Refuge House, Inc. — Internal Reference

T3C Caseload Point System & Staffing Ratios

How Refuge House sizes mixed Service Package workloads to stay within compliant T3C ratios — points follow the assigned designee, with an interactive load calculator.

Blueprint: April 2026 Governing policy: FC-WCM-01 Rules registry: caseload-points v1.0 Staff & Reviewers
Baseline 120 points = full load
Formula 120 ÷ CM ratio = points/child
Attribution Points follow the designee
Optimal range 100–120 points (combined)
Maximum allowable 130 (supervisor approval)
Aftercare 0.5 pts → Aftercare Coordinator

Each Service Package is weighted by its Case Manager (CM) ratio from the T3C Blueprint. A full load is 120 points; the more intensive the package (lower ratio), the more points each child carries. This lets a Case Specialist (designee code CASE_SPECIALIST; governing policy texts use the Blueprint term "Case Manager") hold a mixed caseload across packages while staying within compliant ratios — and it extends the same currency to every other assigned role.

Base formula: 120 total points ÷ Service Package CM ratio = point value per child.  e.g. Basic 120÷20 = 6 · MBH 120÷15 = 8 · STASS 120÷12 = 10 · TFFC 120÷6 = 20.

Attribution — who carries the points

An assigned designee acquires the point value for the role.
  • Point values ride the designee assignment, not the case file. If the Case Specialist also holds the Education Liaison designee for a child, that individual acquires both point values.
  • If the Education Liaison is a different person, the Case Specialist does not acquire the liaison's points — each holder carries their own line.
  • The only values that stack on the Case Specialist without a separate assignment are foundational case-complexity qualifiers (below), because they make the base case itself heavier and no separate designee absorbs that work.
  • Management zones evaluate each person's combined total across every role they hold.

Service Package point values — CASE_SPECIALIST

Service PackageCM RatioPoints / ChildRationale
T3C Basic Foster Family Home1:206Lowest complexity, highest ratio
Substance Use Support Services1:158Recovery coordination, weekly therapy monitoring
Short-Term Assessment (STASS)1:1210Time-limited but intensive assessment coordination
Mental & Behavioral Health1:158Standard behavioral health complexity
IDD/Autism Spectrum Disorder1:158Standard ratio with specialized developmental needs
Human Trafficking Victim/Survivor1:158Standard ratio with trauma specialization
Sexual Aggression/Sex Offender1:158Standard ratio with specialized treatment coordination
Treatment Foster Family Care (TFFC)1:620Highest intensity; 60-day reviews; step-down planning
Specialized Treatment Foster Family Care1:620Highest intensity, research-based model
Complex Medical Needs / Medically Fragilebase value — adjusted by the medical-complexity qualifier (see below)Variable15High complexity, medical coordination required

Specialty designee point values (Add-On delivery roles)

Add-On and specialty work is delivered by dedicated designee roles. The point value accrues to whoever holds that designee assignment for the child — it is not a modifier stacked onto the Case Specialist's line.

Specialty designeeApplies toPointsApplied when
Parenting Support SpecialistPARENTING_SUPPORT_SPECIALISTPregnant & Parenting Youth Add-On+2Per youth receiving the Add-On, to the assigned specialist
Transition SpecialistTRANSITION_SPECIALISTTransition Support Services Add-On+2Per youth receiving the Add-On, to the assigned specialist
Kinship Support WorkerKINSHIP_SUPPORT_WORKERKinship Caregiver Support Add-On+1Per child in a kinship home, to the assigned worker
Education LiaisonEDUCATION_LIAISONAny package (T3C Function #5)+1Per assigned child, to the assigned liaison (policy-set starting value)
Specialty & Add-On rules
  • STASS is NOT eligible for any Add-On Services per the T3C Blueprint.
  • Specialty points do not accrue during the aftercare period — aftercare is a flat 0.5 points to the Aftercare Coordinator regardless of prior package or Add-Ons.
  • Example: an MBH child (8) whose Case Specialist also holds the Transition Specialist designee = 10 points for that person. If a different staff member is the Transition Specialist, the Case Specialist carries 8 and the specialist carries 2.

Foundational case-complexity qualifiers

Qualifiers capture case-level complexity that makes the base case heavier. They are assigned at the individual case level, carry a duration (effective-dated with a review/end date), require Treatment Director approval, and accrue to the Case Specialist only — they never change the other service roles' weights. The medical-complexity qualifier (Complex Medical / Medically Fragile package only) is the first in the catalog.

Complexity levelAdditional pointsTotalCriteria
Standard Medical+015Routine medical monitoring
Moderate Complexity+318Multiple specialists, daily medications
High Complexity+520Medical equipment, nursing visits
Medically Fragile+82324/7 medical oversight, life-sustaining equipment
Implementation guidance — additional qualifiers

Further foundational qualifiers are proposed for cases with documented extreme behavioral concern or significant substance-addiction issues. Their point values and default durations are being defined with the Treatment Directors and will be added to the rules registry when set; they are not yet in effect.

Aftercare status

Aftercare = 0.5 points (flat) — to the Aftercare Coordinator designee

When a child's status changes to "Aftercare" in Radius, the case carries a flat 0.5 points for the six-month aftercare period (post-discharge follow-up, minimum two contacts per month). The points accrue to the holder of the AFTERCARE_COORDINATOR designee for that child — deliberately a distinct role from the Case Specialist, although the current interim fallback resolves to the Case Specialist when no coordinator is assigned. During aftercare the child carries 0 points for every other role. Points are removed when aftercare completes at six months or when services are formally declined and documented (FC-AF). Short-Term Assessment (STASS) children do not enter aftercare status per the T3C Blueprint.

Caseload management zones

Zones evaluate each person's combined cross-role point total — Case Specialist lines plus any specialty designee lines plus aftercare cases held.

ZonePoint rangeStatusAction required
LowUnder 80Under-utilizedMay indicate capacity for additional assignments
Green100–120OptimalNormal operations
Yellow121–130MonitorRequires supervisor awareness; consider rebalancing
Red131+Over capacityImmediate intervention required

Optimal target is 100–120 points; the maximum allowable is 130 (with supervisor approval); 80 is the minimum threshold below which a load may be under-utilized. Loads between 80 and 99 sit below the optimal band — building toward a full load.

Build one person's combined load line by line to see total points, child count, and the resulting zone in real time. Each line is (package base + specialty roles this person also holds for these children + case qualifier) × children. Aftercare cases held as Aftercare Coordinator are counted separately at a flat 0.5 each. Points only count on a line when this person holds the designee assignment that carries them.

Load a sample:
Service PackageSpecialty role also heldCase qualifier (CMMF)ChildrenPoints
Aftercare cases held (0.5 each, as Aftercare Coordinator)CasesPoints
0
Active case points
0
Aftercare points
0
Combined total
0
Total children
0
080100120130+
Low Under-utilized — add load lines to begin.
Reading "Specialty role also held"

Selecting a specialty role on a line means this person holds that designee for those children — so those points land in this person's total. If a different staff member holds the specialty designee, leave the line at "None": those points belong to the other person's load, not this one's.

How aftercare caps work

Aftercare carries minimal points but real workload. Practice guidance for the Aftercare Coordinator role: do not exceed 40 aftercare cases (20 pts) when carrying no other active load, or 20 aftercare cases (10 pts) when combined with an active load (combined = any active points in any role).

The caseload point system governs the Case Manager column (the Blueprint term for the CASE_SPECIALIST designee). The full T3C staffing model also sets ratios for therapists, behavior support/mentors, crisis management, and aftercare, plus per-home placement limits. Roles with per-child assignments carry point values in the rules registry; unit-scoped coverage roles (on-call therapist, crisis management, RN consultant) are evaluated as unit-census coverage obligations instead.

Service PackageCase ManagerLicensed TherapistBSS / MentorCrisis MgmtAftercare CMFoster Home Limit
Basic1:20N/AN/AN/AN/APer home study approval
Substance Use1:151:141:151:251:25Per home study approval
STASS1:121:12N/A1:25N/A4 STASS children
Mental Health1:151:141:151:251:25Per home study approval
IDD/Autism1:151:121:151:251:25Per home study approval
HT Survivor1:151:141:151:251:25Per home study approval
Sexual Aggression1:151:141:151:251:25Per home study approval
TFFCOn-Call Licensed Therapist required 24/71:61:111:61:251:252 TFFC children
Specialized TFCResearch-based model1:61:111:61:251:252 STFC children
Complex Medical24/7 RN availability requiredVariable1:141:151:251:25Per home study approval
Reading the matrix

A ratio of 1:15 means one staff member in that role per 15 children receiving that package. Foster-home limits cap how many children of a package a single verified home may hold. Crisis Management and Aftercare CM run at 1:25 across all treatment packages. Licensed-therapist assignments currently resolve to external treatment-team contacts (commonly STAR Health network) — their tallies function as Blueprint-ratio monitoring.

Why a point system

Fixed per-package ratios break down the moment one person holds a mixed workload — a Case Specialist might carry Basic, MBH, and a TFFC child at once, and might also hold a specialty designee for some children. The point system converts every role's ratio into a common currency (points), so a blended, multi-role load can be measured against a single ceiling. A full load is 120 points; the optimal operating band is 100–120, evaluated on each person's combined cross-role total.

Attribution is designee-driven: the point value for a role accrues to whoever holds that designee assignment for the child. This makes the system extensible — any role in the designee catalog can be given point values in the rules registry, and its holders' loads become measurable without changing the model.

Worked scenarios

ScenarioComposition (single person's combined load)ChildrenPointsZone
A — Mixed standard8 Basic (48) + 6 MBH (48) + 3 IDD (24) + 4 Aftercare (2)21122Yellow
B — High-intensity4 TFFC (80) + 3 HT (24) + 2 STASS (20) + 6 Aftercare (3)15127Yellow
C — Basic focus15 Basic (90) + 4 MBH (32) + 10 Aftercare (5)29127Yellow

Load any of these in the Load Calculator tab to see the math build up line by line.

Governance & where this is codified

The caseload point system is the contact-capacity guardrail behind Refuge House's worker contact and monitoring duties. It is codified in policy, operationalized in procedure, and declared machine-readably in a knowbase registry:

Rules registry — machine-readable source
registries/caseload-points.md (v1.0)
The versioned, parseable source of truth for every point value, qualifier, zone band, and eligibility rule on this page. This page's data tables and calculator constants are generated from it; point values change only by editing the registry.
FC-WCM-01 — Governing
Worker Contact & Monitoring Policy + Procedure
Defines the "caseload point" term and the 120-point maximum; Procedure §13a directs Treatment Managers / CPMS to assign and monitor caseloads using these point values so required contact frequency stays achievable.
Staffing Plan — Part F
T3C Professional Staffing Plan
Part F (Caseload & Workload Sizing) scales staffing to actual census via the point system and the §749.679 caseload caps — not to a theoretical maximum.
FC-AF — Aftercare
Aftercare Services Policy + Procedure
Establishes the 0.5 point aftercare allocation per active aftercare case unless services are formally declined and documented; aftercare points accrue to the aftercare designee holder.
Designee registry
registries/designee-requirements.md
Defines which designee roles exist and when each is required. The point rules key on the same designee codes — the two registries sync into RadiusBifrost together.
FC-04 — Crisis
Crisis Management Policy
Sets the 1:25 Crisis Management staffing ratio reflected in the staffing matrix.
Blueprint
DFPS T3C System Blueprint (April 2026 quarterly edition)
Source of the per-package ratios, Add-On eligibility rules (incl. STASS exclusion), and aftercare provisions. Current edition per the knowbase regulatory-source registry (T3C-BLUEPRINT 2026-04).
Implementation guidance — compliance dashboard (being built)

A caseload compliance dashboard is being built into RadiusBifrost: it syncs the rules registry, reads designee assignments by child, materializes an itemized point record per child and role, and renders per-person combined loads with zone status, drill-down itemization, and unassigned-children gap surfacing. Until it ships, Treatment Managers / CPMS continue to apply these point values manually per FC-WCM-01 Procedure §13a, using this page and the calculator as the reference.

§749.679 — Requirements for Caseloads

Minimum Standards set no fixed numeric caseload, but require that caseloads "meet the needs of children and support foster homes." The point system is Refuge House's method for demonstrating that obligation across mixed caseloads, alongside the §749.305 office-sharing caseload limits.

TBRI alignment

Predictable, bounded workloads support the TBRI principles the agency operates under: Connection (consistent designee assignment, aftercare continuity through transitions), Empowerment (clear, manageable workload expectations), and Correction (capacity preserved for crisis response and trauma-informed intervention rather than overload).