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Library: Policy

340:75-19-28. Difficulty of care payments for the child in tribal custody

Revised 9-15-22

(a) Difficulty of care (DOC) payments are available to reimburse tribal foster parents for the care of the child in tribal custody.

(b) The Indian child welfare (ICW) worker submits a written request for DOC to tribal IV-E program staff when the ICW worker determines the child meets DOC criteria.  Tribal IV-E program staff approves or denies the written request within 10-calendar days from the date the request is received.   1

(c) The written request details the child's special needs, including statements from medical or psychological reports that describe the child's condition and diagnosis, utilizing the rate descriptions per Oklahoma Human Services (OKDHS) Appendix C-20, Child Welfare Services Rates Schedule, as amended from time to time.

(1) The effective date of DOC approval is the first day of the month in which Child Welfare Services receives the request.

(2) No retroactive payments are made prior to the date of the request.

(d) The ICW worker:

(1) reviews the child's DOC rate increase every six months;

(2) one month prior to the end date of DOC approval, submits notification to tribal IV-E program staff for continuation of DOC or that DOC is no longer needed;

(3) notifies tribal IV-E program staff when the Indian child's placement changes to a placement other than tribal foster care or the child returns to his or her own home; and

(4) when the child's special needs change, requiring a DOC rate change, prepares a detailed request and submits the request to tribal IV-E program staff.  tribal IV-E program staff terminates the original request.

Revised 9-15-22

1. Oklahoma Human Services tribal IV-E program staff:

(1) reviews the initial difficulty of care (DOC) request;

(2) enters the information in KIDS Difficulty of Care screen;

(3) approves or denies the request on KIDS;

(4) sends written notification of the decision to the Indian child welfare (ICW) worker and tribal IV-E program staff;

(5) reviews any updated DOC request or rate change and provides written notification of continued approval or denial of the request to the ICW worker and tribal IV-E program staff; and

(6) terminates, when applicable, the DOC approval in KIDS Difficulty of Care screen.

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