# REFUGE HOUSE, INC. | Policy Information | Details | | :---- | :---- | | **POLICY NAME** | Admission Screening Policy | | **POLICY NUMBER** | FC1-01 | | **ORIGINATED** | 6/04 | | **APPROVED BY** | Board of Directors | | **APPROVED ON** | 5/15/25 | | **EFFECTIVE DATE** | 5/15/25 | | **LAST UPDATED** | 5/15/2026 | | **LAST APPROVED** | 5/22/2026 | | **SECTION** | FC1 | | **DATE(S) OF REVISION** | 6/04, 8/05, 7/06, 4/20/07, 5/26/07, 2/25/08, 8/5/08, 1/22/09, 8/29/09, 1/1/10, 3/23/10, 8/1/11, 1/16/12, 5/15/25, 7/09/25.1, 12/08/25, 6/15/26 | | APPLICABLE T3C PACKAGES: | APPLICABLE T3C ADD-ON SERVICES: | | :---- | :---- | | ☒ T3C Basic Foster Family Home | ☒ Transition Support Services for Youth & Young Adults | | ☒ Substance Use Support Services | ☒ Kinship Caregiver Support Services | | ☒ Short-Term Assessment | ☒ Pregnant & Parenting Youth or Young Adult | | ☒ Mental & Behavioral Health | | | ☐ Sexual Aggression/Sex Offender | | | ☐ Complex Medical Needs or Medically Fragile | | | ☐ Human Trafficking Victim/Survivor | | | ☒ Intellectual or Developmental Disability (IDD)/Autism Spectrum Disorder | | | ☒ T3C Treatment Foster Family Care | | ## **PURPOSE:** To establish a standardized process for the timely and effective screening of all children and youth referrals to determine appropriateness for services and placement within Refuge House's foster care program, incorporating trauma-informed principles and ensuring the best possible match between child needs and foster family capabilities. ## **POLICY:** Refuge House evaluates all children and youth referrals immediately upon receipt to determine appropriateness for services and placement within the agency's foster care program. All screening evaluations are conducted in an efficient manner that allows for a timely response and initiation of services. Refuge House completes a thorough foster home screening and verification process prior to any family home becoming licensed with the Agency, ensuring that each family meets all required criteria outlined in RCCL Minimum Standards, DFPS Contracts, YFT level of care guidelines, Bureau of Indian Affairs guidelines, and COA quality practice standards, with each family as a whole being able to successfully care for any child or children placed and entrusted into the Agency's care. Refuge House recognizes the impact of trauma on children in care and incorporates trauma-informed principles throughout the screening process. ## **PACKAGE-SPECIFIC REQUIREMENTS:** ### **CORE REQUIREMENTS** 1. **Initial Screening Criteria** Refuge House will assess whether the agency has a foster home with a current opening appropriate for the child's age, gender, and T3C Service Package requirements. The agency will evaluate the child's ability to be safely served in a family-based setting, considering behavioral, physical, emotional, educational, and developmental needs while maintaining focus on the least restrictive environment principle. 2. **Foster Home Capacity Verification** The agency will verify that the prospective foster home has completed all pre-service training requirements, maintains all current certifications, has demonstrated ability to meet the specific needs presented by the child, and has adequate physical space and resources. Additionally, the foster family must demonstrate understanding of trauma-informed care principles and commitment to the TBRI® model. 3. **Medical and Behavioral Screening** Initial screening will include review of the child's medical history and current medications, behavioral incidents and interventions in the past 30 days, mental health diagnoses and treatment needs, educational placement and special services, and any safety concerns or risk factors that require specialized care or supervision. This screening ensures the agency can meet the child's needs within available resources. 4. **Cultural and Linguistic Considerations** Screening will assess the child's cultural background and identity needs, primary language and communication requirements, religious or spiritual practices important to the child, dietary restrictions or preferences based on culture or religion, and need for culturally matched placement when appropriate. The agency prioritizes maintaining cultural connections whenever possible. 5. **Legal and Permanency Factors** The screening process will review the child's legal status and permanency goal, ICWA applicability and tribal affiliation, sibling placement needs and visitation requirements, family connections and visitation plans, and any court orders affecting placement or services. This ensures compliance with all legal mandates from the outset. 6. **Service Coordination Requirements** Initial screening identifies all current service providers and appointments, STAR Health enrollment and service coordination needs, educational advocates and ARD meeting schedules, therapeutic services and frequency requirements, and specialized medical or developmental services. This allows for seamless continuation of essential services. 7. **Documentation and Response Timelines** All screening activities are documented in the child's electronic record, and the agency provides a timely placement decision to DFPS/SSCC in accordance with the applicable contract response-time requirements. If additional information is needed, the agency communicates the specific needs to DFPS/SSCC immediately. The specific response and documentation timeframes are operational and are maintained in FC1-01.1. 8. **T3C Service Package Determination** During screening, the agency will identify the appropriate T3C Service Package based on the child's presenting needs, review foster home credentials for the identified package, and ensure alignment between child needs and foster family capabilities. This determination guides all subsequent service planning. 9. **Foster Family Readiness Assessment** For each potential placement, the agency confirms the foster family's current availability and willingness to accept placement, completion of required training for the child's service package, understanding of the child's specific needs and behaviors, and ability to support the child's permanency plan and family connections. 10. **Transition Support Services for Youth & Young Adults** When screening youth ages 14 and older, the assessment will include evaluation of independent living skills, educational and vocational goals, preparation needs for adulthood, and existing transition planning. The agency ensures foster homes are prepared to support youth in developing these critical life skills. 11. **Kinship Caregiver Support Services** When screening for placement with verified kinship caregivers, the process will evaluate the existing relationship between the child and kinship caregiver, assess any additional support needs, and ensure all licensing requirements are met. 12. **Pregnant & Parenting Youth or Young Adult** Screening for pregnant or parenting youth will include assessment of foster homes prepared to support both the youth and their child, including appropriate physical space, parenting support capabilities, and understanding of the unique needs of young parents. ### **MENTAL & BEHAVIORAL HEALTH SUPPORT SERVICES:** 13. **Enhanced Behavioral Health Screening** For children requiring Mental & Behavioral Health Support Services, screening must include comprehensive review of DSM-5 diagnoses with particular attention to emotional disorders, current psychiatric medications and compliance history, frequency and intensity of therapeutic interventions needed, history of psychiatric hospitalizations within the past year, and risk assessments for self-harm or aggression. This enhanced screening ensures the agency can provide the intensive therapeutic support required. 14. **Therapeutic Service Eligibility** The screening process will verify the child's eligibility for STAR Health-covered therapeutic services including individual therapy (minimum weekly), family therapy, group therapy, and psychiatric services for medication management. The agency must confirm ability to coordinate and ensure attendance at all required therapeutic appointments. Foster Family Home Caregivers must support the child's participation in individual, family, and group therapy. 15. **Crisis History and Intervention Needs** Screening will document any history of behavioral crises requiring emergency intervention, current crisis plan and de-escalation strategies, mobile crisis team involvement in the past 90 days, and need for enhanced supervision or environmental modifications. This information is critical for matching with foster families trained in crisis intervention. 16. **Foster Family Specialized Training Verification** For Mental & Behavioral Health placements, verify the foster family has completed the required specialized mental health support training, demonstrates understanding of therapeutic milieu principles, can support medication compliance and appointment attendance, and has capacity to implement behavioral interventions. Additionally, confirm 24/7 case manager availability for crisis response. (Specific training-hour requirements are maintained in FC1-01.1.) ### **INTELLECTUAL OR DEVELOPMENTAL DISABILITY (IDD)/AUTISM SPECTRUM DISORDER SUPPORT SERVICES:** 17. **Developmental Disability Screening Criteria** For children requiring IDD/Autism Support Services, screening must assess documented developmental disabilities or autism spectrum diagnosis, current developmental functioning across all domains, communication methods and assistive technology needs, sensory processing differences requiring environmental adaptations, and medical complexity requiring specialized care. This comprehensive screening ensures appropriate placement matching. 18. **Adaptive Functioning Assessment** The screening will evaluate the child's adaptive functioning in daily living skills, need for assistance with personal care and hygiene, ability to communicate needs and preferences, social skills and peer interaction patterns, and required level of supervision for safety. This assessment guides matching with foster families experienced in supporting developmental needs. 19. **Medical and Equipment Needs Screening** For IDD/Autism placements, screen for specialized medical equipment requirements, medication administration complexity, need for nursing consultation or oversight, dietary restrictions or feeding difficulties, and seizure disorders or other medical conditions. Verify foster home capacity to manage these medical needs with appropriate training and support. 20. **Educational and Therapeutic Support Requirements** Screening will identify current special education services and accommodations, related services (OT, PT, speech therapy), behavioral support plans in educational settings, vocational or life skills programming needs, and coordination requirements with school districts. This ensures continuity of developmental support services. 21. **Foster Family IDD/Autism Competency Verification** For IDD/Autism placements, verify the foster family has completed the required specialized IDD/autism support training, demonstrates experience with developmental disabilities, understands communication and sensory support strategies, can implement structured routines and visual supports, and has access to Registered Nurse consultation as needed. Confirm commitment to the required aftercare services. (Specific training-hour and aftercare-duration requirements are maintained in FC1-01.1.) ### **SUBSTANCE USE SUPPORT SERVICES:** 22. **Substance Use Support Services Screening** For children being considered for Substance Use Support Services, verify the child presents with a DSM-5 diagnosis of substance-related and/or addictive disorder, documented history of problematic substance use requiring specialized monitoring, or significant risk factors for developing substance use disorder. Confirm the child is medically stable for community-based care (not requiring inpatient detoxification or residential treatment). The Treatment Director shall review and approve clinical eligibility. Verify foster family has completed required substance abuse awareness training and maintains a substance-free home environment. ### **SHORT-TERM ASSESSMENT SUPPORT SERVICES:** 23. **Short-Term Assessment Support Services Screening** For children being considered for Short-Term Assessment Support Services, verify the child meets one of the four eligibility categories: (1) newly entering foster care requiring assessment to determine appropriate Service Package, (2) transitioning from an unpaid placement requiring evaluation, (3) returning after unauthorized absence requiring reassessment, or (4) post-placement disruption requiring evaluation before new placement. Confirm Add-On Services are not needed, as they are not eligible for this package. Verify available foster homes have capacity (maximum 4 children unless sibling group). ### **T3C TREATMENT FOSTER FAMILY CARE SUPPORT SERVICES:** 24. **T3C Treatment Foster Family Care Support Services Screening** For children being considered for T3C Treatment Foster Family Care Support Services, verify the child has a DSM-5 diagnosis for emotional, conduct, or behavioral disorder AND meets two or more of the following criteria: (1) major self-injurious actions including suicide attempt within the last 12 months, (2) difficulties presenting significant risk of harm to others including frequent or unpredictable physical aggression, or (3) additional DSM-5 diagnosis of substance-related and/or addictive disorder with severe impairment. The Treatment Director shall review and approve clinical eligibility, as required by Texas Family Code Section 264.1073 and TAC §700.1335. Verify foster family holds dual credentials (Treatment Foster Family Care AND Basic Foster Family Home) and has capacity (maximum 2 children per home due to intensity of services). ## **DEFINITIONS:** * **BSM**: Behavioral Support and Management * **COA**: Council on Accreditation * **CPU**: Centralized Placement Unit * **DFPS**: Department of Family and Protective Services * **DSM-5**: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition * **ICWA**: Indian Child Welfare Act * **IDD**: Intellectual or Developmental Disability * **MEPA**: Multiethnic Placement Act * **RCCL**: Residential Child Care Licensing * **RH**: Refuge House * **SSCC**: Single Source Continuum Contractor * **STAR Health**: State of Texas Access Reform – specialized healthcare program for children in foster care * **T3C**: Texas Child-Centered Care * **TBRI**: Trust-Based Relational Intervention® – an evidence-based, trauma-informed approach for children who have experienced trauma * **YFT**: Youth for Tomorrow ## **REFERENCES:** * T3C Blueprint Standards: FC 1.01, FC 1.02 * T3C Blueprint Standards: Pages 76-86, Mental & Behavioral Health Support Services * T3C Blueprint Standards: Pages 123-135, IDD/Autism Spectrum Disorder Support Services * T3C Blueprint Standards: Pages 67-75, Short-Term Assessment Support Services * T3C Blueprint Standards: Pages 136-147, T3C Treatment Foster Family Care Support Services * T3C Blueprint Standards: Substance Use Support Services requirements * Texas Family Code Section 264.1073 * Texas Administrative Code Rule §700.1335 * DFPS Chapter 749 Minimum Standards: §749.1101 (who may I admit — eligibility), §749.1103 / §749.1105 (young-adult admission), §749.1107 (information documented at the time of admission), §749.1115 (information provided to caregivers) * DFPS 24-Hour RCC Requirements (FY26) * SSCC Contract Requirements: (if applicable) * Indian Child Welfare Act: 25 U.S.C. §§1901-1963 * Multiethnic Placement Act of 1996 (MEPA) * COA Quality Practice Standards **SSCC alignment (FY-26):** Reviewed against the 2INgage Provider Manual Rev. 1.2026; aligned — no additional provider-specific provisions required. Cross-reference: FC-CQI-01 Continuous Quality Improvement Policy; FY-26 SSCC coverage tracker (`temporary-reference/fy26-sscc-joint-monitoring/sscc-alignment/`). **SSCC alignment (FY-26) — EMPOWER:** EMPOWER Provider Manual Rev. 1.2026 — reviewed; aligned, no additional provider-specific provisions required. Cross-reference: FC-CQI-01 Continuous Quality Improvement Policy; FY-26 SSCC variance matrix. **SSCC alignment (FY-26) — OCOK:** OCOK Network Management Operations Manual Rev. 7-1-2025 — reviewed; aligned, no additional provider-specific provisions required in this document. Cross-reference: FC-CQI-01 Continuous Quality Improvement Policy; FY-26 SSCC variance matrix. **SSCC alignment (FY-26) — 4Kids:** 4Kids4Families Joint Operations Manual (Dec 2025) / Subcontractor Agreement — reviewed; aligned (4Kids items here are casework/Minimum-Standards-level), no additional provider-specific provisions required in this document. Cross-reference: FC-CQI-01 Continuous Quality Improvement Policy; FY-26 SSCC variance matrix. **SSCC alignment (FY-26) — Belong:** Belong Stage I & II Provider Manual (Aug 2025) / Provider Services Agreement — reviewed; aligned, no additional provider-specific provisions required in this document. Cross-reference: FC-CQI-01 Continuous Quality Improvement Policy; FY-26 SSCC variance matrix. **SSCC alignment (FY-26) — SFCS:** SFCS Placement Provider Manual (July 2020, publicly-sourced — currency unconfirmed) / 2019 Affiliate Provider Agreement — reviewed; aligned, no additional provider-specific provisions required in this document. Cross-reference: FC-CQI-01 Continuous Quality Improvement Policy; FY-26 SSCC variance matrix. ## **RELATED PROCEDURES:** * FC1-01.1 Admission Screening Procedure * FC2-01 Admission Assessment Policy * FC6-01 Admission Matching & Criteria for Child Placement Policy * Admission Matching & Criteria for Child Placement * FC-SU-01 Substance Use Support Services Policy * FC-STASS-01 Short-Term Assessment Support Services Policy * FC-TFFC-01 T3C Treatment Foster Family Care Support Services Policy * RH ICWA Services Policy * RH BSM Policy Manual * RH Caregiver Manual ## **FORMS/ATTACHMENTS:** * Initial Intake Information Form * RH Individual Crisis Management Screening Tool * Trauma-Informed Intake Supplement * Placement Tracking Log * Mental & Behavioral Health Screening Checklist * IDD/Autism Support Services Screening Tool * Substance Use Screening Tool * Short-Term Assessment Eligibility Checklist * Treatment Foster Family Care Clinical Review Form --- *This policy document establishes the governing principles for Admission Screening. The corresponding procedure document (FC1-01.1) operationalizes these principles by providing specific implementation details (who, when, where, and how). While policies require Board approval and remain relatively stable, procedures may be updated by the Executive Director to adapt to regulatory changes, technological advancements, or operational improvements without requiring Board approval, provided such changes maintain alignment with the policy's intent.*