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Are all Child Placing Agency (CPA)/Foster Family Home T3C Service Packages eligible for the Add-On Services?
No. The Short-Term Assessment Support Services Package is not eligible for the Add-On Services.
Are all CPAs and General Residential Operations (GROs) eligible to provide all Service Packages and 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.
Will GRO facilities be able to provide more than one Service Package?
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.
What Service Packages will Emergency Shelters be eligible to apply to provide?
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.
Will foster homes be able to provide more than one Service Package?
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.
Are there supposed to be differences between the current Contract and Open Enrollments for Treatment Foster Family Care and QRTPs, and the T3C Treatment Foster Family Care and Tier II GRO Service Package requirements?
Yes, there are some minor differences.
Is Tier I considered Treatment services?
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
What is the 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.
Will you include resources or a list in the next Blueprint release that tell which treatment models are considered Evidence-informed?
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.
For the packages designed for those victims/survivors of human trafficking one of the training requirements states: "A Universal Human Trafficking Prevention Training specifically designed for victims/survivors of Human Trafficking is required for all staff and Direct Delivery Caregivers." Could you elaborate on what is meant by this?
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.
What Service Package would the biological child of a youth or young adult who is parenting and is placed in the Tier I: Services to Support Community Transition for Youth & Young Adults who are Pregnant or Parenting Service Package have?
There is not a specific Service Package for the children of youth/young adult parents under the T3C System. Rather DFPS will continue to provide funds to cover the care and maintenance of the child of youth or young adult parent that is in DFPS conservatorship or extended foster care. The reimbursement rate for this care will be $46.90 per day that will be paid in addition to the Service Package rate for the services offered to the youth/young adult parent.
If a teenager is in her third trimester of pregnancy, will she be categorized under the Tier I: Complex Medical Needs Treatment Services to Support Community Transition or Tier II: Complex Medical Services to Support Stabilization while residing in a general residential facility?
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.
If a provider is not credentialed for the Kinship Services Add-On, can the agency still license kinship families to provide Basic Foster Family Home Services? Or is the Add- On a requirement for all Kinship homes that are licensed?
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.
Does the required paid leave for all Direct Delivery Caregivers include part-time employees?
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. Additionally, while Direct Delivery Caregivers are the ones required by the T3C System Blueprint to receive these benefits, Providers are not prohibited from expanding paid leave to other staff and contractors, but the funding for that expansion is not accounted for under the T3C Rates currently.
In the T3C System Blueprint, both the GRO-Tier I and Tier II Service Packages state “The GRO must have a customized daily Recreation Schedule that supports the physical, social, and emotional well-being needs of children in a manner that is age and developmentally appropriate, and consistent with the operation’s Treatment Model.” Does that mean customized for the individual child, like what is required for a child receiving Treatment Services under Minimum Standards, or does that mean customized to be appropriate for all of the children receiving a particular Service 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.
Why isn’t “Childcare Services” identified as a required Programmatic Service type under the Permit Services for all of the Service Packages in the T3C System Blueprint?
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 GRO Service Packages require the residential provider to have Permit Services for Transitional Living under the Programmatic Services if the provider will accept youth age 14 and older. Isn’t that counter to the intent when a child needs a more structured treatment program, particularly for the GRO- Tier II Service Packages?
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.
Can a provider subcontract for Aftercare Case Management?
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.
Are the T3C rates enough to cover the increased requirements?
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.
Do I need to employ or contract certain service providers, such as licensed therapists or physicians?
Yes, as per the specific Service Package Expectations.
Where can we go for resources on how to implement aspects of the Service Packages, such as what does Continuous Quality Assurance and Improvement (CQAI) look like, or getting support for developing logic models?
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 ReadyExternal Link website.
Is there a certain number of paid days of Intermittent Alternative Care (aka respite) that need to be provided?
The rate methodology for T3C is calculated based on 40 days of paid Intermittent Alternative Care per year to inform the Service Package rates.
Could you provide more guidance on what a Behavior Support Specialist/Mentor is and what kind of qualifications that individual might need?
For purposes of T3C, a Behavior Support Specialist/Mentor is an employee or contracted service provider, who builds rapport with the child, youth, or young adult, and seeks to engage, support, and coach the child and their Caregiver/s 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/Mentor.
If a CPA has multiple branches, will each branch office be required to have it’s own Licensed Child Placing Agency Administrator if there is a LCPAA at the main location?
DFPS will defer to HHSC-CCR and Minimum Standards on this determination. The intent of the Staffing Requirement of “Full-time Licensed Child Placing Agency Administrator dedicated to single Child Placing Agency” in the Service Packages is not to exceed the Minimum Standards regarding main verses branch offices, it is only to prevent an LCPAA from one independent provider from being the LCPAA for another unaffiliated provider.
If a CPA chooses not to become Credentialed for the Transition Support Services for Youth & Young Adults Add-On Service, does that mean that the CPA and Foster Home are not responsible for meeting the youth or young adult’s transition planning needs?
No, there will still be requirements surrounding addressing the youth or young adult’s transition planning needs regarding prudent parenting, normalcy, experiential learning and PAL services in the DFPS Contract or SSCC Provider Network Agreement contract that will not change under T3C. The Add-On Service provides extra funds for additional staff and financial support to the foster parents to defray the costs of supporting the youth or young adult with meeting their needs in a holistic way, but it does have added requirements beyond what is contained in the Contract.
If a CPA chooses not to take advantage of the Transition Support Services for Youth & Young Adults Add-On Service, do they still need to add the Transitional Living Programmatic Service to their Permit?
No, but they do need to ensure that they are permitted for the Young Adult Care Special Services if there may be young adults age 18+ in DFPS conservatorship placed in their foster homes.
If a provider has questions about Permit changes related to T3C compliance, who can we contact?
You can access HHSC-CCR staff who are familiar with T3C by emailing the Minimum Standards box at RCCRStan@hhs.texas.gov.
Can an external service provider, such as a therapist, be contracted with multiple residential operations under T3C?
There is nothing in the T3C System Blueprint that prevents an external service provider from contracting with multiple residential operations, but the time required per child and per operation may be greater than under the Service Levels System, which may reduce the number of operations that an external service provider can work with. This would depend on various factors impacting each residential operation, such as their selected Treatment Models, and the Service Packages that they plan to apply for Credentialing in, due to the Staffing Requirements including on-call availability, and service planning team and time frames, including child progress documentation and staffings informing the Quality Assurance and Continued Stay Guidelines.
Can a GRO or RTC serve both Tier I and Tier II Service Packages in the same facility?
Yes, as long as all of the different requirements for each Service Package are met. Additionally, if they are housed in the same building, the provider would want to consider some separation to delineate the different areas to account for Minimum Standards requirements, as well as the T3C Generally Appropriate Staff to Child Ratios and considerations such as any additional security deemed necessary for the children in Tier II, and to ensure that the behaviors of the higher acuity children in the Tier II area don’t negatively impact the children in Tier I.
If a GRO has utilized a contracted Psychiatrist, whose training exceeds that of a Registered Nurse and whom is routinely on-site and is available via phone or video conference 24 hours a day/7days a week to direct and oversee the administration of psychotropic and other medications to children, to fulfill a requirement for accreditation with The Council on Accreditation (COA), can that Psychiatrist fulfill the requirement for a Registered Nurse in the Tier I: Mental & Behavioral Health Treatment Services to Support Community Transition Service Package? What about to fulfill the requirements for a Registered Nurse in the Tier II Service Packages?
For the Tier I: Mental and Behavioral Health Treatment Services Package, utilizing a contracted individual whose qualifications exceed that of a Registered Nurse, such as a psychiatrist, would be acceptable. However, be aware that the rate methodology for the Service Package only supports the cost of an RN. For the Tier II Service Packages except the Complex Medical Services to Support Stabilization (which requires an RN on staff, not just contracted), the model was built to specifically include that an RN is on-site during regular business hours, so at this time, your current arrangement utilizing the contracted Psychiatrist that is not on site daily during business hours would not fulfill the requirement.
Can we use a Physician Assistant for our Treatment Director in the Complex Medical Needs or Medically Fragile Support Services Package, since the qualifications for Treatment Director are listed as a physician or a licensed Registered Nurse?
No. The qualifications for Treatment Director as identified in the T3C System Blueprint are taken from Minimum Standards and the type/s of Treatment Services required on the operation’s license for the specific Service Package, so those qualifications would likely only change in the event of changes to Minimum Standards.
What role can therapy interns, under appropriate supervision, play within T3C?
Because interns are not eligible for Superior STAR Health Credentialing, Licensed Professional Counselor Intern (LPCI), Licensed Chemical Dependency Counselor Intern (LCDCI), and other types of therapist interns can be used for services that are not Medicaid eligible. Examples include, but are not limited to, service planning, one-on- one behavioral intervention (that is not an actual therapy session as defined by Medicaid), and other non-Medicaid eligible services.
For Foster Family Home Service Package Add-Ons, in the Staffing Requirements section of the Blueprint, what is the meaning behind “dedicated Kinship Caregiver Home Support staff and infrastructure”, as well as “dedicated transition Support/Mentor Staff”, and “dedicated Parenting Support/Mentor Staff”?
The use of "dedicated" means that the specific Add-On staff is dedicated to working only with the Add-On Service in mind for the child/Kinship Caregiver Family they are assigned to, while there would be a separate Case Manager assigned to the child for the purposes of their Service Package planning and needs.
For the Intermittent Alternate Care, does this mean that as an agency we can withhold payment from the foster home that has placement of the child to pay the alternative care providers? Also, can we have volunteers provide this function free of charge on occasion?
No. It means that the rate includes funding such that the CPA is required to pay the foster home their normal pass-through rate for the child’s Service Package and any applicable Add-On Services for each day of Intermittent Alternate Care (respite). In addition, the CPA is responsible for paying the alternative care providers who take the child for the days of respite the same pass-through rate as the child’s foster family home. The rate methodology for T3C is calculated based on 40 days of paid Intermittent Alternative Care per year to inform the Service Package rates. An agency can have volunteers so long as it has been approved in your policies and procedures (meeting Minimum Standards) for providing care, free of charge, for days over and above the required minimum of 40 paid days, which will allow your foster families to save their paid days for when it is most needed.
Could you provide any additional information about what the new Cost reports under T3C will look like?
HHSC Provider Finance is revising the 24-Hour Residential Child Care cost report template to align with and complement the T3C rate methodology. The cost report will collect incurred costs associated with providing services under both the legacy and T3C systems while providers are providing care for children under both systems. Once all children have been transitioned to T3C, HHSC will only collect costs associated with operating under T3C.
The cost report template will require GRO and CPA providers to report paid units of service for each T3C service package and add-on(s), legacy paid days, and allowable costs to deliver residential foster care. HHSC will collect hours and allowable compensation for employed and contracted staff hours and wages for non-administrative and administrative personnel and payroll taxes and Workers' Compensation premiums and claims for staff, and facility, administrative and operations costs associated with providing services.
The definition for IT System in the T3C System Blueprint requires that it "meets industry standards for secure data storage" but I know that the contract may have special requirements. Where can I find the most up to date IT Data and Systems Security Requirements for DFPS Contractors?
Updates to the DFPS Data and System Security Requirements that are applicable to contractors were released on 9/17/2024, and the current requirements in their entirety can be found in the DFPS Data and System Security RequirementsPDF Document document.
In regard to the Service Package requirement related to collecting data to track Service Package referrals, is the expectation to track all referrals, including those outside of our operation’s child eligibility criteria?
The mandate for providers to track referrals for placement was already established as a result of the most recent Legislative session, so it actually pre-dates the T3C System Blueprint being published, and the T3C System Blueprint is actually trying to help provide guidance with the requirements outlined.
If you are receiving inappropriate (not within your operation’s scope) referrals, then you would want to be able to collect the data on those referrals and your responses in a manner that can generate reports to provide to the Department and/or SSCCs for purposes of the larger Continuous Quality Assurance and Improvement process that is built into T3C and will be overseen/coordinated by UT. You should also verify that your operation’s information and availability of placements is correct in GPS, and for your responses, ensure that you are copying the appropriate referral source (such as CPS Regional Placement email box or SSCC Point of Contact regarding placement processes).
What does “Length of Service” mean and how does an operation add that to their Treatment Model since they do not determine the length of service for children in Foster Care, as it can vary depending on permanency options, even for children in a T3C Basic Foster Family Home Support Services Package?
The operation’s Treatment Model (and thus Logic Model) along with the Quality Assurance and Continued Stay Guidelines should inform your anticipated length of service, which is the approximate amount of time that your operation needs to meet the needs and goals identified for the population of children being served under the distinct Service Package. Even for the T3C Basic Foster Family Home Support Services Package, you are still providing services to achieve the child’s individual goals:
- Assessing the child for needing/participating in therapy for trauma stemming from abuse/neglect and from separation from family,
- Actively incorporating the family and child’s support network into service planning and supporting the child’s permanency by preparing for reunification and placement with relatives/fictive kin as a less restrictive placement type, and
- The Program Director under the Quality Assurance and Continued Stay Guidelines will review the child’s goals and services every six months to ensure they align with the child’s custom strengths, needs, and permanency plan, and the child continues to benefit from them, as well as that there is not a less-restrictive placement type that is appropriate to meet the child’s current needs.
Your Treatment Model may have approximate time frames built in for a child’s progress reviews, but if not, using the current average for the time from admission to discharge, or even using an average of one year to start (two Continuing Stay Guideline reviews) and then assessing your data as you integrate the Treatment Model may result in future refinement of your initial estimate on Anticipated Length of Service.
Could you clarify which Service Packages require that the Registered Nurse be on staff, and can’t just have the RN be contracted?
The following Service Packages require that the Registered Nurse be on staff:
- Complex Medical Needs or Medically Fragile Support Services;
- IDD/Autism Spectrum Disorder Support Services;
- GRO: Tier I Complex Medical Needs Treatment Services to Support Community Transition; and
- GRO: Tier II Complex Medical Services to Support Stabilization.
An error was identified in Appendix II.B and III.B that inadvertently left GRO: Tier II Complex Medical Services to Support Stabilization off of this section, which will be corrected in the January 2025 version of the T3C System Blueprint.
Updated If we do not meet the suggested ratio under General Appropriate Staff to Child Ratio based on Service Package, do the compensation rates change?
You will receive the rate posted in the T3C System Blueprint. However, you may need to include information, such as actual ratios used, with your cost report. In the long term, if multiple providers do not use the funding provided in the rate to support the number of staff that results in the recommended ratios for the specific service package, then the rates could be reduced.
"For tracking referrals with the IT System, do child referrals that are outside of the Provider’s age range served need to be tracked?
Yes. Data about children outside of a Provider’s target population is needed to better refine the referral process. Target population includes age range, gender, etc.
Could you clarify which roles among the LCCA/LCPAA, Program Director, and Treatment Director can be shared by the same person for a single operation/agency?
- LCPAA/LCCA and Program Director – Yes, these can be the same person if the individual meets all qualifications for both roles, as verified and approved by Residential Child Care Regulation (RCCR), and the operation/agency has a method to track the time put towards each function per each Service Package Credentialed for, for the purpose of Cost Reporting.
- LCPAA-LCAA and Treatment Director – Yes, these can be the same person if the individual meets all qualifications for both roles, as verified and approved by RCCR, and the operation/agency has a method to track the time put towards each function per each Service Package Credentialed for, for the purpose of Cost Reporting.
- Program Director and Treatment Director – No, these cannot be the same person, the Quality Assurance and Continued Stay Guidelines requires that both of these individuals (and additional clinical staff such as Registered Nurse for some Service Packages) review the child’s goals and services to ensure they align with child’s custom strengths, needs, and permanency plan, and provide written confirmation that the child, youth, or young adult continues to meet criteria for and is benefitting from the Evidence-informed Treatment Model offered through the program, and that a less-restrictive Service Package is not appropriate to meet the child’s custom needs.
Could the same person be employed under two different permits to serve as the same role, in regards to the LCCA/LCPAA, Program Director and Treatment Director?
The T3C System Blueprint is very clear that each permitted operation/agency needs to have a Full-time LCCA/LCPAA dedicated to a single operation/agency by the time of being awarded the Full Credential, and the only exceptions made will be Providers who hold multiple permits under the same parent entity when the conditions specified in Minimum Standards are met. Residential Child Care Regulation (RCCR) may have separate specific requirements regarding the Treatment Director being a full-time employee of a single agency/operation, but the Rate Structure and intention under T3C is to ensure that each permitted agency/operation has the focused, dedicated attention of a full-time Program Director and Treatment Director, although accommodations will be made for providers who hold two permits under the same parent entity, similar to the LCCA/LCPAA, as long as the Provider has a means for tracking the time spent by the individual at each operation/agency and on each Service Package for Cost Reporting purposes, and the workload of both (census, Service Packages, etc.) is manageable for one individual and approved by RCCR in the case of the Treatment Director.
Can you explain more regarding the roles of the Behavior Support Specialist and Aftercare Case Manager? Specifically, can one person hold both roles, requirements, etc.
The Aftercare Case Manager should have the same qualifications as other staff performing case management activities, and the rate methodology staffing model for the Behavior Support Specialist is also based on an individual with a Bachelor’s degree, similar to a Case Manager. The current rate methodology is intended for these positions to be held by separate individuals with FTEs for Service Packages that have them identified in the Staff Requirements section, but as long as the Provider has a method for tracking the amount of time put towards the different functions per Service Package for the purposes of cost reporting, they can be held by the same individual.
For Medically Complex Aftercare Coordination, can it be performed by the Treatment/Medical Director?
The Aftercare Case Manager should have the same qualifications as other staff performing case management activities at a minimum, and while the current rate methodology is intended for these two positions to be held by separate individuals with FTEs for Service Packages that have them identified in the Staff Requirements section, as long as the Provider has a method for tracking the amount of time put towards the different functions per Service Package for the purposes of cost reporting, they can be held by the same individual. Keep in mind that if the child goes to another waiver program like HCS or adoption, the Provider is still required to provide Aftercare Coordination for the entire period specified in the T3C System Blueprint and to track the child outcomes.
What if the foster parent does not want to take respite?
The Provider must have policies and procedures to ensure that foster parents have the ability to take 40 days of paid Intermittent Alternative Care (aka respite) per year, including Caregivers to provide respite being identified and qualified before it is needed. While there is no required minimum number of days that foster parents must take, it is recommended that the Provider include something in their policies and procedures to ensure that case management staff regularly discuss and document the ability to take this time away and to encourage the use particularly during periods of stress and change. The Provider would only document days that were actually utilized on the Cost Report once it is modified to reflect T3C requirements.
If we commit to one of the case management IT Systems at this time, will they be able to accommodate any changes/modifications that may come up during or after the application process/ completion?
The process and costs for changes should be one of the conversations that you have with your IT system vendor prior to purchasing the system.
When the T3C System Blueprint identifies “a degree in a human services field from an accredited college or university” as part of the qualifications for the Treatment Director position, what degrees fall under that classification?
All Treatment Director qualifications are taken from Minimum Standards to reflect the type of Treatment Services required on the Permit for the specific Service Package. Per §749.43 (37) and §748.43 (35), this is defined as “A field of study that contains coursework in the social sciences of psychology and social work including some counseling classes focusing on normal and abnormal human development and interpersonal relationship skills from an accredited college or university. Coursework in guidance counseling does not apply.” You can always verify with your Licensing representative as to specific instances.
Is T3C looking for specific assessment tools for outcome measures for Continuous Quality Assurance and Improvement (CQAI)?
No, just that you are utilizing one or more tools that you identify for purposes of your CQAI process.
New For Service Packages that require a registered nurse, is there a requirement to establish formal supervision by a physician or another nurse?
The duties and responsibilities of the registered nurse do not entail direct delivery of Medicaid paid services, and the rate methodology assumes that the registered nurse does not require formal supervision.
New For the group therapy requirement, the T3C System Blueprint does not specify a minimum age. Can the provider designate a minimum age for children to participate in this group?
Group therapy is only required in the T3C System Blueprint, for Service Packages of children whose treatment needs would benefit from it. If a provider has children in a Service Package that requires it, they may want to work with their therapist to establish age groups for different therapy groups.
New For Continuous Quality Assurance and Improvement (CQAI) process, to measure Logic Model outputs, are there any requirements for the provider to prove reliability or validity of the assessment tools? Would an informal survey count?
The provider can use any applicable assessment that will allow for testing the provider’s Logic Model, whether purchased or created. It is possible that upon reviewing the data, the provider may determine that the assessment tool is not adequate, and then the provider would need to come up with an alternate method.
New Do we need to create a Driver position, if we have those duties under the Direct Care Staff already?
That position can be combined with another function and shared among multiple individuals. In your application, make sure that you indicate you are using the same person for multiple roles, and that you have a method for tracking time spent in each role for cost reporting purposes.
New For positions that don't have minimum qualifications in Minimum Standards or detailed in the T3C System Blueprint, there is guidance in the FAQ about how a position like the Behavior Support Specialist/ Mentor should have a college degree, similar to a Case Manager. Is there any exception for the ability to substitute experience?
Yes, as long as the qualifications are not in Minimum Standards or the T3C System Blueprint, the provider can customize their Policies and Procedures to meet an appropriate standard. The rate methodology provides for the salary of an individual with a college degree in specialized positions, such as the Behavior Support Specialist/ Mentor.
What are the required child caregiver ratios?
The Licensing Minimum Standards include the mandated child to staff caregiver ratios. T3C includes ratio guidelines in the Generally Appropriate Staff to Child Ratio Based on Service Package 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. In support of contract requirements, the T3C System Blueprint specifies in the Service Package Expectations that awake night Direct Delivery Caregivers are required in foster homes where there are 7 or more children, and for all GROs. An update that will be officially included in the October 2024 version of the T3C System Blueprint is that for GROs, there must be at least one awake night Direct Delivery Caregiver in every separate cottage or building that has at least 1 child or youth in DFPS conservatorship. Information on awake night staff ratios was formerly in both the Service Package Expectations and the Generally Appropriate Staff to Child Ratio Based on Service Package sections, but now is only located under the Generally Appropriate Staff to Child Ratio Based on Service Package section to identify the staff ratios that are taken into account for the rate methodology and supported by the current rates, with the understanding that contracts may be more explicit in ratio expectations.
Can provider case managers have dual roles, i.e. a child’s case manager can also act as the child’s aftercare case manager once the child is discharged?
Some service packages have expectations around therapists per a specified number of children. If the therapists are engaging in Medicaid billable activities, what is accounted for in the rate?
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 needs change, does the Service Package change?
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.
In regards to sibling group placements, how do you credential and prepare a foster home for needs that could be identified later as traumas arise, but be able to maintain the sibling group placement?
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.
What does oversight of compliance with T3C implementation look like?
There will be a monitoring process, that is currently under development, as well as periodic recredentialing.
What evidence do we have that T3C will work?
The design of T3C was largely based on provider and other stakeholder input, and as the experts in the industry, what those individuals determined would be needed to provide quality services to children in foster care. The transition to this new system will be an iterative process where lessons will be learned, and modifications will be made for continued improvement. Successful implementation can only be achieved if there is frequent, timely, and transparent communication between the Department and all stakeholders. There will be a 3rd party Continuous Quality Assurance and Improvement process that will use data and stakeholder input to further improve the system as T3C is implemented and into the future.
What is the difference between GRO Tier I and Tier II for children with behavioral health needs?
The main difference is the objective for the services and the level of intervention needed to ensure the child’s needs are able to be met—GRO: Tier II focuses on services for children that are having a hard time self-regulating and are yet not at a place to be able to successfully participate and complete a treatment program. GRO Tier I (with the exception of the Basic Child Care and Emergency Emotional Support and Assessment Center) is designed for children who need RTC treatment but through less-intensive means when compared to their peers in a Tier II setting.
If a child’s next placement, whether family/ kinship placement/ foster home, does not want to participate in our Aftercare Case Management, how do we handle that? Would we have to continue to try to make contact for the entire required period of Aftercare?
Yes, it would be important for your operation to develop Policies and Procedures on how your Aftercare Case Management staff will collaboratively approach and repeatedly attempt to engage with the child’s next placement, and ensure proper documentation and submission of those attempts. Among the many purposes of Aftercare Case management to keep in mind when establishing those Policies and Procedures are:
- To provide the child with a degree of continuity and connection to the people from their prior placement and allow for a gradual sense of closure;
- To ensure that the options for local services that will assist in best meeting the child’s needs have been identified and set up timely so that they can be utilized in maintaining the child’s progress in addressing their needs; and
- To offer insight to the child’s unique challenges and assist in problem-solving how to manage them given prior experience with the child.
Among the overarching goals of Aftercare from the prior placement’s perspective would be to support the success of the next placement and avoid a placement disruption, as those Aftercare service outcomes will impact your operation’s statistics that you will need to track under the Service Package’s requirements regarding Desired Individual Outcome, and will in turn contribute to information that will be reviewed during re-Credentialing.
All Credentialed placements would also have the ability to develop Policies and Procedures on how they will collaboratively work with prior placements that offer Aftercare to utilize Aftercare planning efforts and capitalize on information gathering opportunities for service planning that will best support the child’s transition from the prior placement.
What is the difference between the Registered Nurse responsibilities for GRO Tier I and GRO Tier II Service Packages?
For GRO Tier I, the following service packages require a Registered Nurse:
- Substance Use Treatment Services to Support Community Transition;
- Complex Medical Needs Treatment Services to Support Community Transition;
- Mental & Behavioral Health Treatment Services to Support Community Transition;
- Intellectual or Developmental Disability (IDD)/Autism Spectrum; and Disorder Treatment Services to Support Community Transition.
All of these packages have some differences in responsibilities, but all require that the RN is routinely on-site and is available via phone or video conference 24 hours a day/7 days a week, and all include the responsibility to oversee the administration and distribution of medication. Oversight of the administration and distribution of medication does not mean that the RN has to be physically present for the actual administration of medication but needs to be available 24/7 via phone or video conference for questions and providing guidance to ensure accuracy of administration and documentation. Based on a provider’s Treatment Model and the responsibilities assigned to the RN, the amount of time that they are routinely on-site may change at times, and it will be the provider’s responsibility to show in their policies and procedures how they are ensuring that the RN is utilizing the Treatment Model to inform their interactions with the children and ensure that medical approaches support the child’s treatment goals under the Service Package.
For GRO Tier II, all service packages require a registered nurse to be on-site during regular business hours, and in accordance with the Treatment Model, and is available via phone or video conference 24 hours a day/7 days a week to direct and oversee the child’s treatment and stabilization progress, as well as the administration of psychotropic and other medications to children, youth, and young adults. The language of the Tier II requirements is more detailed because of federal requirements for QRTPs.
Are prior placement providers required to conduct Face to Face Aftercare visits?
The focus is on doing what makes sense, and encouraging collaboration between Caregivers, with the goal of maintaining the continuity of care and sense of connection for the child. If the child’s prior and subsequent placements are in the same region, it may make sense to have at least the first visit in-person, particularly for children that are especially sensitive to change. Ultimately, it is in the best interest of both the prior and subsequent placement, to work together to ensure a smooth transition and minimize chances of disruption for the child, in terms of child outcome tracking for both providers.
What does planning for and arranging Aftercare Services look like when the next placement is unknown?
If the current placement doesn’t know where the location of the child’s next placement will be at the time of assembling the initial Service Plan (such as in the case with a Tier II where a step-down paid placement may be needed prior to transition to family/fictive kin), they should still be identifying the specific ongoing treatment goals and types of services that they would recommend and intend to refer for as part of preparing for the child’s transition and aftercare once a subsequent placement is located, and ensure they are updating those items over the course of the Service Plan Reviews. Then once the next placement is identified, it’s important to have policies regarding the approaches that the Aftercare Caseworker will take to encourage the free flow of information and allow the providers to work together to identify, refer to, and utilize the best available resources in that locale for the child before, during, and after the move has occurred.
Is the Single Child’s Plan of Service (Form 3300) being updated to include T3C?
At this time, Form 3300 has been identified by CPS Program as only requiring a single additional field to indicate the child’s Service Package, similar to the field that already exists to indicate the child’s Level of Care. The development of Form 3300 was a very involved, collaborative process with the provider community, and while there are T3C-related details that could be added to the form, since SSCCs are not currently requiring use of the form, and completion of the transition to T3C will be shortly before the currently planned final roll-out of Community-Based Care statewide, at this point, there are concerns about the bandwidth of providers to achieve the collaboration required to completely update the form when the focus of many providers is ensuring their own efficiency during the transition to T3C and subsequently to CBC.
Are CPAs allowed to have children from different service packages living in the same foster home?
Yes, in fact, the ability to better serve sibling groups where each child has different needs is a benefit of having a foster family home trained and Credentialed to provide multiple Service Packages.
Why is there no longer an independent third-party review to ensure fair and consistent utilization reviews? Having the provider make the determination for the Continuing Stay Guidelines seems to be inviting disagreements between providers and SSCCs.
For this initial iteration of T3C, it was determined that leaving the decision with the provider who knows the child best from daily interaction will result in a more accurate review. However, if Continuous Quality Assurance and Improvement (CQAI) leads to concerns about the process, this may be reevaluated.
For those of us with a one or two person CPA office, how would the “dedicated” aspect of the staff required for Add-On Services work?
The use of "dedicated" means that the specific Add-On staff is dedicated to working only with the Add-On Service in mind for the child/Kinship Caregiver Family they are assigned to, while there would be a separate Case Manager assigned to the child for the purposes of their Service Package planning and needs.
How will T3C effect contracted or external Providers who provide services to the children in Foster Care, such as Skills Training?
T3C will require that contracted or external Providers utilized by Residential Operations will need to be trained in, actively utilize, and incorporate in their documentation the Provider’s Treatment Model.
When will a Provider begin to receive the new rate based on the package they are providing?
Once a Provider has been issued an Active Interim Credential or Active Full Credential, and children have been electronically placed into a T3C Service Package.
Can a Case Manager provide Aftercare Services, since they have the best most trusting relationship with a child?
Yes, but the Provider should show how they are accommodating the workload of the Case Manager given the additional responsibilities and ensure that there is a method for the Case Manager to track and document time put towards each function for cost reporting purposes.
What is the intention behind the inclusion of a Physician for the Tier I: Emergency Emotional Support & Assessment Center Service Package?
The intention is that the Physician is providing the needed services to support the operation’s treatment milieu – different than what is provided during a routine medical visit or as a part of the child’s Texas Health Steps and is not just ensuring that the child has a designated Primary Care Provider (PCP). The Service Package includes the following requirements for the Physician:
- A Licensed Physician must be readily accessible and available to consult and provide direction regarding assessments, evaluations, treatment care planning for children, youth, and young adults that qualify for this Service Package.
- The Physician should provide necessary training and technical assistance to staff including Direct Delivery Caregivers, regarding clinical and medical assessment, engagement, child-centered, trauma-informed de-escalation techniques based on the child’s custom needs.
- The Licensed Physician may be on-staff with the operation or may provide services under a contract or another form of written agreement with the operation.
- If the General Residential Operation chooses to contract for or enter into a written agreement for provision of any of the tasks, the contracted personnel must be trained in, practice, and remain current with delivery of the operation’s Evidence-informed Treatment Model.
Will shelters be able to admit children who are already rated as needing Tier II?
If a child has a Tier II Recommended Service Package but a bed is not yet available to meet their specific needs, and the child meets one of the potential combinations of requirements identified in the Service Package Description section for the GRO Tier I: Emergency Emotional Support and Assessment Center Service Package, then the child could be placed in that Service Package.
Will a residential provider have to undergo a separate Credentialing process with DFPS and the SSCCs (Single Source Continuum Contractor), or even with each SSCC?
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.
Will DFPS have to review and credential each of a CPA's homes?
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.
Do all foster homes have to be Credentialed for T3C Basic Foster Family Home Support Services, as well as any additional Service Packages that they actually want to provide?
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.
Can a foster home be Credentialed to provide the T3C Treatment Foster Family Care Services Package, the Mental & Behavioral Health Support Services Package, and the Human Trafficking Victim/ Survivor Support Services Package, depending on the referrals they receive?
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.
Do all GRO Tier I operations have to be Credentialed for T3C Basic Child Care Operation Service Package, as well as any additional Service Packages that they actually want to provide?
Does a residential provider have to get Credentialed to provide Supervised Independent Living (SIL) Services?
Does T3C follow current minimum standards?
Yes. The Permit Type(s) and Permit Service(s) are based on current Residential Child Care Regulation (RCCR) 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.
Do Add-On Services need to be listed on the Permit?
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.
Will providers need new permits?
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.
Are new policies and procedures required for T3C?
Yes. Updated or revised policies/procedures will need to be submitted as part of the Credentialing process.
How does a Child Placing Agency (CPA) determine which foster home can provide service packages beyond basic?
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.
What will the process look like for agencies, to include any ongoing evaluation, as related to completion of Credentialing and the development of a logic model?
DFPS will release an update to providers outlining the step-by-step Credentialing process, including a comprehensive list of what providers will need to submit to become Credentialed. This list and step-by-step process is anticipated to be released in July of 2024. At a minimum, it is anticipated that providers will be required to demonstrate and articulate the ability to provide the distinct Service Package and/or Add-On Service(s) based on the provider’s /operation’s infrastructure, specific policy, procedures, organization charts, business and training plans, and the Treatment and Logic Models. Providers will maintain Credentialed status for a period. Prior to the expiration of the Credentialed timeframe, the provider will need to apply to become re-Credentialed. As the foster care system transitions to the T3C System, there will be changes to the policy, process, and tools used to monitor SSCC and Residential Child Care Contracts. DFPS will be working internally, and with stakeholders to inform the modifications, and to finalize the new approach to monitoring and oversight.
What is the state’s priority for credentialing each of the services packages?
DFPS is currently working with the SSCCs and other stakeholders to develop the Interim and the Full Credentialing process- depending on the number of applications submitted at a given time, DFPS may have to prioritize the order in which applications are processed. This will be informed by which of the Service Packages represent the greatest need for children and youth in care at the time.
What does Licensing look at as far as Credentialing?
To be clear, HHSC-CCR is not involved in the Credentialing process, it is a process that is being controlled by DFPS, although if a provider has questions about how to change their permit for the purpose of being Credentialed, the provider can contact rccrstan@hhs.texas.gov and Residential Child Care Regulation staff that have been familiarized with T3C can provide assistance.
The Permit Type and Permit Service(s) listed in the Blueprint will be verified as a part of the Credentialing process. The process is being built in a way that avoids duplication- meaning if Licensing has already verified that the provider’s policy, procedures, staffing model, etc. meets the requirements to provide certain services based on minimum standards or law, then DFPS will not be asking for submission of the same information as part of the Credentialing process as long as the minimum standards fulfill the entirety of the T3C requirements; rather DFPS would only ask for a copy of the provider’s Permit with Services (as listed by Service Package in the Blueprint) attached.
Are there steps or instructions for Credentialing foster homes, including whether CPAs need to enter the Service Packages the home is Credentialed for into a system?
The CPA needs to assess the skills and experience of the foster caregivers and their desire to work with children presenting certain needs in regards to the Service Packages that the CPA gets Credentialed for. The CPA will need to create their own process for assessment and Credentialing in their policies for review during the CPA’s Credentialing review, so you won’t need to complete the Credentialing of your foster homes until the CPA is Credentialed to ensure that your process is approved. The process should include an update/addendum of the Home Study to identify the specific Service Packages that have been authorized for that home. By January 1, 2025, all IT-related updates to the CLASS Provider Portal and DFPS IMPACT will have been implemented, so that once a CPA has been Credentialed, they can enter updates to their foster homes’ entry in the Provider Portal to reflect the Service Packages that the home has been Credentialed for.
Could you provide more information regarding the Interim Credential eligibility criteria around having a history of termination of contract for convenience?
This criterion will only apply to terminations for convenience that have occurred in the last three DFPS Fiscal Years (since September 1, 2021), and that were initiated by DFPS (not an SSCC). This clarification will be included in the October 2024 version of the T3C System Blueprint.
For the Interim Credentialing process, will the review result in an all-or-none decision for all of the Service Packages that an operation has applied to provide?
No, it won’t necessarily be an all-or-none decision. In fact, once DFPS completes the review of the entirety of the lowest acuity/rate Service Package and approves it as meeting all of the requirements, the rest of the process to issue the Inactive Interim Credential for that particular lowest acuity/rate Service Package will proceed simultaneously with the review for the subsequent Service Package(s) and Add-On Service(s) that are on the same application. And if for the subsequent Service Package(s) and Add-On Service(s) there is one or more that is approved, but others are denied for some reason, the Inactive Interim Credential would be issued for all of the subsequent ones approved together, while the provider could take the Service Packages that were denied and re-work the issues identified to subsequently re-submit a new application with just those Service Packages.
Is a provider eligible to apply for the Interim Credential if they are on Heightened Monitoring?
Is a provider eligible to apply for the Full Credential if they are on Heightened Monitoring?
Does the Credentialing process look at whether a Treatment Model and Logic Model will actually work?
The initial Credentialing process is intended to look at the provider’s demonstration of how the Treatment Model and Logic Model serve as the basis of the provider’s program, and why they think it will work for the specific population that is served by that Service Package. The Annual Credential Reports and Re-Credentialing process will verify how the provider has utilized data collection and the Continuous Quality Assurance and Improvement (CQAI) process to refine the Logic Model and if necessary, the Treatment Model, for the specific population that is served by each Service Package.
Can you elaborate on the requirements of the Interim vs. Full Credential, in regard to providers who have only an “Initial” Permit?
For an Interim Credential, the provider must have a “Full” Permit for the licensed operation they wish to be credentialed for, or if the operation only has an “Initial” Permit, the provider must hold a “Full” Permit for a similar licensed operation.
For the Full Credential the licensed operation applying for a Credential can have either an “Initial” or “Full” Permit.
How long does it take to the complete the Interim Credentialing application?
There is no timeframe, as it depends on a number of factors, including size of the operation, the number of Service Packages being applied for, and how long you have been preparing.
How long will it take to accredit an organization once the application has been submitted?
There is no exact timeframe at this time, because it depends on a number of factors, and this is a brand-new process.
What is the difference between Inactive Interim Credential and Active Interim Credential?
The Inactive Interim Credential is the 120-day maximum period when the Provider is hiring staff and completing parts of their Implementation Plan that must be ready by the time they move to the Active Interim. Under the Active Interim Credential, the provider has met all necessary requirements to operate specific to the approved Service Package(s) or Add-On Service(s), and contingent on contract amendment(s), may begin serving children under T3C, while still completing parts of their approved Implementation Plan in the up to 12 full calendar months after they are awarded the Active Interim, prior to obtaining their Full Credential.
Are there services such as “young adult care” that don’t show up on the physical copy of the permit?
Yes, for programmatic and special services that do not show up on the permit an email from your licensing rep verifying your approval for that service will suffice, as supporting documentation.
Our T3C application folder on SharePoint is now empty after submission. Is this intended or an error?
It is as intended as long as you have already marked “Ready for Review”.
Is there a central contact for YFT that we can utilize to ask questions during the Credentialing process?
Should we include information on specific children as examples in the documentation that we upload for Credentialing?
No, the Provider should not include information on specific children as examples and must not include any Personal Identifying Information (PII) on a child within the documentation uploaded to the T3C Credentialing Platform. If PII is found within the documents upon review, the entire contents of the Provider’s application and supporting documentation will be deleted due to security concerns, and the Provider will have to start their application process over again.
For providers that have already started working on their Interim Credential application, will the addendum attestation form be released for us to complete?
No, it will be provided to the provider by your assigned Credentialing Analyst upon verification that your application requires it.
For policy and handbook updates, do we still need to submit changes created due to T3C to Licensing, even though we are submitting them to T3C?
Yes, Licensing should have your most up to date policies and handbooks on file and will need to ensure that any changes you make that relate to Minimum Standards have been appropriately addressed.
New Do we need to go through Interim Credentialing, or can we go straight to the Full Credentialing application process?
No, you do not need to go through Interim Credentialing if you are already prepared to meet all requirements for the Full Credential.
New Once a provider is awarded an Inactive Credential, will that be for one Service Package or multiple Service Packages, if the provider has applied for more than one?
The Inactive Credential will be awarded for all approved Service Packages at once.
New Once a Provider is awarded an Inactive Credential, is the 120-day timeframe concurrent or consecutive for the Service Packages?
The Inactive Credential maximum timeframe is 120 days from the award for all Service Packages.
New Can I apply for Credentials for multiple permitted facilities on one application?
New Will the application review by the Credentialing Analyst be for all Service Packages applied for concurrently, or one at a time?
It will be for all of them concurrently.
New Do I have to apply for Credentials for each CPA Branch on a separate application?
No. You only need one Credential for the CPA - not for each branch.
Who administers the 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.
How will providers know the results of 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.
When is the CANS 3.0 Assessment completed?
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.
Is the CANS 3.0 Assessment recommendation for a Service Package the sole determining factor for where the child is placed?
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.
What happens if a child, who is brand new to conservatorship, is placed under a Service Package to meet a particular need that was identified in the child’s application for Placement, but the CANS 3.0 Assessment recommendation does not match that Service Package?
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.
How will you be able to accurately assess the child’s needs, especially behavioral/emotional needs, if the CANS 3.0 is done in the first 30 days, yet behaviors often don’t surface until after the honeymoon period (up to 3 months)?
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.
Will young adults age 18 and older be required to complete the CANS 3.0 assessment on the schedule required by the Service Package that they are placed in, or at least annually if they are placed in Supervised Independent Living (SIL)?
Logistically, how is the CANS 3.0 going to be accomplished? The shear volume seems like a huge undertaking… will this potentially be passed down to the child care providers?
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.
For a child or youth that is non-verbal, how can the CANS accurately assess them for a service package?
The CANS Assessment would take into account the documentation in the child or youth’s current and historical case file, as well as interviews with other required individuals. While the CANS 3.0 Assessment recommended Service Package, and other supporting documentation will be used to inform the process, the knowledge and professional judgement of the SSCC or DFPS staff working to secure placement based on the individual child’s needs and best interest will be the basis for the selected Service Package and placement type.
In cases where a child or youth needs to be immediately placed, due to allegations of abuse or neglect, how does that work with needing a CANs Assessment?
There will be situations where the need for a placement is urgent or the child’s needs are such that there is no time to complete the CANS 3.0 Assessment, Pre-Placement visit, etc. The caseworker will still make a request for the CANS assessment for the child. In these circumstances the caseworker would select the initial recommended service package and would have the opportunity to update the packages after the CANS is completed.
If a full CANS assessment will be conducted each time, I am concerned about the long-term validity due to assessment fatigue. If a child is required to complete a CANS assessment, per T3C service package requirements, more than once per year, will the full assessment be administered each time, or will an abridged version be administered to prevent assessment fatigue?
The CANS captures the story of the child. It is not a tool used for discovery but rather a tool that organizes the information gleaned from the discovery process (aka assessment). Once the story of the child is captured at one point in time, an update will be needed as required under T3C to update that story as new information is learned; typically referred to as a re-assessment. With the CANS, the re-assessment is really updating the information that needs to be updated, not re-doing the entire CANS. The CANS re-assessment will not take up a lot of time - The information from the previous CANS should populate the ‘re-assessment’ CANS and then the assessor can update the items that need to be changed because there is new information. A change in any ratings will also require a brief rationale to be provided explaining any changes.
Will DFPS staff be responsible for becoming certified in administering the CANS 3.0 assessment?
Yes, to ensure that the person administering the CANS 3.0 Assessment has access to the most current information on the case, administration of the CANS 3.0 Assessment will move from STAR Health to the child welfare system under the T3C System. A new type of staff, known as the CANS Assessor, will be a part of the placement team for each Single Source Continuum Contractor (SSCC) and DFPS (in areas that have not yet transitioned to CBC).
For children who are newly entering DFPS conservatorship, will the CANS' Recommended Service Package be known prior to their placement?
No, there will be situations where the need for a placement is urgent or the child’s needs are such that there is no time to complete the CANS 3.0 Assessment, as the CANS Assessors will still have 30 days to complete the initial CANS Assessment. The initial removal placement will be guided by other supporting documentation from the child's Case File to inform the process, the knowledge and professional judgement of the SSCC or DFPS staff working to secure placement based on the individual child’s needs, and best interest will be the basis for the selected Service Package and placement type.
Do Treatment Directors, Therapists, Case Managers and/or other clinical staff that will be involved in child service planning need to be certified in the CANS 3.0?
While it would be helpful for these staff to engage in the training and certification process to enable precise interpretation and application of the CANS recommendations to service planning, that is not required at this time. In order to go through the training and certification please visit TCOM Training – Praed FoundationExternal Link.
Will the CANS 3.0 be ready in January 2025?
When will the CANS Assessment be finalized and tested?
The CANS 3.0 Assessment will be rolled out in January 2025.
Where do we find a copy of the CANS 3.0?
There may be a copy now available on the TCOMExternal Link for purposes of learning and preparing for the certification exam to administer the CANS.
Will the CANS 3.0 result in a recommendation for multiple Service Packages, since a child can have multiple needs where they may meet the criteria for more than one Service Package?
No. The CANS 3.0 will result in a single Recommended Service Package for the child. While a child may meet the criteria identified under multiple Service Package Descriptions, the CANS Recommended Service Package is intended to help with identifying and prioritizing the most immediate needs requiring treatment at the time of the assessment.
New When a child who is new to care is placed in a pre-T3C System placement, will their CANS 3.0 be handled under the current administration process or by DFPS/SSCC CANS Assessors?
Continue to use the current administration process.
Under the T3C System, will General Residential Operations and Foster Family Home no longer be reimbursed according to the child’s Level of Care?
That’s correct. DFPS will no longer reimburse the SSCC or DFPS Residential Contractors in accordance with the Service Level System.
When do providers need to start planning the transition?
Providers should initiate the planning process now.
Is the T3C System Blueprint the Contract requirements for residential provider operations to provide T3C?
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.
Can a residential provider still utilize a Treatment Model that they have developed?
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.
The T3C System Blueprint emphasizes that therapy services should be authorized and paid for through STAR Health, but can a residential provider have the majority of therapists utilized on staff and pay them a salary or contract directly with them?
Medicaid eligible services should be sought through STAR Health.
Can a residential provider continue to utilize Microsoft Word and Excel documents through the operation’s shared Google Drive as their Information Technology (IT) System?
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.
What does the transition of CPAs and their Foster Homes look like?
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.
How are CPAs with multiple branches supposed to address the Generally Appropriate Staff to child ratios? Does each branch need to meet that same approximate staff ratio for each Service Package, or does the total number of all specific staff positions that serve that Service Package across all branches need to meet that same ratio?
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.
Will T3C completely replace the Service Levels System?
Will providers need new DFPS contracts?
In most cases, no, just an amendment to your current DFPS contract(s). The plan is for DFPS to amend DFPS contracts with Residential Contractors and SSCCs to incorporate the T3C System Blueprint, including 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. However, Emergency Shelters contracted directly with DFPS that change their permitted services in order to provide a T3C Service Package may need to undergo a process of review where they will have a new contract number assigned and need to sign a correlated contract document.
How long does it take for a residential provider to obtain an additional Permit Service in order to be eligible for offering a Service Package?
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.
Will DFPS be releasing a list of approved evidence-informed Treatment Models?
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.
Is there a grace period for the implementation process?
Providers will have to become Credentialed before September 1, 2027.
What happens if/when a provider cannot meet the deadline to implement T3C?
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.
Is DFPS going to streamline processes?
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.
What is the role of emergency shelters in T3C?
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.
What happens to TLPs or SILs when they don’t fall into those tiers?
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.
Will YFT be involved in T3C?
As the Texas Foster Care System evolves into T3C, the need for services provided by YFT will also evolve. YFT’s DFPS contract has been amended to include utilization of their clinical assessment skills to assist the Department in reviewing aspects of the Credentialing process, such as integration of Treatment Models and Logic Models.
I am a new provider. Where do I start?
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.
How can we get assistance to be able to navigate implementing T3C in our own program?
If you have specific questions on the Blueprint that are not addressed in the current FAQs, please reach out to our mailbox DFPSTexasChildCenteredCare@dfps.texas.gov. For additional training opportunities, please visit T3CReady.org, and you can reach out to the info@t3cready.org mailbox for questions about a Readiness Assessment that can help you to tailor implementation to your own program.
When will funding be available? How long will the funding be guaranteed?
The 88th Legislature fully funded the foster care rates presented under the T3C rate methodology for the current biennium, and these rates will be available to pay to Credentialed providers under the T3C System in January 2025. Cost Reports specific to T3C will be used to inform adjustments to the rates as determined by the Texas Legislature through the appropriations process.
Do you already need to already be contracted as a QRTP in order to apply for a Credential for Tier II Service Packages?
No, you just need to meet all of the requirements in the T3C System Blueprint for the Tier II Service Packages that you are applying to be Credentialed for.
How will T3C align with Community Based Care, in terms of how the SSCC's pay, monitor, etc.?
All SSCCs will be required to utilize T3C Service Packages in some way. Each SSCC will have the ability to determine what service packages they wish to purchase from providers to meet the needs of their communities. DFPS will reimburse each SSCC in accordance with the same Methodological Rate Schedules found in the Blueprint during the transition. Under the T3C System, SSCCs will continue to have flexibility within the Community-Based Care model to pay Residential Child Care providers using a customized rate schedule, with a minimum pass-through requirement established in the SSCC contract. The evolution of monitoring under the T3C System is still in the initial planning stages, but updates will be available in future versions of the T3C System Blueprint.
Will providers still be required to comply with “Cost Report” accounting under T3C?
Yes, the Cost Report will change from being Service Level-based to T3C-based, and the first Cost Report specifying the T3C breakdowns would be due in FY2026. The new Cost Report will be more complex as it will follow the elements/requirements listed for the Service Package(s). Those requirements align with the methodology used to calculate the rates, so it is safe to assume that the cost report will ask for costs associated with those elements.
Is the "Foster Family Home Pass Through Portion" identified for Service Packages in the Blueprint a minimum or maximum? Can it be changed by the SSCC?
It is the minimum daily amount that the CPA must pass through to the Foster Family. SSCCs will continue to have flexibility within the Community-Based Care model to negotiate and pay Residential Child Care providers using a customized rate schedule, however the Foster Family Home Pass Through Portion for the foster family is still a minimum pass-through requirement established in the SSCC contract.
What is the expectation for monitoring of Continuous Quality Assurance and Improvement (CQAI) in regards to Logic Models?
How CQAI will be incorporated into contract monitoring by DFPS or the SSCCs has not yet been developed. The vision behind having a CQAI component incorporated into the Logic Model review is to ensure that there is a structure and predictable approach for review and improvement of the program. If an aspect of the Treatment Model is listed as an input or resource in the Logic Model, it should tie to an expected outcome. If after testing through experience, it is determined that it is not resulting in the intended outcome, then the model may need to be adjusted, either by looking at different data, adjusting the input, etc. While the format for how CQAI of the Logic Model will be monitored has not been developed yet, the Department expects that there will be adjustments made to the Logic Model based on the review results and what is learned, so at least initially, the issue would be if the CQAI process was not done at all, or if something that is noted as not reaching the intended outcome is not adjusted going forward.
For operations that are Nonfinancial Contractors, providing Basic Level of Care residential services at no cost to DFPS children or the state, since they can’t take advantage of the increased rates under T3C and may not have the ability to access grants or extra funds to make some of the changes needed to fulfill all T3C requirements, what does their future look like under T3C?
Current Nonfinancial Contractors should review the requirements laid out in the Blueprint for the most applicable Service Package (T3C Basic Child Care Operation for GROs, T3C Basic Foster Family Home Support Services for CPAs), and identify any requirements that would be cost prohibitive for implementing within your program. When your operation submits the Credentialing application (this would be necessary regardless of whether you apply under the Interim Credential or the Full Credential), your operation would identify those requirements that you are seeking to waive, specifying how your funding structure/requests for financial support for making the changes and inability to utilize DFPS reimbursement or the Transition Grants makes it cost prohibitive, and explaining how your program will ensure that the quality of care and services envisioned under T3C for children in DFPS custody placed in that Service Package with your operation would not be substantially dissimilar from that for children placed in that Service Package at an operation that does meet all of the T3C requirements. The DFPS Credential Division, in collaboration with CPS Program, Contracts, and Legal would consider the specifics of the waiver request, and determine whether a Credential application can be approved on a case-by-case basis. If the Credential is awarded, it is possible that there may be specific monitoring at some point in the future, likely in connection with your operation’s eventual Re-Credentialing for the Service Package, to support your operation’s compliance with the overall intention of T3C and that the granting of the waiver hasn’t negatively impacted the services available to the children, but no concrete decisions have been made regarding that at this time.
If a GRO does not plan to serve youth age 14+, do they still need to have the transition to adulthood preparation and planning requirements, including the training of staff?
Since the Service Package Expectations, including those requirements, are part of the rate methodology for all GRO Packages, regardless of the ages that the operation serves, staff would need to have the knowledge and training indicated, and the policies and procedures would still need to outline the approach, delivery, and documentation of experiential learning for if a child turns 14 while in placement. Also, nothing restricts the operation from providing modifications of those same kinds of services at an appropriate developmental and functional level for children under 14.
Are there guidelines regarding how many days of Intermittent Alternate Care (also known as respite) per month a CPA is required to provide to foster parents?
T3C will not be making any restrictions regarding when foster parents can be provided Intermittent Alternate Care, other than the CPA must offer 40 days of paid Intermittent Alternate Care and must follow Minimum Standards requirements.
What actions would be appropriate to take if a Provider wants to combine functions, such as including the Educational Liaison, Cross System Coordination, as roles that Case Managers will be responsible for?
It would be recommended that, at a minimum, the Provider decrease the Generally Appropriate Staff to Child Ratio based on Service Package, to accommodate the increased workload, and to have a method for the Case Manager to track time for cost reporting purposes.
If we start with individuals serving multiple functions, but over time are able to move to a more focused job description for individuals, how will we report or account for those changes with SSCCs or DFPS?
The Provider would ensure that they have updated all policies and procedures and other documentation to reflect the changes made, and that changes made are included in the Provider’s T3C System Annual Credentialing Report and upon Re-Credentialing.
Could there ever be a need for a single CPA branch office to need 2 Treatment Directors?
Potentially, depending on the number of children being served by that branch office and the Service Packages those children require given the differing qualifications for Treatment Directors over certain packages.
Among the STAR Health Medicaid services that the CANS 2.0 would often recommend for children with complex physician and mental health needs is Targeted Case Management (TCM). The Staffing Requirements section of each Service Package in the T3C System Blueprint reinforces that “All Case Management functions must be performed by actual employees of the operation.” Does this mean that residential providers will no longer be able to utilize TCM? Will CANS 3.0 continue to recommend services such as TCM, in addition to the Recommended Service Package?
Residential providers will continue to be able to utilize TCM, rehabilitation, and all other Medicaid allowable services through STAR Health network credentialed providers when the child is eligible for and receives authorization for those services. The case management functions that are referenced in the T3C System Blueprint as needing to be performed by actual employees of the operation are those that deal with managing the child’s case during their time in the current placement, such as:
- Developing and updating of service plans.
- Making referrals for services to achieve the goals identified in the service plans.
- Maintaining direct contact with the child and their other caregivers to monitor placement fit and treatment progress.
- Ensuring that documentation of the child’s activities, progress, and services is included in the child’s file in the Information Technology System.
How are Permanency Care Assistance and Adoption assistance subsidies, as well as Post-Permanency Service rates/eligibility affected by the change to T3C Service Packages?
DFPS completed the process to publish multiple new and amended Rules in the Texas Administrative Code to reflect T3C in December, 2024. Among those were three related to these topics. TAC Rule §700.844External Link addresses how the maximum monthly payment is identified for adoption assistance when the child was under the T3C System prior to the adoptive placement, based on the child’s Recommended Service Package. TAC Rule §700.1039External Link similarly addresses how the maximum monthly payment is identified for the Permanency Care Assistance program. TAC Rule §700.1733External Link updates the eligibility for Post-Permanency Residential Treatment Services to incorporate T3C Service Packages. There are three remaining Rules changes that are still pending, regarding Enhanced Adoption Assistance and the T3C reimbursement methodology.
What is the timeline for appeals once the CANS 3.0 results in a Recommended Service Package?
There is no timeline because there is no one to appeal to. If the Provider has concerns regarding the Recommended Service Package, they should communicate with the caseworker and the child’s legal parties and support network. The ultimate determination of what the Selected Service Package will be rest with the caseworker using their knowledge and professional judgment based on the child’s individual needs and best interest.
Once a provider has submitted their Credentialing application, should they be requesting a new CANS 3.0 Assessment while they await their Credential Award?
No. Children will not require a CANS 3.0 prior to their administrative transition to a T3C Service Package once the Provider becomes Credentialed unless a TIER II placement is recommended by the provider.
To meet the requirements of the Quality Assurance and Continued Stay Guidelines, would a signature from the Program Director (and any other required staff, such as RN and Treatment Director depending on Service Package) on the service plan meet that requirement? Or is additional documentation needed?
You could create a template to contain the relevant information for the Quality Assurance and Continuing Stay Guidelines Review to be signed by the staff required by the specific Service Package and append that page behind the child’s Service Plan to ensure that you send both to the Caseworker timely, but just signing the Service Plan on the lines already provided would not be enough in and of itself. The Caseworker needs to have documentation with the written confirmation reflecting the specific pieces of information identified in the T3C System Blueprint to upload to IMPACT to support that the utilization review was completed and to authorize starting the new period of the child’s Selected Service Package, which is only active in the system for a limited time frame because it has to be reviewed (the process that was previously handled via YFT reviews).
To meet all of the requirements of the physician position for the GRO Tier I: Emergency Emotional Support and Assessment Center Service Package, can the Provider utilize multiple resources to create a composite to meet all the standards?
Yes, as long as the resources are all physicians (MDs or DOs), and all of the Service Package requirements are met.
Will transitional living program clients still maintain LOC's, and that can be included under the basic childcare package?
All GROs are required to be licensed to provide Transitional Living Services as a part of the Permit Services for T3C. This 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. If the Provider currently has a special low-supervision TLP program for youth age 16+ as identified in Minimum Standards, then the Provider should identify what Service Package(s) will qualify for that program, as children will not just retain Levels of Care after 9/1/2027. 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.
Will SSCCs maintain discretion over contracts ending when a Provider transitions to T3C? It has been noticed that for SSCCs, when the provider isn’t in their physical catchment area, will terminate contracts when the provider isn’t accepting all referrals, even if those referrals are outside of that provider’s license.
T3C doesn’t impact that aspect of the CBC model giving the SSCCs flexibility over managing their own network, however, T3C will make it easier for SSCCs to match child needs to what is available from a Provider based on the Service Packages that they are Credentialed for.
New Do all agencies get an Inactive Credential as a first step, even if you have met all requirements for an Active Credential?
In general, yes, because there are steps associated with the transition of children that should be completed prior to Active Credential.
New Can you have a youth placed under the pre-T3C System and another placed under the T3C System in the same foster home?
New What sort of documentation will providers need to be able to initially assign children who are currently placed to Service Packages?
Upon award of the Inactive Credential, detailed instructions and examples for documentation to include in the child’s file, as well as to complete the Transition Spreadsheet, will be provided. This is detailed under “Transition of Children and Youth From Current to T3C System After A Provider Becomes Credentialed” in the T3C System Blueprint.
New Do current foster homes have to receive the training for each Service Package that the CPA Credentials them for, before we can enter them in the CLASS Provider Portal?
Under the Interim Credential application, the CPA is allowed to present an Implementation Plan for when they will create and provide additional training tailored to specific Service Packages, as long as in the CPA’s Foster Home Credentialing Policies and Procedures, approved as part of the application, demonstrate how the CPA will judge a Foster Home’s experience to be Credentialed for specific Service Packages.
Under the Full Credential application, the CPA must already have created and submitted their training curriculum with their application, but the physical training of foster parents can be completed during the Inactive Full Credential.
New For GROs, can children with different Service Packages that require different Treatment Services on the Permit be housed in the same building?
Within the parameters of residential children care regulations and in accordance with Minimum Standards, children with diverse Service Package needs may reside in the same building, provided that their placement supports child safety, and aligns with the GRO’s trauma and evidence-informed Treatment Model(s). For specific questions related to your operation’s limitations, please consult your Residential Child Care Regulations (RCCR) Licensing Representative.
Once a residential provider is Credentialed, will all children who are already placed under that provider automatically convert from a Service Level to a T3C Service Package?
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.
So, can a child remain placed with the same residential provider and be transitioned to T3C when the provider becomes Credentialed, without having to move?
When a child is brand new to conservatorship, what Service Packages would be eligible to accept the child before the CANS 3.0 Assessment is complete?
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 .
Will SSCC’s still receive blended rates and be able to determine rates for their network providers for children that are placed with network providers that are not yet Credentialed to provide T3C?
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.
Can a child that qualifies for Treatment Services under Minimum Standards be placed in either a Support Services Package in a foster home or a Services to Support Community Transition Package in a GRO Tier I?
Who ultimately decides which package a child is eligible for, and how is the start date of the new reimbursement level communicated?
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.
What will happen in a scenario where a provider or foster home’s Credential for a particular service package is expiring or being discontinued and will not be renewed, but there are children in the placement utilizing that service package?
If a placement’s current Credentialing status for a service package changes and they are no longer offering a Service Package that has been selected for a child placed in their care, IMPACT will not be able to pay the rate associated with the Service Package after the expiration/discontinuation date. Providers will need to notify the child’s caseworker with sufficient time for the caseworker to make any needed decisions regarding which of the remaining Service Packages will best meet the child’s needs, or if moving to an alternate placement that offers the Service Package would be more appropriate. Child Placing Agencies should keep this in mind when developing their policies and procedures around Re-Credentialing their foster homes.
When children are first administratively transitioned to a T3C Service Package, after the Provider becomes Credentialed, does new placement paperwork need to be completed?
For children with dual diagnosis of IDD/Autism and Medically Complex or Fragile, what Service Package would they fall under?
The CANS will give the Recommended Service Package that best meets the child’s individual needs. If the Provider has concerns regarding the Recommended Service Package, they should communicate with the caseworker and the child’s legal parties and support network, however, the Selected Service Package cannot just be driven by the rate. The ultimate determination of what the Selected Service Package will be rest with the caseworker using their knowledge and professional judgment based on the child’s individual needs and best interest.
Will a Spanish curriculum be offered?
At this time, a Spanish version of the training curriculum is not available.
This curriculum for T3C is only 90 minutes when SSCCs contracts require HT to be 2 hours. Are you counting the testing period towards the 2-hour requirement?
This training is 90 minutes and is specific to the T3C Credentialing Process. Please discuss your contract requirement with your SSCC.
Can we add additional resources/activities to this curriculum, and if so, do we need approval?
Yes, feel free to add additional resources/activities to the curriculum. You do not need approval.
When can this curriculum be implemented?
Once you receive the completion certificate and training materials, you are welcome to implement the training.
Can we embed videos into the presentation and make it a PowerPoint presentation with trainers' notes?
You may embed videos into the presentation as long as you do not change the content of the training. If you modify any part of the training, you will need to seek DFPS approval.
If we do a Human Trafficking Training already, will this training take place of that, or do we just add this to that?
As part of the T3C Credentialing process, a provider may use the DFPS Universal Human Trafficking Prevention Training or their own Human Trafficking training, if their training meets basic requirements for T3C Credentialing purposes.
Approximately how much time will be required to provide this training to our team?
This training should take 1.5 hours to deliver to staff and caregivers.
How many credit/contact hours do our participants receive?
This training allows participants 1.5 hours of credit.
We can create our own Human Trafficking training for T3C as long as it meets requirements. Do we have to run our training by someone? Will we provide our training during the credentialing process to see if it meets the requirements?
Yes, when you submit your Credentialing application, you will need to run your Human Trafficking training through the Credentialing review, following the process identified on the T3C Human Trafficking: Alternative Trainings webpage. This ensures that the training includes the same core components to constitute an equivalency of information as what is contained in the DFPS Universal Human Trafficking Prevention Training.
Is this an annual training?
Is this training required to be in-person, or is it encouraged to be in-person?
This training can be delivered in-person or virtually.
Will this training replace the Human Trafficking Training in the DFPS Learning Hub?
Is this curriculum used to train the youth?
No, this curriculum is geared to training provider staff and caregivers, who then use the tools learned from training with the children and youth who they serve.
When does implementation of this training start? Now or when T3C starts?
Implementation of the training can begin once you receive a completion certificate and link to the training materials.
Will this training be mandatory for our foster parents?
Yes, if the foster parents would like to be credentialed in one or more T3C Service Packages.
Will this be something that can be used to train people outside of the DFPS industry?
Will the current DFPS Human Trafficking Training in the DFPS Learning Hub meet the core components required to pass approval for being equivalent to the DFPS Universal Human Trafficking Prevention Training required for T3C Service Packages?
No, as detailed on the T3C Human Trafficking: Alternative Trainings webpage, the process and application used to submit an alternative training curriculum for review and approval includes a set of core components required to constitute an equivalency of information, and the current DFPS Human Trafficking Training in the DFPS Learning Hub does not meet all of the required core components.
My organization already has a Human Trafficking Prevention Training, and does not plan on using the DFPS Universal Human Trafficking Prevention Training. Is there anything my organization needs to do differently as a part of the application process for Credentialing to ensure we meet all of the requirements?
For providers who will not be utilizing the DFPS Universal Human Trafficking Prevention Training – Train the Trainer Curriculum, for Service Packages that are not exclusive to children, youth, and young adults who are victims/survivors of Human Trafficking, additional information on the process required for obtaining approval of the Provider’s Curriculum as part of the Credentialing process has been released on the Human Trafficking: Alternative Trainings page of the T3C Public Webpage.
Does a residential provider have to use the Universal Human Trafficking Prevention Training created by DFPS and disseminated through a "Train the Trainer" model?
No. Providers may choose to adopt this model by having one or more staff members complete the “Train-The-Trainer” training to gain access to the curriculum, so that they can train the rest of the staff and Caregivers on the Universal Training. Alternatively, providers wanting to use a different model and training for Service Packages that are not exclusive to children, youth, and young adults who are victims/survivors of Human Trafficking, may submit for review and approval, as a part of the Credentialing process, the curriculum that they intend to use to meet this requirement under T3C. Additional information on the process required for obtaining approval of the Provider’s Curriculum as part of the Credentialing process has been released on the Human Trafficking: Alternative Trainings page.
If an operation wants to utilize the Universal Human Trafficking Training that DFPS is developing, what will that look like?
During Fall 2024, DFPS hosted Train-the-Trainer sessions via webinar that providers could send their intended training staff person to, to obtain training on the curriculum and facilitation. DFPS has made an ongoing training available in the external Learning Management System (LMS)External Link, utilizing recordings from those webinars. Going forward, any provider staff that wishes to become certified to present the Universal Human Trafficking Prevention Training will need to complete the training in the LMS in order to receive their certificate and gain access to the curriculum.
New Is the Human Trafficking Prevention Training required for staff that have no direct child contact?
New We are trying to determine what Service Packages our current families should be Credentialed for, based on the children currently in their care. How would we evaluate that?
Review the Service Package Description for the specific diagnoses and behavioral/redirection needs for a child to qualify for a Service Package and apply that knowledge to the Foster Homes experience, per your approved Foster Home Credentialing Policies and Procedures.
