Dual Agency Rates

0900-511.12 | Revision Date: 08/03/18

Overview

This policy guide provides information on how to obtain or set a dual agency rate for a child, including instruction on rate changes and steps to take when supplemental rates are requested.

TABLE OF CONTENTS

Policy

Dual Agency Rates

Supplement Rates

Nonminor Dependents (NMDs)

Caregiver Training

Procedure

Requesting a Dual Agency Rate

CSW Responsibilities

SCSW Responsibilities

ARA Responsibilities

DCFS Regional Center Section Responsibilities

Rate Changes

CSW Responsibilities

Requesting the Supplement to the Dual Agency Rate

CSW Responsibilities

SCSW Responsibilities

ARA Responsibilities

Approvals

Helpful Links

Attachments

Forms 

Referenced Policy Guides

Statutes

Version Summary

This policy guide was updated from the 07/01/14 version, to reflect that Approved Relative Caregiver (ARC) Program recipients are eligible for the dual agency rate if they otherwise meet all other criteria for the rate; and the eligibility criteria for the dual agency and the supplemental rate.

POLICY

Dual Agency Rates

Children who are California Regional Center clients, receiving AFDC-FC, ARC, Kin-GAP, or AAP benefits, and residing in one of the following locations, are eligible to obtain a dual agency rate, per WIC Sections 11464 and 16121.

• Adoptive home

• Approved home of a relative(s)

• Home of a nonrelative extended family member (NREFM)

• Home of a non-related legal guardian, or former non-related legal guardian when the guardianship of the child otherwise eligible for AFDC-FC has been dismissed due to the child turning eighteen (18) years old

• Licensed family home of a non-relative

• Licensed foster family home not vendored by Regional Center

Dual agency rates are not available to Foster Family Agency (FFA) homes, group homes/Short-Term Residential Therapeutic Program (STRTP), or community care facilities vendored by a Regional Center.

The dual agency rates are:

• monthly dual agency flat rate for children, three (3) years and older, or children under three (3) years with a developmental disability, who are eligible to receive services under the Lanterman Act, and receive AFDC-FC, ARC, Kin-GAP, or AAP benefits.

• monthly dual agency flat rate for children under three (3) years who receive services under California’s Early Start Intervention Services Act, and receive AFDC-FC, ARCor AAP benefits, but have not yet been determined to have a developmental disability.
  

The State has issued clarification that neither an Individual Program Plan (IPP) nor current receipt of regional center services is required for dual agency rate eligibility. Whether the child or youth has an “active” or “inactive” case with a regional center is irrelevant for dual agency rate eligibility. An eligibility letter or other documentation of eligibility for regional center services issued by a regional center is sufficient to establish eligibility for the rate.

Supplement Rates

Children receiving the monthly dual agency flat rate funded with AFDC-FC, ARC, Kin-GAP, or AAP benefits who meet the following requirements may also be entitled to a supplemental monthly payment rate of $250, $500, $750, or $1,000 per month:

• The child is three (3) years or older and is receiving AFDC-FC, ARC, Kin-GAP, or AAP benefits.

• The child is a client/consumer of a Regional Center, or has documentation of eligibility (the child has been diagnosed with a developmental disability) for regional center services issued by a regional center

• The child needs extraordinary care and supervision that cannot be met by the dual agency rate, including at least one of the following issues:

• Severe impairment in physical coordination and mobility

• Severe deficits in self-help skills

• Severely disruptive or self-injurious behavior

• A severe medical condition (including severe vision, hearing, or speech impairments)
  
  The above are general categories. The determination of extraordinary care and supervision required is assessed through the SOC 837 as outlined in the Requesting the Supplement to the Dual Agency Rate procedures.

When a child/youth is first determined eligible for a dual agency rate, the child must be immediately assessed for the supplemental rate. Additionally, if the caregiver or his or her representative makes a request to establish or increase the supplement, the regional center makes a referral to establish or increase the supplement, or if the CSW determines it is appropriate for the child to establish or increase the supplement, the child should be re-assessed for his/her eligibility for a supplemental rate. CSWs must track and always assess for the supplemental rate throughout the child’s life as their needs and behaviors may change and require an additional adjustment to the supplemental rate.DCFS must also determine the child’s eligibility for a supplemental rate within ninety (90) days of the request, or the Regional Center’s referral or upon the CSW’s own initiation of the process for a supplement to the rate.

DCFS must also determine the child’s eligibility for a supplemental rate within ninety (90) days of the request, the Regional Center’s referral or upon the CSW’s own initiation of the process for a supplement to the rate.However, per the State’s instruction, the failure of the regional center to sign the SOC 837 or to provide information for the assessment of the child’s needs shall not relieve DCFS from timely completion of the assessment within the 90-day timeframe. Staff shall continue with and finalize the assessment and eligibility determination for a supplement to the dual agency rate, and appropriate level of the supplement based on the extraordinary care and supervision needs of a child/youth in consultation with California Regional Centers. If after ten (10) business days a regional center has not provided information to assist in the completion of the SOC 837, staff shall continue to process the request using other available information, collect information from other professionals and the caregiver or adoptive parent for the completion of the SOC 837 and issue an eligibility determination for a supplement to the rate within the 90-day timeframe based on the most current information available about the child/youth.

As needed, staff may consult with the DCFS Regional Center section for assistance, and utilize input and recommendations discussed through the Child and Family Team process.

Nonminor Dependents (NMDs)

A Nonminor Dependent (NMD) who is eligible for Regional Center services, is in a qualified placement, and meets all the dual agency rate criteria, is eligible for the dual agency rate and supplement. However, the dual agency rate and supplement cannot be paid if the youth is in a Supervised Independent Living Plan (SILP).

Back to Policy

Caregiver Training

Caregivers of dual agency children are not required to complete training to qualify to receive the dual agency rate. As stated above, eligibility for the Dual Agency Rate requires only that the child be eligible for regional center services, is receiving AFDC-FC, ARC, Kin-GAP, or AAP, and resides in one of the qualified placements. If the child has co-occurring special health care needs or mental health needs that may warrant additional caregiver training, the Dual Agency Rate and the Supplement shall be paid independently and without delay pending the caregiver’s fulfillment of any additional training recommendations.

Specific standards exist for a parent/caregiver supervising a child with special health care needs All children with medical or physical needs, or a specified condition must be brought to the Public Health Nurse (PHN) for review and a caregiver training recommendation. All children with special health care needs must be referred to the Medical Case Management Services (MCMS) Unit, as that caregiver may require F-Rate training and/or renewal training. The process includes the completion of the DCFS 1696, F-Rate and Regional Center (ARM) Rate Indicators and the DCFS 149A from the child’s physician, or a medical report on the physician’s letterhead and a prescription slip from the physician in lieu of the DCFS 149A, and provision of a copy of the caregiver’s F-Rate training certificate (if available), to the Public Health Nurse (PHN) for review. The PHN’s recommendation on the DCFS 1696, must be discussed with the caregiver, and the caregiver’s completion of the necessary training must be verified. The SCSW and ARA must be consulted to assess the child’s safety in placement and to determine next steps, if there are issues surrounding a caregiver’s refusal or inability to complete recommended training.

When a dual agency child has a mental health issue(s), in addition to a developmental disability, CSWs must consult with the office’s Service Linkage Specialist (SLS) and/or co-located DMH staff.

If a dual agency child/youth is in a qualified placement, the dual agency rate (and any applicable supplemental rate), if higher, must be requested, in lieu of a Level of Care (LOC) level and/or Specialized Care Increment (SCI) rate. If the assessed LOC level and/or SCI rate is higher, then the higher rate should be requested. Any higher or additional rate the child qualifies for should be requested.

Back to Policy

PROCEDURE

Requesting a Dual Agency Rate

CSW Responsibilities

1. Prior to requesting a dual agency rate, document that the child is a consumer of and/or eligible for Regional Center Services in CWS/CMS, Health Notebook, Summary Page.

2. Complete a DCFS 280, Technical Assistance Action Request to request the appropriate dual agency rate.

1. Attach verification of the child’s eligibility for Regional Center Services, including the effective date (e.g. approval letter and/or verification letter from the Regional Center, a copy of the Individualized Family Service Plan (IFSP), Individual Program Plan (IPP), or Client Development and Evaluation Report (CDER).

• Unless the eligibility date is otherwise stated in the document, the date of the verification document should be presumed to be the date of eligibility for regional center services. If there is any question regarding the documentation presented, contact the regional center that determined the child’s regional center eligibility.
  
  
• If there is a problem obtaining documentation from the Regional Center, consult with the DCFS Regional Center section.

2. If simultaneously requesting the dual agency supplement to the rate for the same child, refer to Requesting the Supplement to the Dual Agency Rate.

3. Document all contacts in the Contact Notebook and all medical information in the Health and Education Notebook in CWS/CMS.

SCSW Responsibilities

1. Review the DCFS 280 (or AAP2 for PAS cases) and all attachments.

1. If approved, submit for ARA's approval.

2. If not approved, return to the CSW for corrective action.

2. Review and ensure that the child’s eligibility for Regional Center Services is documented in the Child’s Health Notebook’s Summary Page.

ARA Responsibilities

1. Review the DCFS 280 (or AAP2 for PAS cases) and all attachments.

1. As appropriate, approve for submission to the TA.

2. If not approved, return to the CSW for corrective action.

DCFS Regional Section Responsibilities

1. Upon request, assist the CSW with obtaining necessary verification/ documentation from the Regional Center and/or in resolving concerns and issues regarding the rate assessment.

1. If there is a dispute with the Regional Center that cannot be resolved, consult with the Regional ARA/RA.

2. If the Regional ARA/RA cannot resolve the dispute, consult with the section's supervisor/manager following the chain of command.

Rate Changes

CSW Responsibilities

1. For a child receiving Early Start Intervention Services, who has not yet been determined to have a developmental disability, contact the Regional Center and/or caregiver thirty (30) days before the child turns three (3) years old to request verification of whether or not the child will still be eligible for Regional Center Services after turning three (3) years old.

1. If the child remains eligible after turning three (3), submit a DCFS 280, Technical Assistance Action Form requesting the appropriate rate, attaching verification from the Regional Center that the child has a developmental disability or is eligible for Regional Center services after turning three years old.

2. If the child is not eligible for ongoing Regional Center Services, submit a DCFS 280 to request that the dual agency rate be changed to the appropriate basic rate, Level of Care (LOC) rate or SCI rate (as appropriate). Consult, as applicable, with the PHN, LOC Unit or D-Rate Clinical Evaluator to determine if the child may qualify for an SCI (F-Rate or D-Rate).

2. If there are changes affecting the dual agency rate such as:
   
   

1. verification and/or any information received that states a child is no longer eligible for Regional Center Services, Early Start Services or AFDC-FC/ARC/Kin-GAP/AAP
   
   
2. a child receiving Early Start Intervention Services is determined to have a qualifying disability and can receive the monthly dual agency flat rate prior to turning three years old.
   
   As applicable:
   

1. Submit a DCFS 280 (or AAP 2 for PAS cases) requesting to change to the appropriate rate.

2. Notify the Eligibility Worker (EW) that the child is no longer eligible for the dual agency rate.

3. Attach any supporting documentation from the Regional Center.

4. For children who are no longer eligible for Early Start Program Services, consult as applicable, with the PHN, LOC Unit or D-rate Clinical Evaluator to determine if the child may qualify for a SCI/appropriate LOC level rate.

1. Refer the child to other available services or resources in the community (as appropriate).

3. If a disagreement arises with the caregiver and/or Regional Center regarding the rate, consult with the SCSW. If the SCSW cannot resolve the disagreement, consult with the DCFS Regional Center Section.

4. Document all contacts in the Contact Notebook and all medical information in the Health and Education Notebook in CWS/CMS. If the child has been found to be no longer eligible for Regional Center services, enter the end-date in the Health Notebook Summary Page.

Back to Procedure

Requesting the Supplement to the Dual Agency Rate

CSW Responsibilities

1. Inform caregivers caring for dual agency children/youth about the availability of the supplement to the dual agency rate for children determined to have extraordinary care and supervision needs that cannot be met by the basic dual agency rate, and how to request it. Document the provision of this information in the Contact Notebook.
   
   

2. If the caregiver, adoptive parent, or Regional Center make a referral for a supplemental rate; or when initiating the process of establishing or increasing a supplement; document that contact in the Contact Notebook, including:

• That a request and/or action for the supplemental rate was made

• The identity of the person making the request and/or action

• The date that the request was received and/or when the action was initiated

3. Complete and send the requestor and the caregiver (if not the requestor) the Letter Acknowledging the Request for Supplemental Rate (available in Spanish).

4. Review the child’s case records, including documents received from the Regional Center (e.g. IPP) to determine the child’s diagnosis and treatment as recommended by the Regional Center.

5. Complete a SOC 837, Supplement to the Rate Questionnaire based on the most current information available.

• This information can be obtained by phone, fax, email, or mail from a Regional Center Service Coordinator or other Regional Center representative, directly from the caregiver, and if needed, other professionals working with the child’s case (e.g. marriage and family therapist, licensed clinical social worker, and medical, educational, or mental health professionals).

• If the Regional Center representative states that their agency’s policy is to not sign the SOC 837, the CSW must document on the SOC 837 the name of the RC Service Coordinator, with the date they declined to sign.

• If after ten (10) business days, a Regional Center has not provided information to assist in the completion of the SOC 837, continue to process the request using other available information; collect information from other professionals and the caregiver or adoptive parent for the completion of the SOC 837, and issue an eligibility determination for a supplement to the rate within the 90-day timeframe based on the most current information available about the child/youth..

6. Complete the SOC 836, Supplement to the Rate Eligibility Form (or SOC 835, Supplement to the Dual Agency Rate - Multiple Questionnaire Worksheet and SOC 836, if multiple SOC 837’s were used) using information on the SOC 837, to determine eligibility for, and the appropriate level of the supplement to the rate.

7. Forward the completed SOC 837, and if requested by the Regional Center, the SOC 835 and SOC 836 (as applicable) via fax, email, or mail to the representative who provided the information. .

8. If the request for the supplement is approved:

1. Complete the DCFS 280, Technical Assistance Action Request (or AAP 2 in PAS cases), requesting for the supplement to the rate, and noting theeffective date.

2. Attach the SOC 837, SOC 836, and SOC 835 (as needed) to the DCFS 280 for SCSW's review and approval.

3. After SCSW and ARA approval and signature, the DCFS 280 (AAP 2 for PAS cases) is forwarded to the TA/EW, with the attached SOC 837, SOC 836, and SOC 835 (as needed) and verification of RC eligibility such as IPP or RC letter.

9. If the request for the supplement is denied:

• Submit a DCFS 280 (or AAP 2 for PAS cases) requesting that a NOA pertaining to the denial of the supplement to the rate be send to the caregiver, including the date of the denial.

10. File copies of the completed DCFS 280 (or AAP 2 for PAS cases), SOC 837, SOC 836, and SOC 835 (if applicable), in the child’s Service Eligibility Folder (yellow).

11. Upon request, provide copies of completed SOC 836 and SOC 837 to the caregiver or adoptive parent.

12. If a disagreement arises with the caregiver, adoptive parents, and/or Regional Center regarding the rate, consult with the SCSW. If the SCSW cannot resolve the disagreement, consult with the DCFS Regional Center section..

13. Document all contacts in the Contact Notebook and all medical information in the Health and Education Notebook on CWS/CMS.

• If there is new medical information gathered in the process of completing the SOC 837, provide this information/documentation to the PHN.

SCSW Responsibilities

1. Review the DCFS 280 (or AAP 2 for PAS cases) and all attachments.

1. If approved, return to CSW for submission to the TA/EW and forward to the ARA for approval and signature.

2. If not approved, return to the CSW for corrective action.

ARA Responsibilities

1. Review the DCFS 280 (or AAP 2 for PAS cases) and all attachments.

1. As appropriate, approve for submission to the TA/EW.

2. If not approved, return to CSW for corrective action.

Back to Procedure

APPROVALS

SCSW Approval

• DCFS 280

• AAP 2

ARA Approval

• DCFS 280 when requesting the dual agency rate or the dual agency supplement to the rate

• AAP 2 for PAS cases when requesting the dual agency rate or the dual agency supplement to the rate

HELPFUL LINKS

Attachments

Dual Agency Children/Youth – Medical Needs and Dual Agency Children/Youth – Mental Health Needs

Entering Regional Center Services into CWS/CMS
Effective Date of Eligibility for the Supplement to the Dual Agency Rate

Forms

CWS/CMS

AD 4320, Adoption Assistance Agreement

DCFS 280, Technical Assistant Action Request

Health and Education Passport

NOA 290, Rate Change

NOA 290, Denial

LA Kids

AAP 2, Payment Instructions Adoptions Assistance Program

DCFS 149A, Medical Care Assessment

DCFS 21A, Letter Acknowledging the Request for a Supplemental Rate

DCFS 21A (Spanish), Letter Acknowledging the Request for a Supplemental Rate

DCFS 280, Technical Assistant Action Request

SOC 835, Supplement to the Dual Agency Rate – Multiple Questionnaire Worksheet

SOC 836, Supplement to the Rate Eligibility Form

SOC 837, Supplement to the Rate Questionnaire

Referenced Policy Guides

0070-516.10, Assessing a Child’s Development & Referring to a Regional Center

0600-530.00, Public Health Nurses (PHNs): Roles and Responsibilities
0600-505.10, Placing Children with Special Health Care Needs

0070-560.05, Joint Response Referral: Consulting with PHN

0100-520.35, Kinship Guardianship Assistance Payment (Kin-GAP) Program

0100-560.40, Supervised Independent Living Placement (SILP)

0200-511.05, Adoption Assistance Program (AAP) Benefits and Medi-Cal Benefits

1000-504.10, Case Transfer Criteria and Procedures
0900-511.10, Rates for Placement and Related Services

0900-522.10, Specialized Care Increment (SCI) – D-Rate

0900-522.11, Specialized Care Increment (SCI) – F-Rate

Statutes

All County Letter No. 08-54 – Provides instructions regarding the supplement to the Regional Center rate.

All County Letter No. 08-17 – Provides instructions regarding the Dual Agency Rate

All County Letter 16-54 – states that neither an Individual Program Plan (IPP) nor current receipt of regional center services is required for dual agency rate eligibility

All County Letter 17-67 - states in pertinent part that the failure of the regional center to sign the SOC 837 or to provide information for the assessment of the child’s needs shall not relieve the county from timely completion of the assessment for the dual agency supplemental rate.

All County Letter 17-112 – states that ARC recipients are eligible for the dual agency rate

Welfare and Institutions Code (WIC) Section 17710 – Defines a child with special health care needs and an individualized health care plan team, including a list of medical conditions covered and the in-home health care to be provided by the caregiver.

WIC Section 4512(a) – States in part that “developmental disability” means a disability that originates before an individual attains age eighteen (18), and continues, or can be expected to continue, indefinitely, and constitutes a disability for the individual. This term includes mental retardation, cerebral palsy, epilepsy, and autism. It also includes disabling conditions found to be closely related to mental retardation or that require treatment similar to that required for individuals with mental retardations.

WIC Section 11364 – Describes the Kinship Guardianship Assistance Payment Program including specialized care increment, dual agency rate and clothing allowance.

WIC Section 11464(a) – States in part that children who are consumers of Regional Center Services who also receive AFDC-FC or AAP benefits have special needs that may require care and supervision beyond what is typically provided in foster care. To address these needs, it is necessary to provide a rate for care and supervision that is higher than the average rate they would otherwise receive.

WIC Section 11464(c-f) – Sets forth the criteria, requirements, and appropriate dual agency and supplement to the rates.

WIC Section 11464 (c)(2)(A) – Authorizes the supplement to the dual agency rate.

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