Services to Foster Children and Their
Families from the TFC Agency
· *Matching process for children and their families identifying needs of the child/family and strengths of prospective TFC parents for initial placements and moves within a TFC program. This includes a screening process to determine if a TFC referral is appropriate for therapeutic foster care services.
· *Pre-placement visits.
·
*Schedule and coordinate the child’s treatment
plan; initial treatment plan within 10 days, comprehensive treatment plan
within 30 days and reviews every 90 days. All treatment plans developed by the
agency should be coordinated with the DHR county social worker and based upon
the goals established in the child’s Individualized Service Plan (ISP). The TFC
agency is required to obtain a copy of the Comprehensive Family
Assessment/Intake Evaluation form and an ISP from the referring
· *Individual, weekly visit with the TFC child. (This contact does not negate the requirement for DHR staff to make face-to-face contact minimally once per month with children in TFC placements.)
· Monthly face-to-face or telephone contact with school (minimum) to monitor the child’s progress.
· Monthly face-to-face or telephone contact with child and/or family therapist (minimum) to monitor progress in counseling.
· *Assist in referral to other programs/services the TFC child may need, as identified in the family’s ISP, including the coordination of transportation to appointments, family visits and activities.
· Assist the child with the development or maintenance of skills by the provision of no more than 18 hours weekly of individual basic living skills training and no more than 5 hours per week of group basic living skills training to include but not limited to behavior education, money management, shopping, healthy lifestyles, stress management, meal preparation, personal hygiene, housekeeping, medication management, laundry and using public transportation. Individual goals in each of these therapeutic areas must be taken from needs identified as deficits for the child and should be authorized in the context of the ISP.
· Coordinate the child’s involvement in at least one extracurricular activity, e.g., band, karate, various sports, Boy or Girl Scouts, etc. per the family’s ISP. (This does not include paying for the activity or materials required in the performance of the activity. DHR shall be responsible for payment of the activity from flex or other available local funds.)
· Attend ISPs and IEP’s along with the child and therapeutic foster parents.
· *Provide family support with birth family/supervise family visitation as outlined in the ISP/Treatment Plan. This support includes the provision of services to assist the child’s family members to understand the nature of the child’s illness and how to help the child be maintained in the community by providing education about the child’s illness, expected symptoms, medication management, parenting support, therapeutic visitation support, educational advocacy and/or to encourage school success, as identified in the family’s ISP.
· Assist in the development of independent living skills, as identified in the ISP. (DHR shall accept the fiscal responsibility for purchasing individual items to accomplish ILP goals.)
· Provide monthly group therapy (counseling) sessions for TFC children by a qualified rehabilitative services professional (minimally an LCSW or qualified Master’s Degree) in a face-to-face interaction where interventions are tailored toward achieving specific goals and/or objectives as identified in the family’s ISP.
· Provide five hours per week of crisis intervention services, as needed, to alleviate a crisis for the child or to assist the family to alleviate a crisis for the child.
· *Discharge planning.
· Maintain a no-reject/no-eject policy for children who meet program criteria.
· Provide a 14 day notice in the event a disruption should occur, as appropriate to the child’s health and welfare.
· Regularly administer outcome measures, at a minimum of every 90 days.
· Monthly report to DHR describing services provided during the month and the child’s progress toward achieving goals that are outlined in the treatment plan.
· Maintain regular communication with DHR, counselors, teachers and other persons relevant to the child that is being served by the program.
· Quality assurance component, which includes outcomes, measures for all children in the TFC program
·
Ensure program compliance with Minimum
Standards for Child Placing Agencies, Minimum Standards for Foster
Family Homes, and the Therapeutic Foster Care Manual.
·
*Assistance in creating a behavior management
plan for the child with the other members of the ISP team. All TFC agencies
shall maintain staff that have expertise in the
development of such plans. (DHR shall
assume the responsibility that behavioral management plans have been completed
on all children that require them.)
·
*Participation in the ISP team in determining goals
for children and their families, including allowances, need for clothing,
observance of special occasions, etc. (DHR
shall be fiscally responsible for clothing, allowances, gifts for special
occasions, etc.)
Services to TFC Families From the TFC Agency:
· Daily difficulty of care payment as identified in the contract between the agency and the foster parent. A minimum daily rate of $16.00 per day is required. There is no requirement regarding the maximum a foster parent may be paid as a daily rate for care. All contracts between foster parent and the TFC agency must be reviewed and approved by State DHR.
· Forty hours pre-service training, including GPS, to TFC families prior to licensure.
· Twenty-four hours of annual training to each TFC parent.
· Monthly support group/meeting for therapeutic foster parents.
· Ensure homes comply with Minimum Standards for Foster Family Homes.
· Conduct annual license renewal and semi-annual visits.
· Weekly face-to-face contact/support to foster families to strengthen their ability to provide a safe nurturing environment for the child.
· On-call crisis intervention.
· Forty-eight hours respite per month. For respite periods longer than 48 hours, the agency and foster parents shall have in their contractual agreement how respite will be paid. The county department will not be billed for respite.
· *Reimbursement for mileage to the TFC child’s appointments, visits, etc. if the destination is outside a fifty (50) mile radius from the foster home. (For special circumstances, which are clearly delineated in the ISP on rare occasions, county departments may authorize mileage to be paid through the county department.)
· Assistance with transportation of child, when needed.
· Assistance with and ensuring that required Medicaid documentation of provided billable services is being properly maintained.
· Have staff available to TFC families and children 7 days per week, 24 hours per day.
* All bulleted points (*) require intense collaboration with DHR. DHR
will be responsible for many services that have traditionally been provided by
TFC providers. These are highlighted in BOLD within the bulleted section above.
Should DHR and the ISP team agree that these services are needed, and the TFC
agency agrees to provide them, they must be authorized by the ISP document and
an 1878 completed to authorize payment. All services, whether core or
ancillary, must be authorized by the ISP document with outcomes identified to a
specific area of need.
CORE SERVICES
FOR STEP-DOWN TFC CATEGORY OF CARE (contingent on 50% reduction in TFC
provider’s daily rate for Step-Down TFC category of care)
Services to Foster Children from the TFC
Agency
· *Matching process for children and their families identifying needs of the child/family and strengths of prospective TFC parents for initial placements and moves within a TFC program. This includes a screening process to determine if a TFC referral is appropriate for therapeutic foster care services.
· *Pre-placement visits.
·
*Schedule and coordinate the child’s treatment
plan; initial treatment plan within 10 days, comprehensive treatment plan
within 30 days and reviews every 90 days. All treatment plans developed by the
agency should be coordinated with the DHR county social worker and based upon
the goals established in the child’s Individualized Service Plan (ISP). The TFC
agency is required to obtain a copy of the Comprehensive Family
Assessment/Intake Evaluation form and an ISP from the referring
· *Individual, monthly visit with the TFC child. (This contact does not negate the requirement for DHR staff to make face-to-face contact minimally once per month with children in TFC placements.)
· Quarterly face-to-face or telephone contact with school (minimum) to monitor the child’s progress.
· Quarterly face-to-face or telephone contact with child and/or family therapist (minimum) to monitor progress in counseling.
· *Assist in referral to other programs/services the TFC child may need, as identified in the family’s ISP, including the coordination of transportation to appointments, family visits and activities.
· Assist the child with the development or maintenance of skills by the provision of no more than 9 hours weekly of individual basic living skills training and no more than 3 hours per week of group basic living skills training to include but not limited to behavior education, money management, shopping, healthy lifestyles, stress management, meal preparation, personal hygiene, housekeeping, medication management, laundry and using public transportation. Individual goals in each of these therapeutic areas must be taken from needs identified as deficits for the child and should be authorized in the context of the ISP.
· Coordinate the child’s involvement in at least one extracurricular activity, e.g., band, karate, various sports, Boy or Girl Scouts, etc. per the family’s ISP. (This does not include paying for the activity or materials required in the performance of the activity. DHR shall be responsible for payment of the activity from flex or other available local funds.)
· Attend ISPs and IEP’s along with the child and therapeutic foster parents.
· *Provide family support with birth family/supervise family visitation as outlined in the ISP/Treatment Plan. This support includes the provision of services to assist the child’s family members to understand the nature of the child’s illness and how to help the child be maintained in the community by providing education about the child’s illness, expected symptoms, medication management, parenting support, therapeutic visitation support, educational advocacy and/or to encourage school success, as identified in the family’s ISP. It is expected that if the child’s permanent plan is to return home, more time may be spent in family support when a child has reached a step-down level. (DHR has the responsibility to recruit traditional foster homes for children for whom return to home relatives is not an option. It is not expected that all children in TFC shall step-down within the TFC program.)
· Assist in the development of independent living skills, as identified in the ISP. (DHR shall accept the fiscal responsibility for purchasing individual items to accomplish ILP goals.)
· Provide group therapy (counseling) sessions, only as needed, for TFC children by a qualified rehabilitative services professional (minimally an LCSW or qualified Master’s Degree) in a face-to-face interaction where interventions are tailored toward achieving specific goals and/or objectives as identified in the family’s ISP.
· Provide 3 hours per week of crisis intervention services, as needed, to alleviate a crisis for the child or to assist the family to alleviate a crisis for the child.
· *Discharge planning.
· Maintain a no-reject/no-eject policy for children who meet program criteria.
· Provide a 14 day notice in the event a disruption should occur, as appropriate to the child’s health and welfare.
· Regularly administer outcome measures, at a minimum of every 90 days.
· Monthly report to DHR describing services provided during the month and the child’s progress toward achieving goals that are outlined in the treatment plan.
· Maintain regular communication with DHR, counselors, teachers and other persons relevant to the child that is being served by the program.
· Quality assurance component, which includes outcomes, measures for all children in the TFC program
·
Ensure program compliance with Minimum
Standards for Child Placing Agencies, Minimum Standards for Foster
Family Homes, and the Therapeutic Foster Care Manual.
·
*Assistance in creating a behavior management
plan for the child with the other members of the ISP team. All TFC agencies
shall maintain staff that have expertise in the
development of such plans. (DHR shall
assume the responsibility that behavioral management plans have been completed
on all children that require them.)
·
*Participation in the ISP team in determining
goals for children and their families, including allowances, need for clothing,
observance of special occasions, etc. (DHR
shall be fiscally responsible for clothing, allowances, gifts for special
occasions, etc.)
Services to TFC Families From the TFC
Agency:
· Daily difficulty of care payment as identified in the contract between the agency and the foster parent. A minimum daily rate of $8.00 per day is required. There is no requirement regarding the maximum a foster parent may be paid as a daily rate for care. All contracts between foster parent and the TFC agency must be reviewed and approved by State DHR.
· Twenty-four hours of annual training to each TFC parent.
· Monthly support group/meeting for therapeutic foster parents.
· Ensure homes comply with Minimum Standards for Foster Family Homes.
· Conduct annual license renewal and semi-annual visits.
· Weekly face-to-face contact/support to foster families to strengthen their ability to provide a safe nurturing environment for the child.
· On-call crisis intervention.
· Twenty-four (24) hours respite per month. For respite periods longer than 48 hours, the agency and foster parents shall have in their contractual agreement how respite will be paid. The county department will not be billed for respite.
· *Reimbursement for mileage to the TFC child’s appointments, visits, etc. if the destination is outside a fifty (50) mile radius from the foster home. (For special circumstances, which are clearly delineated in the ISP on rare occasions, county departments may authorize mileage to be paid through the county department.)
· Assistance with transportation of child, when needed.
· Assistance with and ensuring that required Medicaid documentation of provided billable services is being properly maintained.
· Have staff available to TFC families and children 7 days per week, 24 hours per day.
* All bulleted points (*) require intense collaboration
with DHR. DHR will be responsible for many services that have traditionally
been provided by TFC providers. These are highlighted in BOLD within the
bulleted section above. Should DHR and the ISP team agree that these services
are needed, and the TFC agency agrees to provide them, they must be authorized
by the ISP document and an 1878 completed to authorize payment. All services,
whether core or ancillary, must be authorized by the ISP document with outcomes
identified to a specific area of need.