Sec. 07.02.11.31. State Standard Rates for Out-of-Home Placement under the Direct Supervision of a Local Department

A. Board Rates and Clothing Allowance.

(1) Board rates and monthly clothing allowances are set forth in Schedules A and B of Regulation .39 of this chapter.

(2) The board rate is effective for the full month in which the child reaches the lower age specified for each group.

(3) The board rate is based on the cost of maintenance expenses for the child.

(4) The monthly clothing allowance covers the purchase and upkeep of clothing.

B. The emergency care rate is for the care of the child who was placed in out-of-home placement on an emergency basis. This rate may not be paid for more than 2 months.

C. The regular care rate, as defined in Regulation .03B of this chapter, is for the care of the child who requires usual and ordinary supervision in a foster family or pre-adoptive home.

D. A relative may be eligible to receive foster care rates for the care of a committed child if the relative's home meets the approval requirements for a foster home, as described in COMAR 07.02.25.

E. The intermediate care rate set forth in Regulation .39, Schedule A of this chapter is for the care of the child who requires intermediate care as defined in Regulation .03B of this chapter.

F. Foster parents who receive intermediate care rates shall:

(1) Provide care for a child who requires intermediate care;

(2) Have the desire to make a major investment of time, and the ability to give affection and attention without positive response from the child;

(3) Be required to supervise or provide prescribed physical care, such as the preparation of special medication;

(4) Have the ability to accept and cope with difficult child behaviors;

(5) Participate in social service, medical, or psychiatric treatment plans for the child;

(6) Participate in training arranged by the local department and the cost of this training may not be borne by the foster parents.

G. The local department shall include in the child's and the foster family's case records a written justification for including the child in the intermediate payment category. The justification shall include a written certification or evaluation by a physician, psychologist, or licensed social worker stating that the child requires a high degree of supervision and care.

H. Treatment Foster Care.

(1) The treatment foster care rate is paid only to foster parents who are providing treatment foster care through one of the State's public treatment foster care programs in accordance with Regulation .33 of this chapter.

(2) Treatment foster care payments shall be made monthly.

(3) The payment shall consist of the board rate according to Schedule A of Regulation .39 of this chapter, and a supplemental treatment difficulty of care stipend.

(4) The Administration shall set the amount of the treatment foster care stipend by service intensity level for local departments that operate a public treatment foster care program.

(5) The payment for respite care services for the public treatment foster care program shall be according to Schedule A of Regulation .39 of this chapter, unless the respite placement is a purchase of care placement, which will be paid at the negotiated per diem rate.

I. Supportive Services.

(1) Supportive services may be purchased in order to maintain the child in the community.

(2) Supportive services may be purchased from:

(a) A foster family who by virtue of special training or experience is able to provide supportive services; or

(b) Another provider appropriate to the special needs of the child.

(3) Supportive services purchased according to §I(2)(a) and (b) shall be approved in writing by the director of the local department or the director's designee who is other than the caseworker. This written approval shall confirm that:

(a) The child requires the identified supportive service because of a health problem, or an emotional or behavioral problem; and

(b) The service provider is capable, by virtue of special training or experience, of providing the needed service.

(4) The services may not be purchased or authorized until the Executive Director of the Social Services Administration or the Director's designee has allocated the amount of funds that are available to purchase them.

J. Retainer Fee. Foster parents who are approved as emergency foster homes may be paid a separate retainer fee, contingent on availability of funds, in accordance with State guidelines.

K. When a child in group care makes a planned visit to a foster family for a weekend or other period, the local department shall pay the foster family the per diem rate in Schedule A of Regulation .39 of this chapter for each overnight stay of the child's visit. The local department shall pay transportation costs from and to the group care placement.

L. A special clothing grant may be made as needed according to the child's age as specified in Schedule B of Regulation .39 of this chapter. The monthly clothing allowance may not be paid for the same month that the initial clothing allowance is paid. The initial clothing allowance is not available to the child in group care when the clothing allowance is in the negotiated rate paid to the provider.

M. Medical Care. Medical care for foster children is provided under the Medical Care Programs of the State. Provision is not made for payment for medical care from out-of-home placement funds, except that:

(1) Payment may be made for essential medical needs for a child when the service or equipment is not available through the Medical Assistance and Health Choice Programs, or other established health care programs;

(2) If a child is covered under the child's parents' medical insurance, the scope of the coverage shall be ascertained and used first;

(3) For costs not available through the Medical Assistance and Health Care Programs of the State, reimbursement shall be made to foster parents for out-of-pocket medical expenses incurred for foster children as set forth in §N(2) of this regulation.

N. Procedures for Reimbursement.

(1) Foster parents shall retain all nonreimbursed bills. Bills for nonprescription drugs shall be accompanied by a physician's statement concerning the child's need for the drugs.

(2) Local departments are authorized to pay from their administrative funds the following items:

(a) Eyeglasses beyond the one pair per year covered by the Maryland Medical Assistance Program and for cost of eyeglass repair as needed;

(b) Nonprescription drugs if accompanied by a physician's statement as to the child's need for them;

(c) Any payment or copayment required for each prescription filled on behalf of a foster child enrolled in the Maryland Medical Assistance Program;

(d) Any other medical service that the child requires, if accompanied by a physician's statement as to the child's need for the service, or a court order.

O. Transportation for or on behalf of the foster child, whether reimbursed to a foster parent or paid to a vendor, may be allowed under the following special circumstances:

(1) To carry out a special plan for the child;

(2) To provide regular transportation required over a period of time;

(3) To provide essential transportation when the distance or the means of transportation or the time of day entails unusual cost.

P. The amount reimbursed may include:

(1) Public transportation costs for the child or for the adult to accompany him when necessary, or both, provided, however, that the costs may not be met when the adult is an employee of another agency;

(2) Incidental expenses such as meals;

(3) Cab fare when necessary because of emergency need or lack of less expensive means of transportation;

(4) Mileage reimbursement at the same rate paid to State employees, when a foster parent furnishes transportation in a personally owned car.

Q. Funeral Expenses.

(1) The local department may pay funeral expenses not exceeding $650 for a child who dies while in out-of-home placement.

(2) Any resources of the foster child including insurance benefits or the child's estate, or of an individual who was legally responsible for the child's support, are to be used to pay for burial expenses.

(3) The cost of funeral expenses shall be charged to State funds.

(4) Special direct burial expenses, such as the cost of a burial lot, vault when required, grave digging, and burial clothing, which are met by family or friends are exempt from this requirement.