Intensive Services Foster Care (ISFC) programs represent a specialized approach within the foster care system, designed to provide a higher level of support and services to children and youth with significant mental health, emotional, or medical needs. This guide offers a comprehensive overview of ISFC programs, outlining their purpose, eligibility criteria, and how they function to support vulnerable young individuals and their caregivers.
What is the Intensive Services Foster Care (ISFC) Program?
Intensive Services Foster Care (ISFC) is more than just a placement; it’s a robust mental health and medical treatment program delivered within the nurturing environment of a specialized foster family home. Administered through Foster Family Agencies (FFAs), ISFC is designed as a short-term intervention, typically lasting between 12 to 18 months. The primary goal is to stabilize youth by addressing their specific needs as outlined in their individualized Needs and Services Plan.
Each child or youth in an ISFC program benefits from a dedicated ISFC team. This team collaborates closely with the young person, participates in Child and Family Team (CFT) meetings, and provides substantial support to the foster caregiver. FFAs provide crucial 24/7 crisis intervention services and assign a dedicated FFA Social Worker to each case. Depending on the youth’s particular needs, they may also receive support from a clinical professional, an In-Home Support Counselor, or a Registered Nurse.
Caregivers within the ISFC program are specially trained to handle the complexities of intensive care and are compensated at the highest foster care rate, acknowledging the demanding nature of this role. ISFC homes are categorized into two types: those specializing in youth with Serious Emotional and Behavioral Needs (SEBN) and those focused on youth with Special Health Care Needs (SHCN). It’s important to note that ISFC programs are not designed for emergency placements, emphasizing the planned and supportive nature of this intervention.
Who is Eligible for an Intensive Services Foster Care Program?
Eligibility for the Intensive Services Foster Care Program is determined by specific criteria based on the needs of the child or youth. There are distinct criteria for youth with Serious Emotional and Behavioral Needs (SEBN) and those with Special Health Care Needs (SHCN).
Eligibility for ISFC – Serious Emotional and Behavioral Needs (SEBN)
The ISFC-SEBN program is designed for children and youth aged 6 to 20 who have, within the last six months, exhibited or experienced one or more of the following:
- Adjudicated violent offenses: Involvement in violent crimes that have been legally determined.
- Aggressive and assaultive behavior: Demonstrating patterns of physical aggression towards others.
- Animal cruelty: Acts of harm or neglect towards animals.
- Commercially Sexually Exploited Children (CSEC): Youth involved in or at risk of commercial sexual exploitation.
- Eating disorders: Diagnosed conditions like anorexia, bulimia, or binge eating disorder.
- Fire setting: Intentional and repeated behavior of setting fires.
- Gang activity: Active participation or significant involvement in gang-related behaviors.
- Habitual truancy: Persistent unexcused absences from school.
- Psychiatric hospitalizations: Requiring inpatient care for mental health conditions.
- Running away from placement: Repeated instances of leaving assigned placements without permission.
- Severe mental health issues: Diagnosed mental health conditions requiring intensive support.
- Substance abuse: Problems related to the use of drugs or alcohol.
- Three or more placement disruptions due to behavior: Experiencing multiple changes in living arrangements due to behavioral challenges.
- Stepping down from a STRTP: Transitioning from a Short-Term Residential Therapeutic Program to a less intensive setting.
- Level of Care (LOC) deems them eligible for ISFC: Formal assessment determining the need for ISFC services.
Eligibility for ISFC – Special Health Care Needs (SHCN)
The ISFC-SHCN program caters to children and youth from birth to age 20 who have medical conditions requiring specialized in-home health care or conditions that could rapidly decline, potentially leading to severe injury or death. These medical conditions often necessitate dependency on one or more of the following:
- Enteral feeding tube: Requirement for nutrition to be delivered directly to the stomach or intestines.
- Total parenteral feeding: Need for nutrients to be administered intravenously.
- Cardiorespiratory monitor: Use of equipment to monitor heart and breathing functions.
- Ventilator: Dependency on a machine to assist or control breathing.
- Oxygen support: Requirement for supplemental oxygen.
- Urinary catheterization: Need for a catheter to drain urine from the bladder.
- Renal dialysis: Requirement for treatment to filter waste from the blood due to kidney failure.
- Ministrations imposed by tracheostomy, colostomy, ileostomy, or other medical or surgical procedures or special medication regimens: Complex medical needs arising from surgical procedures or requiring specific medication protocols, including injections and intravenous medications.
Similar to SEBN eligibility, SHCN youth eligibility is also formally determined through a Level of Care (LOC) assessment.
Navigating the Intensive Services Foster Care Referral Process
The referral process for Intensive Services Foster Care is initiated with a recommendation from the Child and Family Team (CFT). Before a formal referral to the ISFC program, the CFT must convene and determine that ISFC is a suitable treatment option for the child or youth. It is crucial to understand that ISFC is a treatment program, not simply a placement, and it is delivered within a specialized ISFC Resource Family home.
ISFC homes are not available for emergency placements, and finding a suitable home can take time as it requires careful matching and approval. Therefore, while ISFC is a valuable resource, placement is not guaranteed. The age range for ISFC-SEBN youth is 6-20 years, while for ISFC-SHCN youth, it extends from 0-20 years. For Nonminor Dependents (NMDs), their willingness to engage with the ISFC team, attend therapy, reside in an ISFC home, and meet NMD requirements is essential.
The process involves the assigned Children’s Social Worker (CSW) completing a referral packet through the Referral Portal on LA Kids and emailing the necessary documents as a single attachment to the designated ISFC inbox. The ISFC Administrative team then reviews the referral. If the youth has not yet been assessed for ISFC eligibility, and if the current caregiver is interested in becoming ISFC certified through a Foster Family Agency (FFA), the team will request a Level of Care (LOC) determination. The ISFC Administrative team then facilitates the process with the caregiver, referred to as a “Matched caregiver.” “Unmatched caregivers” are considered only for youth transitioning from more intensive settings like a Short-Term Residential Therapeutic Program (STRTP), Group Home, Hospital, or Transitional Shelter Care (TSC).
Required Documents for ISFC Referral
To refer a youth for ISFC, specific documents are required, and they differ slightly based on whether the referral is for Serious Emotional and Behavioral Needs (SEBN) or Special Health Care Needs (SHCN):
| 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 Public Health Nurse (PHN) |
| Release of Information |
Completed referral packets, including all required documents as a single attachment, should be emailed to [email protected].
Upon receipt of the referral, the ISFC Administrative team will determine the subsequent steps based on whether the youth is already “Matched” with a potential ISFC home or is “Unmatched” and requires identification of an ISFC home. Detailed procedures for matching and placing ISFC youth are available in supplementary documents.
Procedures for Unmatched and Matched Youth
Unmatched Youth: For youth who are stepping down from a higher level of care setting such as a STRTP, Group Home, Hospital, or TSC and do not have a pre-identified ISFC home, their case will be presented if there is an appropriate opening based on age and gender. If no suitable opening exists, the CSW will be informed of the lack of current availability. If an ISFC placement is identified, the CSW will be invited to a pre-match teleconference with the inter-agency ISFC team and the FFA. During this presentation, honesty and transparency about the youth’s strengths and challenges are crucial. If accepted, the CSW and FFA will collaborate to establish a placement date. Subsequently, the DCFS ISFC team will provide a rate letter to the CSW.
Matched Youth: These are youth already living in a home where the caregiver is either already an ISFC provider or in the process of becoming one. Placement as an ISFC case cannot occur until the caregiver completes the certification process, the youth meets LOC eligibility criteria, and the case is presented and approved at a pre-placement teleconference. For matched youth who have recently been hospitalized or are stepping down from a STRTP, Group Home, or TSC within the last six months, they automatically qualify for ISFC and may not require a new LOC determination. Once the caregiver is ISFC certified, the referral packet is complete, and LOC eligibility is confirmed (if necessary), a pre-placement teleconference is scheduled with the FFA to finalize and approve the placement. Following approval, a rate letter is issued to the CSW and the FFA.
Portability and Static Rate in ISFC Programs
Portability: This feature allows Resource Families to transition their approval between different foster care statuses, such as from a County Relative Foster Care (REFA) or Non-ISFC FFA to an ISFC FFA, or vice versa. When a caregiver is looking after a youth who is being evaluated for ISFC Level of Care, and the caregiver wishes to become an ISFC provider, the DCFS ISFC team can offer guidance and support through the certification process. The caregiver must agree to work with an ISFC FFA, meet all ISFC requirements, and complete necessary training. To initiate this process for a matched youth, the assigned Children’s Social Worker can submit a referral via the Referral Portal.
Static Rate: The Static Rate mirrors the ISFC rate in compensation but is a temporary measure, lasting initially for 60 days. It can be extended for another 60 days if specific criteria are still met and the caregiver is actively pursuing ISFC certification. In ISFC, this rate may be applied in emergency placement scenarios for youth who appear to meet ISFC criteria but have not yet had a formal LOC determination, provided the caregiver is committed to ISFC certification. Each case for a Static Rate is reviewed by the ISFC Administrative team for eligibility, and if approved, a rate letter is provided to the CSW.
Conclusion
Intensive Services Foster Care programs offer a critical lifeline for children and youth with complex needs, providing targeted, intensive support within a family-like setting. By understanding the eligibility criteria, referral processes, and key components of ISFC, professionals and caregivers can effectively utilize this program to enhance the well-being and stability of vulnerable young people. The collaborative approach of ISFC, involving dedicated teams and specialized caregivers, ensures a comprehensive network of support aimed at fostering positive outcomes for youth in foster care.
