Request for Authorization
Procedure From Policy 700.0020: Support Services
A. If the required service is court ordered, unaffordable, or cannot be acquired unless it is purchased by the Department, or if the service will be funded through Medical Assistance (MA), the worker can request authorization for payment for this service through the DCYF #005 process. The DCYF #005 contains a listing of services that must be authorized through this process.
B. The worker completes the DCYF #005 on-line and submits to his/her Supervisor for approval. The DCYF #005 is completed in accordance with Instructions for Completion located in On-line Help:
1. A separate DCYF #005 must be completed for each service being requested;
2. A separate DCYF #005 must be completed for each child who is to receive a separate service; and
3. If a service is being requested for a family at one (1) fee, regardless of the number of family members involved, only one (1) DCYF #005 needs to be completed. The child most closely associated with the need for this service must be identified.
C. The approval route of the DCYF #005 depends on the service type.
D. The appropriate designee gives final approval.
E. The Business Office prints an official copy of the DCYF #005 for the vendor. When the DCYF #005 is used for Emergency Shelter Equivalency Placement for Adolescents, copies of the form are distributed in the following manner: Business Office - white; Shelter Placement Unit - yellow; Primary Service Worker - green.
F. The Business Office processes the DCYF #005 (in situations involving Day Care, the Business Office electronically forwards a copy of the DCYF #005 to DHS.
G. The Vendor submits the original or a copy of the invoice, which is printed on the back of the vendor copy of the DCYF #005, to the Business Office in accordance with the following procedures (in situations involving Day Care, the vendor submits the DCYF #005 directly to DHS for payment):
1. The vendor ensures that the DCYF #005 number is included on the invoice;
2. There must be a separate invoice for each DCYF #005;
3. The requested rate on the invoice must correspond to the authorized rate on the DCYF #005; and
4. Payment will be made only for services authorized on the DCYF #005 and provided within the approved timeframes.
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