Treatment Foster Care: Family-Based Care for Children with Severe Needs

Treatment foster care (TFC; sometimes known as therapeutic foster care) is a family-based placement option for children with serious emotional, behavioral, or medical needs who can be served in the community with intensive support. Key elements of TFC include highly skilled caregivers who are part of the child’s treatment team and who receive supervision and support from program staff; enhanced case management; and coordinated delivery of behavioral and other community-based services. Typically TFC homes serve only one or two children at a time.

This study includes a qualitative component that describes the range of ways TFC is administered, utilized, and financed in states. A final report from that portion of the study is available at a link below. That report describes how TFC is implemented and supported by states. It provides an overview of the key program elements of TFC defined by states and how states differentiate TFC from traditional 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. Interviews with state officials and key stakeholders revealed that there is significant variation among state TFC programs. State profiles in the report’s appendix highlight similarities and differences in the ways 6 states with robust TFC services have organized their programs. The states profiled include Connecticut, Illinois, New York, North Carolina, North Dakota, and Tennessee. Topics explored in the profiles include program models, licensure and training requirements, strategies used to recruit foster homes, criteria for placing children in TFC, access to behavioral health services, financing, and monitoring/quality assurance.

Previously Available Brief:

Still to Come:

A quantitative component to the study is still underway and will be using administrative data from 3 states’ foster care and Medicaid programs to describe how children flow through TFC programs and will identify the types and quantity of behavioral health services they receive, as compared with children in traditional foster care and congregate care placements. Results from the quantitative portion of the study will be available late in 2018.