Specialized Care Increment (SCI) – D-Rate
0900-522.10 | Revision Date: 1/28/2025

Overview

The Specialized Care Increment (SCI) 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 concerns.  This policy provides instruction for referring potentially eligible children for a D-Rate assessment in cases where there is an open Probate Legal Guardianship, Legal Guardianship and/or a Kin-GAP case ordered by the Court prior to 01/01/2017 or retroactive D-Rate prior to 04/01/2021.

Table of Contents

Version Summary

This policy guide was updated from the 12/23/2014 version, to clarify the process of referring a child/youth for a D-Rate evaluation, which children are eligible, and the implementation of Level of Care (LOC) determination for SCI rates starting 04/01/2021. Also, the D-Rate Unit is now known as the Residential Care Liaison (RCL) Unit.

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 concerns.  It is a flat rate determined by the child/youth’s age.  The Residential Care Liaison (RCL) Unit, formerly referred to as the D-Rate Unit, assesses children for the D-Rate criteria who have open Probate Legal Guardianship cases, Legal Guardianships and/or Kin-GAP cases ordered by the Court prior to 01/01/2017 or retroactive D-Rate (prior to 04/01/2021) requests. The Level of Care (LOC) program started determining SCI rates effective 04/01/2021, based on the child’s needs and level of care within a tier rate system.

D-Rate Determinations

The determination regarding the SCI D-Rate funding is based on a mental health assessment completed by a California licensed mental health professional (Licensed Clinical Social Worker, Marriage and Licensed Family Therapist, Licensed Professional Clinical Counselor, 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 mental health assessment must include a mental health diagnosis and indicate one of the following regarding the child/youth:

  • Displays psychotic features
  • Is a suicide risk
  • Is at risk of violence
  • Has substantial impairment in at least two of the following areas:
    • Self-care
    • School functioning
    • Family relationships
    • Functioning in the community

And include of the following:

  • The child/youth is at risk of removal from the current placement or has already been removed.
  • The impairments have been present for six months or are likely to continue for more than one (1) year, if untreated.

An initial D-Rate assessment begins by providing the DCFS RCL Unit the completed DCFS 1695 D-Rate Referral form with an attached mental health assessment (s). The mental health assessment can be in the form of the Multidisciplinary Assessment Team (MAT) assessment or any clinical assessments performed by California licensed mental health professionals.

Additional Required Eligibility Funding Assessments

  • Supplemental Security Income (SSI) – For all children/youth eligible or potentially eligible for a SCI rate, consult with the SSI Unit.  In addition, a mandated Supplemental Security Income (SSI) screening is required for all youth 16 ½ years old.
  • Regional Center/Dual Agency – For all children/youth receiving Regional Center services, CSW will need  to  assess if they qualify for the dual agency rate in lieu of a D-rate.

D-Rate Criteria

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

  • Children must be between the ages of five (5) and eighteen (18) years old or a Nonminor Dependent (NMD), if they continue to meet the eligibility and funding criteria. 
    • Children ages thirty-seven (37) to fifty-nine (59) months may be referred with Assistant Regional Administrator (ARA) approval .
      • For dependent children/youth that are not eligible for Aid to Families with Dependent Children-Foster Care (AFDC-FC), DCFS reviews other state assistance, family assistance, and other variables to determine the General Relief Ineligible (GRI) and the appropriate rate.
  • The child/youth is diagnosed with behavior(s) inappropriate to the child/youth’s developmental age that impairs the child/youth in critical life areas, according to the Diagnostic and Statistical Manual of Mental Disorders (currently DSM V).
Children who qualify for the D-Rate present with severe emotional disturbances and the examples below are some common behaviors or indicators.
  • The child/youth display disturbances or behaviors which are characterized by varying degrees of personality disorganization and departures from normal modes of thinking, feeling, perceiving and acting.
    • These children/youth often exhibit impairment in reality testing, judgment and communication, and react to daily living experiences with excessive fearfulness, aggression, depression, or withdrawal. Outbursts of rage, excessive verbal or physical aggressiveness (including overt or covert hostility) are common.
  • Suicidal ideation or attempts are not uncommon.
  • The child/youth responds with extreme impulsivity and assumes rigid postures of fight or flight when frustrated. 
  • The child/youth exhibit maladaptive behaviors which are hostile, provocative, distrustful, manipulative, defiant or vengeful and these behaviors place them in chronic conflict with caregivers, teachers, peers and society at large.
  • The child/youth's volatile, unpredictable, destructive, and antisocial quality of behavior triggers concern that they are a danger to self, others and/or property. 
  • Diagnostic impressions vary but most revolve around psychosis, borderline conditions, severe personality and character disorders, and unsocialized aggressive reactions.
  • The child/youth has a clinical evaluation, which may include a MAT assessment, supporting D-Rate eligibility or is receiving SSI for emotional needs.
  • Placement histories of the child/youth generally reveal rejection, placement disruptions, prior hospital commitments, and multiple replacements.
  • Educational inventories frequently reveal major learning deficits consistent with the cycle of rejection, disruptions and replacements. 
  • The child/youth coming from a Short Term Residential Therapeutic Program (STRTP), Community Treatment Facility (CTF) or psychiatric hospital can be presumed eligible.  If a child/youth is already receiving Supplemental Security Income (SSI) for psychiatric reasons, the child/youth can also be presumed to meet eligibility.

RCL Program

The RCLs are CSW III’s assigned to cover all the regional offices under the supervision of the RCL Supervisor. The RCL Program provides assistance with the following:

  • Assists the case-carrying CSW with Initial D-Rate determinations regarding Los Angeles County foster care funding that is not covered under the LOC program including children with Legal Guardianship through Probate Court, Legal Guardianship ordered by the Los Angeles County dependency court prior to 1/1/2017, and Retroactive D-Rate requests prior to 4/01/2021.  
  • The RCL staff review and reassess the children/youth’s progress annually to determine if children/youth continue to meet eligibility requirements and make recommendations regarding goals and treatment options. The annual reassessments will be in collaboration with the assigned CSW and mental health team, if available. 
  • RCLs may be able to assist with referrals and resources; however, the CSAT Manager or Service Linkage Specialist, should be contacted first for linkage to comprehensive mental health services which may include individual, group and family therapy, in-home therapy, case management and TBS; specialized requests for a one-on-one, and psychological assessments through a DCFS appointed psychologist. Respite Care and collaboration with the Regional Center should be sought. Educational linkages and academic support should be available through the Educational Specialists. PHNs may be able to provide resources for health care. RCLs, Service Linkage Specialist, the Regional Center and case-carrying CSW should collaborate with referrals to community social and recreational resources.

Caregiver Requirements

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

  • Most resource parents residing in Los Angeles County prior to 4/01/2021
  • Most relatives residing in Los Angeles County prior to 4/01/2021
  • Legal guardians who received legal guardianship prior to 1/01/2017
  • Kin-GAP legal guardians who received legal guardianship prior to 1/01/2017
  • Most Nonrelative extended family members (NREFMs) residing in Los Angeles County prior to 4/01/2021
  • All Los Angeles County probate legal guardians

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

  • Resource parents licensed through a Foster Family Agency (FFA) 
  • Resource and/or relative homes not approved by Resource Family Approval (RFA)
  • Nonminor dependent (NMD) in a Supervised Independent Living Placement (SILP).
  • STRTP, Treatment Centers, Group Homes and Intensive Services Foster Care (ISFC) placements 

Caregiver Training

Caregiver training includes an initial twelve (12) hours of Core Training plus four (4) hours of specialized training classes, to be certified to receive SCI funding and six (6) hours yearly thereafter to be remain certified (consistent with the Level of Care policy for caregivers receiving the SCI rate). The 12-hour Core Training is offered through the Foster and Kinship Care Education (FKCE) Program

 

 

Exemptions to Caregiver Training Requirements

Caregivers with closed dependency cases who are receiving a SCI as part of their AAP or KIN-Gap payment are no longer required to participate in the D-rate Certification training once their case is closed.

The CSW and/or the RCL should document, in the CWS/CMS Contacts and on the DCFS 1695 D-Rate Referral form, why a caregiver, receiving D-Rate funding for a child with an open DCFS case, why a caregiver, receiving D-Rate funding for a child with an open DCFS case is exempt from the D-Rate training requirements.

Caregiver Expectations

Caregivers are also expected to:

  • Participate in the child/youth’s treatment including family counseling (when clinically indicated).
  • Arrange transportation to various facilities and providers.
  • Provide social and recreational activities consistent with the child/youth’s needs.
  • Familiarize themselves with special education and the Individualized Education Plan (IEP) process.
  • Advocate for the child/youth’s educational needs and rights in partnership with the child/youth’s teachers.
  • Learn daily interaction skills to meet the child/youth’s needs and avail themselves of support groups and/or foster parent associations to develop support techniques.

For recipients of state and federally-funded Kin-GAP Programs, the SCI D-Rate funding is available to the relative guardian if the legal guardianship was established prior to 1/01/2017 and if 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.

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.

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).

PROCEDURE

CSW Responsibilities

  1. Within one (1) business day of notification or observation that a child/youth may exhibit severe emotional/behavioral problem, discuss the observations with the caregiver and explain the D-Rate Evaluation process.
  2. Create the D-Rate Referral packet by including the following  required forms:
    • DCFS 1695, D-Rate Indicators and Child Referral
    • A mental health assessment completed by a mental health professional and any information regarding the child/youth’s functioning in school and in the community.
    • Documents that are helpful, but not required include:
      1. DCFS 179 MH
      2. Minute orders for MAT Assessment, counseling services or Release of Information to DCFS.
      3. Caregiver training certificates within the year.
  3. Forward the D-Rate Referral packet to  DCFSdratereferrals@dcfs.lacounty.gov for review and assignment to an RCL.
  4. Within one (1) business day of receiving an approved D-Rate Referral packet from the RCL, complete the Automated 280, attach the DCFS 1695 and submit them both to the SCSW (and ARA if required) for approval and signature.
  5. Within one (1) business day of receiving a denied D-Rate Referral packet from the RCL, 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. Complete the Automated 280 directing Revenue Enhancement staff to issue a Notice of Action to the caregiver and submit it, along with the DCFS 1695 to the SCSW for approval.
  6. Within one (1) business day of receiving the Automated 280 from the SCSW, forward the Automated 280 and all other appropriate documentation to the Technical Assistant/Eligibility Worker (TA/EW) for processing.
  7. Place copies of all documentation in the case file.

RCL and SCSW Responsibilities

Receive and log the D-Rate Referral packet on a “D-Rate Referral Log”.
  1. Review the D-Rate Referral packet to confirm that it contains the following:
    • A mental health assessment or MAT assessment, psychological evaluation, psychiatric evaluation, therapist letter and/or documentation from mental health services providers that includes:
      • A DSM diagnosis
      • Documentation that the caregiver(s) is/are able and willing to meet the child/youth’s needs.
      • Documentation indicating that the child/youth has impairments in functioning in two or more areas.
  2. If the mental health service provider information is missing, the CSW and/or Legal Guardian shall obtain a mental health assessment of the child/youth from the child/youth’s mental health agency where they are receiving mental health services. The RCL may be able to assist with gathering necessary documentation. 
  3. The RCL SCSW will review D-Rate packet and assign to an RCL to complete D-Rate assessment.
  4. The assigned RCL will review the DCFS 1695 referral form and accompanying attachments and will request additional documentation if needed. 
  5. The assigned RCL will document on the D-Rate Referral form:
    • Whether or not the child/youth is currently linked to any services identified to address his or her emotional/behavioral needs. If the child/youth is not linked, refer the child to CSAT staff for linkage.
    • Whether or not there is documentation of impairments in functioning in two or more areas.
    • Whether or not caregiver has received SCI Training and if available, obtain a copy of the SCI Training Certificate. If the caregiver has not attended the SCI training, recommend the caregiver complete training as soon as feasibly possible.
  6. After reviewing all documentation/information available, the RCL will make a determination as to whether or not the D-Rate criteria has been satisfied. The RCL will document on the D-Rate Evaluator’s portion of the DCFS 1695 referral form what documentation and/or information was used to make the determination and forward the D-Rate Referral packet to the RCL SCSW for review and approval.
  7. If in agreement with the RCL’s determination, the RCL SCSW will sign the DCFS 1695 referral form and return it to the RCL. If the RCL SCSW is not in agreement with the determination, the RCL SCSW will return to the 1695 referral form to the RCL for corrective action.
  8. Upon approval from RCL SCSW, the RCL will then sign the DCFS 1695 referral form and provide a copy of the form to the primary CSW with an approval or denial letter.
    • The RCL will upload the signed DCFS 1695 referral form in CWS/CMS and document under the green, Case Management Section tab whether the D-rate assessment was approved or denied.
    • The primary CSW will notify the caregiver of the outcome of the D-Rate assessment.

D-Rate Referrals for Retroactive (Prior to 4/01/2021) D-Rate Funding

D-Rate Referrals for retroactive, prior to 4/01/2021, D-Rate funding are requested through the Services Bureau (SB) Liaisons.  The SB Liaisons will e-mail DCFSdratereferrals@dcfs.lacounty.gov a copy of the Attorney Inquiry with the dates of the requested retroactive D-Rate assessment and attach documentation of the child’s mental health services during the requested retroactive time frame from the mental health service providers. The packet should include a mental health assessment, MAT assessment, psychological evaluation, psychiatric evaluation, therapist letter and/or documentation from mental health services providers that indicate a DSM diagnosis, documentation that the caregivers(s) is/are able and willing to meet the child/youth’s needs and documentation indicating that the child/youth has impairments in functioning in two or more areas.

 

RCL and SCSW Responsibilities

Receive and log the AAP Inquiry and D-Rate Referral packet on the “D-Rate Referral Log”.
  1. RCL SCSW will review the D-Rate Referral packet and assign the AAP Inquiry for a retroactive D-Rate assessment to an RCL for assessment. If the mental health service provider information is missing, the RCL SCSW will inform the SB Liaison of the need for mental health and functioning impairment documentation and the possibility the D-Rate Assessment will be denied without appropriate documentation.
  2. The assigned RCL will review the DCFS 1695 referral form and accompanying attachments.
  3. If the mental health service provider information is missing, the CSW and/or Caregiver/Adoptive Parent will be requested to obtain a mental health assessment of the child/youth from the child/youth’s mental health agency where the child/youth was reported to have be receiving mental health services during the dates of the retroactive assessment.  The RCL may be able to assist with gathering necessary documentation. 
  4. The assigned RCL will document on the D-Rate Referral form:
    • Whether or not the child/youth was linked to any mental health services identified to address his or her emotional/behavioral needs during the requested time frame.
    • Whether or not the child has a documented mental health diagnosis during the requested time frame.
    • Whether or not there is documentation of impairments in functioning in two or more areas during the requested time frame.
  5. After reviewing all documentation/information available, the RCL will make a determination as to whether or not the D-Rate criteria has been satisfied. The RCL will document on the D-Rate Evaluator’s portion of the DCFS 1695 referral form what documentation and/or information was used to make the determination and forward the D-Rate Referral packet to the RCL SCSW for review and approval.
  6. If in agreement with the RCL’s determination, the RCL SCSW will sign the DCFS 1695 referral form and return it to the RCL. If the RCL SCSW is not in agreement with the determination, the RCL SCSW will return to the 1695 referral form to the RCL for corrective action.
  7. Upon approval from RCL SCSW, the RCL will then sign the DCFS 1695 referral form and provide a copy of the form to the primary CSW (if there is one assigned) and to the SB Liaison with an award or denial letter. 
    • The RCL unit's STC will upload the signed DCFS 1695 referral form in CWS/CMS and document under the green, Case Management Section tab whether the D-rate assessment was approved or denied.

D-Rate Referrals for Kin-GAP cases prior to 1/01/2017 are initiated at the Legal Guardian’s request through the Kin-GAP EW or by contacting the Warmline.  There will be a Kinship worker assigned to complete the DCFS 1695 D-Rate Referral form and gather documentation regarding the child’s mental health services and impairments in functioning.  The Kinship worker will e-mail the completed DCFS 1695 D-Rate Referral form with attachments to DCFSdratereferrals@dcfs.lacounty.gov to be assigned to an RCL.

RCL and SCSW Responsibilities

  1. The assigned RCL will review and document on the D-Rate Referral form:
    • Whether or not the child/youth is linked to any mental health services identified to address his or her emotional/behavioral needs.
    • Whether or not the child’s has a documented mental health diagnosis.
    • Whether or not there is documentation of severe impairments in functioning in two or more areas during the requested time frame.
  1. After reviewing all documentation/information available, the RCL will make a determination as to whether or not the D-Rate criteria has been satisfied. The RCL will document on the D-Rate Evaluator’s portion of the DCFS 1695 referral form what documentation and/or information was used to make the determination and forward the D-Rate Referral packet to the RCL SCSW for review and approval.
  2. If in agreement with the RCL’s determination, the RCL SCSW will sign the DCFS 1695 referral form and return it to the RCL. If the RCL SCSW is not in agreement with the determination, the RCL SCSW will return to the 1695 referral form to the RCL CSW for corrective action.
  3. Upon approval from RCL SCSW, the RCL will then sign the DCFS 1695 referral form and provide a copy of the form to the RCL Unit’s STC and the Kinship Center worker with an award or denial letter.
    • The RCL unit’s STC will upload the signed DCFS 1695 referral form in CWS/CMS and document under the green tab whether the D-rate assessment was approved or denied.

Annual D-Rate Re-Certification Alert

The RCL will receive an alert from the Eligibility Worker (EW)  or can retrieve from the SITE the due dates of D-Rate re-certifications.  The D-Rate re-certifications will only need to be completed for children who were ordered into Legal Guardianship prior to 01/01/2017 or for children who have Legal Guardianship through Probate Court.  The D-Rate eligibility will expire at the end of twelve (12) months unless another assessment is completed and determines the D-Rate shall continue.

RCL Responsibilities

  1. Consult with the CSW, caregiver, mental health providers and child/youth/NMD, if appropriate, to determine continued D-Rate eligibility.
  2. Send the completed re-assessments to the RCL SCSW for review and approval or denial.
  3. If in agreement with the RCL CSW’s determination, the RCL SCSW will sign the DCFS 1695 referral form and return it to the RCL.  If the RCL SCSW is not in agreement with the determination, the RCL SCSW will return to the 1695 referral form to the RCL for corrective action.
  4. Upon approval from RCL SCSW, the RCL will then sign the DCFS 1695 referral form and provide a copy of the form to the child’s primary CSW and EW with an award or denial letter.          
  5. The RCL unit’s STC will upload the signed DCFS 1695 referral form in CWS/CMS and document under the green tab whether the D-rate assessment was approved or denied.
APPROVALS

SCSW Approval

  • DCFS 417
  • DCFS 1695
  • DCFS 280

D-Rate SCSW Approval

  • D-Rate Referral Packet
  • D-Rate Initial Certification
  • D-Rate Re-certification
HELPFUL LINKS

Forms

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 AND OTHER MANDATES

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.