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

(Revised 7/1/2023 ML #3737)

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Treatment Foster Care (TFC) is a therapeutic intervention intended to meet the complex behavioral health needs of children in a least restrictive family setting. This level of care is for children who experience frequent and ongoing symptoms and behaviors that result in increased services, supports and provider training to address complex trauma.

 

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). The agency offering TFC shall assess and recommend licensure of a family home to provide care to a child eligible for a specific level of treatment foster care. The two levels of treatment foster care in a family setting include:

 

  1. Enhanced Treatment Foster Care (ETFC): Highly trained family setting where the foster care provider(s) engage in the daily care, supervision and intense treatment of a child placed in their home who is experiencing frequent symptoms and behaviors that impact their mental and behavioral health.

     

  2. Treatment Foster Care (TFC): Highly trained family setting where the foster care provider(s) engage in the daily care, supervision and treatment of a child placed in their home who is experiencing occasional symptoms and behaviors that impact their mental and behavioral health.

 

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 ina treatment provider home at one time. However, the authorized licensing agency may request to amend the license for additional placements if further assessment of the family is completed and the household can accommodate additional children in need of placement. 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, levels of care needs, and the ability of the foster care providers to provide necessary care to the child/ren.

 

Adoptive Placement: If a provider offering care to the child who meets the TFC level of care has been approved for adoptive-placement, the family shall be assessed to determine if they are able to accommodate an additional TFC placement. If appropriate, an amendment to the TFC 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.

 

Financial Agency/Custodian:

TThe custodial agency of the child in foster care is responsible to manage all financial agreements and make the necessary referrals based on the child's level of care needs. Upon acceptance into a TFC program, the custodial case manager will maintain full case management responsibilities of the child; ensuring permanency planning takes place, child and family team meetings are held, monthly face-to-face visits occur, payment invoices are submitted timely for reimbursement, etc.

 

Referrals to Treatment Family Foster Care:

Custodial agencies must contact the local TFC agency office to review the referral procedures. A current universal application (SFN 824) is required to be submitted along with recent assessments, necessary documentation and relevant releases of information to the TFC agency. 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 and greater

    1. Children under the age of 6 are not eligible for the Enchanced or Treatment Foster Care level of care.

    2. Referrals can be made to Regular Foster Care.

  2. Placement Length of Stay Maximums

    1. Enchanced Treatment Foster Care = 6 consecutive or nonconsecutive months (180 days) per foster care episode.

    2. Treatment Foster Care = 12 consecutive (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 department.

    3. c. Maximums in the ETFC and TFC levels of care began July 1, 2022, with revisions made July 1, 2023.

Episode: A foster care episode is considered the duration of time from when a child enters foster care under public custody until they are discharged. Episode duration varies for each child. The placement length of stay maximums are specific to the child’s full foster care episode. For example, if the child is in foster care for 22 months, they are only eligible for TFC level of care for 12 consecutive or 18 non-consecutive months while in foster care.

 

Extension Request: The treatment foster care agency, with support of the child's collateral contacts, must submit the SFN 1780, Treatment Foster Care Extension Request, at least 30 days prior to reaching placement maximums.

 

Cross Regional TFC Referrals:

The licensed Therapeutic Foster Care agency has the authority to determine available resources to best meet the needs of the child/ren being referred for placement. If the TFC agency and custodial case manager determine an available provider home located outside of the geographical area is appropriate, notification to HHS is only required if an amendment to a license is requested to meet bed capacity requirements.

 

Multiple TFC Placements :

The Treatment Foster Care agency has the authority to determine available resources that best meet the statewide needs of the child/ren being referred for placement. If multiple placements are considered for one provider and there is more than one custodial agency involved; the TFC agency must:

  1. Assess the foster care provider home capacity to provide for multiple placements based on individual child needs;
  2. Determine if a license amendment is required to serve multiple placements. If so, the authorized licensing agency must request, in writing, an amendment for increased bed capacity from the department;
  3. Inform the custodial agencies (Zone, DJS, or Tribe) of the eligible child who meets the TFC level of care; and
  4. Facilitate a conference call with the involved custodial agencies to:
  1. Discuss and review the needs of the child/ren currently in the home and the needs of the child/ren approved to place in the home;
  2. Discuss any opposition or concerns regarding the placement; and
  3. After notification to and consultation with all parties, if an agreement is not made collectively, the final determination for additional placement/s into a TFC home shall be made by the Department as the licensing agency.