COMMENT DUE DATE:
March 20, 2014
DATE:
February 12, 2014
Shirley Russell, Child Welfare Services (405) 521-2881
Dena Thayer, OIRP Programs Administrator (405) 521-4326
Nancy Kelly, OIRP Policy Specialist (405) 522-6703
RE:
APA WF 13-07
The proposed policy is Permanent . This proposal is subject to the Administrative Procedures Act
SUBJECT:
Chapter 75 Child Welfare
Subchapter 8. Therapeutic Foster Care and Developmental Disabilities Services
OAC 340:75-8-1 [AMENDED]
OAC 340:75-8-4 [AMENDED]
OAC 340:75-8-6 through 340:75-8-14 [AMENDED]
(Reference WF 13-07)
SUMMARY:
The proposed revisions to Subchapter 8 of Chapter 75:(1) amend the rules to comply with federal and state statutes and regulations and Oklahoma Pinnacle Plan requirements related to the provision of child welfare service; and (2) update division, unit, and position titles consistent with the Oklahoma Department of Human Services (DHS) reorganization.
OAC 340:75-8-1 is amended to revise sentence structure and modify definitions to more closely track existing language.
OAC 340:75-8-4 is amended to update statutory references and revise sentence structure and division name to be consistent with the agency reorganization.
OAC 340:75-8-6 is amended to modify requirements for therapeutic foster care placement providers, revise sentence structure, and update references to be consistent with the agency reorganization.
OAC 340:75-8-7 is amended to modify service requirements for therapeutic foster care placement providers and revise sentence structure and division name to be consistent with agency reorganization.
OAC 340:75-8-8 is amended to clarify duties and responsibilities of therapeutic foster care contractors, revise sentence structure, update citations, and update references to be consistent with agency reorganization.
OAC 340:75-8-9 is amended to clarify placement procedure requirements and update references to be consistent with agency reorganization.
OAC 340:75-8-10 is amended to remove certain approval procedures and update references to be consistent with agency reorganization.
OAC 340:75-8-11 is amended to clarify modifications for supporting placement stability and update references to be consistent with agency reorganization.
OAC 340:75-8-12 is amended to update references concerning regional resource coordinator duties.
OAC 340:75-8-13 and 340:75-8-14 are amended to update references to be consistent with agency reorganization.
PERMANENT APPROVAL:
Permanent rulemaking is requested.
LEGAL AUTHORITY:
Director of Human Services; Section 162 of Title 56 of the Oklahoma Statutes; and Title 45 of the Code of Federal Regulations (CFR) Parts 98 and 99.
Rule Impact Statement
To:Programs administrator
Office of Intergovernmental Relations and Policy
From:Deborah G Smith, Director
Child Welfare Services
Date:January 24, 2014
Re:Chapter 75 Child Welfare
Subchapter 8. Therapeutic Foster Care and Developmental Disabilities Services
OAC 340:75-8-1 [AMENDED]
OAC 340:75-8-4 [AMENDED]
OAC 340:75-8-6 through 340:75-8-14 [AMENDED]
(Reference WF 13-07)
Contact:Shirley Russell 405-521-2881
A.Brief description of the purpose of the proposed rule:
Purpose.The proposed revisions to Subchapter 8 of Chapter 75:(1) amend the rules to comply with federal and state statutes and regulations and Oklahoma Pinnacle Plan requirements related to the provision of child welfare service; and (2) update division, unit, and position titles consistent with the Oklahoma Department of Human Services (DHS) reorganization.
Strategic Plan impact.
The proposed rules achieve DHS goals by providing processes related to regulations and guidelines that support and strengthen the family and protect its members.
Substantive changes.
OAC 340:75-8-1 is amended to revise sentence structure and modify definitions to more closely track existing language.
OAC 340:75-8-4 is amended to update statutory references and revise sentence structure and division name to be consistent with the agency reorganization.
OAC 340:75-8-6 is amended to modify requirements for therapeutic foster care placement providers, revise sentence structure, and update references to be consistent with the agency reorganization.
OAC 340:75-8-7 is amended to modify service requirements for therapeutic foster care placement providers and revise sentence structure and division name to be consistent with agency reorganization.
OAC 340:75-8-8 is amended to clarify duties and responsibilities of therapeutic foster care contractors, revise sentence structure, update citations, and update references to be consistent with agency reorganization.
OAC 340:75-8-9 is amended to clarify placement procedure requirements and update references to be consistent with agency reorganization.
OAC 340:75-8-10 is amended to remove certain approval procedures and update references to be consistent with agency reorganization.
OAC 340:75-8-11 is amended to clarify modifications for supporting placement stability and update references to be consistent with agency reorganization.
OAC 340:75-8-12 is amended to update references concerning regional resource coordinator duties.
OAC 340:75-8-13 and 340:75-8-14 are amended to update references to be consistent with agency reorganization.
Reasons. The proposed revisions provide clear and concise rules for DHS staff, clients and service providers to ensure therapeutic foster care services are administered uniformly.Due to the reorganization of DHS, division names and terminology are changed.This allows for more consistent application of policy and better ensures the safety of children in the custody of DHS.
Repercussions. The proposed modifications are designed to create uniformity of application of policy and to ensure that children in need of therapeutic foster care are able to receive needed services.
Legal authority.Director of Human Services; Section 162 of Title 56 of the Oklahoma Statutes; and Title 45 of the Code of Federal Regulations (CFR) Parts 98 and 99.
Permanent rulemaking approval is requested.
B.A description of the classes of persons who most likely will be affected by the proposed rule, including classes that will bear the costs of the proposed rule, and any information on cost impacts received by the Agency from any private or public entities:The classes of persons most likely to be affected by the proposed rules are DHS staff, children placed in therapeutic foster placements, and therapeutic foster care service providers.The affected classes of persons will bear no costs associated with implementation of the rules.
C.A description of the classes of persons who will benefit from the proposed rule:The classes of persons who will benefit are DHS staff, therapeutic foster care placement providers and children placed in therapeutic foster care placements.
D.A description of the probable economic impact of the proposed rule upon the affected classes of persons or political subdivisions, including a listing of all fee changes and, whenever possible, a separate justification for each fee change:The revised rules do not have an economic impact on the affected entities.There are no fee changes associated with the revised rules.
E.The probable costs and benefits to the Agency and to any other agency of the implementation and enforcement of the proposed rule, the source of revenue to be used for implementation and enforcement of the proposed rule and any anticipated effect on state revenues, including a projected net loss or gain in such revenues if it can be projected by the Agency:DHS includes the cost of printing and distributing the rules, which is estimated to be less than $20.The revised rules will result in enhanced delivery of services to positively impact clients, families and therapeutic foster care service providers.
F.A determination whether implementation of the proposed rule will have an impact on any political subdivisions or require their cooperation in implementing or enforcing the rule:The proposed rules do not have an economic impact on any political subdivision, nor will the cooperation of any political subdivisions be required in implementation or enforcement of the rules.
G.A determination whether implementation of the proposed rule will have an adverse economic effect on small business as provided by the Oklahoma Small Business Regulatory Flexibility Act:There are no anticipated adverse effects on small business as provided by the Oklahoma Small Business Regulatory Flexibility Act.
H.An explanation of the measures the Agency has taken to minimize compliance costs and a determination whether there are less costly or nonregulatory methods or less intrusive methods for achieving the purpose of the proposed rule:There are no less costly or non-regulatory methods or less intrusive methods for achieving the purpose of the proposed rules.
I.A determination of the effect of the proposed rule on the public health, safety, and environment and, if the proposed rule is designed to reduce significant risks to the public health, safety, and environment, an explanation of the nature of the risk and to what extent the proposed rule will reduce the risk:
Implementation of the proposed rule revisions clarify and update rules which facilitate quicker benefit delivery and may reduce risks to children's health, safety, and environment.
J.A determination of any detrimental effect on the public health, safety, and environment if the proposed rule is not implemented:If the proposed rule revisions are not implemented, processes may not be followed as intended which may delay the delivery of benefits and services to persons who are in need.
K.The date the rule impact statement was prepared and, if modified, the date modified:Prepared June 17, 2013; modified December 3, 2013; modified January 24, 2014.
SUBCHAPTER 8. THERAPEUTIC FOSTER CARE AND DEVELOPMENTAL DISABILITIES SERVICES
PART 1. THERAPEUTIC FOSTER CARE
340:75-8-1. Purpose, legal base, and definitions
Revised 3-26-107-1-14
(a) Purpose.Therapeutic foster care (TFC) serves those in Oklahoma Department of Human Services (DHS) custody who:
(1) children three are 3 through 17 years of age, in Oklahoma Department of Human Services (OKDHS) custody, who meet medical necessity criteria; and or
(2) youth, up to 19 are 18 through 20 years of age or until completion of high school, if the youth continues to meet medical necessity criteria and requests and have voluntarily requested extended services, who: per Oklahoma Administrative Code (OAC) 340:75-6-110; and
(3) meet medical necessity criteria established by the Oklahoma Health Care Authority (OHCA) per OAC 317:30-5-741;
(A)(4) respond to close relationships within a family setting;
(B)(5) require more intensive behavioral health services than available in traditional foster family settings; and when additional supports, such as outpatient services, systems of care, or modification of the child's individualized education plan are not available or will not meet the child's needs in his or her established placement; and
(C)(6) do not require 24-hour awake supervision.
(b) Legal base.
(1) Section 1-7-103 of Title 10A of the Oklahoma Statutes (10A O.S. § 1-7-103) mandates that OKDHS review and assess each child in OKDHS custody to determine the type of placement consistent with the child's treatment needs in the nearest geographical proximity to the child's home.
(2) 10A O.S. § 1-9-110 mandates that OKDHS develop and implement a diversity of community-based residential care, as needed, to provide for adequate and appropriate community-based treatment or rehabilitation of each child in a:
(A) foster home;
(B) group home;
(C) community residential center; or
(D) non-secure facility consistent with the child's individualized treatment needs and, when possible, in or near the child's home community.
(c) Definitions.The following words and terms, when used in Part 1 of this Subchapter, shall have the following meaning, unless the context clearly indicates otherwise:
(1) "APS Healthcare Service (APS)" means the agency under contract with OHCA responsible for prior authorization for:
(A) the admission and extension of Medicaid or Title XIX reimbursed inpatient psychiatric treatment and TFC services; and
(B) Medicaid or Title XIX reimbursed outpatient behavioral healthcare services "Oklahoma Department of Human Services (DHS) placement agreement for residential behavioral management services (RBMS)" means the contract entered into between DHS and an agency providing TFC services, including all attachments and exhibits.
(2) "Oklahoma Health Care Authority (OHCA)"means the entity designated for administering Title XIX Medicaid reimbursement, and responsible including both the responsibility for the establishment of medical necessity criteria for children receiving TFC services and prior authorization for the admission and extension of Medicaid or Title XIX reimbursed TFC services.
(3) "Therapeutic foster care (TFC)" means residential behavioral management services provided in a specialized foster care setting for a child who:
(A) meets medical necessity criteria, per Oklahoma Administrative Code (OAC) 317:30-5-741;
(B) has special psychological, behavioral, social, and or emotional needs requiring more intensive, therapeutic care than may be found in the traditional foster care setting;
(C) accepts and responds to close relationships within a family setting; and
(D) requires more intensive or therapeutic services than are found in traditional foster care and when additional supports, such as outpatient services, systems of care, or modification of the child's individualized education plan are not available or will not meet the child's needs in his or her established placement.
(4) "TFC contractor" means a licensed child care agency that meets OKDHS and OHCA requirements to provide residential behavioral management services in a foster care setting.A TFC contract agency:
(A) provides direct clinical treatment services to the child placed; and
(B) recruits, trains, certifies, reimburses, and provides supportive services to the TFC foster parent.
340:75-8-4. Contract procedures for therapeutic foster care
Revised 5-26-057-1-14
(a) Contracts for the provision of therapeutic foster care (TFC) placements are issued in accordance with OAC 340:2-13-10 per Oklahoma Administrative Code (OAC) 340:2-13-75 through 340:2-13-14.18 340:2-13-89 and Section 85 of Title 74 of the Oklahoma Statutes.Prior to issuance of the Oklahoma Health Care Authority (OHCA) Title XIX contract for TFC services, providers are approved as eligible TFC contractors by the Children and Family Services Division (CFSD) Child Welfare Services programs manager supervisor for TFC as eligible TFC contractors.
(b) Contracts for the provision of TFC placements are monitored on-site at least annually to ensure that services provided are in compliance with contract terms, per OAC 340:2-13-14.14 OAC 340:2-13-102.
340:75-8-6. General requirements for contracted therapeutic foster care placement providers
Revised 3-26-107-1-14
Contracted therapeutic foster care (TFC) placement providers must:
(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 of from the child's assigned Child Welfare Services (CWS) county of jurisdiction and county of placement worker specialist, when different, according to the requirements set forth in the Oklahoma Department of Human Services (OKDHS) contract.The TFC contractor notifies the CW county of jurisdiction worker of the initial treatment plan meeting within five days of the child's placement;¢ 2 & 3
(3) assume responsibility for maintenance of 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:
(i) is removed by anyone without authorization;
(ii) is taken into custody by law enforcement officials;
(iii) runs away; or
(iv) otherwise cannot be accounted for, the TFC contractors immediately notify by phone the:
(I) CW county of jurisdiction and county of placement workers assigned CWS specialist;
(II) contract liaison; and
(III) police.
(B) The contractor submits a written incident report to the child's CW county of jurisdiction worker 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.Prior consultation and consent from DHS and the child's parent(s) are not required for routine and ordinary medical care.Provision of all medical or dental care is documented in the contractor's case record, including notification and attempts of notification in emergency situations per OAC 340:75-6-88.Prior consultation and consent from DHS and the child's parent or parents are obtained per OAC 340:75-6-88:
(A) Prior consultation and consent from OKDHS and the child's parent(s) are required for emergency medical care.If When the appropriate OKDHS authority cannot be contacted and the situation is life-threatening, the contractor has the authority to obtain emergency care and treatment, and notifies OKDHS at the earliest possible time.;
(B) Prior consultation and consent from OKDHS and the child's parent(s) are required for any extraordinary medical procedure, such as surgery and invasive procedures.; and
(C) Prior consultation and consent from OKDHS and the child's parent(s) are not required for ordinary medical care.Provision of all medical or dental care is documented in the contractor's case record, including notification and attempts of notification in emergency situations, per OAC 340:75-13-6 before administering any new psychotropic medication when a separate and specific consent is requested by a physician or medical facility;
(6) notify the CW county of jurisdiction and county of placement workers assigned CWS specialist or specialists and the contract liaison of any accidental or non-accidental injuries sustained by the child, per OAC 340:75-3-6.1 340:75-3-400 and 340:75-6-88;
(7) ensure that the child's religious and cultural observations of the child observances, practices, or beliefs comply with 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, mail, and visitation, per OAC 340:75-6-30 and 340:75-11-237;
(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 approval from the CWS county of jurisdiction worker specialist any time the child travels overnight outside of the county of placement or Oklahoma, per OAC 340:75-6-89;
(12) develop and implement written policy and procedures defining situations in which any person, other than family members previously approved by the CWS county of jurisdiction worker specialist, may take the child away from the placement on a day pass, not to exceed six hours, without supervision of the placement provider.
(A) The TFC contractor does not allow a child any overnight visitation between custody children and parents or parties of the deprived case without the prior planning and documented written approval of the child's CW county of jurisdiction and county of placement workers assigned CWS county of jurisdiction specialist.Overnight visitation with peers is considered time outside of the direct supervision of the TFC parent and is addressed through the child's treatment plan and Form 04TF006E, Unsupervised Time Assessment.
(i) The contractor is responsible for:
(I) completing an evaluation of the appropriateness of the overnight plan;
(II) submitting the overnight plan to the CW county of placement and county of jurisdiction workers and supervisors;
(III) securing written confirmation of the plan from the CW county of placement and county of jurisdiction workers and supervisors; and
(IV) documenting the results in the child's case.
(ii) CW county of placement and county of jurisdiction workers and supervisors are responsible for reviewing the overnight plan developed and submitted by the TFC contractor.
(B) The TFC contractor does not secure any placement without the prior planning and documented written approval of the CWS county of jurisdiction worker specialist.
(C) If When the TFC contractor utilizes volunteers, the contractor's policy for approval and utilization of volunteers must, at a minimum, require criminal history and sex offender registry checks;
(13) develop and implement written policy and procedures that prohibit the utilization of any child in OKDHS custody for commercial purposes;
(14) submit written reports to the child's CWS county of jurisdiction and county of placement workers 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;
(15) develop and implement written policy and procedures for discipline that comply with OAC 340:75-7-38 and Sections 1-7-105 of Title 10A of the Oklahoma Statutes (10A O.S. § 1-7-105);
(16) ensure each employee and TFC parent is trained in an approved passive physical restraint curriculum defined in OAC 340:75-11-237;
(17) develop and implement written policy and procedures requiring the TFC contractor, and all employees of the contractor, having reason to believe any child in placement has been subject to abuse or neglect to report the matter to the child abuse hotline Oklahoma Child Abuse and Neglect Hotline (Hotline) the same day of the incident.Failure to report is a misdemeanor pursuant to 10A O.S. § 1-2-101;
(18) 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 contractor in the presence of any child in placement;
(19) develop and implement written policy and a system for resolution of grievances by any child placed and by the TFC parent regarding the substance or application of any written or unwritten policy or rule, decision, act, or omission of the TFC contractor, or employees or agents of the contractor, per OAC 340:2-3-49 and 340:2-3-50;
(20) afford the TFC parent the same rights as all foster parents in Oklahoma, per 10A O.S. § 1-9-119;
(21) develop and implement written policy and procedures regarding communicable disease, per OAC 340:75-1, Part 9;
(22) develop and implement written policy and procedures that certify compliance in providing or continuing to provide a drug-free workplace in accordance with per the Drug-Free Workplace Act of 1988;
(23) develop and implement written policy and procedures to maintain confidentiality with regard to children in placement in order 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;
(24) plan and coordinate each child's discharge with the child's CWS county of jurisdiction worker and county of placement worker assigned specialist or specialists, if when different, and provide a minimum of 48 hours-notice to discharge, except in medical or psychiatric emergencies.On-site crises intervention must be provided prior to any emergency discharge.Contractor's The TFC contractor's recommendation for discharge is approved by the a child's CWS county of jurisdiction worker and county of placement worker specialist if different prior to the contractor's implementation of the discharge plan;
(25) submit a written discharge summary to the child's CWS county of jurisdiction worker 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;
(26) ensure that all staff comply compliance with the:
(A) minimum licensing standards defined in the Oklahoma per Child Care Services (OCCS) licensing standards for child-placing agencies; and
(B) staffing requirements per OKDHS Placement Agreement for TFC;
(27) develop and implement written policy and operating procedures regarding corrective discipline procedures for employees;
(28) ensure that the foster 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;
(29) develop and implement written policy and operating procedures to govern the foster 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 home, such as respite placements, family visits, and medication administered during school hours;¢ 24
(30) develop written policy and operating procedures regarding the use of physical force restraint 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 restraint 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 have been exhausted; and
(31) develop and implement written policy, and operating procedures, and supervision guidelines regarding 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.
INSTRUCTIONS TO STAFF 340:75-8-6
Revised 3-26-107-1-14
1.Therapeutic foster care (TFC) records review.Child Welfare Services (CWS) workers specialists, supervisors, CW field liaisons, and Children and Family Services Division staff may review therapeutic foster care (TFC) case documentation any time when there are questions regarding the care or treatment for a child in Oklahoma Department of Human Services (OKDHS) custody.Review of the TFC case documentation occurs in the TFC contractor's office.
2.A child's individual treatment plan (TP) must be 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 time, date and location of the meeting are established at the time of placement.
(3) The TFC contractor sends written confirmation via email of the TP meeting to the CWS specialist and supervisor within 10 business days.
(4) Participants in the meeting must include CWS staff and TFC contractor.
(5) Other relevant members of the child's team including, but not limited to, TFC foster parents, biological parents or connections, court appointed special advocate (CASA), Tribal representatives, and external services providers may be invited to participate.
(6) The TFC 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 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 CWS specialist must participate in the treatment planning process.If unable to attend as planned, the TFC contractor prepares the TP and sends the plan via email to the CWS specialist, supervisor, and district director with the subject line "Missed TFC TP Team Meeting."
(1) The CWS specialist or supervisor reviews the proposed TP, and when in agreement, signs and returns the original signature to the TFC contractor within two business days.When not in agreement, the CWS specialist must immediately contact the TFC contractor to negotiate changes or to set a new meeting time and provide required signatures.
(2) Other CWS employees may provide an original signature on the TP in lieu of the assigned specialist only when the assigned specialist has provided notification of his or her agreement with the plan.
(3) In the event the TFC contractor does not receive a response from the CWS specialist, supervisor, or district director within five business days after providing the TP to the assigned specialist, notification is sent to TFC program staff and the respective regional director via email with a subject line "Lack of Response -TP Process."
24. Transportation of medication.CWS workers specialists transport medication for the child in OKDHS custody per Oklahoma Administrative Code 340:75-6-88 Instructions to Staff # 4 8.
340:75-8-7. Contracted therapeutic foster care services
Revised 3-26-107-1-14
(a) Contractor rules.Therapeutic foster care (TFC) contractors meet Oklahoma Health Care Authority (OHCA) rules as described in Parts 1, 3, and 5 of OAC the Oklahoma Administrative Code (OAC) 317:30-3 and Part Parts 21 and 83 of OAC 317:30-5.¢ 1
(b) TFC services.Contracted TFC services are based on the child's assessed needs and are provided consistent with the goals and objectives of the child's treatment plan (TP), and in accordance with per OAC 317:30-5-241.2 and OAC 317:30-5-742.2 and include:
(1) individual therapy;
(2) family therapy.The TFC contractor:
(A) works with the parent(s) parent or parents or placement provider to whom a child in TFC will be discharged;
(B) seeks to support and enhance the child's relationship with family members, including siblings;
(C) arranges for and encourages regular contact and visitation between the child and parent(s) parent or parents and other family members; and
(D) engages the child's parent(s) parent or parents and siblings in visitation and family therapy with the child, when the case plan is reunification.The TFC contractor provides consultation, support, and technical assistance to the TFC parent in the implementation of the child's treatment plan TP;
(3) group rehabilitative treatment.Group When provided, group rehabilitative treatment services include includes education and supportive services, such as basic living skills, social skills redevelopment, interdependent living, self-care, lifestyle change, and recovery principles, and other similar services.Thirty minutes of individual therapy, family therapy, or both, may be provided in lieu of one hour of group rehabilitative treatment;
(4) substance abuse or chemical dependency therapy, as needed, by a child with behavioral or emotional problems directly related to substance abuse.A minimum of two hours of education and prevention therapy per 90-day period is required for a child who does not have behavioral or emotional problems directly related to substance abuse;
(5) basic living skills redevelopment provided by the TFC parent;
(6) social skills redevelopment provided by the TFC parent;
(7) crisis behavior management and redirection services to ensure therapeutic contract staff availability are available for response 24 hours a day, seven days a week for response.Response includes providing face-to-face or telephone intervention during a crisis to the residential placement provider during a placement crisis to stabilize the child's behavior and prevent placement disruption.Face-to-face intervention must be utilized prior to a child's placement in a higher level of care, unless there is an imminent safety risk.Crisis behavior management and redirection services are consistent with the goals and objectives of the child's treatment plan TP;
(8) collaboration with Child Welfare Services (CWS) specialists in the completion of the youth's basic life skills assessment and the development of the youth's Independent Living (IL) plan; and
(9) independent living (IL) services consistent in compliance with the IL program administered by Oklahoma Department of Human Services (OKDHS), per Part 13 of OAC 340:75-6; and
(9) (TFC agency developed policy and operating procedures that support collaboration with Child Welfare (CW) workers in the completion of the child's basic life skills assessment and the development of the child's IL plan.¢ 2
(c) Contractor TFC contractor requirements.TFC contractors are required to provide services and meet requirements as identified in OAC 340:75, OAC 317:30-5-740, OAC 317:30-5-740.1 and the TFC contract.The contractor residential behavioral management services (RBMS) contract:.
(1) seeks to ensure services provided to the youth age 16 to 21 assist in planning for the youth's future and enhancing individual strengths and abilities Specialized treatment services to augment the services provided by the TFC contractor may be obtained when a child experiences severe functional impairment, exhibiting the need for additional treatment beyond the established TFC individualized treatment plan and ability of the TFC contractor to provide.Specialized treatment services require a Medicaid provider and prior authorization from OHCA, and are not provided by the TFC contractor;
(2) ensures the youth in OKDHS custody applies for Medicaid upon his or her 18th birthday, if the youth remains in placement in voluntary care to complete his or her secondary education; The CWS specialist is required to participate in the coordination of all requests for additional treatment services for a child in a TFC placement with the TFC contractor.The CWS specialist and TFC contractor consider the:
(A) duration, intensity, and frequency of the child's behaviors;
(B) child's specialized treatment needs including, but not limited to, sexual perpetration, long-term substance abuse, and highly sexualized behaviors;
(C) number of crises requiring on-site response; and
(D) child's progress on his or her TFC treatment plan; and
(3) ensures TFC staff comply with the qualifications in OHCA rules, per OAC 317:30-5-740 and 317:30-5-740.1;
(4) after the initial placement of a child, provides clothing.Emergency funds for clothing may be accessed per OAC 340:75-13-45;
(5) ensures recreation, other than school and church attendance, is available through a wide range of activities to provide the child opportunities to pursue his or her talents, hobbies, or interests;
(6) supports all permanency planning efforts as identified on the child's Form 04KI012E, Individualized Service Plan (ISP);
(7) advocates for educational services in the community that best meet the needs of each child in compliance with Section 1-113 of Title 70 of the Oklahoma Statutes.
(A) The contractor:
(i) ensures timely school enrollment and provides the child's school with the information defined in the TFC contract at the time of enrollment; and
(ii) provides or arranges tutoring services in conjunction with the CW county of jurisdiction or county of placement worker.
(B) A child in TFC may:
(i) attend a private school accredited by Oklahoma.OKDHS does not pay the cost or related cost of private school education; and
(ii) be home schooled consistent with OAC 340:75-6-50.The TFC contractor consults with the Children and Family Services Division (CFSD) TFC programs manager and the involved CW field liaison in the decision to home school;
(8) completes a written incident report describing any extreme behavioral incident or major rule violation, including the contractor's response.The contractor provides a copy to the child's CW county of jurisdiction and placement workers and contract liaison, and files in the TFC record per contract specifications;
(9) complies with children's rights per OAC 340:75-11-237;
(10) complies with all general requirements per OAC 340:75-8-6;
(11) complies with all other requirements specified in the OKDHS contract;
(12) maintains documentation of the child's runaway status and leave days defined in the contract and reports leave days on Form 04CB002E, CFSD Claim for Purchase of Residential Care; and
(13) submits Form 04CB002E for reimbursement to CFSD Administrative Services Unit.TFC contractors are reimbursed by:
(A) OHCA at a fixed daily rate for the provision of Medicaid services per OAC 317:30-5-743 and 317:30-5-744; and
(B) OKDHS at a fixed daily rate.The fixed daily rate is a blend of Title IV-E federal funds, per eligibility of each child served, and state funds.
INSTRUCTIONS TO STAFF 340:75-8-7 [REVOKED]
Revised 5-15-09
1.Additional services available to children in TFC.Specialized treatment services to augment the required services provided by the therapeutic foster care (TFC) contractor may be obtained when a child experiences severe functional impairment, exhibiting the need for additional treatment beyond the required TFC services.The specialized treatment services are provided by a Medicaid behavioral health contractor other than the TFC contractor and require prior authorization by the APS Healthcare reviewer for Medicaid reimbursement.
(1) Services provided to a child in TFC by a psychiatrist or licensed PhD psychologist in private practice require prior authorization by APS Healthcare for Medicaid reimbursement.
(2) The Child Welfare (CW) county of jurisdiction and county of placement workers participate in coordination of all requests for additional treatment services for a child in a TFC placement with the TFC contractor.In requesting additional services from a licensed PhD psychologist in private practice, the CW county of jurisdiction and county of placement workers consider the:
(A) duration, intensity, and frequency of the child's behaviors;
(B) child's specialized treatment needs including, but not limited to, sexual perpetration, long-term substance abuse, and highly sexualized behaviors;
(C) number of crises requiring on-site response; and
(D) child's progress on his or her TFC treatment plan.
2.Independent living (IL).Per Part 13 of OAC 340:75-6, the CW county of placement worker:
(1) ensures that the youth's basic life skills assessment is completed; and
(2) arranges for the youth to attend the annual IL seminar.
340:75-8-8. Therapeutic foster care contractor requirements
Revised 5-15-097-1-14
(a) Therapeutic foster care (TFC) contractors:
(1) engage in active recruitment of potential TFC parents who reflect the racial and ethnic diversity of children requiring placement, in compliance with the Multiethnic Placement Act of 1994 and per Oklahoma Administrative Code (OAC) 340:75-7-10;
(2) engage in active recruitment of potential TFC parents who are receptive and capable of meeting the service needs of all Oklahoma Department of Human Services (DHS) custody children determined to be eligible for TFC placement;
(1)(3) certify TFC homes according to rules established by Oklahoma Child Care Services (OCCS), Children and Family Services Division (CFSD) Child Welfare Services (CWS), OAC 340:75-7-10 through 340:75-7-19, Oklahoma Health Care Authority (OHCA), and the requirements outlined in Oklahoma Department of Human Services (OKDHS) DHS Placement Agreement for Residential Behavioral Management Services placement agreement for residential behavioral management services (RBMS) in TFC Settings;
(2)(4) ensure each TFC parent receives the appropriate pre-service training according to CCS rules, OHCA rules per OAC 317:30-5-740.1, CWS resource family requirements including Bridge, and the requirements outlined in RBMS in TFC sections, prior to the placement of a child in the home;
(5) ensure the TFC home meets all certification requirements prior to the placement of a child in the home;
(3) engage in active recruitment of potential TFC parents who reflect the racial and ethnic diversity of children requiring placement, in compliance with the Multiethnic Placement Act of 1994 per OAC 340:75‑7-10;
(4)(6) continually evaluate the TFC parent's ability to provide TFC services and meet the needs of children receiving residential behavior management services RMBS in a foster care setting per OAC 340:75-7-94;
(5) ensure each TFC parent:
(A) is trained according to OCCS rules, OHCA rules per OAC 317:30-5-740.1, and CFSD resource family requirements including Bridge, and the requirements outlined in OKDHS Placement Agreement for RBMS in TFC Settings, prior to the placement of a child in the home;
(B) meets the requirements for in-service training as defined in the OKDHS contract; and
(C) has access to respite care per OAC 340:75-8-11;
(6)(7) participate in regularly scheduled staffings with CWS program staff for any child abuse and neglect referral on a home certified by the contractor.Each foster care resource file must contain a log of all investigations and screened out referrals for use as a continual assessment of safety and resource home developmental needs;
(8) ensure that no TFC home is used for new placements or respite care while under investigation for child abuse or neglect.New placements or respite care cannot resume without specific consent of TFC program staff;
(9) ensure each TFC parent meets the requirements for in-service training as defined in the DHS RBMS contract;
(10) completes complete Form 04TF006E, Unsupervised Time Assessment, for all TFC children age six and older, regardless of age, anytime an assessment is made that the child has the ability to have time away from the TFC parents' parent's or parents' direct supervision, other than the child's participation in extracurricular educational activities for grades K through 12.When establishing a plan for unsupervised time, consideration is given to a child's individual need or desire to participate in activities with peers, such as religious, cultural or community events, other age-appropriate activities, or employment.This assessment includes, but is not limited to, the utilization of child care and the TFC parent or parents availability to respond to behavioral needs and all problems when the child is not under their direct supervision.The assessment is documented as part of the child's ongoing TFC treatment plan with a copy of the finalized plan provided to the TFC parent or parents;¢ 1
(11) requests request approval from the CFSD programs manager CWS program staff for TFC prior to accessing child care for a child five 5 years of age or younger.OKDHS does not reimburse for child care for a child in TFC placement.The written request includes the:
(A) therapeutic justification in the child's treatment plan of daily child care outside of the child's TFC placement home;
(B) ability of child care staff or child care provider to meet the child's emotional and behavioral needs and all problems;
(C) availability of the TFC parent and TFC contractor staff to respond to behavioral needs and all problems at in the child care environment;
(D) verification of child care center's licensing status, star ratings, and adult: to child ratio, per OAC 340:75-7-65(a)(3)(A);
(E) proposed weekly schedule for child care utilization;
(F) planned length of use of child care as a service component of the child's treatment plan; and
(F)(G) verification of TFC approval as a respite provider when an individual is providing child care copy of the child's Form 04TF006E;
(7) completes Form 04TF006E, Unsupervised Time Assessment, for children age six and older anytime an assessment is made that the child has the ability to have time away from the TFC parents' direct supervision.The assessment is documented as part of the child's ongoing TFC treatment plan;¢ 1
(8)(12) do not accept applications from any foster parent certified by any other agency, including all licensed child-placing agencies and OKDHS, without prior written approval of the current certifying TFC contractor and written approval of the CFSD programs manager CWS program supervisor for TFC;¢ 2
(9) do not certify the TFC home unless at least one TFC parent is available to provide care for the child any time the child is not in school;
(10)(13) do not certify an a OKDHS employee as a TFC parent without prior written approval from the CFSD CWS director or designee.The TFC contractor submits the written request to the CFSD programs manager CWS program supervisor for TFC.The review of the request is consistent with OAC 340:75-7-12;
(11)(14) do not certify a TFC agency employee assigned to the TFC program as a TFC parent without prior written approval from the CFSD programs manager CWS program supervisor for TFC.The request includes a copy of TFC agency policy regarding certification of employees of the TFC agency; and
(12)(15) do not accept a foster parent application from a person licensed to provide child care services.Families are not approved as licensed family child care homes and TFC homes at their home or in any other location.
(b) TFC homes may be jointly approved per OAC 340:75-7-19.
(1) Joint approval of a TFC home occurs following written approval between the TFC contractor and the other certifying agency.
(2) A TFC home certified by more than one agency may not accept new placements from either certifying agency without prior written agreement of all certifying agencies. ¢ 2
INSTRUCTIONS TO STAFF 340:75-8-8
Revised 7-1-087-1-14
1. Unsupervised time for children in TFC therapeutic foster care (TFC) placement.Child Welfare Services (CW) staff in the county of placement:
(1) consults with the therapeutic foster care (TFC) therapist and the TFC foster parent regarding the decision to complete Form 04TF006E, Unsupervised Time Assessment;
(2) reviews the completed Form 04TF006E and the accompanying Support Plan signed by the child, the TFC therapist, the TFC foster parent, and the TFC agency director;
(3) discusses the completed Form 04TF006E, accompanying Support Plan, and TFC treatment plan (TP) with his or her supervisor and the county of jurisdiction worker and supervisor when different from the county of placement;
(4) secures necessary signatures and returns the signed plan to the TFC therapist to be filed in the TFC case with copies provided to the TFC parents and the child; and
(5) reviews Form 04TF006E and Support Plan at each treatment plan TP review and any time when the child's behavior or needs changes change.
2.Joint approval.Child Welfare (CW) staff:
(1) refers all requests for joint approval of therapeutic foster care (TFC) homes in writing to the Children and Family Services Division programs manager for TFC, per OAC 340:75-7-19;
(2) does not encourage or recommend that the TFC parent seek approval with another TFC agency prior to the resolution of any issues with the current certifying TFC contractor; and
(3) encourages the TFC parent to address the issues with the director of the contractor's TFC program or through the TFC contractor's grievance process.
340:75-8-9. Placement procedures in therapeutic foster care homes
Revised 3-26-107-1-14
(a) Therapeutic foster care (TFC) is the least restrictive community-based residential care placement setting.Children in Oklahoma Department of Human Services (OKDHS) custody served in TFC placements are ages three 3 through 17 years of age, male or female, and determined by the Oklahoma Health Care Authority (OHCA) authorized reviewer to meet the medical necessity criteria for TFC services, per OAC Oklahoma Administrative Code (OAC) 317:30-5-741.
(1) The child has been diagnosed with any DSM-IV Diagnostic and Statistical Manual of Mental Disorders (DSM) AXIS I primary diagnosis, with the exception of V codes and adjustment disorders, accompanied by a detailed description of the symptoms supporting the diagnosis.
(2) The child's conditions are directly attributed to a mental illness or serious emotional disturbance as the primary need for professional attention.
(3) It has been determined by the inpatient authorization reviewer that the child's current disabling symptoms cannot be or have not been managed in a less intensive treatment program.
(4) There is evidence that the child's presenting emotional or behavioral problems prohibit full integration in a family or home setting without the availability of 24-hour crisis response, behavior management, and intensive clinical interventions from professional staff, preventing the child from living in a traditional family home.
(5) The child is medically stable and not actively suicidal or homicidal and not in need of substance abuse detoxification services.¢ 1
(6) The parent or the legal guardian of the child in DHS custody is afforded the opportunity to actively participate in the child's treatment and planning.
(b) The Child Welfare Services (CWS) county of jurisdiction worker specialist and supervisor assess each child's treatment needs per OAC 340:75-6-40 and 340:75-6-85.The CW worker CWS specialist seeks TFC placement when the:
(1) child's treatment needs can no longer be met in the child's own home, relative home, or traditional foster family setting;
(2) child does not require a group home placement; and
(3) child does not meet the medical necessity criteria for inpatient psychiatric treatment.
(c) A child whose behavior requires 24-hour awake supervision or who poses a danger in a family setting is not appropriate for TFC placement.
(d) The TFC contractor receives referrals for the placement of children from the area regional resource coordinator (ARC)(RRC), per OAC 340:75-8-12.¢ 2
(e) The TFC contractor requests a TFC authorization extension 30 calendar days prior to the expiration of the authorized length of stay.If When the OHCA authorized reviewer denies the extension of services, the TFC contractor provides written notification within one working business day of the denial to the CWS county of jurisdiction and county of placement workers, if different specialist.¢ 3
(f) TFC contractors document in writing an assessment of the agency's ability to serve a child age five and under 5 years of age or younger prior to placement.The written documentation is maintained for onsite review during program audits and includes:
(1) the assessed diagnosis and proposed treatment plan for the child;
(2) the credentials, experience, and training of the TFC contractor's staff documenting the staff's ability to develop an age appropriate treatment plan and deliver clinical services to children, five 5 years of age or younger, with emotional disturbances or behavioral disorders; and
(3) other information as requested by the CFSD programs manager for TFC; and
(4)(3) a description of the proposed TFC parent's:
(A) age, availability, experience, and skills;
(B) family structure;
(C) ability to meet the needs of a child, including a child age five 5 years of age or younger; and
(D) parenting responsibilities to other children in the home, children in foster care or therapeutic foster care TFC placement, any adopted children, and any birth children.
(g) The TFC contractor does not place more than two children in a TFC home without prior written approval from the CFSD programs manager CWS programs supervisor for TFC via the completed form Form 04FT003E, Request for Third Placement.The TFC contractor submits the written request that includes:
(1) primary treatment needs for the proposed placement of a third child and any subsequent children in the TFC home;
(2) availability, placement history, skills, completed or planned corrective action, and additional contractor supports of the TFC parent identified for proposed placement of a third child;
(3) risk factors considered and compelling reasons for proposed placement of a third child;
(4) documentation of TFC contractor contact with CW workers CWS specialists or supervisors for each child in the home, involved professionals, and each TFC family member, regarding the impact of the proposed placement of a third child;
(5) documentation of TFC contractor's review of any separated siblings placed in the proposed third placement; and
(6) other information as requested by the CFSD CWS programs manager for TFC.
(h) Title XIX payments for TFC services are not made for TFC parents who move out of Oklahoma.TFC placements are made only in Oklahoma.¢ 4
(i) A child may remain in TFC placement on a voluntary basis after age 18 years of age, per OAC 340:75-6-110.¢ 5
INSTRUCTIONS TO STAFF 340:75-8-9
Revised 3-26-107-1-14
1.Authorization for therapeutic foster care (TFC).
(1) APS Healthcare Oklahoma Health Care Authority (OHCA).A child in Oklahoma Department of Human Services (OKDHS) custody is authorized for TFC placement by OHCA inpatient authorization reviewers of APS Healthcare.Reviewers initially evaluate the child's current treatment needs to determine whether the child likely meets the criteria for TFC services.
(A)The CW county of jurisdiction worker Child Welfare Services (CWS) specialist requests APS OHCA evaluation for admission to TFC by calling 1-800-762-1560 1-800-522-0114, selecting the Inpatient Prior Authorization option, and requesting a TFC evaluation.
(B) The CWS county of jurisdiction worker specialist provides to the APS OHCA reviewer accurate and complete information regarding the child's behavior.The information provided is documented in Form 04KI010E, Placement Worksheet.
(C) When the reviewer determines the child likely meets criteria for TFC, the reviewer faxes the "sounds like" designation to the area resource coordinator (ARC) regional resource coordinator (RRC).
(D) The CWS county of jurisdiction worker specialist makes the placement request on the child's KIDS Placement Recommendation screen, and the supervisor approves the placement request immediately following the TFC approval by the reviewer.The CW CWS supervisor's approval of the placement request indicates that Form 04KI010E has been reviewed for com complete and pertinent referral information is included.
(E) To appeal a TFC denial by OHCA, the child's CWS county of jurisdiction or county of placement worker specialist contacts the CFSD programs manager CWS programs supervisor for TFC.
(2) Contractor listing.TFC contractors are found in the KIDS Resource Directory, resource category - Residential-State Office Authorized, resource type - Therapeutic Foster Care Contractor.
2.ARC RRC assignment.The CW CWS programs supervisor's approval of the recommendation for TFC placement initiates the secondary case assignment to the ARC RRC.Refer to OAC Oklahoma Administrative Code (OAC) 340:75-8-12 ITS for the ARC's RRC's role and responsibilities.
3.Lower level placement options.When the child no longer meets criteria for TFC placement and can be placed in a lower level of care, the CWS county of jurisdiction worker specialist immediately makes plans for the next appropriate placement.Placement options for a child who no longer meets criteria are:
(1) his or her own home;
(2) a relative home;
(3) an adoptive home;
(4) foster family care, including joint approval of the TFC home per OAC 340:75-8-8, and contract foster care; or
(5) independent living.
4.Out-of-state placements.CW CWS staff are not authorized to approve TFC placement of a child in OKDHS custody with a TFC parent who is moving out-of-state.
5.Extended placement services.The CWS county of jurisdiction worker specialist and supervisor determine whether the child in TFC placement is eligible for voluntary services after age 18 years of age.If the child is eligible and requests voluntary care, the CWS county of jurisdiction worker specialist completes requirements per OAC 340:75-6-115.9 340:75-6-110.
340:75-8-10. TFC Therapeutic foster care placement in close proximity to child's home community
Revised 3-26-107-1-14
(a) Placement within the closest geographic proximity.The therapeutic foster care (TFC) contractor places the child in custody:
(1) in a therapeutic foster home within the closest geographic proximity as possible of to the county of residence of the child's parent(s); or
(2) if the child is in Oklahoma Department of Human Services (OKDHS) permanent custody, within the closest geographic proximity as possible of to the child's county of court jurisdiction.
(b) Proximity of siblings.The TFC contractor considers the placement and accessibility of the placed child's sibling(s), if the sibling(s) is in OKDHS Oklahoma Department of Human Services (DHS) custody.
(c) Approval.If a placement is not available within the closest geographic proximity as possible, and the child must be placed outside a 40-mile radius a signed agreement is required between the TFC contractor accepting the child for placement and Child Welfare (CW) staff.The TFC contractor initiates the signed agreement with approval granted by the CW county of jurisdiction worker and supervisor and the sending and receiving area resource coordinators (ARCs).
(d)Disruption.If disruption occurs in the TFC placement and the custody child's disrupted placement is not in the closest geographic proximity as possible, the TFC contractor serving the child seeks placement, in accordance with per (a) and (b) of this Section, in one of the TFC contractor's homes.
(1) If the TFC contractor cannot place the child, whose TFC placement disrupted, in accordance with per (a) and (b) of this Section, the TFC contractor contacts other TFC contractors serving the identified close proximity area of the child for availability of an appropriate TFC placement.
(2) If another TFC contractor can appropriately place the child within the 40–mile radius per (a) and (b) of this Section, OKDHS transfers the child to that TFC contractor for placement.
(3) The CW county of jurisdiction worker is responsible for transporting the child immediately following the identification of the need for TFC placement.When efforts to locate new placement are not successful, the TFC contractor provides notification of discharge to the Child Welfare Services (CWS) specialist per Oklahoma Administrative Code 340:75-8-6 (24).
(4) The CWS specialist arranges for alternate placement and transportation in accordance with the timeframes established by the TFC contractor's notification of discharge.
(e) Exception to placement within the closest geographic proximity.If all reasonable efforts to place a child within the closest geographic proximity to the county of residence of the child's parent(s), or, in the case of a child in the permanent custody of OKDHS, the child's county of jurisdiction and the TFC contractor has an appropriate TFC home outside a 40-mile radius, an exception is made to place the child.The exception is approved with a signed agreement initiated by the TFC contractor and signed by the CW county of jurisdiction worker and supervisor, the CW county of placement worker and supervisor, and the sending and receiving ARCs.
340:75-8-11. Therapeutic foster care placement stability
Revised 6-1-077-1-14
(a) Notification of respite placement.The therapeutic foster care (TFC) contractor notifies the Child Welfare (CW) county of jurisdiction and county of placement workers, area resource coordinators (ARCs) involved in the placement, and the contract liaison of all placement changes, including all types of respite, for each child in TFC placement.¢ 1Assessment of placement stability.Therapeutic foster care (TFC) contractors and Child Welfare Services (CWS) specialists continually assess the stability of a child's placement.When indications of instability are identified, the TFC contractor and CWS specialist jointly evaluate the need for additional services and supports to maintain the current placement.
(b) Supporting placement stability.The TFC contractor and CWS specialist review the child's current treatment plan and determine the need for modifications including, but not limited to:
(1) the need for further evaluation;
(2) specialized treatment services;
(3) increased communication between team members;
(4) wrap around services;
(5) additional supports for the foster parents;
(6) use of disruption prevention staffing; and
(7) behavior redirection and crisis management services.¢ 1
(c) Placement disruption.Disruption is an unplanned change in a child's placement and occurs when a child is removed from a therapeutic foster home and will not return.Disruptions include all placement changes that are not related to a planned movement towards the child's identified permanency goal.Unless an emergency exists the:
(1) TFC contractor does not move children in therapeutic foster care placement without DHS approval.
(2) TFC parent provides a 30-calendar day advance notice to the TFC contractor when requesting a child's removal from the TFC home, unless a more immediate removal is required to protect the health or safety of the child or TFC family members.
(d) Disruption staffing.A disruption staffing will occur for all unplanned placement changes.
(b)(e) Respite care.Respite care is a planned provides reprieve and support for the TFC parent, child, or both.Respite for children in therapeutic foster care is only provided in certified therapeutic foster homes.There are four classifications of respite care: with whom a child is placed and includes a defined time frame for the length of stay and an identified date for the child's return to the TFC parent with whom the child is placed.
(1) Respite location.Respite care is provided in the home of a TFC parent, certified and trained by the TFC contractor.Respite care does not occur in emergency shelters.
(2) Planned respite.Planned respite is a planned reprieve Reprieve for the TFC parent with whom a child is placed includes a defined timeframe, not to exceed 14 calendar days, and specifies the date for the child to return.
(3)(2) Unplanned respite.Unplanned respite is an unplanned or crisis reprieve, Reprieve for the TFC parent with whom a child is placed due to a crisis or emergency circumstance includes a defined timeframe, not to exceed three working business days, for the TFC parent with whom the child is placed.If circumstances warrant an extension beyond three business days of the respite stay, the TFC contractor submits a written request for the extension to the assigned TFC agency contract liaison for their agency.Any extension of unplanned respite will not exceed a total of 14 calendar days.
(A) The TFC contractor submits a written request for an extension of time, if needed, to the CW county of placement supervisor.
(B) A copy of the county approved respite extension is sent by the TFC contractor to the CW county of jurisdiction supervisor, when different from the county of placement, and Children and Family Services Division (CFSD) programs manager for TFC for information purposes.
(4)(3) Transitional respite.Transitional respite is a Reprieve for stabilization and assessment period, not to exceed five working days, utilized following a TFC home placement disruption, is not to exceed five business days.This period that allows the TFC contractor and CWS county of jurisdiction worker specialist time to develop an appropriate plan for the child's next placement.If circumstances warrant an extension beyond five business days of the respite stay, the TFC contractor submits a written request for the extension to the assigned TFC agency contract liaison for their agency.Any extension of transitional respite will not exceed a total of 14 calendar days.
(A) The TFC contractor submits a written request for an extension of time to the CW county of jurisdiction supervisors for approval.
(B) A copy of the approved extension is maintained in the child's case and sent to the CFSD programs manager for TFC for information purposes.¢ 1
(4) Administrative Respite.Care provided for children when safety or contract compliance is under review in the TFC home.These periods are identified by the contractor or DHS.Circumstances could include, but are not limited to, abuse and/or neglect investigations, new criminal offenses by an adult household member, or contract violations that impact safety or may affect the requirements for continued certification.
(A) DHS immediately notifies the TFC contractor when a need for administrative respite is identified and provides details of safety concerns.
(B) When concerns are identified by the TFC contractor, DHS programs staff are notified within one business day that a child has been moved to a respite setting for administrative respite and provided details of safety concerns.
(C) The contractor and CWS programs staff agree to a specified time period for the respite care and establish a date to review the use of continued respite.
(f) Notification of respite placement.The TFC contractor notifies, via Form 04FT004E, Notice of Child's Location, the CWS county of jurisdiction and county of placement specialists, regional resource coordinators involved in the placement, and the contract liaison of all placement changes, including all types of respite, for each child in TFC placement.¢ 1
(c)(g) TFC contractor.The TFC contractor:
(1) ensures the respite TFC parent is informed of the child's current treatment issues, behavioral, medical, and physical needs, and any child specific supervision or safety plans; and
(2) supervises the respite TFC parent in the implementation of the in-home treatment strategies identified in the TFC contractor's individualized treatment plan for the child; and
(3) provides behavior redirection and crisis management services to prevent disruption of TFC placements, per OAC 340:75-8-7.¢ 1
(d) TFC parent.The TFC parent provides 14 days notice to the TFC contractor when requesting a child's removal from the TFC home, unless the removal is required to protect the health or safety of the child or TFC family member.
INSTRUCTIONS TO STAFF 340:75-8-11
Revised 6-1-077-1-14
1.Placement reviews.
(1) The Child Welfare (CW) county of jurisdiction and county of placement workers review all notices of the child's placement changes, including respite, to ensure the child's placement stability Upon receipt of Form 04FT004E, Notice of Child's Location, the Child Welfare Services (CWS) specialist updates the KIDS placement episode screen to reflect changes.
(2) If the therapeutic foster care (TFC) contractor, TFC parent, and CWS county of jurisdiction and county of placement workers specialists agree that the crisis management services additional supports for stability:
(A) are successful in stabilizing the child, the child returns to the TFC placement; or
(B) are not successful in stabilizing the child and the TFC placement is disrupted, the CWS county of jurisdiction worker specialist immediately plans for the next appropriate placement.
340:75-8-12. Responsibilities of area resource coordinators
Revised 5-26-057-1-14
Therapeutic foster care (TFC) contractors receive referrals for the placement of children in Oklahoma Department of Human Services custody in TFC homes from the area regional resource coordinator (ARC)(RRC).¢ 1Child Welfare workers assigned as ARCs have responsibilities for the referral of children to TFC contractors RRC staff are responsible for the referral process of children to TFC contractors.¢ 21
INSTRUCTIONS TO STAFF 340:75-8-12
Revised 6-1-077-1-14
1.ARC assignments.The area director:
(1) assigns a Child Welfare (CW) worker in the respective Field Operations Division (FOD) service area as the area resource coordinator (ARC); and
(2) determines the number of ARC assignments and the counties assigned to each ARC in the respective area.
2.ARC Regional resource coordinator (RRC) responsibilities.The ARC RRC:
(1) manages the placement referral process for a child requiring therapeutic foster care (TFC) placement in the respective FOD Child Welfare Services (CWS) area;
(2) coordinates placement referrals in the area region by maintaining frequent contact with TFC contractors through regularly scheduled area regional placement meetings, telephone contact, and email as determined by the number of TFC placement requests in the area;
(3) receives the Bed Vacancy Report from TFC vendors at a frequency determined in the area but no less than once per week;
(4) receives secondary case assignment for placement automatically through KIDS;
(5)(4) receives the "sounds like" designation from APS the Oklahoma Healthcare Authority authorizing TFC assessment;
(6) prints Form 04KI010E, Placement Worksheet, and KIDS Placement Recommendation screen and reviews for completeness.If the information is not complete, the ARC notifies the CW county of jurisdiction supervisor that Form 04KI010E is inadequate for referral;
(7) submits Form 04KI010E and KIDS Placement Recommendation screen print to TFC contractors as soon as possible;
(8) submits Form 04KI010E to TFC contractors who report vacant beds matching the needs of the child referred.The ARC ensures, as first priority, all TFC placements are within 40 miles of the child's home or community;
(5) obtains information from the child's CWS county of jurisdiction specialist on the child's strengths, needs, and connections and reviews the referral information to ensure accuracy and complete detail;
(6) closes the recommendation in KIDS by adding "Denied/Incomplete" in the status line of the authorization screen when no information is received from the specialist to support the placement recommendation, and then closes their secondary assignment in KIDS.The RRC notifies the worker, supervisor, and district director by email that the placement recommendation was closed;
(7) forwards recommendation for placement to agencies in close proximity to the child's connections when complete information is obtained;
(9)(8) tracks placement referrals until the child is placed and keeps the CWS county of jurisdiction worker specialist informed of the status of the placement referral by e-mail email;
(10)(9) maintains a TFC placement file for each child referred for TFC from the area that includes the printed Form 04KI010E and Placement Recommendation screen, "sounds like" designation authorizing TFC assessment, and any letters from TFC contractors declining to place all referral information/placement documentation in the KIDS case file cabinet;
(11) consults with and refers to the ARCs in adjoining areas to verify TFC home availability, if placement is not available within 40 miles of the child's home or community;
(12)(10) upon notification of the child's placement from the TFC contractor and CWS county of jurisdiction worker specialist of the child's placement:
(A) authorizes the placement;
(B) enters the name of the TFC contractor who accepted the child for placement;
(C) documents placement justification on KIDS Placement Authorization screen; and
(D) end dates his or her RRC secondary case assignment for placement in KIDS; and
(13) immediately e-mails Children and Family Services Division (CFSD) Placement Section if all TFC contractors decline placement and sends the TFC placement file to Placement Section if placement in a higher level of care is appropriate; and
(14)(11) completes a monthly report of TFC placement referrals and the number of placements declined by TFC contractors and submits the report to the CFSD programs manager CWS programs supervisor for TFC by the fifth working tenth business day of the following month.
340:75-8-13. Additional responsibilities of the Child Welfare worker
Children in Oklahoma Department of Human Services (OKDHS) custody and in therapeutic foster care (TFC) placements receive Child Welfare (CW) child welfare services consistent with OAC 340:75-6-47 and 340:75-6-85 Oklahoma Administrative Code 340:75-6.¢ 1 through 3
INSTRUCTIONS TO STAFF 340:75-8-13
Revised 3-26-107-1-14
1.Child Welfare (CW) worker's Services (CWS) specialist role and responsibilities.CWS specialists have responsibilities for children in Oklahoma Department of Human Services (DHS) custody and in therapeutic foster care (TFC) placements.The CWS specialist's role and responsibilities for a custody child in out-of-home placement are defined per Oklahoma Administrative Code (OAC) 340:75-6.The CWS specialist is responsible for:
(1) A child placed in Oklahoma Department of Human Services (OKDHS) custody and a Therapeutic Foster Care (TFC) home:
(A) in the child's county of jurisdiction, receives CW services from a CW worker in the county of jurisdiction; and
(B) outside of the child's county of jurisdiction, receives CW services from a CW worker in the county of jurisdiction and a CW worker in the county of placement.
(2) CW county of jurisdiction and county of placement workers have responsibilities for children in OKDHS custody and TFC placements.The CW county of jurisdiction worker's role and responsibilities for a custody child in out-of-home placement are defined in OAC 340:75-6-47 and 340:75-6-85.The assignment of a CW county of placement worker or a TFC contract liaison does not diminish the CW county of jurisdiction worker's roles and responsibilities for a child in OKDHS custody and TFC placement.
2.CW county of jurisdiction worker's responsibilities.The CW county of jurisdiction worker is responsible for:
(1) developing and implementing the child's permanency plan.The permanency plan is an integral part of the case plan for a child who is in OKDHS custody and TFC placement, per OAC 340:75-6-31 and 340:75-6-85;
(2) ensuring communication and coordination of all CW workers assigned CWS specialists in all involved counties and all service providers;
(3)(2) immediately transporting the child for a pre-placement visit or placement, upon receiving notice that a TFC contractor has identified an appropriate TFC home.The county of jurisdiction worker may refuse to place a child in the custody of OKDHS in a TFC home;
(4)(3)completing, and, at the time of placement, providing to the TFC contractor copies of Form 04FC011E, Placement Agreement for Out-of-Home Care, Form 04KI005E, Child's Individualized Service Plan (ISP), Form04KI004E, Placement Provider Information, and Form 15GR004E, Notice of Grievance Rights - Minors in OKDHS Custody, per OAC 340:2-3-49.Failure of the CW county of jurisdiction worker to provide the information included in these forms may jeopardize the child's safety and well-being.The TFC contractor may refuse the placement of any child in OKDHS custody without this information; supplying information crucial to promoting the child in placement's safety and well-being and failure to provide the information may jeopardize the child's safety and well-being.The TFC contractor may refuse the placement of any child in DHS custody without the information in (A) through (L) of this Instruction.The CWS specialist provides the TFC contractor with completed copies of:
(A) Form 04FC011E, Placement Agreement for Out-of-Home Care,;
(B) Form 04KI005E, Child's Individualized Service Plan (ISP),;
(C) court approved Form 04KI012E, Individualized Service Plan (ISP), as applicable;
(D) Form 04KI004E, Placement Provider Information,;
(E) and Form 15GR004E, Notice of Grievance Rights - Minors in OKDHS Custody, per OAC 340:2-3-49;
(F) birth certificate;
(G) immunization records;
(H) court order for DHS custody;
(I) medical card;
(J) CWS specialist and supervisor's office and cell phone numbers;
(K) name, address, and telephone number of the last school the child attended; and
(L) independent living assessment, if the child is 16 years of age or older;
Failure of the CW county of jurisdiction worker to provide the information included in these forms may jeopardize the child's safety and well-being.The TFC contractor may refuse the placement of any child in OKDHS custody without this information;
(5) providing to the TFC parent a copy of the child's:
(A) birth certificate;
(B) immunization records;
(C) court order for OKDHS custody;
(D) court-approved Form 04KI012E, Individualized Service Plan (ISP), as applicable;
(E) medical card;
(F) CW county of jurisdiction worker and supervisor's phone numbers; and
(G) independent living assessment, if the child is 16 years of age or older;
(6)(4) providing to the TFC contractor the name and address of the school the child last attended, so the TFC contractor can enroll the child in school, per OAC 340:75-8-7.The CW county of jurisdiction worker assists assisting the TFC contractor in locating the child's school records and facilitating the transfer of school records from one school district to another;
(7)(5) transporting the child for admission to the new placement with adequate clothing or an emergency clothing authorization per OAC 340:75-13-45;
(8)(6) placing ensuring the child enters placement with a 30-day supply of any medication currently prescribed for the child to allow for uninterrupted treatment until alternate follow up medical care is received.The CWS county of jurisdiction worker specialist documents the receipt and release of all medication on Form 04MP011E 04MP012E, Receipt and Release of Prescription and Over-the-Counter Medication(s), as described in per OAC 340:75-6-88 Instructions to Staff # 4 8;
(9)(7) updating the KIDS Placement screens information to reflect current placement status;
(10)(8) providing completed Forms 04KI025E, Change in Placement Notification for Child's Attorney, and 04KI026E, Change in Placement Notification for Judge, in accordance with per OAC 340:75-6-86, when there is a change in the child's living arrangements;
(11)(9) maintaining on-site, monthly face-to-face contact with the child, when placed in the county of jurisdiction, in accordance with per OAC 340:75-6-48;
(12) maintaining monthly phone contact, if the child is placed outside the county of jurisdiction, with the county of placement worker and updating the county of placement worker on the court status and permanency plans;
(13) maintaining the child's primary case record.When the child is placed outside the county of jurisdiction, the CW county of jurisdiction supervisor assigns secondary case responsibility to the county of placement in KIDS and the CW county of jurisdiction worker forwards a copy of the child's paper case record to the county of placement per OAC 340:75-1-26;
(14) consulting with the TFC contractor at the time of admission and giving input into the development of the contractor's treatment plan for the child.The contractor's treatment plan is completed within 30 days of placement;
(15) maintaining involvement with the development and review of the TFC contractor's treatment plan for the child and participating on-site or by phone in the TFC contractor's 90-day reviews of the contractor's treatment plan for the child;
(16) reporting any earned income of the child to the Family Support Services worker or the assigned custody specialist on Form 08MP013E, Information/Referral - Social Services;
(17)(10) participating in all activities associated with the development and continual revision of the child's TFC treatment plan;
(11) arranging ensuring family visitation occurs through coordination with the TFC contractor, including transportation and supervision per OAC 340:75-6-30;
(18) completing reports to the court.
(A) The county of jurisdiction worker informs the child, the TFC contractor, and the TFC parent of the CW case progress and ongoing court status.
(B) When the child is placed in a TFC home outside of the county of jurisdiction, the CW county of jurisdiction worker informs the CW county of placement worker of the CW case progress and ongoing court status;
(19) advising the TFC contractor and the TFC parent of the local post adjudication review board (PARB) meetings, permanency planning review meetings, dates and times of court hearings, and any case staffing that requires the input of the TFC contractor and TFC parent;
(20) entering the end date of the placement in KIDS Placement screens when the child in TFC placement is ready for discharge or if a disruption occurs; and
(21) obtaining the child's next placement and transporting the child to that placement in compliance with OAC 340:75-8-1 through 340:75-8-14.
(12) informing the child, the TFC contractor, and the TFC parent of the dates and times of court hearings, the updated case progress, ongoing court status, and changes to the child's permanency goal; and
(13) informing the TFC contractor of any case staffing, meeting, or action that would include the input of the TFC contractor.
3.CW county of placement worker's responsibilities.When the child is placed in a TFC home outside of the county of jurisdiction, the CW county of placement worker:
(1) provides information to the CW county of jurisdiction worker regarding the child's progress and any problems in the child's TFC placement;
(2) maintains contact with the child per OAC 340:75-6-48; and
(3) may participate on-site or by phone in the TFC contractor's 90-day reviews of the contractor's treatment plan for the child.
340:75-8-14. Responsibilities of the contract liaison
A Child Welfare (CW) worker Services (CWS) specialist, in the county where the Therapeutic Foster Care (TFC) contractor's office is located, is assigned as a liaison to each TFC contractor as the contract liaison contracted therapeutic foster care agency.
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INSTRUCTIONS TO STAFF 340:75-8-14
Revised 3-26-107-1-14
1.The county director and the Child Welfare (CW) supervisor, in the county where the therapeutic foster care (TFC) contractor's office is located, assign Oklahoma Department of Human Services (DHS) therapeutic foster care (TFC) program supervisors assign a CW worker Child Welfare Services (CWS) specialist as the liaison to the TFC contractor.
2.The CW worker assigned as contract liaison has responsibilities to the TFC contractor.The liaison to the TFC contract contracted agency is responsible for:
(1) assisting the TFC contractor in maintaining effective working relationships with CWS field staff and assists in problem resolution;
(2) providing consultation to the TFC contractor about Oklahoma Department of Human Services DHS policy and TFC contract requirements;
(3) tracking the use of runaway and leave days and reviewing Form 10AD012E, Claim Form, and Form 04CB002E, CFSD Claim for Purchase of Residential Care, submitted monthly by the contractor for accuracy;
(4) providing the TFC contractor with the Dear Provider Letter upon admission;
(5) completing the monthly Liaison Report and submitting the report to the Children and Family Services Division (CFSD) TFC programs manager programs supervisor by the fifth working tenth business day of the month;
(6) reviewing the TFC contractor's informational memo notifying the CW supervisor of the name, address, and phone number of any therapeutic foster home certified by the TFC contractor in the contractor's county;
(7)(4) entering the specific therapeutic foster homes certified by the TFC contractor in the KIDS Resource Directory creating new TFC family resources for homes certified by the TFC contractor in the KIDS Resource Directory and updating TFC home resources in KIDS to reflect changes and closures reported by the contracted agency;
(8)(5) assisting in the ongoing assessment of the TFC contract and in the contract monitoring by participating as a member of the assessment team in the annual on-site contract assessment and in the ongoing assessment of the TFC contract;
(9) performing the quarterly on-site monitoring of the TFC contract; and
(10)(6) knowing the TFC contract requirements and reporting contract violations to the CFSD TFC programs manager supervisor.
