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Appendix 1618.3: Discussion Guide – Negotiating Permanency Care Assistance

CPS September 2010

The following guide is for use in negotiating agreements for permanency care assistance.

Other sources of information include the following:

  •  Form 2116 Permanency Care Assistance Worksheet;

  •  Information provided by the permanent managing conservator;

  •  Information in the child’s case record; and

  •  Information in the record of the permanent managing conservator record, including the home screening.

Exceptional Expenses Related to Initial Placement

When placing a child, the worker considers whether the placement can be made without incurring exceptional expenses, as follows.

Sibling Groups

When placing a sibling group, consider how the family plans to incorporate the children into the home. Does the family have adequate furniture, space, and supplies? What additional furniture or supplies are needed? Does the home require remodeling in order to make the placement?

Children With Disabilities

If the child being placed has disabilities, are any special accommodations required, such as ramps and lifts? How does the family plan to provide for these needs? Will insurance, Medicaid, or other resources offset some or all of the costs?

Climate Considerations

Does the child need special clothing because the child is being placed in a climate with severe weather? Is there a need for additional clothing because the child’s clothing is inadequate?

Considering other resources

What other resources are available to help with the family’s exceptional expenses? What is the expected duration of the expense, in months? (Divide the total up-front costs into monthly payments of limited duration.)

What are the reasonable projected costs and how much assistance does the family expect to need to handle the costs?

Special Maintenance

  •  What health or behavioral care needs does the child have? If the child requires significant health care or behavioral care, does the child require frequent medical or therapy appointments? Do the appointments result in a loss of wages for the family or increased costs for providing additional child care for other children who live in the home? Is out-of-town travel necessary?

  •  Does the child have specialized ongoing needs, such as adaptive clothing, specialized food, specialized equipment, as a result of a chronic health condition?

  •  Is attendant care needed for the child? If yes, how frequently and at what cost? Will Medicaid or other programs assist with the cost?

  •  What is the projected cost for the identified needs?

  •  How does the family plan to provide for these needs? Will insurance, Medicaid, or other resources be available to offset some or all of the costs?

Child Care

  •  If both parents are employed outside the home, how will care be provided? How long will care be needed? Will it be needed only until the child begins school? Will child care be needed during the summer or for school holidays?

  •  If child care is unrelated to employment, why is the care needed? For example, routine care may be needed to allow the permanent managing conservator to make frequent trips away from home to care for an aging parent or a sibling who is ill.

  •  How does the family plan to provide for these needs? What other resources are available to offset some or all of the costs?

  •  Will the parents need money to help pay for the cost of that care and if so, how much money will be needed per month and how long will assistance be needed?

Supportive Educational Needs

  •  Does the child have special education needs? What is the school system doing to meet those needs?

  •  What are the child’s unmet needs, and how can they be met? What is the cost and duration of extra services, such as tutoring?

  •  If the permanent managing conservator requests help with private school tuition, are all of the requirements for assisting with private schooling documented?

Maintaining Contact With Siblings and Other Family Members

  •  If the child has siblings who are in foster care, are in another placement, or live with family members, and the siblings are important to the child, does the child visit with them? If so, how frequent have the visits been? What arrangements and agreements have been made to continue contact?

  •  Will continued contact require extraordinary expenses, such as airfare? Will the family require help paying for those visits? How much will the visits cost?

Routine Maintenance

If a child has ongoing needs, the worker considers the following:

  •  To what extent does the child’s routine needs significantly increase the family’s maintenance expenses? What specific expenses will be significantly increased and by how much?

  •  Does the family have very limited income and resources? Are the income and resources temporary or permanent? Does the permanent managing conservator have a special bond with the child? For example, is the permanent managing conservator related to the child or the child’s foster parents? Are there special circumstances in the family that impairs the ability of the permanent managing conservator to provide for the child temporarily or permanently, such as age, retirement, school attendance, poor health, or unemployment?

  •  If the child’s placement is with a foster parent or relative, to what extent, if any, will the loss of foster care maintenance significantly impair the ability of the family to provide for the child’s basic necessities? How did the family intend to manage with less support?

  •  In the case of a sibling group, will costs be significantly greater than what the family initially planned when they decided to take permanent managing conservatorship of the child? What are those costs?

  •  Will incorporation of the child or sibling group into the home require the family to incur additional long-term housing costs by moving to larger quarters or making home improvements to accommodate the child?

  •  Is the child being placed significantly delayed in an aspect of development and therefore especially in need of long-term exposure to special activities than is usual for most children? What are the child’s developmental delays? What are the activities? What are the increased costs?

  •  If both permanent managing conservators are employed, will one permanent managing conservator reduce or change his or her employment to be at home with the child?

  •  Does the child have needs that require the full time attention, or nearly full time attention, of one or both permanent managing conservators?

  •  How do the permanent managing conservators plan to provide for the child’s routine maintenance? Do they understand that they will be responsible for the child’s support, just as any parents would be? After paying monthly bills, how much disposable income is left for the family to live on? Do they think that the permanent managing conservators will need help paying for routine maintenance? If so, why? Is help with the child’s maintenance essential? What is the least they will need help with to be able to provide for the child?

Negotiating the Terms of the Permanency Care Assistance

To negotiate an agreement for permanency care assistance, the permanent managing conservator and the caseworker work together to:

  •  identify the child’s need for services;

  •  identify the resources available for meeting those needs, including the resources available to the permanent managing conservator; and

  •  build a case (base on the needs and resources) for providing permanency care assistance.

The resources available to the permanent managing conservator may include:

  •  Medicaid;

  •  the public school system;

  •  the local mental health system; and

  •  other community or private resources and services.

To the extent possible, discussion about the need for assistance must take into consideration both current and future needs. If the child’s circumstances change, the permanent managing conservator may ask to renegotiate the agreement.

Additional Discussion Points

  •  What is the monthly income of the permanent managing conservator? Is it the same as the income reported in Form 2286 Parenting Application, or reported during the home screening? If the monthly income is different, how is it different? How many in the family are dependent on the income of the permanent managing conservator for support? Are any children attending college, and does the permanent managing conservator pay for the college-related expenses?

  •  What community resources are available to help with the child’s service needs? Is the child already using the resources (such as local early child intervention program), and is the family aware of them?

  •  Does the child have income that will move with the child into permanent managing conservatorship, such as Retirement, Survivors, Disability Insurance (RSDI)? Does the permanent managing conservator understand that those benefits must be used to meet the child’s needs before using permanency care assistance?

  •  Is the child with a disability eligible for Supplemental Security Income (SSI)? Does the permanent managing conservator understand that he or she can elect to receive SSI that also includes Medicaid coverage instead of receiving permanency care assistance and vise versa? Does the family understand the consequences of electing SSI benefits over permanency care assistance?

  •  Will the family be able to add the child to the family’s health insurance? If the child is moving out-of-state and the receiving state will not provide Medicaid coverage, how does the family plan to provide health insurance for the child? If Texas Medicaid is provided, will the family’s health care providers be willing to enroll in the Texas Medicaid program? If not, should Medicaid coverage be excluded from the agreement?

  •  Are there special or unusual circumstances in the family that need to be considered when negotiating the agreement for permanency care assistance?

  •  How long will permanency care assistance be needed?

  •  Will an agreement for deferred assistance meet the child’s needs at this time? (See 1618 Negotiating Permanency Care and Deferred Agreements.)

Arriving at a Payment Amount

To determine the appropriate monthly payment for Permanency Care Assistance, the worker takes the following steps:

1.   Begin with a need amount of zero.

2.   Review the worksheet completed by the permanent managing conservator and discuss each item that is appropriate to the child being placed.

3.   Include as a factor, the child’s current and projected needs, as identified in this item, and the projected costs of those needs.

4.   Include as a factor, whether the child requires health or behavioral care that is not covered by Medicaid or the family’s health insurance.

5.   Consider all of the community resources available for meeting the child’s needs. Do not include the costs for services that a child is entitled to receive from a public entity; such costs are not included in the payment for permanency care assistance.

6.   When the permanent managing conservator must have help providing for the child’s routine maintenance, determine how the extent to which the costs will increase the costs of the child’s placement.

7.   Determine what, if any, are the child’s short-term needs, the cost of meeting those needs, and the duration of the need.

8.   Determine what, if any, are the child’s long-term needs, the cost of meeting those needs, and the duration of the need.

9.   Include as a factor, the family’s current and projected income, expenses, and any special circumstances that impact the family’s ability to support the child.

10. Consider any income that the child will bring into the placement.

11. Determine, with the family, the amount the family will provide to meet the child’s needs and then subtract that amount from the monthly need.

12. The remaining costs, if any, represent the unmet need. If the need does not exceed the payment ceiling, the remaining cost becomes the monthly payment that can be made by DFPS. If the unmet need exceeds the payment ceiling, the payment ceiling becomes the maximum amount.

13. Determine how long the permanency care assistance will be needed.

14. Prepare and execute the appropriate agreement for permanency care assistance.

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