8160 Authorizing, Extending, or Terminating Services
CPS November 2006
Before services can be authorized a worker must ensure that:
• a written contract is in place; and
• a contract is entered in the IMPACT system, unless otherwise specified in the description of the service.
If a contract is not in place or has not been entered into IMPACT, contact the regional contract manager.
8161 Direct Services — Authorizing, Extending, or Terminating
8161.1 Active Cases — Authorizing, Extending, or Terminating Direct Services
CPS November 2006
In addition to the instructions in this section, workers must follow all regional procedures.
8161.11 Considering Priority Funding
CPS November 2006
Workers must consider the following funding sources before all others when referring a client for direct services:
• Medicaid or CHIP (Children's Health Insurance Program): If the client is eligible, Medicaid or CHIP must be used before any other funding is used. Workers must notify contractors of a client's Medicaid eligibility at the time of referral or as soon as possible after the initiation of services. The contractor is required to have a written procedure for routinely obtaining information from clients regarding Medicaid or CHIP status, the HMO in which the client is enrolled at the time of the initial visit, and at least monthly thereafter. Workers must document the information for monitoring purposes. Medicaid does not pay for foster and adoptive parent services. Title IV-B funds must be used for these services.
• Private Insurance: Workers must ask clients whether they have and are willing to use private insurance before other funding is used. (Since private insurance requires meeting an annual deductible and specified co-payments that DFPS cannot pay, neither DFPS nor the provider can require the client to use private insurance.)
8161.12 Authorizing Service
CPS November 2006
All direct services to clients in active cases, (including children in foster and adoptive homes), must be authorized in writing by the appropriate worker and supervisor before the service is delivered.
Unauthorized or incorrectly authorized services will not be paid:
To authorize services, workers send the contractor a complete referral that contains:
• a signed and dated Form 2054, Service Authorization.
Form 2054 serves as an eligibility document and cannot be backdated. The print date must be clearly visible on the form, and the service must begin on or after the print date. Because a contractor is subject to loss of reimbursement, the contractor must have the service authorization form in hand before providing services.
A properly completed Form 2054 Service Authorization contains the:
• name of the contractor and contract number;
• names of client or family members who are to receive services;
• types services requested;
• number of units for each service requested;
• time limit for the service. Enter the effective (start) date and the end date in the IMPACT system. The end and termination dates are always the same on the original Form 2054, Service Authorization. Service may be provided for fewer than six months, but may not exceed six months;
• CPS worker's signature and signature date; and
• CPS supervisor's signature and signature date.
• any regional form specific to the service; and
• sufficient documentation for the contractor to understand the client's circumstances and involvement with CPS, that is, a plan of service, investigation report, risk assessment tool, report to the court, and so on.
8161.13 Establishing End Dates
CPS November 2006
An authorized direct service ends when:
• the end date on Form 2054 is reached; or
• the authorized units are exhausted.
8161.14 Adding, Extending, or Reauthorizing Service
CPS November 2006
Workers may authorize additional units of service, or extend or reauthorize the original units of service, according to regional procedures and funding limitations. This may be done as often as necessary while the client's case remains open.
Before the End Date: |
After the End Date: |
|---|---|
• Update Form 2054 by increasing the number of authorized units. Then: • Forward the form to the contractor. |
• Start a new Form 2054 to authorize new or additional units of service. Then: • Forward the form to the contractor. |
8161.15 Terminating Service
CPS November 2006
The worker may terminate service before the end date on Form 2054, Service Authorization, and before all authorized units will have been delivered. To do so:
• change the termination date on Form 2054 to the actual date the service will end;
• verbally inform the contractor of the change; and
• send the updated Form 2054 to the contractor before the new termination date.
Consequence of Failure to Properly Terminate Service
If the worker does not notify the contractor in advance and does not send the updated Form 2054 with the new termination date, the contractor may continue to provide service and must be paid.
8161.2 Post-Adoptive Services (Consummated Adoptions)
CPS November 2006
The contractor determines and documents eligibility for post adoptive services and authorizes the services.