(A)Each Title IV-E agency, as defined in rule 5101:2-1-01 of the Administrative Code, is to use the statewide "agreement for Title IV-E agencies for the provision of non-placement services," hereinafter referred to as the " non-placement agreement," in the statewide automated child welfare system (SACWIS) when:

(1)Contracting for aftercare support from a qualified residential treatment program (QRTP) is negotiated at a different rate than the medicaid rate for non-medicaid eligible children.

(2)Contracting for aftercare services by a QRTP.

(3)The IV-E agency chooses to use the "non-placement agreement" for any non-placement service contract.

(B)Each Title IV-E agency is to enter all information on the "non-placement agreement," including the "Title IV-E schedule B rate information (schedule B)" into SACWIS.

(C)Each Title IV-E agency is to print the completed "non-placement agreement" and the "schedule B" from SACWIS in order to obtain signatures for the contract between the Title IV-E agency and the provider.

(D)The negotiated and agreed upon rate for the QRTP aftercare support is to be specified for all non-placement services in SACWIS on the "schedule B" and is to be attached to the "agreement for Title IV-E agencies and providers for the provision of child placement." The rates listed on the "schedule B" are to be for all children or may be child specific.

(E)The negotiated and agreed upon rate for the non-placement service is to be specified for all non-placement services in SACWIS on the "schedule B" and is to be attached to the "non-placement agreement." The rates listed on the "schedule B" are to be for all children or may be child specific.

(F)Any changes to the "non-placement agreement," including the "schedule B" are to include an addendum to be entered into SACWIS. The addendum is to be signed by all parties and attached to the "non-placement agreement," or the"agreement for Title IV-E agencies and providers for the provision of placement."

(G)Invoicing procedures are to at a minimum correspond to the agreed upon rates as specified on the "schedule B" in SACWIS and on the "non-placement agreement," including all addendums. All invoices are to include but are not limited to the following:

(1)Provider's name, address, telephone number, fax number, federal tax identification number, Title IV-E provider number, if applicable.

(2)Billing date and the billing period.

(3)Name of child, child's date of birth, and the child's SACWIS person identification number.

(4)Discharge date for the begin date of the six months of aftercare support, if applicable .

(H)Each Title IV-E agency is to establish a written monitoring procedure to provide reasonable assurance that the terms and conditions of the contract are being followed. Monitoring procedures may include, but are not limited to the following:

(1)A review of the progress reports submitted by the provider to the agency to ensure the services being delivered are in accordance with the child's treatment/discharge plan.

(2)) A comparison of invoices to the agreed upon rate amount in SACWIS to ensure billing accuracy.

Effective: 10/28/2021

Five Year Review (FYR) Dates: 10/28/2026

Certification: CERTIFIED ELECTRONICALLY

Date: 10/18/2021

Promulgated Under: 119.03

Statutory Authority: 5101.141, 5153.166

Rule Amplifies: 5101.141, 5153.166