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<regulation prefix="Regulation" num=".32" citation="COMAR 07.02.11.32" title_num="07" subtitle_num="02" chapter_num="11" heading="State Standard Rates for Purchased Out-of-Home Placement Services.">
  <paragraph num="A.">
    <text>Purchased Foster Care.</text>
    <paragraph num="(1)">
      <text>The purchased family foster care rate is for the care of a child who requires extra supervision and attention in a home equipped to give this special care. This type of purchase may be used to prevent placement of a child in a group care facility, or to enable his discharge from a group care facility.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Rates for the purchase of care from licensed child placement agencies are provided for purchased family care supervised through the licensed child placement agencies.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Licensed child placement agencies are reimbursed as follows:</text>
      <paragraph num="(a)">
        <text>Foster care purchased from agencies, which includes room and board, is paid according to the negotiated rate issued by State Department of Education and the terms of the contract with the Department.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Purchase of Supportive Services.</text>
        <paragraph num="(i)">
          <text>Provision is made to purchase supportive services, as needed, in order to maintain the children in the community.</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>These special supportive services may be purchased from two sources which are the foster family who by virtue of special training or experience is able to provide them, or through another resource appropriate to the special needs of the child.</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>The supportive services to be provided shall be approved in writing by the director of the licensed child placement agency or the director's designee who is other than the caseworker. This written approval shall confirm that the child requires the identified supportive service because of a health (physical or mental) condition, or an emotional or behavioral problem, and that the service provider is capable, by virtue of special training or experience, of providing the needed service.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(c)">
        <text>Supportive 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.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Private Child Placement Agency Treatment Foster Care Rate.</text>
    <paragraph num="(1)">
      <text>This rate, paid according to the negotiated rate issued by the State Department of Education and the terms of the contract with the Department, provides for the care of a child who requires treatment foster care as defined in Regulation .03B of this chapter.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>In recognition of the severe nature of the problems of children cared for in treatment foster homes, a supplemental difficulty of care stipend is paid to these foster parents. The Department shall set the amount of the stipend to be included in the contract with the private provider agency.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Initial Clothing Allowance. The initial one-time only clothing allowance as set forth in Schedule B of Regulation .39 of this chapter may be made on behalf of any child entering foster care to meet basic clothing needs.</text>
  </paragraph>
  <paragraph num="D.">
    <text>Group Care in an Institution or Group Home.</text>
    <paragraph num="(1)">
      <text>The Administration shall negotiate rates for:</text>
      <paragraph num="(a)">
        <text>Basic care which includes room, meals, and clothing;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Social work service to a child dealing with the child's placement and needs, including identified special services in addition to the facility's routine supervision and services;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Health-related services including psychological, psychiatric, medical, and dental services not provided under the Medical Assistance Program and Health Choice Program; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Approved education program or school, for the period of actual attendance, needed as part of an individual treatment plan not paid for by the Maryland State Department of Education and not generally available.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Supplemental Services.</text>
      <paragraph num="(a)">
        <text>If funds are available, the local department may purchase supplemental services for a child on an individual need.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Supplemental services are services:</text>
        <paragraph num="(i)">
          <text>Not included in the negotiated rates listed in §D(1) of this regulation and not available from other resources but needed to complete the treatment plan for a child; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Approved by the local director or the director's designee as a need based on written documentation in the child's case record.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(c)">
        <text>Supplemental services include, but are not limited to:</text>
        <paragraph num="(i)">
          <text>Speech therapy;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Transportation related to special education; or</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>One-to-one staffing.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Cooperative Relationships—Purchase of Care.</text>
    <paragraph num="(1)">
      <text>In any purchase of care plan, the local department and the agencies or facilities involved are required to jointly develop and carry out a responsible plan for services appropriate to the needs of the child, his natural family, or other significant persons in the child's life. The plan shall be implemented by regular interagency contacts. The group facility shall send a written report on the status of the child to the local department at a minimum of every 180 days.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The local department worker shall remain involved with the child and the child's family during and after purchase of care to assure continuity of care and treatment, coordination of interagency effort, and to minimize the duration of purchase of care when possible.</text>
    </paragraph>
  </paragraph>
</regulation>