Wyo. Code R. 049-0029-6
Providers of Substitute Care Services, Certification of
Chapter 6: Therapeutic Foster Care Programs
Effective Date: 11/08/2017 to Current
Rule Type: Current Rules & Regulations
Reference Number: 049.0029.6.11082017
(a) All Therapeutic Foster Care (TFC) programs must comply with all sections of this Chapter and the following Chapters and Sections:
(i) Chapter 1: All
(ii) Chapter 2: All
(iii) Chapter 3: Sections 1 through 18, Sections 20 through 28, and 30 through 32.
(a) TFC is a family-based, intensive treatment foster care program for severely emotionally disturbed (SED) youth. Programs are operated by any entity that arranges for the placement or temporary care, maintenance, and supervision of children in a place other than the home of their parents or relatives.
(b) A TFC must be a legal entity eligible to bill Medicaid.
(c) A TFC recruits, trains, approves and provides oversight for its own TFC foster homes.
(a) A TFC home shall not house more than five (5) children, including the TFC foster parents' own children, with no more than two (2) foster children in their care at one (1) time.
(b) No more than two (2) infants under two (2) years of age shall be placed in one (1) TFC home, including the TFC foster parent's own children.
(c) The above guidelines shall be observed at all times, including during the provision of respite.
(d) Exceptions (e.g., maintenance of family groupings) shall be approved on a case-by-case basis by the Administrator/Executive Director or designee and certifying authority.
(a) A TFC program shall have, at a minimum, an Administrator/Executive Director, and sufficient staff to provide for all components of the ITPC, as described in Chapter 3, Section 30, to include licensed, provisionally licensed and/or certified mental health professionals (on staff or by contract) to direct the ITPC.
(b) Direct care shall be provided by TFC foster parents.
(a) TFC staff shall complete a twenty (20)-hour orientation program and twenty (20) hours of annual training.
(b) TFC foster parents shall complete a twenty (20)-hour orientation program before they work directly with children in care and twenty (20) hours of annual training.
(a) In order to qualify for placement in a TFC program, a child must have a Diagnostic and Statistical Manual (DSM) diagnosis and meet qualifications for Serious Emotional Disturbance (SED).
(b) The following are required within 14 days of admission to a TFC program:
(v) Developmental history and current developmental functioning with respect to physical, psychological and social areas, including age appropriate adaptive functioning and social problem-solving;
(vi) Psycho-educational assessment;
(vii) An assessment of the need for psychological testing, neurological evaluation and speech, hearing and language evaluations; and
(viii) A problem list, related to the reasons why the child was admitted to this level of care.
(a) The TFC program shall develop, adopt, follow and maintain on file written policies and procedures to recruit and approve TFC foster parents capable of providing quality services, while ensuring reasonable and adequate safeguards to children and their families.
(b) TFC foster parents shall be twenty-one (21) years of age or older.
(a) All TFC programs shall complete and keep on file prior to approving a TFC foster home:
(i) Background checks on the prospective TFC foster parent(s) and any other adults residing in the home as set forth in Chapter 3, Section 10.
(ii) References. Five (5) positive references shall be obtained for each prospective TFC foster parent:
(A) Three (3) non-relative references from persons who have known the applicant for at least two (2) years, and have a general knowledge about the applicant’s ability to care for children; and
(B) Two (2) references (e.g., parents, siblings) to assess family relationships and support the appropriateness of the applicant to provide foster care.
(iii) Physician or other licensed medical professional statement verifying prospective TFC foster parent(s) is physically, cognitively, and emotionally capable of providing care for the children;
(iv) TB testing as set forth in Chapter 3, Section 12.
(v) Three (3) or more interviews with the prospective TFC foster parent(s).
(A) Interview each prospective TFC foster parent and household member separately;
(B) Provide sufficient information to acquaint the family with the TFC program and its philosophies and practices; and
(C) Two (2) of the three (3) interviews shall be conducted at the family home, with all family members present for one (1) of the in home interviews.
(b) Health and Safety Inspection. The TFC program shall develop procedures to inspect and monitor every foster home to ensure a safe and healthy environment for children and shall perform a safety and health inspection of the home (addressing all items in Section 9 of this chapter).
(c) Written Home Study.
(i) The written home study shall include documentation of all interviews and information gathered during home study process and shall also include:
(A) Date of interviews and home visits;
(B) Identifying information about all household members including relationship in the family;
(C) Physical and mental health assessment;
(D) Substance use history of family living in the home; and
(E) Motivation for becoming a TFC foster family;
(F) Social history and current functioning;
(G) Family of origin, composition, birth order, parents' marriages, separations, other children of prior relationships;
(H) Parenting;
(I) Family relationships;
(J) Employment and finances; and
(K) Recommendation of approval or disapproval and basis for recommendation.
(a) The TFC program shall develop procedures for the maintenance of a safe, hygienic, and sanitary environment and monitor adherence to procedures in order to protect the health, safety and welfare of the residents.
(b) The TFC program shall conduct and document in the TFC foster home file an annual health and safety inspection of the TFC foster home to ensure that the home meets the health and safety requirements in Chapter 3, Section 18 and 20, as well as:
(i) All forms of tobacco and alcohol shall be stored out of reach of children in a locked or inaccessible area; and (ii) TFC foster parents shall not engage in the excessive use of alcohol at any time they are in the presence of a foster children and will not operate a motor vehicle while transporting a foster children if any alcohol has been consumed.
(a) Approval/disapproval of TFC foster homes is the responsibility of the TFC program.
(b) No TFC foster parent shall be approved to provide care prior to completing the required orientation training.
(c) TFC foster homes shall be certified to provide care for a specific number of children, based upon the ability of the TFC foster parents and the size of the TFC foster home, not to exceed two (2) placements and for a period not to exceed two (2) years. A copy of the certificate with the expiration date of the certification must be sent to the regional DFS foster care coordinator with documentation that the background checks have been completed for all of the TFC foster parents.
(d) TFC foster homes shall be reviewed on an annual basis (including an update of the original home study) and an in-home inspection must be completed and documented in the TFC foster home file.
(a) In addition to the requirements listed in Chapter 3, Section 26, the following requirements shall be met:
(i) No child shall be required to participate in uncompensated work assignments unless the work is related to housekeeping, maintenance of the TFC foster home or grounds, personal hygienic needs, or the work is part of an approved vocational or training program.
(ii) Foster children may be given permission to baby-sit with the approval of the Administrator/Executive Director or designee and the child's DFS caseworker and shall receive compensation based on current 'market value' paid for babysitting.
(iii) Neither work experience or the length of time spent on non-paid chores shall interfere with a child's time for school, study periods, play, sleep, community contacts or visits with family, and shall be designed to serve the child's interest.
(iv) The TFC foster family shall comply with applicable child labor laws.
(v) Children shall be provided proper supervision when working with or in proximity to power-driven machinery.
(a) Develop comprehensive case management to support the child, the parents and/or legal guardian, and the TFC foster parents.
(b) Maintain and document ongoing communication with the TFC foster family by visiting in the TFC foster home at least one (1) time each week unless indicated more often based on the circumstances of the case and at least one (1) home visit each month shall occur when the child is present.
(c) In addition to home visits, each child shall be seen alone once each month.
(d) Provide outpatient treatment services consistent with an intensive approach to severe emotional disturbances. Specifically:
(i) Individual mental health and/or substance abuse treatment for the child, as needed; and
(ii) Family therapy as required by the ITPC and discharge plan.
(e) Provide or arrange for appropriate consultation and treatment by a psychiatrist if indicated by the assessment.
(f) Put in place a mechanism for the monitoring of service delivery which shall be accomplished at least every thirty (30) days or more as needed and shall meet the following criteria:
(i) Include a random selection of case files with a minimum of five (5) case files; and
(ii) Documentation shall include input from the child and the foster parents.
(a) Respite is defined as a planned period of relief from direct care.
(b) Respite providers shall meet one (1) of the following criteria:
(i) Be an approved TFC foster home; or
(ii) Be approved by the TFC Administrator/Executive Director or designee. Approval of a home, at a minimum, includes a completed application, two (2)
or more positive references, home inspection, approved by DFS if the child is in DFS custody and a background check (pursuant to Chapter 3, Section 10).
(c) The respite provider shall be provided with information on how to obtain medical care for the children, instruction on addressing the needs of the children, contact information for the children’s regular caregivers, caseworker, parents, counselors, and other emergency information.