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Payment Determination
The Wraparound payment is prorated for the first and last month of treatment when the first and last day is not the first day or the last day of the month:
- Wraparound payments start the first day of service, and
- End the day before the last day of service.
Runaways or Gap In Services
When a youth receiving Wraparound Services is a runaway the SW/PO will make a determination to continue benefits if it is two days or less to avoid an interruption in funding. When the child is absent for 3 consecutive days or more during a calendar month, the SW/PO must have SWS and SSPM approval to continue payment to for up to 14 calendar days.
To resume Wraparound Services after a runaway episode of 14 days or more, the SW/PO must submit a SCZ63A for approval. As long as it is less than six months, the SW/PO can submit a modified RISC referral (or an updated AAP 2), by attaching the previous RISC referral to approve a new Wraparound episode. A modified RISC referral are the same as a new RISC referral; a new ISP must be completed by the provider which will note a new start date for a new Wraparound episode.
Note: Modified RISC referrals are for DFCS to determine a new Wraparound episode.
The modified RISC referral must include the beginning date of the new episode. The modified RISC may include a new or the same provider as the previous episode.
When an AAP youth is on the run and receiving Wraparound, the updated AAP 2 is not considered a new Wraparound episode. A new Wraparound episode is only considered when the current Wraparound period (18 months) has expired. The youth must return to the adoptive home before a new episode is considered.
Wraparound Youth Returns Home During The Wraparound Period
Once a FC child/youth is determined to be eligible for Wraparound Services he/she remains eligible for the time period specified in his or her ISP. AAP youth are approved for 18 months for each episode.
When the child/youth returns home and the ISP has ended a new Wraparound period can be requested. A new referral is sent to the RISC for approval. When approved, this a new Wraparound episode.
When the family is eligible for CalWORKs, CalFresh and Medi-Cal, the youth must be added back to all programs. When the youth is added back to the family’s Medi-Cal case, FCE must discontinue the Medi-Cal Program portion of their Wraparound case. When there is no underlying Medi-Cal for youth returning home, FCE will maintain the established Medi-Cal. Refer to Payment Rules.
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