IV-A. B. Decision Levels

DECISION LEVELS

PAYMENT ISSUES

DECISION

WHO MAKES RECOMMENDATIONS

WHO WILL AUTHORIZE

1.	Standard Board

Level A– Pending Levels of Care Assessment

None

Caseworker

2.	Continued payment up to 7 days absence from foster home or from another placement without contract and child is to return, whether or not dual payment

None

Caseworker

3.	Continued payment to a foster home after 7 days temporary absence – with or without dual payment

Caseworker and Supervisor

Up to 30 days: Program Administrator, Assistant Program Administrator, Supervisor (after development of written guidelines

4.	Continued payment over 14 days in residential and group care

Caseworker and Supervisor

Residential Services Manager

5.	Payment other than standard rate:

Less:

e.g., rent, groceries, security deposit (Policy, standards, guidelines need to be developed)

Caseworker

Caseworker and Supervisor

Caseworker

Casework Supervisor

6.	Attendance at private school and payment of tuition and/or room and board in excess of board rate (Guidelines including dollar amounts needed to speed requests for decisions)

Caseworker and Supervisor

Deputy Director or designee

7.	Non established rates for residential facility

Request to establish rate by caseworker and supervisor

Residential Services Manager

8.	Paying child directly

Caseworker

Casework Supervisor

9.	Paying young adult directly

Caseworker

Casework Supervisor

10.	Payments to parents (board and clothing):

Up to 3 months

Over 3 months

Caseworker

Caseworker & Supervisor

Casework Supervisor

PA/APA

11.	Canteen – Regional Administration should make automatic payment to kids at MYC

None

Caseworker

12.	Adoption Assistance

Caseworker and Supervisor

Commissioner or designee

SERVICE AUTHORIZATIONS

13.	Transportation for child as provided in policy

None

Caseworker

14.	Transportation for parents as provided in policy

Under $300/year

For parents over $500/year

(Requires policy revision)

None

Caseworker

Casework Supervisor

15.	Contingency fund expenditures as provided in policy

Under $200

Over $200

(Requires policy change)

(Regional budgets tracking and accountability systems need to be put in place)

Caseworker

Caseworker Supervisor

16.	Payment for Medicaid covered services to a non-Medicaid provider, e.g., counseling

(Guidelines including limits on expenditures and time periods need to be developed)

Caseworker

Casework Supervisor

17.	Payment for non-Medicaid covered medical services, e.g.:

•	Tattoo removal

•	Porcelain front teeth

•	Orthodontia

•	Drugs prescribed by physician

Caseworker

None

Caseworker

None

Casework Supervisor,

High Risk PA/APA

18.	Education beyond high school

•	Allocation per child

•	Individual bills

Caseworker and supervisor

None

Program Specialist

Fiscal Staff in Central Office

19.	Phone calls

•	Necessary per case plan

None

Caseworker

20.

Car seats

Caseworker

Casework Supervisor

21.	Foster parent’s child care during:

•	Administrative case reviews

•	Court appearances

•	Necessary travel for child

None

Caseworker

22.	Clothing – supplemental

(when guidelines, regional budgets and accountability systems established, this could go to caseworker)

Caseworker

Casework Supervisor

23.

Tutoring

Caseworker

Casework Supervisor

24.	Summer school (high school)

Caseworker

Casework Supervisor

25.	Driver’s Education

Caseworker

Casework Supervisor

26.	Interpreters

•	Hearing impaired

•	Non-English speaking

Caseworker

Casework Supervisor

27.	Class/school trips

Caseworker

Casework Supervisor up to $50, PA/APA over $50

28.	Legal costs for juvenile

Caseworker

Casework Supervisor

29.	Child going with foster parent on family trip

Caseworker

Caseworker under $100

Casework Supervisor over $100

DECISION LEVELS

NON-PAYMENT ISSUES

DECISION (NON-MONEY)

WHO MAKES RECOMMENDATION

WHO SHOULD AUTHORIZE

Medical Treatment

1.	Routine treatment

•	Check-ups/exams

•	Immunizations

None

Caseworker/may delegate implementation

2.	Selection of provider

None

Parent in V cases

In other cases, caseworker may delegate to foster parent, child or other caretaker

3.	Second opinions/specialized evaluations

None

Caseworker/may delegate implementation

4.	Invasive diagnostic procedures

Caseworker

Casework Supervisor (depends on degree of risk. The higher the risk, the higher the decision)

5.	Hospital admissions

Caseworker

6.	Emergency medical treatment

None

Caseworker, ACES after hours, Licensed caretakers

Surgery

None

Caseworker (depends on degree of risk. The higher the risk, when there are alternatives, the higher the decision)

8.	Anesthesia

None

9.	Alternative treatment procedures

None

10.	No resuscitation (no code)

Caseworker and Casework Supervisor make request based on physician’s recommendation

Commissioner

11.	Experimental treatment

12.	High-risk treatment

13.

Abortion

None

Child

14.	Circumcisions

Caseworker

Parent in V cases

Casework Supervisor (in consultation with parent if appropriate)

DECISION (NON-MONEY)

WHO MAKES RECOMMENDATION

WHO SHOULD AUTHORIZE

Education

1.	Non-public school education, if no Department fund involved

Caseworker

Supervisor

2.	Participation in certain courses e.g. sex education, advanced placement

Foster parent or other caretaker

Caseworker

3.	Field/class trips

Foster parent or other caretaker

Caseworker

4.	Program (impact on rehabilitation and reunification requirements need to be considered)

(Policy guidelines needed)

Caseworker

Supervisor

5.	Extra-curricular

•

Sports

•

Music

Foster parent

Caseworker

Life Plan Decisions

1.	Long-term foster care agreement

Caseworker/Supervisor

PA/APA

2.	Joining military (guidelines needed)

Caseworker

Supervisor

Marriage

Caseworker/Supervisor

Commissioner

4.	Driver’s licenses

Caseworker/Supervisor

PA/APA

5.	Hunting licenses

Foster parent/other caretaker

Caseworker

6.	Consents to petition to adopt

Caseworker/Supervisor Recommendation reviewed by Program Specialist/AAG

Commissioner

DECISION (NON-MONEY)

WHO MAKES RECOMMENDATION

WHO SHOULD AUTHORIZE

Placement

1.	Type of placement

Caseworker

Supervisor

2.	Specific home

Caseworker

Supervisor

3.	Moving child or not

Caseworker

Supervisor

4.	Independent Living

Caseworker

Supervisor

5.	Placement n homes of different religion

Caseworker

Supervisor

6.	Placement in own home

Caseworker

Supervisor

7.	Moves out of state

Caseworker/Supervisor

Administrator or designee of Interstate Compact on Placement of Children

8.	Waiver of probation for child in adoptive home

Caseworker

Adoptive Supervisor

9.	Waiver of requirements of petition to court for judicial review recommending dismissal within 6 months of placement of a child in his own home

Casework Supervisor

10.	Out-of –State placements

Casework Supervisor

11.	Placement in an in-state residential treatment center (policy for 10 & 11 need expansion and clarification)

Casework Supervisor

Bureau Director

12.	Placement in therapeutic foster homes Level C, Pending Levels of Care Assessment

Caseworker

Casework Supervisor

13.	Change in levels of care

Caseworker requests Levels of Care Assessment

Program Manager, Levels of Care

DECISION (NON-MONEY)

WHO MAKES RECOMMENDATION

WHO SHOULD AUTHORIZE

Miscellaneous

1.	Name changes

Caseworker/Supervisor

Deputy Bureau Director

2.	Parental visitation plan

Caseworker (with input from court, foster parent, child, etc.)

Caseworker/Supervisor

3.	Ownership of vehicles

None

4.	Out-of-state travel for child

•	When no long-term foster care agreement is in effect

•	When a long term foster care agreement is in effect

Foster parent

Caseworker

Foster parent (up to 30 days)

Case plan

Caseworker

Objective

Caseworker

Extended

Caseworker and youth

8.	How assertively to deal with runaways

Caseworker

9.	Legal representation for child

Caseworker

10.	Method for providing child clothing, purchase authorization or clothing allowance

Caseworker

11.	Media coverage – pictures – story

Caseworker/Supervisor/PA

Bureau Director

12.

Funerals

(policy update needed)

Caseworker

Caseworker Supervisor with parent and foster parent input as appropriate

13.	Burial vs. cremation