James City County Revenue Maximization Partner Training Pack

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    JAMES CITY COUNTY DIVISION OF SOCIAL SERVICES

    REVENUE MAXIMIZATION PARTNER TRAINING PACK

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    Introduction

    The Virginia Department of Social Services (VDSS) has long recognized that the current

    structure of the Commonwealths social services delivery system is not able to fully meet the

    expanding and changing needs of its residents. Attempting to respond appropriately to theunique needs of Virginias individuals and communities is made difficult by the overridingrequirements of Federal statutes and regulations.

    The demands of increasing individual and community needs in the face of limited Stateand local funding have challenged us all. With the diversity of the issues, it takes time and

    caution for the proper planning. With the competing demands, meeting one need oftendiminishes the ability to meet another. It is an art to effect a process to accomplish this. All inall, this is hard work. And hard work takes time.

    VDSS interest in securing additional Federal revenues in support of local initiatives is to

    carefully balance a vision of healthy communities with efforts to maximize the delivery processto help meet the unmet needs within each community.

    The concept of revenue maximization is not new. The State office has, in the past fewyears, made concerted efforts to achieve some statewide revenue maximization initiatives that

    have enabled us to realize Statewide initiatives such as the implementation of welfare reform andthe automation of our major programs.

    VDSS is now in a position to help localities that are interested in increasing the ability oftheir human services to better meet the needs of their residents. We have been offered many

    suggestions from many localities. We have studied local efforts to understand what they are

    doing and to identify some common threads that can be sewn across the Commonwealth. Thisprocess has challenged us to open doors that have never been opened and to simultaneously push

    other doors open a little wider than they have been in the past.

    The synergy of the process is what makes it work. Together, the VDSS and localdepartments of social services (LDSSs) in pilot localities have collectively developed a processthat now can be replicated by other interested localities... hopefully without duplicating the pain

    that the pilot jurisdictions have endured.

    The experience of the pilot localities has helped us to assure that we can both reinforcelocal initiatives and fully comply with Federal and State requirements for integrity,

    accountability, and reporting. We have learned a lot from this experience and are pleased to beable to share it with other localities interested in better meeting the needs of Virginians.

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    Vision

    The Federal Revenue Maximization Program will enhance and expand human service initiativesin our community by working with our community partners to identify and provide funding for

    programs to meet current and future unmet needs.

    Local Program Name

    A N C H O R

    (Addressing Needs and Community Health by Optimizing Resources)

    Unmet NeedsUNMET NEEDS = COMMUNITY NEEDS SERVICES AVAILABLE

    Through a collaborative process, the needs of the community and the existing available services

    will be reviewed. The unmet needs will be prioritized and funded as reimbursed funds are madeavailable. All funds which are reimbursed to the James City County Division of Social Servicesthrough the Revenue Maximization program must be used to fund unmet human services needs.

    Partners are an important link between the DSS and community organizations that serve theneeds of our local citizens.

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    Program Goals & Objectives

    Identify unmet human services needs in our community by

    Collaborating with community leaders

    Reviewing the Report Community Assessment of Health andHuman Service Needs in the Greater Williamsburg Area

    Identify local funds that are eligible for reclamation by

    Meeting with Directors and Finance Officers of communityprograms and agencies

    Reviewing budgets and annual reports

    Form partnerships with community agencies to maximize resources by

    Establishing requirements

    Signing contractual agreements

    Allocate reimbursed funds for identified community human services needs by

    Establishing an oversight group

    Providing a process to request funds

    Prioritizing funding to support programs for unmet needs

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    Requirements for Community Partners

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    Requirements for Community Partners

    Partnerships are contractual agreements between an agency, the James City County Division ofSocial Services and the State Department of Social Services. The requirements are set by the

    State and comply with Federal regulations. Funds that are eligible to be claimed and reimbursed

    are Local or State funds used for administrative activities such as case management. The

    funding source may not be Federal grants or private contributions.

    The other requirements for partnership are:

    Must have eligible clients

    Must have case files

    Must be reasonable candidates for foster care or out of home placement

    Must sign a contract

    Must comply with all State & Federal requirements including review and audit of claimedexpenditures

    Must submit quarterly reports for reimbursed claims Must retain case files for three (3) years

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    Description of IV-E Activities

    Allowable IV-E Activities1. Any preparation for or participation in court-related activities regarding the placement

    of a juvenile, court reviews, dispositional hearings, or other judicial determinations2. Case management/removal prevention, including:

    Meeting with child or family regarding the case management process

    Preparing/updating service plans, social histories or family assessments, to includeidentifying the childs or familys strengths and/or weaknesses

    Contacts with parents, family, teachers, etc. related to developing, revising, or

    supervising a childs service plan

    Case/administrative reviews and/or conferences, including FAPT meetings,

    development of goals, written service agreements, and routine supervisoryactivities

    Referral to appropriate medical, psychological, therapeutic, and social services

    required by the child/family as specified in the service plan

    completing social work type activities

    3. Activities related to determining the IV-E eligibility of the child

    4. Any training related to the determination of a childs eligibility for IV-E reimbursements5. Any training related to the acquisition or enhancement of case management skills that

    support the delivery of services to Title IV-E children

    6. Any travel related to the activities listed in 1-5 above7. Recruitment, approval, and training for agency volunteers performing allowable activities8. Rate setting

    9. A proportionate share of related agency overhead

    Non-Allowable IV-E Activities1. Directly providing social services, treatment, and counseling, including:

    psychotherapy done on an individual or group basis

    treatment sessions or provisions of direct social services designed to help thechild/family manage the childs adjustment to school / community or alleviate

    personal or behavioral problems

    counseling sessions with, or direct provision of social services, to biological parents

    to remedy home conditions, such as abuse or inappropriate discipline

    travel associated with above activities

    2. Child protective service investigations

    Common Activities1. General administrative activities and training, to include:

    reviewing agency policy and procedures, conducting performance evaluations or handling grievance issues,

    budget planning, payroll issues, or fiscal management

    meetings or training related to human service issues

    2. Any training related to administrative skills, including word processing, data entry, teambuilding, time management, and travel associated with these activities

    3. Paid sick leave, personal leave, annual leave, or any breaks

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    Case Evaluation

    Problems People

    Problems PeopleAbuse Mother

    Neglect FatherMedical SiblingsMental Child

    Behavior GrandmotherEducation Grandfather

    Criminal Significant OtherEnvironmentSafety

    Indigence

    Title IV-E foster care pre-placement prevention can reimburse for services for the family and thechild/ren.

    When determining eligible candidates, one must evaluate the potential for removal not an

    occurrence of removal.

    The above documentation must be in the case file. Good documentation includes court orders,

    court reports, CASA reports, CAFAS forms, CSB reports, etc.

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    Documentation of Case Review FormContact Program Manager VDSS for form-not available in electronic format

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    Documentation of Case Review

    (Continued)

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    Documentation of Case Review Instructions

    The Case Review Form is a guide for the caseworkers to use when determining whether a casemay be eligible for reimbursement. This is also the form that the case reviewers and the State

    auditors will use when they review a sampling of the cases.

    Eligible: Y____ N_____ NA_____ - Mark the appropriate line at the end of the review

    Date: - Note the date the case review is being completed

    Locality - Name of agency and county

    Case #: - Enter your agencys case #

    Date case opened: - Enter the date the case was opened for any type of services or assessment

    Date case closed: - Enter the date the case was closed

    Is this case a prenatal case? If there were no other children in the family, this case would not

    be eligible, as there must be a child.

    Is child living with parents? Self explanatory

    Verify that one of the following three exists in the Case Plan: Generally your cases will either

    be eligible based on a court proceeding (# 2), or a case plan (# 3).

    Corrective action needed in the case file: If the case reviewer feels the case needs to be

    returned to the caseworker for more documentation, it will be noted here.

    Evidence for Risk Factors for Parents: Designate which risks are present from the parents.Beside each risk, use the code at the bottom of the page to specify which parent this risk appliesto, and enter the letter. Beside the letter, add the # of the line that directly identifies where this

    documentation can be located in the record. For example, if the mother had a heart transplant,put M #1 in the blank. Under #1 at the bottom, specify Service Plan dated 9-19-99". This

    shows the reviewer that the mother has a serious medical problem and where that documentationcan be located.

    Continue to complete the other documentation about potential neglect, potential abuse, and

    evidence of childs risk factors in the same manner as above.

    To be considered reasonable candidates several risk factors should be identified. However ifthere is one strong factor that places the child/ren at risk of entering foster care, such as serious

    medical problems for the child with no health insurance, one factor may be all that is necessary.The more factors that can be identified, the stronger the case for reimbursement.

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    Case Review Guidelines

    An important part of the Revenue Maximization Program is the case review. In order to bereimbursed for the state and local dollars that have been spent on your agency, you must certify

    which cases are reasonable candidates for foster care or other out of home placements.

    Reasonable candidates are those children for whom there is:

    $a defined case plan which clearly indicates that absent effective preventionservices, foster care is the planned arrangement for this child; or

    $an eligibility determination form has been completed to establish the childseligibility under Title IV-E; or

    $evidence of court proceedings in relation to the removal of the child from thehome, in the form of a petition to the court, a court order, or a transcript of thecourts proceedings.

    Most of the cases we serve will either meet the first or last criteria above.

    In order to be determined reasonable candidates, a case review must be completed on a sample ofthe cases for which reimbursement is being claimed. All children entering the program shall be

    assessed to assure that they are reasonable candidates. Costs claimed will be fairly allocated toTitle IV-E equitably on the case count basis. That is, if only 80% of the children serviced each

    quarter under our agreement with the partners qualify as reasonable candidates for Title IV-E,only 80% of those allowable costs will be claimed.

    The Pre-Placement Prevention provision of Title IV-E provides support for family preservationand other community-based prevention services to enable children to continue to live safely intheir home. So in cases where foster care prevention services are in place, they should qualify as

    reasonable candidates, thus reimbursable.

    In order to be allowable IV-E activities, the casework must be administrative in nature. See page6 for allowable/administrative activities. They cannot include activities such as directlyproviding counseling services or investigating child abuse and neglect.

    We will be asking your agency to designate an internal coordinator to oversee the case reviews.

    They will work closely with the JCCDSS Case Review Coordinator. Their responsibilities willbe to:

    $ arrange for the space for the case reviews in their respective agency

    $ assure the Case Reviewers access to the facility and the cases to be reviewed

    $ supervise the pulling of the cases for the scheduled case reviews$ interface with the Case Reviewers$ return the cases to the workers$ receive the completed Case Review Worksheets from the Case Reviewers,

    assign the worksheets for follow-up action by agency staff, ensurethat appropriate action is taken, and report the results of the follow-up

    actions.

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    The Case Reviewers will complete the Documentation of Case Reviews for IV-E Foster CarePrevention and Pre-Placement (see pages 12-13) at the time of the review to confirm eligibility.

    The Case Reviewers can be agency staff, or the Social Services staff, if necessary, will assistwith the case review process. This form documents the risk of potential out-of-home placement

    for the child, including risk factors for the entire family.

    Some major highlights to remember when reviewing cases:

    Cases will be submitted based on their status on the last day of the quarter, or September 30,December 31, March 31, and June 30. (Note: Since we are using the last day of the month to

    consider eligibility of cases, whenever possible, consider the timing of the case closure withconsideration to the revenue maximization program.)

    From this entire list of open cases, your staff will identify which ones are eligible forreimbursements, based on the work they are doing with the children and their families. Youwill request reimbursement for the eligible cases.

    The Case Summary is a form completed by your staff at the end of each quarter. Thisprovides the necessary information to request reimbursement for specified cases and to

    determine an access rate or a % of the total cases that meet eligibility. Case records require documentation that services are being offered, monitored, and managed

    to prevent the child/children from entering foster care. Reports from other disciplines arehelpful, as well as court reports, referral letters, social histories, service plans, and quarterly

    documentation regarding the progress of the case. We consider the entire case file asdocumentation, which includes services to the parents as well as the children. Case recordsneed to clearly identify the problems in the family and the goals identified to alleviate those

    problems. A case that is open but not eligible for reimbursement only hurts the percentage,thus lowering our reimbursement rate.

    All revenue maximization cases must be available for audit purposes for three yearsfrom the last quarter that reimbursement was issued. It is important to implement a

    record retention system within your organization to meet this requirement.

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    Case Summary Form

    Find form by clicking on the forms link on the Partners Page

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    Case Summary Instructions

    Agency/ Worker- Write the name of the agency and the staff person who owns the records andis completing the form

    Date of Submission - Enter the date that the submission is being completed, usually the last dayof the quarter

    Case Name - Please enter the case name, whether it is the child or the family

    Case # or SSN - For record keeping, we must have either the agency case number or the Social

    Security number for the case name

    Childrens Names - Enter all of the children in the family whom you are serving

    Date on going case opened - Enter the date the case was opened in your agency

    Date on going case closed - Enter the date the case was closed in your agency

    Quarterly Count - For each quarter; enter the status of the case on the last day of the quarter, orMarch 31, June 30, Sept. 30, Dec. 31. If the case were closed on March 28th , a C would be

    entered in the third quarter. If the record has the necessary documentation to qualify as areasonable candidate, and it was still open, an E would be entered. If the case was open butdid not have the needed documentation to support eligibility, an X would be entered.

    # Of Eligible Children - Total the number of children who were eligible

    Submit this completed form to your agencys Revenue Maximization Coordinator for submission

    for reimbursement.

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    Confidentiality Agreement

    I, __________________________________________, as a case reviewer with thefederal revenue maximization project, agree to preserve the confidentiality of all family and childinformation that is received as the result of this case review.

    Signature________________________________________________

    Date_______________________________

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    Revenue Determination & Reimbursements

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    Documentation of Time

    Your agency has several options to document your staffs time spent on the eligible cases.

    Depending on the funding of the staff and their types of cases, documentation of their time can

    be accomplished by one of the following ways:

    Certifying that 100% of their time is spent on eligible case (see page 19)-Staff can sign a

    statement certifying that all of their cases are eligible for Title IV-E reimbursement, as theyare all at risk of entering foster care if pre-placement prevention services are not provided.This method makes documenting time very easy and the position would be 100%

    reimbursable, however, staff must be offering administrative activities to all of their cases.

    Completing time sheets-If staff carry a variety of cases, it may be necessary to complete amonthly time sheet. Specify the amount of time (in half-hour increments) devoted to each

    activity code for every day you worked within the month. Report any activity occurringmore than 15 minutes. For example, if you conducted IV-E activities from 9:00-10:50, thenyou would record 2 hours of IV-E activities for that day. If you conducted IV-E activities

    from 9:00-10:35, then you would record 1.5 hours for that day. Your total number of hoursfor the month should be equivalent to at least 8 hours per weekday for the month. Do not

    record any time on days that you were not scheduled to work. With the completion of thetime sheets, staff are indicating how many hours each day they spend on case management orallowable IV-E activities (see page 6). Once a calculation is completed, it will show what

    % of your time is spent on eligible cases, thus what percent of your time can be claimed forreimbursement.

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    Time Sheet Form

    Find form by clicking on the forms link on the Partners Page

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    Certification Statement for Dedicated Positions

    I certify that in the month of , all of my activities have been 100% dedicated to

    pre-placement and prevention of foster care functions.

    Signature

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    Revenue Determination

    The dollar amount of reimbursed revenue will vary by agency. The total amount to be claimed

    must meet the eligibility requirements discussed in the section on Claims for Reimbursement.

    The computation of the reimbursed amount is based on the source and amount of local/statefunds expended, the access rate determined by the State Department of Socia l Services and theFederal Financial Participation (FFP) rate set by the Federal government. The effective rate is thefinal percentage of reimbursement.

    Sources of Revenue

    Revenue streams for agencies may include generated revenue, private donations, state/federal

    grants or local government contributions. Eligible revenues for Revenue Maximization are localand state funds. The other revenue streams are not allowed at this time.There is no ceiling on theamount of funding spent.

    Access Rate

    This is a percentage factor used to determine the rate of reimbursement. It is computed bydividing the total number of agency cases (or children) by the total number of eligible cases (or

    children). For example, if an agency had 100 cases and if 75 of those cases served were eligiblefor Title IV-E pre-placement prevention, the agency access rate would be 75%. The State

    Department of Social Services sets the access rate through an on-sight random case file review.If an agency client base has a significant change (increase or decrease), it is up to the agency tonotify the local Social Services Agency.

    FFP (Federal Financial Participation Rate)

    This amount is currently set at 50%. This means that the Federal government will reimburse fiftycents for each dollar claimed. For example, an agency spends $80,000 for allowable activities

    and requests reimbursement for the full amount. The Federal government would allow 50% to bereimbursed for a total of $40,000.

    Effective Rate

    This is the percentage of reimbursed funds after all factors are considered. Fox example, the

    Total amount claimed $50,000Times the FFP Rate 50%Times the Access Rate 75%Amount reimbursed $18,750

    Effective Rate 37.5% ($18,750/$50,000)

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    Claims for Reimbursement

    Claims for reimbursement are to be submitted quarterly to James City County Social ServicesRevenue Maximization Coordinator. The quarters end 9/30, 12/31, 3/31 and 6/30. In order to

    request reimbursement, the funds must be expended. Budgeted but not spent funds are NOT

    eligible. All claims must represent actual costs and be based upon a cash basis accountingprocess (estimates and accruals are not allowed). Claims must be tied to case files of all personsreceiving the services for which expenditures are being claimed. Documents supporting theexpenditure must be available for verification and audit. Types of eligible expenditures are

    compensation of employees, material and equipment, travel, and allocated overhead. All claimsmust be necessary for administration of a prevention program.

    In preparing quarterly claims, the agency should complete the following steps:

    1. Prepare an invoice summarizing the total claimed (Appendix page 23). The agency directormust sign this.

    2. Attach supporting documentation, including financial reports or spreadsheets and invoicecopies.

    3 A summary listing of case files by name and number are required. This list will be used to

    select random samples for auditing purposes.

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    Appendix

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    Sample Reimbursement Memorandum

    Date

    MEMORANDUM

    TO: Pat Lewis, Revenue Maximization CoordinatorJames City County Division of Social Services

    FROM: Your Agencys Name

    RE: Title IV-E Pre-placement Prevention Claims for Reimbursement

    Please find the attached claim in the amount of $XX,XXX for the DATE OF THE QUARTER.

    To the best of my knowledge and belief:

    1. All costs included in this claim are allowable under the requirements of OMB Circular A-87,Cost Principles for State and Local Governments, Title IV-E of the Social Security

    Act and relevant regulations and other applicable State and Federal policy. Unallowablecosts have been adjusted for in allocating costs as indicated in the claim. Remaining

    costs have not been previously claimed for Federal reimbursement

    2. All costs included in this claim are properly allocable to Title IV-E on the basis of a

    beneficial or causal relationship between the expenses incurred and benefiting program.All costs have been accounted for consistently.

    3. All costs included in this claim are treated as identified in the approved plan for thisproject.

    4. All costs included in this claim are initial submissions of public expenditures and havenot been previously submitted to VDSS for reimbursement.

    I declare that the foregoing is true and correct.

    Agency Coordinator/Director

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    Sample Partnership Contract

    MEMORANDUM OF AGREEMENT BETWEEN THE JAMES CITY COUNTY DIVISION OF SOCIAL

    SERVICES AND

    YOUR AGENCY

    This agreement is entered into by the James City County Department of Social Services, hereinafter referred to as

    "LDSS," and, Your Agency, hereinafter referred to as "the Partner."

    I. Purpose

    The purpose of this agreement is to assure that the Partner provides administrative services in support of thepre-placement preventive services provided consistent with Title IV-E of the Social Security Act.

    This agreement will be subject to all relevant and applicable State and Federal regulations. In accordancewith the requirements of the Virginia Department of Social Services (VDSS), LDSS will retain ultimate

    responsibility for the administration of services provided by the Partner as a part of this agreement.

    II. Definitions

    The definitions of "administration" under Title IV-E of the Social Security Act includes the followingactivities:

    referral to services,

    preparation for and participation in judicial proceedings,

    development of the case plan,

    case reviews,

    case management and supervision,

    recruitment and licensing of foster homes and institutions,

    rate setting,

    a proportionate share of related agency overhead, or

    activities closely related to those listed above.

    It is agreed by both LDSS and the Partner that the scope of services described in Attachment A is fullywithin this definition of "administration" under Title IV-E. The rate of Federal Financial Participation

    (FFP) associated with Title IV-E administrative costs is 50 percent. That is, the Federal government willreimburse the County of James City for half of its total eligible expenditures, not to exceed the total amountshown in Attachment B. The proceeds in this initiative will be used to expand or enhance human service

    initiatives.

    In order to receive 50 percent FFP, however, the Partner will be required to report the total actual costs

    incurred under this agreement to LDSS as a "certified public expenditure." The Partner will be required tocertify that the non-Federal funds used to support these expenditures will be public funds that are not beingused as match for any other Federal Program.

    The County and VDSS have entered into an agreement that authorizes the LDSS to, in turn, certify thesepublic expenditures to VDSS. VDSS, in turn, will include these public expenditures in the claim for

    reimbursement for the U. S. Department of Health and Human Services.

    FFP may be claimed at the rate of 50 percent for all administrative costs associated withPre-placement prevention for every child provided the case plan for the child stipulates that, absent theprovision of pre-placement prevention services, the child would be a "reasonable candidate" for removal

    from his or her home.

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    "Reasonable candidates" are those children for whom there is:

    a defined case plan which clearly indicates that, absent effective prevention services, foster case is theplanned arrangement for the child;

    an eligibility determination form which has been completed to establish the child's eligibility underTitle IV-E; or

    evidence of court proceedings in relation to the removal of the child from the home, in the form of apetition to the court, a court order, or a transcript of the court 's proceedings.

    The Partner understands that LDSS can only claim FFP for administrative costs incurred with respect to"reasonable candidates."

    III. Responsibilities of the Parties

    A. The Partner will be responsible for providing administrative support to Title IV-E pre-placementpreventive services as described in Attachment A and submitting to LDSS, no less frequently thanquarterly, a report documenting:

    1. administrative services provided by the Partner in support of pre-placement preventive servicesprovided to "reasonable candidates" as defined under Title IV-E, where possible identifying

    specific services programs, number of persons served, and outcomes achieved during the pastreporting period;

    2. actual costs incurred compared to the approved budget appearing as Attachment B;

    3. significant changes (if any) in the volume, scope or nature of administrative services to be

    provided by the Partner in support of pre-placement preventive services to "reasonable candidates"during the coming period; and

    4. issues affecting LDSS programs that require resolution.

    B. LDSS will be responsible for monitoring the provision of administrative support services by thePartner to LDSS customers and, no less frequently than quarterly:

    1. reviewing the report submitted by the Partner, resolving issues raised;

    2. working with the Partner, other community agencies, and VDSS to assure that the persons servedfor whom the Partner is providing administrative support services are "reasonable candidates";

    3. reporting to the VDSS on the administrative support services provided by the Partner to"reasonable candidates" and the total public expenditures that the Partner has certified to theLDSS; and

    4. reinvesting the proceeds in this initiative to expand existing or develop new human serviceprograms.

    C. Partner agrees to retain all books, records, and other documents relating to this Agreement or any claimsubmitted hereunder until the later of:

    a. five (5) years after the date of the final report for the applicable period;b. a resolution of audit findings; orc. disposition of non-expendable property.

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    D. Partner agrees that VDSS, LDSS, or either of their agent(s) shall, during the term of this Agreementand for five (5) years after the date of the final report for the applicable period, be allowed reasonable

    access to examine any documents and financial records pertaining to the reimbursed RevenueMaximization claim or any other payments made pursuant to this Agreement.

    E. In the event that the Partner has received funds from the allocation of reimbursed fund pool and adisallowance of the Partner claim results in a loss of funds under this Agreement, the LDSS will deductan amount equal to the disallowed claim from future payment(s) to the Partner, upon the final

    determination of any appeal.

    IV. Terms of the Agreement

    A. This agreement shall cover all properly documented services provided by the Partner since July 1,2000, that are subsequently submitted to the LDSS for allowable federal reimbursement within the

    terms of this agreement. This agreement shall remain in effect until June 30, 2001, or until either partynotifies the other party of its intent to terminate the agreement, whichever is sooner.

    B. Termination shall take effect no sooner than 60 days after written notification by one party to the other,unless an alternative date is agreed upon. Such notification will be mailed first class, postage prepaid,to the following addresses listed below:

    LDSS: Partner:Your Agency Name

    Director/AdministratorYour Address

    If the Agreement is so terminated, then each party shall within sixty (60) working days of thetermination date reimburse the other party for any monies owed.

    C. This agreement may be renewed by LDSS upon written agreement of both parties for 5 (five) one yearperiods, under the terms of the current agreement, and at a reasonable time (approximately 60 days)prior to the expiration.

    D. The LDSS reserves the right to cancel and terminate this agreement, in part or in whole, withoutpenalty, upon 60 days written notice to the Partner. Any cancellation notice shall not relieve the

    contractor of the obligation to deliver and/or perform on all outstanding deliverables prior to theeffective date of cancellation.

    APPROVED BY LDSS: APPROVED BY THE PARTNER:

    _______________________________ ________________________________Director's Signature Director's Signature

    _______________________________ ________________________________

    Director's Name Director's Name(Printed or typed) (Printed or typed)

    _______________________________ ________________________________Date Date

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    Contact Information

    Pat Lewis, Revenue Maximization Coordinator

    James City County Social Services5249 Olde Towne RoadWilliamsburg, Virginia 23188(757) 259-3162 email: [email protected]

    Patty Sharp, Case Review CoordinatorJames City County Social Services5249 Olde Towne RoadWilliamsburg, Virginia 23188(757) 259-3104 email: [email protected]

    Rosemary Randall, Budget Management SpecialistJames City County Social Services5249 Olde Towne RoadWilliamsburg, Virginia 23188(757) 259-3129 email: [email protected]

    Diana Hutchens, DirectorJames City County Social Services

    5249 Olde Towne RoadWilliamsburg, Virginia 23188(757) 259-3124 email: [email protected]

    Richard Wethington, State Revenue Maximization CoordinatorDepartment of Social ServicesTheatre Row Building730 E. Broad StreetRichmond, Virginia 23219-1849(804) 692-1313 email: [email protected]

  • 7/31/2019 James City County Revenue Maximization Partner Training Pack

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    Contents

    Page

    Introduction 1Vision, Local Program Name, Unmet Needs Formula 2

    Program Goals & Objectives 3Requirements for Community Partners 4Description of IV-E Activities 6Case Evaluation 7Documentation of Case Review Form 8Documentation of Case Review Instructions 10Case Review Guidelines 11Case Summary Form 13Case Summary Instructions 14

    Confidentiality Agreement 15Revenue Determination & Reimbursements 16Documentation of Time 17Time Sheet Form 18Certification of Dedicated Position 19Revenue Determination 20Claims for Reimbursement 21Appendix 22Sample Reimbursement Memorandum 23Sample Partnership Contract 24Contact Information 27