Therapeutic Xxxxxx Care. The Co-Neutrals’ previously set a target of 150 new therapeutic xxxxxx care homes (TFC) in SFY14. The Co-Neutrals’ October 2013 commentary cited DHS data showing that by the end of SFY13, there were 586 TFC homes open as of June 30, 2013 and that almost 50 percent (282 homes) had no children placed in them. The revised baseline data submitted by DHS in March 2014 indicates that 548 TFCs were open on July 1, 2013. Of these 548 TFCs, 102 homes were “joint approved,” meaning they were authorized to provide at least one type of regular xxxxxx care as well as therapeutic xxxxxx care. As such, 446 of the open TFCs were approved for TFC placements only. As of December 31, 2013, DHS has approved 56 new therapeutic xxxxxx homes, or 37 percent of the target. Though DHS’ revised data for July 1, 2013 shows fewer TFCs as vacant – not fostering any children – than the data DHS supplied to the Co-Neutrals for the October 2013 commentary, vacancy rates are still high compared to regular xxxxxx care and relative to reports of demand from DHS staff. On July 1, 2013, DHS’ data indicates that of homes licensed as TFCs only (not joint approved), 28% had been vacant at least six months and 18% had been vacant for more than a year. As of December 31, 2013, 26% of homes approved as TFCs only had been vacant at least six months and 20% of TFC-only homes had been vacant for more than one year.4 The Co-Neutrals did not set a target for TFC net gain/loss in SFY14, but have calculated this number to bring transparency to the continuum of available placements for children. DHS reports 548 approved TFCs on July 1, 2013 and 547 approved TFCs on December 31, 2013, for a net loss of one TFC home during the first half of SFY14. The Co-Neutrals discussed the challenges around therapeutic xxxxxx care with DHS leadership, with the appropriate DHS management staff, with providers and with caseworkers and supervisors charged to find appropriate placements for children in care. In light of these discussions and the low number of therapeutic homes licensed through December 31, 2013, the Co-Neutrals are not convinced that DHS presently has in place an adequate process to meet the target outcome for additional TFCs, nor its Pinnacle Plan commitment to match children’s individual needs with available and appropriate placements and to maximize the available supply of existing homes. On March 21, 2014, DHS submitted a plan to the Co-Neutrals, which is currently under review. Based on a review of DHS’ ...
Therapeutic Xxxxxx Care. Since the settlement of this litigation, DHS has struggled to develop and maintain an adequate pool of therapeutic xxxxxx care (TFC) homes and to remove barriers that prevent children with higher-level needs from receiving therapeutic care in family-based settings. For this report period, the Co-Neutrals have determined that DHS has made good faith efforts to achieve substantial and sustained progress toward the Target Outcome, based primarily on the department’s work to develop its own, internal therapeutic xxxxxx care program, known as Enhanced Xxxxxx Care (EFC). DHS began to implement the EFC program this period by enhancing therapeutic services and other supports for traditional and kinship xxxxxx families caring for children with higher-level needs. As described in greater detail below, the Co-Neutrals validated that DHS established 106 new therapeutic xxxxxx home placements for children in care through this new treatment home program. Like DHS’ decision years ago to recruit and manage traditional xxxxxx homes both internally and through private agencies, DHS’ EFC program is designed to supplement the TFC homes developed and managed by private agencies. DHS has historically relied on private, contracted agencies to recruit, approve, and manage TFC homes for children in custody. TFC homes are intended to provide children in need of behavioral health treatment with family-based placements and appropriate services, thereby avoiding or limiting placement in congregate care settings, including shelters. DHS’ current leadership team acknowledged that the department can no longer rely solely on its legacy TFC program and TFC agency partners to meet the placement needs of all children in DHS custody who require therapeutic services and supports but can reside in a family-based placement. DHS’ TFC program and agency partners remain a part of the department’s placement continuum, but there are significant and declining limits to their capacity. DHS undertook substantial work over the last two years to meet the therapeutic placement and service needs of children in care, including: completion of the state’s first systemwide needs assessment to identify the levels and types of therapeutic placements children in custody require across the state based on a population assessment; development of additional placements within the continuum of care to best meet the identified therapeutic needs of children in least restrictive placements; and programmatic improvements to...
Therapeutic Xxxxxx Care. Children who are eligible to be placed in therapeutic xxxxxx care (TFC) homes have been assessed to have emotional and behavioral health needs and can live in the community with specially trained xxxxxx parents and therapeutic services. TFCs are intended to ensure that children in need of behavioral health treatment can live in family-based placements with appropriate services and avoid placement in congregate care settings, offer family-based placements for those children ready to step-down from higher-levels of care and support more stable and therapeutic placements for children with increased behavioral needs. At the beginning of the reform, DHS identified TFC homes as a key component of Oklahoma’s continuum of care and as the primary family-based placement resource for children with behavioral health treatment needs. As documented in the Co-Neutrals’ previous Commentaries, DHS and its private agency partners, who recruit, approve and manage the homes, have not been successful in their efforts to grow the pool of Oklahoma’s therapeutic xxxxxx homes. As a result, with respect to recruiting and retaining TFC homes, DHS has been unable to meet its annual Target Outcomes for new TFC home development and net gains during this reform effort. In fact, DHS has reported net losses for the last six report periods, with the largest net loss of 109 TFC homes reported most recently for SFY18. In addition to the decrease of open TFC homes across the state, the number of children served in TFCs has also steadily decreased. Further, during SFY18, the number of private TFC agencies partnering with DHS decreased from 10 to six, as four agencies canceled their TFC contracts. As discussed further below, these agencies, as a group, have struggled throughout the reform to recruit and retain TFC families and to show progress in improving the quality of individualized treatment services provided to children in their programs. As a result of these trends, DHS’ primary family-based placement option for children in DHS custody with increased behavioral needs has contracted throughout most of this reform, despite the acute need in Oklahoma for an expanded pool of quality TFC homes able to meet the specialized needs of children in DHS custody. TFC New Home Development and Net Gain/Loss The Co-Neutrals accepted DHS’ proposed Target Outcome for new TFC home development for SFY18, which was set at 138. DHS reported that its private agency partners developed 17 new TFCs during the firs...
Therapeutic Xxxxxx Care. Recommendation Status Updates 1 Clarify if TFC will be a medically necessary service available to any child who may need a placement outside of their home, or if it a service that will be solely available to children in the custody of child welfare.
Therapeutic Xxxxxx Care a. Under the State’s Medi-Cal Plan, the TFC service model allows for the delivery of short-term, intensive, highly-coordinated, and individualized SMHS, to children and youth up to age 21 who have complex emotional and mental health needs and who are placed with trained, intensely supervised and supported TFC parents (see MHSUDS INFORMATION NOTICE NO.: 17-021, xxxxx://xxx.xxxx.xx.xxx/services/MH/Documents/PPQA%20Pages /MHSUDS_Information_Notice_17-021_TFC_Claiming. pdf; DSS ACIN i-52- 16E). The TFC service model is intended for youth who require intensive and frequent mental health support and is a home-based alternative to high-level care in institutional settings such as group homes and STRTPs. The TFC parent is both a Medi-Cal provider and a caregiver who works directly with the child/class member. The approved reimbursement methodology allows MHPs to claim reimbursement from local and/or federal funding sources for a combination of certain SMHS service activities under one TFC per diem rate. To provide TFC, a caregiver must be associated with an FFA that also has a contract with DMH. For purposes of this Agreement, a “TFC parent with a prior relationship” is an individual who has an existing relationship with a particular child and is willing to become a TFC parent and who will work with an FFA that is also a DMH provider for that child. A child receiving TFC should also be receiving ICC and, if medically necessary, IHBS.
Therapeutic Xxxxxx Care. A family-based treatment option for children with complex behavioral or emotional needs who can be served in the community with intensive support. Refer to AMPM Policy 320-W. The Contractor shall develop, and publish to its website, TFC admission, continued stay, and discharge criteria for medical necessity that aligns with the criteria specified in AMPM Policy 320-W. The Contractor shall submit its TFC Medical Necessity Criteria for prior approval as specified in Section F,
Therapeutic Xxxxxx Care. Overview The Agreement stipulates that DOHS “shall develop Therapeutic Xxxxxx Family Homes and provider capacity in all regions and shall ensure that all children who need this service are timely placed in a Therapeutic Xxxxxx Family Home with specially trained therapeutic xxxxxx parents, in their home community whenever possible.” Achievements and Developments In response to these Agreement items, DoHS developed a new intensive family-based residential setting for higher needs youth at high risk for admission to an RMHTF, referred to as a Stabilization and Treatment (STAT) Home. These homes were not intended to take the place of the legacy tiered xxxxxx care system, but to supplement it as a short-term or temporary placement strictly for stabilization of the youth after which the youth would be sent back to the prior placement setting (or another suitable tiered setting.) Although STAT had the support of legislation authorizing higher payments to caregivers, at the time of the June 2023 SME Report, only one STAT home had been recruited and fully trained, 3 had neared completion of training, and only 14 families had expressed interest in taking part in this new service. As a result, the STAT home model was discontinued during the time between the July 2023 and January 2024 SARs, and there is now a renewed focus on providing services youth with higher levels of need within the existing tiered system. The existing system has included the following three tiers:
Therapeutic Xxxxxx Care. The boarding payment for Tribal custody children is paid by OKDHS for those children who meet and require Therapeutic Xxxxxx Care (TFC). The following procedure must be followed for those children:
Therapeutic Xxxxxx Care. The boarding payment for Tribal custody children is paid by OKDHS for those children who meet and require Therapeutic Xxxxxx Care (TFC). The following procedure must be followed for those children: The Tribal worker completes the placement worksheet; The Tribal worker contacts APS to see if the child meets criteria for TFC; If APS indicates that it appears that the child may meet criteria for TFC, the Tribal worker faxes the placement worksheet to the Tribal Liaison who enters it on KIDS The Area Resource Coordinator (ARC) assists the Tribal worker in obtaining an assessment for authorization for TFC; If the Tribal custody child is authorized, TFC agencies identify potential placements; The Tribal ICW worker accepts the appropriate placement; The Tribal Liaison enters the TFC placement in the KK case; The Tribal Liaison notifies the ARC of the TFC placement The Tribal worker is responsible for visiting the child in the TFC home at least once a month. The tribal worker provides the TFC agency with office and after-hour telephone numbers as well as their e-mail address.
Therapeutic Xxxxxx Care
