Refuge House, Inc. — Foster/Adoptive Parent Agreement

Master Agreement (blanket) · governs the full Refuge House & foster/adoptive home relationship · durable across changes in T3C credential status

T3C Service Packages & Scope of Care

Refuge House provides T3C services only under the Service Packages and Add-On Services for which it holds an active T3C credential at the time of placement. A foster/adoptive home may care for children only under the package(s) for which both Refuge House and the home are currently credentialed and verified. This Agreement is intentionally not tied to any single credential milestone. As Refuge House's credentials advance (Inactive Interim → Active Interim → Full), this Agreement remains in full effect without re-signing. The packages a given home is authorized to serve are recorded on the home's DFPS verification certificate and on any T3C Service Package Addendum(s) (Appendix V); adding a package is handled by an Addendum plus a home-study verification addendum (26 TAC §749.2803(a)(5); §749.2453) — never by re-executing this Agreement.

The current list of T3C packages for which Refuge House is credentialed, and the corresponding rates, is maintained in the Refuge House rate reference and reimbursement portal (see Appendix I) and is updated by reference. Refuge House communicates credential changes to foster/adoptive homes with appropriate notice.

Packages this home is verified to serve at the time of signing (checked by Refuge House):

Set once, at verification. Later additions are recorded by a Service Package Addendum (Appendix V) and the home's verification certificate — not by re-signing this Agreement.

THIS IS AN AGREEMENT BETWEEN Refuge House, Inc. AND [[TEXT:home_name]] (Foster/Adoptive Home).

Purpose. This Agreement outlines the formal relationship between Refuge House and foster/adoptive homes, establishing the mutual responsibilities, expectations, rights, and obligations of both parties in providing quality care for children placed in foster care. It details the reimbursement structure, home requirements, training expectations, confidentiality protocols, and procedures for addressing concerns to ensure clear understanding between Refuge House and foster/adoptive caregivers.

This Master Agreement is executed on or prior to the home's first T3C credentialing — and in all cases at the time the home is verified (26 TAC §749.2487(a)) — and thereafter as needed for material changes to the arrangement. It remains in effect unless and until it is replaced. Refuge House's T3C credential status and the applicable rate schedule (Appendix I) may change over the life of this Agreement; such changes are incorporated by reference and communicated to all foster/adoptive homes with appropriate notice, and do not require re-execution of this Agreement.

Amendments and material changes. When there is a material change — for example, a change in applicable law, DFPS Minimum Standards, contract requirements, or Refuge House policy that affects the parties' responsibilities — Refuge House may, at its discretion, either (a) incorporate the change by issuing a written addendum to this Master Agreement, or (b) request that the foster/adoptive parent(s) sign a new Master Agreement. An addendum signed by the parties becomes part of, and is governed by, this Master Agreement. Routine updates (such as credential-status or rate-schedule changes) are handled by reference under the preceding paragraph and do not require a new signature.

Governing Framework & Authority

Contracting Entity. In this Agreement, "Contracting Entity" means the Department of Family and Protective Services (DFPS) or the Single Source Continuum Contractor (SSCC) under whose contract a given child is placed. In most instances DFPS and the SSCC may be referenced interchangeably; where a requirement is specific to the contract under which a child is placed, that Contracting Entity's requirement controls for that child.

Minimum Standards vs. contract. Some requirements are governed by the DFPS Minimum Standards (26 TAC Chapter 749) and the Texas Administrative Code and apply to every child regardless of Contracting Entity; others are specific to the DFPS or SSCC contract under which a child is placed. It is Refuge House's intention to align both under this single master services agreement.

Authoritative document. The requirements stated in this Master Agreement are authoritative for the relationship between Refuge House and the foster/adoptive home unless and until they are overridden in writing — by a separate written agreement (including an addendum under this Agreement) or by an approved variance under 26 TAC Chapter 745, Subchapter J. Where the Minimum Standards, an applicable T3C Service Package, and a Contracting Entity's contract differ and no written override applies, the strictest applicable requirement controls.

Refuge House agrees to provide services to the foster home named above under the following conditions:

1 · Reimbursement Terms

1. Reimbursement Schedule. Refuge House shall reimburse caregivers on a semi-monthly basis for children placed in their care. Payments are made one month in arrears, covering two periods: the 1st–15th and the 16th–last day of the month. In some cases, Refuge House may have previously arranged payment schedules.
2. Rate of Reimbursement. Actual rates are detailed in Appendix I and are also available at Refuge House's reimbursement portal. Rates are tied to the child's assigned T3C Service Package and any applicable Add-On Services and are updated by reference as the T3C Methodological Rate Schedule changes.
3. Payment Source. Children placed with Refuge House are under the conservatorship of the Department of Family and Protective Services (DFPS) or a Single Source Continuum Contractor (SSCC) provider. Refuge House contracts with SSCCs for child-welfare services in Community-Based Care (CBC) regions (see Appendix II). Youth for Tomorrow (YFT) is a statewide tool used within the T3C system; it is not an SSCC and does not provide case management or placement services. SSCC regional assignments may change as CBC expands. Daily reimbursements from these entities are provided to Refuge House, which then distributes them to the foster/adoptive home.
4. Expense Responsibility. Unless otherwise agreed in writing prior to placement, all expenses associated with the care of each child shall be borne by the foster/adoptive home and covered by the reimbursement provided, based on the child's assigned T3C Service Package and any Add-On Services. Foster parents agree to use the daily reimbursement to provide for the physical needs of the child, including appropriate clothing in sufficient quantities, personal items, and hygiene items, and to maintain a belongings inventory with supporting evidence of purchase submitted electronically. Personal items purchased for the child are the property of that child and shall be provided to the child at discharge.
5. Exclusions from Reimbursement. Refuge House does not guarantee reimbursement for days not compensated by the Contracting Entity (e.g., hospitalization or juvenile detention). The date of a child's discharge from care is not payable to the caregiver(s).
6. Transfer of Care. If a child is transferred to another home, the per-diem amount for the day of transfer is payable to the receiving caregiver(s).

2 · Child Placement and Authority

1. Foster parents will not accept a non-relative child for 24-hour care from any source other than Refuge House.
2. A foster child will only be released with the consent of Refuge House.
3. Refuge House retains the right to remove a foster child at its discretion.
4. Refuge House, Inc. is responsible for the admission and discharge of all foster children in the home. Foster parents must give 24-hour notice for an emergency removal of a child and allow 30 days for a non-emergency removal.

3 · Supervision and Monitoring

1. Refuge House is responsible for regular supervision and visits of the foster home.
2. Foster parents agree to periodic visits and inspections of the foster home by the Licensing Division of DFPS at all reasonable times.
3. Foster parents understand that Refuge House is responsible for supervision of the foster home and agree to follow all agency rules outlined in RH policies and the Foster Parent Handbook.

4 · Visitation and Travel

1. Visits by the child's parents or relatives must be arranged through Refuge House and approved by DFPS.
2. Visitation arrangements to and from the home will be agreed upon by DFPS and Refuge House; documentation shall be made in appropriate log notes.
3. Foster parents agree to give Refuge House prior notice before taking a foster child on an overnight trip or out of the region or state, and to meet all conditions required by DFPS and Refuge House.

5 · Home Requirements and Capacity

1. Foster family homes will not exceed the total capacity stated on the home's verification — generally up to six children, including the foster family's own children and any children for whom the family provides day care or respite. A higher capacity (seven or eight children) applies only when authorized by an approved capacity exception (26 TAC §749.2551; §749.2557).
2. Foster family homes will not be out of compliance with child/adult ratios at any time and will comply with all supervision rules and regulations. Where 24-hour awake supervision applies — including any home approved for more than six children — the home will provide continuous awake supervision and nighttime monitoring to ensure the safety of all children (24-Hour RCC Contract §1115). Refuge House is responsible for any required awake-supervision self-reporting to DFPS.
3. Not more than two infants and two additional children under six years old will be cared for in any agency foster home at the same time, unless the placement is necessary to maintain a sibling group. These numbers include the children of the foster family (26 TAC §749.2551).
4. Foster parents will keep the home and grounds clean from rodents, insects, and stray animals and ensure compliance with all environmental safety protocols.

6 · Training and Compliance

1. Foster parents agree to maintain compliance with Refuge House Policies and Procedures and DFPS Minimum Standards.
2. Foster parents agree that all caregivers in or supporting the home will complete required pre-service training or provide evidence of prior completion. Under the T3C System, foster parents serving under a specialized T3C Service Package must complete the package-specific training spelled out in Appendix VI before a child is placed under that package, as required by the T3C Blueprint and 26 TAC §749.863 (and §749.863(c) for Treatment Foster Family Care). Core (non-package) training is in Appendix IV. Package-specific curriculum may be delivered within other required Refuge House training rather than as separate sessions — for example, TBRI® is integrated throughout all Refuge House training, and Trauma-Informed Care, Psychotropic Medication, SAMA, and Normalcy appear in the core curriculum. Where a required competency is already covered by another approved Refuge House course, it may be met through that course; Refuge House determines how each requirement is satisfied under FC-16 (Staff & Caregiver Training) and confirms completion on the Service Package Addendum (Appendix V).
3. Foster parents agree to complete all mandatory ongoing training set forth by DFPS, the applicable SSCC, YFT (as applied by the contracting entity), the T3C Blueprint, Minimum Standards, and Refuge House on a yearly basis (Appendix IV).
4. Foster parents agree to the terms of the DFPS Contract, the T3C Blueprint requirements, all Minimum Standards, and all Refuge House Policies and Procedures. Copies of these documents — including the Refuge House policies relating to discipline and child management (26 TAC §749.121) — are provided to the family at the time of verification and remain available through the Refuge House website (26 TAC §749.2488(e)).
5. Scope of Care by Credential. Foster parents may provide care only under the T3C Service Package(s) for which both Refuge House and the home are currently credentialed and verified. Adding a package is accomplished through a T3C Service Package Addendum (Appendix V) together with a home-study verification addendum, and does not require a new Master Agreement.

7 · Documentation and Reporting

1. Refuge House agrees to provide a medical consent form at the time of each child's placement; copies are filed in the child's record and the foster home record.
2. Foster parents will provide, in a timely manner, all required reports to Refuge House regarding foster children and other events impacting the provision of foster care as established by DFPS, Minimum Standards, and Refuge House policies.
3. All serious incidents (Appendix III) must be reported to the RCM and caseworker within 4 hours, with written documentation submitted within 24 hours.
4. Foster parents agree to use the recommended medium and mode for communication and documentation for each child's record, using Refuge House's secure channels rather than standard email.
5. Secure Handling of Protected Information — No PHI by Email. To protect children's protected health information (PHI) and personally identifiable information (PII), foster parents shall not transmit PHI or PII by standard email — including to Refuge House staff. Documents containing PHI/PII are submitted only through Refuge House's secure channels:
   • Direct upload to the foster parent's assigned secure Egnyte folder, or a password-protected, time-limited Egnyte share link (upload-only; no access to other documents);
   • the Foster Parent Portal, gated by a signed privacy and security agreement and authenticated by device- and/or email-based token or challenge;
   • secure sharing via Pulse, gated by token-based and challenge-based authentication with two-factor authentication (2FA); or
   • physical delivery of paper copies to Refuge House staff.
   Documents received from a third party are uploaded as provided rather than forwarded by email. Refuge House provides training and support so this expectation is met in practice, recognizing that secure handling depends on consistent caregiver and staff habits, not technology alone.
6. Technology-Forward Communication — SMS as a Primary Channel. Refuge House is a technology-forward agency. Foster parents agree to use text messaging (SMS) as a primary channel for two purposes: (1) routine, operational communication with Refuge House — for example, scheduling, reminders, availability, and general coordination; and (2) delivery of documents and forms for electronic signature, including secure, tokenized signing links sent to the caregiver's device for signature via Pulse. Both uses are governed by the separate Foster Parent SMS Communication Agreement, which covers consent, message terms, carrier charges, and opt-out. SMS message content is not used to transmit protected health information (PHI) or personally identifiable information (PII); a signing link delivered by SMS directs the caregiver to an authenticated, secure session, and any documents containing PHI/PII are accessed only through the secure channels described above (secure Egnyte, the Foster Parent Portal, or Pulse).

8 · Procedural Requirements

1. Inactive homes will be re-evaluated before additional placements are made.
2. Foster parents agree to participate in service-plan development and implementation.
3. Foster parents agree not to accept any individual 18 years or older for care into the home who is not related to the foster family or the children in care.
4. Foster parents agree to notify Refuge House before accepting a relative into the home for care or to reside.
5. Foster parents will notify Refuge House of any change that affects the home's verification — including a change in household composition (marriage, divorce, separation, death, or birth), the home's capacity, the ages or genders of children served, or the services the home provides — before the change occurs when possible, and otherwise immediately upon discovery (26 TAC §749.2655; §749.2803; §749.2805).
6. Foster parents will notify Refuge House before moving to another residence. Refuge House will not use that home until temporary verification for the new location is issued. Approval of the new residence is valid for only 6 months from issuance and is not renewable; verification at the new address will be completed before the temporary verification expires, or Refuge House shall not use that home.
7. Discipline measures must be consistent with licensing standards and Refuge House's policies on child management and discipline.
8. Childcare must be provided by a licensed facility or by individuals at least 21 years old whose criminal history and central registry background check has been completed.
9. Foster parents agree to give 30 days' notice to discontinue foster parenting. An exit survey will be completed upon termination.
10. Foster parents agree to develop and maintain an individualized disaster/emergency evacuation plan, reviewed annually and updated as needed, ensuring all household members are familiar with it as their developmental level permits, and to provide it upon request.

9 · Your Rights

• To be treated with respect and dignity by Refuge House personnel and contractors.
• To expect Refuge House to ensure the health and safety of its operations to the extent reasonable and within its ability to influence.
• To receive adequate and appropriate information necessary to provide quality care, as specified in this Agreement.
• To adequate and appropriate training to complete the responsibilities and expectations specified in this Agreement.
• To refuse any placement, if you do so prior to signing a placement agreement.
• To receive the support you need from Refuge House, including the ability to contact the Refuge House Case Manager and/or On-Call Worker.
• To expect your personal non-public information to remain private, unless you authorize release or it is otherwise required by law.
• To lodge a complaint or file a grievance without fear of retaliation.

This rights summary supplements — and does not replace — the DFPS Statement of Foster Parents' and Child-Placing Agency's Rights and Responsibilities (Form 3001), which is provided and acknowledged separately at verification.

10 · Confidentiality

It is the policy of Refuge House that service-providers, care-providers, and employees may not disclose, divulge, or make accessible confidential information belonging to or obtained through their affiliation with Refuge House to any person — including relatives, friends, and business or professional associates — other than persons with a legitimate need and to whom Refuge House has authorized disclosure. Confidential information shall be used solely for performing services for Refuge House. This policy is not intended to prevent disclosure where required by law.

Except for certain specified circumstances, Texas law and federal regulations require that all childcare records which directly or indirectly identify a client, former client, or potential client of Refuge House be kept confidential. This includes a prohibition against providing any information — including names and electronic images of past or current foster/adoptive children — on social networking sites.

I understand that violation of this confidentiality requirement can result in immediate dismissal from my duties with Refuge House, subject to the discretion of the Executive Team, and that I may be liable for both civil and criminal penalties.

I agree to conform to all rules and regulations of Refuge House and all agencies and departments placing children with Refuge House to the best of my ability, and to respect the confidential nature of all case records and my personal contacts with clients.

Social-media posting about foster children requires pre-approval from DFPS Media Relations, including names, photos, and personally identifiable information. Refuge House does not permit foster/adoptive parents to create relationships with biological family on social networking sites unless pre-approved in writing. Upon termination, all documents and materials, regardless of medium, that may contain or be derived from confidential information shall be returned.

11 · Privacy Statement

Refuge House is committed to assuring the privacy of your nonpublic confidential information. All information shared with any third party, orally or in writing, will be managed according to legal and ethical considerations. Information may be used or disclosed in connection with: your verification process; treatment and care you provide (to develop service and treatment plans); information requested or subpoenaed by a court or investigator; and information requested by another agency for placement of a child in your care or in the event of a transfer of CPAs.

1. We may compile and summarize information you give us, but not in a manner that would personally identify you.
2. We do not disclose nonpublic personal information about our families or former families to anyone, except as permitted by law.
3. We may disclose information to a therapist, psychiatrist, psychologist, clinical social worker, or third parties you have authorized who need it.
4. We may disclose all collected information to DFPS or court investigators upon request or subpoena.
5. We maintain physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.

In all other situations, your information may be released to appropriate individuals or agencies only upon your written authorization or when our staff has been served a valid subpoena. You may retract your authorization at any time.

Release. I hereby authorize Refuge House to release non-public information it obtains by or about me to (1) ensure service-providers have the most accurate information to develop a service plan, and (2) assist service-providers in providing care to foster/adoptive youth.

12 · Filing a Complaint or Grievance

What it is. A complaint is an informal and/or verbal concern raised to a service-provider, foster/adoptive parent or substitute care-provider, case manager, supervisor, manager, or other appropriate individual to obtain resolution. Verbal reports of concern are not grievances. A grievance is a formal mechanism to express concern or dissatisfaction — including violation of personal rights, service delivery, manner of treatment, professional conduct, or personal experiences.

Lodging a complaint. Raise it with any employee, directed to someone with authority to address the issue or knowledge of the appropriate channels. Complaints may be made by email, telephone, or in person.

Filing a grievance. Submit to the Quality Development Director by U.S. Mail or in PDF format via email to quality@refugehouse.org, including: the complainant's name; pertinent details (dates, procedures, names of relevant individuals); contact information for follow-up; and a signature and date.

Response timeframe. Within fifteen (15) business days of receipt, the Executive Director or assignee shall ensure a thorough investigation. Within 5 days after completing the investigation, the complainant receives a written response.

Appeal. If not satisfied, the complainant may request an appeal to the Board President, who has 10 days to conduct an Executive Review. A written response is provided within 5 days of completing the Executive Review, which is the final determination.

13 · Acknowledgement & Signatures

By signing below, the foster/adoptive parent(s) acknowledge they have read, understand, and agree to the terms of this Master Agreement, including the Confidentiality, Privacy, and Release provisions, and that this Agreement is signed at the time the home is verified.

Refuge House, Inc. · Foster/Adoptive Parent Agreement — Master form · effective on the date signed at verification · signed electronically via Pulse.