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1540 Foster Care Assistance Eligibility Requirements for Young Adults Formerly in DFPS Conservatorship

1541 Extended Foster Care Assistance

CPS March 2012

Young adults ages 18-22 who remain in or return to Extended Foster Care may be eligible for Extended Foster Care assistance. To be eligible, the young adult must meet the requirements found in DFPS’s Rule 40 TAC §700.316. In particular, the young adult must sign Form 2540 Voluntary Extended Foster Care Agreement (VEFCA), and meet at least one of the educational and work-related eligibility criteria. These requirements, and acceptable documentation for the requirements, are described in section 10400 Extending Foster Care for Young Adults Who Are 18 or Older and its subitems.

The eligibility specialist performs an annual review of eligibility for all young adults who are receiving Extended Foster Care assistance. Although the caseworker is responsible for verifying that the young adult participates in one of the permissible educational and work-related activities throughout the year, the eligibility specialist annually reviews the documentation provided by the caseworker to ensure that the young adult remains eligible following all applicable requirements and guidance in section 10400 Extending Foster Care for Young Adults Who Are 18 or Older and its subitems. See 10423 Monitoring Continued Participation and Annual Eligibility Review.

The eligibility of young adults between the ages of 21 and 22 who are meeting the extended assistance requirement – “regularly attending high school or enrolled in a program leading toward a high school diploma or high school equivalence certificate” – must be changed from Title IV-E to state-paid eligible. In addition, the young adult’s Medicaid eligibility type is changed to “State-Paid” coverage as well. The effective date of these eligibility changes are the 1st of the month after the month the young adult turns 21. The eligibility specialist makes these changes after the annual review of eligibility due at the young adult’s 21st birthday.

For additional policies about the Form 2540 Voluntary Extended Foster Care Agreement (VEFCA) see 1543.1 Youth Age 18 or Older in Voluntary Foster Care: Signing Over SSI and RSDI Benefits.

1542 Return for Extended Foster Care

CPS March 2012

Young adults age 18-21 who have aged out of CPS foster care at age 18 or later and desire to return for extended foster care may do so under the conditions described in 10500 Trial Independence and Return for Extended Foster Care.

Texas Administrative Code §700.346

1543 Payment for Long-Term Care in Adulthood

CPS December 2011

When a youth who is aging out of DFPS-paid substitute care still needs care and supervision in adulthood as the result of a disability, the youth’s caseworker arranges for the care and supervision to begin as soon as the youth ages out of substitute care. (See 10340 Preparation for Long-Term Care or Support in Adulthood for Youth with Disabilities.) If an existing source of income is available to pay for the youth’s continuing care in adulthood, the caseworker arranges for the income to be used for the cost of that care.

Youths with disabilities retain their Social Security Administration disability determinations when they turn 18, and their eligibility for supplemental security income (SSI); Retirement, Survivors, and Disability Insurance (RSDI); and Veterans Administration (VA) benefits usually continues. The Social Security Administration is responsible for assigning a protective payee for a youth’s benefits when the youth turns 18. If the Department of Aging and Disability Services (DADS) assumes guardianship of a youth who is in extended foster care, DFPS continues to be the representative payee of the youth’s SSA benefit while the youth remains in extended foster care.

1543.1 Youth Age 18 or Older in Voluntary Foster Care: Signing Over SSI and RSDI Benefits

CPS December 2011

Youth who turned age 18 while in DFPS managing conservatorship and who meet certain eligibility requirements, may be eligible for extended foster care and continue receiving DFPS services. Youth sign the Voluntary Extended Foster Care Agreement (VEFCA, Form 2540) as an agreement to participate in an activity that allows them to remain eligible for extended foster care. Youth sign the VEFCA before his or her 18th birthday and upon returning to foster care from Trial Independence.

A youth receiving Social Security Administration (SSA) benefits, such as Supplemental Security Income (SSI) or Retirement, Survivors, Disability Insurance (RSDI), or other monthly benefits to which they are entitled, must also sign the Voluntary Extended Foster Care Financial Agreement (VEFCA), which is an attachment to the VEFCA. The youth signs the VEFCA Financial Agreement on or after his or her 18th birthday which is a different time frame than when the VEFCA must be signed. The youth's CPS caseworker sends a copy of the signed Financial Agreement to the foster care eligibility specialist, the regional SSI coordinator and the regional CPS Children’s Income Accounting unit.

By signing the VEFCA Financial Agreement, the youth agrees to allow DFPS to use his or her monthly benefit for the youth's cost of care while they are in the extended foster care program. The youth further agrees to allow SSA or the issuing entity to name DFPS as the representative payee for his or her benefit. If SSA or the issuing entity allows the youth to be his or her own payee, the youth agrees to turn over his or her monthly benefits to the DFPS.

If SSA or the issuing entity names DFPS the payee, the monthly benefit is issued directly to DFPS. When SSA or the issuing entity names the youth to be his or her own payee, the monthly benefits are sent directly to the youth. Each month the youth turns over the benefit by signing the back of the check and sending it to the regional CPS Children’s Income Accounting unit. The unit deposits the check into the regional children's income account. Refusal to turn over the monthly benefit results in the termination of foster care eligibility.

Young adults in DADS guardianship and in DFPS paid placements are not considered in the DFPS Extended Foster Care program, as DFPS does not have case management responsibility for these individuals. Instead a Guardianship Extended Foster Home Placement agreement is signed by the DADS guardian for these young adults. The agreement includes a Financial Agreement and is signed by the DADS guardian for youth who are receiving SSI, RSDI or other monthly benefits to which the youth is entitled. By signing the Financial Agreement, the DADS guardian agrees to have DFPS apply the young adult's benefits to pay for his or her placement as long as the guardianship client remains in the DFPS paid placement. The DADS guardian also agrees to allow the Social Security Administration or the issuing entity to name DFPS as the representative payee to receive any SSI, RSDI or other monthly benefits to which the guardianship client is entitled.

For further information on foster care eligibility requirements for the Extended Care program see:

1530 Foster Care Assistance Eligibility Requirements for Children and Youth Who Are in DFPS Conservatorship

10400 Extending Foster Care for Young Adults Who Are 18 or Older

1544 Medicaid for Young Adults Who Age Out of Foster Care

CPS June 2014

A young adult who ages out of foster care may be eligible for Medicaid under either the Former Foster Care Children (FFCC) program or the Medicaid for Transitioning Foster Care Youth (MTFCY), provided that he or she meets the eligibility requirements.

A young adult age 18 through 25 may be eligible for healthcare coverage through the FFCC program.

A young adult age 18 through 20 may be eligible for healthcare coverage through the MTFCY program.

DFPS initiates the coverage by sending an automated referral through the IMPACT system to HHSC as the young adult ages out of foster care.

Upon receiving the referral, HHSC determines which program the young adult qualifies for.

For details, see:

10140 Overview of Healthcare Coverage for Youth and Young Adults Who Age Out of Foster Care

DFPS’s Medicaid handout (Form 1014), which includes a flow chart on page 2 explaining how to get help by calling 2-1-1.

1550 DFPS Accounting Staff Information and Responsibilities

1551 Foster Care Maintenance Payments

CPS May 2016

To receive foster care maintenance payments, private child care facilities must be approved by DFPS for participation. Foster care maintenance payments are intended to cover a child’s basic needs, not the needs of the provider.

1551.1 Rates for DFPS Foster Care Maintenance Payments

CPS May 2016

DFPS’s foster care rates are determined by the service level that the child needs, subject to adjustments based on the extent to which other services provided by outside parties meet the child’s needs or on other factors consistent with the child’s needs.

In the rate structure, rates are based on analysis of cost reports and other pertinent financial and statistical information including statistics published by the United States Department of Agriculture (USDA) on the expenditures on a child by families. DFPS determines a child’s service level based on the child’s characteristics, as described in DFPS’s application form, and the descriptions of service levels. The Health and Human Services Commission approves the rates for foster care payments.

DFPS Rules, 1 TAC §355.7103

1551.2 Participation in the Paid Foster Care Program

CPS May 2016

To receive foster care maintenance payments for a DFPS child, all DFPS and non-DFPS families and private, nonprofit, and for-profit facilities, group homes, and child-placing agencies must complete a contract or agreement with DFPS. The foster care provider and DFPS must sign the contract or agreement and it will be in effect for a designated period stated in writing in the contract or agreement.

When this period expires, the contract continues according to its then-current terms until either party terminates the contract, or until DFPS notifies the provider of a change. At this point, the contract ends, and a new contract begins if the provider agrees in writing to the new terms.

1551.3 Effective Dates of Foster-Care Maintenance Payments

CPS May 2016

The effective date for beginning foster care maintenance payments is the date the child meets all eligibility requirements for foster care assistance. DFPS pays for the calendar day on which a child is placed, but not for the calendar day the child is discharged. DFPS does not pay two different facilities for foster care assistance for the same child on the same date. As a result, the conservatorship worker must record in the case record the date the child enters and leaves each facility.

DFPS Rules, 40 TAC §700.329

1552 Payment for Foster Care

CPS May 2016

If a child is in a placement paid for by DFPS the child’s cost of care is paid for with both federal and state funds, and payments designated or designed to be used for the child’s care, such as child support funds. When a federal benefit is the source of payment, such as monthly Supplemental Security Income (SSI) and Retirement Survivors Disability Income (RSDI) payments, DFPS follows federal law and policy.

Texas Family Code §264.109

20 C.F.R. §416.640; 20 C.F.R. §404.2040

Other sources of payments, settlements, gifts, inheritance, certificates of deposits, stocks, bonds, and insurance policy pay-outs are normally not used for cost of care. If a caseworker or other party is requesting that these funds be used for cost of care, or for any other reason, state office accounting staff contacts the Office of General Counsel or the Regional Attorney before approving any expenditure.

SSA Payments

Social Security Administration (SSA) monthly benefits are deposited in one month and are used to pay the cost of care the following month. This ensures that if a placement breaks down the provider is not reimbursed for the cost of care when the child is no longer in that placement. Normally, the cost of care will exceed the monthly payment; however, in cases where it does not, the excess amount is conserved for the child and placed in the child’s savings account.

For SSI children, SSI and RSDI lump sums are managed as set out in 1580 Managing a Supplemental Security Income (SSI) Lump Sum or Retirement, Survivors, and Disability (RSDI) Lump Sum for a SSI Child.

1553 Recoupment of Foster Care Maintenance Overpayment

CPS November 2019

A recoupment is a process to retrieve funds when an overpayment is made to a foster care provider. The IMPACT system identifies when an overpayment has been made to a foster care provider and generates a Prior Period Adjustment (PPA) invoice to recoup the overpaid funds. A CPS regional foster care billing coordinator can also create a PPA invoice to recoup funds through IMPACT. A billing coordinator may also manually recoup an overpayment from a foster care provider, outside the IMPACT system, through the process described in 1553.2 Manual Recoupment, when appropriate.

1553.1 Basic Recoupment

CPS November 2019

DFPS is required to recoup any overpayment, even if the error is made by DFPS.

Using IMPACT to Maintain Accurate Records

To ensure historical data is held in IMPACT, it is important that recoupments are processed online whenever possible.

The preferred method to retrieve the funds is to recoup the entire overpayment amount from the next payment, or payments, made to the provider. The regional foster care billing coordinator does this by approving a Prior Period Adjustment (PPA) invoice within the IMPACT system.

On occasion a provider becomes aware that the provider received an overpayment and mails a check to the CPS regional foster care billing office returning the overpaid funds to DFPS. The regional foster care billing coordinator determines whether the recoupment can be taken from a subsequent payment to the provider in the following month. If the overpayment can be recouped from the subsequent payment, the regional foster care billing coordinator returns the check to the provider and includes a completed Returning a Refund Check to the Provider letter (Form 8103b).

Notifying the Provider if the Recoupment Amount Exceeds 50% of the Next Payment

If the recoupment amount exceeds 50% of the provider’s next payment, regional foster care billing coordinator must notify the provider before approving the recoupment invoice in IMPACT. See 1553.3 Notification to Providers of Recoupment that Exceeds 50% of Next Payment.

1553.2 Manual Recoupment

CPS November 2019

Regional foster care billing staff follow the procedures described in the sections below when a manual recoupment must be completed. The following are examples of situations requiring a manual recoupment:

  •  The provider’s contract or placement has been terminated and there are no subsequent payments to the provider from which to recoup the overpayment through a PPA invoice.

  •  The dollar amount of the overpayment is substantial and will require more than six months to be recouped from future invoices.

  •  Three months have elapsed since a PPA invoice was approved in IMPACT to recoup the overpayment but there have not been adequate payments to the foster care provider to offset the overpayment.

1553.21 Review of the Invoice Recoupment Report

CPS November 2019

To assist foster care billing staff identify PPA invoices that are approved and in pending status for over three months, an ad hoc query report is generated from IMPACT. The monthly report lists all invoices with a negative balance dating more than three months from the date the invoice was approved. The report is called the Invoice Recoupment Report and is distributed to all regional foster care billing staff.

The regional foster care billing coordinator is responsible for reviewing the report and completing a manual recoupment, as described below, on each such invoice.

1553.22 Manual Recoupment Process

CPS November 2019

To initiate manual recoupment the regional foster care billing coordinator takes the following steps.

1.  Ensure the adjusting invoice is still outstanding in IMPACT before beginning the recoupment process. Check the payment history to verify the amount to be recouped is correctly reflected in the adjusting invoice. Forms referenced below are located on the DFPS intranet.

2.  Complete a Request for Payment Letter (Form 8103a). In the letter, include:

  •  An explanation of when and how the overpayment occurred.

  •  The payment due date, which is 30 days from receipt of the letter.

  •  The address for payment. Payments are sent directly to state office Accounting Division.

3.  Complete a Request for Payment to DFPS (Form 8102fc). The provider uses this form to track the reimbursement, which may be made as one payment or several. If several payments are being made, the provider sends with each payment a new copy of the Form 8102 with the latest payment documented.

4.  Email the completed Request for Payment Letter and Form 8102fc to the ACCOUNTING FORM 8102 mailbox.

5.  Send the completed Request for Payment Letter and Form 8102fc to the provider by certified mail.

6.  Keep copies of the Request for Payment Letter (8103a) and Form 8102fc for their records.

7.  Mark the Manual Recoupment Requested box found on the invoice in IMPACT.

1553.23 Provider Responds within 30 Days

CPS November 2019

If the provider responds to the Request for Payment letter before the 30-day time limit expires, the regional foster care billing coordinator immediately sends an email to the ACCOUNTING FORM 8102 mailbox.

The provider’s response may be any of the following:

  •  Disagreement, which would initiate the appeal process.

  •  Agreement to pay the overpayment in full.

  •  Request for a repayment plan.

State office accounting staff update the status of the recoupment process to reflect this communication.

1553.24 Documenting Receipt of Payment (State Office)

CPS November 2019

When the payment is received by the state office Accounting Division, state office accounting staff complete the Receipt of Refund section on the copy of the Form 8102fc that accompanied the payment.

1553.25 When Payment is Not Received within 30 Days

CPS November 2019

If the payment is not received within 30 days of the Request for Payment Letter noted in Step 2 of 1553.22 Manual Recoupment Process, the state office Accounting Division pursues by sending a certified demand letter.

If funds are not received in response to the certified demand letter further action may be taken by state office Legal Services and the Accounting Division,

1553.26 Provider Does Not Respond Within 30 Days

CPS November 2019

If the regional billing staff are contacted after the 30 day time frame, they should not agree to any type of change until the Accounting Division in state office is contacted to determine the status of the recoupment process.

The Accounting Division in state office takes over the process once the time frame has expired. The provider may have been put on hold as a result of the recoupment or the recoupment could be headed to the Office of the Attorney General (OAG) for referral.

1553.3 Notification to Providers of Recoupment that Exceeds 50% of Next Payment

CPS November 2019

If the amount to be recouped is greater than 50% of the next projected payment, the regional foster care billing coordinator performs the following actions:

1.  Notifies the provider about the recoupment by phone.

2.  Documents the phone call on the Phone Log (Form 8103c).

3.  Does either of the following:

  •  If the provider agrees with the planned recoupment, approves the PPA invoice to recoup the overpayment.

  •  If the provider disagrees with the planned recoupment, records the reasons on the Phone Log. The regional foster care billing coordinator tells the provider that the provider’s comments and information will be relayed to the director of the state office Accounting Division.

1553.31 Extreme Hardship and Repayment Plans

CPS November 2019

If the provider states the repayment of the full amount at one time will create an extreme hardship, the regional foster care billing coordinator requests a letter from the provider explaining the reasons for the hardship. The regional foster care billing coordinator informs the provider that the letter must be received within 10 business days of the phone call.

If the letter of extreme hardship is received within 10 business days of the phone call, the following areas are considered when establishing a repayment plan:

  •  Remaining time in the placement.

  •  Current provider status (such as active or inactive).

  •  Impact on the child.

  •  Provider’s financial situation and contents of the letter explaining hardship.

  •  Monthly repayment installment amounts.

Repayment in Monthly Installment

Repayment plans are limited to the following restrictions:

  •  Repayment amounts approved at the regional level are not to exceed 12 months.

  •  Requests for more than a 12-month period or an extension must be approved by the assistant commissioner for CPS and the director of the Accounting Division, if given sufficient cause.

  •  Under no circumstances are any repayment plans to exceed 24 months.

A repayment plan may be offered to the provider if the number and amounts of payments fall within the stated guidelines.

The repayment plan must be documented on the Provider Repayment Plan Documentation and Approval Form (Form 8103d-fc) and submitted for approval, as referenced below.

Dollar Thresholds for Repayment

Timeframe for Repayment

Required Written Approval From

Under $50,000

12 months or less

CPS regional operations and support administrator

$50,000 - $100,000

12 months or less

CPS regional director

$100,000 or more

12 months or less

CPS director of field

Any

More than 12 months, not to exceed 24 months

As appropriate for dollar threshold (see above) AND assistant commissioner for CPS AND director of accounting

Payment Methods

Repayments may be made one of two ways.

  •  The total overpayment may be divided and deducted from future invoices. This is the preferred method.

  •  The total overpayment may be divided and monthly payments mailed in by the provider. This is used if there are no future invoices projected, or if there have not been adequate payments within the last three months.

Payment Plan Agreement

When the form has been approved and signed by the required DFPS authority, accounting staff mail the form to the provider for signature.

When the signed form is returned, accounting staff send it to the Foster Care Billing Program specialist in state office. The program specialist logs in the repayment information and forwards the original document to the Accounting Division at mail code E-672.

Renegotiating the Payment Plan

If at any time the provider requests a new payment plan, or if the provider ceases to make payments in accordance with the approved payment plan, regional staff forwards the information to the Foster Care Billing Program specialist who contacts the DFPS Accounting division

Accounting Division staff must determine if the debt has already been submitted to the Office of the Attorney General (OAG). If the debt has been submitted to the OAG, the provider must contact the OAG to make arrangements for payment. If the debt has not been submitted to the OAG, a new Form 8103d-fc must be completed and approved by appropriate personnel.

1553.4 When Not to Initiate Recoupment Procedures

CPS November 2019

DFPS always seeks to recoup any overpayment of foster care funds, except in limited circumstances when recoupment is not in the best interest of DFPS.

If there is a question about whether an overpayment should not be recouped, regional foster care billing staff request a decision from the CPS regional director by sending the following information in a memorandum:

  •  The payment history for the dates in question.

  •  The outstanding balance to be recouped.

  •  The extenuating circumstances, explained in detail.

If the request to forgo recoupment is approved by the CPS regional director, regional foster care billing staff forward the memorandum to the CPS division administrator for Federal and State Support.

The division administrator forwards the memorandum to the appropriate person for approval, as shown in the table below. The decision must be approved in writing. The division administrator also sends a copy to the director of the Accounting Division.

If the recoupment amount is ...

then written approval must be obtained from the ...

up to $10,000 ...

CPS regional operations and support administrator

$10,000 - $25,000 ...

CPS regional director

$25,001 - $50,000 ...

CPS assistant commissioner

Over $50,001 ...

DFPS commissioner

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