Tracking #2006-00905

I:/06081001.rtf
[I:/06081001.doc]

(12 CCR 2509-4)

[Note:  Statement of basis and purpose included w/#06-9-26-1, Tracking #2006-01133]

[Instructions: replace lines 1011529 through 1011559]
7.306.52  Reimbursable and Non-Reimbursable Subsidized Adoption Case Services [Rev. eff. 1/1/07]
Case services are a type of purchased program services that support a case plan for children in out-of-home placement or subsidized adoption.
Case services are provided to meet a child's special needs identified when the child is placed for adoption and which are not covered by the adoption assistance or Medicaid subsidies.
To be eligible for case services in subsidized adoption, the Subsidized Adoption Agreement (CW-SA-3) must be in place and the case open in the Department's automated reporting system as a subsidy case.
A.  Medical
1.  Orthodontia
a.  Cosmetic reasons - not reimbursable.
b.  Special needs directly related to the reason for which the child was classified as special needs, e.g. cleft palate or injury related to an abuse will be reimbursable.
2.  Eye Glasses
Eyeglasses are not reimbursable using case services dollars as Medicaid pays for one pair of glasses per year.  
Payment for additional eye glasses in a year or contacts related to the child's special needs identified at the time of the initial subsidized adoption agreement are reimbursable.
3.  Medication
a.  Routine that is not related to the child's special needs - not reimbursable.
b.  If related to child's special needs - reimbursable.  The medication must be prescribed by a licensed physician and related to the special need identified at the time the child was approved for subsidized adoption.
4.  Special Therapies - Speech, Occupational, and Physical
a.  If not available through other community and family resources - reimbursable.  School-age children should receive these services through the school system.
b.  When these services are available in hospitals and clinics – not reimbursable as Medicaid covers these costs. 
5.  Special Equipment
Special medical needs/equipment, as prescribed by a physician may be reimbursable.
For severely physically-challenged children, special exceptions should not exceed $2,000 without a supervisor's written authorization.
B.  Psychological Services
1.  Time-limited out-patient therapy for children living in states that do not accept Medicaid for this service - reimbursable, if related to the child's special needs and a written plan is obtained from the service provider which contains:
a.  Diagnosis.
b.  Prognosis.
c.  Length of service.
d.  Individuals who will be seen in therapy.
e.  A cap on the amount of money to be spent for the psychological exam or therapy.
f.  Frequency of contact (i.e., once a week, twice a month, etc.).
g.  Type of therapy being provided (i.e. individual, group, family, etc.).
2.  If time-limited out-patient therapy is available using Medicaid – not reimbursable. 
3.  Day treatment - not reimbursable as Medicaid provides for this service.
4.  Residential child care facility - not reimbursable as Medicaid provides for this service.
5.  In-patient psychiatric hospitalization - not reimbursable as Medicaid provides for this service.
(Children who are Medicaid eligible may receive some in-patient psychiatric services under the Medicaid Program.)

(12 CCR 2509-6)

[Instructions: replace lines 1011877 through 1011955]
7.500.2  ASSESSMENT OF FOSTER HOME AND ADOPTIVE HOME [Rev. eff. 1/1/07]
A.  Content of the Assessment
A family assessment, using the Structured Analysis Family Evaluation (SAFE) instrument to determine the character and suitability of the applicant(s), appropriateness of the home, and child care practices, must be completed.  The assessment shall include, but not be limited to, the following:
1.  Social History/Background (Adults and Children)
Separate and joint interviews with the applicant(s), all adults residing in the home (both related and non-related to the applicant), and all children residing in the home regarding at least significant events in family background, evaluation of applicants' knowledge and capacity to care for children and ability to maintain long term relationships and life changes including issues of grief and loss.
2.  Current Status of the Family (Family System/Lifestyle)
Marital relationship, interrelationships with significant persons outside the nuclear family, lifestyle changes, methods of decision making, parenting/child rearing, methods of discipline, religion, finances, extended family, child care plan in the event of emergency and/or when parents work away from the home; assessment of any children in the home; an assessment of the family's interest and ability to meet the special needs of a child, including financial responsibility; assessment of ability to accept legal risk placement; and, assessment of family's strengths, including individual/family strengths and self-esteem.
For kinship care, ability to meet the individualized needs of the specified child(ren), and assessment of the relationship with birth parents and extended family members as they impact capacity of the applicants to care for the child(ren).  When completing the assessment, Section 7.708, “Rules Regulating Family Foster Care Homes”  should be consulted.
3.  Motivation for a Child
Include a discussion of the child to be placed, attitudes toward foster care/adoption by applicants, other adults residing in the home, children, and others such as extended family, and discussion of fertility, if relevant.  Assess the physical, mental and emotional capability of the applicant(s) to parent a child(ren) through adoption and their ability to reevaluate and readjust expectations.
4.  Transracial Assessment
Applicants fostering/adopting a child of a different ethnic and cultural background shall preserve continuity of the child's ethnic and cultural identity in a positive manner.  Factors should include, but are not limited to, consideration of the child's family, community, neighborhood, faith or religious beliefs, school activities, friends, and child's and family's primary language.  Documentation of this requirement shall be in the case file.
5.  Child Safety and Well-Being
Address each of the following factors that contribute to or contraindicate potential for abuse:
a.  Personal history of abuse and beliefs regarding physical punishment.
b.  Knowledge of child development and expectations of children.
c.  Coping skills in dealing with anger, frustration, and provocation from children.
d.  Ability to maintain control when angry.
e.  Capacity for compassion and empathy.
f.  Ability to separate own needs and perceptions from those of others.
g.  Availability of support systems.
h.  In kinship care, ability to set boundaries with birth parents to maintain safety for the child(ren) in care.
6.  Children with Special Needs
The applicant’s interest, preparation and willingness to care for a child(ren) with disabilities such as emotional, mental and physical, and the ability to meet the special needs of the child(ren).  The home study must include an assessment as to how the child(ren)’s special needs will impact the family and extended family.
7.  Relationship with the County Department
Discuss the applicant’s ability to work with the child welfare system, court, birth parents, and others in the child’s life, including willingness to obtain help from professionals involved.
8.  Post-Adoptive Services
The applicant’s ability to assist with possible post-adoptive issues of the child, including, but not limited to:
a.  Questions about the birth family.
b.  Locating and obtaining non-identifying information about the birth family.
c.  Search and possible reunification of the adopted child with the birth family.
d.  Willingness to assist adopted child with counseling, if needed, related to adoption issues.
9.  In kinship care, the ability to provide a permanent home through adoption, guardianship or permanent custody.
B.  State Department's Automated System, Colorado Bureau of Investigation (CBI), and Federal Bureau of Investigation (FBI)
1.  Prior to full certification of a family foster home, there shall be a review and documentation in the provider record of:
a.  Findings from the State Department's automated system, regarding applicants and persons who reside in the home of the applicant;
b.  Written statements from references;
c.  Health information;
d.  The review of existing agency case records, including the automated system, for prior foster home certifications or denials; and,
e.  Investigations of any concerns raised from the application and/or aforementioned sources of information.
f.  The results of the face-to-face interview on all members of the household.
g.  A fingerprint-based criminal history record check with the CBI.
h.  A comparison search on the ICON State's contracted system, using the name and date of birth, with available criminal history information.  The purpose is to determine any crime(s) for which an applicant was arrested or convicted and the disposition.  This search must be completed regardless of whether the CBI fingerprint history confirms or does not confirm a criminal history.
Section 7.708 outlines specific additional requirements for family foster homes.
2.  Prior to the placement of any child or prior to provisional certification of a “child specific”  or kinship care home, the county department shall obtain fingerprints and complete a criminal record check on the applicant(s) and any other person 18 years of age or older living in the household from the Colorado Bureau of Investigation (CBI).
3.  Fingerprint-Based Criminal History Background Checks
a.  FBI checks for foster parents:
Federal Bureau of Investigation (FBI) checks shall be initiated for any applicant(s) if the applicant(s) has resided in Colorado for less than 24 months, except for emergency placement as described in Section 7.304.21, D, 2, f.  The Federal Bureau of Investigation reports shall be sent directly to the county department submitting the request for information.
b.  FBI checks for prospective adoptive parents:
Federal Bureau of Investigation (FBI) checks shall be initiated for all prospective adoptive parents.  The Federal Bureau of Investigation reports shall be sent directly to the county department submitting the request for information
c.  FBI checks for other members of the household:
Federal Bureau of Investigation (FBI) checks shall also be initiated for any other person 18 years of age or older living in the household, if that person has resided in Colorado less than 24 months.  The Federal Bureau of Investigation reports shall be sent directly to the county department submitting the request for information.
4.  All CBI and FBI fingerprint-based criminal record reports, including court dispositions if applicable, shall remain confidential in the county department records, except as provided in Section 7.500.2, C, 3.
C.  Other Requirements
1.  Documentation of any previous emotional problems, mental illnesses, substance abuse issues, or marital problems that may have an impact on the care of a child(ren).  Include any factors which would impact the safety and well-being of any child(ren) in the home.
2.  The application for adoption or foster care shall be denied for reasons listed in Section 7.500.312, D, and may be denied for reasons listed in Section 7.500.312, E.  If the applicant has ever been rejected as a prospective adoptive or foster parent or has been the subject of an unfavorable finding, the home study must address the reasons for the unfavorable finding and any resolution of disagreements concerning the finding.
3.  For the purposes of conducting an adoptive home study, the county department, qualified individual, and child placement agencies shall be required to report to the court the results of a fingerprint-based criminal history records check when it reveals that the prospective adoptive parent was convicted of a felony or misdemeanor of:
a.  Child abuse or neglect;
b.  Spousal abuse;
c.  Any crime against a child;
d.  Any crime, the underlying factual basis of which has been found by the court on the record to include an act of domestic violence, as specified in Section 18-6-800.3, C.R.S.;
e.  Violation of a protective order, as described in Section 18-6-803.5, C.R.S.;
f.  Any crime involving violence, rape, sexual assault, or homicide;
g.  Any felony drug-related conviction within, at a minimum, the past five (5) years.
No person convicted of a felony offense as specified in items a-g, above, shall be allowed to adopt a child.
4.  As part of the assessment, the agency must:
a.  Conduct a minimum of one joint face-to-face interview with a couple, one individual face-to-face interview with each adult member of the household and an age/developmental appropriate face-to-face interview with all children residing in the home.  For single applicants, a minimum of two interviews will be required.
b.  Conduct at least one face-to-face interview in the applicant's home.
c.  Perform an on-site inspection for foster homes to determine compliance with the Minimum Rules and Regulations for Family Foster Homes, Section 7.708.  Approval of local zoning, health, or fire departments must be documented in the foster home file when the situation warrants.
d.  Spread out interviews over a period of not less than seven (7) consecutive days.
e.  Update the assessment annually in the form of an addendum.  An addendum shall include at least one home visit and a review of the current medical status.  During each subsequent addendum, applicants shall be questioned regarding any child abuse investigations during the previous year.
5.  The application and medical records will be reviewed;  any issues that are identified will be discussed with the applicants.  No physical examination shall be required of any person who in good faith relies upon spiritual means or prayer in the free exercise of religion to prevent or cure a disease unless there is a reason to believe such person’s physical condition is such that he/she would be unable to care for a child, or such person has a communicable illness.
6.  The county department shall not perform a foster home or adoptive home assessment on a member of its own staff.  The worker should check with the supervisor for county policies and procedures regarding completing assessments on county staff.
7.  Water, if from any source other than a regular municipal water supply, shall be tested for compliance with water quality requirements.
8.  A current photograph of the family shall be requested and maintained in the file.
9.  For the purposes of conducting an adoptive home study, the home study is to be completed ninety (90) working days from receiving the completed background checks.
10.  The county department shall not deny to any person the opportunity to become an adoptive or foster parent on the basis of race, color, or national origin of the person, or of the child involved.
D.  Additional Requirements
List characteristics of child(ren) the home is approved for:  age, sex, race, legal risk, and special needs (such as medical, physical, emotional).  Following the completion of the assessment, a narrative report that summarizes and evaluates the information obtained must be completed.  It shall be attached to the SAFE questionnaires 1 and 2.

(12 CCR 2509-8)

[Instructions: replace lines 1132206 through 1132207]
7.708.36  Physical Restraint [Rev. eff. 1/1/07]
If a family foster care home uses physical restraint with a foster child(ren) in care in an emergency situation when the foster child is a danger to himself/herself or others, the family foster care home must be pre-approved by the certifying authority to conduct restraints and must be in compliance with all the rules concerning physical restraint as found at Sections 7.714.53 - 7.714.536. The family foster care home must notify the placing caseworker when a child is restrained.