Download Department Memorandum dated 5/13/06: Orthodontic Special Funds

Department of Family and
Children’s Services
Office of the Deputy Director
Memorandum
To:
All DFCS Staff
From:
Ken Borelli, Deputy Director
Department of Family and Children Services
Date:
May 13, 2006
Subject:
Orthodontic Special Funds Requests
In order to evaluate and approve orthodontic special needs please review the following
guidelines. There are 2 issues, which need to be resolved in processing Orthodontic
Funding Requests. They are:
Issue #1) Fiscal Regulations prohibiting pre-payment for services.
Issue #2) Eligibility requirements prohibiting payment for services once a child is emancipated
or the case is closed.
I) Resolving Issue #1
Social Workers need to work with orthodontists to obtain agreement for the orthodontist to
receive payment in one of two ways:
Payment option #1) Orthodontist will bill for services as services are rendered. This
means that there are several up-front payments for molds and installation of the braces,
then monthly payments for follow-up services. This is preferred over the next option.
Payment option #2) Orthodontist will be paid for services at the time of service. This
means that the SW will need to request checks for specific amounts, depending upon
the service being provided, and the child will need to walk into the appointment with the
check in hand.
II) Resolving Issue #2
Early identification of the dental need is critical to a satisfactory resolution of the need. The
sooner the worker can develop an orthodontic plan, the better able to cover the payment for
services. This should also be reviewed at the ILP and or emancipation planning level and
relevant staffing.
Depending upon how long the child will be a dependent, the planning to ameliorate this issue
will change:
Scenario #1) the child will probably be in care long enough to cover all treatment.
Possible Solutions: No contingency planning will be needed.
Scenario #2) the child will probably emancipate before treatment is completed.
Possible Solutions: Work with ILP (EYS) and other community funding sources to cover
the monthly treatment fee (which ranges from $50-$350 per month) once the child is
emancipated.
In addition it will be important to assess if a parent, or guardian will have enough money
to pay the monthly treatment fee once the case is closed, including work insurance
coverage.
Determine too, if there are any community resources that would help pay for treatment.
In any case scenario, a post closure treatment plan is necessary because if there is no
way to get post-case closure treatment paid for, what happens to the service follow
through? What is the treatment plan and payment plan for follow up? These questions
need to be addressed in writing for management to review before approval can be
finalized.
If you have submitted an orthodontic request in the past it and it is still pending, it will be
returned to you to complete the above procedures. Please attach a memo addressing the
relevant issues of payment for services, and follow up dental care.
Contact: Mary Beth Rogers 975-5680 or Alana Rainville 975-5791.