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340:75-8-6. Required protocol for therapeutic foster care (TFC) or intensive therapeutic family care (ITFC) contractors

Revised 9-15-22

          TFC or ITFC contractors:

(1) maintain a written case record on each child that documents all services provided or obtained for the child while in placement;  ■ 1

(2) implement and review an individualized treatment plan for each child in placement, with documented input from the child's assigned (CWS) specialist, according to the requirements set forth in the Oklahoma Human Services (OKDHS) contract;  ■ 2 & 4

(3) assume responsibility for maintaining basic needs of each child placed;

(4) accept responsibility for a reasonable knowledge of the child's whereabouts at all times.

(A) When a child is:

(i) removed by anyone without authorization;

(ii) taken into custody by law enforcement officials;

(iii) missing from care; or

(iv) otherwise unaccounted for, the TFC or ITFC contractor immediately notifies, the:

(I) assigned CWS specialist or CWS supervisor.  CWS staff follows protocol and completes missing from care notifications, per Oklahoma Administrative Code (OAC) 340:75-6-48.3; and

(II) local law enforcement with the child's physical description, last known location, any known possible locations, and the child's special needs that may enhance the urgency to locate the child.  The TFC or ITFC contractor contacts the TFC program staff for assistance when encountering any difficulty contacting the CWS specialist or CWS supervisor.

(B) The contractor submits a written incident report to the child's assigned CWS specialist describing the circumstances and files a copy in the child's case record;

(5) ensure the child receives all needed routine, specialized, and emergency medical care in a timely manner provided by a medical provider who accepts Medicaid payment.

(A) OKDHS authorizes the TFC or ITFC parent and TFC or ITFC administrator in writing, through the placement provider agreement, to consent to routine and ordinary medical care and treatment the child in OKDHS custody needs upon the advice of a licensed physician, per OAC 340:75-14-3.

(B) Prior consultation and consent from OKDHS, the child's parent(s) or guardian, and the court, when applicable, as set out by Section 1-3-102 of Title 10A of the Oklahoma Statutes (10A O.S. § 1-3-102), are required for:

(i) emergency medical care.  When appropriate OKDHS staff cannot be located and the situation is life-threatening, the provider obtains emergency care and treatment and notifies OKDHS at the earliest possible time; and

(ii) any extraordinary medical care and treatment, such as surgery, general anesthesia, blood transfusions, or invasive or experimental procedures requires consent of the:

(I) child's parent or guardian, when the child is in OKDHS emergency or temporary custody;

(II) court of jurisdiction, when the child is in OKDHS emergency or temporary custody, and the treatment is related to the abuse or neglect, or the parent or guardian is unavailable or will not consent; or

(III) court of jurisdiction, when the child is in OKDHS permanent custody.

(C) The provider must comply with OKDHS policy for administering prescribed psychotropic medication found in OAC 340:75-14-3.

(D) The contractor agrees to immediately report all emergency medical care to the child's assigned CWS specialist and to document the manner of report and response in the child's case record.  The contractor ensures that CWS specialists, parents, and guardians are advised of physician recommendations regarding the use of psychotropic medications and the contractor must comply with OKDHS policy, per OAC 340:75-14-3.  Neither OKDHS, a TFC or ITFC parent, nor TFC or ITFC contractor staff may consent to a child in OKDHS custody undergoing an abortion or sterilization procedure, initiating termination of life support, or implementing a "do not resuscitate" order;

(6) notify the assigned CWS specialist or specialists and the TFC liaison of any accidental or non-accidental injuries the child sustains, per OAC 340:75-3-400 and 340:75-14-3;

(7) ensure the child has oppurtunity to engage in religious and cultural observances, practices, or beliefs, per OAC 340:75-6-49;

(8) develop and implement written policy and procedures regarding each child's access to legal counsel, court-appointed special advocate (CASA), OKDHS staff, phone, email, mail, and visitation, per OAC 340:75-6-30, 340:75-11-237, and 340:75-14-2.  The policy must ensure the:

(A) child has the right to interact with the child's attorney, guardian ad litem, CASA, and OKDHS staff in a manner and setting assuring confidentiality;

(B) child's attorney, guardian ad litem, and CASA have the opportunity to meet with the child, observe the child in appropriate settings, including the child's current placement, and review the child's documents, reports, records, and other information relevant to the court case; and

(C) TFC or ITFC parent is advised of his or her right to submit a report to the court for presentation at the review hearing to assist the court in reviewing the child's placement and status;

(9) develop and implement written policy and procedures regarding the maintenance and safeguarding of each child's clothing, personal items, property, and funds while placed;

(10) ensure the completion of a clothing and personal item inventory for each child entering and leaving placement and ensure each child leaves the placement with all of his or her clothing and personal items;

(11) obtain prior OKDHS approval any time the child travels overnight or outside of Oklahoma, per OAC 340:75-6-89;

(12) may not secure any placement without the prior planning and documented written approval of the CWS specialist.

(13) develop and implement written policy for the approval and use of volunteers,  per 10 O.S. § 404.1, when the TFC or ITFC contractor utilizes volunteers that, at a minimum, require criminal history, Restricted Registry, and sex offender registry checks;

(14) develop and implement written policy and procedures that prohibit the utilization of any child in OKDHS custody for commercial purposes;

(15) submit written reports to the child's CWS specialist or specialists describing the child's stay in placement, progress toward meeting the identified treatment plan, education, and medical care as requested for court hearings, and file a copy of the reports in the child's case record;

(16) develop and implement written policy and procedures for discipline that comply with OAC 340:75-7-38 and 10A O.S. § 1-7-105;

(17) ensure each employee and TFC or ITFC parent is trained in an approved passive physical restraint curriculum;

(18) develop and implement written policy and procedures requiring the TFC or ITFC contractor, and all contractor employees, with reason to believe any child in placement was subject to abuse or neglect, to report it to the Oklahoma Abuse and Neglect Hotline the same day of the incident.  Failure to report is a misdemeanor and failure to report with prolonged knowledge is a felony, per 10A O.S. § 1-2-101;

(19) develop and implement written policy that prohibits possession or use of tobacco and tobacco products by any child in placement, and prohibits the use of tobacco or tobacco products by employees of the TFC or ITFC contractor in the presence of any child in placement;

(20) develop and implement written policy and a system for resolving grievances by any child placed and by the TFC or ITFC parent regarding the substance or application of any written or unwritten policy or rule, decision, act, or omission of the TFC or ITFC contractor, TFC or ITFC employees, or agents of the contractor, per OAC 340:2-3-49 and 340:2-3-50;

(21) afford the TFC or ITFC parent the same rights as all foster parents in Oklahoma, per 10A O.S. § 1-9-119;

(22) ensure each employee and TFC or ITFC parent has reasonable knowledge of the rights of a child in OKDHS custody, per OAC 340:75-14-2 and 10A O.S. § 1-9-119.1;

(23) develop and implement written policy and procedures regarding communicable disease, per OAC 340:75-1, Part 9;

(24) develop and implement written policy and procedures that certify compliance in providing or continuing to provide a drug-free workplace, per the Drug-Free Workplace Act of 1988;

(25) develop and implement written policy and procedures to maintain confidentiality with regard to children in placement to comply with OKDHS rules regarding the protection, use, and release of client information, per 10A O.S. § 1-6-102 and Part 3 of OAC 340:75-1;

(26) plan and coordinate each child's discharge with the child's CWS assigned specialist or specialists, when different, and provide a minimum of 72-business hours' notice to discharge, except in medical emergencies.  On-site crisis intervention is provided prior to any emergency discharge;  ■ 3

(27) submit a written discharge summary to the child's CWS specialists within 30-calendar days of the child's discharge and file a copy in the child's case record.  The discharge summary includes:

(A) a summary of treatment services;

(B) child's progress on the treatment plan;

(C) reason for discharge; and

(D) recommendations for future placements and services for the child's treatment needs;

(28) ensure compliance with:

(A) minimum licensing standards per Child Care Services licensing standards for child-placing agencies; and

(B) staffing requirements per OKDHS Contract Agreement for TFC or ITFC;

(29) develop and implement written policy and operating procedures regarding corrective discipline procedures for employees;

(30) ensure any TFC or ITFC agency staff member responsible for conducting resource family assessments (RFAs) or annual updates attended OKDHS training prior to conducting RFAs or updates.  The staff member attends a minimum six hours of mandatory training annually;

(31) ensure the TFC or ITFC parent maintains a current Life Book for each child, regardless of the child's age that documents the child's stay in care, and provides continuity throughout the child's life, per OAC 340:75-7-37;

(32) develop and implement written policy and operating procedures to govern the TFC or ITFC parent's maintenance and administration of prescription and non-prescription medication to each child in placement, including transporting prescription and non-prescription medication when the child receives medication any place other than the TFC or ITFC home, such as respite placements, family visits, and medication administered during school hours;  ■ 5

(33) develop written policy and operating procedures regarding the use of physical force for behavior management of any child placed.

(A) The use of mechanical restraints and the use of medication for behavior management are prohibited in the care and treatment of the child in OKDHS custody.

(B) The use of physical force is permitted when it is necessary for the protection of the child or others consistent with an approved passive physical restraint curriculum, such as when the child's behavior poses an immediate danger or threat of danger to self or others and other methods were exhausted;

(34) develop and implement written policy, operating procedures, and supervision guidelines regarding the use of solitary confinement and separation programs, such as restricting the child to his or her own room for a cooling off period.  The duration of room restriction is specified at the time of assignment and is consistent with the child's chronological age; developmental level; behavioral, emotional, and medical needs; and availability of supervision;

(35) for each scheduled review hearing, coordinate with the CWS specialist and the TFC or ITFC parent for a youth 14 through 17 years of age to ensure the youth's availability to respond to the court's inquiry, in person, by phone, or by other electronic means, about the youth's plan for skills development and transition to successful adulthood;

(36) assist the CWS specialist and TFC parent with ensuring youth in the eighth, ninth, or tenth grades are enrolled in the Oklahoma's Promise, formerly known as the Oklahoma Higher Learning Access Program, and provide TFC or ITFC parents with information on the program's eligibility, application guidelines, and academic requirements; and

(37) for any youth 14 years of age and older, assist the CWS specialist and youth, as needed, to remedy concerns of identity theft or fraudulent use of the youth's identity noted through a review of the his or her credit report provided by OKDHS.  


Revised 9-15-22

1. Therapeutic foster care (TFC) or intensive therapeutic family care (ITFC) records review.  Child Welfare Services (CWS) specialists, supervisors, and program staff may review TFC or ITFC case documentation when there are questions regarding the care or treatment for a child in Oklahoma Human Services (OKDHS) custody.  Review of the TFC or ITFC case documentation occurs in the TFC or ITFC contractor's office.

2. A child's individual treatment plan (TP) is finalized with original signatures and approved by the Oklahoma Health Care Authority within 30-calendar days of placement.

(1) The TP meeting is scheduled no more than 20-calendar days from the time of placement.

(2) The meeting's time, date, and location are established at the time of placement.

(3) The TFC or ITFC contractor sends written confirmation via email of the TP meeting to the CWS specialist and supervisor within 10-business days.

(4) The meeting's participants must include CWS staff and the TFC or ITFC contractor.

(5) Other relevant members of the child's team including, but not limited to, TFC or ITFC parents, biological parents or connections, court-appointed special advocate (CASA), tribal representatives, and external services providers may be invited to participate.

(6) The TFC or ITFC contractor provides a copy of the finalized TP to the CWS specialist within two-business days following the TP meeting.

(7) The CWS specialist must provide the TFC or ITFC agency with a copy of the original signature within two-business days of receipt of the finalized TP.

(8) TPs are reviewed and revised every 90-calendar days of placement following the same protocol.

3. The TFC or ITFC contractor is required to provide notice of discharge at least 72-business hours prior to scheduled discharge when the contractor determines that it cannot continue a child's placement.  When the child is assessed to meet residential treatment criteria and no bed is available, the TFC or ITFC contractor makes arrangements for temporary placement and then issues the 72-business hour notice to discharge.  Notice of discharge is provided in a manner that reasonably ensures the assigned CWS staff receives the notice.  Notice of discharge may be provided in person or by phone, but must also be provided in writing via fax or email to the CWS specialist, CWS supervisor, and district director.

4. The CWS specialist must participate face-to-face in the initial treatment planning process.  Subsequent meetings are also face-to-face unless the CWS specialist is driving more than 80 miles one way, then he or she may phone in every other meeting with prior approval from his or her supervisor.

5. Medication transportation.  CWS specialists transport medication for the child in OKDHS custody, per Oklahoma Administrative Code 340:75-14-3 Instructions to Staff.

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