Integrated Care Coordination Program

The Department of Family and Protective Services (DFPS) created the Integrated Care Coordination (ICC) program to improve outcomes and the coordination of care for children and youth in foster care who have specialized needs. DFPS contracted with Pathways Youth and Family Services to assume full responsibility for case management and placement for children that DFPS refers to the program. The vendor is responsible for expanding foster care capacity and ensuring these children and youth get the coordinated services they need.

This pilot program shifts highly complex and time-consuming cases from caseworkers to a vendor that can focus on them exclusively. The vendor has all the data and resources it needs to navigate all of the systems of care these children require. The program is designed to give children with specialized needs the attention they deserve, while allowing caseworkers to focus more time on other children.

The pilot will serve up to 150 children. Children and youth whose legal county of residence is Harris County can be included in the pilot if they meet one or more of the following criteria. The child or youth:

  • Was admitted to a hospital and stayed longer than medically necessary. 
  • Was admitted to a psychiatric hospital and stayed longer than medically necessary. 
  • Is currently or would need to be served through a child-specific contract.
  • Had at least two residential treatment center (RTC) admissions in the past twelve months.
  • Had at least two psychiatric admissions over the past twelve months, even if not medically necessary
  • Can also have his/her case escalated by a caseworker who thinks the program would be appropriate.

Program Location: Harris County

Program Location Harris County in Texas Map

The pilot tests use of a new rate model, which provides for a per diem case management rate and a per diem placement rate. The case management rate is a flat rate for all children in the pilot.

The placement rate provides an intensive, front-loaded rate which supports stabilization of the child and provision of all the services and supports the child needs and gradually steps down over time, meant to coincide with the child’s stabilization.

This rate is not tied to the child’s level of need as is done in the legacy foster care system. This rate structure removes the incentive to keep a child at a higher level of care in order to receive higher payment, and instead incentivizes the provision of care in more home-like settings and achievement of positive permanency for the child or youth.

Timeline: The initial project timeline is December 1, 2017 – November 30, 2019.

DFPS will evaluate the process and outcomes throughout the life of the project.

Background: In 2015, the Department of Family and Protective Services (DFPS) and the Health and Human Services Commission (HHSC) commissioned an assessment of how the Texas child welfare system serves children and youth with high needs and to outline ways to improve their care.

Based on the findings the assessment and under the leadership of Governor Greg Abbott, DFPS received a grant from the Governor’s Criminal Justice Division to create this program. DFPS issued a request for information (RFI) in June 2016 to gather information to inform the procurement of the ICC Vendor.

DFPS issued a draft request for applications (RFA) on January 19, 2017 to inform the final RFA, which was issued on March 7, 2017. DFPS executed a contract with Pathways Youth and Family Services.


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Questions and Answers

Who qualifies for the pilot?

Children and youth whose legal county of residence is Harris County can be included in the pilot if they meet one or more of the following criteria.

  • Children or youth with an admission to a psychiatric hospital with a length of stay past medical necessity. 
  • Children or youth with an admission to a medical hospital with a length of stay past medical necessity.
  • Children or youth with an active child specific contract or who would otherwise need a child specific contract.
  • Children with at least two Residential Treatment Center (RTC) admissions over the past twelve months.
  • Children with at least two psychiatric admissions over the past twelve months, even if not past medical necessity.
  • Caseworkers also have the ability to escalate cases for whom they think the program would be appropriate.
Who is the ICC?

The Integrated Care Coordination vendor is Pathways Youth and Family Services.

When will the ICC program start serving children?

The ICC vendor begins serving children December 1, 2017. Cases will begin to be referred in November 2017.

Where will the ICC program be located?

The pilot will be located in Harris County, for children and youth whose legal county is Harris County.

How does ICC differ from Community-based Care?

The integrated care coordination program is one of several strategies to transform the foster care system and is part of the agency’s strategy to accelerate components of the Community-based Care model model. The ICC and FCR models share some features:

  1. Contractor serves all children referred (“No Eject/No Reject”)
  2. Contractor is paid a rate that is not dependent on the child’s level of care (as is done in the legacy system).
  3. Performance-based contracting

Key Differences:

  1. The ICC model is for a specialized population of children/youth, not the full foster care population.
  2. The ICC model is not implemented in phases. The vendor will work with children/youth and their families at the launch of the program.

DFPS will consider whether to keep the ICC program as a separate program or incorporate it into the Community-based Care model after evaluating the ICC model in the pilot program.

What are the key outcomes the pilot is seeking to address?
  1. Children/youth’s educational needs are met.
  2. Children/youth’s physical health needs are met.
  3. Children/youth’s behavioral health needs are met.
  4. Children/youth in ICC have a reduced level of need.
  5. Youth have the knowledge to transition from foster care to independent living.
  6. Children/youth are safe in the care of ICC.
  7. Children/youth experience placement stability while in ICC care.
  8. Increase in the percentage of youth who stay in extended foster care after they reach age 18.
  9. % of Children/youth who leave ICC into a positive permanency placement.
  10. Children/youth remain in foster care for a shorter time before achieving positive permanency.
  11. Children/youth under the age of 18 who exit ICC into a positive permanency placement remain in that placement.
  12. Children/youth participate in decisions that impact their lives.


What tasks will the vendor be performing vs. DFPS staff?

Vendor Responsibilities:

  • Child placement (available 24 hours/7 days a week)
  • Case management, including court participation, and
  • coordination with all necessary systems of care
  • Services for parents
  • Kinship program and PAL services
  • Coordinate with CPS in cases where ICC child/youth has
  • siblings served in legacy CPS system

DFPS Responsibilities:

  • Referral of children/youth to ICC vendor
  • Case management oversight
  • Technical Assistance
  • Quality Assurance Contract Monitoring
  • Program Evaluation
  • Maintenance of IMPACT system
  • Coordinate with ICC Vendor in cases where ICC vendor is serving sibling of children in legacy CPS system