Caregiver Policies and Procedures

Fiscal/Finance Reimbursement Policies


Room and Board

Our agency pays support for all kinship children. The starting rate of board is $21.00 per day for each child in care, based on the rate established by the Department of Human Services.


Each kinship caregiver agrees to accept financial support for the kinship child only from ASCI, and only for the days when the child was actually in the kinship home. In case of an error in the board check, you are to contact your caseworker at once, or in the caseworker’s absence, their supervisor. Since the name of each kinship child and the number of days in your care for each child is noted on the check stub, you can quickly determine if an error has been made. It is your responsibility to report promptly to your caseworker or caseworker’s supervisor any error in the board check.

If an overpayment does occur, you must repay the agency. Also, you should remember that you are not entitled to receive support for a kinship child from sources other than our agency. If you receive support for a kinship child from another source (e.g., welfare or Social Security) for a period during which ASCI paid board for the child, this also constitutes an overpayment, and you will be expected to repay the agency.


ASCI values the relationships our kinship caregivers have with the children in their care. ASCI believes you have the primary responsibility to provide for all the transportation needs of the child(ren) in your care. ASCI will provide support with coordinating and developing a plan for the transportation needs of the child(ren) in your care. More specifically, you agree that you will arrange for, participate in and provide transportation to the following:

  • Ongoing routine and emergency medical, therapeutic and dental checkups.
  • School and educational programs.
  • Social programs.
  • Sibling visitations.
  • Birth parent visitations.
  • Court.
  • Other special programs the child(ren) needs.

Should you ever use a taxicab?

If no other transportation resource is available and an emergency exists, a cab may be used. Because of the expense involved, a cab should be used only in the case of an extremeemergency. A receipt is necessary for cab fare reimbursement; therefore, only recognized and licensed cab companies may be used.

Income Tax

Kinship children are not considered your dependents. Board reimbursements are not considered income. No expenses may be deducted for a kinship child. The IRS says expenses for which you are not reimbursed may sometimes be deducted for a kinship child. Consult with a tax expert regarding this.

Social Media

Photos of children in care are not permitted to be released on social media as it is critical that their identities be kept confidential due to their involvement in the child welfare system. Furthermore, based on “reasonable and prudent parenting” standards, biological parents have the right to determine if their child’s image will be released in the media or via social media. If a child achieves permanency with you, you are permitted to post social media images as you deem appropriate.

We truly understand that sharing family photos via social media platforms is a common practice, however, due to the vulnerable nature of children involved in the child welfare system, the necessity of ensuring confidentiality and upholding the rights of their biological parents during this process is critical.

Managed Care and Medical/Vision/Dental Care Policies

If the child placed with you has known medical needs, the social worker will inform you of these at the time of placement. You will be given information pertaining to immunizations, feeding schedule, toilet habits of infants and toddlers, etc. You are expected to keep an up-to-date record of your kinship child’s medical and dental appointments, as well as any illness and accidents requiring a doctor’s attention.

There are, of course, problems that may develop after placement, and these should be discussed with the ASCI caseworker. For children who are covered by Medical Assistance, you may use only those Medical Assistance-enrolled health care providers who accept Medical Assistance. Our agency will be unable to pay for, or reimburse to you, services secured from other doctors, dentists, therapists, pharmacists, etc. Your caseworker should discuss this with you at the initial home visit.

During the completion of the enrollment form, you will be asked to provide a primary care physician’s (PCP) name and address, as well as a health maintenance organization (HMO). The three HMO plans available to our clients are Gateway, Unison (formerly known as United Health Care) and UPMC. If you are not sure what PCO choices are available, contact your ASCI caseworker who will then contact the ASCI managed care liaison (MCL) for assistance. The forms are then submitted to the MCL, who faxes them to ACCYF’s managed care department to activate insurance coverage.

Usually, a provider notification letter is forwarded within a week to the MCL with the following information: the child’s MA number (also called the recipient number), health plan choice, date that the insurance becomes effective, insurance member number and the name/address of the PCP who was selected. At your request, a copy of the letter may be forwarded to you.

To avoid being billed for doctors’ visits, no appointments should be made until you or your ASCI caseworker has contacted the MCL to verify enrollment has been confirmed. If there is an emergency, please make sure the child receives medical care. The medical bill should be forwarded to your CYF caseworker immediately for payment.

Caregivers must use the physician’s practice or clinic specified on the child’s insurance card; however, the child can be seen by other doctors within that particular practice. A Second Chance, Inc., will be unable to pay for, or reimburse to you, services secured from other doctors, dentists, therapists, pharmacists, etc.

It should be noted, you cannot contact the HMO on your own to make changes; however, changes can be submitted to your ASCI caseworker. Changes or corrections are not effective immediately. Another provider notification letter will be generated from ACCYF’s managed care department through appropriate requests.

It should also be emphasized that you may incur out-of-pocket expenses when permission is not obtained from the child’s PCP before the child is seen in the emergency room for “non-life-threatening” illnesses. In those cases when the PCP is not available, the caregiver should call the health plan member services number.

Examples of life-threatening situations where the child should be taken directly to a hospital are difficulty breathing, loss of limb, loss of speech, overdose, heavy bleeding, car accident, broken bones, chest pain or blackouts. The kinship caregiver should not wait, but get medical attention as soon as possible in these circumstances!

It is also required that all kinship children participate in the Early Periodic Screening and Diagnosis Treatment (EPSDT) program. This program encompasses the administration of specific health screening and testing for detection of such health risks as lead poisoning, anemia, hearing/vision loss and developmental delays at the appropriate ages. You should keep in mind when choosing a PCP to choose one who is familiar with EPSDT. Upon receiving an EPSDT exam, the parents should obtain appropriate documentation and submit it to the ASCI caseworker. 

For children who are covered by Medical Assistance, you may use only Medical Assistance-enrolled health care providers who accept it. Our agency will be unable to pay for, or reimburse to you, services secured from other doctors, dentists, therapists, pharmacists, etc.

The MCL is available to assist with any questions you might have in regard to the managed-care process. 

Payment for Medical Services

Each kinship child will be issued a Medical Assistance card, and you must present this card to the hospital or doctor at the time the child is taken for treatment. This card covers the payment for medical services provided to the kinship child. If a child has not yet been provided with a Medical Assistance card, the health care service needs prior approval from the Department of Human Services caseworker, and the clinic or physician should bill Department of Human Services directly. ASCI cannot reimburse kinship caregivers for paid medical bills.


1. Who is responsible for making sure the child receives medical, vision and dental attention when needed?

Since you are the person who is administering the child’s daily needs, this is primarily your responsibility. If there is no car at your disposal, it is expected that you would use public transportation, or ask extended family members or friends to help you, just as you would with your own child. If there are serious reasons why you cannot handle this duty, please discuss this with your ASCI caseworker.

2. What do I do in case of an emergency need for medical treatment?

See that the child gets immediate medical attention at the nearest hospital and contact your ASCI caseworker as soon as possible. If an emergency occurs after working hours, or on weekends or holidays, please call our main phone number (412-342-0600) to be transferred to our answering service. The answering service will contact the on-call supervisor. The supervisor can contact your ASCI caseworker, if necessary. Our agency must be notified immediately of a serious illness, injury or death of a kinship child.

3. What do I do in the case of planned hospitalization?

If the hospitalization is not an emergency, notify your ASCI caseworker well in advance so they can provide the necessary Medical-Surgical Consent signatures from the child’s birth parents. You cannot legally authorize hospital admissions or surgery for your kinship child unless you have been given medical rights via court order.

4. Am I responsible for prescriptions?

You are responsible for having the prescriptions filled as needed. The Medical Assistance card does cover payment for prescriptions. If your kinship child has an Access card, please present the card to the pharmacist when you obtain a prescription.

5. What is the procedure for eye examinations and glasses?

Since Medical Assistance will pay for eye glasses in conjunction with an EPSDT referral or a school medical referral, it is necessary to secure the EPSDT screening or the school medical referral prior to the vision examination. Vision examinations are to be done by Medical Assistance-enrolled ophthalmologists; a prescription for eyeglasses should be written if glasses are necessary. The prescription, the child’s Medical Assistance card and either the school medical or EPSDT referral are to be taken to a Medical Assistance-enrolled optician or optometrist, who will prepare the glasses; Medical Assistance should be billed for these services.

Additional Policies and Procedures


For a preschool-aged kinship child, find out whether the child has been immunized, and ask the CYF caseworker about verification of the child’s birth date. This information is required for registration in school. As a kinship caregiver, you are responsible for ensuring that the child goes to school regularly and on time. Your ASCI caseworker will want to be kept informed as to the child’s progress in school. You should enlist the aid of the CYF and ASCI caseworkers, particularly if there are problems surrounding performance, attendance or behavior.

School Enrollments and Placements

As of 2015, the Every Student Succeeds Act (ESSA) is in place to make sure students in placement have the right to remain in their home schools, provided that it is in their best interest. All students coming into care at ASCI must be referred to the Allegheny County School Stability Specialist and team by the agency’s education liaison. Caregivers and students are to enroll in school once the “best interest” decision has been made. All referrals should be initiated via ASCI’s Intake department or Navigator program. Should your student have an Individual Educational Plan (IEP) or received any type of instructional or therapeutic services, please present this information and documents to your caseworker immediately. 

School Handbooks, Codes of Conduct and Expected Behavior at School

At the beginning or at a student’s first day of attendance at school, caregivers and family should become familiar with the school and the school district’s rules for acceptable behavior by reading the district’s Codes of Conduct. This publication is often given to students to take home or can be found on the school district’s website. Many school districts have created and written restorative practices, which change their approach to student discipline. However, Codes of Conduct do not just detail discipline but a district’s acceptable use policies for equipment and facilities, as well. The areas listed below are often described in a school district’s Codes of Conduct or handbook:

  • Connecting with School based parent organizations,
  • Exploring the school district’s “Restorative Justice” plan if one is in place,
  • Refer to School based rules and regulations for classroom and building,
  • Identify and list school district policies regarding infractions and their sanctions,
  • Explains School Building rules and list examples of good behavior,
  • Identifies specific sanctions and those offenses that warrant out of school suspension,
  • Defines in-school suspension and how class exclusion results,
  • Interprets school district disciplinary documentation,
  • Lists procedures for dealing with student misconduct,
  • Articulates Shared Responsibilities and Student Rights in school,
  • Explains how students and their caregivers and families comply with school meetings and hearings; both informal or formal.  Some hearings may deal with appropriate educational student placements for instruction.

Work Permits in the State of Pennsylvania for Students Seeking Employment

Pennsylvania has very clearly defined labor laws regarding minors (children) working and also stipulates how many hours in one day they may work. Students in Pennsylvania may apply for a work permit by going to their school district administrative office. 

Students living in the City of Pittsburgh need not attend Pittsburgh Public Schools to apply for one at the Oakland Administration Building: 341 S. Bellfield Pittsburgh, PA 15213. 

Students living in Philadelphia may apply at the School District of Philadelphia Education Center: 440 North Broad Street Philadelphia, PA 19130. 

All students will have to present documents for proof of age: driver’s license, identification card, birth certificate, passport, baptismal record or school ID, providing it shows date of birth.

Notification to A Second Chance, Inc., of changes within the placement

This includes notification of the following in the indicated timeframes:

  • Runaway
    • A child on the run must be reported immediately when the kinship caregiver becomes aware. This will require action by A Second Chance, Inc., therefore, if this occurs between 9:00 a.m. and 4:30 p.m., Monday-Friday, contact your ASCI caseworker immediately. If the ASCI caseworker is unavailable, speak with the receptionist who will direct your call to the appropriate supervisor. If a child runs away after business hours, A Second Chance, Inc.’s 24-hour answering service can be accessed by calling 412-342-0600 and pressing zero (0) once the voicemail message begins to play.
  • Change in address, etc.
    • Any change in address, health, marital status (i.e., marriage, separation or divorce), etc., must be reported within 48 hours of the change for review by A Second Chance, Inc. 
  • Change in household members
    • Any changes to the family and household composition must be reported immediately for review by A Second Chance, Inc.
  • Crimes/arrest
    • Any criminal acts committed by any member of the household, including the kinship caregiver and anyone over the age of 14, must be reported immediately for review by A Second Chance,  Inc.
  • Medical emergencies
    • All medical emergencies involving the kinship caregiver’s family must be reported immediately for review by A Second Chance, Inc. 

Please be aware that any kinship caregiver who knowingly fails to immediately report any of the above, will be at risk of being disqualified as a caregiver. This disqualification shall result in the recommendation from ASCIto CYF that the child immediately be removed from the home.


For vacations or trips outside Allegheny County that include your kinship child, it is necessary to follow certain steps. First, discuss your plans well in advance with the CYF caseworker, who must secure permission for the child to go on the trip from the natural parents, ACCYF social worker and child advocate attorney. (If the judge grants permission to travel, you do not have to get the aforementioned permission to travel with the kinship child.)

If you are traveling within Pennsylvania or any other state and have a Medical Assistance card for the kinship child, this card can be presented in case of medical needs. If your kinship child does not have a Medical Assistance card, or if the medical provider refuses to accept the card, payment can be made by ACCYF for emergency medical care.

If the child requires overnight hospitalization or emergency medical care while traveling, you are required to notify your ASCI caseworker immediately. If the hospitalization occurs on a weekday after 4:30 p.m., or on a weekend or holiday, please call 412-342-0600 for our on-call emergency service.

Emergency in the Kinship Family

How to handle kinship children during a crisis in your own family:

  1. Illness: If it is not of a serious nature, it should be handled within your extended family. The ideal approach is to plan for the kinship child as you would for your own child.
  2. Death: If there is a death in your immediate family, it is expected that you will make similar               plans. However, if this is not feasible, ask the caseworker to help you plan for the kinship child’s needs during this time.
  3. An emergency requiring one or both kinship caregivers to go out of town, refer to above paragraphs.
  4. In any event, it is important to notify your caseworker immediately, per the instructions in Section C, page 18.

Question: Does the agency have a preferred plan or approach if we are faced with such crises?

Since the kinship child has had to cope with a variety of environments in his/her young life, continuity of care and environment is very important. It is generally best if an approved relative who agrees to become a substitute caregiver can be brought into the home to care for the child, rather than have the child live away from the home.


Regular visitation between the kinship child by birth parents, siblings and other family members is encouraged by our agency, since its primary function is to reunite the family when circumstances permit. Regular visitation is considered to mean at least once every week. Where appropriate, your kinship child may have overnight and weekend visits with his/her birth family by prior agreement with the CYF caseworker and the birth parents. Your caseworker will be informed of these arrangements.

Visits should take place in a setting and under circumstances that allow birth parents, siblings and the child to relate in as normal and relaxed a manner as possible. The setting may be the foster home, the agency, the parents’ own home or any other agreeable, appropriate location. The child is not to be taken away from your home except by agency staff, for any reason, unless you have been informed of this by your caseworker in writing prior to the occasion.

The exact visitation plan for each child is part of an overall placement and individual service plan developed by CYF in collaboration with our agency and the child’s birth parents and the caregivers of siblings. Kinship caregivers will be consulted in developing this plan in areas that involve them. Kinship caregivers can expect to play a major role in carrying out the visitation plan, ranging from transportation to hosting visits. Close cooperation between the caseworker and caregiver is critical to a successful plan.

Question: What happens if the birth parents arrive at my home unexpectedly?

As previously stated, it is agency policy for all visits to be prearranged. If the birth parents should arrive unexpectedly, you must inform them that you do not have the authority to permit such a visit. Simply instruct them to notify their CYF caseworker. Under no circumstances should you allow the visit to occur.

Birth Parent Consent (Prudent Parenting)

Kinship caregivers should be aware that while a child is in kinship care, the child’s natural parents retain certain rights with regard to the child, unless those rights are terminated by court action. One of the most obvious rights is the right to visit regularly and frequently (at least every week) with the child.

Other rights involve the right to consent or deny consent for a variety of procedures and activities. You should know the steps needed to allow sufficient time to secure parental consent; ask your caseworker.

Consent of the child’s natural parent(s) is needed for:

  • Hospital admission (except in severe emergencies).
  • Surgery and anesthesia.
  • Out-of-county travel.
  • An Individual Educational Plan (IEP) developed for children who require special education.
  • Participation in some contact sports (often football).
  • Pictures of and/or identifying information about the child for any publication or media purpose.
  • Any waiver of liability concerning the child (sometimes part of camp applications).
  • Enlistment in the Armed Forces (prior to age 18).
  • Marriage (prior to age 18).

These are some of the situations that may require consent, however, due to the Prudent Parenting law, kinship caregivers are able to make many of the decisions on their own when it’s in the best interest of the child. Again, please notify your CYF and ASCI caseworkers if any of the above situations (or others) arise, which may require consent of the natural parents.

Discipline of Kinship Children

We wish to take this opportunity to remind kinship caregivers that physical punishment of kinship children is not permitted. This has been ASCI’s policy from the start, and there are a number of reasons why this policy was developed.

As most kinship caregivers know, kinship children may have suffered physical abuse while living with their natural families. This abuse may leave emotional scars, as well as physical injuries, which even a mild form of physical punishment can reactivate. Any injury to a kinship child that results from physical punishment while in a foster home is a very serious matter for the child, our agency and the kinship caregiver. In fact, caregivers may be legally liable in such a situation.

We do not wish to alarm you but believe you must know that excessive physical discipline that results in serious injury to a child is considered abuse by Pennsylvania Act 124, the Child Protective Services law. Such injury must be reported and investigated by the Pennsylvania Department of Public Welfare; the results must be reported to their Harrisburg office.

We urge you to discuss any problems or questions you may have about disciplining your kinship child with your caseworker. We know that discipline is necessary, and we will do our best to help you decide on an appropriate form of discipline that helps your kinship child.

A copy of the agency-approved Discipline Policy Statement is attached in the Appendix.

Foster Parent Association: The Foster Parent Association (FPA) is a countrywide organization with local chapters in various localities. While the FPA is an organization independent of our agency, we recognize and support the services provided by the FPA. These services provide opportunities for kinship caregivers to meet one another and discuss common concerns and needs; to plan social events; to engage speakers knowledgeable about areas related to children and kinship parenting; and to provide information about pending legislation that may influence kinship caregivers.