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Library: Policy

340:75-7-53. Difficulty of care payments (DOC) for the eligible child

Revised 9-17-18

(a) DOC payments available for the eligible child in certain types of foster care placements.

(1) DOC rates are available to reimburse the Oklahoma Department of Human Services (DHS), tribal, supported, or coordinated foster care resource parent for additional care and supervision required due to the child's extraordinary physical, mental, or emotional needs.

(2) DOC reimbursement is not available to the child in a specialized community home, specialized foster care and agency companion through Developmental Disabilities Services, community-based residential care, inpatient care, or a therapeutic foster care home.

(3) The resource parent is eligible for pro-rated DOC payments when the child attends an Indian boarding school, Oklahoma Schools for the Deaf or Blind, or a similar residential program and returns to the resource home for weekends or school vacations.

(A) When the child returns to the resource home for school vacations the monthly DOC rate is used.

(B) The days the child spends in the resource home are documented in KIDS and the DOC payment is automatically generated.

(4) The resource parent is eligible for the DOC payment for up to 10-calendar days during each of the child's health or behavioral health hospitalization events when the child is expected to return to the resource home.

(b) DOC rates and descriptions.DOC reimbursements are provided for the eligible child in addition to the foster care maintenance or adoption assistance payment, per DHS Appendix C-20, Child Welfare Services Rates Schedule.

(1) The descriptions in DHS Appendix C-20 are used as guidelines from which DHS makes the most appropriate increase recommendation.

(2) Not every situation clearly fits in one rate category.

(3) The child's age is considered when determining the appropriate rate category.

(4) When approved, DOC payments are:

(A) not retroactive unless an exception was approved; and

(B) available the first day of the month the DOC rate is requested.

(c) DOC request.The resource parent or DHS may initiate the request for DOC payments.

(1) The DOC review process is completed within 10-calendar days after receipt of all information necessary to make a determination.

(2) Each DOC authorization is limited to six months.  • 1


Revised 9-17-18


1.(a) Requesting difficulty of care (DOC) payments for the child in Oklahoma Department of Human Services custody.

(1) When to request a DOC rate payment.The child welfare (CW) specialist for the child requests a DOC payment rate immediately in the child's KIDS case when:

(A) the child's special needs are determined appropriate for a DOC payment utilizing the rate descriptions to justify the payment rate; or

(B) a request is made by a resource parent after a discussion about the rate descriptions to determine the payment rate.

(2) Requesting DOC rate payments in KIDS.To request the DOC rate payment in the child's case, the CW specialist:

(A) selects the Placement screen and placement client;

(B) selects a new or continued request;

(C) enters specific details in the recommendation text box justifying the need and appropriate DOC level.The CW specialist scans medical or psychological reports that describe the child's condition and diagnosis with the request into the child's case KIDS File Cabinet;

(D) clicks on Add to electronically send the request to the designated person; and

(E) receives a KIDS-generated email notification of a status change when the DOC request is approved or denied.

(3) DOC rates I through V.The district director approves or denies the request in KIDS based on the documentation provided within 10-business days from the request date.

(4) Exceptions for retroactive DOC payment.When a DOC request or approval is delayed and the district director determines a retroactive payment is appropriate, the district director requests the exception from the Child Welfare Services Operations and Business Processes Section who has final approval.

(5) The district director reviews the child's placement type and when a child in coordinated foster care (CFC) is approved for any level of DOC on an original approval or continuing approval, the district director granting approval sends an email notification to with the child's name and KK number.TFC program staff provides the CFC contractor with the necessary documentation to file claims for DOC payment.

(b) DOC review.KIDS generates an email notification for the DOC rate payment review date one month before the DOC approval end date.Approval termination occurs when the child's placement status changes to a higher level foster care placement or when the child returns to his or her own home or other non-paid placement.The CW specialist:

(1) requests termination of the DOC rate payment when the determination is made that the child no longer requires DOC payments;

(2) notifies TFC at when requesting early termination of the DOC rate payment for a child in CFC placement;or

(3) determines on the review date the child's special needs status and if the child's special needs:

(A) meet the criteria.Based on the determination, the CW specialist either requests continuation or termination of the DOC payments; or

(B) have changed, requiring a DOC rate change.When a DOC rate change is required, the CW specialist submits a request with detailed information.

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