REIMBURSEMENT


The DSS-5094 Form is the form used by the agency to request reimbursement from the state for the money paid to the foster parents. A new form is created each month for each child in foster care reflecting the amount paid to the foster parent by the "Calculate Vendor Fees" and subsequently the "Print Payment/Vouchers Report". 

Each time the procedure is run the current values are compared to the values present at the last run, and the data fields that have changed are identified with the printing of an asterisk (*) immediately to the left of the changed values. 

Placement information dollar amounts are selected from the last "Calculate Vendor Fees" run for the month and year keyed. 

To print the DSS-5094 forms, you must select a 'Print Option' as follows: 


Option Results 

C Print DSS-5094 forms only for those children where some value
has changed since the LAST printing. Do not print placement
information. 

A Print DSS-5094 forms for all children irregardless of value
changes. Print placement information but do not print the 
dollar amounts. 

R Print DSS-5094 forms for all children irregardless of value
changes. Print placement information along with the dollar
amounts to be reimbursed by the state. 

NOTE: DSS-5094 forms are not printed for children whose placement authority has been terminated for more than 90 days. 

Form DSS-5094 is the Child Placement and Payment Report
This report is a mechanism provided by the state for a county to request reimbursement of payments made to foster homes and to pass certain data about the child to the state systems.

Without an automated method to prepare the form, workers make hand-written changes or corrections onto a state-printed turnaround form, then key the data directly into the state system. The turnaround form is a printout of the values stored in the state system as of the last modification.

The "Work with Placements" procedure supports a function which will print a portrait-oriented version of the DSS-5094 on plain paper. The data on the report is created every time any data element reported on the form is changed during "Work with Placements" operations. 

Printing the DSS-5094 Child Placement and Payment Report
The reports are printed using the "Print DSS-5094 Reports" procedure.
Selection by Provider is mandatory.
Selection by 'Print Only Images NOT Previously Printed?' is mandatory; default value is 'Y', optional 'N'.
Selection by Person Number is optional; default is *ALL.
Selection by Thru Date Created is optional; default is System Date.
Selection by 5094 Batch Number is optional; default is 0.
All Images meeting the selection criteria are printed.
All Images not previously printed are marked with a 5094 Batch Number pulled from Placement Controls.
Printing sequence is always Date and Time Created, within Client ID, within Provider.


Reprinting the DSS-5094 reports
The DSS-5094 reports may not be re-printed.
The program always selects the most recent version of the DSS-5094 data to print.

Change or Correction
Until the state systems change, the DSS-5094 processing requires that users distinguish between modifications to the 5094 that are "changes" from those that are "corrections." Before you leave an application, you must indicate in the space shown below. This is true whether you add or maintain a placement application.


Menu option: Prepare Reimbursement Forms (DSS-5094)

Selection

Provider
Print Option - A = ALL, C = Changes Only, R = Reimbursement Amount
Worker ID Blank = All Workers
Payment Month and Year