The question of the child's
level of care is becoming more and more significant in the negotiation of adoption assistance and in
hearings involving disagreements over the amount of adoption assistance. The payment a child actually received or would
receive in a foster home suitable to their level of care at the time of the
most recent negotiation sets the limit on the amount of adoption assistance
that is eligible for federal financial participation (FFP). The foster care payment a child actually
received or would receive is based largely on the child's level of care.
Interestingly, this issue is
connected to the current dispute over
the incorrect claim of Dan Shook of ODJFS that adoption assistance payment
rates may not exceed the foster care rates of county agency foster homes. Last week, I realized that I had overlooked
Paragraph (E)(2) of OAC 5101:2-49-05 and so, I believe, had Mr. Shook. Paragraph (E)(2) states:
To
determine the amount the FCM payment would have been if
the child had been placed in a foster home operated by the PCSA,
the PCSA shall:
(2) Determine
the amounts of any special, exceptional or intensive needs difficulty of care
payments, clothing payments, school supplies, and other allowable FCM payments which are not part of the daily or monthly
foster care board rate,. . . ."
Three points
are relevant here.
1.
In
order to determine the child's foster care payment rate would be at the time of
the most recent negotiation of adoption assistance, one most consider the
child's level of care and determine if the level of care indicated a
specialized foster home (treatment, therapeutic). If the child were already in a treatment,
therapeutic or other foster care setting prior to adoptive placement, then the
question is answered.
2.
If
a specialized level of care is warranted either by the child's actual placement
in a treatment or foster home or is indicated by an assessment of the child's
level of care, then level of support in the foster home becomes the maximum
amount of adoption assistance that is eligible for FFP.
3.
If
there are no agency foster homes that are suitable for children with
specialized or "difficulty of care" needs, then the rate the child
would receive in the treatment home affiliated with a private service provider
would set the maximum amount of adoption assistance that would be eligible for
FFP.
The
use of objective level of care instruments, interpreted by qualified, unbiased
professionals, could provide an effective means of establishing the practical
ceiling on the amount of adoption assistance that could be negotiated in any
given case.
Problems
Specialized
"difficulty of care" definitions of foster care can be found in OAC
rule 5101:2-47-18. It appears, however,
that few counties use these definitions. Instead, they employ their own level
care criteria. There are not standard
tools for assessing a child's level of care currently in use.
Adoptive
parents and advocates need access to individual county's level of care
instruments and criteria as well as the foster care payments that are
associated with each level of care.
Without that information, adoptive parents and agencies find themselves
arguing about the scope of possible adoption assistance payments, unless the
child is placed for adoption from a specialized foster home that is consistent
with the child's level of care.
Information
on levels of care exists. It needs to be collected and compiled. ODJFS, the
Ohio Association of Child Caring Agencies (OACCA), as well as individual
counties are possible sources. Once this
information is available, there is need for a method of determining how the
level of care criteria apply to a given child.
