State Practices in Treatment/Therapeutic Foster Care.

Title: State Practices in Treatment/Therapeutic Foster Care. 
Author(s): Seibert, Julie.;Feinberg, Rose.;Ayub, Asha.;Helburn, Amy.;Gibbs, Deborah. 
Published: 2018 
Available from: Assistant Secretary for Planning and Evaluation (ASPE) 
http://aspe.hhs.gov/ 
Room 415F 
U.S. Department of Health and Human Services 
200 Independence Av, SW 
Washington, DC 20201 

Printable version (PDF): https://aspe.hhs.gov/system/files/pdf/259121/TREATMENTFOSTERCARE.pdf

Abstract: This federally funded report presents findings from an investigation into how therapeutic foster care (TFC) is implemented and supported by States. Information for the report comes from key informant interviews, representing a variety of perspectives on TFC, and a review of relevant literature. The report provides an overview of the key program elements of TFC defined by States and how States differentiate TFC from foster care. The report also provides a description of how States provide adjunct services, such as case management and behavioral health services to children in TFC. Finally, the report includes information on the different funding strategies employed by States to support TFC services. Findings indicate key elements of TFC include highly skilled caregivers (TFC parents) who are part of the child’s treatment team, enhanced case management, and coordinated delivery of behavioral health and other community-based services. The study also found that although TFC may be a cost-effective alternative to residential care, funding challenges limit its use in many States. States typically fund TFC using Medicaid funds for clinical and therapeutic services and Title IV-E funds for daily care of eligible children. TFC may also be supported with funds from state child welfare, juvenile justice and behavioral health agencies, and provider agency fundraising. Finally, the study found States have employed a variety of strategies to increase Medicaid funding for TFC, such as defining TFC as a service in the state Medicaid plan, categorizing TFC as a rehabilitative service, and using waivers authorized by Section 1115 and Titles 1915(b) and (c) of the Social Security Act. The report concludes TFC is successfully utilized by several States as an alternative to congregate care. Appendices include State profiles. 6 references. 

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