Virginia Administrative Code › Title 12 - HEALTH › Agency 30 - DEPARTMENT OF MEDICAL ASSISTANCE SERVICES › Chapter 50 - AMOUNT, DURATION, AND SCOPE OF MEDICAL AND REMEDIAL CARE SERVICES › Part IV - Eligibility Requirements › Section 12VAC30-50-480 - Case management for foster care children

Current through Register Vol. 40, No. 24, July 15, 2024
A. Target group. Children or youth with
				  behavioral disorders or emotional disturbances who are referred to treatment
				  foster care by the Family Assessment and Planning Team of the Comprehensive
				  Services Act for Youth and Families (CSA). "Child" or "youth" means any
				  Medicaid eligible individual to 21 years of age who is otherwise eligible for
				  CSA services. Family Assessment and Planning Teams (FAPT) are multidisciplinary
				  teams of professionals established by each locality in accordance with
				  §§ 2.1-753, 2.1-754, and 2.1-755 of the Code of Virginia to assess
				  the needs of referred children. The FAPT shall develop individual services
				  plans for youths and families who are reviewed by the team. The FAPT shall
				  refer those children needing treatment foster care case management to a
				  qualified participating case manager.
B. Services will be provided in the entire
				  state.
C. Services are not
				  comparable in amount, duration, and scope. Authority of § 1915(g)(1) of
				  the Act is invoked to provide services without regard to the requirements of
				  § 1902(a)(10)(B) of the Act.
D. Definition of services. Case management
				  shall assist individuals eligible for Medicaid in gaining and coordinating
				  access to necessary care and services appropriate to the needs of a child. Case
				  management services will coordinate services to minimize fragmentation of care,
				  reduce barriers, and link children with appropriate services to ensure
				  comprehensive, continuous access to needed medical, social, educational, and
				  other services appropriate to the needs of the child. The foster care case
				  manager will provide:
1. Periodic assessments
				  to determine clients' needs for psychosocial, nutritional, medical, and
				  educational services.
2. Service
				  planning by developing individualized treatment and service plans to describe
				  what services and resources are needed to meet the service needs of the client
				  and help access those resources. Such service planning shall not include
				  performing medical and psychiatric assessment but shall include referrals for
				  such assessments. The case manager shall collaborate closely with the FAPT and
				  other involved parties in preparation of all case plans.
3. Coordination and referral by assisting the
				  client in arranging for appropriate services and ensuring continuity of care
				  for a child in treatment foster care. The case manager shall link the child to
				  services and supports specified in the individualized treatment and service
				  plan. The case manager shall directly assist the child to locate or obtain
				  needed services and resources. The case manager shall coordinate services and
				  service planning with other agencies and providers involved with the child by
				  arranging, as needed, medical, remedial, and dental services.
4. Followup and monitoring by assessing
				  ongoing progress in each case and ensuring services are delivered. The case
				  manager shall continually evaluate and review each child's plan of care. The
				  case manager shall collaborate with the FAPT and other involved parties on
				  reviews and coordination of services to youth and families.
5. Education and counseling by guiding the
				  client and developing a supportive relationship that promotes the service
				  plan.