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Therapeutic Foster Care

Arizona Complete Health-Complete Care Plan utilizes AMPM Policy 320-W Therapeutic Foster Care for Children for admission, continued stay, and discharge criteria. 

Criteria for Admission

  1. The recommended level of care determined using CALOCUS/ECSII, optional resource for FFS programs, shall be used to demonstrate sufficient necessity for admission to the indicated level of care without requiring additional PA for a period of no less than 30 days,
  2. The recommendation for TFC shall come through the CFT practice specified in AMPM Policy 580,
    1. An interim service plan coordinated through Integrated Rapid Response can be used to establish this recommendation for admission, prior to the establishment of a full CFT.
  3. An assessment, as outlined in AMPM 320-O and AAC Title 9, Chapter 10, which indicates the member has been diagnosed with a behavioral health condition and indicates symptoms and behaviors to be treated, and
  4. Special consideration will be given to children with two or more of the following:
    1. Multiple out-of-home placements (foster homes, Behavioral Health Residential Facility (BHRF), Behavioral Health Inpatient Facility (BHIF), Residential Treatment Center (RTC), etc.),
    2. History of disruption from a foster home due to behaviors,
    3.  One or more hospitalizations due to a behavioral health condition in the last year,
    4. Chronic pattern of suspensions from school, daycare, or day programming,
    5. Adoption disruption or potential adoption disruption,
    6.  Significant trauma history or trauma-related diagnosis,
    7. Placed or at-risk of placement in a congregate care setting,
    8.  At-risk of placement disruption due to behaviors requiring a higher level of supervision,
    9. Identified as a potential victim of trafficking,
    10.  Criminal justice involvement,
    11.  Co-occurring developmental disability, and
    12. At-risk of being removed from their home by Department of Child Safety (DCS) due to behavioral concerns.
  5. As a result of the diagnosed behavioral health condition, there is evidence that the member has a moderate functional impairment as indicated by the CALOCUS/ECSII score and/or other clinical indicators. This moderate functional and/or psychosocial impairment per the behavioral health assessment and ISP, reviewed and signed by a BHP:
    1.  Has not improved or cannot be reasonably expected to improve in response to a less intensive level of care, or
    2. Could improve with appropriate community-based treatment but treatment is not available, therefore warranting a more intensive level of care.
  6. Does not require or meet clinical criteria for a higher level of care.

Criteria for Continued Stay

All of the following criteria shall be met

  1. An assessment which indicates the member has been diagnosed with a behavioral health condition and indicates symptoms and behaviors to be treated,
  2. An expectation by the CFT that continued treatment at the TFC shall improve the member’s condition so that this type of service shall no longer be needed, and
  3. The member continues to demonstrate moderate functional or psychosocial impairment as a result of a behavioral health condition.

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. The member demonstrates sufficient symptom or behavior relief as achieved as evidenced by completion of the TFC treatment goals,
  2. The member’s functional capacity is improved, at minimum, as evidenced by an improved CALOCUS/ECSII score and/or other clinical indicators of improved functioning,
  3. The member can be safely cared for in a less restrictive level of care, as identified by the CFT,
  4. The CFT has identified that appropriate services, providers, and support 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 the member’s clinical outcome,
  6. There is potential risk that continued stay in TFC may precipitate regression or decompensation of the member’s condition, or
  7. A current assessment of the member’s symptoms, behaviors, and treatment needs by the CFT has established that continued care in TFC is no longer adequate to provide for the member’s safety and treatment and therefore a higher level of care is necessary.

Reference AHCCCS AMPM Policy 320-W