Frequently Asked Questions
- Service Package Details
- What does care look like under T3C?
- Credentialing Process
- CANS 3.0 Assessment
- Making the Transition
- The Placement Process
Service Package Details
No. The Short-Term Assessment Support Services Package is not eligible for the Add-On Services.
No. CPAs are only eligible to provide the 9 Support Services Packages, including T3C Basic Foster Family Home Support Services, and the 3 Add-On Services. GROs are only eligible to provide the 9 Services to Support Community Transition Packages in GRO Tier I, including T3C Basic Childcare Operation, and the 6 Stabilization Services Packages in GRO Tier II.
Yes. They can become Credentialed to provide as many Service Packages as they would like, so long as they meet all the qualifications for providing each of those Service Packages.
The GRO Service Package that most closely aligns with the services offered by Emergency Shelters in the current system is the Tier I: Emergency Emotional Support & Assessment Center Services.
Yes, as long as the CPA has been Credentialed to provide those Service Packages and Add-Ons, and the CPA has Credentialed the foster home to provide those Service Packages and Add-Ons according to their approved policy.
Yes, there are some minor differences.
This varies by Service Package, but for Tier I the GRO must be able to provide Treatment Services for the following Service Packages:
- Sexual Aggression/Sex Offender Treatment Services to Support Community Transition
- Substance Use Treatment Services to Support Community Transition
- Emergency Emotional Support & Assessment Center Services
- Complex Medical Needs Treatment Services to Support Community Transition
- Intellectual or Developmental Disability (IDD)/Autism Spectrum Disorder Treatment Services to Support Community Transition
- Human Trafficking Victim/Survivor Treatment Services to Support Community Transition
- Mental & Behavioral Health Treatment Services to Support Community Transition
For children age 5 and under, the CPA must coordinate and ensure that comprehensive assessments, evaluation, screenings, and treatment services are provided within 21 days of admission, including administering the CANS 3.0 Assessment. For children over the age of 5, the CPA must coordinate and ensure assessments and services are provided within 30 days of admission, including the CANS 3.0 Assessment. The maximum length of service and stay is 30 days for children age 5 and under. The maximum length of service and stay for children over the age of 5 is 45 days, with an option for one 15-day extension.
A graphic depiction, developed by the provider, that presents the shared relationships among the resources, activities, inputs, outputs, outcomes, and impact for each Service Package and/or Add-On Service. A Logic Model depicts how the provider’s program will work, what it is expected to achieve, and identifies the components that will be used to inform provider program improvements through the continuous quality improvement process and is intended to change through this process.
At this time, DFPS is not intending to publish a listing of Evidence-informed Treatment Models in the April 2024 T3C System Blueprint. The T3C System is intentionally designed to allow providers flexibility in identifying the Evidence-informed or Evidence-based Treatment Model or Models that best serve as the framework or foundation for the agency or operation’s particular program based on the custom needs of the population served.
This was to distinguish the fact that the needs of children, youth, and young adults that have been victims or are survivors of Human Trafficking-have different needs that cannot be addressed by the “Universal Human Trafficking Prevention Training for all staff and Caregivers” that is being designed by DFPS, they require something more specialized to prevent re-victimization.
Yes. The individual fulfilling the Staffing Requirement of the Program Director or the Treatment Director specific role for one Service Package can also fulfill the same role for other Service Packages at the same operation, as long as the individual meets all of the requirements/ qualifications in the Blueprint .
In terms of the biological child/children, who is placed with the youth or young adult in the Tier I: Services to Support Community Transition for Youth & Young Adults who are Pregnant or Parenting Service Package, the rate for the youth’s placement already includes funds intended for the care and maintenance of their child.
The youth or young adult’s optimal Service Package would be informed by the CANS 3.0 Assessment, the Application for Placement, and ultimately the knowledge and expertise of the youth’s permanency planning team.
Yes, as long as the CPA is credentialed for the T3C Basic Foster Family Home Support Service Package, they can still credential & license kinship families to provide that specific package – the Kinship Caregiver Support Add-On is not a requirement in order to license kinship homes, it is just intended as an optional added benefit for CPAs that have programming and are Credentialed to provide the Kinship Add-On Service.
The T3C System Blueprint states “The General Residential Operation must have a staff benefit package that, at a minimum, includes paid annual vacation and sick leave for all Direct Delivery Caregivers and/or Cottage Parents to support wellness and retention”. This was intended to support full-time (40 hours/week) Caregivers. However, providers are not prohibited from including part-time Caregivers in the staff benefit package.
This refers to a Recreation Schedule that is specific to the population of children served by a single Service Package, which is customized to support their unique physical, social, and emotional well-being needs. If an individual child qualifies for Treatment Services under Minimum Standards, the provider would need to have a Recreation Schedule that is personalized to that individual child’s needs in compliance with Minimum Standards, which may include aspects of the Recreation Schedule customized for the population of children served under that child’s Service Package. Further questions on ensuring compliance with Minimum Standards should be directed to the provider’s Licensing Representative.
All residential operations permitted by HHSC-CCR have to provide “Child Care Services". It was not listed under Permit Services, because it is required for all Permit Types.
The inclusion of Transitional Living as a part of the Permit Services offers assurance that the operation has the skill, knowledge, and experiential learning programming available, as a part of the all-inclusive Service Package to meet the needs of youth while they are in the provider’s care. While Transitional Living is a Permit Programmatic Service required to become Credentialed to provide the Service Package to youth 14 and older, it does not serve as the entire basis for the Package. Standards and the T3C Blueprint emphasize adjusting/adapting transitional living services based on the custom needs of the child, which may vary based on age, development, length of stay, clinical needs, supervision needs, and where the individual youth is in relation to their own treatment. Providers are encouraged to reach out to their Licensing Representative if they have questions about how best to structure their program and policies to comply with all of the relevant Minimum Standards.
The T3C System design envisioned the provider delivering Aftercare Case Management Services directly, in order to provide the child with a degree of continuity and connection to the people from their prior placement, DFPS is open to providers proposing other ways to meet Aftercare Case Management requirements, which may include contracting for those services. DFPS would evaluate the provider’s proposal to determine if it meets the requirements/intent necessary to become Credentialed.
The new rate methodology breaks down all of the requirements, including required positions and allots them an amount under the daily rate. Provider completion of the cost reports will ensure that future changes to rates are appropriate.
The T3C System Blueprint identifies what positions are required for each Service Package, and what positions are eligible for subcontracting, verses the positions that must be staff.
Specific questions that aren’t in the FAQ can be addressed to the T3C email box at DFPSTexasChildCenteredCare@dfps.texas.gov. There are also many resources available online, such as through the Texas Alliance of Child and Family Services’ T3C Ready website.
What does care look like under T3C?
The Licensing Minimum Standards include the mandated child to staff caregiver ratios. T3C includes ratio guidelines that informed the rate methodology and vary based on an operation’s specific Evidence-informed Treatment Model, and dependent on the complexity of the caseload.
Yes.
Licensed therapists are included in many of the Service Packages to oversee treatment and service planning for children, youth, and young adults.
If the child’s behaviors or emotional needs change, such that the child could potentially be better served by a different Service Package, the provider would want to communicate with the child’s SSCC or DFPS Caseworker so that a new CANS 3.0 assessment can be performed to determine if the change in Service Package is recommended. Based on the CANS results, the knowledge and professional judgement of the SSCC or DFPS staff and the child’s stakeholders, based on the child’s individual needs and best interest would be the basis for the selection of the actual Service Package.
The model allows for flexibility in credentialing for multiple service packages, so that providers can serve the needs that arise in the same placement. It is important that the provider ensure that they create a training plan to prepare the foster family for all possible service packages that they are credentialed for.
There will be a monitoring process, that is currently under development, as well as periodic recredentialing.
Credentialing Process
No. DFPS is in the process of establishing a single-streamlined Credentialing process, where once Credentialed, the provider will be eligible to provide the distinct Service Package(s) to any child or youth in DFPS Conservatorship, or young adult in Extended Foster Care. Separate from the Credentialing process, providers will still be required to enter into contracts with DFPS and/or the SSCCs to deliver the services.
No. Once a CPA becomes Credentialed to provide one or more of the Service Packages and/or Add-On Services, the organization will be required to have a process (which will be evaluated as a part of the CPA’s Credentialing process) in place to assess individual foster homes and Caregivers to provide the CPA’s Credentialed services.
No. Foster homes providing the Short-Term Assessment Support Services and T3C Treatment Foster Family Care Support Services Packages are not required to be Credentialed in T3C Basic Foster Family Home Support Services.
Yes, so long as the CPA has been Credentialed to provide those Service Packages, and the CPA has Credentialed the foster home to provide those Service Packages according to their approved policy.
No.
No.
Yes. The Permit Type(s) and Permit Service(s) are based on current RCCR (Residential Child Care Regulation) Minimum Standards requirements and are included to show what type of Permit and/or Services would be required to become Credentialed to provide a particular Service Package.
Yes. In order to become Credentialed the Child Placing Agency will need their Permit to reflect the corresponding Permit Services as listed for the particular Add-On Service in the T3C System Blueprint.
A new permit is not required, unless the provider is seeking to become Credentialed for a Service Package(s) that requires a different type of permit than what the organization is operating under today.
Yes. Updated or revised policies/procedures will need to be submitted as part of the Credentialing process.
The CPA needs to assess the skills and experience of the foster caregivers and their desire to work with children presenting certain needs. The CPA will need to include the process for assessment and credentialing in their policies for review during the CPA’s credentialing.
CANS 3.0 Assessment
The SSCC or DFPS (in areas not yet under Community-Based Care) will be responsible for administering the CANS 3.0 Assessment.
The enhanced CANS 3.0 Assessment results will continue to be entered into eCANS by the CANS Assessor staff and will be accessible to medical and behavioral health providers through STAR Health, as well as residential provider staff with Health Passport access.
All children ages 3 years and older will receive an initial CANS 3.0 assessment within 30 days of removal, and annually thereafter. For children receiving therapeutic services, a CANS 3.0 assessment will be required every 90 days from the date of the initial CANS 3.0 assessment. A CANS 3.0 assessment will also be required at the time of a child’s placement change or at the request of the SSCC or DFPS (if still under legacy) caseworker.
No. When determining placement for a child under T3C, the process considers the following:
- The CANS 3.0 Assessment, which will provide a recommended Service Package;
- The child’s removal affidavit and current Application for Placement, which will provide more details on the child’s needs, history, and family functioning; and
- The knowledge and professional judgment of the SSCC or DFPS staff working to secure placement based on the individual child’s needs and best interest.
The CANS 3.0 Assessment will identify the Service Package recommendation based on the child’s most challenging primary need; if the CANS 3.0 Assessment results in a recommendation that does not match the initial Service Package selection for the child’s placement, then:
- First it needs to be determined whether the current residential provider is Credentialed for the recommended Service Package. If so, then the child will remain in the same placement, but the Service Package can be updated to match the recommendation.
- If the child’s current placement is not Credentialed to provide the recommended Service Package, then the DFPS or SSCC staff and the child’s various stakeholders need to determine whether remaining in the current placement is in the child’s best interest, or if a different placement should be sought to better meet the child’s needs.
If the child’s behaviors or emotional needs change, such that the child could potentially be better served by a different Service Package, the provider would want to communicate with the child’s SSCC or DFPS Caseworker so that a new CANS 3.0 assessment can be performed to determine if the change in Service Package is recommended. Based on the CANS results, the knowledge and professional judgement of the SSCC or DFPS staff, working with the child’s various stakeholders, based on the child’s individual needs and best interest would be the basis for the selection of the actual Service Package.
Yes.
The number of new DFPS and SSCC staff positions allocated to complete the CANS 3.0 for the children required to receive it at the frequency required was calculated based on historical and forecast data. While there may be challenges during the initial transition, such as getting children their first CANS 3.0 assessment and on the needed schedule, there is not an anticipated need for this role to move to providers.
Making the Transition
That’s correct. DFPS will no longer reimburse the SSCC or DFPS Residential Contractors in accordance with the Service Level System.
Providers should initiate the planning process now.
The T3C System Blueprint is not intended to replace or encompass all contractual terms and conditions, but it does lay out the framework and parameters that will be requirements when they are incorporated into the DFPS RCC Contract and the DFPS-SSCC Contracts.
No, providers may choose to adopt this model and train their staff and Caregivers on the Universal Training, or they may submit for review and approval, as a part of the Credentialing process, a different model and training that they intend to use to meet this requirement under T3C.
Yes. The provider’s Treatment Model can be one that they have developed independently or one that they have purchased, so long as it is Evidence-informed and meets the core elements identified throughout the T3C System Blueprint for each Service Package for which the provider becomes Credentialed. The T3C Treatment Model should be based on certain qualifying assumptions around the specific population (as defined by the Service Package and/or Add-On Service(s)) served and must be customized to treat and provide care based on these unique needs. All provider staff and Caregivers must be trained in and actively practice the organization’s Treatment Model.
Medicaid eligible services should be sought through STAR Health.
Residential providers are required to have an Information Technology (IT) System(s) that allows for data collection to support quality assurance, Continuous Quality Improvement, case management documentation, billing/invoicing, reporting, and child-level outcome tracking processes. The provider must have the ability to track placement referrals, admissions, and discharge data by child, youth, or young adult, broken out by referral source (whether SSCC or DFPS), by the number and percentage of referrals that did and did not result in admission, the reasons for denial of admissions based on referrals, and for children that were admitted, the average Length of Service, based on the time from admission to discharge.
During the transition, DFPS will maintain a centralized Credentialing system and CPAs, once Credentialed by DFPS for the provision of certain Service Packages, will then be able to utilize their approved policy to Credential each of their foster homes for one or more Service Packages, based on the individual foster home’s specialty or interests.
It is based on the total number of children, youth and young adults who the CPA serves in a certain Service Package(s) across all branches.
Yes.
The plan is for DFPS to amend DFPS contracts with Residential Contractors and SSCCs to include the Service Package(s) and Add-On Service(s) requirements based on the type(s) of service(s) the individual provider is Credentialed to provide.
The Permit process is managed by the HHSC-Child Care Regulation Division, so DFPS encourages providers to initiate the process by reaching out to their Licensing Representative to discuss the addition. HHSC-CCR estimates that the process takes an average of a month for review and approval.
Selection of the appropriate evidence-informed Treatment Model is a provider decision, and the Department does not intend to maintain a listing or directory of approved evidence-informed Treatment Models at this time.
Providers will have to become Credentialed before September 1, 2027.
If a provider chooses not to actively work towards implementation of T3C to become Credentialed before September 1, 2027, then DFPS and the SSCCs would make a determination as that deadline approaches on when they would discontinue placing children with that provider and move children to Credentialed providers.
DFPS is streamlining the Credentialing process by only requiring that a provider submit to the process through DFPS, as opposed to having multiple processes where providers would submit to both DFPS and the SSCCs, to support efficiency and consistency during transition. The interim credentialing process will allow eligible providers to begin providing services at T3C rates, while working towards becoming fully credentialed.
The GRO Service Package that most closely aligns with the services offered by Emergency Shelters in the current system is the Tier I: Emergency Emotional Support & Assessment Center Services, but the requirements of this Service Package are such that emergency shelters will likely have to make changes to their HHSC-CCR permits, and the staffing and services that they offer.
Supervised Independent Living operations (SILs) will continue to be part of the T3C Foster Care Continuum and full array of services for young adults age 18 and over, although SILs do not explicitly fit into the Foster Family Home and GRO Tier I and Tier II Service Packages. A Transitional Living Program is a Programmatic Service permitted by HHSC-CCR, which will be required for all GRO Tier I and Tier II Service Packages that accept children age 14 and older, as assurance that the operation has the skill, knowledge, and programming available, as a part of the all-inclusive Service Package to meet the needs of youth while they are in the provider’s care. Minimum Standards and the T3C Blueprint emphasize adjusting/adapting transitional living services based on the custom needs of the youth- which may vary based on age, development, length of stay, clinical needs, supervision needs, and where the individual youth is in regards to their own treatment. Current TLP providers, most of which maintain the TLP as part of their GRO, will need to identify an appropriate Service Package that complements the needs of the youth who their program focuses on, such as Tier I: T3C Basic Child Care Operation, and modify their policies and procedures accordingly.
As the Texas Foster Care System evolves into T3C, the need for services provided by YFT will also evolve.
Refer to the Community Based Care Map to determine if you will be providing services in a SSCC catchment area, and if so, contact the SSCC for that area to inquire about what capacity is needed.
The Placement Process
Once a provider is Credentialed in one or more service packages, all of the children placed under the provider will need to receive a CANS 3.0 Assessment; CPAs will have an additional step of Credentialing all of their foster homes for any or all of the Service Packages that the CPA is Credentialed to provide, according to the CPA’s approved policy. If the child, youth, or young adult’s CANS 3.0 Assessment recommends a Service Package that is not offered in the current placement, the SSCC or DFPS permanency planning team and provider will work together to determine the appropriate Service Package.
Yes.
T3C envisions that most children coming into care will be placed in a foster home Credentialed for T3C Basic Foster Family Home Support Services or Short-Term Assessment Support Services, or if GRO services is the preference, then either T3C Basic Child Care Operation or Emergency Emotional Support & Assessment Center Services. However, if there are specific details of the child’s needs in the Application for Placement that indicate an apparent need for a particular Service Package, for example a Complex Medical Needs or Medically Fragile Support Services foster home or a Human Trafficking Victim/Survivor Treatment Services to Support Community Transition Service Package GRO, then the DFPS or SSCC staff can work with the Placement Team to identify an appropriate provider .
DFPS will reimburse the SSCC the methodological rate for the corresponding Service Package. The SSCC’s will continue to negotiate the terms and conditions of their contracts, including customized rates with their network providers.
Yes.
Based on the CANS results, the knowledge and professional judgement of the SSCC or DFPS staff and the child’s stakeholders, including the placement provider, based on the child’s individual needs and best interest, would be the basis for the selection of the Service Package. If the child remains in the same placement under a different Service Package, there will be an agreed start date that is communicated.