The T3C System Blueprint contains specific terminology and concepts essential for understanding the components and requirements of each distinct Service package and Add-On-Service. To promote a shared understanding key terms and concepts are described below.
- Add-On Service (Child Placing Agencies Only)
- A set of clearly defined criteria with an established daily rate that supports eligible children, youth, and young adults with specific needs living with a Credentialed Foster Family Home Caregiver supported by a Credentialed Child Placing Agency that includes one or more of the following services:
- Transition Support Services for Youth & Young Adults 14 years and older,
- Kinship Caregiver Support Services (Paid to Child Placing Agency only) for verified kinship foster family homes, and
- Pregnant & Parenting Support Services.
- Aftercare Services
- Support services planned in anticipation of discharge and provided post-discharge to children that have transitioned to a new placement. Aftercare Services vary by Service Package/Add-On Service. Funding to support the provision of Service Package-specific aftercare has been included in the applicable daily rate paid while the child is in placement to be used to support post-discharge services. While the type, resources, frequency, and duration of services may vary by Service Package/Add-On Service, aftercare requirements include one, more than one, or all the following expectations:
- Collaboration with the child’s core Service Planning team, which dependent on the case, should include: the child, the child’s parents, the child’s CPS or SSCC caseworker, attorney ad-litem, guardian ad-litem and/or CASA volunteer, STAR Health Service Coordinator, relatives, subsequent Caregivers, and other stakeholders.
- Collection, documentation, and tracking of child outcome data, related to the provision of Aftercare Services.
- Prior to transition, administration, and completion of the CANS 3.0 Assessment. Review of assessment with Service Planning team members to identify strengths and needs to build on and address in subsequent placement.
- Assistance with school enrollment (if applicable per the child’s age). Prior to discharge and if possible, the child must be enrolled in school. Any issues should be addressed with assistance of the education liaison for the operation.
- Development and maintenance of the Education Portfolio.
- Assistance with identification, facilitation and support of affirming, normative, age-appropriate, positive-peer relationships, and activities within the child’s community at the subsequent placement. Activities can include any number of things that are meaningful to the child and contribute to positive well-being, which may include sports, fine arts, volunteering, employment, extra-curricular, school activities, etc.
- Organization and facilitation of the transition to other medical and mental health providers, as needed. This includes collaboration to ensure that there is no lapse in therapy or medication, if applicable.
- Assessment, assistance, and support of the needs of parents and/or subsequent Caregivers and family.
- Consistent and ongoing engagement with the child and families to support transition and to maintain healthy connections.
- Behavior Support Specialist or Mentor
- For the purposes of T3C, an employee or contract service provider, who builds rapport with the child, youth, or young adult, and seeks to engage, support, and coach the child and their Caregiver in the utilization of various techniques that will aid in optimizing the child’s functioning in an efficient and effective manner. The rate methodology staffing model is based on an individual with a Bachelor’s degree, similar to a Case Manager, to allow providers to have flexibility in filling the role for T3C Service Packages with staffing requirements including a Behavior Support Specialist or Mentor.
- Caregiver
- For purposes of T3C, a person, including an employee, foster parent, cottage parent, contract service provider, or volunteer, whose day-to-day responsibilities include direct care, supervision, guidance, and protection of a child, youth, or young adult in care.
- Child and Adolescent Needs and Strengths (CANS) 3.0 Assessment
- A multi-purpose tool developed for children’s services to support decision making, including identification of the optimal Service Package (for T3C) and planning, to facilitate quality improvement initiatives, and to allow for the monitoring of outcomes of children, youth, and young adults in care.
- Continued Stay Guidelines
- Incorporated in the provider’s policy and procedures, these guidelines directly link to the evidence-informed or evidence-based Treatment Model and are used as the means for determining a child’s continued need for placement beyond the expectation established for the program. The timeline for review should coincide with the expected duration of stay based on the provider’s selected and approved Treatment Model, and any time limitations of the Service Package. These guidelines at a minimum must address:
- The primary reason the child met the admission guidelines, and a detailed documented reason for how he or she continues to require on-going services established upon placement, or how those services are being changed or replaced with others.
- How services are adjusted for the child based on an updated CANS assessment.
- How services continue to support the child’s individual need for safety, improved well-being, and permanency in accordance with the child and family plans of service.
- A less-restrictive placement type/service option is not appropriate to meet the child’s individual needs.
- Continuous Quality Improvement
- For purposes of T3C, this means the formal structure and process used by the Child Placing Agency or General Residential Operation for defining and examining programs strengths and challenges and testing, improving, and learning from solutions on an on-going basis. This process is intended to be proactive and cyclical, using data to improve the quality of services and outcomes for children, youth, and young adults based on the individual Service Package and/or Add-On Service (if applicable).
- Credential
- For purposes of T3C, this means a Child Placing Agency, General Residential Operation, or foster home has met the qualifications, as determined by DFPS, to offer a specific Service Package or Add-On Service (Child Placing Agencies only). DFPS will make the determination for Child Placing Agencies and General Residential Operations, while the individual Child Placing Agency will assess whether the individual foster home meets the qualifications.
- Daily Foster Care Rate
- The per diem rate paid to an SSCC, or Child Placing Agency, or General Residential Operation for providing a distinct Service Package or Add-On Service(s).
- Evidence-based
- Practice that is shown to be effective based on rigorous evaluation and factors in expertise of professionals and the characteristics, culture, and preferences of those the practice will support.
- Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
- Handbook used by health care professionals as the authoritative guide to the diagnosis of mental and behavioral disorders. DSM-5 contains descriptions, symptoms, and other criteria for diagnosing mental and behavioral disorders.
- Evidence-based
- Practice that is shown to be effective based on rigorous evaluation and factors in expertise of professionals and the characteristics, culture, and preferences of those the practice will support.
- Evidence-informed
- Component parts include knowledge gained through research, practice, and experience, use of data collection, tracking, and analyzation to ensure that desired outcomes are being achieved and are continuing to meet the customized needs of the unique population. Please note that use of an Evidence-based Treatment Model may be used in lieu of an Evidence-informed Treatment Model as referenced throughout the T3C System Blueprint.
- Extended Foster Care
- A voluntary program that allows a young adult to reside in a paid foster care placement after DFPS legal conservatorship ends upon turning age 18. The young adult is eligible for Extended Foster Care if he or she is participating in qualifying activities which can be found in Chapter 10400 of the Child Protective Services Handbook.
- Information Technology (IT) System
- For purposes of T3C, there is a requirement that all providers engage in selection and utilization of a computer system(s) that includes hardware, software, and equipment operated by provider staff (users) and allows for data collection to support Quality Assurance, Continuous Quality Improvement, case management documentation, billing/invoicing, reporting, and child-level outcome tracking processes in a manner that protects confidentiality, and meets industry standards for secure data storage.
- Interim Credential
- An initial, short-term Credential that can be applied for by General Residential Operations and Child Placing Agencies that meet certain eligibility requirements. Within state and federal statute and regulatory requirements, DFPS-approved providers could start providing T3C Service Packages and Add-On Services based on evaluation of a comprehensive plan, but prior to meeting all of the requirements to become fully Credentialed. Providers approved for the Interim Credential would subsequently be required to become fully Credentialed within a set time frame. The Interim Credentialing process will be time-limited and will be eliminated as an option to providers during the transition to T3C.
- Intermittent Alternate Care
- Commonly referred to as “Respite Care”, this is a planned alternative 24-hour care provided for a child, youth, or young adult by a licensed Child Placing Agency as a part of the Child Placing Agency or home’s regulated childcare and lasts more than 72 consecutive hours. For purposes of T3C, funding to support Intermittent Alternate Care has been built into the daily foster care rate.
- Kinship Caregiver
- Relatives and other people (known as fictive kin) who the child or family have a significant relationship with and who can provide stability for children when they can't safely reside with their parents. For purposes of T3C, Kinship Caregivers are verified Caregivers through a licensed Child Placing Agency.
- Logic Model
- 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.
- Minimum Standards
- Chapter 42 of the Texas Human Resources Code requires the Health and Human Services Commission to regulate childcare and child-placing activities in Texas, and to create and enforce Minimum Standards. HHSC develops rules for childcare in Texas. Once proposed, reviewed, and adopted, these rules become part of the Texas Administrative Code. (Read the childcare licensing rules.) Each set of Minimum Standards is based on a particular chapter of the Texas Administrative Code and the corresponding childcare operation permit type(s). The Minimum Standards mitigate risk for children in out-of-home care settings by outlining basic requirements to protect the health, safety, and well-being of children in care. For purposes of T3C, providers must be licensed through HHSC-Child Care Regulation Division (CCR). Service Package and Add-On Service requirements that are consistent with Minimum Standards will be monitored through CCR.
- Normalcy
- The ability of a child in foster care to engage in activities that are suitable for children, youth, and young adults of the same age, level of maturity, and developmental level as determined by a reasonable and prudent parent standard. Examples include, but are not limited to, extracurricular activities, in-school and out-of-school activities, enrichment activities, drivers’ education and experience, cultural activities, employment opportunities, and frequent communication with family, friends, and peers via in-person visits, phone calls, and through social media (if safe and appropriate).
- Permit Services
- For purposes of T3C, this refers to the treatment, programmatic, and/or special services that are required of the operation (Child Placing Agency or General Residential Operation) that are a part of the permit issued by HHSC-Child Care Regulation Division and is distinct for each Service Package and/or Add-On Service.
- Permit Type
- For purposes of T3C, this refers to the operation’s type (Child Placing Agency or General Residential Operation) that are a part of the permit issued by HHSC-Child Care Regulation Division and is distinct for each Service Package and/or Add-On Service.
- Pre-Placement Visit
- Occurs before placement and allows the child, youth, or young adult to visit with potential Caregivers to determine if the child, youth, or young adult feels that the placement is a good fit and allows time to process the change.
- Promising Practice
- A practice that is superior to an appropriate comparison practice using conventional standards of statistical significance (in terms of demonstrated meaningful improvements in validated measures of important child outcomes, such as mental health, substance abuse, well-being or safety) as established by at least one study that was rated by an independent systemic review for the quality of the study design and execution and determined to be well-designed and well-executed; and utilized some form of control group.
- Service Coordination
- A special kind of care management that is performed by a Superior STAR Health Service Coordinator and is a benefit for all STAR Health members. As a part of Service Coordination, the STAR Health Service Coordinator works with STAR Health members (children and youth in DFPS conservatorship or young adults in Extended Foster Care) and their medical consenter to:
- Identify healthcare needs.
- Develop an Individual Service Plan (ISP) along with their medical consenter, community supports, and providers.
- Ensure that services are received timely.
- Help to find providers and access covered services.
- Coordinate Medicaid covered services with social and community support services.
- Service Package
- Clearly defined set of criteria that is intended to meet the custom needs of the child, which is used to evaluate a provider for a Credential. Each Service Package has a unique daily rate. Children, youth, and young adults may have competing needs, however only one primary Service Package will be determined at the time of placement and will serve as the basis for the single daily reimbursement rate.
- Service Plan
- Commonly referred to as the “Single Child’s Plan of Service”, for purposes of T3C, this is the provider's developed plan that is narrowly tailored to address the child’s custom goals, progress achieving goals, and services that will be provided to a child, youth, or young adult to meet specific goals while served by the provider. The Service Plan must incorporate the CANS 3.0 Assessment.
- Single Source Continuum Contract/Contractor (SSCC)
- Entity with whom DFPS enters a contract for the provision of the full continuum of substitute care, case management, and reunification services in a designated geographic catchment area.
- Staff
- For purposes of T3C, Child Placing Agency or General Residential Operation staff includes a person an operation employs full-time or part-time to work for wages, salary, or other compensation. This includes all Child Placing Agency or General Residential Operation staff, agency or operation contractors, volunteers, and any owner who interacts with a child, youth, or young adult receiving the specified Service Package or Add-On Service.
- STAR Health
- A comprehensive, single source Medicaid managed care model for children and youth in DFPS conservatorship and young adults up to age 22 in Extended Foster Care. Benefits of STAR Health include:
- Immediate access to services when the child or youth is taken into DFPS conservatorship.
- Support of a statewide (Medicaid) provider network.
- Continuity of care supported by Health Passport, a proprietary healthcare data management system.
- Ability to develop innovative and flexible solutions to support child welfare system changes and needs.
- Simplification of system changes required to coordinate care.
- A one stop shop to assist with physical health, behavioral health, dental, vision, pharmacy benefits, value-added services, and transportation. Dedicated STAR Health staff with many years of prior child welfare experience and specific foster care training.
- Time-limited Service
- Varies by Service Package and provider’s Treatment Model, it is the anticipated length of time that it will take for a child, youth, or young adult to successfully complete a program prior to discharge.
- Trauma-informed agency or organization
- A Child Placing Agency or General Residential Operation that is trauma-informed is an organization or agency that:
- Realizes the widespread impact of trauma and the potential paths for recovery;
- Recognizes the signs and symptoms of trauma in children, youth, young adults, families, staff, Caregivers, and others involved in the child welfare system;
- Responds by fully integrating knowledge about trauma into policies, procedures, and practices; and
- Seeks to actively resist re-traumatization.
- Treatment Model
Commonly referred to as a "program model", it serves as the foundation and framework for the provider’s program. For purposes of T3C, a Treatment Model is not solely the therapeutic technique(s) or specific clinical intervention(s) being used to treat the individual child’s diagnosis (as may be offered through STAR Health). Rather it is the holistic, trauma-informed approach to care that considers the physical, emotional, social, and spiritual well-being needs of children requiring a distinct Service Package, and serves as the program’s structure for providing care, including the approach to planning, and providing therapeutic/clinical intervention(s), case management, training, policy and procedures, recreation, service planning, and Aftercare Services (if applicable). The provider’s Treatment Model can be one they have developed independently or one that they have purchased, so long as it meets the core elements listed above and is Evidence-informed, or a Promising Practice, or is Evidence-based. 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 operation's Treatment Model.
A General Residential Operation’s Evidence-informed Treatment Model for each Tier I Service Package (except for Tier I: T3C Basic Child Care Operation and Tier I: Emergency Emotional Support & Assessment Center) and the Evidence-based Treatment Model for each Tier II Service Package should include a defined, Anticipated Length of Stay to complete the treatment or stabilization program. The actual length of stay will be child, youth, or young adult dependent, and based on individual need.
- Universal Human Trafficking Prevention Training
- Childcare providers and Caregivers are in a unique position to intervene and educate those vulnerable to becoming victims of human trafficking. DFPS is in the process of developing a Human Trafficking Prevention Training and a companion “Train the Trainer” model, which is anticipated to be released in the fall of 2024. Providers may choose to adopt this model and train their staff and Caregivers, or they may submit, as a part of the Credentialing process, a different model they intend to use to meet this requirement under T3C. It is the Department’s intent that relevant information provided in the Universal Human Trafficking Prevention Training be shared with children, youth, and young adults being served by the provider. Each provider will have the flexibility to determine how best to share this information; examples include providing information through service plan meetings, during home visits, or through one-to-one communication between the Caregiver and child. This training is required and funding to support this training has been included in the daily rate for all Service Packages. For providers offering one of the three Service Packages designed specifically to serve victims/survivors of Human Trafficking, the agency or organization will need to use a training that is specific for prevention for that population of children, youth, and young adults.