Frequently Asked Questions
Note: Recent FAQ additions are denoted with at the bottom of each section.
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Topics
- Service Package Details
- What does care look like under T3C?
- Credentialing Process
- CANS 3.0 Assessment
- Making the Transition
- The Placement Process
- IT-Related Questions
- Human Trafficking Training
Service Package Details
No. The Short-Term Assessment Support Services Package is not eligible for the Add-On Services.
No. CPAs are only eligible to provide the 9 Support Services Packages, including T3C Basic Foster Family Home Support Services, and the 3 Add-On Services. GROs are only eligible to provide the 9 Services to Support Community Transition Packages in GRO Tier I, including T3C Basic Childcare Operation, and the 6 Stabilization Services Packages in GRO Tier II.
Yes. They can become Credentialed to provide as many Service Packages as they would like, so long as they meet all the qualifications for providing each of those Service Packages.
The GRO Service Package that most closely aligns with the services offered by Emergency Shelters in the current system is the Tier I: Emergency Emotional Support & Assessment Center Services.
Yes, as long as the CPA has been Credentialed to provide those Service Packages and Add-Ons, and the CPA has Credentialed the foster home to provide those Service Packages and Add-Ons according to their approved policy.
Yes, there are some minor differences.
This varies by Service Package, but for Tier I the GRO must be able to provide Treatment Services for the following Service Packages:
- Sexual Aggression/Sex Offender Treatment Services to Support Community Transition
- Substance Use Treatment Services to Support Community Transition
- Emergency Emotional Support & Assessment Center Services
- Complex Medical Needs Treatment Services to Support Community Transition
- Intellectual or Developmental Disability (IDD)/Autism Spectrum Disorder Treatment Services to Support Community Transition
- Human Trafficking Victim/Survivor Treatment Services to Support Community Transition
- Mental & Behavioral Health Treatment Services to Support Community Transition
A graphic depiction, developed by the provider, that presents the shared relationships among the resources, activities, inputs, outputs, outcomes, and impact for each Service Package and/or Add-On Service. A Logic Model depicts how the provider’s program will work, what it is expected to achieve, and identifies the components that will be used to inform provider program improvements through the continuous quality improvement process and is intended to change through this process.
At this time, DFPS is not intending to publish a listing of Evidence-informed Treatment Models in the April 2024 T3C System Blueprint. The T3C System is intentionally designed to allow providers flexibility in identifying the Evidence-informed or Evidence-based Treatment Model or Models that best serve as the framework or foundation for the agency or operation’s particular program based on the custom needs of the population served.
This was to distinguish the fact that the needs of children, youth, and young adults that have been victims or are survivors of Human Trafficking-have different needs that cannot be addressed by the “Universal Human Trafficking Prevention Training for all staff and Caregivers” that is being designed by DFPS, they require something more specialized to prevent re-victimization.
There is not a specific Service Package for the children of youth/young adult parents under the T3C System. Rather DFPS will continue to provide funds to cover the care and maintenance of the child of youth or young adult parent that is in DFPS conservatorship or extended foster care. The reimbursement rate for this care will be $46.90 per day that will be paid in addition to the Service Package rate for the services offered to the youth/young adult parent.
The youth or young adult’s optimal Service Package would be informed by the CANS 3.0 Assessment, the Application for Placement, and ultimately the knowledge and expertise of the youth’s permanency planning team.
Yes, as long as the CPA is credentialed for the T3C Basic Foster Family Home Support Service Package, they can still credential & license kinship families to provide that specific package – the Kinship Caregiver Support Add-On is not a requirement in order to license kinship homes, it is just intended as an optional added benefit for CPAs that have programming and are Credentialed to provide the Kinship Add-On Service.
The T3C System Blueprint states “The General Residential Operation must have a staff benefit package that, at a minimum, includes paid annual vacation and sick leave for all Direct Delivery Caregivers and/or Cottage Parents to support wellness and retention”. This was intended to support full-time (40 hours/week) Caregivers. However, providers are not prohibited from including part-time Caregivers in the staff benefit package.
This refers to a Recreation Schedule that is specific to the population of children served by a single Service Package, which is customized to support their unique physical, social, and emotional well-being needs. If an individual child qualifies for Treatment Services under Minimum Standards, the provider would need to have a Recreation Schedule that is personalized to that individual child’s needs in compliance with Minimum Standards, which may include aspects of the Recreation Schedule customized for the population of children served under that child’s Service Package. Further questions on ensuring compliance with Minimum Standards should be directed to the provider’s Licensing Representative.
All residential operations permitted by HHSC-CCR have to provide “Child Care Services". It was not listed under Permit Services, because it is required for all Permit Types.
The inclusion of Transitional Living as a part of the Permit Services offers assurance that the operation has the skill, knowledge, and experiential learning programming available, as a part of the all-inclusive Service Package to meet the needs of youth while they are in the provider’s care. While Transitional Living is a Permit Programmatic Service required to become Credentialed to provide the Service Package to youth 14 and older, it does not serve as the entire basis for the Package. Standards and the T3C Blueprint emphasize adjusting/adapting transitional living services based on the custom needs of the child, which may vary based on age, development, length of stay, clinical needs, supervision needs, and where the individual youth is in relation to their own treatment. Providers are encouraged to reach out to their Licensing Representative if they have questions about how best to structure their program and policies to comply with all of the relevant Minimum Standards.
The T3C System design envisioned the provider delivering Aftercare Case Management Services directly, in order to provide the child with a degree of continuity and connection to the people from their prior placement, DFPS is open to providers proposing other ways to meet Aftercare Case Management requirements, which may include contracting for those services. DFPS would evaluate the provider’s proposal to determine if it meets the requirements/intent necessary to become Credentialed.
The new rate methodology breaks down all of the requirements, including required positions and allots them an amount under the daily rate. Provider completion of the cost reports will ensure that future changes to rates are appropriate.
Yes, as per the specific Service Package Expectations.
Specific questions that aren’t in the FAQ can be addressed to the T3C email box at DFPSTexasChildCenteredCare@dfps.texas.gov. There are also many resources available online, such as through the Texas Alliance of Child and Family Services’ T3C Ready website.
The rate methodology for T3C is calculated based on 40 days of paid Intermittent Alternative Care per year to inform the Service Package rates.
For purposes of T3C, a Behavior Support Specialist/Mentor is an employee or contracted service provider, who builds rapport with the child, youth, or young adult, and seeks to engage, support, and coach the child and their Caregiver/s in the utilization of various techniques that will aid in optimizing the child’s functioning in an efficient and effective manner. The rate methodology staffing model is based on an individual with a Bachelor’s degree, similar to a Case Manager, to allow providers to have flexibility in filling the role for T3C Service Packages with staffing requirements including a Behavior Support Specialist/Mentor.
DFPS will defer to HHSC-CCR and Minimum Standards on this determination. The intent of the Staffing Requirement of “Full-time Licensed Child Placing Agency Administrator dedicated to single Child Placing Agency” in the Service Packages is not to exceed the Minimum Standards regarding main verses branch offices, it is only to prevent an LCPAA from one independent provider from being the LCPAA for another unaffiliated provider.
No, there will still be requirements surrounding addressing the youth or young adult’s transition planning needs regarding prudent parenting, normalcy, experiential learning and PAL services in the DFPS Contract or SSCC Provider Network Agreement contract that will not change under T3C. The Add-On Service provides extra funds for additional staff and financial support to the foster parents to defray the costs of supporting the youth or young adult with meeting their needs in a holistic way, but it does have added requirements beyond what is contained in the Contract.
No, but they do need to ensure that they are permitted for the Young Adult Care Special Services if there may be young adults age 18+ in DFPS conservatorship placed in their foster homes.
You can access HHSC-CCR staff who are familiar with T3C by emailing the Minimum Standards box at RCCRStan@hhs.texas.gov.
There is nothing in the T3C System Blueprint that prevents an external service provider from contracting with multiple residential operations, but the time required per child and per operation may be greater than under the Service Levels System, which may reduce the number of operations that an external service provider can work with. This would depend on various factors impacting each residential operation, such as their selected Treatment Models, and the Service Packages that they plan to apply for Credentialing in, due to the Staffing Requirements including on-call availability, and service planning team and time frames, including child progress documentation and staffings informing the Quality Assurance and Continued Stay Guidelines.
Yes, as long as all of the different requirements for each Service Package are met. Additionally, if they are housed in the same building, the provider would want to consider some separation to delineate the different areas to account for Minimum Standards requirements, as well as the T3C Generally Appropriate Staff to Child Ratios and considerations such as any additional security deemed necessary for the children in Tier II, and to ensure that the behaviors of the higher acuity children in the Tier II area don’t negatively impact the children in Tier I.
For the Tier I: Mental and Behavioral Health Treatment Services Package, utilizing a contracted individual whose qualifications exceed that of a Registered Nurse, such as a psychiatrist, would be acceptable. However, be aware that the rate methodology for the Service Package only supports the cost of an RN. For the Tier II Service Packages except the Complex Medical Services to Support Stabilization (which requires an RN on staff, not just contracted), the model was built to specifically include that an RN is on-site during regular business hours, so at this time, your current arrangement utilizing the contracted Psychiatrist that is not on site daily during business hours would not fulfill the requirement.
No. The qualifications for Treatment Director as identified in the T3C System Blueprint are taken from Minimum Standards and the type/s of Treatment Services required on the operation’s license for the specific Service Package, so those qualifications would likely only change in the event of changes to Minimum Standards.
Because interns are not eligible for Superior STAR Health Credentialing, Licensed Professional Counselor Intern (LPCI), Licensed Chemical Dependency Counselor Intern (LCDCI), and other types of therapist interns can be used for services that are not Medicaid eligible. Examples include, but are not limited to, service planning, one-on- one behavioral intervention (that is not an actual therapy session as defined by Medicaid), and other non-Medicaid eligible services.
The use of "dedicated" means that the specific Add-On staff is dedicated to working only with the Add-On Service in mind for the child/Kinship Caregiver Family they are assigned to, while there would be a separate Case Manager assigned to the child for the purposes of their Service Package planning and needs.
No. It means that the rate includes funding such that the CPA is required to pay the foster home their normal pass-through rate for the child’s Service Package and any applicable Add-On Services for each day of Intermittent Alternate Care (respite). In addition, the CPA is responsible for paying the alternative care providers who take the child for the days of respite the same pass-through rate as the child’s foster family home. The rate methodology for T3C is calculated based on 40 days of paid Intermittent Alternative Care per year to inform the Service Package rates. An agency can have volunteers so long as it has been approved in your policies and procedures (meeting Minimum Standards) for providing care, free of charge, for days over and above the required minimum of 40 paid days, which will allow your foster families to save their paid days for when it is most needed.
HHSC Provider Finance is revising the 24-Hour Residential Child Care cost report template to align with and complement the T3C rate methodology. The cost report will collect incurred costs associated with providing services under both the legacy and T3C systems while providers are providing care for children under both systems. Once all children have been transitioned to T3C, HHSC will only collect costs associated with operating under T3C.
The cost report template will require GRO and CPA providers to report paid units of service for each T3C service package and add-on(s), legacy paid days, and allowable costs to deliver residential foster care. HHSC will collect hours and allowable compensation for employed and contracted staff hours and wages for non-administrative and administrative personnel and payroll taxes and Workers' Compensation premiums and claims for staff, and facility, administrative and operations costs associated with providing services.
Updates to the DFPS Data and System Security Requirements that are applicable to contractors were released on 9/17/2024, and the current requirements in their entirety can be found in the DFPS Data and System Security Requirements document.
The mandate for providers to track referrals for placement was already established as a result of the most recent Legislative session, so it actually pre-dates the T3C System Blueprint being published, and the T3C System Blueprint is actually trying to help provide guidance with the requirements outlined.
If you are receiving inappropriate (not within your operation’s scope) referrals, then you would want to be able to collect the data on those referrals and your responses in a manner that can generate reports to provide to the Department and/or SSCCs for purposes of the larger Continuous Quality Assurance and Improvement process that is built into T3C and will be overseen/coordinated by UT. You should also verify that your operation’s information and availability of placements is correct in GPS, and for your responses, ensure that you are copying the appropriate referral source (such as CPS Regional Placement email box or SSCC Point of Contact regarding placement processes).
The operation’s Treatment Model (and thus Logic Model) along with the Quality Assurance and Continued Stay Guidelines should inform your anticipated length of service, which is the approximate amount of time that your operation needs to meet the needs and goals identified for the population of children being served under the distinct Service Package. Even for the T3C Basic Foster Family Home Support Services Package, you are still providing services to achieve the child’s individual goals:
- Assessing the child for needing/participating in therapy for trauma stemming from abuse/neglect and from separation from family,
- Actively incorporating the family and child’s support network into service planning and supporting the child’s permanency by preparing for reunification and placement with relatives/fictive kin as a less restrictive placement type, and
- The Program Director under the Quality Assurance and Continued Stay Guidelines will review the child’s goals and services every six months to ensure they align with the child’s custom strengths, needs, and permanency plan, and the child continues to benefit from them, as well as that there is not a less-restrictive placement type that is appropriate to meet the child’s current needs.
Your Treatment Model may have approximate time frames built in for a child’s progress reviews, but if not, using the current average for the time from admission to discharge, or even using an average of one year to start (two Continuing Stay Guideline reviews) and then assessing your data as you integrate the Treatment Model may result in future refinement of your initial estimate on Anticipated Length of Service.
Could you clarify which Service Packages require that the Registered Nurse be on staff, and can’t just have the RN be contracted?
The following Service Packages require that the Registered Nurse be on staff:
- Complex Medical Needs or Medically Fragile Support Services;
- IDD/Autism Spectrum Disorder Support Services;
- GRO: Tier I Complex Medical Needs Treatment Services to Support Community Transition; and
- GRO: Tier II Complex Medical Services to Support Stabilization.
An error was identified in Appendix II.B and III.B that inadvertently left GRO: Tier II Complex Medical Services to Support Stabilization off of this section, which will be corrected in the January 2025 version of the T3C System Blueprint.
What does care look like under T3C?
The Licensing Minimum Standards include the mandated child to staff caregiver ratios. T3C includes ratio guidelines in the Generally Appropriate Staff to Child Ratio Based on Service Package that informed the rate methodology and vary based on an operation’s specific Evidence-informed Treatment Model, and dependent on the complexity of the caseload. In support of contract requirements, the T3C System Blueprint specifies in the Service Package Expectations that awake night Direct Delivery Caregivers are required in foster homes where there are 7 or more children, and for all GROs. An update that will be officially included in the October 2024 version of the T3C System Blueprint is that for GROs, there must be at least one awake night Direct Delivery Caregiver in every separate cottage or building that has at least 1 child or youth in DFPS conservatorship. Information on awake night staff ratios was formerly in both the Service Package Expectations and the Generally Appropriate Staff to Child Ratio Based on Service Package sections, but now is only located under the Generally Appropriate Staff to Child Ratio Based on Service Package section to identify the staff ratios that are taken into account for the rate methodology and supported by the current rates, with the understanding that contracts may be more explicit in ratio expectations.
Yes.
Licensed therapists are included in many of the Service Packages to oversee treatment and service planning for children, youth, and young adults.
If the child’s behaviors or emotional needs change, such that the child could potentially be better served by a different Service Package, the provider would want to communicate with the child’s SSCC or DFPS Caseworker so that a new CANS 3.0 assessment can be performed to determine if the change in Service Package is recommended. Based on the CANS results, the knowledge and professional judgement of the SSCC or DFPS staff and the child’s stakeholders, based on the child’s individual needs and best interest would be the basis for the selection of the actual Service Package.
The model allows for flexibility in credentialing for multiple service packages, so that providers can serve the needs that arise in the same placement. It is important that the provider ensure that they create a training plan to prepare the foster family for all possible service packages that they are credentialed for.
There will be a monitoring process, that is currently under development, as well as periodic recredentialing.
The design of T3C was largely based on provider and other stakeholder input, and as the experts in the industry, what those individuals determined would be needed to provide quality services to children in foster care. The transition to this new system will be an iterative process where lessons will be learned, and modifications will be made for continued improvement. Successful implementation can only be achieved if there is frequent, timely, and transparent communication between the Department and all stakeholders. There will be a 3rd party Continuous Quality Assurance and Improvement process that will use data and stakeholder input to further improve the system as T3C is implemented and into the future.
The main difference is the objective for the services and the level of intervention needed to ensure the child’s needs are able to be met—GRO: Tier II focuses on services for children that are having a hard time self-regulating and are yet not at a place to be able to successfully participate and complete a treatment program. GRO Tier I (with the exception of the Basic Child Care and Emergency Emotional Support and Assessment Center) is designed for children who need RTC treatment but through less-intensive means when compared to their peers in a Tier II setting.
Yes, it would be important for your operation to develop Policies and Procedures on how your Aftercare Case Management staff will collaboratively approach and repeatedly attempt to engage with the child’s next placement, and ensure proper documentation and submission of those attempts. Among the many purposes of Aftercare Case management to keep in mind when establishing those Policies and Procedures are:
- To provide the child with a degree of continuity and connection to the people from their prior placement and allow for a gradual sense of closure;
- To ensure that the options for local services that will assist in best meeting the child’s needs have been identified and set up timely so that they can be utilized in maintaining the child’s progress in addressing their needs; and
- To offer insight to the child’s unique challenges and assist in problem-solving how to manage them given prior experience with the child.
Among the overarching goals of Aftercare from the prior placement’s perspective would be to support the success of the next placement and avoid a placement disruption, as those Aftercare service outcomes will impact your operation’s statistics that you will need to track under the Service Package’s requirements regarding Desired Individual Outcome, and will in turn contribute to information that will be reviewed during re-Credentialing.
All Credentialed placements would also have the ability to develop Policies and Procedures on how they will collaboratively work with prior placements that offer Aftercare to utilize Aftercare planning efforts and capitalize on information gathering opportunities for service planning that will best support the child’s transition from the prior placement.
For GRO Tier I, the following service packages require a Registered Nurse:
- Substance Use Treatment Services to Support Community Transition;
- Complex Medical Needs Treatment Services to Support Community Transition;
- Mental & Behavioral Health Treatment Services to Support Community Transition;
- Intellectual or Developmental Disability (IDD)/Autism Spectrum; and Disorder Treatment Services to Support Community Transition.
All of these packages have some differences in responsibilities, but all require that the RN is routinely on-site and is available via phone or video conference 24 hours a day/7 days a week, and all include the responsibility to oversee the administration and distribution of medication. Oversight of the administration and distribution of medication does not mean that the RN has to be physically present for the actual administration of medication but needs to be available 24/7 via phone or video conference for questions and providing guidance to ensure accuracy of administration and documentation. Based on a provider’s Treatment Model and the responsibilities assigned to the RN, the amount of time that they are routinely on-site may change at times, and it will be the provider’s responsibility to show in their policies and procedures how they are ensuring that the RN is utilizing the Treatment Model to inform their interactions with the children and ensure that medical approaches support the child’s treatment goals under the Service Package.
For GRO Tier II, all service packages require a registered nurse to be on-site during regular business hours, and in accordance with the Treatment Model, and is available via phone or video conference 24 hours a day/7 days a week to direct and oversee the child’s treatment and stabilization progress, as well as the administration of psychotropic and other medications to children, youth, and young adults. The language of the Tier II requirements is more detailed because of federal requirements for QRTPs.
The focus is on doing what makes sense, and encouraging collaboration between Caregivers, with the goal of maintaining the continuity of care and sense of connection for the child. If the child’s prior and subsequent placements are in the same region, it may make sense to have at least the first visit in-person, particularly for children that are especially sensitive to change. Ultimately, it is in the best interest of both the prior and subsequent placement, to work together to ensure a smooth transition and minimize chances of disruption for the child, in terms of child outcome tracking for both providers.
If the current placement doesn’t know where the location of the child’s next placement will be at the time of assembling the initial Service Plan (such as in the case with a Tier II where a step-down paid placement may be needed prior to transition to family/fictive kin), they should still be identifying the specific ongoing treatment goals and types of services that they would recommend and intend to refer for as part of preparing for the child’s transition and aftercare once a subsequent placement is located, and ensure they are updating those items over the course of the Service Plan Reviews. Then once the next placement is identified, it’s important to have policies regarding the approaches that the Aftercare Caseworker will take to encourage the free flow of information and allow the providers to work together to identify, refer to, and utilize the best available resources in that locale for the child before, during, and after the move has occurred.
At this time, Form 3300 has been identified by CPS Program as only requiring a single additional field to indicate the child’s Service Package, similar to the field that already exists to indicate the child’s Level of Care. The development of Form 3300 was a very involved, collaborative process with the provider community, and while there are T3C-related details that could be added to the form, since SSCCs are not currently requiring use of the form, and completion of the transition to T3C will be shortly before the currently planned final roll-out of Community-Based Care statewide, at this point, there are concerns about the bandwidth of providers to achieve the collaboration required to completely update the form when the focus of many providers is ensuring their own efficiency during the transition to T3C and subsequently to CBC.
Yes, in fact, the ability to better serve sibling groups where each child has different needs is a benefit of having a foster family home trained and Credentialed to provide multiple Service Packages.
For this initial iteration of T3C, it was determined that leaving the decision with the provider who knows the child best from daily interaction will result in a more accurate review. However, if CQIA leads to concerns about the process, this may be reevaluated.
The use of "dedicated" means that the specific Add-On staff is dedicated to working only with the Add-On Service in mind for the child/Kinship Caregiver Family they are assigned to, while there would be a separate Case Manager assigned to the child for the purposes of their Service Package planning and needs.
T3C will require that contracted or external Providers utilized by Residential Operations will need to be trained in, actively utilize, and incorporate in their documentation the Provider’s Treatment Model.
Once a Provider has been issued an Active Interim Credential or Active Full Credential, and children have been electronically placed into a T3C Service Package.
Yes, but the Provider should show how they are accommodating the workload of the Case Manager given the additional responsibilities and ensure that there is a method for the Case Manager to track and document time put towards each function for cost reporting purposes.
Credentialing Process
No. DFPS is in the process of establishing a single-streamlined Credentialing process, where once Credentialed, the provider will be eligible to provide the distinct Service Package(s) to any child or youth in DFPS Conservatorship, or young adult in Extended Foster Care. Separate from the Credentialing process, providers will still be required to enter into contracts with DFPS and/or the SSCCs to deliver the services.
No. Once a CPA becomes Credentialed to provide one or more of the Service Packages and/or Add-On Services, the organization will be required to have a process (which will be evaluated as a part of the CPA’s Credentialing process) in place to assess individual foster homes and Caregivers to provide the CPA’s Credentialed services.
No. Foster homes providing the Short-Term Assessment Support Services and T3C Treatment Foster Family Care Support Services Packages are not required to be Credentialed in T3C Basic Foster Family Home Support Services.
Yes, so long as the CPA has been Credentialed to provide those Service Packages, and the CPA has Credentialed the foster home to provide those Service Packages according to their approved policy.
No.
No.
Yes. The Permit Type(s) and Permit Service(s) are based on current RCCR (Residential Child Care Regulation) Minimum Standards requirements and are included to show what type of Permit and/or Services would be required to become Credentialed to provide a particular Service Package.
Yes. In order to become Credentialed the Child Placing Agency will need their Permit to reflect the corresponding Permit Services as listed for the particular Add-On Service in the T3C System Blueprint.
A new permit is not required, unless the provider is seeking to become Credentialed for a Service Package(s) that requires a different type of permit than what the organization is operating under today.
Yes. Updated or revised policies/procedures will need to be submitted as part of the Credentialing process.
The CPA needs to assess the skills and experience of the foster caregivers and their desire to work with children presenting certain needs. The CPA will need to include the process for assessment and credentialing in their policies for review during the CPA’s credentialing.
DFPS will release an update to providers outlining the step-by-step Credentialing process, including a comprehensive list of what providers will need to submit to become Credentialed. This list and step-by-step process is anticipated to be released in July of 2024. At a minimum, it is anticipated that providers will be required to demonstrate and articulate the ability to provide the distinct Service Package and/or Add-On Service(s) based on the provider’s /operation’s infrastructure, specific policy, procedures, organization charts, business and training plans, and the Treatment and Logic Models. Providers will maintain Credentialed status for a period. Prior to the expiration of the Credentialed timeframe, the provider will need to apply to become re-Credentialed. As the foster care system transitions to the T3C System, there will be changes to the policy, process, and tools used to monitor SSCC and Residential Child Care Contracts. DFPS will be working internally, and with stakeholders to inform the modifications, and to finalize the new approach to monitoring and oversight.
DFPS is currently working with the SSCCs and other stakeholders to develop the Interim and the Full Credentialing process- depending on the number of applications submitted at a given time, DFPS may have to prioritize the order in which applications are processed. This will be informed by which of the Service Packages represent the greatest need for children and youth in care at the time.
To be clear, HHSC-CCR is not involved in the Credentialing process, it is a process that is being controlled by DFPS, although if a provider has questions about how to change their permit for the purpose of being Credentialed, the provider can contact rccrstan@hhs.texas.gov and CCR staff that have been familiarized with T3C can provide assistance.
The Permit Type and Permit Service(s) listed in the Blueprint will be verified as a part of the Credentialing process. The process is being built in a way that avoids duplication- meaning if Licensing has already verified that the provider’s policy, procedures, staffing model, etc. meets the requirements to provide certain services based on minimum standards or law, then DFPS will not be asking for submission of the same information as part of the Credentialing process as long as the minimum standards fulfill the entirety of the T3C requirements; rather DFPS would only ask for a copy of the provider’s Permit with Services (as listed by Service Package in the Blueprint) attached.
The CPA needs to assess the skills and experience of the foster caregivers and their desire to work with children presenting certain needs in regards to the Service Packages that the CPA gets Credentialed for. The CPA will need to create their own process for assessment and Credentialing in their policies for review during the CPA’s Credentialing review, so you won’t need to complete the Credentialing of your foster homes until the CPA is Credentialed to ensure that your process is approved. The process should include an update/addendum of the Home Study to identify the specific Service Packages that have been authorized for that home. By January 1, 2025, all IT-related updates to the CLASS Provider Portal and DFPS IMPACT will have been implemented, so that once a CPA has been Credentialed, they can enter updates to their foster homes’ entry in the Provider Portal to reflect the Service Packages that the home has been Credentialed for.
This criterion will only apply to terminations for convenience that have occurred in the last three DFPS Fiscal Years (since September 1, 2021), and that were initiated by DFPS (not an SSCC). This clarification will be included in the October 2024 version of the T3C System Blueprint.
No, it won’t necessarily be an all-or-none decision. In fact, once DFPS completes the review of the entirety of the lowest acuity/rate Service Package and approves it as meeting all of the requirements, the rest of the process to issue the Inactive Interim Credential for that particular lowest acuity/rate Service Package will proceed simultaneously with the review for the subsequent Service Package(s) and Add-On Service(s) that are on the same application. And if for the subsequent Service Package(s) and Add-On Service(s) there is one or more that is approved, but others are denied for some reason, the Inactive Interim Credential would be issued for all of the subsequent ones approved together, while the provider could take the Service Packages that were denied and re-work the issues identified to subsequently re-submit a new application with just those Service Packages.
Yes.
Yes.
The initial Credentialing process is intended to look at the provider’s demonstration of how the Treatment Model and Logic Model serve as the basis of the provider’s program, and why they think it will work for the specific population that is served by that Service Package. The Annual Credential Reports and Re-Credentialing process will verify how the provider has utilized data collection and the CQI process to refine the Logic Model and if necessary, the Treatment Model, for the specific population that is served by each Service Package.
For an Interim Credential, the provider must have a “Full” Permit for the licensed operation they wish to be credentialed for, or if the operation only has an “Initial” Permit, the provider must hold a “Full” Permit for a similar licensed operation.
For the Full Credential the licensed operation applying for a Credential can have either an “Initial” or “Full” Permit.
There is no timeframe, as it depends on a number of factors, including size of the operation, the number of Service Packages being applied for, and how long you have been preparing.
There is no exact timeframe at this time, because it depends on a number of factors, and this is a brand-new process.
The Inactive Interim Credential is the 120-day maximum period when the Provider is hiring staff and completing parts of their Implementation Plan that must be ready by the time they move to the Active Interim. Under the Active Interim Credential, the provider has met all necessary requirements to operate specific to the approved Service Package(s) or Add-On Service(s), and contingent on contract amendment(s), may begin serving children under T3C, while still completing parts of their approved Implementation Plan in the up to 12 full calendar months after they are awarded the Active Interim, prior to obtaining their Full Credential.
CANS 3.0 Assessment
The SSCC or DFPS (in areas not yet under Community-Based Care) will be responsible for administering the CANS 3.0 Assessment.
The enhanced CANS 3.0 Assessment results will continue to be entered into eCANS by the CANS Assessor staff and will be accessible to medical and behavioral health providers through STAR Health, as well as residential provider staff with Health Passport access.
All children ages 3 years and older will receive an initial CANS 3.0 assessment within 30 days of removal, and annually thereafter. For children receiving therapeutic services, a CANS 3.0 assessment will be required every 90 days from the date of the initial CANS 3.0 assessment. A CANS 3.0 assessment will also be required at the time of a child’s placement change or at the request of the SSCC or DFPS (if still under legacy) caseworker.
No. When determining placement for a child under T3C, the process considers the following:
- The CANS 3.0 Assessment, which will provide a recommended Service Package;
- The child’s removal affidavit and current Application for Placement, which will provide more details on the child’s needs, history, and family functioning; and
- The knowledge and professional judgment of the SSCC or DFPS staff working to secure placement based on the individual child’s needs and best interest.
The CANS 3.0 Assessment will identify the Service Package recommendation based on the child’s most challenging primary need; if the CANS 3.0 Assessment results in a recommendation that does not match the initial Service Package selection for the child’s placement, then:
- First it needs to be determined whether the current residential provider is Credentialed for the recommended Service Package. If so, then the child will remain in the same placement, but the Service Package can be updated to match the recommendation.
- If the child’s current placement is not Credentialed to provide the recommended Service Package, then the DFPS or SSCC staff and the child’s various stakeholders need to determine whether remaining in the current placement is in the child’s best interest, or if a different placement should be sought to better meet the child’s needs.
If the child’s behaviors or emotional needs change, such that the child could potentially be better served by a different Service Package, the provider would want to communicate with the child’s SSCC or DFPS Caseworker so that a new CANS 3.0 assessment can be performed to determine if the change in Service Package is recommended. Based on the CANS results, the knowledge and professional judgement of the SSCC or DFPS staff, working with the child’s various stakeholders, based on the child’s individual needs and best interest would be the basis for the selection of the actual Service Package.
Yes.
The number of new DFPS and SSCC staff positions allocated to complete the CANS 3.0 for the children required to receive it at the frequency required was calculated based on historical and forecast data. While there may be challenges during the initial transition, such as getting children their first CANS 3.0 assessment and on the needed schedule, there is not an anticipated need for this role to move to providers.
The CANS Assessment would take into account the documentation in the child or youth’s current and historical case file, as well as interviews with other required individuals. While the CANS 3.0 Assessment recommended Service Package, and other supporting documentation will be used to inform the process, the knowledge and professional judgement of the SSCC or DFPS staff working to secure placement based on the individual child’s needs and best interest will be the basis for the selected Service Package and placement type.
There will be situations where the need for a placement is urgent or the child’s needs are such that there is no time to complete the CANS 3.0 Assessment, Pre-Placement visit, etc. The caseworker will still make a request for the CANS assessment for the child. In these circumstances the caseworker would select the initial recommended service package and would have the opportunity to update the packages after the CANS is completed.
The CANS captures the story of the child. It is not a tool used for discovery but rather a tool that organizes the information gleaned from the discovery process (aka assessment). Once the story of the child is captured at one point in time, an update will be needed as required under T3C to update that story as new information is learned; typically referred to as a re-assessment. With the CANS, the re-assessment is really updating the information that needs to be updated, not re-doing the entire CANS. The CANS re-assessment will not take up a lot of time - The information from the previous CANS should populate the ‘re-assessment’ CANS and then the assessor can update the items that need to be changed because there is new information. A change in any ratings will also require a brief rationale to be provided explaining any changes.
Yes, to ensure that the person administering the CANS 3.0 Assessment has access to the most current information on the case, administration of the CANS 3.0 Assessment will move from STAR Health to the child welfare system under the T3C System. A new type of staff, known as the CANS Assessor, will be a part of the placement team for each Single Source Continuum Contractor (SSCC) and DFPS (in areas that have not yet transitioned to CBC).
No, there will be situations where the need for a placement is urgent or the child’s needs are such that there is no time to complete the CANS 3.0 Assessment, as the CANS Assessors will still have 30 days to complete the initial CANS Assessment. The initial removal placement will be guided by other supporting documentation from the child's Case File to inform the process, the knowledge and professional judgement of the SSCC or DFPS staff working to secure placement based on the individual child’s needs, and best interest will be the basis for the selected Service Package and placement type.
While it would be helpful for these staff to engage in the training and certification process to enable precise interpretation and application of the CANS recommendations to service planning, that is not required at this time. In order to go through the training and certification please visit TCOM Training – Praed Foundation.
Yes.
The CANS 3.0 Assessment will be rolled out in January 2025.
Making the Transition
That’s correct. DFPS will no longer reimburse the SSCC or DFPS Residential Contractors in accordance with the Service Level System.
Providers should initiate the planning process now.
The T3C System Blueprint is not intended to replace or encompass all contractual terms and conditions, but it does lay out the framework and parameters that will be requirements when they are incorporated into the DFPS RCC Contract and the DFPS-SSCC Contracts.
No, providers may choose to adopt this model and train their staff and Caregivers on the Universal Training, or they may submit for review and approval, as a part of the Credentialing process, a different model and training that they intend to use to meet this requirement under T3C.
Yes. The provider’s Treatment Model can be one that they have developed independently or one that they have purchased, so long as it is Evidence-informed and meets the core elements identified throughout the T3C System Blueprint for each Service Package for which the provider becomes Credentialed. The T3C Treatment Model should be based on certain qualifying assumptions around the specific population (as defined by the Service Package and/or Add-On Service(s)) served and must be customized to treat and provide care based on these unique needs. All provider staff and Caregivers must be trained in and actively practice the organization’s Treatment Model.
Medicaid eligible services should be sought through STAR Health.
Residential providers are required to have an Information Technology (IT) System(s) that allows for data collection to support quality assurance, Continuous Quality Improvement, case management documentation, billing/invoicing, reporting, and child-level outcome tracking processes. The provider must have the ability to track placement referrals, admissions, and discharge data by child, youth, or young adult, broken out by referral source (whether SSCC or DFPS), by the number and percentage of referrals that did and did not result in admission, the reasons for denial of admissions based on referrals, and for children that were admitted, the average Length of Service, based on the time from admission to discharge.
During the transition, DFPS will maintain a centralized Credentialing system and CPAs, once Credentialed by DFPS for the provision of certain Service Packages, will then be able to utilize their approved policy to Credential each of their foster homes for one or more Service Packages, based on the individual foster home’s specialty or interests.
It is based on the total number of children, youth and young adults who the CPA serves in a certain Service Package(s) across all branches.
Yes.
In most cases, no, just an amendment to your current DFPS contract(s). The plan is for DFPS to amend DFPS contracts with Residential Contractors and SSCCs to incorporate the T3C System Blueprint, including the Service Package(s) and Add-On Service(s) requirements based on the type(s) of service(s) the individual provider is Credentialed to provide. However, Emergency Shelters contracted directly with DFPS that change their permitted services in order to provide a T3C Service Package may need to undergo a process of review where they will have a new contract number assigned and need to sign a correlated contract document.
The Permit process is managed by the HHSC-Child Care Regulation Division, so DFPS encourages providers to initiate the process by reaching out to their Licensing Representative to discuss the addition. HHSC-CCR estimates that the process takes an average of a month for review and approval.
Selection of the appropriate evidence-informed Treatment Model is a provider decision, and the Department does not intend to maintain a listing or directory of approved evidence-informed Treatment Models at this time.
Providers will have to become Credentialed before September 1, 2027.
If a provider chooses not to actively work towards implementation of T3C to become Credentialed before September 1, 2027, then DFPS and the SSCCs would make a determination as that deadline approaches on when they would discontinue placing children with that provider and move children to Credentialed providers.
DFPS is streamlining the Credentialing process by only requiring that a provider submit to the process through DFPS, as opposed to having multiple processes where providers would submit to both DFPS and the SSCCs, to support efficiency and consistency during transition. The interim credentialing process will allow eligible providers to begin providing services at T3C rates, while working towards becoming fully credentialed.
The GRO Service Package that most closely aligns with the services offered by Emergency Shelters in the current system is the Tier I: Emergency Emotional Support & Assessment Center Services, but the requirements of this Service Package are such that emergency shelters will likely have to make changes to their HHSC-CCR permits, and the staffing and services that they offer.
Supervised Independent Living operations (SILs) will continue to be part of the T3C Foster Care Continuum and full array of services for young adults age 18 and over, although SILs do not explicitly fit into the Foster Family Home and GRO Tier I and Tier II Service Packages. A Transitional Living Program is a Programmatic Service permitted by HHSC-CCR, which will be required for all GRO Tier I and Tier II Service Packages that accept children age 14 and older, as assurance that the operation has the skill, knowledge, and programming available, as a part of the all-inclusive Service Package to meet the needs of youth while they are in the provider’s care. Minimum Standards and the T3C Blueprint emphasize adjusting/adapting transitional living services based on the custom needs of the youth- which may vary based on age, development, length of stay, clinical needs, supervision needs, and where the individual youth is in regards to their own treatment. Current TLP providers, most of which maintain the TLP as part of their GRO, will need to identify an appropriate Service Package that complements the needs of the youth who their program focuses on, such as Tier I: T3C Basic Child Care Operation, and modify their policies and procedures accordingly.
As the Texas Foster Care System evolves into T3C, the need for services provided by YFT will also evolve. YFT’s DFPS contract has been amended to include utilization of their clinical assessment skills to assist the Department in reviewing aspects of the Credentialing process, such as integration of Treatment Models and Logic Models.
Refer to the Community Based Care Map to determine if you will be providing services in a SSCC catchment area, and if so, contact the SSCC for that area to inquire about what capacity is needed.
If you have specific questions on the Blueprint that are not addressed in the current FAQs, please reach out to our mailbox DFPSTexasChildCenteredCare@dfps.texas.gov. For additional training opportunities, please visit T3CReady.org, and you can reach out to the info@t3cready.org mailbox for questions about a Readiness Assessment that can help you to tailor implementation to your own program.
The 88th Legislature fully funded the foster care rates presented under the T3C rate methodology for the current biennium, and these rates will be available to pay to Credentialed providers under the T3C System in January 2025. Cost Reports specific to T3C will be used to inform adjustments to the rates as determined by the Texas Legislature through the appropriations process.
No, you just need to meet all of the requirements in the T3C System Blueprint for the Tier II Service Packages that you are applying to be Credentialed for.
All SSCCs will be required to utilize T3C Service Packages in some way. Each SSCC will have the ability to determine what service packages they wish to purchase from providers to meet the needs of their communities. DFPS will reimburse each SSCC in accordance with the same Methodological Rate Schedules found in the Blueprint during the transition. Under the T3C System, SSCCs will continue to have flexibility within the Community-Based Care model to pay Residential Child Care providers using a customized rate schedule, with a minimum pass-through requirement established in the SSCC contract. The evolution of monitoring under the T3C System is still in the initial planning stages, but updates will be available in future versions of the T3C System Blueprint.
Yes, the Cost Report will change from being Service Level-based to T3C-based, and the first Cost Report specifying the T3C breakdowns would be due in FY2026. The new Cost Report will be more complex as it will follow the elements/requirements listed for the Service Package(s). Those requirements align with the methodology used to calculate the rates, so it is safe to assume that the cost report will ask for costs associated with those elements.
DFPS will host Train-the-Trainer sessions that providers can send their intended training staff person to obtain training on the curriculum and facilitation in Fall, 2024. DFPS will also ensure that additional opportunities are available for training provider Trainers in the future.
It is the minimum daily amount that the CPA must pass through to the Foster Family. SSCCs will continue to have flexibility within the Community-Based Care model to negotiate and pay Residential Child Care providers using a customized rate schedule, however the Foster Family Home Pass Through Portion for the foster family is still a minimum pass-through requirement established in the SSCC contract.
How CQI will be incorporated into contract monitoring by DFPS or the SSCCs has not yet been developed. The vision behind having a CQI component incorporated into the Logic Model review is to ensure that there is a structure and predictable approach for review and improvement of the program. If an aspect of the Treatment Model is listed as an input or resource in the Logic Model, it should tie to an expected outcome. If after testing through experience, it is determined that it is not resulting in the intended outcome, then the model may need to be adjusted, either by looking at different data, adjusting the input, etc. While the format for how CQI of the Logic Model will be monitored has not been developed yet, the Department expects that there will be adjustments made to the Logic Model based on the review results and what is learned, so at least initially, the issue would be if the CQI process was not done at all, or if something that is noted as not reaching the intended outcome is not adjusted going forward.
Current Nonfinancial Contractors should review the requirements laid out in the Blueprint for the most applicable Service Package (T3C Basic Child Care Operation for GROs, T3C Basic Foster Family Home Support Services for CPAs), and identify any requirements that would be cost prohibitive for implementing within your program. When your operation submits the Credentialing Application (this would be necessary regardless of whether you apply under the Interim Credential or the Full Credential), your operation would identify those requirements that you are seeking to waive, specifying how your funding structure/requests for financial support for making the changes and inability to utilize DFPS reimbursement or the Transition Grants makes it cost prohibitive, and explaining how your program will ensure that the quality of care and services envisioned under T3C for children in DFPS custody placed in that Service Package with your operation would not be substantially dissimilar from that for children placed in that Service Package at an operation that does meet all of the T3C requirements. The DFPS Credential Division, in collaboration with CPS Program, Contracts, and Legal would consider the specifics of the waiver request, and determine whether a Credential Application can be approved on a case-by-case basis. If the Credential is awarded, it is possible that there may be specific monitoring at some point in the future, likely in connection with your operation’s eventual Re-Credentialing for the Service Package, to support your operation’s compliance with the overall intention of T3C and that the granting of the waiver hasn’t negatively impacted the services available to the children, but no concrete decisions have been made regarding that at this time.
Since the Service Package Expectations, including those requirements, are part of the rate methodology for all GRO Packages, regardless of the ages that the operation serves, staff would need to have the knowledge and training indicated, and the policies and procedures would still need to outline the approach, delivery, and documentation of experiential learning for if a child turns 14 while in placement. Also, nothing restricts the operation from providing modifications of those same kinds of services at an appropriate developmental and functional level for children under 14.
T3C will not be making any restrictions regarding when foster parents can be provided Intermittent Alternate Care, other than the CPA must offer 40 days of paid Intermittent Alternate Care and must follow Minimum Standards requirements.
It would be recommended that, at a minimum, the Provider decrease the Generally Appropriate Staff to Child Ratio based on Service Package, to accommodate the increased workload, and to have a method for the Case Manager to track time for cost reporting purposes.
The Provider would ensure that they have updated all policies and procedures and other documentation to reflect the changes made, and that changes made are included in the Provider’s T3C System Annual Credentialing Report and upon Re-Credentialing.
Potentially, depending on the number of children being served by that branch office and the Service Packages those children require given the differing qualifications for Treatment Directors over certain packages.
The Placement Process
Once a provider is Credentialed in one or more service packages, all of the children placed under the provider will need to receive a CANS 3.0 Assessment; CPAs will have an additional step of Credentialing all of their foster homes for any or all of the Service Packages that the CPA is Credentialed to provide, according to the CPA’s approved policy. If the child, youth, or young adult’s CANS 3.0 Assessment recommends a Service Package that is not offered in the current placement, the SSCC or DFPS permanency planning team and provider will work together to determine the appropriate Service Package.
Yes.
T3C envisions that most children coming into care will be placed in a foster home Credentialed for T3C Basic Foster Family Home Support Services or Short-Term Assessment Support Services, or if GRO services is the preference, then either T3C Basic Child Care Operation or Emergency Emotional Support & Assessment Center Services. However, if there are specific details of the child’s needs in the Application for Placement that indicate an apparent need for a particular Service Package, for example a Complex Medical Needs or Medically Fragile Support Services foster home or a Human Trafficking Victim/Survivor Treatment Services to Support Community Transition Service Package GRO, then the DFPS or SSCC staff can work with the Placement Team to identify an appropriate provider .
DFPS will reimburse the SSCC the methodological rate for the corresponding Service Package. The SSCC’s will continue to negotiate the terms and conditions of their contracts, including customized rates with their network providers.
Yes.
Based on the CANS results, the knowledge and professional judgement of the SSCC or DFPS staff and the child’s stakeholders, including the placement provider, based on the child’s individual needs and best interest, would be the basis for the selection of the Service Package. If the child remains in the same placement under a different Service Package, there will be an agreed start date that is communicated.
If a placement’s current Credentialing status for a service package changes and they are no longer offering a Service Package that has been selected for a child placed in their care, IMPACT will not be able to pay the rate associated with the Service Package after the expiration/discontinuation date. Providers will need to notify the child’s caseworker with sufficient time for the caseworker to make any needed decisions regarding which of the remaining Service Packages will best meet the child’s needs, or if moving to an alternate placement that offers the Service Package would be more appropriate. Child Placing Agencies should keep this in mind when developing their policies and procedures around Re-Credentialing their foster homes.
IT-Related Questions
IT Introduction to T3C for SSCCs:
IT Followup for SSCCs - User Stories:
For technical questions, you can email DFPSTexasChildCenteredCare@dfps.texas.gov.
Human Trafficking Training
At this time, a Spanish version of the training curriculum is not available.
This training is 90 minutes and is specific to the T3C Credentialing Process. Please discuss your contract requirement with your SSCC.
Yes, feel free to add additional resources/activities to the curriculum. You do not need approval.
Once you receive the completion certificate and training materials, you are welcome to implement the training.
You may embed videos into the presentation as long as you do not change the content of the training. If you modify any part of the training, you will need to seek DFPS approval.
As part of the T3C Credentialing process, a provider may use the DFPS Universal Human Trafficking Prevention Training or their own Human Trafficking training, if their training meets basic requirements for T3C Credentialing purposes.
This training should take 1.5 hours to deliver to staff and caregivers.
This training allows participants 1.5 hours of credit.
Yes, when you submit your Credentialing application, you will need to run your Human Trafficking training through the Credentialing review, following the process identified on the T3C Human Trafficking: Alternative Trainings webpage. This ensures that the training includes the same core components to constitute an equivalency of information as what is contained in the DFPS Universal Human Trafficking Prevention Training.
No.
This training can be delivered in-person or virtually.
No.
No, this curriculum is geared to training provider staff and caregivers, who then use the tools learned from training with the children and youth who they serve.
Implementation of the training can begin once you receive a completion certificate and link to the training materials.
Yes, if the foster parents would like to be credentialed in one or more T3C Service Packages.
No.
No, as detailed on the T3C Human Trafficking: Alternative Trainings webpage, the process and application used to submit an alternative training curriculum for review and approval includes a set of core components required to constitute an equivalency of information, and the current DFPS Human Trafficking Training in the DFPS Learning Hub does not meet all of the required core components.
For providers who will not be utilizing the DFPS Universal Human Trafficking Prevention Training – Train the Trainer Curriculum, for Service Packages that are not exclusive to children, youth, and young adults who are victims/survivors of Human Trafficking, additional information on the process required for obtaining approval of the Provider’s Curriculum as part of the Credentialing process has been released on the Human Trafficking: Alternative Trainings page of the T3C Public Webpage.