Implementation of the Intensive Services Foster Care Program

The California Department of Social Services (CDSS) has issued instructions regarding the implementation of the Intensive Treatment Foster Care (ISFC) program.

The ISFC program is intended to serve children who require intensive treatment and behavioral supports, as well as children with specialized health care needs (including those served under ITFC). The program is designed to ensure that foster youth receive the services they need in a home-based family care setting and that they do not remain or enter a short-term residential program or Group Home.

To achieve this, the ISFC program provides core services and supports, including arranging access to mental health treatment, providing trauma-informed care, and providing transitional support during placement in a permanent home. ISFC program participants who meet the eligibility criteria of other publicly funded programs including mental health, education, and health services will have these services arranged for them by the Foster Family Agency (FFA) or the county.

Children eligible to receive help from the ISFC program are children or nonminor dependents in foster care who require higher level of supervision, as is determined by the Level of Care (LOC) Rate Determination Protocol.

An ISFC resource family includes a licensed foster family home or a certified family home of a licensed Foster Family Agency. An ISFC resource parent is a committed member of the youth’s team who has the ability to meet the individual’s intensive care needs. Non-related legal guardians and Kinship Guardianship Assistance Payment (Kin-GAP) Facilities are not eligible for the ISFC program.

To deliver these services, the ISFC program may either use a licensed FFA or a county licensed to run a FFA, or they may be operated directly by the county as a government program.  In either case, the ISFC program includes Therapeutic Foster Care (TFC) for youth under the age of 21 who are Medi-Cal eligible and meet medical necessity criteria. Each of the involved parties have several responsibilities. FFAs and Counties operating an ISFC must identify and train IFSC foster parents, placement matching, providing core services, and coordination of the appropriate professional and para-professional staff.

TFC parents and caregivers are specially trained and work under the supervision of the TFC agency and in conjunction with the ISFC staff (unless the youth is on probation or child welfare).

ISFC resource parents must complete participate in the development of the child’s plan ensure the well-being of the child, and be in the Resource Family Approval (RFA) program. They must also complete 40 hours of training prior to placement covering topics such as trauma, behavior de-escalation techniques, and cardiopulmonary resuscitation, and is described in depth in ACIN I-28-18.

For child placement, if a child requires immediate placement based on criteria behavioral identifiers, the Social Worker/Probation Officers may make immediate placement at the ISFC level to ensure safety pending an LOC rate determination. If a child has experienced any of the criteria behavioral identifiers within the last twelve (12) months, the placing agency may pay the ISFC rate for up to sixty (60) days, which may be extended pending local county manager approval. This extension should only be granted in the event that an HBFC setting cannot be found.

An ISFC level placement may be made before pre-placement training is completed if certain criteria are met depending on circumstance and those involved.

The ISFC does not allow more than two children in foster care and/or one ISFC eligible child placed in each resource family home, except in sibling group placements where the total number of children in a single resource family home is five (5).

FFA’s that have transitioned or are interested in transitioning to an ISFC program must submit an amended FFA Program Statement Template that is updated to reflect the new ISFC requirements to the Foster Care Rates Bureau. New ISFC programs that were not ITFC providers will receive a rate approval and issued rate letter, as well as a program letter from FCRB with a date effective. Counties not operating as an FFA that intend to opt-in to ISFC public delivery of benefits must submit an ISFC Program Description to the department pending approval.  (ACL 18-25, March 13, 2018.)