as reflected; however, for consistency purposes for this report, California’s monthly rates have been converted to per diem rates.

Description of Service Types/Rate Levels See http://www.childsworld.ca.gov/PG1649.htm for each county’s specific rates and assessment tools/methodology. Source: Excerpts below from http://www.childsworld.ca.gov/PG1649.htm

Specialized Care

1. What is specialized care? Specialized care provides a supplemental payment to the family home provider, in addition to the family home basic rate, for the cost of supervision (and the cost of providing that supervision) to meet the additional daily care needs of an Aid to Families with Dependent Children‐Foster Care (AFDC‐FC) child who has a health and/or behavior problem. Placement of children who need specialized care in family homes complies with the intent of State and federal requirements that a child is entitled to placement in a family environment, in close proximity to the parent's home, and consistent with the best interest and special needs of the child. California's specialized care rate setting system promotes these concepts. 2. Can any AFDC‐FC child with a health and/or behavior problem receive a specialized care increment? Children who are placed under the authority of a court order, either as a dependent or ward of the Juvenile Court, relinquishment, voluntary placement agreement or guardianship may be eligible to receive a specialized care rate if the county has a specialized care system. Not all counties in California have a specialized care system.

3. Are there any restrictions on the type of facility in which the child must be placed to receive a specialized care rate? Children placed in a licensed or approved family home, licensed small family home, the certified home of a Foster Family Agency non‐treatment program or the home of a relative or nonrelated legal guardian may be eligible to receive a specialized care rate.

4. Who is responsible for the development, maintenance, and administration of the specialized care rate setting system in California? California's county welfare departments are responsible for developing, maintaining, and administering county‐specific specialized care systems. The State provides technical assistance to counties to modify or adopt a system. Currently 54 counties have specialized care systems.

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: State agency does not use a tool, but county agencies might. Each county has its own criteria for determining the increment.

Information on rate‐setting process/frequency: Basic rates are increased annually, and revised to reflect rates of inflation (adjusted according to the California Necessities Index). The last time specialized care rates were changed was in 2008. The specialized care rates are increased when the legislature grants an increase to the specialized care rates. A county may choose to apply a cost‐of‐living adjustment to its specialized care increment during the 2011–12 or 2012–13 fiscal years. To the extent that a county chooses to apply a cost‐of‐living adjustment during that time, the state shall not participate in the costs of that adjustment.


Colorado Profile Family Foster Care Rates Table (Rates implemented in 2009) Service type/level Age ranges Per Diem % of family foster care


‐‐ 11‐14 $13.08

15‐21 $14.12

Specialized County specific ‐‐

NOTES: (1) Colorado is a county‐based state, so the 64 counties each negotiate their own rates with providers. The rates listed above are the “base anchor rates” that the state agency sets (based on the cost to raise a child per day). However, counties can go above or below these rates in terms of what they pay providers. (2) The specialized rates and classifications are county‐specific. Counties use their own needs‐based care tools to classify children into different rates.


School clothes $86 per time child is placed in care

Respite $20 per month, given to foster care provider (e.g., babysitting)

Description of Service Types/Rate Levels The specialized rates and classifications are county‐specific. Counties use their own needs‐based care tools to classify children into different rates.

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: State agency does not use a tool, but county agencies do. Each county has its own needs‐based care tool.

Information on rate‐setting process/frequency: Rates are changed based on legislative decision‐making. No set timeframe upon which rates are reviewed/changed. Last change was actually a decrease. Rates are not revised to reflect rates of inflation.


Connecticut Profile


caseload in this category Foster/Relative Care 0‐5 $25.73

66.4% 6‐11 $26.03 12‐18 $28.24

Medically Complex $46.63 6.9%

Therapeutic FC $91.07 2.0%

Therapeutic FC Wrap $133.00 16.0%

Therapeutic FC Medically Fragile $130.63 0.7%

NOTES: (1) Percentage of caseload data: Total does not equal 100%, due to some providers being paid child specific rates, not the standard per diem.


Emergency clothing $300 per initial removal

Camp Not defined

Graduation expenses $500 per child

Sibling visits $100 per visit

Wrap Services $5,000 per request. Wrap funds are used for expenditures that go beyond what is normally paid for. Wrap funds are to be used to preserve the child in the home or placement. These expenditures are very individualized and would be difficult to subject to a bidding process.

Description of Service Types/Rate Levels A child with complex medical needs is one who has one or more of the following:

a diagnosable, enduring, life‐threatening condition a medical condition that has resulted in substantial physical impairments medically caused impediments to the performance of daily, age‐appropriate activities at home,

school or community a need for medically prescribed services as identified on the Certification of Child’s Complex

Medical Needs form, DCF‐2101.

Those children with behavioral disorders, mental health needs, or intellectual disability who do not have one or more of the conditions listed above are not included in the category of children with complex medical needs.

Therapeutic Foster Care (TFC) is an intensive, structured, clinical level of care provided to children with serious emotional disturbance (SED) within a safe and nurturing family environment. Children in TFC receive daily care, guidance, and modeling from specialized, highly trained, and skilled foster parents. TFC families receive

support and supervision from private foster care agencies with the purpose of stabilizing and/or ameliorating a child's mental/behavioral health issues, and achieving individualized goals and outcomes based upon a comprehensive, multifocal care plan, and facilitating children's timely and successful transition into permanent placements (e.g., reunification, adoption, or independent living).

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care:

Child and Adolescent Needs and Strengths, Mental Health (CANS‐MH)

Ohio Youth Problems, Functioning and Satisfaction Scales (Ohio Scales)

Information on rate‐setting process/frequency: Increases in rates are requested with the biennial budget request. Due to the financial crisis of the past few years, the state hasn’t had an increase since the SFY 08 fiscal year. Rates are revised to reflect rates of inflation; requested every 2 years.


Delaware Profile Family Foster Care Rates Table (Basic rates implemented in 2000; Governor’s Task Force (GTF) rates implemented in 2003) Level of Care (LOC) Rate Table

Service type/level Age ranges Per Diem % of family foster care caseload in this category

Child Level of Care: 0 0‐9 $13.04

‐‐ 10‐15 $14.84

16 & up $16.79


‐‐ 10‐15 $16.84

16 & up $18.79


‐‐ 10‐15 $17.84

16 & up $19.79


‐‐ 10‐15 $18.84

16 & up $20.79

Baby Rate $13.04 ‐‐

Governor’s Task Force (GTF) Rate Table

CHILD Level PROVIDER Level Per Diem % of family care caseloadin this category

GTF 1 or 2 Paid according to the child’s Level of Care and Age (per table above)

‐‐

GTF Level 3 GTF Level 3 $35.00 ‐‐



GFT Level 3 GTF Level 4 $35.00 ‐‐



GFT Level 3 GTF Level 5 $35.00 ‐‐



All Levels of Care and GTF Levels

Emergency $55 $13.04 (baby)

‐‐

NOTES: (1) Governor’s Task Force (GTF) rates: these levels are associated to the 2001 task force report. The GTF made recommendations for a variety of settings, and because of budget and workforce barriers the state was only able to implement GTF Levels 3‐5. (GTF Level I (Basic) and Level 2 (Moderate) have not been implemented). Due to this, state operates off two different payment tables currently:

Level of Care Rates: which assign children by level of care (0‐3) and age group, and are paid to foster parents with GTF levels of 0‐2.

GTF Rates: which assigns both children and foster parents GTF levels (parents GTF levels based on experience, training, etc) and rate is determined accordingly, per table above.

(2) Percentage of caseload receiving various rates: Approximately 57% of foster families receive what is considered the basic rate for children in their home and 43% of foster families receive a higher rate for children in their home.


Emergency clothing A 1 time, separate payment. Maximum by child's age:

0‐9 yrs: $120.17

10‐15 yrs: $148.84

16+ yrs: $211.05 Maximum by GTF:

GTF Level 3, 4, or 5: $211.05

Clothing & Incidentals $211.05 per request. As requested by the provider and approved by the client's case worker

School supplies All foster care clients are provided $150 per year ‐ with additional funds as approved by caseworker/supervisor.

Travel/camp As approved by caseworker, supervisor and regional administrator. Cost varies per request. No maximum amount memorialized.

Graduation expenses $300 per request. As requested by the provider and approved by the client's caseworker.

Description of Service Types/Rate Levels Information entered by a caseworker from an element table in the SACWIS system calculates a score based on the child’s needs and a caregiver’s effort caring for a particular child to determine the level of care. Caregivers are rated on skills, experience and training to calculate a payment schedule. GTF Tables with further detail on characteristics of children, assessment, child’s needs, services required of the foster family, training, supports, and systems needs are found in Appendix, Division of Family Services, Foster Care Model. **NOTE: GTF Basic Level I and Moderate Level 2 have not been implemented. However, state notes that the information under the “characteristics of children” and “child’s needs” columns for these two tables utilize related domains to how the Levels of Care are determined.

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: DSCYF Self Developed Assessment

Information on rate‐setting process/frequency: The last basic foster care rate increase was 2000. The Governor's Task Force rates for Levels 3, 4, and 5 were established in 2002. Rates are not revised to reflect rates of inflation.


District of Columbia Profile Family Foster Care Rates Table (Rates implemented in 2010) Service type/level Age ranges Per Diem % of foster family care

caseload in this category Regular 0‐11 $30.66

‐‐ 12 & up $32.97

Special 0‐11 $31.26‐‐

12 & up $34.17

Handicapped 0‐11 $33.23‐‐

12 & up $36.52

Multi‐Handicapped 0‐11 $38.99‐‐

12 & up $43.04

NOTES: (1) Many of DC’s foster homes are contracted through private agencies. The rates above are guidelines for private agencies’ payments to foster parents, though some may actually pay different rates.


Emergency clothing Available on request for special circumstances

Graduation expenses

Other things a child may need could be provided on a case‐by‐case basis

Description of Service Types/Rate Levels Placement classification is determined by: the placement unit; individual social workers; and availability. CFSA policy for determining the Level of Care and establishing the appropriate board rate. In determining the level of care that a child requires, CFSA uses four levels to determine the maintenance amount that a child will receive. Based upon the needs of the child, a level is awarded. The awarded level translated to a per diem amount which is a calculation of the amount of money that it may cost to provide care on a daily basis for that child. These levels and rates are established agency policy. The following is a discussion of determinants used to establish a level. Level I – Normal The normal board rate is paid for the basic and routine care required by a child who comes from a neglecting or abusing family. It is expected that basic care will include bringing the child into the regular, daily life of the family and providing 24 hour/day adult supervision. Level II – Special The special board rate is paid for the child who has a regular, recurring special need that requires extraordinary time or expense on the part of a foster parent. A special need would be a recurring or on‐going, professionally diagnosed medical, psychiatric, education or social need. Level III – Handicapped

The handicapped rate is paid for a child who needs foster parent intervention because he cannot accomplish normal age‐appropriate life processes (e.g. eating, bathing, toileting, dressing, ambulating, emotional and/or social control) without adult intervention. Children who are classified as handicapped require parents who are specially trained to provide daily care and participate in the child’s treatment plan. Level IV – Multi‐Handicapped The multi‐handicapped board rate is paid for a child who requires adult intervention in more than one age‐appropriate daily living process (e.g. eating, bathing, toileting, dressing, ambulating, emotional and/or social control). This rate is reserved for the most severely handicapped children. Extensive training may be needed for parent to provide an adequate level of care for the multi‐handicapped child.

Information on rate‐setting process/frequency: Currently no set schedule for how often rates are revised. Rates are revised to reflect rates of inflation, on a variable frequency.


Florida Profile Family Foster Care Rates Table (Rates implemented in 2006) Service type/level Age ranges Per Diem % of family foster care


‐‐ 6‐12 $14.47

13 & up $16.93

Medical $16.57 ‐‐

Emergency: Family Shelter 0‐11 $13.74‐‐

12 & up $14.86

NOTES: (1) Rates are guidelines, not absolute limits or requirements. In line with the policy memos, the CBC (community based care) lead agencies are supposed to pay their providers at least the minimum, but actual payment levels depend on local negotiation within their allocated total budget for the purpose. The amount should be the “floor,” but it is not audited. (2) Medical per diem is a stand‐alone paid for room/board/basic essentials to the foster parent, but for homes designated Medical Foster Homes it is supplemented for eligible children in these placements according to an assessed level of reimbursement in the Medicaid Handbook. If a foster home gets certified as a Medical Foster Home under a program in the Department of Health, they can claim additional reimbursements at different levels for children in their homes from another department's budget (Medicaid). The amount that they can claim depends on the needs of the child. There are three levels of reimbursement: Level I ($38.80 per day); Level II ($48.50 per day); Level III ($67.90 per day). This would be additional reimbursement available for the people caring for those children, but like many other services it is not considered part of the child welfare budget. Medical foster care is administered by the Department of Health/Children's Medical Services, but the Agency for Health Care Administration is the Medicaid agency and actually pays for the services.


These may be paid by local community based care lead agencies but there is no statewide rate structure. What is paid depends on CBC (community based care) lead agency negotiation with foster parent providers.

Description of Service Types/Rate Levels Medical foster care: The use of medical foster care is determined by a multidisciplinary assessment team under the management of the Department of Health/Children’s Medical Services and levels of Medicaid reimbursement determined according to a State Plan and Medicaid Handbook (AHCA). The Dept. of Children and Families is heavily engaged in the process, but does not unilaterally make the determination. A child welfare caseworker identifies a child potentially eligible for, and refers for assessment, to medical foster care services according to the interagency (Dept. of Health/Children’s Medical Services, Department of Children and Families, Agency for Health Care Administration) Statewide Operational Plan. The assessment is done by a multidisciplinary team, using criteria in the Plan. Services are delivered under Department of Health management, and paid for using Medicaid funds from AHCA. The child welfare agency does not include the funds for these services in its budget. For more information, see Florida Medicaid, Medical Foster Care Services Coverage and Limitations Handbook (http://portal.flmmis.com/FLPublic/Portals/0/StaticContent/Public/HANDBOOKS/CL_07_070201_MFC_ver1_1.pdf).

Information on rate‐setting process/frequency: Rates are only increased across the board when specific legislative appropriation for this purpose is received. Rates are not revised to reflect rates of inflation.


Georgia Profile Family Foster Care Rates Table (Rates implemented in 2007) Service type/level Age ranges Per Diem % of family foster care

caseload in this category Standard 0‐5 $14.60

78% 6‐12 $16.50 13 & up $18.80

Waiver—higher rate No fixed maximum; based on the needs

of the child

22%


Initial clothing Will reimburse a foster parent for some initial clothing purchases, especially if the child has no clothes to speak of. Only allowed based on the foster parent providing receipts. Maximums vary by age:

0 ‐12 yrs: $200

13+: $300

Clothing After a year, the foster parent can go for another clothing allowance (flat $300 across all age groups) but receipts are needed; it is not automatic. The clothing reimbursement is not intended to fully cover the clothing costs of the child—more an incentive to the foster parents.

Description of Service Types/Rate Levels Staff can request a waiver for a higher rate for an individual child based on special or unique needs of the child. The waiver of the normal rate needs to be approved by staff in the central state office. There is no set scale for what the waiver can be (e.g., a CAFAS score of “x” leads to a per diem increase of $y per day). It is really incumbent on the assigned case manager to make a compelling argument that special and unique needs of the child require a waiver.

Information on rate‐setting process/frequency: There is no specific frequency with which rates change. Rates are not revised to reflect rates of inflation.


Idaho Profile

Family Foster Care Rates Table (Rates implemented in 2012)

NOTES: (1) Level III Specialized rates are supplements to the basic rates, however Treatment rates are stand‐alone. (2) Payment for Shelter Care: Payment for placement of children requiring temporary, emergency alternate care is twenty dollars ($20) per day for children from birth through age seventeen (17), for a maximum of thirty (30) days of shelter care for each uninterrupted placement. (3‐18‐99) {IDAPA 16.06.01) (3) Clothing is a separate payment from room and board; rates above do not include clothing. In most regions they go by a standard up to $50 per month in addition to the room and board, but mostly it is figured out by a clothing inventory and discussion between social

worker, birth parent and foster parent.


Emergency clothing No maximum set

Clothing/School clothes Costs for clothing will be paid, based upon the Department's determination of each child's needs. For school clothes, no maximum set

Books/School supplies No maximum set

Camp No maximum set

Diaper No maximum set

Graduation expenses No maximum set

Holidays/birthdays $30 for Christmas gifts and $20 for birthday gifts paid in the appropriate months

Sibling visits No maximum set

Supplemental school fees in year round schools No maximum set

School fees School fees due upon enrollment will be paid directly to the school or to the alternate care providers, based upon the Department's determination of the child's needs.


Level II Basic 0‐5 $9.9081% 6‐12 $11.15

13‐18 $14.89

Level III Specialized: Mild – Basic + (Supplement to basic rate)

$2.96 2%

Level III Specialized: Moderate – Basic + (Supplement to basic rate)

$4.93 3%

Level III Specialized: Severe – Basic + (Supplement to basic rate)

$7.89 6%

Treatment: Mild (Range w/ Maximum) $26.30‐$32.88

8% Treatment: Moderate (Range w/ Maximum) $39.45‐$46.03

Treatment: Severe (Range w/ Maximum) $52.60‐$59.18

Shelter Care (Level I) 0‐17 $20.00

Description of Service Types/Rate Levels Source: Excerpts below from Guide for Specialized Foster Care. See Appendix for a copy of this form.

Level III Specialized Foster Care Payment Schedule Guideline: Level III Mild Base Rate + $90

For children that require the resource parents to expend extra amounts of time and energy to meet the child’s needs.

chronic medical problems

frequent time‐consuming transportation for parental visits or appointment

behaviors requiring extra supervision and control

the need for preparation for independent living

Level III Moderate Base Rate + $150

For children with conditions which require considerable amounts of time, energy and commitment on the part of the resource parents to meet the child’s needs.

ongoing major medical problems

behaviors which require immediate action or control

alcohol or drug abuse

Level III Severe Base Rate + $240

For children with conditions which will require extraordinary amounts of time, energy and commitment on the part of the resource parents to meet the child’s needs.

Axis I Diagnosis

severe developmental disability

severe physical disability such as quadriplegia

Treatment Foster Care Payment Schedule Guideline: Treatment Mild

$800 ‐ $1,000

The needs of the child at this level would necessitate additional supervision and/or intervention by the treatment foster parent that would extend beyond Level III Severe. Treatment Mild Level may include:

Coordinating intervention strategies with multiple service providers and involving multiple systems, which would also include working with the child/youth’s parent/guardian.

Safety plans are in place and monitored by the resource parent

Weekly behavioral tracking of the child and documentation by the resource parent

Support by the CFS social worker/clinician or contracted designee that would included a minimum of one monthly face‐to‐face contact with the child and treatment resource parent, and phone contact with the treatment resource parent at least every seven days. This pattern of contact may be more frequent if determined necessary by the Department based on the needs of the child/youth.

Treatment Moderate $1,200 – $1,400

The needs of the child at this level would necessitate additional supervision and/or intervention by the treatment resource parent that may involve:

Coordinating comprehensive intervention strategies with multiple service providers and involving multiple systems, which would also include working with the child/youth’s parent/guardian.

Daily behavioral tracking and documentation

Support by the CFS social worker/clinician or contracted designee that would included a minimum of face‐to‐face contacts with the child and treatment resource parent every other week, and phone contact with the treatment

resource parent at least every seven days. This pattern of contact may be more frequent if determined necessary by the Department based on the needs of the child/youth.

Treatment Severe $1,600 ‐ $1,800

The needs of the child at this level would necessitate constant supervision and or intervention by the treatment resource parent that may involve:

Coordinating comprehensive intervention strategies with multiple service providers and involving multiple systems, which would also include working with the child/youth’s parent/guardian. The complexity of the child’s needs would necessitate an intervention plan that was highly flexible, creative, and adaptive while maintaining communication will all relevant individuals so that interventions are consistent throughout the child’s experience.

A safety plan that is not intermittent, but must be continuously maintained throughout the placement period

Behavioral tracking and documentation that monitors incremental periods throughout the day (ie. Hourly)

Support by the CFS social worker/clinician or contracted designee that would include face‐to‐face contacts with the child and treatment resource parent at least every seven days, and an additional phone contact with the treatment resource parent at least every seven days. This pattern of contact may be more frequent if determined necessary by the Department based on the needs of the child/youth.

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: Child and Adolescent Level of Care Utilization System (CALOCUS)

Level III Specialized Foster Care

Information on rate‐setting process/frequency: Rates are only changed if requested by the agency and approved by the Idaho Legislature. This does not happen annually. Rates are not revised to reflect rates of inflation.


Illinois Profile Family Foster Care Rates Table (Rates implemented in 2008) Service type/level Age ranges Per Diem % of family foster care

caseload in this category Basic Licensed (DCFS supervised) Under age 1 $12.63

13.3%

1–4 $12.89

5–8 $13.45

9–11 $14.30

12 & up $15.48

Basic Licensed (private agency supervised) Under age 1 $36.43

58.7%

1–4 $36.69

5–8 $37.25

9–11 $38.11

12 & up $39.29

Specialized Licensed (private agency) Avg. rate – all ages $119.48 28.0%

NOTES: (1) Private agency rates: DCFS pays the entire amount to the private agency and it passes through the room and board portion of the payment to the foster parents. For regular performance foster care, the private agencies are required to pay at least the rates listed for basic DCFS homes. To state’s knowledge, virtually all foster care agencies pay foster parents this DCFS‐specified minimum amount. There is one agency which historically has utilized its own contributed and/or endowment funds to pay somewhat more. See Note under table below regarding payments for incidentals within the private agency rates. (2) Specialized rates: These are the rates as negotiated with each private agency based initially upon its submission of a budget and, after audited costs are available, based on audited costs as limited by any cost‐of‐living increase factor. Part of the negotiations involves assuring that the private agency passes on to the foster parent an amount sufficient for the care of children with specialized needs.


Emergency clothing $289.05 per child per incident

Books/School supplies $50 per year

Camp $260.35 per year

Graduation expenses $512.50 per occasion (Jr. and Sr. high school graduation only)

Holidays/birthdays $10 per birthday and per holiday (such as Christmas or Chanukah)

Sibling visits $150 per visit (not per child per visit)

Supplemental school fees in year round schools $10.25 per year

School trips $104.55 per child per approved trip

Camp clothing and supplies $97.38 per year

Home infant equipment $307.50 once per infant

NOTES: (1) For Department homes, the per diem rates do not include non‐recurring incidentals such as camping fees, camp clothing, or graduation expenses. These are paid separately as foster parents request them. However, the Private Agency regular foster care rates include a payment, beyond the room and board rate, of $19.79 per month per child. It covers the non‐recurring incidentals that are listed below. The private agency receives the funds and disperses them to foster parents as they document the expenses they have.

Below is an excerpt from Department Payment Procedures 259. This applies only to private agency regular foster care programs, who receive the funds monthly, based on what are believed to be the average non‐recurring incidentals costs. “**Includes $19.79 per month for non‐recurring incidentals for the following child expenses but not limited to:

1. Replacement clothing not covered by the monthly clothing allowance 2. Camp expenses 3. Lessons in recreation or artistic endeavors 4. Music instrument purchase or rental 5. Membership fees and equipment for Boy Scouts, Girl Scouts, 4‐H, YMCA, YWCA, 6. School supplies 7. Gym shoes and equipment 8. Graduating expenses 9. School trips 10. Tutoring 11. Summer school fees 12. Travel unrelated to placement 13. Medical expenses not covered by the Healthy Kids Program 14. Interpreter/Translation Expenses”

Description of Service Types/Rate Levels The Child and Adolescent Needs and Strengths (CANS‐MH) form is completed as part of a staffing. If the score of needs is sufficient, the child is eligible for specialized foster care. There is then a decision as to whether the child needs primarily Medical Needs specialized foster care or Mental Health Needs specialized foster care. An appropriate specialized provider is then selected.

Diagnostic Methods and Tools Used to Determine Eligibility for Specialized Foster Care, Residential Treatment, and Transitional and Independent Living Programs CAYIT

The Child and Youth Investment Team (CAYIT) Program is a multi‐disciplinary team decision‐making process responsible for identifying, developing and ensuring the timely implementation of service delivery for DCFS/POS youth in care facing threats to their placement stability and overall well‐being.

Child and Youth Investment Teams (CAYIT) provide access to additional supports, services and/or placement types (e.g., Specialized Foster care, residential treatment, and transitional and independent living programs).

The Child and Youth Investment Teams are comprised of a trained facilitator, clinical reviewer and implementation coordinator charged with ensuring the timely implementation and delivery of services recommended. Mandatory or required participants of all CAYIT staffings include the youth (when 12 years or older), the youth’s substitute caregiver, current treatment providers and the assigned DCFS/POS caseworker or supervisor. Additional participants will include identified family members, school personnel, specialty consultants and youth‐selected sources of support.

The Child and Adolescent Needs and Strengths (CANS‐MH) is completed in conjunction with all CAYIT staffings. A child or youth meets the criteria for “specialized foster care” based on the severity and duration of his or her impairment as indicated by the CANS – e.g., scores of 2 or 3 in one or more area. Then, a matching checklist is employed that assures agreement between a child’s diagnosed needs and the specialized program chosen, as well as geographic proximity between the program and the child’s family’s location. CAYIT Goals: Ensure safety and placement stability.

Promote resiliency and increase well‐being by building on the youth’s strengths and increasing supports (e.g., relationships with identified family, family, extended family, and community).

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: Child and Adolescent Needs and Strengths, Mental Health (CANS‐MH)

CANS 2.0

Information on rate‐setting process/frequency: The intent is annual rate increases based on a COLA to maintain payment for cost of care for foster children. However, Illinois state law requires a balanced budget, and requires that available funds are subject to appropriation. Appropriations are limited to available funds. The effect is to limit COLAs and rate increases. Rates are revised to reflect rates of inflation; intent is annually if affordable.


Indiana Profile


caseload in this category Foster care (maintenance payment) 0‐4 $18.88

‐‐ 5‐13 $20.51

14‐18 $23.66

Foster care with Services 0‐4 $26.65

‐‐ 5‐13 $28.28

14‐18 $31.43

Therapeutic Foster Care 0‐4 $38.79

‐‐ 5‐13 $40.42

14‐18 $43.57

Therapeutic Plus 0‐4 $62.54

‐‐ 5‐13 $64.17

14‐18 $67.32

Non‐ward baby (added to teen mom’s per diem)

0‐4 $18.88

NOTES: (1) These rates have been set by the Department of Children’s Services. DCS‐licensed foster parents receive the rates listed above. Child Placing Agencies (CPAs) are required to pay their foster parents at least the amounts listed. CPAs may pay parents higher rates than those above, but will not be reimbursed by DCS for those additional costs.


Initial clothing Up to $200 when child is initially removed from home

Special occasion allowance Special occasion allowance: $50 for birthday, $50 for December holidays

Travel expenses Incurred on behalf of a child in the foster home if the parent travels more than 5.3 miles a day (approx 162 miles/mo) in a month for a specified purpose. The payment is excess miles paid at the State mileage rate.

Foster care liability insurance

DCS will pay the premium for foster care liability insurance for foster parents through the DCS approved vendor.

Annual Personal allowance (includes, but not limited to: high chair, car seat, baby equipment, prom dress or special occasion clothing, school pictures, school events/fees, equipment and fees for extracurricular activities, tutoring, summer school, bus passes)

Up to $300 annually per child after child has been in placement at least 8 days

Other payments Other costs for caring for a child that are not included in maintenance or enhanced supervision payment and are not described above [in the provider manual]. The costs be determined by the department to be prudent and reasonably necessary in order to serve the child's assessed needs in connection with the child's permanency plan or other plan of care and treatment. Requires an appeal to the Regional

Manager for additional funds.

NOTES: (1) Excerpts above from Indiana Department of Child Services Provider Manual: Child Placing Agency Rates, located at http://www.in.gov/dcs/files/CPA_Provider_Manual_with_Appendix.pdf. Please see this document for more information on incidental payments/reimbursements.

Description of Service Types/Rate Levels Source: Excerpts below from Indiana Department of Child Services Provider Manual: Child Placing Agency Rates. See http://www.in.gov/dcs/files/CPA_Provider_Manual_with_Appendix.pdf for a copy of this document.

Foster Care: This option is for a child 0‐18 years old that scores at a “1‐Foster Care” on the CANS placement decision model. The child’s needs can be met in a family and community setting with access to school, friends and community‐based resources. Child may have a history of mild behavioral/emotional needs that require a low level of service (such as outpatient therapy). Foster Care with Services: This option is for a child 0‐18 years old that scores at a “2‐Foster Care with Services” on the CANS placement decision model. For children 0‐5, child has moderate developmental needs. For children 5‐18 years old, child has moderate behavioral/emotional needs. In addition to foster care in the community, the child, family, and foster family may be supported with treatment and support services to address and manage identified needs. Therapeutic Foster Care: This option is primarily for a child 5‐18 years old who scores at a “3‐Therapeutic” on the CANS placement decision model. At this level of care, child has either a medical, developmental or behavioral/emotional need, or a high‐risk behavior, that is moderate to severe. In addition to foster care in the community, the child, family and foster family are supported with treatment and support services to address and manage identified needs. (Note: child may also have a combination of any of the needs above). This may also be an option for a child 0‐5 years old in appropriate circumstances as determined by the department. Therapeutic Plus Foster Care: This option is primarily for a child 5‐18 years old who scores either at the group home or residential placement on the CANS (i.e., 4‐7 on the CANS placement decision model) but can be supported in a foster home with intensive services. This also may be an option for a child 0‐5 years old in appropriate circumstances determined by the department.

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: Child and Adolescent Needs and Strengths (CANS)

Information on rate‐setting process/frequency: Department has rate setting authority for Foster Parents under IAC 465 2‐18. They are required to hold an annual public hearing and to review rates annually. Rates are revised annually to reflect rates of inflation.


Iowa Profile Family Foster Care Rates Table (Rates implemented in 2012) Service type/level Age ranges Per Diem % of family foster care


‐‐ 6‐11 $16.62

12‐15 $18.19

16‐20 $18.43

Level 1: Basic Maintenance + $4.81 0‐5 $20.79

‐‐ 6‐11 $21.43

12‐15 $23.00

16‐20 $23.24


‐‐ 6‐11 $26.24

12‐15 $27.81

16‐20 $28.05


‐‐ 6‐11 $31.06

12‐15 $32.63

16‐20 $32.87

NOTES: (1) Percentage of caseload data not available; however state reports that many of the children receive the basic rate. Basic and Level 1 comprise the majority of the caseload, and a small number for Levels 2 and 3. (2) At initial placement all foster families receive the basic rate until the Foster Child Behavioral Assessment is completed.

Payment or reimbursement for incidentals (other than the daily rate):

NOTES: (1) Ancillary services/other tangible goods: Both may be authorized, before these are purchased, by the service area manager when a child’s escrow funds are not available. (Escrow funds would be a child who receives SSI or SSA funds, etc.) Tangible goods are for a special needs child include, but not limited to, building modifications, medical equipment not covered by Medicaid, educ. Materials not covered by educational funds, & communication devices not covered by Medicaid. Child care when the foster parents work, the child is

Type of payment/reimbursement Maximum $ provided

Annual clothing allowance/Emergency clothing

$237.50 for every child if need be and every calendar year. The clothing allowance is at the judgment of the worker when clothing is needed at the time the child is removed from the home.

Additional clothing allowance $190.00 per calendar year per child to replace lost clothing, or because of growth or weight change and the child does not have escrow funds to cover the cost. Most children receive up to the $237.50 initially in a calendar year and then if they grow or have a weight change, etc., they can use up to $190 for clothing

Books/school supplies $50 per calendar year per child

Funeral expenses $650

Child care based on child care rates If authorized.

Ancillary services / other tangible goods No max; as needed per child

not in school, provided by a licensed foster parent or licenses/registered child care provider when available, and the provision of child care is identified in the child’s case permanency plan. Ancillary services are (special needs child) specialized classes for a special needs child when directed by the case permanency plan, recreation fees, in‐home tutoring not covered by educational funds.

Description of Service Types/Rate Levels Iowa uses a form entitled the Foster Child Behavioral Assessment, which is based not only on behaviors but other needs. It is completed within 30 days of the initial placement by the caseworker in conjunction with the foster parent, therapist, etc. See Appendix for a copy of this form. The total points from the assessment correspond to the child’s rate level:

0 to 11 points = basic rate

12 to 19 points = Level 1 (basic + $4.81/day)

20 to 35 points = Level 2 (basic +$9.62/day)

36 points and above = Level 3 (basic + $14.44/day) Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care:

Foster Child Behavioral Assessment

Information on rate‐setting process/frequency: Statute sets the rate at 65% of the USDA estimated cost to raise a child in the Midwest. Actual reimbursement level is determined by the state legislature. Rates are not revised annually and the state legislature reviews annually during the legislative session. The legislature and/or the Governor is the only authority that decreases or increases rates. Rates are not revised to reflect rates of inflation


Kansas Profile

Family Foster Care Rates Table (Rates implemented in 2010)

NOTES: (1) Rates above reflect the Department for Children and Families (DCF) recommend rates. State has five regions and rates vary by provider. These services are contracted out and rates are established by contract with private providers. DCF identifies a suggested rate for each type of service (which are the rates listed above). The provider can negotiate the amount of payment for the services provided. The rates differ based on the bids received and accepted from the provider for each region. Normally the provider negotiates a payment within a few dollars of the amount suggested by DCF. The rates do not differ according to the child’s age, only by type of placement.


Emergency clothing $250 per person

Graduation expenses No parameters in policy

Respite care The recommended rate is $32.66 per day limited to 7 consecutive days per episode. The annual limitation would be not to exceed $1,000 (Each year a family could have 4 separate episodes providing 7 consecutive days of respite care).

Day care $1,000 per client per year

Description of Service Types/Rate Levels Specialized settings are settings to accommodate physical needs. Therapeutic settings provide for emotional/behavioral needs of the child. Satellite setting is a temporary, short‐term placement until a more permanent setting that is suitable is identified.


Child and Adolescent Functional Assessment Scale (CAFAS)

Child Behavior Checklist (CBCL)

Information on rate‐setting process/frequency: Rates recommended by DCF (as reflected in the table above) have not been increased since 2009. The contract rates paid to the Foster Care providers for all placement and services are adjusted for inflation, subject to legislative approval. The contract rates were increased in FY 2011, but remained the same for FY 2012. At the award of new contracts, the recommended rates will be reviewed, but they may not change.


Family Foster Home $22.16 50%

Specialized Family Foster Home $53.13 29%

Satellite Foster Home $33.82 19%

Family Foster Home Secure‐PILOT $90.00 Less than .5%

Therapeutic Family Foster Home $115.00 1.5%

Emergency Family Foster Home $36.66 .5%

Emergency Shelter $115.00 Less than .5%


Kentucky Profile Family Foster Care Rates Table (Rates implemented in 2007) Service type/level Age ranges Per Diem % of family foster care


‐‐ 12 & up $24.70

Basic Advanced 0‐11 $24.90‐‐

12 & up $26.90

Care Plus (Therapeutic): Basic $40.00 ‐‐

Care Plus (Therapeutic): Advanced $45.00 ‐‐

Medically Fragile: Basic $40.00 ‐‐

Medically Fragile: Advanced $45.00 ‐‐

Medically Fragile: Degreed $48.00 ‐‐

Specialized Medically Fragile: Advanced $56.40 ‐‐

Specialized Medically Fragile: Degreed $91.55 ‐‐


Emergency clothing/Initial clothing Emergency clothing: Based on child needInitial clothing:

3‐10 yrs: $50

11 & up: $100

School clothes $100 per year

Graduation expenses (senior expenses) $650

Holidays/birthdays $60 per year

LifeBook $50 per year

Description of Service Types/Rate Levels Rate categories are sometimes based on parent training, sometimes on child need, and sometimes a combination of both. Medically Fragile Child has some special medical issues Specialized Medically Fragile

Degreed: Foster parent must be a current active Kentucky RN or a licensed physician

Advanced: Foster parent must be a licensed nurse Care Plus (Therapeutic)

Advanced: Foster parent must be current on training and have at least 1 year experience as a Care Plus home



Information on rate‐setting process/frequency: No set timeframe for rate revisions. Rate changes need legislative approval. USDA guidelines are reviewed to compare with foster care reimbursement rates. Rates are not revised to reflect rates of inflation.


Louisiana Profile Family Foster Care Rates Table (Rates (except for TFC) implemented in 2007; TFC rate implemented in 2012) Service type/level Age ranges Per Diem % of family foster care


‐‐ 2‐5 $13.57

6‐12 $14.96

13‐17 $16.70

Special Board: Category 1 (added to basic rate) 0‐17 Up to $10.00 ‐‐

Special Board: Category 2 (added to basic rate) 0‐17 Up to $20.00 ‐‐

Special Board: Category 3 (added to basic rate) 0‐17 $21.00 or above

‐‐

Specialized Home (added to basic rate and any special board rate; paid whether child is placed in home or not, for home to be available to provide this level of care)

0‐17 $26.30 ‐‐

Alternate Family Care (added to basic rate and any special board rate)

0‐17 $19.73 ‐‐

Therapeutic Foster Care 0‐17 $65.71(includes

administrative payment & payment to foster parent)

‐‐

Diagnostic & Assessment Home (added to basic rate; paid whether child is placed in home or not, for home to be available to provide this level of care)

0‐17 $42.74 ‐‐

NOTES: (1) Percent of caseload data is not available, but state reports that most children are likely receiving just the basic rate. (2) Special Board Rates are supplements to the basic rate in regular foster homes, but may also be supplements to the Specialized, Alternate Family, and Therapeutic Foster Homes. Diagnostic and Assessment Homes do NOT receive special boards. A tiered system determines the amount of special board payment that is allowed for any type of foster home.


Emergency clothing $300 per child at initial entry into care if needed and in other emergency situations such as hurricane destroying home and clothing or sudden extreme growth spurt. Otherwise, a portion of the daily basic care rate is intended to be used to supplement the child's wardrobe on an ongoing basis.

Books/school supplies $50 per year

Camp $200 per calendar year, per child, and only as needed to meet a developmental or socialization need

Graduation expenses $500 per child and one time only as they graduate or earn a GED certificate

Sibling visits No maximum

Emergency personal care items $25 per child at initial entry into care if needed. Otherwise, a portion of the daily basic care rate is intended to be used to supplement the

child's personal care needs on an ongoing basis.

Mileage reimbursement per mile $.51/mile based on odometer readings for foster parents and caseworkers to reimburse for mileage accrued in transporting child to case related activities such as court hearings, medical appointments, therapy appointments, family visits, agency case planning meetings, etc.

Lifebook supplies, photo film, film developing

$100 per year, per child as needed. Includes purchase of school pictures annually.

Description of Service Types/Rate Levels Children are assigned to different rate levels based upon caseworker and supervisor determination of child needs and availability of resources. Source: Information provided by state and excerpts below from:

Louisiana Department of Social Services, Office of Community Services: Chapter 6. Foster Care, Part 16. Payments, Expenditures and Approvals, Section 6‐1605 Board Payments for Foster Children

Louisiana Department of Social Services, Office of Community Services: Chapter 6. Foster Care, Part 16. Payments, Expenditures and Approvals, Section 6‐160 Subsidy Payments for Specialized Foster Family Home

Louisiana Department of Social Services, Office of Community Services: Chapter 6. Foster Care, Part 5. Placement in Certified Family Foster Homes and Other Programs, Section 6‐525 Treatment Foster Homes Alternate Family Care/Therapeutic Foster Care Program {Please note: according to state, the policy regarding the payment rate for TFC agencies has changed since this document. The correct rate is listed in the table above}

See Appendix for copies of these documents.

Specialized Homes: For (1) large sibling groups; (2) children with emotional and/or behavioral problems; (3) children with medical problems, handicapping conditions, and/or developmental disabilities; (4) children with mental retardation; and (5) adolescents. (For more information on Diagnostic and Assessment Homes, See Appendix for a copy of Louisiana Department of Social Services, Office of Community Services, Chapter 9. Home Development, Part 5. Certification Process, Section Certification Process, 9‐555 Certification of Specialized Family Foster Homes). Foster parents who are approved to receive a subsidy are paid $800.00 a month in addition to the regular board rate, any special board rates, and any reimbursable for which the child or foster parent is eligible. These are foster homes which are specialized to provide a certain type of care and service. The subsidy is a fee for the services of the foster parents and for their maintaining the spaces for use by the agency. Alternate Family Care (public agency homes) and Therapeutic Foster Care (private agency homes): For children with difficult behaviors that no regular foster home can be found to provide care and as a next step prior to seeking residential placement. Both the Alternate Family Care Program (AFC), which OCS administers, and the Therapeutic Foster Care Program (TFC), which is privately administered, are designed to provide treatment in a family setting. Treatment foster homes are to provide therapeutic foster family care and comprehensive services to foster children with extraordinary physical, mental, or developmental disabilities or emotional/behavior problems. An AFC or TFC certification requires all children placed in the home to meet the extraordinary needs/problems requirement unless it is a sibling or an infant of the foster child. Diagnostic and Assessment Homes: Used typically for the first 90 days in the few areas of the state that have these homes, when a child enters care and it is obvious the child is going to need specialized care due to medical or behavioral needs and they want to get a good picture of the child’s needs before proceeding with a more permanent placement. (For more information on Diagnostic and Assessment Homes, See Appendix for a copy

of Louisiana Department of Social Services, Office of Community Services, Chapter 9. Home Development, Part 5. Certification Process, Section Certification Process, 9‐560 Certification of Diagnostic and Assessment Homes). Special Board Rate: A special board will require assessment of the time, efforts and events that a foster parent spends based on the special needs of the child, which is over the normal amount of time for a child within their appropriate developmental stage. The time, tasks and efforts of the foster parents to interact, support and/or provide services to ameliorate the “special needs” of the child should, with the approval of the Supervisor, District Manager, Regional Placement Specialist or Regional Program Specialist (both positions will be referred to as RPS throughout the rest of this section of policy) and/or State Office be reflected in the special board compensation. Supporting documentation of the child’s special needs should be filed in the case record, which could include an Individual Education Plan (IEP), speech needs, physical therapy, etc. Also when considering special board for Specialized Homes, AFC and TFC, the foster parent is already being compensated for the placement of the child through their monthly stipend. The children placed in these homes are expected to have a higher level of needs. The special need of the child and the time and efforts of the foster parent should exceed Level 1 and perhaps Level 2 before a special board is requested.

Information on rate‐setting process/frequency: No timeframe by which the rates are reviewed/revised. Based on USDA report on raising children in urban south. Rates are not revised to reflect rates of inflation.


Maine Profile



Level A $16.50 46%

Level B $26.25 24%

Level C –TFC $39.38 10%

Level D –TFC $52.50 12%

Level E –TFC $65.62 7%

Medical‐TFC $60.00 1%

NOTES: (1) Rates do not include daily clothing allowance. These payments are included in the table below. (2) A Special‐TFC rate may be negotiated for children of most severe needs.


Clothing Per diem per child, varies by age:

0‐3 yrs: $1.52

4‐10 yrs: $2.47

11‐20 yrs: $3.67

Diaper $0.99 per diem per child

Description of Service Types/Rate Levels Source: Excerpts below from Child and Family Services Policy V. G‐1. Levels of Care, Effective 1/27/2010. Please see: http://www.maine.gov/dhhs/ocfs/cw/policy/index.html?v__g_1__levels_of_care.htm for a copy of this document.

Levels of Care – Defined Levels of Care (LOC). The following levels of care designations are used to determine the reimbursement rate to be paid to the resource parent. A. LOC A ‐ Basic Care ‐ Minimal Needs. This level is for children who have minimal needs and require the type of care offered in a family resource home for children. "Children with minimal needs" may have occasional episodes of behavioral and/or emotional problems which do not significantly impair the child’s interpersonal relationships and ability to function at home or at school. "Children with minimal needs" are expected to function largely at an age appropriate level educationally, socially, physically, medically, developmentally, and emotionally. B. LOC B ‐ Basic Care ‐ Mild Needs. This level is for children who have mild needs that require a higher than LOC A‐Basic Care level of services in a family resource home. "Children with mild needs" may display the following: minor developmental delays, episodic problems relating with others, infrequent concerns/problems regarding performance in school, limited or short‐term mental health treatment needs, and stable/routine medical needs.

C. LOC C ‐Treatment Care ‐ Moderate Needs. This level is for children who have moderate needs and require the type of care offered in a specialized children’s resource home. "Children with moderate needs" may display the following: moderate developmental delays, ongoing problems with interpersonal relationships including a history of self‐abusive behaviors, and minor episodes of aggression toward others. They may also have ongoing needs for mental health treatment, monitoring of school problems and/or special education needs and/or medical supports. D. LOC D ‐ Treatment Care ‐ High Needs. This level is for children who have high needs that require a higher than LOC C – Treatment Care level of services in a specialized resource home. "Children with high needs" may display the following: significant developmental delays, impulsivity requiring external control, ongoing conflict with others, unresponsiveness to social prompts, need for special education services to address performance and/or behavior issues, slow or no progress in mental health treatment, and may require in‐home supports for medical conditions. They may have a history of self‐abusive behaviors, including assaults to others. E. LOC E ‐ Treatment Care ‐ Severe Needs. This level is for children who have severe needs that require a higher than LOC D – Treatment Care level of services in a specialized resource home. "Children with severe needs" may display the following: severe developmental delays, a risk to self or others including deliberate aggression toward others, inability to maintain control in spite of close supervision, chronic/serious medical condition, and poor/no response to mental health treatment. F. LOC M ‐ Basic Care ‐ Exceptional Medical Care. This level is for medically fragile children in Basic Care with a high level of physical medical need that does or could lead to care in an "intermediate care nursing facility". It is likely that these issues will not moderate and may become more severe over time and require specialized care to support activities of daily living. It must be shown that the resource parent has obtained the training necessary to meet the medical care needs of the child and is directly providing that level of care. Examples of children who meet this criteria include, but are not limited to, children that: require a feeding tube, congenital heart disease/abnormalities requiring surgery and monitoring, weekly to monthly hospital/specialist monitoring, kidney dialysis, severe forms of cancer, and/or severe failure to thrive with long range effects. ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ NOTE: State notes that classification of a child in SPECIAL‐TFC category is based on the special needs or level of the child and/or family.

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: Child and Adolescent Functional Assessment Scale (CAFAS)

Child Habilitation and Assessment

Information on rate‐setting process/frequency: Legislatively driven rate changes. Recently rate changes have only been made based on budgetary issues. To meet budgetary requirements rate changes to foster parents have been made twice in the last 10 years. Rates are not revised to reflect inflation.


Maryland Profile Family Foster Care Rates Table (Rates implemented in 2008) Service type/level Age ranges Per Diem % of family foster care

caseload in this category Regular Care 0‐11 $27.45

43% 12 & up $27.94

Intermediate Care 0‐11 $31.236%

12 & up $31.72

Public Treatment Foster Care 0‐11 $27.45 + DOC stipend 1.3%

12 & up $27.94 + DOC stipend

Private Treatment Foster Care 0‐11 Negotiated48%

12 & up Negotiated

Emergency Care $30.00 0.8%

NOTES: (1) The public TFC homes receive the base board rate, plus a difficulty of care (DOC) stipend which is based upon the needs of the child. The stipend ranges from $350 to $800 (average monthly rate). (2) Private TFC program rates are approved by the Interagency Rate Commission (IRC). Each program submits a budget and staffing ration to justify the rate. The IRC rates vary depending upon what type of services are provided. There is no established range. The IRC rate is the amount the public agency pays to the private agency. The amount paid to the private foster parents is included in that payment. (3) The Emergency Care rate is applicable to public foster homes only. There is no emergency care rate for private TFC. (4) A differential rate is paid for several counties meeting specific criteria relating to percentage of children placed by District of Columbia. The current per diem rates are:

Under 12: $28.76

Over 12: $29.56. There are no separate rates for intermediate or TFC. The differential applies to regular homes only.


Emergency clothing (not provided to private foster care agencies)

$100 per child

Graduation expenses $750 per child

Transportation No maximum. Mileage is reimbursed at the rate set by Department of Budget and Management. As of July 1, 2011, the rate is $.555.

Day care Maximum rates based on Purchase of Care (POC) rates which varies by local jurisdiction. Rates are set by the Maryland State Board of Education.

Description of Service Types/Rate Levels Treatment foster care is governed by regulations. COMAR 02.07.21.06 lists the qualifications. (Excerpts below). A memo was issued in 2009 to reiterate the qualifications for the payment of intermediate rate which are also in regulations (02.07.11.03). The local department assesses the child’s needs and determines what level of service is needed.

Intermediate Care Source: Excerpts below from Policy Guidance on Application for Intermediate Foster Care Rate. See Appendix for a copy of this document. According to COMAR 07.02.11.03, intermediate care is defined as a payment rate above the regular board rate paid to a foster home for a child requiring extra care and supervision because of special physical, emotional, or behavioral needs. COMAR 07.02.11.28G requires the local department to include a written justification in the child’s and foster home records for including the child in the intermediate rate payment category. The justification must include a written certification or evaluation by a physician, psychologist, or licensed social worker stating that the child requires a high degree of supervision and care. COMAR 07.02.11.28 F sets out requirements for foster parents are receiving an intermediate care rate including:

Provide care for a child who requires intermediate care;

Have the desire to make a major investment of time, and the ability to give affection and attention without positive response from the child;

Be required to supervise or provide prescribed physical care, such as the preparation of special medication;

Have the ability to accept and cope with difficult child behaviors;

Participate in social service, medical, or psychiatric treatment plans for the child; and

Participate in training arranged by the local department.

Treatment Foster Care Source: Excerpts below from COMAR 02.07.21.06 provided by state.

A. A child is eligible for treatment foster care if the local department determines that the child: (1) Qualifies for foster care under COMAR 07.02.11.04; and (2) Has one or more of the following conditions:

(a) A serious medical condition including, but not limited to: (i) HIV positive and symptomatic or has AIDS, (ii) Multiple handicaps, or (iii) A symptomatic drug‐exposed newborn; or

(b) A serious emotional, behavioral, or psychological condition including: (i) Psychiatric diagnosis by appropriate qualified professionals, or (ii) History of an ongoing substance abuse problem; or

(c) Developmental disability; or (3) Is in need of a high level of treatment in a family setting.

B. Siblings who do not require treatment foster care may be placed in the same home with a sibling who requires treatment foster care.

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: MD Child and Adolescent Strength and Need Assessment

Information on rate‐setting process/frequency: Foster Care board rates do not change on a schedule. There is no cost of living built in to allow regular increases to the rates. Rates are not revised to reflect rates of inflation. Last rate increase was in 2008.


Massachusetts Profile Family Foster Care Rates Table (Departmental Foster Care rates implemented in 2012; Intensive Foster Care rates implemented in 2010; PACT payments implemented in 2003) Service type/level Age ranges Per Diem % of family foster care caseload

in this category Departmental Foster Care 0‐5 $20.79

59% (w/o PACT supplemental payments)

6‐12 $23.40 13 & up $24.79

Intensive Foster Care N/A $100.94 26%

Departmental Foster Care w/ PACT supplemental payments

Departmental Foster Care rate (based on age) + $7.50/hr (# of hrs varies;

max 40 hrs/week)

15%

NOTES: (1) Departmental Foster Care rates excludes PACT (Parents and Children Together) supplemental payments. PACT supplemental payments are add‐ons to the basic care and maintenance rate if a child has a higher level of needs. There is a request and approval process for PACT payments, and these are decided on an individual basis. For the most part, children are receiving the basic rates. (2) Rate for Intensive Foster Care is the amount the public agency pays the private provider (not what the private provider pays the foster family). The foster family’s rate for intensive foster care is about $50. (3) Rates above do not include a quarterly clothing allowance. These payments are included in the table below.


Clothing Quarterly allowance;

0‐5 yrs: $185.00

6‐12 yrs: $188.75

13 & up: $282.00

Birthday/Holiday $150 per child, annually

Special payments Can be requested on a unique, as‐needed basis

NOTES: (1) See Appendix for a copy of DSS Policy #89‐002 Supplemental Reimbursement Policy, which provides more detail on allowable expenses in the Receiptable Reimbursement Program.

Description of Service Types/Rate Levels Source: Excerpts below from Family Networks RFR provided by state. Intensive Foster Care (IFC) programs provide therapeutic services and supports in a family‐based placement setting to children and youth for whom a traditional foster care environment will not be sufficiently supportive; are transitioning from a residential/group home level of care and require the intensity of services available through this program; or discharging from a hospital setting. Referred children and youth will come from diverse cultural, linguistic, religious, ethnic and/or racial backgrounds and have varying sexual or gender orientations. They may have a range of behavioral, cognitive, and mental health strengths and needs. With the appropriate program strengths, safety planning, and supports, this range for IFC could include children with fire‐setting, sexual offending and sexual reactive behaviors, or various medical needs.

Source: Excerpts below from DSS Policy #89‐002 Supplemental Reimbursement Policy. See Appendix for a copy of this document.

P.A.C.T. (Parents and Children Together) The P.A.C.T. Program compensates foster/pre‐adoptive families who provide planned, specialized services designed to address identified needs related to achievement of the child’s Service Plan goal at the standard hourly rate for a specified number of hours per week. The number of service hours is determined by the child’s P.A.C.T. team, which may be comprised of the child’s Social Worker/Supervisor, Family Resource Worker/Supervisor, the foster/pre‐adoptive family, and the P.A.C.T. coordinator. A foster/pre‐adoptive family delivering P.A.C.T. services may receive reimbursement for up to, but not more than, 40 hours per week. Foster/pre‐adoptive families delivering the maximum 40 hours of P.A.C.T. services per week must be full‐time providers who are not otherwise employed. When a foster/pre‐adoptive child requires P.A.C.T. services beyond the primary foster/pre‐adoptive family’s ability to provide (e.g., foster/pre‐adoptive family is currently providing the maximum of 40 hours per week or is unable to provide a particular task/service), approval to reimburse a qualified adult age 18 or older, known as a P.A.C.T. Assistant, to deliver an additional 20 hours per week, may be granted. P.A.C.T reimbursement maximums (40 hours/individual/week and 60 hours/home/week) are applicable, regardless of the total number of children in the home. Waivers to exceed 60 hours of P.A.C.T. services up to a maximum of 80 hours per week per foster/pre‐adoptive family household may be requested from the Regional Director who determines that the P.A.C.T. is necessary to meet the needs of each child residing in the home for health, safety and well‐being.



Information on rate‐setting process/frequency: Departmental Foster Care Rate increases require

legislative appropriation and explicit direction from the legislature. In 2008, legislation was passed in Massachusetts that says if there is appropriation, the rates should be set to USDA recommended levels. Rates are reviewed every year and increases are sought. The Departmental Foster Care was increased in 2012. Intensive Foster Care rates are governed by MGL Chapter 257 which requires rates be reviewed periodically. The Intensive Foster Care rate was last changed in 2010 and is on schedule to be

revised in 2013. The current PACT rate was set in 2003. Rates are not revised to reflect rates of inflation.


Michigan Profile Family Foster Care Rates Table (Basic rates implemented in 2012) Service type/level Age ranges Per Diem % of family foster care


‐‐ 13‐18 $20.59

Determination of Care Supplement: Level 1 0‐12 Basic + $5.00 ‐‐

13‐18 Basic + $6.00


13‐18 Basic + $11.00


13‐18 Basic + $16.00

Determination of Care Supplement: Level 4 0‐12 Approved rate; max of $80/day

‐‐ 13‐18 Approved rate;

max of $80/day

Medically Fragile: Level 1 Age appropriate daily rate plus:

$8.00 ‐‐


$13.00 ‐‐


$18.00 ‐‐


Approved rate: Max of $80/day

‐‐

Therapeutic Foster Care Supplement Age appropriate daily rate plus:

Max of $50/day ‐‐

NOTES: (1) Percentage of caseload data is not available for FY 11 or 12; However, state reports that approximately 50% of the foster care cases have a DOC level with the majority being spread across Level 1 and Level 2.


Initial clothing Initial clothing allowance (supplement only; based on determined need, not automatically provided to every child); Varies by age

0‐5 yrs: $210

6‐12 yrs: $310

13 & up: $500

Holidays $25 for Christmas

Others: See Appendix for FOM 903‐0 Non Scheduled

Payments DHS‐634 for more detail

Description of Service Types/Rate Levels Rate levels 1‐4 and Medically Fragile designation are determined by results of the appropriate Determination of Care assessment conducted for the foster child.

Source: Excerpts below from FOM 903‐3 Payment for Foster Family Care. See Appendix for a copy of this document.

A determination of care (DOC) supplement may be justified when extraordinary care or expense is required of the foster parents or relative (foster care provider) who is eligible for a foster care payment. The appropriate DOC form is to be completed for every child in a paid foster home or relative placement. The supplement must be based on one or more of the following case situations where additional care is required of the foster care provider or an additional expense exists:

• Physically disabled children for whom the foster care provider must provide measurably greater supervision and care. • Children with special psychological or psychiatric needs which require extra time and measurably greater amounts of care and attention by the foster care provider. • Children requiring special diets which are more expensive than a normal diet and which require extra time and effort by the foster care provider to obtain and prepare. • Children whose severe acting‐out or antisocial behavior requires a measurably greater amount of care and attention of the foster care provider.

See Appendix for copies of the following Determination of Care tools:

Assessment of Determination of Care for Medically Fragile Children in Foster Care

Assessment of Determination of Care for Children in Foster Care (Age one day through twelve years)

Assessment of Determination of Care for Children in Foster Care (Age thirteen years and over)


State‐created Determination of Care

Information on rate‐setting process/frequency: The rates must be legislatively appropriated before they can be raised. An increase may make it to the budget process but the legislature does not always

approve. Rates are not revised to reflect rates of inflation.


Minnesota Profile Family Foster Care Rates Table (Rates implemented in 2012) Service type/level Age ranges Per Diem % of family foster care

caseload in this category CY 2012 Basic 0‐11 $21.06

14% 12‐14 $24.24 15‐20 $25.09

DOC Supplement: Level A (1‐35 pts)

0‐11 Min (1 point): $21.28 –Max (35 points): $28.76

22% 12‐14 Min (1 point): $24.46 –

Max (35 points): $31.94 15‐20 Min (1 point): $25.31 –

Max (35 points): $32.79

DOC Supplement: Level B (36‐70 pts)

0‐11 Min (36 points): $28.98 –Max (70 points): $36.46

22% 12‐14 Min (36 points): $32.16 –

Max (70 points): $39.64 15‐20 Min (36 points): $33.01 –

Max (70 points): $40.49

DOC Supplement: Level C (71‐105 pts)


22% 12‐14 Min (71 points): $39.86 –


Max (105 points): $48.19

DOC Supplement: Level D (106‐140 pts)


12% 12‐14 Min (106 points): $47.56 –


Max (140 points): $55.89

DOC Supplement: Level E (141‐175 pts)


4% 12‐14 Min (141 points): $55.26 –


Max (175 points): $63.59

DOC Supplement: Level F (176‐225 pts)


4% 12‐14 Min (176 points): $62.96 –


Max (225 points): $74.59

NOTES: (1) “DOC” refers to “Difficulty of Care.” All foster children receive a DOC assessment, and based on how many points they are assigned as a result of the assessment, receive a rate that corresponds to the points. “Difficulty of Care” assessed @ .22 per point per day. DOC range is 0‐225.

(2) Minnesota has three classifications of foster homes: (1) Foster Family; (2) Treatment Foster Care; (3) Foster Residence settings. All placements in the three classifications receive basic and are assessed for difficulty of care (supplemental rate). (3) Percent of caseload data are from 2009


Initial clothing allowance Per child as a one time payment for the lifetime. Varies by age:

0‐11 yrs: $425

11–14 yrs: $718

15–20 yrs: $812

Description of Service Types/Rate Levels Rate levels A – F correspond to the number of points a child is assigned on the MDHS Difficulty of Care Assessment. All foster children receive a DOC assessment, and based on how many points they are assigned as a result of the assessment, receive a rate that corresponds to the points. “Difficulty of Care” is assessed @ .22 per point per day, and the point range is 0‐225. See Appendix for a copy of the Difficulty of Care Assessment Schedule.


MDHS Difficulty of Care Assessment

Information on rate‐setting process/frequency: Rates are revised annually and are revised to reflect rates of inflation.


Missouri Profile Family Foster Care Rates Table (Rates implemented in 2008) Service type/level Age ranges Per Diem % of family foster care

caseload in this category Traditional 0‐5 $9.27

94% 6‐12 $11.01 13 & up $12.23

Level A All ages $24.06

6% Level B All ages $48.00

Medical All ages $24.06

Emergency All ages $22.00

NOTES: (1) Data in the table reflects only the public agency homes. 27% of state’s foster care populations are case managed by private contractors. The rates that the public agency pays private contractors are not included in the table above, nor in the percentages. The private contractors negotiate their own contracts with placement providers, but they have to pay within 10% of what the state pays providers. (2) If foster parent training is current, a foster parent may receive an additional $100 per month per child (traditional, medical, Level A).


Clothing Annual allowance:

0‐5 yrs: $250

6‐ 12 yrs: $290

13 & up: $480

Infant allowance (diapers, formula, etc) $50 per month (for 0‐3 yr olds)

Transportation reimbursement for a child's specific needs (ie. court family visit, counseling, medical appointments)

$.37/mile rate. No limit to mileage, however there are policy guidelines pertaining to allowable mileage reimbursement. They get paid the same rate as state workers, as determined by the legislature.

Respite services Respite provider is paid. A unit is a minimum of 12 hours but not more than 24 hours. Foster parents have a set amount of respite units per year per child. All foster parents, with the exception of elevated needs level B foster parents, have 12 units of respite per year. Respite units for elevated needs level B foster parents is 14 units per year plus one weekend per month per level B child.

Childcare services Varies based on geography and age of the child

Description of Service Types/Rate Levels Source: Excerpts below from Child Welfare Manual, Section 4, Chapter 14 Foster Care for Youth with Elevated Needs and Child Welfare Manual, Section 4, Chapter 15 Medical Foster Care. See http://dss.mo.gov/cd/info/cwmanual/section4/ch14/sec4ch14index.htm and http://dss.mo.gov/cd/info/cwmanual/section4/ch15/sec4ch15index.htm for copies of these documents.

Elevated Needs (Level A and Level B):

14.1 Definition

Foster Care for youth with elevated needs is a foster care program designed for the youth who has identifiable and documented moderate or serious emotional and/or behavioral needs. Such a youth requires intensive and individualized intervention to succeed in a community‐based family setting and to achieve their goal of permanency. Resource providers of youth with elevated needs have received specific training in addition to Specialized Training Assessment Resources and Support (STARS) pre‐service training to enable them to work with youth with elevated needs.

14.5 Characteristics of a Youth with Elevated Needs – Level A Youth with elevated needs require greater structure, supervision, and are less able to assume responsibility for their daily care. These youth have typically experienced multiple out‐of‐home placements.

Youth appropriate for Level A fall into one of two categories:

1. Youth presently in a residential setting who may be moved to a less intensive setting, but not to a traditional resource home or to their parents' home; or

2. Youth who lack a viable placement in a traditional resource home and because of their presenting problems would be placed in a residential setting unless an available Level A resource home can be found.

14.5.1 Characteristics of a Youth with Elevated Needs – Level B These youth have serious emotional and/or behavior problems that require the 24‐hour availability of a highly skilled Level B resource parent who is capable of assuming the role of primary change agent. These youth:

1. Because of their presenting problems would be placed in a level III or above residential treatment facility or psychiatric hospital;

2. Have been discharged from a residential treatment facility or psychiatric hospital and who are unable to function in a traditional resource home.

Medical Foster Care:

15.1 Definition A youth in foster care with medically diagnosed extraordinary medical condition(s) and or mental or physical disabilities is eligible to be placed in a resource provider home that is contracted to provider medical foster care if the following statements regarding the foster youth is supported with documentation:

The youth must have a diagnosed medical, mental, or physical condition that requires twenty‐four (24) hour availability of a resource provider specifically trained to meet the elevated medical needs.

The diagnosed condition significantly and substantially impairs the youth’s ability to function on a daily basis.

The youth’s diagnoses and conditions must be included on the Medical Foster Care Assessment Tool, CS‐10, or a physician’s certification for medical foster care.

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: CD 136 (Youth with Elevated Needs Referral Checklist)

CD 137 (Youth with Elevated Needs Referral Form)

Information on rate‐setting process/frequency: No additional detail can be provided regarding how often rate revisions take place, as this is completely contingent upon legislative actions. Rates are not revised to reflect rates of inflation.


Nebraska Profile Family Foster Care Rates Table (Rates implemented in 2010)

Provider: DHHS Traditional Foster Parents Service Level/Type Age ranges Per Diem % of family foster care


0‐27 points 0‐5 $8.09 ‐‐ 6‐11 $10.62

12 & up $12.76

28‐34 points 0‐5 $9.86 ‐‐ 6‐11 $12.43

12 & up $14.60

35‐41 points 0‐5 $11.70 ‐‐ 6‐11 $14.20

12 & up $16.37

42‐46 points 0‐5 $13.51 ‐‐

6‐11 $16.01

12 & up $18.21

47‐51 points 0‐5 $15.32 ‐‐ 6‐11 $17.85

12 & up $20.02

52‐56 points 0‐5 $17.16 ‐‐ 6‐11 $19.69

12 & up $21.86

57‐61 points 0‐5 $18.94 ‐‐ 6‐11 $21.50

12 & up $23.70

62‐66 points 0‐5 $20.75 ‐‐ 6‐11 $23.31

12 & up $25.48

67‐71 points 0‐5 $22.55 ‐‐ 6‐11 $25.12

12 & up $27.29

72‐75 points 0‐5 $24.39 ‐‐ 6‐11 $26.93

12 & up $29.10

76‐79 points 0‐5 $26.60 ‐‐ 6‐11 $29.10

12 & up $31.30

80‐83 points 0‐5 $29.10 ‐‐ 6‐11 $31.66

12 & up $33.83

84‐86 points 0‐5 $32.02 ‐‐ 6‐11 $34.52

12 & up $36.72

87‐88 points 0‐5 $35.28 ‐‐ 6‐11 $37.84

12 & up $39.98

89 or more 0‐5 $38.83 ‐‐ 6‐11 $41.39

12 & up $43.53

NOTES: (1) Reflects points assigned to child through Foster Care Payment (FCPay) Checklist (2) July 1, 2012, per statute, foster parents received an increase in reimbursement of $3.10 per day, per child. This is a 1 year stipend, and will end June 30, 2013.

Provider: DHHS Agency Supported Foster Care Service Level/Type Age ranges Per Diem % of family foster care


0‐24 points $32.00 ‐‐

25‐49 points $43.00 ‐‐

50+ points $69.00 ‐‐

NOTES: (1) DHHS pays “tiered” rate to contractor based on the FC Pay points for an individual child (see table above) (2) July 1, 2012, per statute, foster parents received an increase in reimbursement of $3.10 per day, per child. This is a 1 year stipend, and will end June 30, 2013.

Provider: Nebraska Families Collaborative (Lead Contractor) Service Level/Type Age ranges Per Diem % of family foster care


Basic 0‐5 $27.00 6‐12 $32.00 29% 13‐18 $36.00

Minimal 0‐5 $32.00 6‐12 $38.00 8% 13‐18 $43.00

Moderate 0‐5 $39.00 6‐12 $46.00 18% 13‐18 $51.00

Intensive 0‐5 $54.00 6‐12 $64.00 42% 13‐18 $71.00

Pre‐assessment (first 10 days of placement)

Regardless of age

$38.00 3%

NOTES: (1) Reimbursement rates reflect what subcontractors (Child Placing Agencies) receive, for relative and child‐specific foster homes, rather than what is paid directly to the foster parent. Subcontracting agencies for the Lead Agency (NFC) may vary in their methodology to determine payment rates and what they reimburse foster parents. July 1, 2012, per statute, foster parents received an increase in reimbursement of $3.10 per day, per child. This is a 1 year stipend, and will end June 30, 2013. (2) For relative/child specific foster homes, foster care reimbursements are made directly to the foster parent by NFC and are determined based on the Nebraska DHHS FC Pay checklist with a breakdown by age similar to DHHS Traditional foster parents. The minimum rate NFC reimburses to relative/child specific foster homes is $310/month with the rate increasing according to a child’s needs as determined by the Nebraska DHHS FC Pay Checklist. (3) According to materials provided by state (Response to Senator Dubas: LR236 Attachment F), “Foster parents of children with exceptionally high intensity needs may be paid higher rates using a Special Rate Agreement (SRA).”


Varies based on the provider (e.g., DHHS or lead contractor) See Response to Senator Dubas: LR236 Attachment A and Response to Senator Dubas: LR236 Attachment B in Appendix for detailed information on the payments or reimbursements for incidentals.

Description of Service Types/Rate Levels Source: Excerpts below from Response to Senator Dubas: LR236 Attachment A. See Appendix for a copy of this document.

DHHS: Rate of payment to foster parents is determined through use of the Foster Care Payment (FCPay) Checklist. Each question or item on the checklist deals with a need or behavior of the child that is likely to require something from the foster parent that would be above and beyond what a caregiver usually would do or provide for a child of that age. Each item also has a certain number of points associated with it. The checklist is intended to be completed by a worker, with the foster parent. When it is completed, the number of points is added. That number of points, in combination with the child’s age, determines the monthly payment rate. NFC: Children are assessed at placement and on an ongoing basis, at least every sixty days, but more often if needed, to determine the intensity of care needed for each child. Supplemental pay for each level is calculated using a factor based on the highest level of care for each category. Average monthly payment rate for a relative/child specific placement for all of NFC’s current placements is $399.53 per child, with the lowest being $310/month and the highest being $2,325/month. This does not include the $3.10 daily stipend.

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: Tools vary by provider (DHHS or a lead contractor): includes the Foster Care Rate Evaluation and

Foster Care Rate Form; FC Pay (Foster Care Payment) Checklist

Information on rate‐setting process/frequency: No set schedule upon which rates are revised. Rates are not revised to reflect rates of inflation.


Nevada Profile

Family Foster Care Rates Table (Regular rates implemented in 2007; specialized rates implemented in 2009)

NOTES: (1) The rates above are the base rates for family foster care in Nevada. Counties can augment the State rate with county funds, depending on identified needs of the county. Washoe and Clark Counties (+100,000 population) have add‐on rates that they pay in addition to this base rate. Washoe add‐on rate to regular foster care is $6/day. Clark County uses the same rates as the State for the rural counties. (2) Emergency Shelter rate is paid in Rural Nevada until the date the petition for ongoing custody is filed—usually maximum of 13 days then rate converts to regular family foster rate (3) Percent of caseload data represents January 2009; however, proportion stays fairly consistent


Initial clothing/emergency clothing Initial clothing, for all children entering foster care: Based on age:

0‐4 yrs: $75

5‐12 yrs: $105

13+: $125 Emergency clothing (1 time per year): $50/yr

Books/school supplies August of each year; Maximum varies by age:

5‐12 yrs: $17/yr

13+ yrs: $28/yr

Equipment (E.g., reimbursement for a crib for a new placement that a foster home needs but didn’t have)

$100

Description of Service Types/Rate Levels Source: Excerpts below from Title IV‐E Foster Care Maintenance Payment Program. See Appendix for a copy of this document.

Special Rate Special rates are intended to compensate the foster parent for the additional daily supervision required to care for a child who has special needs which require more time, expertise, and/or supervision on the part of the

Service Level/Type Age ranges Per Diem % of family foster care caseload in this category

Basic 0‐12 $22.4589%

13 & up $25.42

Special Rate 1 Basic + $0.99

11% Special Rate 2 Basic + $2.96

Special Rate 3 Basic + $4.93

Medically Fragile Level I Basic + $4.93

Medically Fragile Level II Basic + $8.22

Medically Fragile Level III Basic + $16.44

Emergency Shelter $25.00

foster parent(s) than is usually expected of a foster parent. These special needs include: Educational Needs: The child has special education needs and is not performing normally for his or her

age and/or development level which require more time, expertise, and/or supervision on the part of the foster parent(s) that is usually expected for a foster parent.

Psychological and Behavioral Needs: The child has needs and behaviors which are considered abnormal for a child of this child’s age which requires more supervision and treatment than is expected for a foster child of this developmental age. The foster parent would be involved in more than monthly treatment for the child.

Medical and Dental Needs: The child has needs beyond routine medical and dental care appointments which requires additional care on the part of the foster parent(s) that are beyond the age‐appropriate needs for a child of this age

The level of the child’s needs is assessed based upon a point value system ranging from 1 – 50 points, with 0 – 19 points indicating no special needs, 20 ‐ 34 points (Level I) indicating special needs, 35 ‐ 49 points (Level II) intensive needs and 50+ points (Level III) exceptional needs. Medically Fragile Rate Medically fragile rates are intended to compensate the foster parent (s) for the additional daily supervision required to care for a medically fragile child with severe and/or chronic medical problems, which require specialized care, intensive medical follow‐up, supportive treatment and continuous monitoring and are based on the level of care needed by the child. The level of care is determined by the child's diagnoses, medical problems, and individual treatment and care needs. As the child's health status changes, the level of care needed by the child may also change. Medically Fragile rates are to reflect improvement or deterioration in health status and care needs. Medically Fragile payments are based on a review of medical documentation of the child's individual level of need and/or risk. Need and/or risk are determined by the child's diagnoses, medical problems, and individual treatment and care needs.

Level I – Lower Risk Medical conditions requiring significant medical follow‐up and specialized care (may include

premature birth, failure to thrive and developmental delays) Drug withdrawal (significant physical symptoms) HIV + (asymptomatic) Fetal Alcohol Syndrome requiring additional care on the part of the foster parent.

Level II – Moderate Risk: Medical conditions requiring intensive medical follow‐up and highly specialized care: May include infants and children who (List not all inclusive):

o Are HIV+ symptomatic (clinical or laboratory: not AIDS diagnosed) o Have bronchopulmonary dysplasia o Need intermittent oxygen o Has a tracheotomy (infrequent suctioning and minimal care required) o Require use of an apnea monitor o Require use of invasive equipment, such as shunt, gastrostomy (G‐tube) feedings, nasogastric

(NGT) feedings, fistulas, catheters Moderate chronic effects of drug exposure (such as hypertonia, moderate developmental delays

and orthopedic problems)

Fetal Alcohol Syndrome ‐ moderate complications Level III – High Risk AIDS diagnosed Chronic, severe medical conditions requiring frequent, intensive care and follow‐up (such as spina

bifida or osteogenesis imperfecta) May include infants and children who (list not all‐inclusive):

o Are on life support systems [ventilator‐assisted/continuous positive air pressure (CPAP)] o Have cardiac or respiratory problems requiring continuous oxygen, medication or special

procedures (such as intensive, frequent tracheal care or suctioning) o Require continuous intravenous therapy (total parenteral nutrition (TPN), intra‐venous

solutions and medications) o Fetal Alcohol Syndrome ‐ severe complications o Severe chronic effects of drug exposure (including episodes of uncontrollable seizures,

acute injury to the brain with long‐term prognosis)

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: Child and Adolescent Service Intensity Instrument (CASII)

Information on rate setting process/frequency: Rate revisions occur as needed based on state funding availability. Rate increases must be submitted and approved through a legislative process. Rates are not revised to reflect rates of inflation.


New Hampshire Profile Family Foster Care Rates Table (Rates implemented in 2011) Service Level/Type Age ranges Per Diem % of family foster care


General (Board & Care) 0‐5 $15.8091.2% 6‐11 $17.14

12‐17 $20.39

Specialized (Board & Care) 0‐5 $21.068.8% 6‐11 $22.85

12‐17 $27.20

Emergency 0‐17 $27.20

NOTES: (1) Percent of caseload data represent payments made on 6/30/11. (2) Rates do not include a daily clothing allowance. These payments are included in the table below.


Emergency clothing $50; One‐time emergency clothing allowance available for children who are placed in foster care and do not have adequate clothing at time of placement. This emergency clothing allowance is not provided to all foster families.

Clothing $1.11 per day per child

Medicaid recipient The full annual premium cost for Medicaid coverage for each foster child.

Foster parent insurance claim Part of annual premium to cover all foster families for any damages incurred as a result of the foster child.

Description of Service Types/Rate Levels Specialized Care is provided to children in foster care who meet specialized care requirements. Children who enter a Specialized Foster Home have demonstrated that their needs are greater than those who are placed in a General Foster Home. Specialized foster parents are experienced care providers who have participated in a series of specialized trainings offered through Granite State College and continue to improve their skills by maintaining sixteen (16) hours of training per year and thirty‐two (32) hours by time of renewal of the license. These foster parents are entitled to the specialized rate only for a child needing specialized care. New Hampshire does not formally use a specific diagnostic tool to determine a child's level of care. All care and services are based on a careful and thoughtful review of all information available about the current situation. This includes the child's or children's needs as reported and as observed, the family's strengths and needs, the history of the alleged maltreatment leading to placement, the permanent and concurrent plan and the ability of the selected placement to work towards those goals and of course, the level of care needed to maintain the safety of the child (ren). All placements are decided in consideration of the unique needs and circumstances of the child and family. The worker arranging for the placement of a child would review all available information on the case and would assess the child and family’s needs. If those needs rose to a

greater level than those placed in general care, administrative approval for the specialized rate would be requested.

Information on rate setting process/frequency: Foster care rates are reviewed biennually for cost of living increases, however there may not be a rate change each time the rates are reviewed; contingent upon the availability and continued appropriation of sufficient funds for this purpose. Rates are not revised to reflect rates of inflation.


New Jersey Profile Family Foster Care Rates Table (Rates implemented in 2012) Service Level/Type Age ranges Per Diem Per Diem % of family foster care


ACUITY 1‐4 ACUITY 5 In Acuity Level 1‐3: 58%In Acuity Level 4: 37% In Acuity Level 5: 5%

Level A 0‐5 $23.54 $31.76 In Level A: 86%

6‐9 $26.07 $34.29

10‐12 $26.86 $35.08

13 & up $27.91 $36.13

Minor Parent (w/ child) $53.53 ‐‐

Level B 0‐5 $25.18 $33.40 In Levels B, C, & D: 14%

6‐9 $27.72 $35.93

10‐12 $28.50 $36.72

13 & up $29.56 $37.78


Level C 0‐5 $26.83 $35.05

6‐9 $29.36 $37.58

10‐12 $30.15 $38.37

13 & up $31.20 $39.42


Level D 0‐5 $28.47 $36.59

6‐9 $31.00 $39.22

10‐12 $31.79 $40.01 13 & up $32.84 $41.06 Minor Parent (w/ child) $58.46 ‐‐

NOTES: (1) Rates do not include a daily clothing allowance. These payments are included in the table below.


Clothing Daily rate; Varies by age and size:Regular

0‐5 yrs: $2.11

6‐9 yrs: $2.11

10‐12 yrs: $2.11

13 & up: $2.69 Oversize

0‐5 yrs: $2.27

6‐9 yrs: $2.27

10‐12 yrs: $2.27

13 & up: $2.96

Description of Service Types/Rate Levels The board rate for a child are based upon what the number of hours the resource family provider spends providing the specific services to the child in placement as determined by the completion of the Resource Family Care Assessment form every three months. Each child in foster care is assessed by a Child Health Unit nurse who assigns an acuity level based upon the health care needs of the child. The acuity level outlines for the nurse the frequency of home visitation, case conferences and when to reassess acuity. Acuity levels are assigned as follows:

Level 1 – well child

Level 2 – well child with behavioral health issues (in counseling but not on medication)

Level 3 – child with a chronic illness that is stable (may be on preventative medication)

Level 4 – child with an acute and/or chronic illness that is active (including all children on psychotropic medications and children requiring monitoring by a physician every three months and infants under 12 months of age requiring frequent monitoring of growth and development.

Level 5 – child with an acute and/or chronic condition that is not stable and can leave to a life threatening condition.

Please note that only Level 5 Acuity provides an additional rate change. Acuity levels 1 through 4 do not result in rate changes within the board rate levels since they are the same.

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: Resource Family Rate Assessment (see Appendix for a copy of this form), Health passport, and Placement Assessment which determines a child's activity level

Information on rate setting process/frequency: Per the United States District Court for the District of New Jersey consent decree, DCF must ensure resource family support rates remain equal to the USDA estimated cost of raising a child in a two parent middle income family in the urban Northeast. The USDA publishes the estimated cost of raising a child in a two parent middle income family in the urban Northeast on an annual basis. DCF reviews these estimates annually and then makes any adjustments to its foster care rates accordingly to remain in line with the USDA estimates. The new rates then become effective in January of each calendar year. The most recent rate increase took place in January 2012. There were some adjustments made to the board rates and clothing due in response to changes in the USDA rates. Rates are not revised to reflect rates of inflation.


New Mexico Profile

Family Foster Care Rates Table (Rates implemented in 2009) Service Level/Type Age ranges Per Diem % of family foster care


Level 1: Foster/Relative Home 0‐5 $16.10 6‐12 $17.20 ‐‐ 13 & up $18.06 Level 2: Specialized Foster Care 0‐5 $22.06

6‐12 $23.16 ‐‐ 13 & up $24.00

Level 3 Variable rate calculated on individual basis according to the needs of the child. Minimum is the max allowable for level

2 foster care, with ceiling of $2,500/month. (Exceptions with

Director’s approval)

‐‐

Treatment/Therapeutic Foster Care 0‐5 $19.50 6‐12 $20.20 ‐‐ 13 & up $20.70

Emergency Foster Home 0‐5 $11.03 ‐‐

6‐12 $11.73

13 & up $12.23

NOTES: (1) Treatment/therapeutic foster care does not include behavioral health costs.


Clothing $600 per calendar year

Activities for children $500 per year

Education expenses $500 per year

Diaper $35 per payment

Family vacation $250/5 days per calendar year

Graduation expenses $750 per lifetime

Holidays/Birthdays $50 per year; Also provide a holiday payment one time per year in December for all children in foster care. Depends on state budget, but typically is $50.

Back to school allowance One time per year at the beginning of the school year for any school age child in foster care. $100.00 if state budget is available.

NOTES: (1) For more detail on payment or reimbursement for incidentals, see PR 8.10.8.8 – PR 8.10.8.30 Permanency Planning Procedures in Appendix.

Description of Service Types/Rate Levels Source: State description and excerpts below from PR 8.10.8.8 – PR 8.10.8.30 Permanency Planning Procedures. See Appendix for a copy of this document.

Level 2 and Level 3 are physical disabilities, medical and high end placements with special needs. Level 2: is for children requiring a higher level of care, structure, and supervision than would be required for a child of similar age or development. Level 3: is for children with significantly higher needs and is generally an alternative to institutional care. Treatment Foster Care is for the most part behavioral. Eligibility for TFC is determined by the Statewide Entity (SE) of the Behavioral Health Purchasing Collaborative. The SE develops and maintains level of care criteria for TFC and all other behavioral health services. More information on the Behavioral Health Purchasing Collaborative can be found at http://www.bhc.state.nm.us. The current SE for the collaborative is OptumHealth.

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: Foster Care Levels of Need (see Appendix for a copy of this form)

Information on rate setting process/frequency: Rates are revised upon request by the agency and approval by the legislature. Rates are not revised to reflect rates of inflation.


New York Profile Family Foster Care Rates Table (Rates implemented in 2010) Service Level/Type Age ranges Per Diem Per Diem % of family foster care


Metro Area Upstate

Regular‐Basic 0‐5 $17.10 $15.58

65.6% 6‐11 $20.15 $18.77

12 & up $23.31 $21.70

Special All ages $37.48 $37.48 22.24%

Exceptional All ages $56.84 $56.84 12.16%

Emergency (Basic) 0‐5 $34.20 $31.16 6‐11 $40.30 $37.54 12 & up $46.62 $43.40

NOTES: (1) Rates represent the Maximum State Aid Rates (MSAR) for Foster Boarding Home Payments and Adoption Subsidies. Local districts may pay up to the MSAR. (New York state does not set minimums). (2) Metro area includes New York City, Nassau, Suffolk, Westchester, and Rockland counties (3) Rates do not include a daily clothing allowance and daily diaper allowance. These payments are included in the table below.


Initial clothing Initial clothing allowance upon entry into foster home; limits set by district.

Clothing Daily clothing allowance Maximum State Aid Rate (MSAR), varies by age:

0‐5 yrs: $.98

6‐11 yrs: $1.37

12‐15 yrs: $2.13

16 & up: $2.61

Books/School supplies There are no statutorily or regulatory stated limitations, but the amounts are up to the discretion of the district.

Camp There are no statutorily or regulatory stated limitations, but the amounts are up to the discretion of the district.

Diaper Daily diaper allowance Maximum State Aid Rate (MSAR): $1.81 per child ages 0‐3

Graduation expenses There are no statutorily or regulatory stated limitations, but the amounts are up to the discretion of the district.

Holidays/Birthdays There are no statutorily or regulatory stated limitations, but the amounts are up to the discretion of the district.

School clothes There are no statutorily or regulatory stated limitations, but the amounts are up to the discretion of the district.

Sibling visits There are no statutorily or regulatory stated limitations, but the amounts are up to the discretion of the district.

Supplemental fees in year round schools There are no statutorily or regulatory stated limitations, but the amounts are up to the discretion of the district.

Sign and Language Interpretation Exp There are no statutorily or regulatory stated limitations, but the

amounts are up to the discretion of the district.

Window guards/child safety preventive measures

There are no statutorily or regulatory stated limitations, but the amounts are up to the discretion of the district.

Compensation for damage caused by child $1,000 per foster child per foster home over a 2‐yr period from the date of placement in that home

NOTES: (1) Please see attachment in Appendix, Program Manual: Standards of Payment for Foster Care of Children, Sections B‐8 – B‐10, B‐1, for more detail about incidental expenses.

Description of Service Types/Rate Levels Source: Excerpts below from Program Manual: Standards of Payment for Foster Care of Children, Sections B‐2 – B‐7 (See Appendix for a copy of this document)

2. DESIGNATION OF CHILDREN IN FOSTER BOARDING HOMES Children in foster boarding homes are designated as Normal, Special, or Exceptional by the local department of social services which has responsibility for the child. This is the case for both children in district‐operated foster boarding home programs and programs operated by voluntary child care agencies. Children should be designated within 90 days of admission and re‐designated according to changes in condition while in care.

a. Normal The board and care payments to foster parents caring for children in the Normal category cover: food, personal care, household furnishings and operations, educational materials, recreation, normal transportation and shelter. Shelter includes rent or homeowner’s costs, maintenance, repairs and fuel and other utilities.

b. Special

The payments for children in this category include those items listed under Normal. The higher maximum allowance is to compensate the foster parents for the additional services that the special children require.

c. Exceptional

Foster parents caring for children in the exceptional category are expected to provide the services required for children in normal category and also to provide close supervision for 24 hours a day. The family environment must be carefully structured to enable these children to live in a foster home rather than institutional or group care.

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: State agency does not use diagnostic tools, but Local Social Services districts might (state is a State supervised, county administered state). Typically children start off in basic/least restrictive settings.

Information on rate setting process/frequency: Revisions require approval of the Division of the Budget (control agency). Rates are reviewed every year for a cost of living adjustment, but might not increase every year. Rates are revised to reflect rates of inflation.


North Carolina Profile



Basic Family Care‐Public Agency Supervising 0‐5 $15.62

50% ‐ 70%

(Maintenance) 6‐12 $19.10

13 & up $20.84

Basic Family Care‐Private Agency Supervising 0‐5 $47.11

(Maintenance + Administrative) 6‐12 $51.42

13 & up $53.85

Therapeutic Foster Care Basic maintenance + $88

30% ‐ 50%

Specialized County discretion

NOTES: (1) North Carolina is a county‐administered state, and specialized foster care rates are up to county discretion. State hears anecdotally that a few counties “bump up” for certain children, there is no state policy. (2) Private Agency rates are the amount paid to the private agency by the public agency. The amount that should be paid to the family is not specified by the state, although the state publicly advocates for the base rate so that all parents are financially supported similarly. State knows many go above and some below the basic rate.

Description of Service Types/Rate Levels Specialized: Rates up to county discretion. Therapeutic foster care: NC Medicaid pays $88/day when the child has been determined medically eligible.

Information on rate setting process/frequency: North Carolina utilizes the USDA "cost to raise a child" report to inform the request to the North Carolina General Assembly. The GA sets the rates based on this request and availability of funds. Rates are reviewed annually, but might not actually change that frequently. The rates require approval by the state general assembly, and that body has not approved any rate changes since 2008. Rates are not revised to reflect rates of inflation.


North Dakota Profile

Family Foster Care Rates Table (Basic and TFC rates implemented in 2012) Service Level/Type Age ranges Per Diem % of family foster care


Basic 0‐4 $22.88

‐‐ 5‐12 $26.23

13 & up $28.78

PATH‐TFC 0‐4 $97.11

‐‐ 5‐12 $97.11

13 & up $97.11

NORTH HOME‐TFC 0‐4 $87.01

‐‐ 5‐12 $87.01

13 & up $87.01

Excess Maintenance Payment (EMP): Level I Regular F/C rate +$1.67

‐‐

Excess Maintenance Payment (EMP): Level II Regular F/C rate + $3.33

‐‐

Excess Maintenance Payment (EMP): Level III Regular F/C rate +$5.00

Excess Maintenance Payment (EMP): Level IV Regular F/C rate + Exceeds $5.00

Emergency $30.00

NOTES: (1) Rates listed for private TFC homes are what the Department pays the private agencies (not necessarily what the private agencies pay the foster homes). (2) Excess Maintenance Payment (EMP) rates are supplements to the regular foster care rate (3) County social service board may add the cost of irregular items allowed in foster care maintenance to the rates in the table above, based on individual need. (4) Does not include stepdowns. A stepdown rate indicates that the child remains in the same home (a therapeutic level home) but the child no longer requires a therapeutic level of care, so the rate is “stepped down” or reduced to reflect the level of care the child currently receives.


Emergency clothing $300 per year and exceptions allowed on a case‐by‐case basis

Yearly allowance Varies by age:

0‐4 yrs: $200

5‐12 yrs: $500

13 & up: $700

Description of Service Types/Rate Levels Determined through completion of the Specialized Family Foster Care/Adoption Assistance Level of Care Evaluation Form (see Appendix for a copy of this form). Requirements for getting assigned to treatment foster care include an Axis 1 diagnosis.

Source: Excerpts below from Therapeutic Family Foster Care 624‐05‐20‐15. See Appendix for a copy of this document.

Therapeutic family foster care is family care in a specially selected foster home, where the foster parents have participated in intense preparation and training for meeting the needs of children who are at risk of placement in a more restrictive setting. It provides more opportunity for one‐on‐one work by the TFFH and the child, and a more intense level of support and availability to the TFFH by the social worker who has a limited number of therapeutic family foster care cases. TFFC is intended to be in lieu of a more restrictive setting for children and youth in need of out‐of‐home care.

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: SFN 1865‐NDDHS (state‐specific assessment tool; See Appendix for a copy of this form)

Information on rate setting process/frequency: Biennial budget, reviewed every 2 years. State receives legislative approval every two years as to what, if any provider increases are approved. They then go into effect annually. (For example, in 2011, the legislature gave an approval for a 3% increase for each of the two years in the upcoming biennium, so the providers knew they would get 3% at the beginning of FY 12 and FY 13. They were notified of the increases/amounts prior to the beginning of each FY). Rates are revised to reflect rates of inflation; biennial review.


Ohio Profile



Foster Care Maintenance Rates Min: $10.00Max: $200.00

‐‐

Difficulty of Care Max Additional Rates: Special Needs

Max: $200.00 ‐‐

Difficulty of Care Max Additional Rates: Exceptional Needs

Max: $200.00 ‐‐

Difficulty of Care Max Additional Rates: Intensive Needs

Max: $200.00 ‐‐

Difficulty of Care Max Additional Rates: Emergency Family Foster Care

Max: $300.00 ‐‐

NOTES: (1) These amounts are the parameters set by the state within which the counties (if they want federal reimbursement) must operate. They are rate ceilings based on reasonableness thresholds for making IV‐E claims to the federal government for reimbursement. In other words, if the counties use a lower rate than the minimum, they will not receive federal reimbursement. If the counties use a higher rate than the maximum plus any additional difficulty of care rates, the county will not receive any federal reimbursement for the amount in excess of the rate ceilings. (2) Uniform Statewide Standards. The 88 counties pay based on their own county approved payment structure. The state does not set payment rates, however it does establish reasonableness thresholds for federal reimbursement purposes based on an annual survey of actual payments made to public agency foster homes.


Clothing/Incidentals (e.g., books/school supplies, camp, diaper, clothing, supplemental fees in year round schools, sports, projects)

$3,000 per child per year

Graduation expenses $1,500 one time per child

Description of Service Types/Rate Levels The 88 counties determine how children are assigned to rate categories in different ways, but there is a rule, 5101:2‐47‐18 Foster Care Maintenance Program Reimbursability: Reimbursements Related to the Difficulty of Care Needs of a Child Placed in a Foster Home, Relative Home, or Pre‐Finalized Adoptive Home. (See Appendix for a copy of this document.). Excerpts from this document are below:

(C) A child eligible for a special needs difficulty of care payment reimbursements is a child placed in a foster home or, on or after April 1, 2005, in a treatment foster home, as defined in rule 5101:2‐1‐01 of the Administrative Code, and who presents:

(1) Moderate emotional or behavioral management problems. These children may display a moderate degree of acting out marked by aggressiveness and/or delinquent behavior such as truancy or running away, substance abuse or any other emotional problems with the primary location of treatment being in the treatment foster home; or

(2) A physical condition determined by a physician which requires specialized care.

(E) A child eligible for an exceptional needs difficulty of care payment reimbursements is a child placed in a foster home or, after April 1, 2005, a treatment foster home, as defined in rule 5101:2‐1‐01 of the Administrative Code, and: if one of the following applies:

(1) Who presents more severe emotional or behavioral management problems than those children with special needs. These children may display a high degree of impulsive and acting out behavior toward themselves or others which is often characterized by verbal and physical aggression; or have multiple and severe psychiatric, emotional and behavioral management problems ranging from personality disorders, severe mental retardation, or autism to aggression toward animals, others and self; sexual acting out, suicidal behaviors or ideation; or.

(2) Who has a physical handicap or disability as determined by a physician which requires a high degree of care and supervision; or who requires medical or remedial services recommended by a physician or other licensed or certified professional for the maximum reduction of physical or mental disability and restoration of the child to his or her best possible functioning level; or.

(3) For whom a licensed or certified professional, including a psychologist or psychiatrist, licensed social worker or licensed professional counselor must be involved in the child's care on an as‐needed basis, but at least on a semi‐annual basis or who has a physical handicap or disability as determined by a physician which requires constant twenty‐four hour a day supervision provided by a licensed/registered nurse or persons closely supervised or trained by a licensed/registered nurse or physician; and.

(4) For whom a licensed or certified professional, including a physician, psychiatrist, psychologist, licensed social worker or licensed professional counselor must be involved in the child's care on at least a monthly basis.

(G) A child eligible for an intensive needs difficulty of care payment reimbursement is a child with intensive health care needs who is placed in a foster home or, on or after April 1, 2005, in a medically fragile foster home, as defined in rule 5101:2‐1‐01 of the Administrative Code, and who meets all of the following criteria:

(1) Under rules adopted by the Ohio department of job and family services(ODJFS) governing payment under Chapter 5111. of the Revised Code for long‐term care services, the child requires a skilled level of care;.

(2) The child requires the services of a doctor of medicine or osteopathic medicine at least once a week due to the instability of the child's medical conditions;.

(3) The child requires the services of a registered nurse on a daily basis; and.

(4) The child is at risk of institutionalization in a hospital, skilled nursing facility, or intermediate care facility for the mentally retarded.

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: County Driven

Information on rate setting process/frequency: Rates change annually. 88 counties pay differently based on their own county approved payment structure. Increases to payments are county driven. The state does not set payment rates, however does establish reasonableness thresholds for federal reimbursement

purposes based on a provider's annual cost report. Rates are revised annually to reflect rates of inflation. The ceilings established contain inflation factors using the consumer price index projected over a period of time.


Oklahoma Profile

Family Foster Care Rates Table (Regular and TFC rates implemented in 2012; other rates implemented in 2006) Service Level/Type Age ranges Per Diem % of family foster care


Regular 0‐5 $13.45‐‐ 6‐12 $15.72

13 & up $17.96

Therapeutic Foster Care All $71.48 ‐‐

Difficulty of Care: Level 1 All Regular + $1.67 ‐‐





Emergency Foster Care 0‐5 $50.00

NOTES: (1) Although percent of caseload data not available, most children are receiving the regular rate (2) Therapeutic Foster Care rate ($71.48 per diem) includes $17.96 for room, board, and administrative costs, and $53.88 for Medicaid (Clinical services).


Start up clothing One‐time authorization for child initially placed in out‐of‐home care, varies by age:

0‐5 yrs: $100

6‐12 yrs: $150

13 & up: $200

Clothing $75/quarter

Description of Service Types/Rate Levels Source: Excerpts below from Children and Family Services Division Rates Schedule. See Appendix for copy of this document. (Note: State notes that the Emergency Foster Care rates in this document do not reflect the current, updated rates.)

Therapeutic Foster Care (TFC) rates TFC is available for children, birth through 18 years of age, who continually meet identified medical necessity criteria as evaluatd by APS Healthcare. TFC serves children with psychological, social, behavioral, and emotional needs that cannot be met in traditional foster care, but can be met within a community‐based family setting. Contracted TFC agencies recruit, train, certify, reimburse, and provie clinical services to children placed in TFC. Clinical services include individual, family, and group rehabilitative therapy. Difficulty of Care (DOC) rate and pyaments DOC Level I rate for foster care: $1.67 per day or $50.00 per month.

A child approved for DOC Level I has one or more of the needs, conditions, or behaviors. The child:

requires ongoing scheduled medical or psychological appointments that routinely occur more than twice weekly;

displays emotional difficulties that result in destruction of property;

requires medical supplies, special equipment, or educational supplies on a routine basis that are not compensable through Medicaid; or

requires daily physical therapy performed by the foster or adoptive family. DOC Level II rate for foster care: $3.33 per day or $100.00 per month. A child approved for DOC Level II has one or more of the needs, conditions, or behaviors described in DOC Level I and, in addition:

requires 24‐hour awake intensive supervision due to severe medical or emotional needs; requires special food preparation and feeding due to a condition that restricts normal eating; requires special equipment for transportation that results in restricted mobility for the child and

foster or adoptive family; displays incontinence of the bladder or bowel that is not age appropriate; displays multiple disabilities, birth defects, or brain damage that prevents normal intellectual or

physical functioning; requires strict monitoring of medication; requires assistance in movement that is very difficult due to the child's size; requires post‐hospitalization care, such as frequent changing of bandages and tubes and special

hygiene techniques; or displays emotional disturbances, developmental delay, or mental retardation that results in

behavior, such as constant difficulties in school, aggressive and delinquent activities, destructiveness, resistance to authority, and sexual disturbances.

DOC Level III rate for foster care: $5.00 per day or $150.00 per month. A child approved for Level III has one or more of the needs, conditions, or behaviors described in DOC Levels I and II and, in addition, requires:

specialized substitute care. DOC Level IV rate for foster care: $7.50 per day or $225.00 per month. A child approved for DOC Level IV has one or more of the needs, conditions, or behaviors described in DOC Levels I, II, and III and requires such specialized care that normally the child would be in institutional or inpatient psychiatric care. The child:

requires special equipment such as: apnea monitor, suction machine, gastrostomy tube, oxygen, tracheotomy tube, or shunt;

requires special feeding or nursing care around‐the‐clock; requires frequent nighttime supervision and care that is not age appropriate; displays frequent seizures or other abnormal physical reactions that require 24‐hour monitoring; displays bizarre, socially unacceptable behavior, violent tendencies, potentially harmful behavior

to self or others, or sexually predatory behavior to others or animals; required previous inpatient mental health treatment or was recently discharged from an inpatient

facility; requires such intensive care that the foster or adoptive family is severely restricted in normal daily

activities and is frequently homebound; requires frequent 24‐hour awake supervision; or requires post‐hospitalization care for severe burns.

DOC Level V rate for foster care: $13.33 per day or $400 per month.

A child approved for DOC Level V has one or more of the needs, conditions, or behaviors described in DOC Levels I, II, III, and IV and has a significant number of intense needs. The child's level of need is likely to become more severe over time and is likely at some time to require personal attendant care or specialized care outside of the home, when prescribed by a professional. A current medical or psychological report within the last six months is required from a qualified physician. This report must include a diagnosis, prognosis, and recommended treatment. Conditions considered in the determination of DOC Level V include a child who has:

been diagnosed by a qualified physician as having severe mental illness, such as child schizophrenia, severe developmental disabilities, brain damage, or autism;

severe physical disabilities or medical conditions that are not expected to improve over time and adversely impact life expectancy when compared with others who have similar physical disabilities or medical conditions;

severely inhibiting diagnosed mental health conditions, defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM), diagnosed within the past

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: Use medical diagnoses and behavioral health diagnoses (DSM)

Information on rate setting process/frequency: No set schedule for revisions, more based on appropriations. Rates are not revised to reflect rates of inflation.


Oregon Profile



Base 0‐5 $18.90

Base only: 84.9% 6‐12 $21.53

13‐20 $24.36

Level of Care: Level 1 (moderate needs) Base + $6.97Base + enhanced supervision: 14.3%

Level of Care: Level 2 (intermediate needs) Base + $13.61

Level of Care: Level 3 (advanced needs) Base + $27.95

Personal Care: Level 1 (moderate care) Base + $6.81

Base + personal care: 0.6%

Personal Care: Level 2 (intermediate care) Base +$13.58

Personal Care: Level 3 (advanced care) Base + $20.38

Personal Care: Level 4 (intensive care) Amt authorized by the Dept

Shelter Care 0‐5 $24.60 6‐12 $28.00 13‐20 $31.60

Enhanced Shelter Care 0‐5 $29.40 6‐12 $33.50 13‐20 $37.90

NOTES: (1) Percent of caseload information represents point‐in‐time data on 8/19/2011. 0.2% of the caseload receives the base rate, enhanced supervision, & personal care combined. (2) Shelter care is an emergency placement determined to be the first placement episode. It is not intended to provide a shelter rate for foster children moving between foster care placements. Enhanced shelter care is limited to 20 days.


Emergency clothing $250 per lifetime of case

Description of Service Types/Rate Levels Source: Excerpts from Oregon Department of Human Services, DHS Policy documents: CANS Screening and Enhanced Supervision – OAR, Personal Care Services – OARs and Foster Care Payments for a Child or Young Adult Living With a Certified Family or Living Independently – OAR. See Appendix for copies of these documents.

“Level of care payment ” means the payment provided to an approved or certified family, a guardian, a pre‐adoptive family or an adoptive family based on the child or young adult’s need for enhanced supervision as determined by applying the CANS algorithm to the results of the CANS screening. “Enhanced supervision” means the additional support, direction, observation, and guidance necessary to promote and ensure the safety and well‐being of a child or young adult when the child or young adult qualifies for a level of care payment. “Personal Care services” means the provision or assistance with those functional activities described in OAR 413‐090‐0120 consisting of mobility, transfers, repositioning, basic personal hygiene, toileting, bowel and

bladder care, nutrition, medication management, and delegated nursing tasks that a child or young adult requires for his or her continued well being. To receive personal care services while living with a certified family, a child or young adult in the care or custody of the Department must: (1) Be eligible to receive medical services funded through either Title XIX of the Social Security Act or the

state general fund; (2) Have no available resources from the natural support system of friends, neighbors, or other

community resources to provide personal care services; and (3) Have a documented diagnosed physical or mental impairment and require personal care services as

determined by a personal care services assessment. “Shelter care payment” means a payment provided to a certified family during the first twenty days of substitute care for a child or young adult in the care or custody of the department, “Enhanced shelter care payment” means a limited term payment provided to a certified family when a child or young adult in the care or custody of the Department moves to a certified family’s home from a placement with a Behavior Rehabilitation Service provider and there is no current level of care determination applicable to the child or young adult.


Information on rate setting process/frequency: Funding for the Match is based on legislative appropriation. Oregon Legislative Session has been a biennial session which then allocates State agency budget approval. The department then sets rates for a 2 year period based on any approval. This recent session 2011; reduced the base foster care rate by 10% starting 1/1/12. Rate reduction 1/1/12 applies only to Base Rate. Please note the Oregon Legislature has recently started an annual session with even years limited to 35 days and the odd year to a 6 month. Most budgets will continue to be projected as biennial. Rates are not revised to reflect rates of inflation.


Pennsylvania Profile

Family Foster Care Rates Table (Implementation year of rates varies by county) Service Level/Type Age ranges Per Diem % of family foster care


Set by counties and providers Varies by county

NOTES: (1) PA has 67 counties. The counties themselves set the rates with the providers. State office does not set minimums or maximums, but will only reimburse up to a certain amount. However counties may exceed these amounts and support with county dollars.


Varies by county Per diems are determined by the counties and providers, and they could include personal incidental costs.

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: Varies by county

Information on rate setting process/frequency: In PA, OCYF currently does not have the authority to set rates for foster care settings. In November of 2007, OCYF developed standard residential provider budget forms to be used by the state’s child welfare system to determine reimbursable state and federal cost in the providers’ per diems. The process incorporates county child welfare staff doing the initial review and OCYF staff providing technical guidance to counties and providers and a final quality assurance review. The review process has evolved over the past five years with the ACF suggested additional support documentation. The use of program descriptions, job descriptions, and allocation plans are important tools in the process to identify allowable Title IV‐E maintenance and administrative costs from unallowable social services, treatment, and education costs. County agencies and OCYF has benefited greatly from knowing the elemental costs wrapped into complex out‐of‐home placement per diem rates. Rates are revised to reflect rates of inflation annually.


Rhode Island Profile



Standard Board 0‐3 $14.39

>90% 4‐11 $13.64

12 & up $15.79

Supplemental Board Base rate + amt as determined by RICHIST

Foster Care Rate Setting Tool

<10%

NOTES: (1) Supplemental Board Rates are determined on an individual basis by committee. RICHIST Foster Care Rate Setting Tool determines additional amount to be added to daily rates (see below). (2) Rates above do not include a clothing allowance provided three times a year. These payments are included in the table below.


Clothing 3 payrolls per year; Varies by age:

0‐3 yrs: $100

4‐11 yrs: $150

12 & up: $250

Emergency Clothing $250 per child

Holidays/birthdays $25 per child per year (holidays/birthdays); $40 per child per year (Christmas)

Description of Service Types/Rate Levels Supplement to the standard rate is determined through use of the RICHIST Foster Care Rate Setting Tool (see Appendix for a copy of this form).

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: RICHIST Foster Care Rate Setting Tool (See Appendix for a copy of this form)

Information on rate setting process/frequency: Foster Board rates have not been updated since July 2001. Rates are not revised to reflect rates of inflation.


South Carolina Profile



Basic 0‐5 $11.0769.80% 6‐12 $11.97

13+ $14.17

Accelerated Basic Rate 1 $17.50 3.60%

Accelerated Basic Rate 2 $25.00 6.30%

Treatment FC $30.00 11.00%

Therapeutic FC/Medical fragile 1 $33.33 6.50%

Therapeutic FC/Medical fragile 2 $41.66 2.60%

Medical fragile 3 $50.00 .05%

Medical fragile 4 $58.33 .02%

Intensive Therapeutic / Medical fragile 5 $66.66 .02%


Clothing $400 per year (or $100 per quarter). All children receive the rate of $100 when they enter foster care and $100 per quarter thereafter, as long as they are in care. Typical clothing is expected to come out of the board rates. The quarterly clothing funding is a supplement to help offset this costs above the typical clothing included in the standard rate.

Graduation Expenses Maximum of $200 is allowed if the child's caseworker documents and requests the funds. Can provide on a limited basis using IL funding funds. One time expense per child

Liability insurance Provided for all foster parents recruited & licensed by DSS. Private agency foster homes are not covered by the DSS policy.

NOTES: (1) State reports that day care is provided separate from the board rate for working foster parents.

Description of Service Types/Rate Levels Central staff review all the requests for special placement and payment. They review all the documents (case summary from case worker, any ratings/diagnosis/summaries etc.) done by Mental Health, doctors, or other licensed professionals. Things considered are emotional issues, behavioral issues (including substance abuse), medical needs and educational needs. They then will assign a child to a level of care most in line with the needs of the child and the foster home/facility that can meet the needs of the child. Sometimes the decision will be subjective, but other times it will be clear (especially the medically fragile or those with a history of MH involvement). Medical fragile (3, 4, and 5) are children usually requiring 24/7 medical type related care. Some have feeding tubes, wheel chair bound, etc.

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: Child and Adolescent Functional Assessment Scale (CAFAS)



Behavior Assessment System for Children (BASC)

Case review, own review document

Information on rate setting process/frequency: The rates are reviewed annually and recommendation sent to agency head to be shared with Governor/Legislature if budget request is needed. All basic rates approved and authorized by the Legislature via the State's budget process. Last change was in 2001. The legislature increased the board rate to bring the rate paid in SC to rank as the 24th highest in the USA. (This was above what the rate would have been based on the USDA Southeast criteria.) When the rate review was done in 2010, the rate paid is still within what it should be based on the USDA criteria as adjusted for SC. (Staff had not done a rate review for 2008 and 2009 due to budget reductions in the state budget. Even though the agency had significant cuts, they kept the FC Board rates hold harmless for those two years.) SC does not rank 24th any longer, since other states have provided increases. Rates are reviewed annually using the USDA Expenditures on Children and Families for the Southeast (as adjusted for inflation using the Consumer Price Index) and adjusted for South Carolina. For example, child care is adjusted since SC provides day care separate from the board rate for working foster parents. Rates are revised to reflect rates of inflation.


South Dakota Profile



Basic Foster Care 0‐12 $15.7175%

13‐18 $18.86

Specialized Foster Care 0‐6 $23.82

5% 7‐11 $26.26

12‐14 $30.24

15‐18 $31.16

Treatment Foster Care 0‐18 Range: $52.77 ‐ $83.09 17%

Emergency Foster Care 0‐18 $22.87 3%

NOTES: (1) Caseload percentages represent data for State Fiscal 2012. (2) Specialized Foster care is provided by Child Protection Services and Treatment Foster Care is provided by private child welfare agencies with each agencies having an individual daily rate as a result of a rate setting process based on cost reports submitted to the Department of Social Services. Average daily rate for Treatment Foster Care is $62.95 between the seven providers. Rates for Treatment Foster Care do not depend on age, and are specific to the provider.


Emergency clothing No set maximums; depends on the needs of the children. Approval provided by supervisors.

School clothes No set maximums; approval provided by supervisors.

Camp No set maximums; approval provided by supervisors.

Diaper No set maximums; approval provided by supervisors.

Graduation expenses No set maximums; approval provided by supervisors.

Sibling visits No set maximums; approval provided by supervisors.

NOTES: (1) Foster care rates include clothing and incidentals, but CPS also assists families in addition to these payments when the need arises.

Description of Service Types/Rate Levels South Dakota has an approval process for Specialized and Treatment Foster Care. Specialized Foster Care: Children who require specialized medical care like feeding tubes, apnea monitors, or other medical conditions would be considered specialized. Treatment foster care is used as a step down from group or residential treatment or to prevent group care or residential treatment and for children who need a more structured foster home setting with intensive therapeutic services due to their emotional or behavioral needs. The Division has plans to form a workgroup next year to review the treatment foster care program. The workgroup will include Division staff and providers of treatment foster care. Tools used to provide information about the child which help determine their needs and guide staff toward selecting appropriate placements are the Initial Family Assessment, and Physical and Mental Health Exams.

Information on rate‐setting process/frequency: Rates are revised to reflect rates of inflation when the legislature appropriates an inflationary increase. Providers received inflationary increases in State Fiscal Year 2013. Rates increase only when appropriated by the legislature.


Tennessee Profile



Basic 0‐11 $23.2693%

12 & over $27.28

Special Circumstances 0‐11 $25.596%

12 & Over $30.01

Extraordinary All ages $45.00 1%


Emergency Clothing $250 per child per circumstance

Graduation Expenses $500 per child

Description of Service Types/Rate Levels Special Circumstance rates are designed for children with unique needs due to a diagnosed medical or mental health condition or a child who requires a level of supervision exceeding that of his/her peers or extra care due to physical, emotional, or mental handicaps. Children with special behavioral problems or alcohol or drug issues may also be eligible. Extraordinary Board rates are reserved for children in foster care whose needs are so unique and extensive that they cannot be met at the regular or special circumstance rate. Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care:

Child and Adolescent Needs and Strengths, Mental Health (CANS‐MH) Information on rate‐setting process/frequency: Assessed annually by USDA recommendations (but rates may not change that frequently). Rates are revised to reflect rates of inflation according to USDA recommendation.


Texas Profile Family Foster Care Rates Table (Rates implemented in 2009) Service type/level Age ranges Per Diem % of family foster care


Basic Foster Family $22.15 ‐‐

Basic Child Placing Agency $39.52 ‐‐

Moderate Foster Family $38.77 ‐‐

Moderate Child Placing Agency $71.91 ‐‐

Specialized Foster Family $49.85 ‐‐

Specialized Child Placing Agency $95.79 ‐‐

Intense Foster Family $88.62 ‐‐

Intense Child Placing Agency $175.66 ‐‐

NOTES: (1) Foster Family rates are the minimum that the Child Placing Agency (CPA) must pay the foster family for DFPS clients. CPA rates are what DFPS pays the child placing agency (2) DFPS has been transitioning the DFPS‐verified homes (e.g., moderate, specialized, intense foster family) to private CPAs.


It depends on the county. Incidentals are up to the discretion of the individual counties. Many of the counties in Texas have what are known as Child Welfare Boards. These Boards determine what incidentals they may provide. Examples of some of the things they have helped with in the past are clothing vouchers, proms, class rings, or other items as determined by the Boards.

Description of Service Types/Rate Levels Texas uses a contracted third party to make the level of need determinations. The current contractor is Youth for Tomorrow. (However, survey respondent was unsure how this determination was made).

Source: Excerpts below from Appendix 6340‐A: Definitions of Service Levels CPS September 2005. See Appendix for a copy of this document.

Children Who Need Moderate Services Children who need moderate services have problems in one or more areas of functioning, including:

behaviors such as:

frequent nonviolent, anti‐social acts,

occasional physical aggression,

minor self‐injurious actions, or

difficulties that present a moderate risk of harm to self or others;

abuse of alcohol, drugs , or other conscious‐altering substances, and:

the extent or frequency of the substance abuse places the child at risk for substantial problems, or

a historical diagnosis of substance abuse or dependency requires regular community support through groups or similar interventions;

developmental delays or mental retardation marked by:

moderate to substantial difficulties with conceptual, social, and practical adaptive skills, including daily living and self‐care, and

moderate impairment in communication, cognition, or expressions of affect; or

primary medical or habilitative needs including assistance with:

occasional exacerbations or intermittent interventions in relation to the diagnosed medical condition,

limited daily living and self‐care skills,

ambulation, or

daily access to on‐call, skilled caregivers with demonstrated competency Children Who Need Specialized Services Children who need specialized services have severe problems in one or more areas of functioning, including:

behaviors such as:

unpredictable nonviolent, anti‐social acts,

frequent or unpredictable physical aggression,

marked withdrawal or isolation,

major self‐injurious actions, including recent suicide attempts, or

difficulties that present a significant risk of harm to self or others;

abuse of alcohol, drugs , or other conscious‐altering substances that results in:

severe impairment, or

a primary diagnosis of substance abuse or dependency


severely impaired conceptual, social, and practical adaptive skills, including daily living and self‐care,

severe impairment in communication, cognition, or expressions of affect,

lack of motivation or the inability to complete self‐care activities or participate in social activities,

inability to respond appropriately to an emergency, or

multiple physical disabilities including sensory impairments; or

primary medical or habilitative needs that require assistance related to:

regular or frequent exacerbations or interventions in relation to the diagnosed medical condition,

severely limited daily living and self‐care skills,

ambulation or confinement to a bed, or

constant access to on‐site, medically skilled caregivers with demonstrated competencies in the interventions needed by children in their care.

Children Who Need Intense Services Children who need intense services have severe problems in one or more areas of functioning that present an imminent and critical danger of harm to self or others, such as:

behaviors that include:

extreme physical aggression that causes harm,

recurring major self‐injurious actions, including suicide attempts,

other difficulties that present a critical risk of harm to self or others, or

severely impaired reality‐testing, communication skills, cognition, expressions of affect, or personal hygiene;

abuse of alcohol, drugs , or other conscious‐altering substances that involves a primary diagnosis of substance dependency in addition to being extremely aggressive or self‐destructive to the point of causing harm;


impairments so severe in conceptual, social, and practical adaptive skills that the child’s ability to actively participate in the program is limited and requires constant one‐to‐one supervision for the safety of self or others, or

a consistent inability to cooperate in self‐care while requiring constant one‐to‐one supervision for the safety of self or others; or

primary medical or habilitative needs that present an imminent and critical medical risk and require assistance with:

frequent acute exacerbations and chronic, intensive interventions in relation to the diagnosed medical condition,

inability to perform daily living or self‐care skills, or

24‐hour on‐site medical supervision to sustain life support.

Information on rate‐setting process/frequency: Determination of potential new rates occurs every two

years before the biennial legislative session and is based on audited cost reports. Final determination of rates is dependent on funding from the Legislature and any other actions that they take. Rates are not revised to reflect rates of inflation.


Utah Profile

Family Foster Care Rates Table (Rates implemented in 2012) Service Level/Type Per Diem % of family foster care


Level I Range: $15.00 ‐$20.00 47%

Level II Range: $18.00 ‐ $23.00 12%

Level III Range: $28.00 ‐ $30.00 11%

Level IV Range: $49.00 ‐ $56.50 30%

NOTES: (1) In Levels I‐III the daily rate is broken out by age groups of 0‐5 years, 6‐11 years, 12 years and older. The payment range within each level depends on age of the child. Levels I‐III include children placed in state licensed foster homes and children placed in proctor homes so that they can be with their siblings even though they may not need the higher level of care. (2) A Level IV proctor home is a family home that is certified under a licensed child placing agency. The rate listed in the table is the amount the public agency pays the private agency. See attachment in Appendix, Placement Structure – Levels of Care for further information


Emergency clothing $163 per child (one‐time emergency clothing at time of initial placement)

Baby Needs $200 per child ‐ every 6 months for any combination of special needs codes (to be used for baby needs such as diapers, special formulas, baby furniture/equipment)

Clothing $200 per child‐every 6 months for any combination of special needs codes(clothing needed over and above the $41.00 included in the monthly foster payment)

Lessons/equipment $200 ‐every 6 months for any combination of special needs codes (music, art, swimming, dance, lesson supplies, etc.)

Recreation $200 per child‐ every 6 months for any combination of special needs codes(to be used for recreation, includes trips, fishing licenses, summer camps, sports/sports equipment, bicycles, etc.)

Gifts $200 per child ‐every 6 months for any combination of special needs codes (to be used for additional Christmas gifts, birthday, graduation, etc.)

School needs/expenses (non‐tuition) $999.99 (to be used specifically for school expenses only that cannot be waived such as locker costs, school equipment, summer school, yearbook, graduation pictures, special classes. Maximum $999.99 following procurement rules. This amount is not included in the child’s 6 month $200.00 allowable amount.)

Miscellaneous Special Need $5,000 (to be used for other expenses not covered under other special needs. Maximum of $5000.00 following procurement rules. This amount is not included in the child’s 6 month $200.00 allowable amount.)

Medically Fragile Child $10.00 in addition to foster or proctor care per diem rate

Transportation $.36/mile (Medical, School, visits, case activity)

NOTES:

(1) Please see attachment in Appendix, State of Utah Out of Home Special Payments Effective July 1, 2001 for more detail about incidental expenses.

Description of Service Types/Rate Levels Utah utilizes the Child and Adolescent Needs and Strengths Assessment to assist workers with determining the level of care. There is also a placement committee that meets to determine the best placement and review the level of care. Source: Excerpts below from Placement Structure – Levels of Care. See Appendix for a copy of this document.

Level I is family based care that provides safe, adequate, standard parental supervision and care. Children in this level of care may have mild to moderate medical or mental health treatment needs and mild behavioral problems. (Formerly known as Basic Foster Care). Level II is family based care that provides a safe environment with adequate parental supervision that may be slightly or moderately more intense than that of a child in Level I care. Children at this level may be physically disabled, developmentally delayed, medically needy or medically fragile, or have a serious emotional disorder (SED), and may require outpatient treatment services more frequently than once a week, such as day treatment and/or special education services. (Formerly known as Specialized Foster Care.) Level III is family based care that provides intensive treatment services and constant supervision in a family living environment by a well trained, experienced out‐of‐home care provider. Children at this level may have severe behavioral, emotional, or medical problems that can still be managed in a foster home. Level III care is for children who are unable to be successful in placements with a lower level of services and supervision. Children in Level III care have behaviors, medical concerns, or other needs that could generally be improved by working with skilled, experienced foster parents that have completed advanced training and have demonstrated skills in working with the issues. (Formerly known as Structured Foster Care.) Level IV is proctor family care through a licensed child‐placing agency. The proctor agency generally has access to highly skilled caregivers as well as a variety of wraparound services needed for the higher, intensive needs of the child. It also includes transition to adult living in a supervised apartment setting.

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: Child and Adolescent Needs and Strengths Assessment (CANS‐MH plus additional modules)

Information on rate‐setting process/frequency: Legislative driven. Foster care rates are technically reviewed each year, but are only adjusted based on legislative appropriation. (New rate setting is only conducted periodically, not on a set schedule.). There have been changes in rates in state fiscal years which being July 1st for the following years. Rates changes were made on July 1, 2002, July 1, 2005, July 1, 2006, July 1, 2007, July 1, 2008, then on July 1, 2009 the family foster care rates were rolled back to the July 1, 2006 rates. July 1, 2010 the payment codes were consolidated and changed to FC1, FC2, FC3, PC1, PC2. The age range for the different rates were also changed. Effective July 1, 2012, there was a rate increase. Rates are not revised to reflect rates of inflation.


Virginia Profile

Family Foster Care Rates Table (Basic rates implemented in 2009; Enhanced rates implemented in 2012) Service type/level Age ranges Per Diem % of family foster care

caseload in this category Basic Maintenance 0‐4 $14.93

‐‐ 5‐12 $17.50

13 & up $22.20Enhanced Maintenance Payment determined by # of points on Virginia Enhanced Maintenance Assessment Tool (VEMAT)

Enhanced rate is supplement to basic

VEMAT: 4 pts $7.46 ‐‐ VEMAT: 8 pts $14.93 ‐‐ VEMAT: 12 pts $22.40 ‐‐ VEMAT: 16 pts $29.86 ‐‐ VEMAT: 20 pts $37.33 ‐‐ VEMAT: 24 pts $44.80 ‐‐ VEMAT: 28 pts $52.26 ‐‐ VEMAT: 32 pts $59.73 ‐‐ VEMAT: 36 pts $67.20 ‐‐


Clothing Per fiscal year, varies by age

0‐4 yrs: $300

5‐12 yrs: $375

13 & up: $450

Description of Service Types/Rate Levels Enhanced maintenance levels of payment are determined using the Virginia Enhanced Maintenance Assessment Tool (VEMAT). For children in foster care, the purpose of the Virginia Enhanced Maintenance Assessment Tool (VEMAT) is to assess the child’s behavioral, emotional, and physical/personal care needs to determine if an enhanced maintenance payment may be necessary to ensure the safety and well‐being of the child. Understanding the needs of the child in each of these domains is not unique to the administration of the VEMAT but is based on and part of the over‐all casework process. Administering the VEMAT should be integrated into case management, using the knowledge about the child gained through all interactions between the ongoing service worker, the child, the family, other individuals knowledgeable about the child, and other service providers. This increases the likelihood that the information discussed in the VEMAT meeting is already the subject of ongoing planning. See Appendix A for a copy of this tool.

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: Virginia Enhanced Maintenance Assessment Tool (VEMAT) (see Appendix for a copy of this tool)

Information on rate‐setting process/frequency: The current Basic Maintenance rates were set in 2009. Rate revisions occur when state staff receives a raise. No time frame is set for increase of Basic Maintenance rates. There is currently an active "rate structuring committee" that is evaluating basic and enhanced maintenance rates and making additional recommendations for rates and guidance changes in the future. The Enhanced Maintenance rates were decreased by 30 per cent and the new rates were effective October 1, 2012. Rates are not revised to reflect rates of inflation.


Washington Profile Family Foster Care Rates Table (Rates implemented in 2008) Service type/level Age ranges Per Diem % of family foster care


Basic only: 51% 6‐11 $16.46

12‐20 $18.91

Level 2 (supplement to basic) $5.85 21%



FC to 21 $18.91 1%

Minor with a child $32.84 1%

NOTES: (1) FC to 21 youth are in post secondary education programs and are no longer dependant, but remain in the foster home (2) Minor with a child is the Basic Foster Care rate for 0‐5 in addition to Basic Foster Care for 12‐20.


Emergency clothing $200 per year

Sibling visits There is no maximum as it is dependent upon the court order, case plan, needs of siblings and ability of various providers.

Description of Service Types/Rate Levels See Appendix for a copy of the Foster Care Rate Assessment Tool, which includes a description of the foster care rate calculation and the various child characteristics/needs comprising the levels.

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: Foster Care Rate Assessment Tool (see Appendix for a copy of this tool)

Information on rate‐setting process/frequency: The rates are not changed on any regular schedule but by legislative mandate. The last rate change was implemented in 2008. Rates are not revised to reflect rates of inflation.


West Virginia Profile Family Foster Care Rates Table (Regular rates implemented in 2003; Specialized rates implemented in 2002) Service type/level Age ranges Per Diem % of family foster care


DHHR Foster Family 0‐18 $19.73 ‐‐

Specialized Foster Family (private agency) 0‐18 At least $19.73 ‐‐

Special Family Care (private agency) 0‐18 At least $19.73 ‐‐

NOTES: (1) DHHR foster homes receive $600/mo, and this is also what the private agencies must pay the specialized homes at a minimum. Actual payment to private agency from DHHR is more than $600/mo (they are paid $50/per child per day; includes administrative costs), but this is what the minimum that must pass through to the foster parent. (2) Supplemental payments may be made to a child in a specialized foster family or special family care setting through Medicaid or Personal Care funds. This is based on the child’s needs. The Child and Adolescent Functional Assessment Scale (CAFAS) and the CANS (Child and Adolescent Needs and Strengths) are used by the specialized agencies to determine the child’s needs and whether therapeutic or other services are necessary. (3) Most children are receiving the $600/mo rate.


Emergency clothing $300 per child (meant to be a one‐time payment when the child first enters foster care)

School clothing $200 per child per year

Transportation Outside of typical transportation; such as for sibling visits, medical appointments

Diagnostic tools used by the child welfare agency to determine a child’s needs/level of care: State's agency does not, but private agencies for specialized care use:

Child and Adolescent Functional Assessment Scale (CAFAS)

Child and Adolescent Needs and Strengths (CANS)

Information on rate‐setting process/frequency: Regular rate was revised in 2003, whereas the specialized rate was revised in 2002. Constant analysis and review is conducted with staff and advocates, increases are submitted when they are shown to be needed and must be passed by a Legislative ruling. Rates are not revised to reflect rates of inflation.


Wisconsin Profile Family Foster Care Rates Table (Rates implemented in 2011) Service Level/Type Age ranges Per Diem % of family foster care


Basic Maintenance Rate: Home Certified Level of Care 1

$7.23 ‐‐

Basic Maintenance Rate: Home Certified above Level of Care 1

0‐45‐11 12‐14 15‐18

$12.03$13.15 $14.96 $15.62

‐‐

Supplemental Rate (for homes Certified above level of Care 1)

Added to basic; Rate depends on level of care and identified

special needs of child

‐‐

Exceptional Rate (for homes Certified above level of Care 1)

Added to basic; Rate varies, but combined basic, supplemental, and exceptional rates cannot

exceed $2,000/mo

‐‐

Notes: (1) Foster homes are classified into Levels of Care, 1‐5. Level 1 foster parents had a previous relationship with the child, or are relatives. (2) Of those children receiving age‐related payments, approximately 13% received only the basic maintenance amount on 12/31/2011.


Initial clothing Initial clothing allowance, if it's child's first placement or it has been at least four months since child was last in out‐of‐home care. Maximums vary by age:

0‐4 yrs: $225

5‐11 yrs: $263

12‐14 yrs: $300

15‐18 yrs; $300

Description of Service Types/Rate Levels Source: Excerpts below from Uniform Foster Care Rate Policy. See Appendix for a copy of this document, which includes the manual for the Child And Adolescent Needs and Strengths (CANS) tool. Also see Appendix for a copy of the state’s rate setting brochure, Understanding the Uniform Foster Care Rate.

Supplemental Rate: an additional monthly payment intended to cover the costs of caring for a child whose needs exceed normal limits of care and supervision for that child’s age. A supplemental rate payment for a foster child is determined using the criteria established at Ch. DCF 56.23, Admin. Code. through the use of the Child and Adolescent Needs and Strengths (CANS) tool, the calculation of the child’s Level of Need, and the providers’ Level of Certification. Exceptional Rate: an additional monthly payment for caring for a child whose needs may be so extreme that the basic maintenance and supplemental payments do not provide sufficient funding to ensure the child’s care in the foster home and to prevent placement in a more restrictive setting.

An exceptional rate payment may be provided on behalf of a foster child only if at least one of the following situations exists:

The payment will enable the child to be placed in a foster home instead of being placed or remaining in a more restrictive setting.

The payment will enable the placement of siblings or minor parent and minor children together.

The payment will assist with transportation to the school the child was attending prior to placement in out‐of‐home care.

o To promote the educational stability of children in foster care, agencies can provide payments

for costs associated with transporting a child to and from the school the child was enrolled in (school of origin) at the time of placement into out‐of‐home care. This cost shall be documented under the Exceptional Payments under Transportation to School of Origin. Only reimbursement made to foster parents shall be claimed here.

To replace a child’s basic wardrobe that has been lost or destroyed in a manner other than normal wear and tear.

o An as‐needed exceptional rate payment for wardrobe replacement is appropriate for reasons such as sudden growth spurts. Any ongoing special circumstances (such as unusual wear of clothing caused by prosthesis) would be more appropriately funded under the supplemental rate.

For a child placed in a foster home before February 21, 2011, and who remains placed in that foster home, equalize the total payment amount lost by the child’s foster parent due to implementation of the method of determining supplemental payments listed in section IV. of this policy.

Foster Home Levels Source: Excerpts below from Wisconsin Administrative Code Ch.DCF 56 Foster Home Care For Children. See Appendix for a copy of this document and for more detail on the requirements and training for each of the foster home types listed.

Level 1: Child Specific Foster Home Level 2: Basic Foster Home Level 3: Moderate Treatment Foster Home Level 4: Specialized Treatment Foster Home Level 5: Exceptional Treatment Foster Home


Information on rate‐setting process/frequency: Basic rates are changed through the legislative process. Rates are not revised to reflect rates of inflation.

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