Mental & Behavioral Health Placement Guide

Target Population

Children, youth, and young adults in foster care who:

• Have a diagnosed mental health condition requiring specialized support (DSM-5 serious mental, emotional, and/or behavioral disorder)
• Need therapeutic services coordinated through STAR Health
• Can be safely served in a family-based setting with appropriate supports in place
• May have co-occurring needs such as trauma history and complex behavioral challenges

Admission Criteria

In addition to all statutory and Minimum Standards requirements, the following must be confirmed before placement:

• Placement type and Service Package align with the child’s needs and strengths as demonstrated through a CANS 3.0 Assessment
• Pre-placement visit was conducted (when appropriate) and was successful
• CPA admissions staff have reviewed the child’s information and determined needs align with MBH services
• Both CPA and Foster Family Home hold current credentials for the MBH package and T3C Basic package

CANS 3.0 Assessment

The CANS 3.0 drives both initial placement decisions and every 90-day service plan review. It evaluates the child’s needs and strengths across clinical, functional, and developmental domains and must be updated at each Continued Stay Review cycle.

Foster Home Credentialing

Staffing Ratios

Therapeutic Services

Therapy is provided by a Licensed Therapist specializing in DSM-5 serious mental, emotional, and/or behavioral disorders in youth, credentialed and contracted with the STAR Health managed care organization. Caregivers must actively support attendance and integrate therapeutic recommendations into daily care.

STAR Health Coordination

24/7 Crisis Availability

Mental Health-Specific Crisis Protocols

• Psychiatric emergency response (active psychosis, severe mood episode)
• Suicidal ideation and self-harm assessment and response
• Severe behavioral escalation protocols
• Coordination with emergency behavioral health services when psychiatric hospitalization may be warranted
• Coordination with the child’s prescribing psychiatrist or psychiatric NP for medication-related crises

Post-Crisis Documentation (FC-04.1 §7) — within 3 business days

• Crisis incident review completed
• Personal Safety Plan updated if new trigger information identified
• Treatment Director clinical recommendations documented

Service Documentation & Cost Coverage

T3C Blueprint p.82 (April 2026)

All services received across STAR Health, HHSC Behavioral Health, ECI, and the education system must be documented in collaboration with the Medical Consenter. When a needed service is denied, the case record must capture: date of request, service type, denial reason, and appeal status. SSCC/DFPS must be notified within 3 business days of any denial.

Educational Coordination

This package requires active coordination and participation in school enrollment, advocating for educational testing, IEP/504 plans, and ensuring accommodations are in place to support the child’s educational success.

Initial Training (4 Hours — Before First MBH Placement)

• Understanding mental health diagnoses in youth
• Creating a therapeutic home environment
• Trauma-informed response to challenging behaviors
• Recognizing signs of mental health crisis
• Crisis response and de-escalation
• Medication management and safety
• Working with the treatment team
• Supporting therapy engagement

Annual Refresher: 2 hours, covering policy updates and case discussion.

Day-to-Day Expectations

Logistical Support

• Coordinate daily routines to accommodate weekly therapy, family therapy, group therapy, and psychiatric appointments
• Integrate therapeutic recommendations and safety plans into caregiving
• Maintain structured, predictable, regulated home environment with medications properly secured

Transportation

• Provide and coordinate transportation to all therapy sessions, psychiatric appointments, STAR Health coordination meetings, and IEP meetings
• Coordinate with Medicaid transportation (MTP) or other approved supports when appropriate
• Provide reliable transportation to emergency behavioral health and crisis services when needed

Service Coordination

• Actively coordinate with STAR Health, HHSC Behavioral Health, school district, therapists, and psychiatrists
• Participate in Service Plan reviews, CFT meetings, treatment team meetings, and IEP meetings
• Communicate with the Case Manager and Treatment Director regarding therapy engagement, medication adherence, behavioral health status, and crisis events

Documentation & Record Keeping

• Daily logs: behavioral observations, mood/affect changes, medication administration, crisis events, therapy engagement
• Psychiatric evaluations, therapy progress notes, safety plans, and medication lists maintained in child’s health file
• Documentation complete to support CSR submission within 15 business days

Normalcy Activities

Caregivers must support age-appropriate Normalcy activities — clothing, hygiene, birthdays, holidays, graduations, extracurriculars, social, cultural, enrichment, and employment activities — consistent with the Service Plan and the Reasonable and Prudent Parent Standard (Texas Family Code §264.125). CPA staff coach caregivers in applying this standard for children whose trauma histories may require individualized pacing.

Active Participation in Treatment

Foster Family Home Caregivers are expected to:

• Participate directly in family therapy as clinically indicated
• Attend treatment team and service planning meetings — CFT meetings, Service Plan reviews, IEP meetings
• Respond immediately to behavioral health needs — using TBRI® de-escalation strategies and contacting CPA on-call staff for support

90-Day Review Checklist

Aftercare Timeline

What Aftercare Covers

• Mental health stability monitoring (therapy attendance, psychiatric stability, medication compliance)
• Continued therapy coordination and STAR Health authorization support
• Medication management support and prescriber coordination
• Crisis prevention support — updated safety plan, 24/7 crisis line access
• Caregiver coaching on mental health-informed responses and crisis triggers
• Connection to community mental health resources and peer family groups