Funding for emergency caregiver placement

Emergency Caregiver Funding for families with whom a child or non-minor dependant has been placed on an emergency basis has been continued.  This funding is also available for placements for a “compelling reason” pending approval as a Resource Family.

In addition, effective July 1, 2019, Emergency Caregiver funding must be paid to an emergency caregiver with whom an Indian child is placed pending approval as a Tribally Approved Home.  A TAH is a home that has been licensed or approved for placement of an Indian child by the Indian child’s tribe, or a tribe or tribal organization designated by the Indian child’s tribe, for foster care or adoptive placement using standards established by the Indian child’s tribe

To initiate funding on or after July 1, 2019, there must be a placement prior to approval in California on an emergency basis, or, for pending Resource Family Approval only, placement for a compelling reason.  Then the emergency caregiver must submit a Resource Family Approval application or initiate the Tribally Approved Home process with the tribe.  Finally, the caregiver must submit an application for emergency assistance.  The beginning date of aid is the date of placement.

Emergency Caregiver funding is available for up to 120 days, or until the emergency caregiver is approved as a Resource Family or Tribally Approved Home, or the child is no longer placed in the home, whichever is first.  (ACL 19-84, September 4, 2019.)

Reasonable accommodations in CDSS and DHCS programs

The California Department of Social Services (CDSS) and the Department of Health Care Services (DHCS) have issued a joint letter reminding counties of their obligation to ensure equal access to persons with disabilities to state and federal funded programs.  This includes providing reasonable accommodations to qualified persons with disabilities and effective communication through auxiliary aids and services.  These obligations apply to all county administered programs, services and activities funded by, or with federal pass-through funds from CDSS and/or DHCS.  These obligations also apply to county contractors and vendors that provide program benefits or services.

Counties must adopt written policies detailing how they will comply with these requirements.  Counties must have a procedure for complaints regarding disability discrimination, including failure to provide a reasonable accommodation.  Counties must inform clients of the county complaint procedure and they may file discrimination complaints with the appropriate state or federal agency.

Title II of the Americans with Disabilities Act (ADA) prohibits counties from excluding from participation, denying benefits or services to, or discriminating against any qualified person with a disability.  A qualified person with a disability is a person with a disability who, with or without accommodation, meets the essential eligibility requirements for the program provided by the public entity.  Disability is a physical or mental impairment that substantially limits one or more major life functions, a record of such an impairment or being regarded as having such an impairment.  California law defines disability more broadly by removing the word “substantially” from the definition of disability, and counties are required to follow California law.  The ADA also guarantees equal access to individuals who have a relationship or association with a disabled person.

The ADA does not require public entities to allow a person with a disability to participate if that person poses a direct threat to health or safety of others.  However, the county must determine whether a person is a direct threat only evaluating whether reasonable accommodations can mitigate or eliminate the risk.  The determination of whether a person poses a direct threat must be made based on objective factual evidence and an individualized assessment.

The ADA requires counties to make reasonable accommodations by modifying their policies, practices, or procedures when necessary to provide equal access to persons with disabilities.   This includes waiving a program rule or policy to help a person with a disability, or a change in the way a county carries out a policy or practice affecting a person with a disability.

Counties must notify all clients of the right to request reasonable accommodations and the protection against discrimination on the basis of disability.

When the county has actual knowledge of a disability or when the need for an accommodation is obvious, county staff must offer to assist with appropriate disability specific accommodations.  Counties are encouraged to train staff to identify disabilities and offer to assist identifying accommodations.

When an individual asks for a change in county policies, practices, or procedures because a disability, this request should be treated as a reasonable accommodation request.  While counties can make a reasonable accommodation request form available, counties cannot require individual to use a specific form for a reasonable accommodation request.   Reasonable accommodation requests can be made in person, by telephone or in writing by the individual or someone acting on the individual’s behalf.  It is not necessary that a person be an authorized representative to request a reasonable accommodation.  There is no limit to the number of accommodation requests a person can make, and each request must be individually evaluated.  Counties cannot impose an arbitrary limit on the duration of a reasonable accommodation.

County staff must document all reasonable accommodation requests and subsequent county actions in the individual’s case file.

If an accommodation is not immediately agreed upon, or if there is a disagreement about the appropriateness of a requested accommodation, county staff must engage in an interactive process with the individual requesting the accommodation or a person acting on their behalf.

A county can deny a reasonable accommodation request only when the accommodation would  fundamentally alter the nature of the program, service or activity, or would impose an undue financial or administrative burden taking into account all resources available to the program, service or activity.  The determination that an accommodation request would be a fundamental alternation or an undue burden must be made by the county welfare department director or designee and must be accompanied by a written statement of the reason for the decision.  If such a decision is made, the county must take alternative action to ensure that the person with a disability can access relevant benefits or services while avoiding a fundamental alteration or undue burden.

Counties cannot impose eligibility criteria that exclude or tend to screen out individuals with disabilities unless such criteria are shown to be necessary for the operation of the program.  Counties must provide programs, activities and services in the most integrated manner possible.  Counties cannot change individuals with disabilities for the cost of reasonable accommodations.

Counties must ensure effective communication with individuals who have vision, hearing or speech disabilities.   Communication with these individuals must be equally effective as communication with people who do not have these disabilities.  This requirement extends to companions of applicants or recipients.  For persons who are blind, have vision loss, or are deaf-blind, this requirement includes providing individuals with disabilities with auxiliary aids and services when necessary to communicate effectively. This can include providing written communication in large print, braille, accessible electronic format for use with a screen reader or via audio recording or a qualified reader.  For persons who are deaf, have hearing loss, or are deaf-blind, this requirement also includes providing a note taker, qualified sign language, oral, cued-speech or tactile interpreter, real-time captioning, telecommunication devices, or written materials.  For persons who have speech disabilities, this requirement includes providing a qualified transliterator.  Counties cannot require persons with communication disabilities to provide their own interpreter.  Counties may allow another adult accompanying an individual with a disability to interpret only in emergency situations or when requested by the persons with a disability.  Counties cannot rely on minors to interpret except in emergency situations when no other interpreter is available.

If counties choose to use Video Remote Interpreting, the service must meet specific technical performance standards.

Counties must consider how the individual normally communicates and must give primary consideration to a request for a particular auxiliary aid or service.

Counties must modify their policies, practices and procedures to allow individual with disabilities to use service animals on their premises.  Counties may not require certification or other proof that an animal has been trained or licensed as a service animal.  When it is not obvious what service an animal performs, county staff may only ask if the animal is required because of a disability and what work or tasks the animal is trained to perform.  (ACL 19-45, May 16, 2019.)

Extended Foster Care for married youth and youth in non-active duty military service

The California Department of Social Services (CDSS) has issued instructions for two changes in eligibility for Extended Foster Care.  First, nonminor dependants can now enter, reenter or remain in Extended Foster Care if they are married or get married.  Married youth in Extended Foster Care will be subject to the same supervision requirements as other nonminor dependants and they are eligible for the same placement options.

For the Transitional Housing Program for Nonminor Dependents, housing providers that allow non-participant roommates cannot exclude married youth on the basis of marital status.

Second, a nonminor dependants who is in the reserve command of any branch of the armed forces or is a member of the National Guard is not eligible for Extended Foster Care.  Nonminor Dependants who are on active duty are not eligible for Extended Foster Care.  Nonminor Dependents are not eligible for Extended Foster Care if they in extended training if the military does not allow a social worker/probation officer to conduct monthly visits and supervision.  The youth would be eligible to re-enter foster care when caseworker visitation can resume.

When a nonminor dependant is enlisted in a part-time military program, their Transitional Independent Living Plan can include military participation as a goal.  (ACL 18-101, September 12, 2018.)

Extended Foster Care for trafficking victims

The California Department of Social Services (CDSS) has issued instructions implementing AB 604 which allows continued eligibility for extended foster care if the court vacates the youth’s underlying adjudication because they were a victim of human trafficking.

SB 855 (2014) clarified that commercially sexually exploited children whose parents were unable to protect them could be adjudged dependents of the juvenile court.  SB 1322 (2016) prohibits arrest or prosecution of a child under age 18 for soliciting or engaging in an act of prostitution for money or other consideration, or loitering with the intent to commit an act of prostitution.  SB 823 (2016) allows a person to petition the court for relief from an arrest, conviction or adjudication for any nonviolent offense that occurred as a direct result of being a victim of human trafficking.

AB 604 allows a youth who was a victim of human trafficking, had their conviction vacated,  and is otherwise eligible to remain under juvenile court jurisdiction to continue to be eligible foster care, extended foster care and related services.  Youth who have had their underlying adjudications vacated are not required to have met their rehabilitative goals to remain eligible for foster care or extended foster care.  Non-minor dependants who have had their underlying adjudications vacated and who choose to exit foster care may re-enter before age 21.

Minors who are under 17 years and 5 months or who do not meet the criteria for transitional juvenile court jurisdiction must be evaluated to determine if it is safe for them to return home without court supervision.  If it is not, a dependency petition should be filed on their behalf.  (ACL 18-113, September 17, 2018.)

Implementation of the Intensive Services Foster Care Program

The California Department of Social Services (CDSS) has issued instructions regarding the implementation of the Intensive Treatment Foster Care (ISFC) program.

The ISFC program is intended to serve children who require intensive treatment and behavioral supports, as well as children with specialized health care needs (including those served under ITFC). The program is designed to ensure that foster youth receive the services they need in a home-based family care setting and that they do not remain or enter a short-term residential program or Group Home.

To achieve this, the ISFC program provides core services and supports, including arranging access to mental health treatment, providing trauma-informed care, and providing transitional support during placement in a permanent home. ISFC program participants who meet the eligibility criteria of other publicly funded programs including mental health, education, and health services will have these services arranged for them by the Foster Family Agency (FFA) or the county.

Children eligible to receive help from the ISFC program are children or nonminor dependents in foster care who require higher level of supervision, as is determined by the Level of Care (LOC) Rate Determination Protocol.

An ISFC resource family includes a licensed foster family home or a certified family home of a licensed Foster Family Agency. An ISFC resource parent is a committed member of the youth’s team who has the ability to meet the individual’s intensive care needs. Non-related legal guardians and Kinship Guardianship Assistance Payment (Kin-GAP) Facilities are not eligible for the ISFC program.

To deliver these services, the ISFC program may either use a licensed FFA or a county licensed to run a FFA, or they may be operated directly by the county as a government program.  In either case, the ISFC program includes Therapeutic Foster Care (TFC) for youth under the age of 21 who are Medi-Cal eligible and meet medical necessity criteria. Each of the involved parties have several responsibilities. FFAs and Counties operating an ISFC must identify and train IFSC foster parents, placement matching, providing core services, and coordination of the appropriate professional and para-professional staff.

TFC parents and caregivers are specially trained and work under the supervision of the TFC agency and in conjunction with the ISFC staff (unless the youth is on probation or child welfare).

ISFC resource parents must complete participate in the development of the child’s plan ensure the well-being of the child, and be in the Resource Family Approval (RFA) program. They must also complete 40 hours of training prior to placement covering topics such as trauma, behavior de-escalation techniques, and cardiopulmonary resuscitation, and is described in depth in ACIN I-28-18.

For child placement, if a child requires immediate placement based on criteria behavioral identifiers, the Social Worker/Probation Officers may make immediate placement at the ISFC level to ensure safety pending an LOC rate determination. If a child has experienced any of the criteria behavioral identifiers within the last twelve (12) months, the placing agency may pay the ISFC rate for up to sixty (60) days, which may be extended pending local county manager approval. This extension should only be granted in the event that an HBFC setting cannot be found.

An ISFC level placement may be made before pre-placement training is completed if certain criteria are met depending on circumstance and those involved.

The ISFC does not allow more than two children in foster care and/or one ISFC eligible child placed in each resource family home, except in sibling group placements where the total number of children in a single resource family home is five (5).

FFA’s that have transitioned or are interested in transitioning to an ISFC program must submit an amended FFA Program Statement Template that is updated to reflect the new ISFC requirements to the Foster Care Rates Bureau. New ISFC programs that were not ITFC providers will receive a rate approval and issued rate letter, as well as a program letter from FCRB with a date effective. Counties not operating as an FFA that intend to opt-in to ISFC public delivery of benefits must submit an ISFC Program Description to the department pending approval.  (ACL 18-25, March 13, 2018.)


Medi-Cal for Unaccompanied Refugee Minors (URMs)

DHCS issued a letter with information and guidance to counties regarding cases for Unaccompanied Refugee Minors (URMs)  URMs who are otherwise eligible get no share of cost full scope Medi-Cal benefits, and are to be treated like foster care children for Medi-Cal eligibility purposes.

Three state-designated URM program service providers should submit applications to the county of residence on behalf of URMs placed with the agency.  Social workers will provide verification letters as proof of eligibility for refugees.  County welfare departments must not delay or deny services for failure to provide the SSN or verification of immigration status, though counties should work to verify status in order to maximize federal financial participation.

URM individuals are eligible for full scope Medi-Cal regardless of immigration status.  Those who meet former foster youth (FFY) eligibility requirements are eligible to continue receiving full scope Medi-Cal under the FFY program.  Counties must follow the appropriate rules on annual redetermination and inter-county transfers.

DHCS ACWDL 18-14 (July 3, 2018).