Intensive Services Foster Care (ISFC) programs are designed to provide a higher level of support and care for children and youth with significant mental health, emotional, or medical needs within a foster care setting. This guide offers a detailed overview of the ISFC program, outlining its purpose, eligibility criteria, and the referral process. Understanding ISFC is crucial for case workers, foster care agencies, and caregivers involved in supporting vulnerable youth. This program serves as a short-term intervention aimed at stabilizing young individuals by delivering intensive services and supports within a nurturing home environment.
What is Intensive Services Foster Care (ISFC)?
Intensive Services Foster Care (ISFC) is a specialized program that delivers focused mental health or medical treatment through Foster Family Agencies (FFAs) and within specially trained ISFC Resource Family homes. It’s structured as a short-term intervention, typically lasting between 12 to 18 months, with the goal of achieving stability for youth in home-based placements. This is accomplished by addressing the goals defined in their individual Needs and Services Plan. Each young person in ISFC benefits from a dedicated ISFC team, which is integral to Child and Family Team (CFT) meetings and provides essential support to the foster caregiver. Furthermore, FFAs ensure 24/7 crisis intervention services and assign a dedicated Social Worker. Depending on the specific needs of the youth, a clinical professional and an In-Home Support Counselor, or a Registered Nurse, will also be part of the support system. Caregivers in ISFC programs receive enhanced training and are provided with the highest foster care compensation rates, recognizing the intensive nature of the care they provide.
There are two primary types of ISFC homes, each specializing in different needs:
- Serious Emotional and Behavioral Needs (SEBN): These homes are equipped to support youth facing significant emotional and behavioral challenges.
- Special Health Care Needs (SHCN): These homes specialize in caring for youth with complex medical conditions.
It’s important to note that ISFC programs are not designed for emergency placements.
Eligibility Criteria for ISFC
Eligibility for the Intensive Services Foster Care (ISFC) program varies depending on whether the youth has Serious Emotional and Behavioral Needs (SEBN) or Special Health Care Needs (SHCN).
ISFC for Serious Emotional and Behavioral Needs (SEBN)
To be eligible for ISFC under the SEBN category, children and youth must be between the ages of 6 and 20 and must have demonstrated one or more of the following within the last six months:
- Adjudicated violent offenses
- Aggressive and assaultive behavior
- Animal cruelty
- Involvement in Commercially Sexually Exploited Children (CSEC) situations
- Eating disorders
- Fire setting
- Gang activity
- Habitual truancy
- Psychiatric hospitalizations
- Running away from placement
- Severe mental health issues
- Substance abuse
- Experiencing three or more placement disruptions due to behavioral issues
- Stepping down from a Short-Term Residential Therapeutic Program (STRTP)
- Meeting Level of Care (LOC) eligibility criteria for ISFC
ISFC for Special Health Care Needs (SHCN)
ISFC for youth with Special Health Care Needs (SHCN) is available for children and youth from birth to age 20 who have medical conditions that are either:
- Likely to rapidly deteriorate, potentially leading to permanent injury or death.
- Require specialized in-home health care due to dependency on one or more of the following:
- Enteral feeding tube
- Total parenteral feeding
- Cardiorespiratory monitor
- Ventilator
- Oxygen support
- Urinary catheterization
- Renal dialysis
- Need for specialized medical procedures or medication regimens, including injections and intravenous medications, related to tracheostomy, colostomy, ileostomy, or other medical or surgical procedures.
Eligibility for SHCN youth is determined through a Level of Care (LOC) assessment specifically for ISFC.
ISFC Referral Process: How to Make a Referral
The referral process for the Intensive Services Foster Care (ISFC) program starts with a recommendation from the Child and Family Team (CFT). It’s essential to understand that ISFC is not simply a placement; it’s an intensive mental health treatment program implemented within a specialized ISFC Resource Family home. Since ISFC homes are not for emergency situations and finding a suitable home can take time, placement is not guaranteed upon referral. The age range for SEBN youth is 6-20 years, and for SHCN youth, it’s 0-20 years. Non-Minor Dependents (NMDs) must consent to participate fully with the ISFC team, including attending therapy sessions and residing in an ISFC home, along with meeting all other NMD requirements.
Alt text: A diverse team of professionals and family members collaboratively discuss a child’s care plan during a Child and Family Team (CFT) meeting, a crucial step in the ISFC referral process.
The process involves the assigned Children’s Social Worker (CSW) completing a referral packet through the Referral Portal on LA Kids and emailing the required documents as a single attachment to the designated ISFC inbox. The ISFC Administrative team then reviews the referral. If the youth hasn’t already been assessed for ISFC eligibility, they will request a Level of Care (LOC) determination, especially if the current caregiver is interested in becoming ISFC certified through a Foster Family Agency (FFA). The ISFC Administrative team will then assist in initiating the certification process for caregivers, known as Matched caregivers. Unmatched caregivers are considered only for youth transitioning from higher levels of care such as STRTPs, Group Homes, Hospitals, or Transitional Shelter Care (TSC).
Required Documents for ISFC Referral
The required documents for referral differ slightly based on whether the youth has SEBN or SHCN:
| Serious Emotional and Behavioral Needs (SEBN) | Special Health Care Needs (SHCN) |
|---|---|
| Youth Profile Sheet – Generated via Referral Portal | Youth Profile Sheet – Generated via 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 Public Health Nurse (PHN) |
| Release of Information |
Completed referral packets, including all listed documents as a single attachment, should be emailed to [email protected].
Upon receipt, the ISFC Administrative team will outline the next steps, which depend on whether the youth is already Matched with a potential ISFC home or Unmatched and requires home identification. Detailed procedures are available in the “Procedures for Matching and Placing ISFC Youth” document.
Procedures for Unmatched Youth
For unmatched youth who are stepping down from a STRTP, Group Home, Hospital, or TSC, their case will be presented if there is an available ISFC placement that matches their age and gender. If no suitable opening exists, the DCFS ISFC team will notify the CSW about the lack of current openings.
If an ISFC placement is identified, the CSW will be invited to present the youth’s case at a pre-match teleconference involving the ISFC inter-agency team and the FFA. During this presentation, it is crucial for the CSW to provide an honest and comprehensive overview of the youth, including both strengths and challenges, both current and historical. If the youth is accepted into the program, the CSW and FFA will collaborate to arrange a placement date. At this stage, the DCFS ISFC team will provide a rate letter to the CSW, detailing the financial aspects of the placement.
Procedures for Matched Youth
Matched youth are those already living with a caregiver who is either already an ISFC provider or in the process of becoming one. However, formal ISFC placement cannot occur until the caregiver completes the ISFC certification process, the youth meets LOC eligibility criteria, and the case is presented and approved at a pre-placement teleconference. For matched youth, the ISFC team will initiate the LOC determination process after receiving the complete referral packet. Notably, matched youth who have recently experienced hospitalization or stepped down from a STRTP, Group Home, or TSC within the last six months automatically qualify for ISFC and do not require a separate LOC determination. Once the caregiver is ISFC certified, the referral packet is complete, and LOC criteria are met (if applicable), a pre-placement teleconference is scheduled with the FFA to finalize and approve the placement. Following approval, the rate letter is issued to the CSW and the FFA, officially confirming the ISFC placement and associated rate.
Portability within ISFC Programs
Portability within the Intensive Services Foster Care (ISFC) program offers Resource Families flexibility in transitioning their approval status. It allows caregivers to move their approval from a County REFA status or a Non-ISFC FFA to an ISFC FFA, or vice versa, without disrupting the care of a child already placed in their home. If a caregiver is currently caring for a youth who is being evaluated for ISFC Level of Care, and the caregiver wishes to become an ISFC provider to better meet the youth’s needs, the DCFS ISFC team can provide guidance and support throughout the process. To port over to ISFC, the caregiver must agree to affiliate with an ISFC FFA, meet all ISFC requirements, and complete the necessary training. The assigned Children’s Social Worker can initiate this process by submitting a referral for a matched youth through the Referral Portal, signaling the start of the portability transition. This ensures continuity of care while enhancing the support system available to the youth.
Understanding the Static Rate in ISFC
The Static Rate in the Intensive Services Foster Care (ISFC) program is a temporary financial provision designed to support caregivers during the initial stages of ISFC placement. It is equivalent to the ISFC rate but is granted on a short-term basis, typically for 60 days. This static rate can be extended for an additional 60 days if specific criteria are still met and the caregiver is actively working towards full ISFC certification.
In the context of ISFC, the static rate may be particularly relevant for emergency placements involving youth who appear to meet ISFC criteria but have not yet undergone a formal Level of Care (LOC) determination. It can also apply when a caregiver is in the process of becoming ISFC certified. Each case requiring a static rate is individually reviewed by the ISFC Administrative team to assess eligibility. If approved, the team issues a rate letter to the CSW, outlining the terms and duration of the static rate. This provision ensures that caregivers are adequately compensated while they navigate the initial complexities of ISFC placement and certification, providing financial stability during this transitional period.
ISFC Procedure: Step-by-Step Guide
This section outlines the procedural steps for referring a child or youth to the Intensive Services Foster Care (ISFC) program, detailing the responsibilities of both the Case-Carrying Children’s Social Worker (CSW) and the ISFC Program Staff.
Case-Carrying CSW Responsibilities
- Conduct a Child and Family Team (CFT) Meeting: The initial step is to convene a CFT meeting. It is imperative that the CFT recommends ISFC as a viable treatment option for the child or youth.
- For Unmatched Youth (Seeking Lower Level of Care): This applies when the youth is transitioning from a higher level of care setting such as a STRTP, Group Home, Transitional Shelter Care, or hospital.
- Prepare and Submit Referral Documents: Compile all required documents into a single attachment and email them to [email protected].
- Youth Case Presentation (If Opening Available): If there is an ISFC placement opening suitable for the youth’s age and gender, the CSW will be contacted to present the youth’s case via teleconference. If no opening is available, the referral request will be declined, and the CSW will be advised to resubmit the referral later to check for updated availability.
- For Youth Meeting ISFC Criteria with Interested Caregiver: If the youth meets ISFC criteria and their current caregiver is willing to undergo ISFC parent training and certification, the CSW must obtain the following:
- A Child Profile Sheet, which is generated through the Referral Portal.
- An ISFC 174MH referral form, also generated using the Referral Portal.
- A signed DCFS 179MH form (Consent for Mental Health Treatment) and a Release of Information form.
- The caregiver’s name, address, and phone number.
- Submit Caregiver Information to ISFC: Send the collected information via email to [email protected]. The ISFC team will then contact the caregiver to provide program details and confirm their interest in participation. Following this, ISFC will submit the youth’s case to the Level of Care (LOC) determination unit to verify ISFC criteria are met.
- Inform Caregiver of LOC ISFC Status: Once LOC ISFC criteria are confirmed, inform the caregiver that they will be connected with an ISFC contracted Foster Family Agency (FFA) for the necessary training and certification process.
ISFC Program Staff Responsibilities
- Monitor Unmatched Referrals Inbox: Regularly check the ISFC inbox for new referrals of unmatched youth. Upon receiving a referral:
- Verify Current Placement: Check CWS/CMS to determine the youth’s current placement setting.
- Schedule Pre-Match Teleconference (If Applicable): If the youth is in a STRTP, TSC, Group Home, or hospital and matches the age and gender for which an agency has an opening, schedule a Pre-Match teleconference with the relevant agency.
- Notify CSW of No Openings: If there are no current openings suitable for the youth’s age/gender, inform the CSW and advise them to resubmit the referral in the future to check for availability changes.
- Handle Referrals from Other Settings: For youth not in STRTPs, TSCs, Group Homes, or hospitals, and if no agency openings are available, inform the CSW that the referral cannot be accepted without a LOC ISFC determination. Also, inform them that the LOC unit is not currently accepting unmatched referrals at this time.
- Maintain Referral Records: Save the youth’s name to the All Referral file on the BCRSD shared drive for tracking purposes.
- Monitor Matched Referrals Inbox: Regularly check the ISFC inbox for new referrals of matched youth.
- Contact Caregiver Regarding ISFC Interest: Inquire with the caregiver(s) about their interest in becoming an ISFC provider.
- Connect Caregiver to FFA (Upon LOC Approval): If the caregiver is interested, inform them that they will be connected with their preferred FFA or one geographically convenient, once LOC ISFC determination for the youth is received.
- Refer to LOC Section: Submit the matched youth’s case to the LOC section for determination.
- Agency Connection and Updates: Upon receiving LOC ISFC determination, connect the caregiver with the chosen agency. Update all relevant information in the weekly log on the BCRSD shared drive.
- Pre-Match Teleconference for Unmatched Referrals:
- Request Agency Input: Prior to the teleconference, email all agencies with the ISFC Resource Family Snapshot Form and ISFC Risk & Compatibility Assessment form to solicit interest in the youth’s case.
- Schedule and Notify Participants: If there are Pre-Match referrals, inform DMH, the CSW, and agencies with openings about the date and time of the Pre-Match teleconference and schedule the CSW to present the youth’s case.
- Prepare Presentation (If CSW Unavailable): If the CSW cannot attend, prepare a case presentation using the information from the referral packet.
- Share Referral Information: Forward the referral and a redacted (criminal history removed) Detention, Jurisdiction/Disposition, or Status Review court report to DMH before the teleconference.
- Agency Referral Post-Teleconference: After the Pre-Match teleconference, forward the referral and redacted court report to the identified agency.
- Record Outcomes: Complete the Pre-Match Teleconference Data Spreadsheet and Weekly Log (on BCRSD Shared Drive) with the outcomes of the call.
- Pre-Placement Teleconference for Matched Referrals:
- Request Required Forms: Remind agencies that the ISFC Resource Family Snapshot Form and the ISFC Risk & Compatibility Assessment form are due for matched youth. Clarify that the ISFC Risk & Assessment form is not needed if there are no other DCFS youth in the home.
- Schedule Teleconference: Upon receipt of the ISFC Resource Family Snapshot Form and the ISFC Risk & Compatibility Assessment form, schedule the pre-placement teleconference.
- Invite Participants and Set Expectations: Invite DCFS ISFC Administrative staff, DMH, and the placement agency to the teleconference. Remind participants that the focus will be on the quality of the match, treatment planning, and safety plans. Inform them calls typically last 20-45 minutes, depending on case complexity, and are prioritized based on need, scheduled on Wednesdays.
- Share Referral Documents: Forward the referral packet, ISFC Resource Family Snapshot Form, 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.
- Finalize Placement and Rate Letter: Following placement approval, confirm the placement date with the ISFC FFA. Generate and send the ISFC Rate Letter to the CSW, SCSW, and FFA ISFC Manager, and send a copy to DMH.
- Update Records: Update the Weekly Log in the BCRSD Shared Drive with the teleconference outcomes. Maintain detailed records of youth placements, home assignments, and dates of program entry, graduation, or dis-enrollment. Add the youth’s name to the Master Youth Log in the BCRSD Shared Drive.
Alt text: ISFC Program Staff collaboratively reviewing case files and coordinating services, demonstrating their responsibilities in managing and overseeing the Intensive Services Foster Care program.
- Weekly Teleconferences with Leadership:
- Submit Weekly Log: Send the finalized Weekly Log to the Program Manager every Friday afternoon. The Program Manager then forwards these logs to the Division Chief and Assistant Division Chief.
- Participate in Weekly Review: Participate in a weekly teleconference with the Division Chief, Assistant Division Chief, and Program Manager every Wednesday morning at 8:30 am. During these calls, record updates to relevant logs and ensure reviews are conducted for issuing Static Rate letters.
- Track LOC ISFC Status:
- Monitor and Update LOC Status: Track the status of LOC ISFC requests and approvals/denials. Follow up with the LOC unit via email for updates, if necessary. Upon LOC confirmation, notify the agency and CSW. If the youth qualifies for LOC, schedule a Pre-Placement teleconference with the FFA and DMH.
- Manage Porting Process: Maintain records of the porting process for matched homes that meet LOC ISFC criteria and where caregivers are undergoing certification training.
- Hospital Discharge Teleconferences: Participate in and follow up on Hospital Discharge Teleconferences to ascertain if youth are returning to their pre-hospitalization caregivers and if these caregivers are interested in ISFC certification.
- Provide Support and Troubleshooting: Address queries and resolve issues for providers, CSWs, and SCSWs, ensuring smooth program operations.
- Contract Compliance: Address contract compliance issues, determine if Corrective Action Plans are needed, and follow up with providers until completion.
- Data and Statistics: Track and maintain monthly statistical data, including youth entries and exits from ISFC homes and Resource Parents.
- Information Dissemination: Distribute information to ISFC FFAs concerning staff and Resource Parent training opportunities, youth events, and programs (e.g., Glamour Gowns, Christmas events, summer camp sign-in, TILP, SILP, etc.).
- Special Incident Reports (SIRs) Review: Review all Special Incident Reports (SIRs) for youth in ISFC to ensure appropriate responses from ISFC FFAs. Forward SIRs needing mental health treatment review to DMH and contact ISFC FFAs regarding any concerns noted in SIRs.
- Audit Meetings: Attend ISFC FFA audit result meetings to ensure program standards are maintained and improved.
- Medical ISFC Oversight: Oversee medical ISFC placements, including monitoring, recruitment, teleconferences, tracking, and logging to ensure appropriate medical care and program adherence.
Approvals for ISFC Program Procedures
SCSW Approval
- None required for these procedures.
ARA Approval
- None required for these procedures.
Helpful Resources and Links
Attachments
Procedures for Matching and Placing ISFC Youth – Detailed guidelines for matching and placing youth within the ISFC program.
Forms
LA Kids Portal
DCFS 179MH – Parental Consent for Child’s Assessment & Participation in Mental Health and/or Regional Center Developmental Services. This form is required for mental health service authorization within the ISFC program.
Referenced Policy Guides
Relevant Policy Guides
- 0080-506.10, Identifying and Arranging Services for Families – Policy guide on identifying and arranging necessary services for families involved in child welfare.
- 0100-510.10, Placement Capacity – Policy guide addressing placement capacities and guidelines within the foster care system.
- 0600-515.11, Community Treatment Facility (CTF) Placements through the Interagency Placement Screening Committee – Policy guide concerning CTF placements and the screening process.
- FYI 24-19, Rates for Placement and Related Services – Information on current rates for placement and related services, including foster care.
Back to Referenced Policy Guides
Statutes and Mandates Governing ISFC
Key Statutes and Mandates
- All County Letter (ACL) 18-25 – Implementation of the Intensive Services Foster Care (ISFC) – Official communication regarding the statewide implementation of ISFC programs.
- 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) – Guidelines for entering LOC and ISFC rates into the state’s child welfare case management system.
- 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 – Details on the cost-sharing ratios for various foster care and related programs for a specific fiscal year.
- 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. – Legal definition of ISFC resource families and eligibility criteria for resource parents.
- WIC Section 17731(c) – States that counties must develop a plan to place children with special health care needs. – Mandate for counties to create plans for placing children with special health care needs, influencing programs like ISFC.
- WIC Section 18360 – Implementation of Intensive Services Foster Care (ISFC) – Legal framework supporting the implementation of Intensive Services Foster Care programs within the state.
