Back to Top ^

Financial Support Systems > Rates and Allowances > D-Rates

Specialized Care Increment (SCI) – D-Rate

0900-522.10 | Revision Date: 12/23/14

Overview

The Specialized Care Increment (SCI)A rate paid in addition to the basic care rate for the care of children/youth with special needs. D-Rate is a higher foster care rate paid, in addition to the basic foster care rate, for the care of a child/youth with severe emotional and/or behavioral problems.  This policy provides instruction for referring potentially eligible children for a D-Rate assessment, creating a Specialized Care Case Plan and ongoing services.

TABLE OF CONTENTS

Policy

Specialized Care Increment (SCI) – D-Rate

D-Rate Determinations

Additional Required Eligibility Assessments

D-Rate Criteria

D-Rate Program

D-Rate Program Staff

Caregiver Requirements

Caregiver Training

Kinship Guardian Assistance Program (Kin-GAP) Legal Guardians

Placement Capacity

Out-of-County Placements

Out-of-State Placements

Procedure

D-Rate Referrals

CSW Responsibilities

D-Rate Evaluator Responsibilities

SCSW Responsibilities

D-Rate SCSW Responsibilities

ARA Responsibilities

Annual D-Rate Re-Certification Alert

D-Rate Evaluator Responsibilities

Approvals

Helpful Links

Forms

Referenced Policy Guides

Statutes

Version Summary

This policy guide was updated from the 07/01/14 version, to include placements that are not eligible to receive the D-Rate on behalf of the child/youth placed in their care. Also, non-substantive changes have been made to streamline the D-Rate process.

POLICY

Specialized Care Increment (SCI) - D-Rate

The D-Rate is the Specialized Care Increment (SCI) rate paid in addition to the basic care rate for the care of a child/youth with severe emotional and/or behavioral problems.  It is a flat rate determined by the child/youth’s age.

D-Rate Determinations

The assessment for the D-Rate must be made by a California licensed mental health professional (Clinical Social Worker, Marriage and Family Therapist, Psychologist or Psychiatrist.)  If the child/youth is placed out-of-state, an assessment by a mental health professional licensed by the host state will be accepted. The diagnosis must indicate one of the following regarding the child/youth:

 

And one of the following:

 

A referral for the initial D-Rate assessment is made to the DCFS D-Rate Unit.  The mental health portion of the assessment is completed by the Department of Mental Health (DMH).  Multidisciplinary Assessment Team (MAT) or clinical assessments performed by California licensed mental health professionals conducted within twelve (12) months of the initial D-Rate assessment referral will be considered by DCFS in lieu of the DMH assessments.

Additional Required Eligibility Assessments

D-Rate Criteria

For a child/youth to receive the D-Rate, the following criteria must be met:

 

Children who qualify for the D-Rate have severe emotional disturbances and the examples below are some common behaviors or indicators.

D-Rate Program

The D-Rate Program provides assistance with the following:

D-Rate Program Staff

The D-Rate Unit staff teams with DMH Medical Case Workers and a Supervising Psychiatric Social Worker.  Each child/youth’s case is reviewed/recertified annually to evaluate progress, re-assess goals and modify treatment options as indicated.

 

There is also a D-Rate Specialized Care Case Planning Team (D-Rate Team) that collaborates to determine the appropriate placement type, requirements and expectations of the caregiver and treatment that corresponds with the D-Rate assessment.

Back to Policy

Caregiver Requirements

D-Rate eligible caregivers (that can receive the D-Rate on behalf of the child/youth) include:

 

The following individuals or groups are not eligible to receive the D-rate on behalf of the child/youth/NMD:

Caregiver Training

Training includes sixteen (16) hours of initial D-Rate certification training and eighteen (18) hours yearly thereafter to be remain certified.  If the specialized training is not available (summer break, etc.), the training is to be completed within three (3) months of the next training session.

 

Caregiver can also meet the training requirement by having the requisite knowledge, training, education, or ability to meet the child/youth/NMD's special needs as determined by the CSW and the D-Rate Evaluator but the D-Rate training is strongly recommended.

 

The CSW and the D-Rate Evaluator must document, in the CWS/CMS Contacts, why a caregiver is relieved from the D-Rate training requirements.

 

Caregivers are also expected to:

Kinship Guardian Assistance Program (Kin-GAP) Legal Guardians

For recipients of both the state and federally-funded Kin-GAP Programs, the D-Rate is available to the relative caregiver or relative guardian once DCFS determines that the assessed child/youth meets the criteria.

 

If the relative guardian resides outside the county with payment responsibility, the county with payment responsibility pays the host county’s specialized care increment (SCI) rate or its own SCI rate if the host county has no Specialized Care Rate Plan or Caregiver Training.

 

If the child/youth meets the criteria for SCI, they may receive the SCI rate upon a re-assessment indicating eligibility even if he or she did not receive the rate prior to entering Kin-GAP.

Back to Policy

Placement Capacity

An out-of-home caregiver cannot have more than two (2) children/youth receiving a specialized care rate, regardless of their license capacity. Additional placements will be considered only:

 

Verification of these requirements must be documented in the CWS/CMS Case Notes.

 

Placement of a third child, with or without special needs, requires ARA approval. When seeking ARA approval for the placement of a third child/youth, CSW's must consider all children/youth in the home, including birth, adopted, relative and guardian and not just the foster care placement.

 

Potential D-Rate eligible children should always be referred for a D-Rate assessment regardless of the D-Rate capacity in their current placement.

Back to Policy

Out-of-County Placements

Out-of-County placements require the cooperation of both county agencies. This applies to children being sent to live with parents or relatives as well as non-relative placements. When children are placed outside of LA County, the host county’s rate and training, along with any educational and/or other requirements apply. See http://www.childsworld.ca.gov/res/pdf/ChildWelfareAgencyRep.pdf for Special Increment Rates (SCI) for counties in California.

 

If the host county does not have an SCI rate, the LA County SCI applies in conjunction with the host county’s basic rates. As needed, the host county’s child protective agency may assist in making a referral to have the child assessed by the host county’s mental health agency or other DCFS approved entity.

Back to Policy

Out-of-State Placements

Out-of-State placements require the cooperation of agencies in both states. All issues related to care, services and funding are based on the Interstate Compact on the Placement of Children (ICPC).

Back to Policy

PROCEDURE

D-Rate Referrals

CSW Responsibilities

  1. Within one (1) business day of notification or observation that a child/youth may have a severe emotional/behavioral problem, discuss the observations with the caregiver and explain the D-Rate Evaluation process.

 

  1. Create the D-Rate Referral packet by including the following required forms:
  1. DCFS 417, Schedule “D” Caregiver Referral
  1. DCFS 1695, D-Rate Indicators and Child Referral
  1. Summary of Findings (SOF) report, if available, and/or a mental health assessment completed within the past 12 months.

 

  1. Forward the D-Rate Referral packet to the SCSW for review and approval.

 

  1. Upon receipt of the approved D-Rate Referral packet from the SCSW, forward the packet to the D-Rate Evaluator.

 

  1. If not approved, consult with the SCSW regarding what corrective action to take for resubmission of the D-Rate Referral packet for approval or next steps for arranging an alternative placement.

 

  1. If the caregiver is noncompliant with requirements to meet the child's needs and it is determined that court involvement is necessary, immediately arrange for the matter to be heard in court.
  1. If the next hearing date is not immediate, request a walk-on.
  1. Inform County Counsel of the planned court involvement and level of risk the child/youth is exposed to.

 

  1. Within one (1) business day of receiving an approved D-Rate Referral packet from the D-Rate Evaluator, complete a DCFS 280, attach the DCFS 1695 and submit them both to the SCSW (and ARA if required) for approval and signature.

 

  1. Within one (1) business day of receiving a denied D-Rate Referral packet from the D-Rate Evaluator, notify the caregiver that the D-Rate was denied and that a Notice of Action (NOA) will be mailed by DCFS Revenue Enhancement with instructions on how to appeal the denial.

 

  1. Within one (1) business day of receiving the signed DCFS 280 from the SCSW, forward the DCFS 280 and all other appropriate documentation to the Technical Assistant/Eligibility Worker (TA/EW) for processing.

 

  1. Place copies of all documentation in the case file.

D-Rate Evaluator Responsibilities

  1. Receive and log the D-Rate Referral packet on the “D-Rate Referral Log”.

 

  1. Review the D-Rate Referral packet to confirm that it contains the following:
  1. A mental health or MAT assessment, completed within the past twelve (12) months that includes:
  1. A DSM diagnosis
  1. Documentation that the caregiver(s) is/are able and willing to meet the child/youth’s needs.
  1. Documentation indicating that the child/youth’s condition(s) warrant the D-Rate.

 

  1. If the D-Rate Referral packet meets the above requirements, complete the D-Rate Evaluator’s portion of the DCFS 1695 and forward the D-Rate Referral packet to the D-Rate SCSW for approval.

 

  1. If a mental health assessment of the child/youth is required, forward the D-Rate Referral packet to the Los Angeles County Department of Mental Health (DMH).
  1. Upon receipt of the DMH mental health assessment from the D-Rate SCSW, complete the D-Rate Evaluator portion of the DCFS 1695 and indicate the approval or denial of the D-Rate.
  1. Provide a copy of the assessment to the CSW and discuss the treatment recommendations made by DMH.
  2. Send the approval letter to the caregiver specifying recommendations made by DMH.

 

  1. Ensure that the child/youth is linked to any services identified to address his or her emotional/behavioral needs.  If the child/youth is not linked, consult with the DMH Specialized Foster Care staff for linkage.

 

  1. If available, obtain a copy of the D-Rate Training Certificate from the caregiver and include in the D-Rate Referral packet.  Annotate the DCFS 1695 regarding the following:
  1. If the caregiver has not attended the D-Rate training, recommend to the caregiver that the training be completed within three months of placement.
  1. If it is determined that training or services are not necessary because the caregiver already possesses the requisite knowledge, training, education or ability to meet the special needs of the child/youth, coordinate with the CSW and document, in the CWS/CMS Contacts, the basis for the conclusion that the caregiver may be relieved from the D-Rate training requirements.
  1. If the caregiver refuses to complete or has not followed through with training and/or services required to meet the child/youth’s needs, inform the caregiver that a recommendation as to the appropriateness of the placement and the necessary course of action to be taken.
  1. Consult with the CSW, SCSW, ARA and County Counsel, as needed, to assess the child/youth's safety in the placement and determine if court involvement is necessary.

 

  1. File a copy of the D-Rate Referral packet and all supporting documents in the “D-Rate Unit files.

 

SCSW Responsibilities

  1. Within one (1) business day of receiving the DCFS 280 and DCFS 1695, review, complete, and sign the DCFS 280 and return it to the CSW.

D-Rate SCSW Responsibilities

  1. Within one (1) business day of receiving the D-Rate packet, review all documentation.
  1. If approved, sign the DCFS 1695 and return the packet to the D-Rate Evaluator.
  1. If not approved, return to the D-Rate Evaluator for corrective action.

ARA Responsibilities

ARA approval is only required when requesting an assessment for any child age 37-59 months or when placing a third child receiving an SCI rate in the home.

 

  1. Within one (1) business day of receiving the packet, review all documentation.
  1. If approved, sign the DCFS 1695 and return the D-Rate packet to the SCSW.
  1. If not approved, return to the SCSW for corrective action.

Back to Procedure

Annual D-Rate Re-Certification Alert

The D-Rate Evaluator will receive an alert three (3) months prior to the D-Rate re-certification due date.  The current D-Rate certification will expire at the end of twelve (12) months unless another assessment is completed and determines the D-Rate shall continue.

D-Rate Evaluator Responsibilities

  1. Consult with the CSW, caregiver, mental health providers and child/youth/NMD, if appropriate, to determine continued D-Rate eligibility.

 

  1. Send the completed recertification to the D-Rate SCSW for review and approval or denial.

 

Back to Procedure

APPROVALS

SCSW Approval

D-Rate SCSW Approval

ARA Approval

Back to Approvals

HELPFUL LINKS

Forms

CWS/CMS

DCFS 280, Technical Assistant Action Request

LA Kids

DCFS 417, Schedule “D” Caregiver Referral

DCFS 1695, D Rate Indicators and Child Referral Form

Referenced Policy Guides

0100-510.10, Placement Capacity

0100-520.35, Kinship Guardianship Assistance Payment (Kin-GAP) Program

0100-525.10, Interstate Compact on the Placement of Children (ICPC)

0100-510.46, Out-Of-County Placements

0900-522.11, Specialized Care Increment (SCI) F-Rate

0900-523.10, Social Security(SS)/Supplemental Security Income (SSI) Benefits for Children in Care

Statutes

All County Letter (ACL) 11-15, New Kinship Guardianship Assistance Payment (Kin-GAP) Program Requirements dated 01/31/11, clarifies that the SCI rates are available for eligible children participating in the Kin-GAP program.

 

California Department of Social Services (CDSS) Manual of Policies and Procedures (MPP) 11-401.323, state that any county wishing to modify or adopt a specialized care system shall submit a proposal to the Department which describes the county's current specialized care system, if applicable, and the county's proposed system.

 

Health and Safety (HS) Code Section 1501.1, states in pertinent part, that when placing children/youth in out-of-home care, particular attention should be given to the individual child/youth’s needs, the ability of the facility to meet those needs, the needs of other children/youth in the facility, the licensing requirements of the facility as determined by the licensing agency, and the impact of the placement on the family reunification plan.

 

Welfare and Institutions Code (WIC) Section 5600.3(a)(2), provides a definition for “seriously emotionally disturbed children or adolescents”.

 

WIC Section 11461(e) (1) provides a definition for "specialized care increment".  It specifies that the specialized care increment shall not be paid to a nonminor dependent placed in a SILP.

Back to Helpful Links