This procedural guide provides information regarding the Intensive Services Foster Care (ISFC) mental health program. This policy describes the program, eligibility criteria, and the referral process.
Table of Contents
- Intensive Services Foster Care (ISFC)
- Youth Eligibility Criteria
- Referral Process
- Static Rate
- Referring a Child/Youth for ISFC
This is a new procedural guide for the Intensive Services Foster Care (ISFC) program for youth who have Serious Emotional and Behavioral Needs (SEBN) or Special Health Care Needs (SHCN).
Intensive Services Foster Care (ISFC)
ISFC is an intensive services program providing specialty mental health or medical health treatment that is delivered by a Foster Family Agency and in a specialized ISFC Resource Family home. ISFC is a program intended to be a short-term placement (approximately 12-18 month to complete the goals outlines in their Needs and Services Plan) intervention to stabilize youth placed in home settings by providing intensive supports, services and interventions. Each youth gets an ISFC team that work specifically to meet the youth’s needs, participates in Child and Family Team meetings and supports the caregiver. The FFA also provide 24/7 crisis intervention, an FFA Social Worker, and depending on the youth' needs, either a clinical and an In-Home Support Counselor, or a Registered Nurse. The caregivers are provide with additional training and are compensated at the highest foster care rate for Resource Parents. There are two types of ISFC homes: one that specialized in youth who have Serious Emotional and Behavioral Needs (SEBN) and one that specializes in youth who have Special Health Care Needs (SHCN). Emergency placements are not available through this program.
Youth Eligibility Criteria
ISFC for youth with Serious Emotional and Behavioral Needs (SEBN) is for children/youth ages 6-20, who within the last six months, have engaged in or experienced one or more of the following:
- adjudicated violent offenses
- aggressive and assaultive behavior
- animal cruelty
- Commercially Sexually Exploited Children (CSEC)
- eating disorders
- fire setting
- gang activity
- habitual truancy
- psychiatric hospitalizations
- running away from placement
- severe mental health issues
- substance abuse
- three or more placement disruptions due to behavior
- stepping down from a STRTP
- Level of Care (LOC) deems them eligible for ISFC
ISFC for youth with Special Health Care Needs (SHCN) is for children/youth ages 0-20, who have a condition that can rapidly deteriorate resulting in permanent injury or death or who have a medical condition that requires specialized in-home health care. Medical conditions requiring specialized in-home health care required dependency upon one or more of the following:
- enteral feeding tube
- total parenteral feeding
- cardiorespiratory monitor
- oxygen support
- urinary catheterization
- renal dialysis
- ministrations imposed by tracheostomy, colostomy, ileostomy, or other medical or surgical procedures or special medication regimens, including injection, and intravenous medication
SHCN youth are deemed eligible through the LOC determination for ISFC.
The referral process begins with a recommendation from the Child and Family Team (CFT). Before a referral is made to the ISFC program, the CFT must recommend ISFC as an option for treatment. ISFC is not a placement, it is an intensive mental health treatment program that is delivered in a specialized ISFC Resource Family home. ISFC homes are not available for emergency placements and it may take some time to locate and approve an ISFC home; therefore, finding a suitable home is not a guarantee. The age range for acceptance for SEBN youth is 6-20 years old; for SHCN youth it is 0-20 years old. Nonminor dependents (NMDs) must be willing to work with the ISFC team, attend therapy sessions, live in an ISFC home, and meet any other requirements for being a NMD.
The assigned CSW completes a referral packet via the Referral Portal on LA Kids and emails the required documents, as one attachment to the ISFC in-box. The ISFC Administrative team reviews the referral and submits a request for a LOC determination, if the youth has not already been determined ISFC eligible and if the caregiver is interested in becoming ISFC certified with a Foster Family Agency (FFA). The ISFC Administrative team will then help initiate the process with the caregiver, who is referred to as a Matched caregiver. Unmatched caregivers are only available for youth stepping down from a STRTP, Group Home, Hospital, or Transitional Shelter Care (TSC).
Documents required to refer a youth for ISFC:
Serious Emotional and Behavioral Needs (SEBN)
Special Health Care Needs (SHCN)
Youth Profile Sheet - generated through the Referral Portal
Youth Profile Sheet - generated through the Referral Portal
ITFC 174MH - generated from the Referral Portal
DCFS 149-149a - completed by the CSW
DCFS 179MH consent for mental health treatment
DCFS 1696 - completed by the county PHN
Release of Information
E-mail the referral packet with the above documents as one attachments to ISFC@DCFS.lacounty.gov
Once the referral is received by the ISFC Administrative team, the team will determine next steps depending on whether the youth is Matched with a home prior to the referral or is Unmatched and needs an ISFC home to be identified. Refer to the attachments "Procedures for Matching and Placing ISFC Youth" for detailed information.
Unmatched youth stepping down from a STRTP, Group Home, Hospital, or TSC will be presented if there is an opening for their age/gender. If there is no opening, the DCFS ISFC team will inform the CSW that there are no current openings.
If an ISFC placement is identified, the CSW will be invited to present the youth at the pre-match teleconference with the ISFC inter-agency team and the FFA. It is important that the CSW presents in an honest and open manner, sharing current and historical strength and challenges. If accepted, the CSW and FFA will work together to set a placement date. At that time, the DCFS ISFC team will provide a rate letter to the CSW.
Matched youth are already in a home and the caregiver is already or will become an ISFC provider. The youth cannot be placed as an ISFC placement until the caregiver completes the certification process, the youth meets LOC eligibility, and is presented and approved at the pre-placement teleconference. The ISFC team will submit for the LOC deternimation after the referral packet is received. Matched youth who have had a hospitalization or have stepped down from a STRTP, Group HOme, or TSC within the last six months automatically qualify for ISFC and do not require a LOC. When the caregiver has completed ISFC certification, the referral packet has been received, and LOC (when applicable) deems the youth eligible for ISFC, a pre-placement teleconference is held with the FFA to finalize and approve the placement and the rate letter is issued to the CSW and the FFA.
PortabilityPortability gives any Resource Family the option to move their approval from a County REFA status or Non-ISFC FFA to an ISFC FFA or vice versa. When a caregiver has a youth placed in their home who is being assessed for LOC for ISFC, and the caregiver wants to become an ISFC provider, then the DCFS ISFC team can guide and assist the caregiver in becoming an ISFC provider for the youth in their care. The caregiver would have to agree to work under an ISFC FFA, meets the ISFC requirements and attend the required classes in order to port over. Assigned Children's Social Worker can completed a referral for a matched youth via the Referral Portal to initiate the process.
The Static Rate is the same amount as the ISFC rate, but is a temporary rate for the caregiver that only lasts for 60 days. The static rate can be extended for an additional 60-days if criteria still exists and the caregiver is working towards the ISFC certification. For ISFC, this rate can sometimes be provided for emergency placements of youth who have not had an LOC determination, but appear to meet the criteria for ISFC, and if the caregiver is working towards being ISFC certified. Each case is reviewed by the ISFC Administrative team for eligibility and provides the rate letter to the CSW, if appropriate.
Referring a Child/Youth for ISFC
Case-Carrying CSW Responsibilities
- Hold a Child and Team (CFT) meeting. The CFT must recommend ISFC as an option for treatment.
- If the youth is unmatched (i.e. seeking a lower level of care and the current placement is a STRTP, Group Home, Transitional Shelter Care, or hospital):
- Attach the required documents as a single attachment and send an email to ISFC@DCFS.lacounty.gov
- CSW will be contacted to present the youth's case via teleconference if there is an opening for a youth, their age/gender. If there is no opening, the request will be rejected and the CSW will be advised to resubmit the referral to determine if there is availability.
- If the youth meets ISFC criteria and their caregiver is interested in being trained and certified as an ISFC parent, obtain the following:
- A Child Profile Sheet generated by using the Referral Portal;
- An ISFC 174MH referral using the Referral Portal;
- A signed DCFS 179MH and Release of Information;
- The name, address, and phone number of the caregiver.
- Send this information via email to ISFC@dcfs.lacounty.gov. ISFC will reach out to the caregiver to explain the details and confirm their interest. ISFC will then submit the youth to the LOC determination section to confirm they meet ISFC criteria.
- If LOC ISFC criteria are meet, inform the caregiver that they will connected to an ISFC contracted Foster Family Agency (FFA) for training and certification.
ISFC Program Staff Responsibilities
- Monitor the ISFC In-box for Unmatched Referrals. Upon receipt of a referral:
- Check CWS/CMS to determine the youth's current placement.
- If the youth is currently in a STRTP, TSC, Group Home, or hospitalized and is the age and gender for which an agency has an opening, schedule a Pre-Match teleconference with that agency.
- If there are no openings for the youth's age/gender, inform the CSW, advise them to resubmit a referral in the future.
- If the youth is not currently in a STRTP, TSC, Group Home, or hospitalized, and of an age and gender for which no agency has an opening, inform the CSW that the referral cannot be accepted without LOC ISFC determination and the LOC unit not accepting unmatched referrals at this time.
- Save the youth's name to All Referral file on the BCRSD shared drive.
- Monitor the ISFC In-box for Matched Referrals
- Ask the caregiver(s) if they are interested in becoming an ISFC provider.
- If so, inform them that they will be connected with the agency of their choice or one close to their location once LOC ISFC determination for the youth is received.
- Refer the matched youth to the LOC section.
- Upon receipt of LOC ISFC determination, connect the caregiver to the agency.
- Update all information on the weekly log on the BCRSD shared drive.
- Pre-Match Teleconference for Unmatched Referrals
- Prior to the teleconference, send an email to all agencies with the ISFC Resource Family Snapshot Form and ISFC Risk & Compatibility Assessment form requesting the youth's case.
- If there are any Pre-Match referrals, inform DMH, the CSW, and agencies with openings of the date and time of the Pre-Match teleconference and schedule the CSW to present the youth's case.
- If the CSW is unavailable, prepare a presentation using information in the referral packet.
- Forward the referral and a redacted (removed criminal history) Detention, Jurisdiction/Disposition, or Status Review court report to DMH prior to the Pre-Match teleconference.
- After the Pre-Match teleconference, forward the referral and redacted court report to the identified agency.
- Fill in the Pre-Match Teleconference Data Spreadsheet and Weekly Log (on BCRSD Shared Drive) with results of the call.
- Pre-Placement Teleconference for Matched Referrals
- Remind agencies that the ISFC Resource Family Snapshot Form and the ISFC Risk & Compatibility Assessment form are due for matched youth. Inform them that the ISFC Risk & Assessment form is not needed, if there are no DCFS youth in the home.
- Upon receipt of the ISFC Resource Family Snapshot Form and the ISFC Risk & Compatibility Assessment form, schedule the teleconference.
- Invite DCFS ISFC Administrative staff, DMH, and the placement agency only to the teleconference and remind participants of the following:
- Conversation will be focused on the quality of the match and treatment and safety plans;
- Calls take anywhere from 20-45 minutes depending upon the complexity of the child's needs and home;
- Calls are scheduled only on Wednesdays and are prioritized based on need.
- Forward the referral packet, the ISFC Resource Family Snapshot Form and the ISFC Risk & Compatibility Assessment form (if needed) and the most recent redacted court report to the DCFS ISFC Program Manager, DMH ISFC Program Manager, DCFS case-carrying CSW, and the placing agency.
- Following the approval of the placement, verify the placement date with the ISFC FFA and generate and send the ISFC Rate Letter to the CSW, SCSW, and FFA ISFC Manager, and a copy to DMH.
- Update the Weekly Log in the BCRSD Shared Drive with the results of the call. Maintain records of the youth placed, homes they are placed in, and the dates of entry, graduation, or dis-enrollment.
- Add the youth's name to the Master Youth Log in the BCRSD Shared Drive.
- Weekly Teleconferences with the Division Chief, Assistant Division Chief, and Program Manager
- Send the finalized Weekly Log to the Program Manager on Friday afternoons. The Program Manager forwards the Weekly Logs to the Division Chief and Assistant Division Chief.
- Participate in a weekly teleconference with the Division Chief, Assistant Division Chief, and Program Manager on Wednesday mornings at 8:30am. During the call, record any updates to relevant logs and ensure the participants conduct reviews for issuing Static Rate letters.
- Track LOC ISFC status requests and approvals/denials
- Email LOC unit for updates, if needed. When LOC is confirmed, email the agency and CSW, to let them know. If the youth qualifies for LOC, schedule a Pre-Placement teleconference with the FFA and DMH.
- Keep records of the porting process for those matched homes that meet LOC ISFC criteria and for which the caregiver is in training to be certified.
- Participate in and follow up on Hospital Discharge Teleconferences to determine if the youth is returning to their pre-hospitalization caregiver and if the caregiver wants to be ISFC certified.
- Answer questions and troubleshoot with providers, CSWs and SCSWs.
- If contract compliance is an issue, determine if a Corrective Action Plan is necessary and follow up with the provider until it is completed.
- Track and maintain monthly statistical data, including entries and exits of youth from ISFC homes and Resource Parents.
- Distribute information to ISFC FFAs regarding training for staff and Resource Parents and youth events and programs (i.e. Glamour Gowns, Christmas events, summer camp sign-in, TILP, SILP, etc.)
- Review all Special Incident Reports (SIR) for youth in ISFC for appropriate responses by ISFC FFAs; forward to DMH any needing review and response regarding mental health treatment; contact ISFC FFA for any concerns noted in the SIR.
- Attend ISFC FFA audit result meetings.
- Medical ISFC placement monitoring, recruitment, teleconferences, tracking and logging.
DCFS 179MH, Parental Consent for Child's Assessment & Participation in Mental Health and/or Regional Center Developmental Services
Referenced Policy Guides
0080-506.10, Identifying and Arranging Services for Families
0100-510.10, Placement Capacity
0600-515.11, Psychiatric Residential Placement through the Interagency Placement Screening Committee
0900-511.10, Rates for Placement and Related Services
All County Letter (ACL) 18-25 – Implementation of the Intensive Services Foster Care (ISFC)
ACL 18-32 – Instructions for Entry of the Level of Care (LOC) and Intensive Services for Foster Care (ISFC) Rates into Child Welfare Services/Case Management System (CWS/CMS)
ACL 18-145 – Sharing Ratios for Foster Family Agencies, Intensive Services Foster Care, Short-Term Residential Therapeutic Programs, Community Treatment Facilities, Group Homes and Transitional Housing Placement Plus Foster Care Programs for Fiscal Year 201-19
Welfare and Institutions Code (WIC) Section 16519.5 – Defines an ISFC resource family as a resource family, which includes a licensed Foster Family Agency (FFA). Non-related legal guardians and Kinship Guardianship Assistance Payment families are not eligible to become ISFC resource parents.
WIC Section 17731(c) – States that the counties must develop a plan to place children with special health care needs.
WIC Section 18360 – Implementation of Intensive Services Foster Care (ISFC)