State of Connecticut Department of Children and Families Discretionary Services Fee Schedule Credentialed Services

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State of Connecticut Department of Children and Families Discretionary Services Fee Schedule Credentialed Services Description Service Types Maximum Rate Assessment of a child or youth, includes an initial face-toface screening, additional face-to-face contacts with the individual and collateral contacts with family members, caretakers and other treatment providers, determination of the individual's strengths and limitations, development of a differential diagnosis, identification of any disability, determination of functional capacity, identification of natural supports and development of review of an individualized service plan. Assessment allows for reimbursement associated with the preparation of the assessment. Duration: 2 to 6 hours, unless approved by a Program Director or above. (see footnote #1) Assessment In Home (596) Assessment Foster Care (610) Area Office negotiates rate based on type and intensity of evaluation needed. Guidelines found at CT Behavioral Health Partnership at http://www.ctbhp.com/providers/covrdsrvcs/covered_services-fees-husky.pdf Assessment: Perpetrator of Domestic Violence is an assessment of an adult member of a current active DCF case. The assessment will include a face-to-face interview(s) with the perpetrator and may include collateral contacts with family members, DCF, the police, court staff, victim advocates, and other involved providers as required. Assessment to id risk factors, to make treatment recommendations and to develop appropriate and timely interventions to assure the safety and well being of all family members. A screening for substance abuse or dependency and mental health issues shall be completed as part of the assessment. Duration: 2 to 6 hours face to face, unless approved by a Program Director or above. (see footnote #1) Behavior Management service is intended to develop or support a therapeutic behavior plan to be followed by parents, caretakers, teachers and/or other service providers. Includes preparation of a written therapeutic behavior plan designed to assist in the management of the child's behavior. Duration: 40 hours or 60 days whichever comes first (see footnote #1) Assessment - interview with client, administration of standardized tests or relevant scales, collateral contacts made for the purposes of completing the assessment, review of relevant records, writing the assessment. Ancillary - court testimony, participation in DCF treatment or service planning meetings, and participation in an Integrated Family Violence Service hub meeting. Assessment DV(640) Behavior Management In home (597) Behavior Management Foster Care (611) $100 per hour $80 per hour $52 per hour 1

Temporary Care service is to provide a short-term break or intervention by separating the child or youth from caregivers for a few hours, or other relatively short period of time in order to assist family members with the practicalities of living and their attending to the needs of all family members. This service is provided in the home of the parent or caretaker. Duration: maximum of 45 hours or 90 days whichever comes first. The rate covers up to 3 children in the home. (see footnote #1) Supervised Visitation is a service used in order to facilitate contact between children or youths in out of home care and their biological parents, relatives or significant others, primarily a site-based service or a community setting. All sites must be approved in advance by the Area Office. (This is not a parent aide service) Duration: maximum of 25 hours or 60 days whichever comes first. This rate includes all of the children in the home. (see footnote #1) Therapeutic Support Staff Services are intended to address the individualized needs of a child or youth with complex behavioral health needs that is at risk of entering a residential level of care or who is being discharged from residential treatment or a more acute level of care. This service is provided for up to eight hours per week per youth and includes a combination of structured and enrichment activities consistent with identified treatment plan objectives, and to assist each child or youth to develop skills that support good decision-making, pro-social choices, life skills that foster independence and skills that replace problematic behaviors. Duration: maximum of 8 hours per week up to 6 months. (see footnote #1) The Area Office may approve either more than eight hours of service per week or an extension beyond 26 weeks based on treatment plan goals and objectives (see footnote #2). Temporary Care Service In Home (294) Temporary Care Service Foster Care (372) Supervised Visit Foster Care (613) Therapeutic Support Staff In-home (609) Therapeutic Support Staff Foster Care (614) $24 per hour; not to exceed $200 per day $45 per hour $40 per hour 2

CHAP (Community Housing Assistance Program) Case Management is a community-based program that provides case management, supervision, educational/vocational support or career development support, and life skills development services, utilizing the DCF approved Life Skills Program - Ansell Casey Life Skills, to youth living in a community housing environment. This case management service is for youth who are committed to the Department as abused, neglected and/or uncared for at the time of placement into the program or at youth's eighteenth (18th) birthday and is intended as a component of a comprehensive treatment plan. As such, the individual providing this service is expected to collaborate with other service providers toward the implementation of the child s individual treatment plan. The service is only for referrals approved by DCF CHAP liaison. Duration: Twelve months -extended maximum to 18 months. For extension of services -see footnote #2. CHAP Case Management $42 per hour or $30.01 per diem based on five(5) hours per week Support Staff Services are intended to address the individualized needs of a child or youth with challenging behavioral presentations. This service is provided for up to five hours per week per youth and includes a combination of structured and enrichment activities consistent with identified treatment plan objectives. Duration: maximum 5 hours per week up to 6 months. (see footnote #1) The area office may approve either more than five hours of service per week or an extension beyond 26 weeks based on case plan goals and objectives (see footnote #2). After School Services Youth (Grades 8-12) provides a variety of youth-centered activities that support positive development and complement school-day activities. The program shall provide indoor and outdoor physical activities, creative experiences for self-expression, rest or quiet time, and individual and small group activities to meet the academic, physical, social and emotional needs of the youth being served. All After School Programs will provide a minimum of forty-five (45) minutes of educational programming and/or educational support and homework assistance (age and developmentally appropriate). Support Staff In-home (620) Support Staff Foster Care (621) After-school services In-Home -Youth Grades 9-12 (776) Foster Care - Youth Grades 9-12 ( 780) $35 per hour $182 for up to 30 hours per week. $364 per week for a vacation period 3

Services are site-based and are multi-dimensional; they are after the school day and during school vacations which may or may not include the summer vacation period. for a 90 day period. The Area Office can approve more than 25 hours of service per week or extend beyond 90 days (see footnote #2). After School Services Traditional (Grades K-7) provides a variety of child-centered activities that support positive development and complement school-day activities. The program shall provide indoor and outdoor physical activities, creative experiences for self-expression, rest or quiet time, and individual and small group activities to meet academic, physical, social and emotional needs of the children being served. All After School Programs will provide a minimum of forty-five (45) minutes of educational programming and/or educational support and homework assistance (age and developmentally appropriate). Services are site-based and are multi-dimensional; they are the after school day and during school vacations which may or may not include the summer vacation period. After-school services In-Home Traditional - K-8 ( 777) Foster-care Traditional K -8 ( 781) $182 for up to 30 hours per week. $364 per week for a vacation period for a 90 day period. The area office can approve more than 25 hours of service per week or extend beyond 90 days (see footnote #2). After School Services Clinical Support for Children (Grades K-7) provides a variety of youth-centered activities that support positive development and complement school-day activities. The program shall provide indoor and outdoor physical activities, creative experiences for self-expression, rest or quiet time, and individual and small group activities to meet the academic, physical, social and emotional needs of the youth being served. All After School Programs will provide a minimum of forty-five (45) minutes of educational programming and/or educational support and homework assistance (age After School Services In-Home Clinical Support K-8 (778) Foster Care -Clinical Support K-8 (782) 4 $295 for up to 30 hours per week $450 per week for a vacation period

and developmentally appropriate). These services are designed to address the individualized needs of children with a range of behavioral health needs. The children have a current diagnosed behavioral health condition and require a structured program, clinical intervention, and support. Services are site-based and are multi-dimensional; they are after the school day and during school vacations which may or may not include the summer period. for a 90 day period. The Area Office can approve more than 25 hours of service per week or extend beyond 90 days (see footnote #2. After School Services Clinical Support for Youth (Grades 8-12) provides a variety of youth-centered activities that support positive development and complement school-day activities. The program shall provide indoor and outdoor physical activities, creative experiences for self-expression, rest or quiet time, and individual and small group activities to meet the academic, physical, social and emotional needs of the youth being served. All After School Programs will provide a minimum of forty-five (45) minutes of educational programming and/or educational support and homework assistance (age and developmentally appropriate). These services are designed to address the individualized needs of children with a range of behavioral health needs. The children have a current diagnosed behavioral health condition and require a structured program, clinical intervention and support. Services are site-based and are multi-dimensional; they are after the school day and during school vacations which may or may not include the summer period. for a 90 day period. The Area Office can approve more After School Services In-Home Clinical Support 9-12 (779) Foster Care Clinical Support 9-12 (783) $236 for up to 30 hours per week $450 per week for a vacation period 5

than 25 hours of service per week or extend beyond 90 days (see footnote #2). ***(foot note 1) Only time spent delivering the service is reimbursable. For example, time spent driving is not reimbursable, unless transporting the child receiving the service. ***(footnote 2) Please refer to Provider Agreement under "Duration of Services" for information regarding the extension of services. 6