Section 359.1  Purpose

 

The purpose of these rules is to identify the various types of services for which the Department may provide payment on behalf of children and families served by the Department.

 

Section 359.2  Definitions

 

"Child-care institution" means a private child-care institution, or a public child-care institution that accommodates no more than 25 children, and is licensed or approved by the Department, meeting the standards established for the licensing. In the case of a child who has attained 18 years of age, the term shall include a supervised setting in which the individual is living independently. The term shall not include detention facilities, forestry camps, training schools, or any other facility operated primarily for the detention of children who are determined to be delinquent. (42 U.S.C.S. 672(c)(2)(a)-(c))

 

"Child only standard of need" means the assistance standard for cases in which no adult member is included, as determined by the Illinois Department of Human Services.

 

"Children for whom the Department has legal responsibility" means children for whom the Department has temporary protective custody, custody or guardianship via court order, or whose parents have signed an adoptive surrender or voluntary placement agreement with the Department.

 

"Family preservation services" means those services provided to children and families who require social services to maintain the family unit intact.

 

"Fictive kin" means any individual, unrelated by birth or marriage, who:

 

is shown to have significant and close personal or emotional ties with the child or the child's family prior to the child's placement with the individual; or

 

is the current foster parent of a child in the custody or guardianship of the Department pursuant to the Child and Family Services Act and the Juvenile Court Act of 1987, if the child has been placed in the home for at least one year and has established a significant and family-like relationship with the foster parent, and the foster parent has been identified by the Department as the child's permanent connection.  [20 ILCS 505/7(b)]

 

"Foster care maintenance payments" means payments to cover the cost of (and the cost of providing) food, clothing, shelter, daily supervision, school supplies, a child's personal incidentals, liability insurance with respect to a child, reasonable travel to the child's home for visitation, and reasonable travel for the child to remain in the school in which the child is enrolled at the time of placement. In the case of institutional care, such term shall include the reasonable cost of administration and operation of such institution as are necessarily required to provide the items described herein, the same is also applicable in cases where a child placed in a foster family home or child-care institution is the parent of a child who is in the same home or institution and payments. (42 U.S.C.S. 675(4)(a)-(b)).

 

"Foster family home" means the home of an individual or family:

 

that is licensed or approved by the state in which it is situated as a foster family home that meets the standards established for the licensing or approval; and

 

in which a child in foster care has been placed in the care of an individual who resides with the child and who has been licensed or approved by the state to be a foster parent:

 

who the Department of Children and Family Services deems capable of adhering to the reasonable and prudent parent standard;

 

who provides 24-hour substitute care for children placed away from their parents or other caretakers; and

 

who provides the care for no more than 6 children, except the Director of Children and Family Services, pursuant to Department regulations, may waive the numerical limitation of foster children who may be cared for in a foster family home for any of the following reasons to allow:

 

a parenting youth in foster care to remain with the child of the parenting youth;

 

siblings to remain together;

 

a child with an established meaningful relationship with the family to remain with the family; or

 

a family with special training or skills to provide care to a child who has a severe disability.

 

The family's or relative's own children, under 18 years of age, shall be included in determining the maximum number of children served. [225 ILCS 10/2.17]

 

"Godparent" is a person who sponsors a child at baptism or one in whom the parents have entrusted a special duty that includes assisting in raising the child if the parent cannot raise the child.  If the person is considered to be the child's godparent, in order for placement to occur, the same placement selection criteria as contained in 89 Ill. Adm. Code 301.60 (Placement Selection Criteria) must be met. If the godparent is not a licensed foster parent, all the conditions currently in effect for placement with relatives in 89 Ill. Adm. Code 301.80 (Relative Home Placement) must be met.

 

"Overpayment" means an amount paid for a service in excess of the actual incurred expenses or rate for that service or a payment for a service that is not rendered.  This includes board payments for a child that continue after the child is no longer in the placement for which the payment is made.

 

"Permanent connection" means a family-like relationship, consistent with a child's best interests, health, safety and well-being, that provides:

 

safe, stable and committed parenting;

 

unconditional love and lifelong support; and

 

a permanent legal status between child and family.

 

For a child for whom the Department is legally responsible, a permanent connection may be the child's parents or another caregiver in the child's home of origin.  When the child cannot be safely returned home, a permanent connection may be the current or former foster parent or relative caregiver, an individual identified as an adoptive or legal guardianship placement resource, or another individual from among the child's or family's lifelong connections with whom a child has developed a familial relationship.

 

"Qualified Residential Treatment Program” means a program that:

 

has a trauma-informed treatment model that is designed to address the needs, including clinical needs as appropriate, of children with serious emotional or behavioral disorders or disturbances and, with respect to a child, is able to implement the treatment identified for the child by the assessment of the child required under 42 U.S.C. 675a(c);

 

has registered or licensed nursing staff and other licensed clinical staff who:

 

provide care within the scope of their practice as defined by state law;

 

are on-site according to a trauma informed treatment model; and

 

are available 24 hours a day and 7 days a week;

 

to the extent appropriate, and in accordance with the child's best interests, facilitates participation of family members in the child's treatment program;

 

facilitates outreach to the family members of the child, including siblings, documents how the outreach is made (including contact information), and maintains contact information for any known biological family and fictive kin of the child;

 

documents how family members are integrated into the treatment process for the child, including post-discharge, and how sibling connections are maintained;

 

provides discharge planning and family-based aftercare support for at least 6 months post-discharge; and

 

is licensed in accordance with 42 U.S.C. 671(a)(10) and is accredited by any of the following independent, not-for-profit organizations:

 

The Commission on Accreditation of Rehabilitation Facilities (CARF)

 

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

 

The Council on Accreditation (COA)

 

Any other independent, not-for-profit accrediting organization approved by the Secretary of Health and Human Services. (42 U.S.C. 672(k)(4))

 

"Relative", for purposes of placement of a child for whom the Department is legally responsible, means any person, 21 years of age or over, other than the parent, who:

 

is currently related to the child in any of the following ways by blood or adoption:  grandparent, sibling, great-grandparent, uncle, aunt, nephew, niece, first cousin, first cousin once removed (children of one's first cousin to oneself), second cousin (children of first cousins are second cousins to each other), godparent (as defined in this Section), great-uncle or great-aunt; or

 

is the spouse, or party to a civil union, of such a relative; or

 

is the child's step-father, step-mother, step-grandfather, step-grandmother or adult step-brother or step-sister; or

 

is the partner, or adult child of a partner, in a civil union with the child's mother or father; or

 

is a fictive kin as defined in this Section.

 

Relative also includes a person related in any of the foregoing ways to a sibling of a child, even though the person is not related to the child, when the child and its sibling are placed together with that person.  For children who have been in the guardianship of the Department, have been adopted, and are subsequently returned to the temporary custody or guardianship of the Department, a "relative" may also include any person who would have qualified as a relative under this definition prior to the adoption, but only if the Department determines that it would be in the best interests of the child to consider this person a relative.  [20 ILCS 505/7(b)]

 

"Siblings" means children who have at least one parent in common.  Children continue to be considered siblings after parental rights are terminated or after one or more of the children are adopted or placed in private guardianship, if they were in the custody or guardianship of the Department pursuant to Article II of the Juvenile Court Act of 1987 immediately prior to the adoption or guardianship.  Step-siblings may be considered "siblings" when the children enter into substitute care together, have a positive relationship and share at least one parent in common.

 

"Substitute care services" means those services provided to children who require placement away from their families or private guardians.  Substitute care includes foster family care, care provided in a relative home placement as defined in 89 Ill. Adm. Code 301.80 (Relative Home Placement), care provided in a group home, care provided in a maternity center or a child care facility, mental health or other institution, and care provided in an independent living arrangement.

 

"Visitation" means face-to-face contact:

 

between parents and their children who are in substitute care;

 

between siblings in substitute care who are placed apart from one another; or

 

between siblings in substitute care with siblings who are not in substitute care (e.g., emancipated, case closed due to independence, adopted, placed in private guardianship, living in home of parent, etc.).

 

(Source:  Amended at 48 Ill. Reg. 8346, effective May 21, 2024)

 

Section 359.3  Introduction

 

The Department will pay for substitute care living arrangements for children for whom the Department is legally responsible, for child welfare services to children and their families determined eligible for them, and for goods, services and benefits necessary for the personal and physical maintenance of children living away from their parents in substitute care living arrangements. The Department will additionally pay for living arrangements for deaf or hearing impaired children for whom the Department is not legally responsible who require placement for educational reasons.  These payments will be made in accordance with the State Finance Act, the Comptroller's Regulations, and the mandates of the Governor's Purchased Care Review Board, and through use of state General Revenue funds, Federal Social Security benefits, and other state and federal funds.

 

Section 359.4  Payments for Substitute Care Services

 

a)         Foster care maintenance payments may be made under this Part only on behalf of a child who has been removed from the home of a relative into foster care, by voluntary placement agreement or judicial determination, and meets the AFDC eligibility requirements under 42 U.S.C. 602 and is in the foster family home of an individual, whether the payments therefor are made to such individual, or to a public or private child-placement or child-agency, or in a child-care institution, whether the payments therefor are made to such institution or to a public or private child-placement or child-care agency, which payments shall be limited so as to include in such payments only those items which are included in the term "foster care maintenance payments" as defined in Section 359.2 of this Part. (42 U.S.C. 672(b)(1)-(2))

 

b)         Payments are made for children for whom the Department has legal responsibility and their children living with them in the following types of substitute care living arrangements if the placements meet the requirements established via the purchase of service contracts and the applicable licensing rules as specified in 89 Ill. Adm. Code 357, Purchase of Service, 89 Ill. Adm. Code 401, Licensing Standards for Child Welfare Agencies, 89 Ill. Adm. Code 402, Licensing Standards for Foster Family Homes, 89 Ill. Adm. Code 403, Licensing Standards for Group Homes, and 89 Ill. Adm. Code 404, Licensing Standards for Child Care Institutions and Maternity Centers:

 

1)         Foster family care is provided in licensed foster family homes.  The Department recognizes the following types of foster family care:

 

A)        Specialized foster family homes and intensive service foster homes receive additional monthly compensation because they accept children with medical, behavioral and/or psychological problems or because they accept pregnant girls or young mothers who are in need of specialized training in parenting skills, child development, money management, and self sufficiency.

 

B)        Emergency foster homes will be paid a flat rate for days of service provided or will receive retainer fees to assure that emergency beds are available 24 hours per day.

 

C)        Department boarding homes are licensed foster family homes operated by foster parents supervised by the Department.

 

D)        Private agency foster homes are licensed foster family homes supervised by licensed child welfare agencies.

 

E)        Relatives who choose to be licensed as foster family homes under the provisions of 89 Ill. Adm. Code 402, Licensing Standards for Foster Family Homes.

 

2)         Relative family care may be provided by a relative as defined in Section 359.2, living within the State of Illinois, as follows:

 

A)        If a relative does not wish to apply for licensure as a foster family home, or has submitted an application for licensure and the application is pending, or has applied for licensure and been denied, the relative may provide care to children for whom the Department is legally responsible as long as the relative family home continues to meet the conditions in 89 Ill. Adm. Code 301.80, Placement and Visitation Services.

 

B)        For children for whom the Department is legally responsible who are residing in a home described in subsection (b)(2)(A), the Department will pay for the related children placed with the relative caregiver at the child only standard of need established by the Illinois Department of Human Services.

 

3)         Relative family care may also be provided to relatives living out of the State of Illinois.  If a relative living in another state is providing care for a child for whom the Department is legally responsible, the relative will receive the full foster care rate if the relative submits documentation to the Department within 120 days after placement of the child that they are licensed, approved or certified in accordance with the other state's standard for licensing, approving or certifying foster homes.  If documentation is not submitted, the Department will reduce the payment to the child only standard of need established for that number of children by the Illinois Department of Human Services.  If, at a future date, the relative submits documentation to the Department that they are licensed, approved or certified in accordance with the other state's standard for foster homes, the payment will be increased to the full foster care rate.

 

4)         Institution and group home care is provided in licensed institutions and group homes.  Rates are established for these facilities via a purchase of service contract with the Department.

 

5)         Subsidized adoptive homes are adoptive homes to which the Department provides financial assistance when a special needs child for whom the Department was legally responsible is adopted.

 

A)        The types of adoption assistance that may be provided include:

 

i)          one-time only payments of non-recurring expenses incurred by or on behalf of the adoptive parents in connection with the adoption of a special needs child up to a maximum of $1500 for each adopted child;

 

ii)         payment for physical, emotional and mental health needs not wholly payable through insurance or other public resources that are associated with or result from a condition(s) whose onset has been established as occurring prior to the completion of the adoption;

 

iii)        ongoing monthly payments in an amount determined in each case by the Department in accordance with 89 Ill. Adm. Code 302, Services Delivered by the Department and Section 302.310, Adoption Assistance Agreements.  The duration of adoption assistance may not extend beyond 18 years of age, although adoption assistance may be provided at the Department's option until the child's 21^st birthday if the child has a physical disability, developmental disability, or mental illness that warrants the continuation of assistance.

 

B)        The purpose, amount, and duration of the adoption assistance will be mutually agreed to by the Department and the adopting parents prior to completion of the adoption in the form of a written agreement.  The amount of financial assistance shall be less than the cost of maintaining the child in an appropriate foster family home.  Special service fees shall cost no more than such services would cost the Department.

 

C)        The Department shall review with the adoptive parent or parents the continuing needs of the child for adoption assistance every two years or more frequently, based on changes in the circumstances of the adoptive parent or parents and the needs of the child being adopted.  The adoptive parent or parents shall renew the adoption assistance agreement every two years prior to the anniversary date of the finalization of the adoption.

 

6)         Related services are not substitute care services but are provided to enhance the care provided to children who require substitute care services.

 

A)        In an effort to upgrade the quality of foster family care, the Department may pay for foster parent training and costs associated with training. These payments are provided as funding allows.

 

B)        Permanent planning and adoption contracts may be negotiated with licensed child welfare agencies.  These contracts are negotiated to develop plans for children in substitute care and to secure adoptive resources for special needs children.

 

(Source:  Amended at 48 Ill. Reg. 8346, effective May 21, 2024)

 

Section 359.5  Payments for Family Preservation and Auxiliary Services

 

Payments are made for the following services provided to children and their families when in compliance with the requirements of negotiated contracts, and authorized approval levels:

 

a)         After care services are social services provided to children who are leaving private agency foster care or care in an institution or group home. The purpose of these services is to help the children adjust to their new environment.  The payment rates are negotiated by contract.

 

b)         Homemaker and emergency caretaker services are provided through individual and agency contracts.  They may be provided to children either in or out of their own homes.  The Department may pay as funding allows for associated costs such as transportation, if appropriate, and medical examinations for advocates, homemakers and emergency caretakers.

 

c)         Counseling/advocacy services are provided to families through individual and agency contracts.  These services are purchased for intact family units and for families who have children in substitute care and as ancillary service to children in substitute care.

 

d)         Family psychiatric evaluations are provided for family counseling purposes when needed and to help evaluate the family's functioning.  These services are purchased at the physician's usual and customary fee, subject to review and comparison with rates set by other state agencies.

 

e)         Family planning counseling is a service available to all clients of the Department.  Additionally, the Department may pay for medical costs related to family planning when payment is not otherwise available.

 

f)         Camping for children living at home may be authorized by the Department when a camping experience is essential for the social development of a child receiving Department child welfare services.

 

g)         Day care is a service utilized to preserve and strengthen family life in times of crisis and to prevent the unnecessary separation of children from their families and to maintain family self-sufficiency.  Day care is provided through agency contracts and individual arrangements with day or night care providers.  The Department may pay for associated costs such as pre-admission physical examinations when such costs are not included in the day care providers fee.

 

h)         Supervised independent living arrangement contracts may be negotiated with service providers to provide social services and supervision to youth in independent living arrangements.

 

Section 359.6  Payments for Independent Living Arrangements

 

The Department may make payments directly to a youth 16 years of age or older for whom the Department has legal responsibility when by plan the youth is living independently from direct caretaker supervision in order to achieve self-sufficiency.

 

(Source:  Amended at 21 Ill. Reg. 10904, effective July 29, 1997)

 

Section 359.7  Payments for Children's Personal and Physical Maintenance

 

The Department shall provide payment for goods and services necessary to ensure the personal and physical maintenance of placed children for whom the Department is legally responsible.  These goods and services include:

 

a)         Initial placement clothing and replacement clothing thereafter if needed.

 

b)         Personal expenses for children in Department of Mental Health and Developmental Disabilities, Department of Public Health, or Department of Rehabilitative Services or other state approved facilities.

 

c)         Camp fees, clothing, and supplies for children in substitute care when such is seen as essential for the child's social development.

 

d)         Cultural enrichment including art, dancing, music, athletic lessons or instruction and related fees such as rental of equipment.

 

e)         Education expenses including books and school fees, summer school fees, school supplies, school insurance for athletic participation only, school trips if appropriate, graduation expenses, and school transportation for handicapped children if not provided by the school district.

 

f)         Travel in order to implement a child's permanency goal or maintain contact with past caretakers.

 

Section 359.8  Payments for Unmarried Mothers (Repealed)

 

(Source:  Repealed at 21 Ill. Reg. 10904, effective July 29, 1997)

 

Section 359.9  Payments for Medical Care

 

a)         Applications will be submitted by the Department in behalf of all children for whom the Department is legally responsible for Medicaid through the Department of Public Aid.  The Department will pay for medical services or expenses for children for whom the Department is legally responsible who are Medicaid ineligible and who have no financial resources.

 

b)         Foster parents, private child welfare agencies, and institutions providing substitute care for children for whom the Department is legally responsible may select a practitioner of choice as long as the practitioner is licensed and has cost standards which comply with levels of payment prescribed by the Department of Public Aid's medical assistance program.

 

Section 359.10  Overpayments and Repayments

 

a)         When an overpayment for a service occurs, the Department will seek to recover the amount overpaid in the following ways:

 

1)         The Department will deduct the amount of the overpayment from future payments to the service provider or from youth who receive their own payments.  The Department will provide advance written notice to the service provider of the youth of the amount of the deduction.

 

2)         If the service provider or youth are no longer receiving payments from the Department, the Department will request in writing repayment of the amount that was overpaid.

 

b)         The Department seeks to recover an overpayment through deduction from future payments.  In determining the amount of the monthly repayment, the Department will take into account the ability of providers to repay the amount without adversely affecting the provider's ability to provide proper care to the children in their care.  Criteria will be based on their income, expenses and family size.  The Department will take into account the ability of youth to repay without adversely affecting their ability to meet basic living expenses such as rent, food and clothing.

 

c)         When the Department seeks to recover an overpayment from providers who are no longer providing a service to the Department or from youth who are no longer receiving payments, it will take into account their ability to repay based on their income, expenses and family size.

 

d)         When providers or youth, who no longer receive payments from the Department, refuse to repay overpaid amounts and the Department has made a reasonable effort to recover the amount, the Department will refer the matter to the State Comptroller and the Attorney General.

 

(Source:  Added at 9 Ill. Reg. 19705, effective December 16, 1985)

 

Section 359.11  Limitation on Federal Financial Participation

 

a)         Beginning with the third week for which foster care maintenance payments are made on behalf of a child placed in a child-care institution, the Department will not receive Federal payments for amounts expended for foster care maintenance payments on behalf of the child unless:

 

1)         the child is placed in a child-care institution that is:

 

A)        a qualified residential treatment program (QRTP);

 

B)        a setting specializing in providing prenatal, post-partum, or parenting supports for youth;

 

C)        in the case of a child who has attained 18 years of age, a supervised setting in which the child is living independently; or

 

D)        a setting providing high-quality residential care and supportive services to children and youth who have been found to be or are at risk of becoming, sex trafficking victims. (42 U.S.C. 672(k)(2)(A)-(D)) or

 

2)         the child is placed in a licensed residential family-based treatment facility with a parent who is in a licensed residential family-based treatment facility for substance abuse, and only when:

 

A)        the recommendation for the placement is specified in the child's case plan before the placement;

 

B)        the treatment facility provides parenting skills training, parent education and individual and family counseling; and

 

C)        the substance abuse treatment, parenting skills training, parent education, and individual and family counseling is provided under an organizational structure and treatment framework that involves understanding, recognizing, and responding to the effects of all types of trauma and in accordance with recognized principles of a trauma-informed approach and trauma-specific interventions to address the consequences of trauma and facilitate healing; (See 42 U.S.C. 672 (j)(1)(A)-(C)), and

 

3)         the child is placed in a qualified residential treatment program and the required assessment to determine the child's appropriate placement is completed within 30 days after the placement is made.

 

b)         If the required placement assessment determines that the placement of a child in a QRTP is not appropriate, a court disapproves or a child who has been in an approved placement in a qualified residential treatment program is going to return home or be placed with a fit and willing relative, a legal guardian, or an adoptive parent, or in a foster family home or the child remains un the placement beyond the 30-day period necessary for the child to transition to the new placement. (42 U.S.C. 672(k)(3)(A)-(B))

 

(Source:  Added at 48 Ill. Reg. 8346, effective May 21, 2024)