De-mystifying Treatment Foster Care (TFC): Understanding the New TFC Guidelines



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De-mystifying Treatment Foster Care (TFC): Understanding the New TFC Guidelines Karen Reilly-Jones, CSA Coordinator Chesterfield, VA Brad Bryant, Executive Director People Places, Inc.

New TFC Guidelines Defines Treatment Foster Care Identifies Service Needs Criteria Identifies Placement Outcome Goals Provides guidance on Uniform Contracting Gives Recommendations to Ongoing Issues

Why TFC Guidelines? Because the 2011 General Assembly required it! The State Executive Council and the Office of Comprehensive Services collected a group of stakeholders to accomplish it.

Common Goal: Children & Families Private Do it for the $$ Do not want kids to get adopted Take the easy kids Public Judge caregivers: adoption & FC should be for love, not money Push adoption to meet quotas rather real belonging TFC parents should walk on water

Common Language TFC = Treatment Foster Care

Treatment Foster Care A community-based program where services are designed to address the special needs of children. Delivered primarily by foster parents who are trained, supervised, and supported by agency staff. Primarily foster family based and is planned and delivered by a treatment team. Continuity of services, is goal-directed and results oriented, and emphasizes permanency planning for the child in care.

NEEDS vs. RESOURCES

Service Needs Criteria CANS indicators (emotional/behavioral needs, risk behaviors, etc.) VEMAT indicators for a high level of daily supervision FAPT/MDT approved and included in the IFSP NOTE: When placing sibling groups, levels of service must be matched to the individual needs of each individual child.

RESULTS??

TFC Goals = DSS Goals Step-down in intensity of services Improved CANS functioning Youth is successfully discharged from treatment foster care (e.g., return to family, adoption, college, etc.) Positive satisfaction survey responses about services Stability in placement (measured by number of homes/families with whom child resides while in TFC) Length of stay is no longer than TFC services are needed

Uniform Contracting All Parties agree to : Child s Permanency Goal Individualized treatment Clearly defined and appropriate TFC levels of care Family Engagement activities No duplication of Medicaid payments

Case Scenario- Sibling Group Four sibling group- Ages 6, 7,9,11 Emergency removal order on all four children for sexual abuse by a family member- priority to place all four children together. All four were initially placed in one TFC Home As of today- all 4 in different homes

Oldest -11 year old Placed at highest TFC level VEMAT: 12 CANS: Many strengths identified, No issues with school, most needs with Primary Caregivers Child rated 3 on impulsivity no 2/3 on Risks Behaviors Removed from TFC home after 6 months- for sexually molesting sibling, destruction of property, fondling a classmate, suspension, suicide ideations, nightmares, high anxiety with family visits. Attends weekly therapy At 10 months- new TFC home has increased concerns with mental /emotional health. Monthly medication management, reports of mood swings, high anxiety, sleep disturbance, & issues with peers REVIEW: Remained on TFC level 4- highest VEMAT 20 CANS: 2=sleep, social functioning, school achievement, impulsivity, depression, anxiety, adjustment to trauma, no 3s

Second Oldest- 9 year old Placed at second highest TFC level VEMAT: 12 CANS: Many strengths identified, No 2s or 3s needs identified for child, most needs with Primary Caregivers Removed from TFC Home after 6 months- for aggression, stealing, food hording, urination around house and sexually reactive behaviors. Placed in a new TFC home- therapy increased to twice weekly; supervised visitations with siblings. Attends weekly therapy At 10 months- new TFC Home, shows good adjustment, engaged in peer group and church activities. Issues are more with emotions (flat affect, depression, lack of motivation, sleep disturbance) REVIEW: Moved down TFC level / 2 out of 4 VEMAT 12 CANS: Multiple strengths identified Scored 2= school achievement, depression, sexually reactive behaviors, sexual abuse, no 3s

De-mystifying Treatment Foster Care (TFC): Understanding the New TFC Guidelines Karen Reilly-Jones, CSA Coordinator Chesterfield, VA Brad Bryant, Executive Director People Places, Inc.