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Therapeutic Foster Care

Admission Requirements

1. Does the member need placement for any of the following reasons?

  • An alternative to detention or incarceration.
  • Ensure community safety in circumstances where a child is exhibiting primarily conduct disorder behaviors.
  • Provide safe housing, shelter, supervision, or permanency placement.
  • An alternative to parents’/Health Care Decision Makers’ or other agencies’ capacity to provide for the member.
  • A behavioral health intervention when other less restrictive alternative is available and meet the member’s treatment needs, including situations when the member/Health Care Decision Maker is unwilling to participate in the less restrictive alternative, or
  • An intervention for runaway behaviors unrelated to a Behavioral Health Condition

Stop!

***MEMBER DOES NOT MEET CRITERIA FOR THERAPEUTIC FOSTER CARE FOR CHILDREN PLACEMENT***

A RECOMMENDATION FOR THERAPEUTIC FOSTER CARE FOR CHILDREN PLACEMENT
MUST BE INITIATED BY THE CFT

2. Does the member exhibit any of the following?

  • A documented diagnosed Behavioral Health Condition, in an assessment done by a licensed BHP, which reflects the symptoms and behaviors necessary for a request for TFC.
  • As a result of the behavioral health condition, there is evidence that the child has recently (within the past 90 days) had a disturbance of mood, thought or behavior that renders the member incapable of independent or age-appropriate self-care or self-regulation. This moderate functional and/or psychosocial impairment per Assessment by a BHP:
    • Cannot be reasonably expected to improve in response to a less intensive level of care, and
    • Does not require or meet clinical criteria for a higher level of care, or
    • Demonstrates that appropriate treatment in a less restrictive environment has not been successful or is not available, therefore warranting a higher level of care.
  • At time of admission to TFC in participation of Health Care Decision Maker and all stakeholders, there are documented plans for discharge and transition which includes:
    • Tentative disposition/living arrangement identified, and
    • Recommendations for aftercare treatment based upon treatment goals.

DOCUMENTATION SUBMITTED MUST ADDRESS THE ABOVE ISSUES

Failure to send complete documentation will result in return of the request.

Continued Stay Requirements

All of the following criteria shall be met

  • The member continues to meet diagnostic threshold for the behavioral health condition that warranted admission to TFC,
  • There is an expectation that continued treatment at the TFC shall improve the member’s condition so that this type of service shall no longer be needed, and
  • The CFT is meeting at least monthly to review progress, and have revised the TFC Treatment Plan and Individualized Service Plan (ISP) to respond to any lack of progress, and for members, the Caregiver to whom the member shall be transitioned after discharge from a TFC has been identified and is actively involved in the member’s care/treatment, if applicable.
  • The member continues to demonstrate (within the last 90 days) moderate functional or psychosocial impairment as a result of the behavioral health condition, as identified through disturbances of mood, thought, or behavior, which substantially impairs independent or age appropriate self-care or self-regulation,
  • Active treatment is reducing the severity of disturbances of mood, thought, or behaviors, which were identified as reasons for admission to TFC, and treatment at the TFC is empowering the member to gain skills to successfully function in the community.

Discharge Readiness Requirements

All of the following criteria shall be met

  • Discharge planning shall begin at the time of admission.
  • Discharge readiness shall be assessed by the TFC staff and the CFT during each Treatment Plan review and update, at least monthly.

The following criteria shall be considered when determining discharge readiness:

  1. Sufficient symptom or behavior relief is achieved as evidenced by completion of the TFC treatment goals.
  2. The member’s functional capacity is improved and the member can be safely cared for in a less restrictive level of care.
  3. The member can participate in needed monitoring and follow-up services or a Caregiver is available to provide monitoring in a less restrictive level of care.
  4. Appropriate services, providers, and supports are available to meet the member’s current behavioral health needs at a less restrictive level of care.
  5. There is no evidence to indicate that continued treatment in TFC would improve member’s clinical outcome.
  6. There is potential risk that continued stay in TFC may precipitate regression or decompensation of member’s condition.
  7. A current clinical Assessment of the member’s symptoms, behaviors, and treatment needs has been reviewed by the CFT and has established that continued care in TFC is setting no longer adequate to provide for the safety and treatment. The CFT will then discuss if a higher level of care is necessary.

Reference AHCCCS AMPM Policy 320-V