1540 Foster Care Assistance Eligibility Requirements for Young Adults Formerly in DFPS Conservatorship
1541 Extended Foster Care Assistance
CPS March 2021
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 Rules 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 10400 Extended Foster Care for Youth Who Are Age 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 10400 Extended Foster Care for Youth Who Are Age 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 first 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 Extended Foster Care Resource Guide.
1542 Return for Extended Foster Care
CPS March 2021
Young adults ages 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 March 2021
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 coordinates with any necessary entity or person for the income to be used for the cost of that care.
A youth with disabilities retains his or her Social Security Administration disability determinations when he or she turns 18, and his or her 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 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.
1544 Medicaid for Young Adults Who Age Out of Foster Care
CPS March 2021
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 18-25 may be eligible for health-care coverage through the FFCC program.
A young adult age 18-20 may be eligible for health-care coverage through the MTFCY program.
DFPS initiates the coverage by sending an automated referral through IMPACT to HHSC as the young adult ages out of foster care.
Upon receiving the referral, HHSC determines which program the young adult qualifies for. See 10140 Overview of Healthcare Coverage for Youth and Young Adults Who Age Out of Foster Care.
1550 DFPS Accounting Staff Information and Responsibilities
1551 Foster Care Maintenance Payments
1551.1 Rates for DFPS Foster Care Maintenance Payments
CPS May 2021
The rates for DFPS foster care maintenance payments are determined by the child’s service level. The rates may be adjusted 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. DFPS determines a child’s service level based on the child’s characteristics and the descriptions of service levels. The Health and Human Services Commission approves the rates for foster care payments.
1551.2 Participation in the Paid Foster Care Program
CPS May 2021
Other than in a catchment area where DFPS contracts with a Single Source Continuum Contractor, all providers of 24-hour residential child care must complete a contract or agreement with DFPS in order to receive foster care maintenance payments. This includes the following providers:
- Foster family homes verified by DFPS.
- General residential operations.
- Residential treatment centers.
- Independent foster family homes.
- Independent foster group homes.
- Supervised Independent Living (SIL) providers.
- Child-placing agencies.
- Any other entity that meets the definition of “child-care institution” in 42 U.S.C. §672.
1551.3 Effective Dates of Foster Care Maintenance Payments
CPS May 2021
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 caseworker must document in the case record the date the child enters and leaves each facility.
1551.4 Foster Care Maintenance Payments to Licensed Foster Family Homes
CPS February 2024
A licensed foster family home refers to a licensed (verified) relative/kinship home or a licensed non-relative/kinship home. The licensed foster family home is paid the same foster care maintenance payment amount for the child regardless of whether the home is a licensed (verified) relative/kinship home or a licensed non-relative/kinship home. The equivalent foster care maintenance payment requirement will be reviewed at each contract renewal or execution.
1552 Payment for Foster Care
CPS May 2021
If a child is in a placement paid for by DFPS, the child’s cost of care is paid for by the following:
- Federal and state funds.
- Payments designated or designed to be used for the child’s care, such as child support.
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.
Other sources of payments or funds are normally not used for cost of care. If a caseworker or other party requests 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 a provider is not reimbursed for the cost of care if the child is no longer in that placement. Normally, the cost of care exceeds 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.
DFPS manages a child’s SSI and RSDI lump sums as set out in 1580 Managing a Supplemental Security Income (SSI) Lump Sum or Retirement, Survivors, and Disability Insurance (RSDI) Lump Sum for a Child Receiving SSI.
1553 Recoupment of Foster Care Maintenance Overpayment
CPS May 2021
A recoupment is a process to retrieve funds when DFPS overpays a foster care provider. The IMPACT system identifies when DFPS overpays 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 May 2021
DFPS is required to recoup any overpayment, even if the error is made by DFPS.
Using IMPACT to Maintain Accurate Records
To ensure IMPACT contains accurate historical data, it is important to process recoupments 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 IMPACT.
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 Form 8103b Returning a Refund Check to the Provider.
Notifying the Provider if the Recoupment Amount Exceeds 50 Percent of the Next Payment
If the recoupment amount exceeds 50 percent of the provider’s next payment, the regional foster care billing coordinator must notify the provider before approving the recoupment invoice in IMPACT. See 1553.3 Notifying Providers of Recoupment that Exceeds 50 Percent of Next Payment.
1553.2 Manual Recoupment
CPS May 2021
Regional foster care billing staff follow the procedures described in the sections below when a manual recoupment is necessary. 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 passed since a PPA invoice was approved in IMPACT to recoup the overpayment, but there have not been adequate payments to the provider to offset the overpayment.
1553.21 Review of the Invoice Recoupment Report
CPS May 2021
The Invoice Recoupment Report helps foster care billing staff identify PPA invoices that are approved and in pending status for over three months. The report is distributed by the CPS Federal and State Support Division (FSS) to all regional foster care billing staff. The monthly report lists all invoices with a negative balance dating more than three months from the date the invoice was approved.
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 May 2021
To initiate manual recoupment, the regional foster care billing coordinator takes the following steps.
- Ensure the adjusting invoice is still outstanding in IMPACT before beginning the recoupment process.
- Check the payment history to verify that the adjusting invoice correctly reflects the amount to be recouped.
- Complete Form 8103a Request for Payment Letter. 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.
- Complete a Form 8102fc Request for Payment to DFPS. The provider uses this form to track the reimbursement, which the provider can make as one payment or several. If the provider is making several payments, the provider sends with each payment a new copy of the Form 8102fc with the latest payment documented.
- Email the completed Form 8103a Request for Payment Letter and Form 8102fc Request for Payment to DFPS to the DFPS Accounting Form 8102 mailbox.
- Send the completed Form 8103a Request for Payment Letter and Form 8102fc Request for Payment to DFPS to the provider by certified mail.
- Keep copies of Form 8103a Request for Payment Letter and Form 8102fc Request for Payment to DFPS for the regional foster care billing coordinator’s records.
- Mark the Manual Recoupment Requested box on the invoice in IMPACT.
1553.23 Provider Responds within 30 Days
CPS May 2021
If the provider responds to the Request for Payment letter before the 30-day time limit expires, the regional foster care billing coordinator immediately emails the DFPS 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 the provider’s response.
1553.24 Documenting Receipt of Payment (State Office)
CPS May 2021
When the state office Accounting Division receives the payment, 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 May 2021
If the payment is not received within 30 days of the Request for Payment Letter, the state office Accounting Division sends a certified demand letter.
If payment is 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 May 2021
The Accounting Division in state office takes over the process once the 30-day 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 for referral.
If regional billing staff is contacted by the provider after the 30-day time frame, regional billing staff must contact the Accounting Division in state office to determine the status of the recoupment before agreeing to a repayment plan.
1553.3 Notifying Providers of Recoupment that Exceeds 50 Percent of Next Payment
CPS May 2021
If the amount to be recouped is greater than 50 percent of the next projected payment, the regional foster care billing coordinator performs the following actions:
- Notifies the provider about the recoupment by phone.
- Documents the phone call on Form 8103c Phone Log.
- 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 May 2021
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 plans approved at the regional level are not to exceed 12 months.
- Requests for longer 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. These requests must be submitted to the CPS division administrator for Federal and State Support.
- Repayment plans must never 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 region must receive notice from the CPS division administrator for Federal and State Support that the repayment plan is approved before it can be offered to the provider.
The repayment plan must be documented on Form 8103d-fc Provider Repayment Plan Documentation and Approval and submitted for approval (see table below).
| Dollar Thresholds for Repayment |
Time Frame 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 |
CPS assistant commissioner and director of accounting, in addition to the approval appropriate for the dollar threshold mentioned above |
Payment Methods
The provider may make repayments 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 to DFPS 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 Form 8103d-fc Provider Repayment Plan Documentation and Approval has been approved and signed by the required DFPS authority, accounting staff mail the form to the provider for signature.
When the provider returns the signed form, accounting staff send it to the Foster Care Billing program specialist in state office. The program specialist logs 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 stops making payments according to 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, the appropriate staff members must complete and approve a new Form 8103d-fc Provider Repayment Plan Documentation and Approval.
1553.4 When Not to Initiate Recoupment Procedures
CPS May 2021
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 CPS regional director approves the request to forgo recoupment, 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 division administrator also sends a copy to the director of the Accounting Division. The decision must be approved in writing before the provider can be notified that recoupment has been waived.
| If the recoupment amount is ... |
then written approval must be obtained from the ... |
|---|---|
Less than $10,000 ... |
CPS regional operations and support administrator |
$10,000–$25,000 ... |
CPS regional director |
$25,001–$50,000 ... |
CPS assistant commissioner |
More than $50,000 ... |
DFPS commissioner |