Saturday, February 21, 2015

Chapter 2, Part 11; The Use of Level Care Assessment Instruments to Determine the Child's Foster Care Payment Rate



NEXT: A few suggestions for introducing the use of level of care assessment tools to help establish the maximum amount of Title IV-E Adoption Assistance that may be negotiated.

 

As you know, a child’s foster home payment rate is related to the maximum Title IV-E Adoption Assistance payment the child may receive.  Federal financial participation (funding) is available up to the child’s foster care payment rate.  How does a prospective adoptive parent know if the child’s foster care payment is high enough?  If prospective adoptive parents suspect that their child’s foster care payment does not accurately reflect the child’s care needs, how can they go about seeking an increase?  The child’s foster care rate, after all, will set the parameters for negotiating adoption assistance.  From a policy standpoint, there does not seem to be any recognized way to answer these questions for Ohio families.  This post and the next will examine this issue and hopefully offer a few useful suggestions.

Ohio and other states, such as Pennsylvania and Colorado, have county administered child welfare systems supervised by the state.  As in most states, foster care rates in Ohio are based on age and the child's level of care, which encompasses the child's care needs and the scope of responsibilities involved in meeting those needs.  In county administered states, however, foster care payment rates are not uniform, but vary from county to county. 

 With respect to children with higher levels of care, Ohio Administrative Code regulations at 5101:2-47-18 describe three categories of “difficulty of care” foster home payments: Special, Exceptional and Intensive.  In practice, however, there are no uniform instruments or procedures for establishing foster care payment rates based upon the child’s care needs and the challenges involved in meeting those needs.  Methods for arriving at foster care payments rates vary across Ohio counties as do foster care payment rates themselves.  Foster families in a particular county may be aware of the method used to establish their own children’s foster care rates, but there is no accessible source of information in which the public can identify and compare procedures for establishing foster care rates in county agencies across the state. 

Why is this important?

There are no established procedures through which prospective adoptive parents in Ohio can obtain a level of care assessment to determine if their child’s foster care payments are adequate.  Inadequate foster care payments, in turn, set incorrect, artificial limits on the parents’ ability to negotiate an adoption assistance payment that reflects the child’s overall needs and family circumstances.  In short, the lower the foster care payment rate, the the lower the amount of Title IV-E Adoption Assistance that is possible to negotiate.

Families in a number of state administered systems have a greater opportunity to obtain an increase in their children’s foster care payments, through the periodic use of recognized level of care assessment instruments.  State administered systems usually have uniform foster care payment rates, based on the children’s age range and level of care. 

A number of states with state administered systems have established procedures for reviewing the individual children’s foster care payment rates through the use of assessment tools that consider the child’s problems along with the level of care and amount of parental involvement required to address those problems.  States such as Indiana, Oregon, and Wisconsin use the Children and Adolescents Needs and Strengths (CANS) tools to assess foster care payment rates. 

According to an Indiana policy letter dated January 14, 2013, “CANS reassessments are required every 180 days and at critical case junctures.”  Foster parents may not only request a CANS review, including situations in which there are “supervision or behavioral concerns that are not adequately addressed by the CANS.”  If the assessment indicates a “higher category of supervision,” the foster care rates will increase.  For more information about CANS see http://www.praedfoundation.org/ .  For information about CANS in Wisconsin, see http://www.wafca.org/CANS.htm.  You can find CANS information applicable to individual states.  Google the name of the state and CANS or the name of the state and CANS forms.  Massachusetts CANS forms for example, brings you to  http://www.mass.gov/eohhs/gov/commissions-and-initiatives/cbhi/child-and-adolescent-needs-and-strengths-cans/cans-forms.html

Minnesota has developed the Minnesota Assessment of Parenting for Children and Youth tool (MAPCY), which will soon be in use throughout the state to determine foster care payment rates on an ongoing basis.  MAPCY includes an emphasis on the amount of care and supervision that the parents need to provide and obtain for their child.  The inclusion of the scope of parental responsibilities captures elements of family circumstances.  Interested parties may contact Josh Kroll at NACAC at 651-644-3036.

Can Ohio develop procedures through which prospective adoptive parents will be able to employ a level of care instrument recognized by the state to determine the child’s proper foster care rate?  Can approved level of care instruments be used to settle disputes over the amount of adoption assistance, by shedding light on the child’s needs and family circumstances?  We will consider these questions and other related issues in the next post.