Treatment Foster Care - Family Setting 624-05-20-15

(Revised 10/1/2024 ML #3864)

View Archives

 

 

Treatment Foster Care (TFC) is an alternative to institutional and residential facilities intended to meet the complex mental and behavioral health needs of children in a least restrictive family setting. This level of care is for children who experience frequent, co-occurring symptoms and behaviors that result in the need for increased services, supports and provider training to address complex trauma. Custodial agencies seeking placement in a TFC home must make a referral through the Children's Treatment Services Level of Care Determination assessment process. For more information on symptoms and behaviors of eligible children, see the Level of Care Chart for reference.

 

Licensing Limits:

A Licensed Child Placing Agency (LCPA) is granted authority by HHS as an authorized licensing agency to recruit and retain foster care providers to offer treatment foster care (TFC).

 

HHS grants authority to the authorized licensing agency to assess and determine the number of placements a TFC provider can best accommodate at one time. It is recommended by the department, no greater than two TFC placements are in a treatment provider home at one time. However, the authorized licensing agency may request to amend the license for additional placements. An amendment to allow for additional beds must be submitted to the CFS Licensing Unit. The license amendment request must be done in advance of a placement.

 

Ongoing assessment of the family is completed by the authorized licensing agency to determine appropriateness of the placements, and the ability of the foster care providers to engage in the necessary treatment interventions to meet the mental and behavioral health needs of children.

 

Adoptive Placement: If a treatment provider has been approved for adoptive-placement, the family shall be assessed to determine if they are able to accommodate an additional treatment placement. If appropriate, an amendment to the license may be requested to increase bed capacity in the home. When the adoption is finalized, the adopted child becomes a member of the household and does not count against licensed bed capacity.

 

Placement Approvals into Treatment Foster Care:

A child who has been approved at TFC will be granted an approval for a 180-period beginning at the date of placement.

  1. Initial 30-day window: The approval to be placed at the TFC level of care is valid up to 30 days; meaning a child must be placed at the TFC level of care within 30 days of receiving the approval from the Qualified Individual, unless otherwise approved by the department. If the TFC placement is not available for more than 30 days or pre-approved by the department, a new Children’s Treatment Services Level of Care Determination must be completed.

  2. Bed Hold: If a child who has been approved and placed at TFC needs temporary psychiatric hospitalization, the temporary hospitalization is allowable. The treatment agency is allowed reimbursement for a 14-day bed hold so long as the child will return to the treatment agency provider home. A new assessment is not required, so long as the approval has not expired.

  3. Transition: A child may be transitioned from one treatment home to another if it is determined in the best interest for their treatment. The child will not require a new assessment. The placement maximums and approval timeframes remain.

  4. Post-Discharge: A child who discharges from TFC but still has a period of time allowed within their 180-day approval timeframe may be re-admitted without a new Children’s Treatment Services Level of Care Determination, if determined necessary for treatment and within 30 days from the discharge date.

  5. Denial: A child who is placed in the TFC level of care and who is denied during a continued stay review must discharge within the approval timeframes.

  6. "Back-to-Back" assessments are prohibited. If denied, the child may not be reassessed for 30 days.

  7. Turning 18: A child who has current TFC approval that extends beyond their 18th birthday, must discharge TFC placement on their 18th birthday.

  8. Secondary placements are used when a child is transitioning or visiting from a primary placement to a secondary placement and will return to the primary placement. Secondary placements are only allowable in a TFC home for 3 calendar days. If the child does not return to the primary placement, the date the child was placed into the TFC home is considered primary.

 

Referrals to Treatment Family Foster Care:

It is the responsibility of the custodial agency worker to submit the Universal Application (SFN 824) and relevant supporting documentation to the treatment agency and upload documentation to Assessment Pro, to initiate an Children’s Treatment Service’s Level of Care Determination. Referrals for TFC must take into consideration the purchase of service agreement parameters the agency has with the Department. TFC referrals must adhere to:

  1. Age Parameters = Children age 6 thru 17

    1. Children under the age of 6 or 18+ are not eligible for TFC.

  2. Placement Length of Stay Maximums

    1. Treatment Foster Care = 12 consecutive months (365 days) or 18 non- consecutive months (545 days) per foster care episode. If a child reaches their TFC placement maximum, he/she may not re-enter the TFC level of care for a period of 90 days unless further treatment is required and approval is granted by the Children's Treatment Services Level of Care Determination.

    2. TFC placement maximums began July 1, 2022, with revisions made July 1, 2023 and July 1, 2024.

  3. Sibling Placements

    1. Children who are not eligible for TFC may be placed simultaneously with a sibling who is TFC eligible.

    2. In order to maintain sibling connections, siblings must be placed in the same provider home for the same timeframe.

 

Treatment Foster Care Reimbursement

The Department will authorize all eligible TFC reimbursement directly to the TFC agency based on billing. Foster Care Maintenance payment policy, 623-05, directs custodial agencies on allowable expenses.

 

A child is prohibited from receiving the TFC daily rate without an approval for the TFC level of care or agency approval for a secondary placement. If the child is placed in a TFC home and their approval expires, the child is no longer eligible for the TFC reimbursement effective the date of expiration. It is imperative that custodial agency workers monitor the approval timeframes.