To obtain a IV-E foster care rate, agencies must be licensed as a Child Caring Agency and/or Child Placing Agency through the Division of Social Services,
attend training and submit the following information to the Office of the Controller no later than March 15, 2012:
Residential Treatment / Foster Care Cost Report including:
- Schedule “A”- Signature Certification of demographic information (original signature page required)
- Schedule “A1” - Facility Physical Locations
- Schedule “B” - Revenues
- Schedule “C” - Expenses
- Schedule “C -1” - Supplemental HRI-R Expenses for Residential Treatment Facilities – Medicaid providers only
- Schedule “C-2” - Position/FTEs by Level of Care – Medicaid providers only
- Schedule “D” – Related Party Transactions – Medicaid providers only
Documentation of Child Care Days - All submitted documentation must be totaled. Please attach a calculator tape if log is created manually.
Agency’s financial audit with the required level of specificity delineating allowable foster care costs is required.
- Agencies that participate in KIDS must submit documentation of childcare days from that data collection system for the time period that coincides with the financial audit submitted.
- Emergency Shelters may submit a Shelter Log.
- All other agencies must submit a list of children for the designated FY that verifies the number of childcare days by category of funding and legal custodian.
- The Executive Director must certify that the number of childcare days provided are true and correct and that childcare records at the agency document the number of days listed for the fiscal year specified.
- Audits must show both revenues and expenditures.
- Revenues must be broken out by fund type.
- Expenditures must show a separation between administrative costs and program costs.
- Administrative costs must also delineate between management and fund-raising costs.
- Program costs must be delineated by type (family foster, group/program setting residential foster care, and non-residential functions (day care or day treatment, for example) as well as identify specific allowable foster care costs (care and supervision cost/childcare staff salaries, food, rent, etc.) within each type.
- Supplemental reports and schedules may be required where audit detail is not clear. Providers, whose financial audit does not have separate cost centers detailing mental health treatment expenses and the staff salaries/benefits prorated to coincide time spent providing these services, (Including therapy and counseling) must separate and report, by service, showing the mental health treatment expenses.
- The agency’s Executive Director must attest (on Schedule A) to the breakdown of expenditures from the audit to the Residential Treatment And Foster Care Cost Report.