T3C Basic Foster Family Home Care Protocol

Package Description

T3C Basic Foster Family Home Support Services provides individualized, trauma-informed foster care for children and youth whose needs can be met in a community-based, family-based setting. Services are delivered through credentialed Foster Family Homes using Trust-Based Relational Intervention® (TBRI®) as the agency's evidence-informed treatment model. The Basic package encompasses individualized service planning, comprehensive family and system coordination, trauma-informed daily care, crisis availability, and a structured 6-month aftercare program.

Package Stack

This protocol governs the Basic package layer. Children on specialized packages are covered by that package's Care Protocol, which incorporates all Basic requirements within a single merged document.

T3C Basic ← This Protocol + MBH + IDD/ASD + STASS + TFFC + SU + KIN add-on + PPY add-on + YTSS add-on

Critical Operational Thresholds

High-Weight Requirements

Requirement	Standard	Authority
Initial Service Plan (ISP)	Within 30 days of placement	TAC §749.1301 — HIGH WEIGHT
Program Director Written Confirmation	Written at every 90-day CSR — not verbal	Blueprint p. 55; FC-CSR-01.1
CSR Submission to SSCC/DFPS	Within 15 business days of review	FC-CSR-01.1
CANS 3.0 (children over age 3)	Annual	Blueprint pp. 50–51; TAC §749.1301–1335
CANS 3.0 documentation to SSCC/DFPS	Within 15 business days of review	FC3-01.1
Service Denial Notification	Notify SSCC/DFPS within 3 business days	Blueprint p. 53; FC-STAR-01.1 §9
Crisis Response — Phone	Within 15 minutes	FC-04.1
Post-Crisis Documentation	Within 3 business days	FC-04.1 §7
Aftercare — Months 1–3	Weekly contact	Blueprint pp. 56–57; FC-AF-01
Aftercare — Months 4–6	Twice-monthly contact	Blueprint pp. 56–57; FC-AF-01

TBRI® Treatment Model

Connecting Principles

Building trust and felt safety — the relational foundation that every other intervention depends on. Caregivers and staff intentionally create conditions for secure connection with each child.

Empowering Principles

Addressing physical regulation needs — nutrition, sleep, sensory processing — that underlie behavior. Caregivers are coached to support regulation before correction.

Correcting Principles

Trauma-informed response recognizing that challenging behaviors stem from unmet needs and past experiences. Therapeutic responses replace punitive reactions across all caregiving situations.

Population

Children, youth, and young adults in Refuge House foster care whose needs are met within a community-based, family-based setting. Anticipated length of service: 12–18 months, individualized per CSR guidelines.

Credentialing Requirement

All Foster Family Homes must be assessed and credentialed for the T3C Basic Foster Family Home Support Services package before receiving a T3C placement. Standard DFPS foster home licensure alone does not satisfy T3C credentialing requirements.

Dual Credential Rule for Specialized Packages

Homes providing any specialized package (MBH, IDD, STASS, TFFC, SU) must hold both the T3C Basic credential and the applicable specialized package credential. Loss of either suspends service delivery for that home until both are reinstated. Homes providing add-on services must hold a separate credential for each add-on.

Credentialing Validity

Requirement	Standard
Initial credential validity	4 years
Annual compliance review	Required each year within the 4-year cycle
Child outcome data review	Annual; part of compliance review
Re-credentialing assessment	At the end of each 4-year cycle

Initial Credentialing Assessment Components

Verification of current DFPS foster home license in good standing
TBRI® training completion and demonstrated competency
Experience with trauma-informed care approaches
Physical environment — therapeutic appropriateness
Support system evaluation and crisis response capacity
Understanding of T3C service delivery requirements
Capacity to provide 24/7 availability for agency contact

Annual Compliance Review

Conducted within each year of the 4-year credentialing cycle:

Compliance review and capacity utilization evaluation
Child outcome data review
Quality improvement participation verification
Ongoing training and competency maintenance verification

Key Form

Foster Family Home Credentialing Assessment — FC-CRED-01 · Reference: FC-17.1 Foster Home Studies and T3C Credentialing Procedure

Initial Service Plan (ISP)

High-Weight Standard — TAC §749.1301

The ISP must be developed within 30 days of placement. This is a HIGH WEIGHT standard under Texas minimum standards. Begin ISP development at or before the placement date.

The ISP is strength-based and individualized, incorporating CANS 3.0 findings and the child's permanency goal. It must address:

Child's individualized strengths, needs, and permanency goal
Therapeutic services and coordination plan
School enrollment, IEP/504 status, and educational support plan
Medical and health care coordination (STAR Health)
Family connections and visitation plan
Normalcy activities and Reasonable and Prudent Parent Standard application
Crisis response plan and personal safety plan
Transition and discharge planning (updated throughout)

CANS 3.0 Assessment

T3C Basic CANS Cadence

Children over age 3 receive a CANS 3.0 Assessment annually throughout placement. The annual CANS 3.0 drives service plan updates — it does not occur at every 90-day CSR. Children in MBH or IDD/ASD packages have an enhanced CANS 3.0 requirement (at every CSR); that standard applies to those packages, not T3C Basic.

CANS 3.0 Requirement	Deadline
Conducted by licensed clinical staff	Annual
ISP adjustment based on CANS 3.0 findings	Within required timeframes per TAC §749.1301
Program Director review of alignment with permanency plan	At each review
Copy of documentation to SSCC/DFPS caseworker	Within 15 business days of review

90-Day Continued Stay Review (CSR)

Component	Requirement
Program Director Written Confirmation	Written — child continues to meet criteria and is benefitting from the program. Not verbal.
Alignment with permanency plan	Confirmed and documented by Program Director
Dual credential status (if specialized package)	Program Director verifies both credentials current before signing
Service plan adjustments	Documented based on review findings
Submission to SSCC/DFPS	Within 15 business days of review

Program Director Written Confirmation — Required

A verbal acknowledgment or informal notation does not satisfy this requirement. The Program Director's written confirmation must be present in CSR documentation submitted to SSCC/DFPS. If the child is on the MBH or STASS package, the T3C Blueprint requires dual Director sign-off (both Treatment Director and Program Director) — see the applicable specialized package Care Protocol.

Service Plan Domains (90-Day Update)

Domain	Content Required
Therapeutic services	Service type, frequency, provider, coordination status
Safety	Updated Personal Safety Plan — current triggers, de-escalation, crisis contacts
Education	School enrollment, IEP/504 status, grade level, attendance, current supports
Health and STAR Health	Active authorizations, pending requests, any denials
Family connections	Visitation plan, contact frequency, family engagement
Permanency	Current goal, progress, concurrent planning if applicable
Normalcy	Current activities, Reasonable and Prudent Parent Standard application
Discharge planning	Readiness indicators, anticipated discharge timeline, transition plan

Key Forms

Program Director Review Form (FC-PDR-01) · CANS 3.0 Assessment Documentation and Service Plan Integration Form · Service Plan T3C Supplement Form

Foster Family Home Support Requirements

Foster Family Home Caregivers provide four categories of support in accordance with court orders and the Service Plan:

Logistical Support

Maintain a structured, predictable, trauma-informed home environment
Implement therapeutic recommendations and safety plans in daily caregiving
Coordinate daily routines to accommodate therapy, medical, and school appointments
Medications secured per licensing requirements

Transportation

Provide and coordinate transportation to all therapeutic, medical, dental, and school appointments
Coordinate with Medicaid Transportation (MTP) or other approved supports when appropriate
Provide transportation to emergency services when needed

Multi-System Coordination

System	Coordination Scope
STAR Health	Medicaid managed care — medical, dental, vision, and behavioral health authorizations
HHSC Behavioral Health	Specialized mental health supports beyond STAR Health coverage
ECI	Early Childhood Intervention for eligible children ages 0–3
Education system	School enrollment, IEP/504 advocacy, special education coordination
Child welfare system	DFPS/SSCC caseworker coordination, court involvement, permanency planning
Health care	Primary care, specialty medical, dental, vision; Medical Consenter collaboration

CPA staff provide training, consultation, and direct advocacy support to Foster Family Home Caregivers to build and sustain multi-system navigation competency.

Documentation and Record Keeping

Contemporaneous documentation of service delivery, child progress, and contacts
Coordination records per court orders and service plan
Crisis event documentation
All documentation maintained to support CSR submission within 15 business days

24/7 Agency Availability

Requirement	Standard
Staff availability	24 hours/day, 7 days/week, 365 days/year
On-call level	Case Manager or above
Phone response	Within 15 minutes
In-person response	Within 1 hour if warranted by situation

Normalcy Activities

Foster Family Home Caregivers must actively support children's participation in age-appropriate normalcy activities — clothing, hygiene products, hair care, birthdays, holidays, graduations, extracurricular activities, sports, enrichment programs, social activities, cultural events, and employment activities for eligible youth. All decisions are made consistent with the Reasonable and Prudent Parent Standard (Texas Family Code §264.125; Human Resources Code §42.042; TAC §749.1291). CPA staff coach and support caregivers in applying this standard with particular sensitivity to children whose trauma histories may require individualized pacing.

Service Denial and Cost Coverage

Cost Coverage Commitment — Blueprint p. 53

Refuge House will ensure delivery of, and cover the cost of, needed services and related supports that are denied by insurance or other funding sources when community alternatives are unavailable. Document all steps taken before invoking agency cost coverage.

Requirement	Action / Deadline
Service denied by STAR Health or other payer	Document in case record: date, service type, denial reason, appeal status
Notification to SSCC/DFPS	Within 3 business days of denial
Alternative funding identification	Agency assesses alternatives before direct coverage
Direct agency coverage	Authorized when alternatives are insufficient or unavailable

Caregiver Training

Training Area	Timing
TBRI® foundations	Before first T3C placement
Trauma-informed care and crisis de-escalation	Before first T3C placement
Multi-system navigation basics	Before first T3C placement
Normalcy and Reasonable and Prudent Parent Standard	Before first T3C placement
Annual refresher	Per credentialing cycle

References

FC-16 Staff and Caregiver Training Policy · FC-16.1 Staff and Caregiver Training Procedure

24/7 Crisis Availability

Requirement	Standard
Staff availability	24 hours/day, 7 days/week, 365 days/year
On-call level	Case Manager or above
Phone response	Within 15 minutes
In-person response	Within 1 hour if warranted by situation

Crisis Response Protocol

Immediate telephone consultation for Foster Family Home Caregivers
Assessment of crisis level and appropriate response
Coordination with emergency services when warranted
Placement stability intervention and support
Notification to SSCC/DFPS caseworker per required timelines

Post-Crisis Documentation

3-Business-Day Requirement — FC-04.1 §7

Within 3 business days of a crisis event:

Crisis incident review completed
Personal Safety Plan reviewed and updated if new trigger information identified
Documentation entered in child's case record
SSCC/DFPS notification completed if required by event type

Key References

FC-04 Crisis Management Policy · FC-04.1 Crisis Management Procedure · TAC §749.339 · TAC §749.901

STAR Health and Health Care Coordination

STAR Health Managed Care

All children in foster care are enrolled in STAR Health (Medicaid managed care for children in care). CPA responsibilities include:

Coordinating medical, dental, vision, and behavioral health service authorizations
Verifying active enrollment and MCO assignment at placement
Coordinating renewal of all authorizations before lapse
Documenting and reporting any service denial to SSCC/DFPS within 3 business days

Medical Consenter Collaboration

All health service documentation is coordinated in collaboration with the child's Medical Consenter. Medical records and health history are maintained in the child's case file. Specialty referrals are coordinated through the Medical Consenter and STAR Health.

Services Not Covered by STAR Health

Explore HHSC Behavioral Health and community alternatives first
If alternatives are unavailable, Refuge House covers cost per §5.9 cost coverage commitment
Document all steps and outcomes in case record

Therapy Services

Children in the T3C Basic package receive regular and frequent individual and family therapy as required by the T3C Blueprint, coordinated through STAR Health and integrated with daily caregiving.

Note on Therapy Frequency

The T3C Basic standard is "regular and frequent" therapy as prescribed by STAR Health authorization and clinical recommendation. The weekly minimum standard applies specifically to the MBH package. If a child's clinical needs exceed what Basic therapy standards provide, consider whether a specialized package credential is warranted.

Human Trafficking Prevention

Universal Human Trafficking Prevention screening applies to all children per FC-HT-01 and the Human Trafficking Prevention Training Implementation Plan.

Mandatory — TAC §749.361; Blueprint pp. 56–57

Aftercare services are mandatory for all children discharged from T3C Basic services. Services continue for a minimum of 6 months following discharge. The Aftercare Case Manager is assigned at or before discharge.

Contact Cadence — Two Phases

Important Distinction — T3C Basic vs. MBH Aftercare

T3C Basic has a two-phase aftercare contact structure. This differs from the MBH package, which requires twice-monthly contact throughout all 6 months. Case managers must apply the correct cadence based on the child's package at discharge.

Phase	Months	Contact Frequency	Mode
Intensive	1–3	Weekly	Calls or in-person meetings
Continued	4–6	Twice monthly	Calls or in-person meetings; flexible scheduling
Crisis availability	All 6 months	24/7	Phone; in-person if warranted

Aftercare Content

Months 1–3 (Weekly — Intensive)

Crisis intervention and resource connection as needed
Transition support and placement/living stability monitoring
Ongoing service coordination (therapy, STAR Health, school)
Family and caregiver engagement

Months 4–6 (Twice Monthly — Continued)

Ongoing resource referrals and case management support
Continued monitoring of stability and service engagement
Flexible scheduling to accommodate youth and family availability

Staffing

Position	Ratio	Notes
Aftercare Case Manager	1:25	Assigned at or before discharge; maintains crisis availability throughout 6-month period

Documentation

Document all contacts and attempted contacts — date, mode, duration, content summary, and next steps. Submit comprehensive documentation to SSCC/DFPS caseworker at the end of each month.

Add-On Note — Kinship

If the child is a Kinship placement, include support group information in the Aftercare Services plan at discharge (see Add-Ons tab, §KIN).

Key Form

Aftercare Monthly Report (FC-AMR-01) · References: FC-AF-01 Aftercare Services Policy · FC-AF-01.1 Aftercare Services Procedure

Add-On Structure

Add-on services are delivered in addition to all T3C Basic requirements. All sections of this Care Protocol apply in full to children receiving any add-on. Each add-on requires a separate Foster Family Home credential. For full add-on requirements, see the dedicated add-on Care Protocol pages.

YTSS — Transition Support Services for Youth & Young Adults

Blueprint pp. 151–153 · FC-YTSS-01

Eligibility: Youth in or transitioning out of foster care who require enhanced independence preparation support.

Required Staff Expertise

PAL (Preparation for Adult Living) Program coordination
State and federal benefits for youth in and after foster care
Benefit application timing and processes

Required Activities (in collaboration with SSCC/DFPS PAL staff)

Casey Life Skills Assessments completion
Regular PAL program event attendance
PAL Life Skills Training completion
Youth Leadership Council participation (if youth is interested)
Circles of Support and transition planning meeting attendance
Extended Foster Care and Transitional Living program navigation

ISP Requirements

Status of state/federal benefit applications or guardianship eligibility
Driver's license plan (including driver's education and auto insurance) or state ID as appropriate

Youth must be informed of expectations of the Add-On Service program.

KIN — Kinship Caregiver Support Services

Blueprint pp. 156–160 · FC-KIN-01

Eligibility: Children placed in kinship (relative or fictive kin) Foster Family Homes.

Required Staff Expertise

Kinship Care, including state and federal benefits available to kinship caregivers
TANF for relative caregivers, Kinship Care payments, and other assistance programs
Verification requirements and expedited processing procedures

Service Delivery Requirements

Must consider custom needs of youth, caregiver, and physical residence
Must be adaptable, including evenings and weekends
Staff available 24/7 to provide immediate response to Kinship Foster Family Home Caregivers

Aftercare (San Antonio only)

Provide or refer Kinship Caregivers to support groups
Include support group information in Aftercare Services plan at discharge
Track participation and outcomes

PPY — Pregnant & Parenting Youth Support Services

Blueprint pp. 161–163 · PPY Add-On

Eligibility: Pregnant and/or parenting youth and young adults in foster care.

Youth must be informed of expectations of the Add-On Service program.

Custom Parenting Plan must address

Safe sleeping arrangements
Childproofing suggestions
Child development and coping with challenging behaviors
Selection of appropriate substitute caregivers
Benefits of reading, singing, and talking to young children
Healthy Relationships, including intimate partner violence prevention

Service Coordination must include support with

ECI (Early Childhood Intervention) referrals
HHSC Women and Children's Health programs
Prevention and Early Intervention Program
Day care (if applicable)
All state, federal, and community benefits
Completion of all required forms and referrals

Staffing Ratios

Position	Ratio	Per
Case Manager	Standard T3C ratio	Children receiving T3C Basic services
Crisis Management Staff	1:25	Standard T3C ratio
Aftercare Case Manager	1:25	Children in aftercare

Administrative Leadership

Position	Requirements
LCPAA	Full-time, dedicated to single CPA
Program Director	May serve as LCPAA; bachelor's degree OR 5 years residential childcare experience; provides written confirmation at every 90-day CSR

Staff Training Requirements

Training Area	Requirement
TBRI® foundational training	Required for all direct service staff
T3C service delivery requirements	Required for all case managers
Multi-system navigation (STAR Health, HHSC, ECI, education)	Required for all case managers
Crisis response protocols	Required for all staff with on-call responsibility
Annual continuing education	Per FC-16 Staff and Caregiver Training Policy

Continuous Quality Improvement

Refuge House maintains an active CQI process for T3C Basic services including:

Child outcome monitoring against CANS 3.0 domain benchmarks
Placement stability tracking and disruption analysis
Foster Family Home performance review and coaching
Aftercare success rate monitoring
Quarterly internal review of service delivery compliance
Annual credentialing audit across all credentialed homes
Integration of CQI findings into staff training and caregiver coaching

Key Form

T3C Service Package Implementation and Compliance Tool (FC-T3C-01)

Regulatory References

Reference	Topic
TAC §749.1301	30-day Service Plan timeline — HIGH WEIGHT STANDARD
TAC §749.1335	Service Plan Review requirements; Foster Family Home support services
TAC §749.339	Crisis response and restriction of privileges
TAC §749.901	Emergency behavior intervention
TAC §749.361	Aftercare services (mandatory, 6 months)
TAC §749.673	Quality improvement
TAC §749.1291	Normalcy activities
Texas Family Code §264.125	Reasonable and Prudent Parent Standard
Human Resources Code §42.042	Normalcy activities (licensing authority)
RCC Contract Term 7	Placement and service requirements; aftercare
T3C Blueprint (April 2026), pp. 49–57	T3C Basic Foster Family Home Support Services requirements
T3C Blueprint (April 2026), pp. 151–153	Transition Support Services (YTSS add-on)
T3C Blueprint (April 2026), pp. 156–160	Kinship Caregiver Support Services (KIN add-on)
T3C Blueprint (April 2026), pp. 161–163	Pregnant & Parenting Youth Support Services (PPY add-on)

Forms

Form	ID	Purpose
Foster Family Home Credentialing Assessment	FC-CRED-01	Initial and re-credentialing
T3C Service Package Implementation and Compliance Tool	FC-T3C-01	QA and compliance monitoring
CANS 3.0 Assessment Documentation and Service Plan Integration Form	—	Annual assessment and ISP update
Program Director Review Form	FC-PDR-01	90-day CSR written confirmation
Service Denial Response Form	FC-SDR-01	Documenting and responding to service denials
Aftercare Monthly Report	FC-AMR-01	Monthly aftercare documentation to SSCC/DFPS
Personal Safety Plan	—	Crisis triggers, de-escalation, emergency contacts
Add-On Service Acknowledgment	FC-ASA-01	Youth notification for YTSS and PPY add-ons
Casey Life Skills Assessment	CLSA	YTSS add-on requirement

All forms available at previewforms.refugehouse.org and in Radius.

Related Policies and Procedures

Document	Relationship
FC-T3C-01 T3C Basic Policy	Governing policy for this package
FC-T3C-01.1 T3C Basic Procedure	Primary operational procedure
FC-17.1 Foster Home Studies and T3C Credentialing Procedure	Credentialing assessment and approval
FC3-01.1 Individual Service Planning Procedure	ISP development; 90-day CSR process; CANS 3.0
FC2-01.1 Admission Assessment Procedure	CANS 3.0 initial assessment
FC-AF-01 Aftercare Services Policy	Mandatory 6-month aftercare policy
FC-AF-01.1 Aftercare Services Procedure	Weekly M1-3 / twice-monthly M4-6 contact; documentation
FC-04 Crisis Management Policy	24/7 crisis policy
FC-04.1 Crisis Management Procedure	Crisis response protocols and timelines; post-crisis documentation
FC-CSR-01 Continued Stay Review Policy	90-day CSR policy
FC-CSR-01.1 Continued Stay Review Procedure	Program Director written confirmation steps
FC7-01.1 Family Connections and Engagement Procedure	Family engagement and visitation
FC-16 Staff and Caregiver Training Policy	Training requirements
FC14-01 Discharge and Permanency Planning Policy	Discharge process
FC-STAR-01.1 STAR Health Coordination Procedure	STAR Health authorization and denial management
FC-HT-01 Human Trafficking Prevention Policy	Universal screening requirement
FC-KIN-01 Kinship Caregiver Support Services	Full KIN add-on requirements
FC-YTSS-01 Youth Transition Support Services	Full YTSS add-on requirements