Placement Service Standards KS 90 Manual

User Manual: KS 90

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Department for Children and Families

Placement Service Standards Manual

Effective: February 5, 2016

All Residential/Group Home placement providers shall be licensed DCF Foster Care and Residential

Facility Licensing and meet the DCF/PPS Placement Standards and requirements in the Child Welfare

Handbook of Client Purchases in order to obtain a provider agreement with DCF.

Implementing a new facility or modifying a provider agreement for an existing facility requires an onsite

review conducted by DCF regional staff. Providers may initiate the process by contacting their DCF

regional office.

The list of the Regional Specialists is located at:

http://www.dcf.ks.gov/services/PPS/Documents/Contract%20Information/ProviderAgreementSe

rvices.pdf

A. Implementing a New Facility or Renewing/Changing a Provider Agreement:

1. DCF regional staff shall assess the need for the type of service requested for a new facility and/or

a change in services listed in an existing provider agreement.

2. DCF regional staff shall provide information to the provider including a copy of the DCF

Placement Standards, Child Welfare Handbook of Client Purchases and contact information for DCF

Foster Care and Residential Facility Licensing.

3. DCF regional staff shall provide technical assistance relative to the DCF Placement Standards and

Child Welfare Handbook of Client Purchases.

4. DCF regional staff shall collaborate with KDOC-JS if the facility wants to serve juvenile offenders

and child in need of care youth.

5. DCF regional staff shall conduct an initial on-site review of the facility to ensure compliance with

the Placement Standards and the Child Welfare Handbook of Client Purchases. The on-site review

shall include a tour of the facility, review of policy and procedures, human resource files and staffing

patterns using the site review instrument. Ninety days after a new facility opens, or a change in

services listed in an existing provider agreement is implemented, DCF regional staff shall return on

site to review case records.

7. DCF regional staff shall provide technical assistance for compliance issues related to the

Placement Standards and the Child Welfare Handbook of Client Purchases and provide a written site

visit report of findings to the Provider.

8. The placement provider and DCF regional staff shall address any concerns prior to establishing a

provider agreement. Program improvement activities for securing compliance shall be completed

within 30 days.

9. The site visit report shall be maintained by DCF Regional Office who maintains the provider

agreement and forwarded to the Provider.

B. On-going Monitoring:

The Child Welfare contractors for Family Preservation and Foster Care shall complete reviews annually.

The purpose of the reviews is to maintain compliance with the DCF Placement Standards and Child Welfare

Handbook of Client Purchases. The contractors shall provide reports containing the results of their on-site

reviews to DCF on an annual basis.

Administrative desk reviews are conducted annually by DCF/PPS. The yearly desk reviews consists of

an overall picture of the facility over the past year. The desk review report will summarize findings from

the DCF Licensing Division incident reports, completed reviews from the Foster Care Contractor and a

review of frequency of use as per DCF SCRIPTS. The report is shared with the DCF Licensing Division,

The Foster Care Contractor, DCF PPS Administration and the facility being reviewed.

Table of Contents

Family Foster Home Descriptions page 4

Family Foster Home

Satellite Family Foster Home

Emergency Family Foster Home

Maternity Foster Home

Specialized Family Foster Home

Relative Foster Home

Kinship/Non-related Kin Care

General Program Requirements and Guidelines for

Family Foster Homes page 6

General Program Requirements and Guidelines for

Therapeutic Family Foster Homes page 12

General Program Requirements and Guidelines which

apply to Residential Placements

Youth Residential Care II page 25

Emergency Shelter page 40

Residential Maternity Care page 55

Transitional Living Program page 70

Community Integration Program page 83

Secure Care page 96

Family Foster Home Descriptions

Family Foster Home

A foster home is a family home in which 24-hour care is provided to children who are in need of out of

home placement to meet their safety and well-being needs. The home shall comply with DCF Foster Care

and Residential Facility Licensing licensure requirements, and be sponsored by a licensed child placing

agency. The foster family is an integral part of the team working with the child and birth family to achieve

timely permanency for the child.

Satellite Family Foster Home

Each satellite family foster home is sponsored by a licensed child placing agency with whom the child’s

referring agency subcontracts for child placement services.

Emergency Family Foster Home

An emergency family foster home is a family home in which 24-hour care is provided on an emergency

basis to children who are in need of out of home placement to meet their safety and well-being needs. The

home shall comply with DCF Foster Care and Residential Facility Licensing licensure requirements, and

be sponsored by a licensed child placing agency.

Maternity Foster Home

A maternity foster home is a home in which 24-hour care is provided to a pregnant or postpartum youth

and her child who is not a TANF recipient, who are in need of out of home placement to meet their safety

and well-being needs. These homes shall comply with DCF Foster Care and Residential Facility Licensing

licensure requirements, and be sponsored by a licensed child placing agency.

Specialized Family Foster Home

Each specialized family foster parent is required to comply with DCF Foster Care and Residential Facility

Licensing licensure requirements and the requirements of the sponsoring agency in regard to minimum

number of in-service training hours to be obtained yearly. Specialized family foster parents are required to

complete more annual in-service training than family foster parents due to specialized needs of the

children/youth for whom they are providing care. Documentation of completion of in-service training hours

shall be kept in the specialized family foster parent’s file. The purpose of in-service training is to provide

opportunities for the specialized family foster parent to increase their skills and parenting ability particularly

with respect to the differences they may encounter in raising children with the developmental needs of the

child to be placed and not born to them.

Relative Foster Home

Twenty-four hour care in the home of a person related to the child. A KBI and DCF Child Abuse/Neglect

Central Registry Check has been completed on all members of the family age 10 and over, and the child’s

referring agency has completed an assessment of the home to determine the child’s safety and well-being

needs will be met by placement in the relative’s home. If DCF Foster Care and Residential Facility

Licensing standards are met, relatives may receive financial assistance for the related child from the child’s

case management provider.

Kinship/Non-Related Kin Care

Twenty-four hour care in a family home setting for not more than 30 days, on a one time basis, for a specific

child with whom the kinship care provider has an existing supportive relationship with the child or the

child’s parent.

Informal Care/Kinship Care should be the first choice for placement when the child’s family cannot provide

adequate care. If the kin are not related to the child, they shall be required to meet DCF Foster Care and

Residential Facility Licensing child care licensing standards and regulations in order to provide out of home

services. To expedite placement of children with non-related kin, the requirement for the completion of PS-

MAPP (the group process or Deciding Together) and the other training required prior to a child being placed

in the home is waived. The non-related kin shall be required to complete the PS-MAPP curriculum and

other pre-service training prior to licensure.

Prior to the child’s placement, the Provider shall request from the local DCF Service Center a Child

Abuse/Neglect Central Registry check on all members of the non-related kin family who are age 10 and

over. The Provider shall also require the members of the family who are age 10 and over sign a statement,

Declaration of No Prohibitive Offenses for DCF Foster Care and Residential Facility Licensing Licensure,

indicating a check of the KBI criminal history database will not reveal any conviction for offenses, unless

they have been expunged, which would prohibit DCF Foster Care and Residential Facility Licensing

licensure. DCF Foster Care and Residential Facility Licensing shall complete the KBI criminal records

check prior to issuing the temporary permit.

Immediately following placement, the Provider shall complete the family assessment and licensing packet.

The packet shall be sent to DCF Foster Care and Residential Facility Licensing no later than 2 weeks after

the child's placement. DCF Foster Care and Residential Facility Licensing shall review the packet and, if

all requirements are met, issue a temporary permit by 30 days after the child's placement. The temporary

permit remains in effect for 90 days from the date of issuance. This temporary license may be extended for

one additional period not to exceed 90 days, to allow the kin time to complete PS-MAPP. No further

extensions shall be granted. Non-related kin shall comply with all licensing requirements of DCF Foster

Care and Residential Facility Licensing prior to a full foster home license being issued.

Case Management Providers shall negotiate a daily payment with the non-related kin providers to cover the

cost of the child's room and board. They shall also provide the same level of supports and services which

are provided to other resource families to ensure the child's needs are met and the placement remains stable.

Each child, newborn thru age 21, entering Kinship/Non-related Kin care shall have met criteria for this

level of placement through use of a placement assessment tool utilized by DCF and the Child Welfare

Community Based Service Provider staff. Each child being placed in Kinship/Non-related Kin care shall

have an existing, supportive relationship with the Kinship/Non-related Kin care giver prior to placement.

The relationship can be with the child or the parent.

General Program Requirements and Guidelines for

all Family Foster Homes

Section 1: General Program Requirements

 Twenty-four hour care in a family home meeting DCF Foster Care and Residential Facility

Licensing licensure requirements and sponsored by a licensed Child Placing Agency.

 Each family foster parent shall complete the PS-MAPP curriculum as a pre-service requirement

 Each family foster parent shall be at least 18 years of age at the time of application to DCF Foster

Care and Residential Facility Licensing for licensure, and have been a member of the household

for at least one year prior to application.

 Each family foster parent shall provide evidence of child care experience and knowledge of child

care methods which will enable any child to develop his or her potential.

 The family foster home shall be licensed for a maximum of 4 foster children, not more than 2 of

whom shall be under 18 months of age, with a total of 6 children in the home including the foster

parents’ own children under 16 years of age. Approval may be granted to care for 2 additional

foster children in order to meet the needs of sibling groups or other special needs of foster children

(K.A.R. 28-4-804).

 The family foster home shall meet the legal requirements of the community as to zoning, fire

protection, water supply and sewage disposal.

Section 2: Services Provided in a Family Foster Home

Services provided in a family foster home include: supervision, food, shelter, age appropriate daily living

skills instruction, transportation, recreation, supporting parent/child interactions (when these have not been

prohibited by the court), participation in development, and review of case plan tasks and objectives.

The daily schedule shall address the needs of the child and the use of time to enhance the child’s physical,

mental, emotional, and social development. Indoor and outdoor recreation shall be provided. All play

equipment, books, and other materials shall be safe, clean, in good repair, and suitable to the developmental

needs and interests of the child. The child shall attend school regularly and also have time for school and

community activities. The child shall be provided opportunities to practice age appropriate daily living

skills.

DCF requires foster parents and designated officials at child care institutions to apply the

reasonable and prudent parenting standard. The standard is characterized by careful and sensible

parental decisions that maintain a child’s health, safety, and best interests while at the same time

encouraging the child’s emotional and developmental growth that a caregiver must use when

determining whether to allow a child in foster care to participate in extracurricular, enrichment,

cultural, and social activities.

Section 3: Criteria for Admission

 Each child, newborn thru age 21 entering a Family Foster Home shall have met criteria for this

level of placement through use of a placement assessment tool utilized by DCF and the Child

Welfare Community Case Management Provider.

 A placement agreement shall be completed between the family foster parents or the home’s

sponsoring agency and the child’s referring agency. A copy of the signed placement agreement

shall be kept in the youth’s file in the family foster home.

Section 4: Accessing Outpatient Mental Health/Substance Use Disorder Services for a Child Residing

in a Family Foster Home

1. Child Welfare Case Management Provider’s shall be responsible to complete a mental health and

substance use disorder screen to determine each youth’s need for further assessment in these areas.

2. If the mental health assessment indicates the need for outpatient mental health treatment services,

the child shall receive the appropriate mental health services through an enrolled Medicaid provider

through KanCare. The MCO assigned to the youth through KanCare will periodically assess the

youth’s progress and continued need for outpatient mental health treatment.

3. If the substance use disorder assessment indicates the need for outpatient substance use disorder

treatment services, the child shall receive the appropriate substance use disorder services through

an enrolled Medicaid provider through KanCare. The MCO assigned to the child through KanCare

will periodically assess the youth’s progress and continued need for outpatient substance use

disorder treatment.

4. If the Mental Health assessment determines the youth may be in need of inpatient mental health or

substance use disorder treatment, the youth shall receive a Psychiatric Residential Treatment

Facility screen or, if the youth’s sole diagnosis is substance use disorder, a referral shall be made

to the MCO assigned to the youth.

Section 5: Scope of Services

Supervision– supervision will be provided by the foster parent or another appropriate care giver during the

foster parent’s absence.

Food and Shelter– nutritious meals and snacks will be provided, the home will meet the child’s health and

safety needs, each child has their own bed in a bedroom which meets DCF Foster Care and Residential

Facility Licensing licensure requirements.

Daily Living Skills Instruction– age appropriate daily living skills instruction will be provided in such

skill areas as: personal hygiene, laundry, meal preparation, shopping, cleaning, money management, and

health.

Transportation– transportation will be provided to school and medical appointments. The foster family

may also assist in transporting the child to social events, interactions with parents, court hearings and

reviews, etc.

Recreation– sufficient time for recreation and for individual, school, and community activities shall be

provided.

Supporting parent/child interactions– foster parents will assure each child is available for the scheduled

parent/child interactions directed in the child’s case plan. Foster parents may choose to make their home

available for some of these interactions or accompany the child to the site for the interactions to provide

mentoring support to the birth family.

Participation in development and review of case plan tasks and objectives– family foster parents are

an integral part of the child’s case planning team and are to be invited to participate in the development and

review of the plan.

Section 6: Education

Family foster parents are responsible to insure school age children attend school regularly, unless for an

excused absence, and the children complete homework assignments. If the child will not be able to attend

school due to illness or an appointment, the family foster parent is responsible to notify the school of this

absence. The family foster parent will also communicate with the school in regard to the student’s school

progress and developing plans to address issues related to school performance.

Section 7: Child’s Rights

Each child residing in a foster family home shall have an opportunity for:

— privacy

— contact with their case manager without the family foster parent present

— recognition of the child’s cultural and religious heritage

— taking personal items with them when they leave the foster home

Section 7.1: Forms of discipline not allowed in the Family Foster home include:

— physical discipline, including hitting with the hand or any object

— restricting movement by tying or binding

— confining in a closet, box, or locked area

— withholding food, rest, or toilet use

— refusing access to the family foster home

Section 8: Record Keeping Requirements for the Family Foster Home

Section 8.1: Child’s File

The family foster home shall maintain a file for each child in placement. The file shall contain the following

information:

— Child’s name and date of birth

— Name and address of the child’s referring agency case manager/social worker

— Placement Agreement or Client Service Agreement (for child placed by DCF staff)

— Medical and surgical consents

— Medical and dental records

— Record of child’s prescription and non-prescription medications and when administered

— Authorization for release of confidential information

— Log of significant incident reports

Section 8.2: 30-Day Progress Reports

Thirty-day progress reports shall document child’s adjustment in the home, school performance (if school

age), medical, dental, vision, and mental health appointments, significant incidents reported, interactions

with parents, and any other significant events or issues related to the child and the placement.

Section 8.3: Transfer of Child’s Medical Records

When a child leaves a family foster home to return home or moves to another out of home placement, the

child’s medical records shall be given to the child’ referring agency to accompany the child.

Section 9: Family Foster Parent In-service Training

Each family foster parent is required to comply with DCF Foster Care and Residential Facility Licensing

licensure requirements and the requirements of the sponsoring agency in regard to minimum number of in-

service training hours to be obtained yearly. Documentation of completion of the in-service training hours

shall be kept in the family foster parent’s file. The purpose of in-service training is to provide opportunities

for the family foster parent to increase their skills and parenting ability particularly with respect to the

differences they may encounter in raising children not born to them.

Training shall be related to one of the following topic areas:

a) Developmental needs of the child to be placed

b) Roles and relationships between the agency, foster parent, birth parent, and child

c) Child management and discipline techniques

d) Separation and the importance of the child’s family

e) Importance of the child’s continued communication and contact with family

f) Supportive services available to the child and to the foster family from the community

g) Communication skills

h) Constructive problem solving

i) First aid, blood borne pathogens, CPR, medications

j) Home safety

k) Human sexuality, including the needs and behaviors of children who have been sexually or

physically abused

Section 10: Reporting Abuse/Neglect

All family foster parents are mandated reporters. Mandated reporters shall report all witnessed or

suspected abuse/neglect to the Kansas Protection Report Center (KPRC) at 1-800-922-5330 or the local

Law Enforcement Agency.

Abuse is any act or failure to act which results in death, physical harm, emotional harm, or which presents

a likelihood of harm to a person under age 18. The broad definition of abuse includes physical abuse,

emotional abuse, and sexual abuse. Neglect is any act or omission resulting in harm to a child or which

presents a likelihood of harm. Neglect includes failure to provide food, clothing, shelter, safety, adequate

levels of appropriate supervision, medical treatment, or education.

Physical Abuse: Infliction of physical harm or the causation of a child's deterioration, and may include,

but shall not be limited to, maltreatment or exploiting a child to the extent the child’s health is endangered.

K.S.A. 38-2202

Sexual Abuse: Any contact or interaction with a child in which the child is being used for the sexual

stimulation of the perpetrator, the child, or another person. Sexual abuse shall include allowing, permitting,

or encouraging a child to engage in the sale of sexual relations or commercial sexual exploitation of a child,

or to be photographed, filmed, or depicted in obscene or pornographic material. Sexual abuse also shall

include allowing, permitting or encouraging a child to engage in aggravated human trafficking, as defined

in K.S.A. 2014 Supp. 21-5426(b), and amendments thereto, if committed in whole or in part for the purpose

of the sexual gratification of the offender or another. K.S.A. 38-2202 (See PPM 0160 or K.S.A. 21-6422

for Commercial sexual exploitation of a child, 21-5426 for aggravated human trafficking, and 21-5501 for

sexual intercourse and sodomy definitions). Contact solely between children shall meet the criteria only if

the contact also involves force, intimidation, difference in maturity, or coercion. K.A.R. 30-46-10.

Mental or Emotional Abuse: Infliction of mental or emotional harm or the causing of a deterioration of a

child, and may include, but shall not be limited to, maltreatment or exploiting a child to the extent the child's

health or emotional wellbeing is endangered. This term may include any act, behavior, or omission that

impairs or endangers a child’s social or intellectual functioning. This term may include the following:

1) terrorizing a child, by creating a climate of fear or engaging in violent or threatening behavior toward

the child or toward others in the child's presence that demonstrates a flagrant disregard for the child;

2) emotionally abandoning a child, by being psychologically unavailable to the child, demonstrating

no attachment to the child, or failing to provide adequate nurturance of the child; and

3) corrupting a child, by teaching or rewarding the child for unlawful, antisocial, or sexually mature

behavior. K.S.A. 38-2202 and K.A.R. 30-46-10

Neglect: Acts or omissions by a parent, guardian or person responsible for the care of a child resulting in

harm to a child, or presenting a likelihood of harm, and the acts or omissions are not due solely to the lack

of financial means of the child's parents or other custodian. Neglect may include but, shall not be limited

to:

(1) failure to provide the child with food, clothing, or shelter necessary to sustain the life or health of

the child;

(2) failure to provide adequate supervision of a child or to remove a child from a situation that requires

judgment or actions beyond the child's level of maturity, physical condition, or mental abilities and

that result in bodily injury or a likelihood of harm to the child; or

(3) failure to use resources available to treat a diagnosed medical condition if such treatment will make

a child substantially more comfortable, reduce pain and suffering, or correct or substantially

diminish a crippling condition from worsening. A parent legitimately practicing religious beliefs

who does not provide specified medical treatment for a child because of religious beliefs shall not

for that reason be considered a negligent parent. K.SA. 38-2202 (t)

Section 11: Significant Incident

A Significant Incident is an unanticipated event which does not rise to the level of a critical incident, but

has the potential risk of a serious adverse outcome.

Section 11.1 Significant Incident Reporting

Significant incidents are to be reported to the youth’s CWCMP case manager and the youth’s parent or

guardian when appropriate per PPM 0513.

The following significant incidents shall be verbally reported immediately with a written report to the

CWCMP case manager within 24 hours of the event (please refer to the following definitions for

clarification):

Significant Incident involving a child in the custody of the Secretary include but are not limited to:

1. death of a parent/primary caregiver (provide date of death)

2. runaway or missing from placement. PPM 5245 shall be followed.

3. arrested for a juvenile offense

4. alleged abuse or neglect

5. child is an alleged perpetrator or victim of a criminal assault of any kind

6. attempted suicide

7. serious physical illness

8. unanticipated medical attention that requires treatment beyond first aid

9. pregnancy. See PPM 0513 D. 2.

10. birth. See PPM 0513 D. 2.

11. emergency change in placement

12. use of illegal drugs

13. suspension of the license of a group or residential facility used by children

14. alleged victim of human trafficking

15. alleged perpetrator of animal abuse

16. other (document specifics)

17. death of child in care

If the significant incident involves abuse, neglect, or exploitation the facility shall also follow mandated

reporting requirements.

All facilities shall have procedures for reporting significant incidents to administrative staff and recording

significant incidents in the resident files. An administrative file of significant incidents must be kept by

facility and a copy of the significant incident shall be placed in the youth’s file.

An administrative file shall be kept by the facility documenting significant incidents that is separate from

the documentation in the youth’s file.

Each foster family shall obtain on-call/emergency contact information for all CWCMP case managers in

the event of an emergency or significant incident.

If the significant incident involves abuse or neglect the foster family shall also follow mandated reporting

requirements.

General Program Requirements and Guidelines for

Therapeutic Family Foster Home

A Therapeutic Family Foster home is a family home in which 24-hour care is provided to children who are

in need of out of home placement to meet their safety and well-being needs. The home shall comply with

DCF Foster Care and Residential Facility Licensing licensure requirements, and be sponsored by a licensed

child placing agency. The foster family is an integral part of the team working with the child and birth

family in order to achieve timely permanency for the child.

Section 1: Therapeutic Family Foster Home

The over-all purpose is to improve the mental health status, emotional, and social adjustment of youth who

require out of home therapeutic placement. Placement in Therapeutic Foster Care (TFC) occurs to support

the youth, allow the youth to function in a setting outside of an inpatient hospital, or prevent the inpatient

placement of the youth.

The Kansas TFC standards are predicated upon the National Program Standards of the Foster Family- Based

Treatment Association (http://www.ffta.org). The national standards indicate that TFC “is agency led and

team oriented”. It is not simply the provision of higher payment and more training to foster parents for work

with more difficult children or youth. Nor is it solely the addition of therapeutic resources external to the

treatment foster home.

DCF requires foster parents and designated officials at child care institutions to apply the

reasonable and prudent parenting standard. The standard is characterized by careful and sensible

parental decisions that maintain a child’s health, safety, and best interests while at the same time

encouraging the child’s emotional and developmental growth that a caregiver must use when

determining whether to allow a child in foster care to participate in extracurricular, enrichment,

cultural, and social activities.

Section 1.1: Goals and Objectives

To facilitate youth reaching the optimal functioning and ability to reside in the community in the least

restrictive environment.

Long term goals of the service are:

• Improve emotional, mental, and functional status of individuals receiving services;

• Reduce unplanned placement changes;

• Increase the youth’s ability to live safely, attend school, and be productive in an inclusive

community environment;

• Increase the likelihood of a youth’s successful return to the family or the successful

implementation of permanency planning; and

• If developmentally appropriate, increase the youth’s capacity for independent living.

Section 2: Description of Youth to Be Served

Youth placed in Therapeutic Foster Care shall be in need of therapeutic intervention. Clinicians and others

familiar with the youth shall document that the youth is at serious risk of placement in a highly structured

residential treatment program, but that the youth has enough internal control to be served in a structured

family home environment by knowledgeable trained foster parents with the support of specialized

behavioral management, school, and psychotherapy or behavioral therapy services.

These youths may exhibit well established patterns of behavior or conduct which are antisocial,

oppositional, defiant, aggressive, abusive, impulsive, rebellious, self-defeating, or sometimes self-abusive.

Youth with special medical needs or developmental disabilities may also require TFC if their behavior is

such that specialized care is warranted. TFC eligible youth may also display a limited ability to delay

gratification and show social and emotional immaturity. They may exhibit significant interpersonal

relationship problems associated with such symptoms as withdrawal, aggressiveness, Asperger’s or autistic

patterns, or peculiar behaviors resulting in rejection by peers. They may have problems with substance use

disorder, sexual acting out, running away, or destruction of property. Youth approved for Therapeutic

Foster Care may also display poorly developed self-help or communication skills.

These youth’s severe behavioral disturbances are primarily derived from environmental influences although

some may exhibit patterns of mild to moderate mental illness. Various medical conditions may complicate

the overall treatment picture. Affective disturbances will likely be prevalent as will be ADHD. Due to a

history of severe physical, emotional, or sexual abuse, youth requiring TFC may avoid adult relationships,

appear impersonal or detached, or exhibit serious oppositional tendencies. Sexual acting out associated with

past sexual abuse will also likely be seen in the typical TFC setting. Youth appropriate for TFC referral are

generally not an immediate danger to harm themselves. They may be potentially dangerous to others or

property through their aggression and disregard for other’s rights.

Youth in these circumstances require a high degree of supervision and intensive service. The youth may

have received treatment in psychiatric institutions, higher levels of residential treatment, or they may be

youth for which diversion from higher levels of treatment is recommended. They may be dually diagnosed

youth who require a combination of support services and therapy to regain control of their physical actions.

TFC youth may exhibit severe interpersonal relationship difficulties, especially with peers. However, they

shall be able to demonstrate at least some positive response to adults and authority. Bizarre or peculiar

behaviors may be exhibited which are sometimes only understood when the underlying causes and

dynamics of the behaviors are understood. Hyperactivity and a hyper-responsiveness to external stimulation

will likely be seen in various cases. Periodically, these youth may need external controls placed upon them.

Many of these youth may be placed on psychotropic medication to facilitate control of impulses, emotions,

attention capacities, or activity levels.

Youth who are immediately dangerous to themselves or others shall not be referred to TFC. Conversely,

youth who do not demonstrate a need for considerable supervision, support, psychotherapy, specialized

school services, psychiatric services or an inability to function within their biological family environment,

shall be helped in a less treatment intensive arrangement.

NOTE: Therapeutic Foster Care services are limited to special needs children who are at eminent

risk of placement in a psychiatric care, developmental disability care or residential facility or who

are referred from such a facility.

Section 3: General Program Description

TFC providers shall demonstrate the clinical and administrative capacity to provide quality services by

meeting the criteria listed below. The Licensed Child Placing Agency or the therapeutic family foster

parents do not provide acute inpatient, psychiatric, or substance use disorder residential treatment. Each

therapeutic family foster home shall meet DCF Foster Care and Residential Facility Licensing licensure

requirements and shall be sponsored by a licensed child placing agency. The provider shall state whether

the services under the Provider Agreement will be carried out by the provider’s staff, by subcontracted staff,

or through cooperative agreements. The provider shall provide, as part of the application, copies of such

agreements.

The provider shall agree that no more than two children will be cared for at any one time in each therapeutic

foster home. Exceptions can be granted for the additional placement of siblings or stepsiblings of the TFC

youth, provided that PPS the referring agency, and TFC program staff all agree that it is clinically good

practice to do so and document the rationale for that decision in the TFC Program youth’s case file. Services

are to be provided to a small number of youth at a time in each therapeutic family foster home to insure that

the children will achieve success with the goals outlined in the Treatment Plan.

Each child’s treatment plan shall be reviewed every 90 days by the child’s treatment team. The treatment

team is composed of the Social Worker Case Coordinator, Case Coordinator Supervisor, child/youth, (if

age appropriate), biological or adoptive parents (when appropriate), therapeutic family foster parents, and

the therapist who is an enrolled KanCare Medicaid provider. CWCMP/DCF Case Managers, other Clinical

Consultants, and educators working with the youth in the local school district are also considered to be an

integral part of the treatment team. The review shall be documented in the child’s case file.

Providers will use the National Standards of the Foster Family-Based Treatment Association (FFTA) as a

guide in addition to standards given in this document. The Provider shall agree that prior to placement in

Therapeutic Foster Care; the child will meet the criteria for placement, as determined by a score on the

referring agency’s placement screening tool and by meeting the general criteria for eligibility for placement

in TFC.

Section 4: Scope of Core Services

The provider will operate and maintain a TFC program and conduct a program evaluation. Criteria for

Therapeutic Foster Care are minimum requirements; exceeding the requirements does not automatically

qualify providers for any other program designation. In addition, please refer to Section I of the National

Standards for more clarification and discussion.

Daily Living Services - daily living services shall be provided and include the following:

 Room, board, child care, personal spending money, and school fees.

 Transportation to appointments within a 60-mile radius; including to and from school, medical care,

recreation, etc.

 Academic activities - assistance with school work, vocational training, and/or G.E.D. training.

Situational Training- to include but not limited to:

 Personal Hygiene – teaching about body cleanliness, use of deodorants and cosmetics, appropriate

clothing, choosing clothing to fit individual and occasion, and keeping clothes neat and clean.

 Health - Identifying and understanding residents’ health needs; securing and utilizing necessary

medical treatment including preventive and health maintenance services; gaining information and

education in health maintenance (including preventive measures, nutrition, menstruation, rest,

cleanliness, family planning, drugs, sexually transmitted diseases, exercise, and motivation for

meeting own health needs), maintaining contact with providers of health services (physician, nurse,

clinic) and using outside Foster s for assistance (clinics, pharmacies, hospitals). KAN BE Healthy

screening shall be provided according to the periodicity schedule and needed follow ups shall be

completed.

 Consumer education for independent living- Budgeting, comparative buying, installment buying,

avoiding risks, identifying illegal or excessive interest rates, use of credit, avoiding or dealing with

debts, using checking and savings accounts, and paying taxes.

Communication skills:

The youth’s articulating thoughts and feelings through appropriate use of such skills as speech, writing, and

use of the telephone.

Home Management:

Making the bed and changing linens, using the vacuum cleaner, dusting, organizing belongings, disposing

of trash, cleaning all areas of the home, operating appliances, cooking complete meals, making simple

repairs, who to call when a major repair is needed, being aware of the need for upkeep, handling

emergencies, knowing first aid.

Situational Guidance:

Identifying and accepting strengths, developing patterns of acceptance and coping with authority figures,

getting along with others, sharing responsibility, being considerate of others, developing friendships,

knowing when to go home when visiting, recognizing or modifying attitudes toward self or others,

responsible work attitudes, tolerance of verbal criticism, reactions to praise, punctuality, and attendance.

Recreation:

Participating in leisure time activities, learning how to spend leisure time, developing outside activities,

managing time, finding recreation with little or no expense involved, finding community projects to take

part in, participating in social groups, participating in sports and games, arts and crafts, and appreciating

fine arts.

Behavioral Health:

Crisis management, social rehabilitation and counseling, Behavioral programming (including design,

consultation and supervision), Counseling towards reunification with family (if appropriate), supportive

counseling including the identification of behavioral and substance use disorder support services needed

for successful transition into the community. If developmentally appropriate, services which develop

increased capacity for independent living.

Therapy:

Individual and/or group therapy as well as psychosocial groups shall be provided as needed and indicated

in the treatment plan for the individual youth. Therapy services are not part of the content of services for

TFC, but rather are provided by an enrolled KanCare Medicaid provider. Therapeutic family Foster parents

are expected to provide the basic day to day counseling the child needs in order to meet treatment goals.

The case coordinator shall insure that individual or group therapy indicated by the treatment plan is

implemented, reviewed as required, and modified as needed. The service delivered shall be documented in

the individual’s case record, including date, place, amount of time, and names of the therapist providing the

service. The therapy shall be directed towards helping the youth adjust to life in the therapeutic family

Foster home, making the experience a period of continuing physical, mental, emotional growth and assist

the youth to understand and accept his family relationships, interpersonal relationships and personal

situations. The ultimate goal is to assist the youth to prepare to function effectively outside the therapeutic

foster home setting.

Tutoring:

Tutoring for remedial purposes shall be provided as needed in addition to normal school work to assist

youth to perform at his/her potential. Tutoring services shall be in accordance with need as indicated by

school staff. The service delivered shall be documented in the individual’s case record including date,

amount of time, and person who provided the service.

Case Coordination:

Responsibility for coordinating the youth’s program and progress with the schools, employer, family,

referring agency, therapist, and other appropriate community Foster s for each youth in residence shall

reside with Case Coordinator.

School/Work Liaison:

The Licensed Child Placing Agency shall ensure routine communications between the staff and any

educational program in which the youth is placed. This may include requesting and participating in the

development of an Individual Education Plan for each resident. The necessity of the latter activity will be

decided in conjunction with the worker assigned to each youth. The day to day school liaison activity may

be the responsibility of the therapeutic foster home. These contacts shall be noted in the youth’s case record.

NOTE: For youth in an employment program, similar contacts and services are to be provided in

conjunction with the youth’s employer when appropriate.

Section 5: Treatment Plan Design

The treatment program design includes a process for assuring appropriate services to a youth determined to

be eligible for Therapeutic Foster Care services. The process includes:

• An initial screening by the case coordinator at the time of admission to the Therapeutic Foster

Care Program (or prior to admission, if possible) to determine the needs of the youth.

• A master treatment plan to be developed within fourteen (14) days which includes input from

the members of the treatment team and therapeutic family foster parents, as well as family involvement

(unless contraindicated by legal constraints). Discharge planning shall be included in the master

treatment plan in order to set goals which reflect youth, parent, and other community stakeholder input.

Long term goals in the areas of physical /emotional health, family relations, daily living skills,

academic and/or vocational skills, interpersonal interactions, and community relationships shall be

addressed, according to the age appropriateness of the plan in relationship to the youth being served.

Goals of treatment plan shall be described, treatment techniques or programs used to treat shall be

identified, and time frames for reaching goals shall be defined. Persons responsible for individual goals

of the treatment plan shall be identified and shall sign the plan, thus indicating their agreement to

provide the service or treatment. The resident shall sign, if of sufficient cognitive ability to grasp the

concept of the treatment plan. The Master treatment plan shall be reviewed, revised and documented

in quarterly reports at least every 90 days by the TFC treatment team.

Section 5.1: Case Coordinator responsibilities

The primary case coordinator will:

• Develop the treatment plan in conjunction with the treatment team

• Coordinate and implement the treatment plan;

• Involve parents and family members in the treatment process, when appropriate;

• Coordinate treatment with other involved agencies;

• Provide training to therapeutic family Foster parents on the individualized treatment plan; and

• Observe and document implementation of each youth’s individualized treatment plan, including the

in-home treatment aspects utilized by the therapeutic foster parents.

• Be available to therapeutic family foster parents 24 hours per day for crisis consultation.

• Minimally, face to face consultation with therapeutic family foster parents and the child shall be

provided one time per week during the first month of placement of a child. Thereafter, face to face

consultation for therapeutic family foster parents and child shall be provided two times per month

until the child completes the therapeutic foster care program. These, however, are minimal guidelines,

and are in no way meant to reflect that only this level of support is required if there are severe

problems that shall be addressed. The level of case coordinator contact shall be addressed in the

Master Treatment Plan and shall be based upon the problems that are to be treated. Weekly contact

by phone must be maintained with both the therapeutic family foster parents and the child regardless

of the situation.

Section 6: Program and treatment planning, documentation and review

The following shall be maintained in the case record for each youth.

Section 6.1: Initial Assessment

Prior to placement in a TFC program, a youth’s strengths and needs shall be assessed. The assessment shall

include but not be limited to the following: (1). Reasons for referral to the TFC program; (2) Evaluation or

assessment in the areas of physical health/medication needs, family relations, academic or vocational

training, community life, interpersonal interactions, daily living skills and treatment needs. (3)

Establishment of a score on the placement screening tool. These assessment results will be made available

to the TFC program, shall be discussed with the therapeutic family Foster parents prior to agreement to

accept the placement and shall be made a part of the TFC child case record.

Section 6.2: Master Treatment Plan

Each youth residing in a therapeutic family foster home shall have a written treatment plan based on a

thorough assessment, within 14 days of placement. Treatment Plans shall be signed by members of the

treatment team and when possible the youth. The Treatment Team is composed of the Social Worker Case

Coordinator, Case Coordinator Supervisor, child/youth, (if age appropriate), biological or adoptive parents

(when appropriate), therapeutic family Foster parents, and the therapist who is an enrolled KanCare

Medicaid provider. CWCMP/DCF Case Managers, other Clinical Consultants, and educators working with

the youth in the local school district are also considered to be an integral part of the treatment team. (NOTE:

If the family is not involved in the treatment process, the reason for this shall be documented in the

TFC file.)

The name(s) of staff responsible for meeting the youth’s needs shall be recorded on the treatment plan.

The Plan shall include the following:

(1) Long term goals in the areas of physical health, family relations, and daily living skills; academic

and/or vocational skills, interpersonal interactions, and community living;

(2) Short term goals which will help a youth eventually reach his/her long term goals in each of the

above areas;

(3) Specific plans for reaching the short term goals including services to be provided and frequency;

(4) Estimated time for reaching short term goals.

The master treatment plan shall be reviewed and revised at least each 90 days. At that time a general written

quarterly progress report shall be completed by the TFC program and therapist. Information obtained from

the parent, guardian, referring agency and the youth shall be considered in the report and updated treatment

plan.

Section 6.3: Weekly Progress Notes

Therapeutic family foster parents and TFC program staff shall provide weekly input and feedback to the

development, revision, and evaluation of the treatment plan as well as carry out the in-home strategies.

Assessment documents shall be included in the case record. Weekly progress notes, written by the case

coordinator and therapeutic family foster parents, shall be entered into the youth’s chart, reflecting the

delivery of services according to the treatment plan. This documentation shall address the youth’s responses

to treatment interventions and progress of the youth on individualized goals and objectives. The note shall

include any significant events or significant incidents that occurred during the week and summarize contacts

with family members and other involved agencies. If an unmet need is identified, the note shall reflect

actions to be taken to revise the plan for the youth.

Section 6.4: Permanency Planning

Assessment and treatment of the child and family that focuses on opportunities for the child to have ongoing

active and meaningful connections to the family, kin, relatives, and community. The goal for achieving

permanency shall be coordinated with the referring agency and included in the treatment plan. The

permanency plan shall include strategies and tasks to accomplish the strategies. Behaviors which place the

child at risk for disruption, activities to prepare the child’s family or kinship network for reunification, and

the identification of other less restrictive living environments and preparing the child for transition to these

settings shall be addressed. The National Standards indicate that “family involvement requires an

unwavering commitment to promoting a service that is culturally competent and respectfully embraces

cultural diversity. TFC programs actively support and enhance children’s relationships with their parents,

siblings and other family members throughout the period of placement regardless of the permanency goal.”

Section 6.5: Discharge Summary/After Care Plan

A discharge summary shall be completed at the time of the youth’s discharge including delineation of

aftercare plans and goals which the youth reached. While discharge planning shall begin at the time of

placement in therapeutic foster care a written plan is still necessary. Written recommendations for aftercare

shall be made and shall specify the nature, frequency, duration, and responsible parties for aftercare

services.

Section 6.6: File Documentation

A dated record of significant observations and occurrences involving each youth shall be maintained. The

record shall include events which may affect the wellbeing of the youth. The record shall be available for

review. Each report shall include the date and time of occurrence, the staff member and/or youth involved,

the nature of the incident and the circumstances surrounding it. The file shall also contain the Placement

Agreement or Client Service Agreement (for child/youth referred by DCF staff).

Section 6.7: Health Records

Records of medications shall be kept in each youth’s case medical record and include: the name of the

prescribing physician; the name of the medication; the dosage prescribed; the purpose of the medication;

noted side effects; the date of the prescription; and the date of review at least every three (3) months. A

record of medication given, amount, date and time, and person dispensing shall be recorded. All doctor and

dental visits, major illnesses and accidents shall be recorded. A current Kan-Be-Healthy shall be maintained

by the TFC program on each youth. Allergies of any resident youth shall be displayed in a conspicuous

place in the case file as well as in the medical section. The health record shall also contain a copy of the

child/youth’s current medical card and medical consent forms.

Section 6.8: Service Documentation

Documentation of services provided shall include: who received the service; staff person providing the

service; amount of time spent providing the service; what service was provided; when was the service

provided; and where was the service provided. Significant incidents are to be reported to the youth’s

CWCMP case manager and the youth’s parent or guardian when appropriate per PPM 0513.

The following significant incidents shall be verbally reported immediately with a written report to the

CWCMP case manager within 24 hours of the event

Section 6.9: Reports

Quarterly Reports shall document progress on specific short-term treatment goals, describe significant

revisions in goals and strategies, and specify any new treatment goals and strategies during the period

covered. The quarterly progress reports shall summarize progress and note changes regarding long-term

placement and treatment goals. The report will be signed by the Supervisor and Case Coordinator at least

every 90 days. Information obtained from the parent, guardian, the referring agency, Case Coordinator,

Supervisor, therapist(s) and the youth shall be considered in the report.

Section 7: Home Visits:

When home visits are a part of the treatment plan, there shall be pre and post home visit contacts between

the youth, their family and the therapeutic family foster parents or the agency program staff regarding the

home visit. Because the goal of placement is return of the youth to a family-like setting, it is important that

home visits be carefully planned and executed in the best interests of permanency planning for the youth.

Section 8: Sponsoring Agency, Staff, and Therapeutic Family Foster Parent Qualifications

Section 8.1: Sponsoring Agency

The Sponsoring Agency shall be a Child Placing Agency licensed by DCF Foster Care and Residential

Facility Licensing. There shall be social work staff designated by the Child Placing Agency to provide

services to therapeutic family foster homes. The TFC Program shall meet the National Standards of Foster

Family-Based Treatment Foster Care, in addition to the other standards listed in this document.

Section 8.2: Administrator

There shall be an administrator with a minimum of a Bachelor’s Degree in Social Services or Human

Services, and at least two (2) years experience in administering a child welfare service delivery program or

a related program commensurate with the size and complexity of the agency; a thorough understanding of

philosophy, purpose, and policy of the agency; and the capacity to provide direction and leadership of the

agency.

Section 8.3: Supervisor

Each TFC program will designate supervisors for their Case Coordinators. Preferably a Supervisor will

have a Master’s degree in social work and a license to practice in the state of Kansas with a minimum of

two years experience in the child placement field. However, a Master’s degree in a related human service

field can substitute for the advanced social work degree provided the Supervisor is licensed to practice in

the state of Kansas and has three years of experience in the child placement field.

Section 8.4: Case Coordinator

Case Coordinators shall have a Master’s degree in social work or in a related human service field and a

license to practice in the state of Kansas. However, a Bachelor’s degree with a license to practice in the

state and at least two (2) years experience in child placement/foster care is acceptable.

Section 8.5: Case Load Capacity

Supervisors shall supervise no more than 5 Case Coordinators. Case Coordinators shall be assigned no more

than 8 youth in TFC homes, although, in some circumstances, exceptions can be made for the case load to

increase to 12. The case load shall be adjusted downward if a difficult client population requires more

intensive support and contact or if the travel/distances impair the Case Coordinators ability to serve the

needs of the youth or foster parents. The Case Coordinator shall supervise no more than 8 TFC homes.

Section 8.6: Therapeutic Family Foster Parents

• Shall be licensed as foster parents by DCF Foster Care and Residential Facility Licensing and be

sponsored by a licensed child placing agency.

• Complete the PS Model Approach to Partnerships in Parenting (PS-MAPP) preparation program.

This training shall be completed prior to placement of any child in the home.

• Shall receive, after the first year, a minimum of 24 hours, per parent in the home, of additional training

annually. CPR and First Aid training does not count toward meeting the minimum 24 hours of annual

training per parent in the home. This training shall, at a minimum, consist of: administration of

medication; orientation to mandatory abuse/ neglect reporting; DCF disciplinary policies; the

management of aggressive behaviors; grief/loss issues of children in care; special issues of working

with children who have emotional/behavioral problems associated with abuse/neglect or traumatic

brain injury; basic training in the concepts of the various diagnostic categories affecting children

placed in TFC homes; training in working with biological/adoptive families regarding issues of

reintegration or dealing with resolving issues within families that prevent children from living at

home; as well as the provision of self-sufficiency or adult living transition skills for children who

may not live with family members after treatment.

• In Service Training shall be on record for each therapeutic family foster parent and shall describe the

professional development plan. It is preferred that the individuals chosen as therapeutic family Foster

parents will be experienced foster parents, but exceptions can be made to allow “new” individuals to

become TFC parents if they demonstrate exceptional parenting abilities. Please see Section III of the

National Standards for more discussion regarding training for the TFC parents.

• Placements in each therapeutic family foster home may only be made by the Sponsoring Agency.

• Shall notify the Sponsoring Agency of any changes or impending changes in the household/family

composition.

• Shall participate actively in the treatment plan and attend Case Planning Conferences as established

by the Treatment Team.

• Shall obtain the Sponsoring Agency’s permission to take a child in placement out of state or to move

to another residence.

• Work with the schools regarding the education of the child and obtain free textbooks and lunches

where applicable. If necessary, the therapeutic family foster parent shall become the Educational

Advocate for foster children in the home, and attend all Individual Educational Plan conferences, and

notify the Sponsoring Agency if there are suspensions or dismissals from school.

• Obtain needed medical/dental/psychiatric care for the child including the KanBeHealthy medical

screenings. Medical information as required by licensing regulations shall be maintained by the foster

parents.

• Incorporate the foster child into the family affording him/her the same privileges and responsibilities

of other family members; appropriate to his/her age and abilities.

• Maintain appropriate renters/homeowners/household care insurance and furnish proof of coverage

upon request to the Sponsoring Agency.

• Understand that the placing agencies cannot be held responsible for damages done to the therapeutic

family foster parent’s home, automobile, household furnishings, or other possessions, done by a

foster child beyond that available in applicable insurance coverage.

• Utilize Respite Care and Foster Parent Support provided by the Sponsoring Agency.

• Complete Daily Behavioral Logs reflecting progress or lack thereof of the child in attaining the goals

of the treatment plan.

Section 8.7: Therapeutic Family Foster Parent Support

Sponsoring Agency shall provide intensive support, technical assistance and supervision to all therapeutic

family foster parents. Respite care for the therapeutic family foster parents shall be planned on at least a

monthly basis, and respite shall be provided both in planned situations and in crisis situations. Respite shall

be provided in homes selected and trained using the same standards for therapeutic family foster parents.

Support groups of therapeutic family foster parents shall be formed to help in the process of affirming and

reinforcing the very central role the therapeutic family foster parents shall have in the treatment of severely

emotionally disturbed youth.

Section 8.8: Staff Training

Pre-Service and ongoing annual in-service training and support will be mandatory for all staff and respite

foster parents working in the TFC program. Annual staff training records will be kept by the TFC program

for review by DCF and DCF Foster Care and Residential Facility Licensing. Administrators, Supervisors,

Case Coordinators and therapeutic family foster parents will complete the 30 hour PS MAPP training.

Additional training shall, at a minimum, consist of: administration of medication; orientation to mandatory

abuse /neglect reporting; DCF disciplinary policies; the management of aggressive behaviors; grief /loss

issues of children in care; special issues of working with children who have emotional / behavioral problems

associated with abuse /neglect or traumatic brain injury; basic training in the concepts of the various

diagnostic categories affecting children placed in TFC homes; training in working with biological /adoptive

families regarding issues of reintegration or dealing with resolving issues within families that prevent

children from living at home; as well as the provision of self-sufficiency or adult living transition skills for

children who may not live with family members after treatment.

Section 9: Child’s Rights

The staff of the Child Placing Agency and therapeutic family foster parents shall allow privacy for each

child. The foster home’s space and furnishings shall be designed and planned with respect for the child’s

right to privacy. The foster home’s design shall also provide supervision according to the ages and needs

of the children/youth in placement. Contacts between the child/youth and his/her parents or guardian shall

be allowed while the child/youth is in care unless the rights of the parents have been terminated by court

order or family contact is not in the child’s best interest. The frequency of contact shall be determined by

the needs of the child/youth and his/her family or guardian.

The Child Placing Agency shall have clearly written policies regarding visits, gifts, mail and telephone calls

between the child/youth and his/her family, or guardian. These policies shall be made known to the

child/youth and his/her family or guardian prior to admission. Youth shall be allowed to send and receive

mail and have telephone conversations with family members or guardian unless the best interest of the

youth or a court order necessitates restrictions. If restrictions on communications or visits are necessary

these shall be reviewed monthly by a psychiatrist, licensed psychologist or social worker with a master’s

degree in social work and the referring agency notified.

A youth shall be allowed to bring personal possessions to the therapeutic family foster home and may

acquire others. Prior to admission, information shall be made available to the youth and their parents or

guardian concerning what possessions a youth may bring to the foster home and the kinds of gifts they may

receive.

Section 9.1: Discipline

Discipline shall be consistent with the policies of DCF and shall not be physically or emotionally damaging.

Only therapeutic family foster parents or substitute care providers, including respite providers, shall

discipline children/youth placed in a TFC home.

Children/youth shall not be:

--Subjected to cruel, severe, unusual or unnecessary punishment.

--Subjected to remarks that belittle or ridicule them or their families.

--Denied food, mail or visits with their families as punishment.

--Punished by shaking, striking or spanking.

--Discipline or control shall fit the needs of each youth.

Section 10: Reporting Abuse/Neglect

All foster parents are mandated reporters. Mandated reporters shall report all witnessed or suspected

abuse/neglect to the Kansas Protection Report Center (KPRC) at 1-800-922-5330 or the local Law

Enforcement Agency.