Contracts TDFPS and SWK

Texas Dept of Family
and Protective Services
Form 2282cx
July 2009
Residential Child-Care Contract
Contract Number
23393175
Resource Number
23884439
Facility Number
880883
Facility License Type
General Residential
Operation
Provider Enrollment
Number
530-08-0062
Renewal Number
GENERAL CONDITIONS
1.
Contracting Parties. Pursuant to Its authority under Texas Human Resources Code (HRC)
40.058, the Texas Department of Family and Protective Services, {Department or DFPS), and
Southwest Key Programs. Inc., an independent contractor, (Contractor), enter Into this
contract (Contract). This Contract, along with all Attachments, constitutes the entire and
complete agreement between the parties. In this Contract, all references to the Department
shall Include the Texas Health and Human Services Commission (HHSC) and any other agency
named In Chapter 531 of the Texas Government Code to the extent that HHSC has transferred
DFPS' functions related to this Contract to itself or to such other agency pursuant to HHSC
authority in Texas Government Code 531.0055, or any other statutory authority of HHSC.
When acting in such capacity, HHSC or such other agency shall be considered an authorized
agent acting on behalf of DFPS.
2.
Governing Law. This Contract shall be construed in accordance with the laws of the State of
Texas {State). Unless otherwise mutually agreed, the venue will be In State District Court,
Travis County, Texas, and resulting payments shall be due and payable In Travis County,
Texas. This Contract shall not be construed to waive any rights, duties, or immunities that
either party has under the laws of the State of Texas and the United States
3.
Purpose. The purpose of the residential child-care contract Is to establish the qualifications,
standards, and terms of delivering specified services to children In contracted care, to set the
terms and conditions of operations and payment, and to specify the method of ensuring
delivery of contracted services. The goal of residential Child care Is to protect the well-being
of the Child, enhance the Child's functional abilities in a 24-hour residential child-care setting,
and prepare the Child for his/her Permanency Goal, by providing the following services as
appropriate:
A) Child-care Services which ensure the health and safety of the Child;
B) Appropriate educational, recreational, and vocational activities;
C) Behavioral Health, diagnostic assessment, and health/preventive health care services;
D) Appropriate supervision for all activities and services while in the Contractor's care;
E) Continuity of care for the integration and coordination of all services referenced in sections
Early rnnnt""rn
Health Authority (MHA), and HHSC.

Form 2282cx
July 2009
B) If the Contractor is a Residential Child-Care Facility, other than a CPA or Independent

Foster Home, sections 6.B), 6.C), 6.D), 16.B), 23, 25.C), 40.F), and 42, of this Contract
are not applicable.
C) If the Contractor is an Independent Foster Home, sections 6.B), 6.C), 6.D), 16.B), 23,
25.C), and 40.F) of this Contract are not applicable.
D) If the Contractor Is a GRO providing Emergency Care Services, sections 6, 10, 16.B), 23,
25.C), 40.F), and 42 of this Contract are not applicable.
E) The Contractor must comply with the special terms and conditions set forth in Attachment
E.
5.
Contractor Warranty. By accepting the Child, the Contractor warrants that:

A) It has the expertise and is licensed to provide programmatic services to meet the Child's
current needs based on the background information provided by the Department;
B) It will accept the Service Level unit rates described in section 33 of this Contract as
payment for the services and the requirements of this Contract; and
C) It will deliver services and meet requirements in a manner that meets high standards of
professional quality.
6.
Contracted Service Levels. The Contractor agrees to and acknowledges the following:
A) DFPS will determine the minimum services provided by the Contractor to each Child based
on the Child's level of need. The Department will designate the level of need as Basic,
Moderate, Specialized, or Intense, as described In Attachment C. The Contractor shall
provide services to children authorized at the Basic, Moderate and Specialized Service
Levels, and shall maintain full compliance with the associated Service Levels as described
in Attachment C for each Child placed with the Contractor.
B) A CPA may submit a request for a Service Level evaluation directly to the Service Level
Monitor (third party contractor) within the first forty-five (45) days of admitting a Child
who has not had an Initial Authorized Service Level during the current paid foster care
stay. All other requests for Service Level evaluations must be directed to the Child's
Caseworker who will forward any approved requests to the Service Level Monitor.
C) CPA's requesting an Initial Authorized Service Level within the first forty-five (45) days of
admitting a Child may be paid the new initial Service Level rate up to sixty (60) days in the
past when the following conditions are met:
i. The retroactive initial Service Level must be submitted for authorization to the Service
Level Monitor within forty-five (45) days of admitting a Child who does not have an
Initial Authorized Service Level;
ii. Upon admission to the CPA, the Child must remain In the same foster home or have
been In Intermittent Alternate Care within the same CPA that is requesting the Initial
Authorized Service Level; and
iii. The Child:
a. Remained less than thirty (30) days in a general residential operation providing
... ,....,.,.,.,...,.,,,...u care
to
a
or
foster home, in which the Child will be placed, is verified to provide treatment
service(s) appropriate to the Child's needs.
with the "-'"' 1""uu'"'

Form 2282cx
July 2009
Voluntary Extended Foster Care or Return to Foster Care.

Children 18 to 22 years of age who meet eligibility criteria and voluntarily agree to participate
in the Extended Foster Care or Return to Foster care programs, as defined In applicable
sections of TAC 700.316, are also eligible for Medicaid, and may be served under the terms of
this Contract once approved by the Department.
CONTRACTED COMPONENTS OF CARE

8.
Basic Living and Social Skills. The Contractor shall teach each Child Basic Living and Social
Skills and use experiential learning activities such that they are able to appropriately care for
themselves and function in the community.
9.
Children's Rights. The Contractor shall:

A) Cooperate with Child Protective Services (CPS) to ensure all children have been given a
written copy of the CPS Rights of Children and Youth in Foster Care at the time of
placement, and for CPA's, at any subsequent placement changes;
B) Support the rights listed in the CPS Rights of Children and Youth in Foster Care;
C) Not deny or restrict, through action or policy, any of the rights listed in the CPS Rights of
Children and Youth in Foster Care; and
D) Provide services to children who are deaf or hard of hearing that ensure effective
communication for children in their care. When providing services to a Child who is deaf or
hard of hearing, contact a Deafness Resource Specialist from the Department for Assistive
and Rehabilitative Services (OARS) for assistance In determining how best to ensure
effective communication is being achieved
(http://www.dars.state.tx.us/dhhs/providers/specialists.asp).
10.
Assessment, Service Planning and Coordination.

A) Diagnostic Assessment. The Contractor shall provide diagnostic assessments as defined In
Attachment C, section M500.02.
B) Service Planning and Coordination. The Contractor shall:
i. Develop, coordinate and Implement a Service Plan that addresses the services that will
be provided to a Child to meet each Child's specific needs.
il. Develop a Service Plan In accordance with the requirements contained in Attachment C
under the sections entitled "Casework and Support Services" and "Service Plans".
iii. Ensure that the Service Plan Incorporates and is consistent with:
a. Permanency Planning and Permanency Goals identified by the Department;
b. Any behavioral goals established by the Department pursuant to 1 Texas
Administrative Code (TAC) 351.13;
c. Components of a Child's Individual Education Plan (IEP) and the Individual
Transition Plan (ITP) that are both developed by the school's Admission, Review,
C) Service Management. The Contractor

L Ensure every Child is enrolled in Service Management that the STAR Health contractor
(Superior/Integrated Mental Health Services) determines meets the criteria for the

Form 2282CX
July 2009
The Contractor shall ensure access to necessary Medical, Dental, and Vision care for
each Child;
ii. The Contractor shall provide access to Texas Health Steps In the following manner:
a. The Contractor shall provide access to Texas Health Steps Medical services within
21 days of a Child's entry into DFPS conservatorship;
b. The Contractor shall provide access to Texas Health Steps Medical services within
14 days of initial placement of a Newborn Child's entry Into DFPS conservatorship;
c. The Contractor shall provide access to Texas Health Steps Dental services within 60
days of a Child's entry Into DFPS conservatorship; and
d. The Contractor shall provide access to the Texas Health Steps annual medical exam,
which Includes a well child exam, to each Child, each year.
iii. The Contractor shall access Medicaid through STAR Health for covered Medical, Dental,
and Vision services available to children.
iv. In the event that neither community nor Medicaid resources are available to fund
recommended Medical, Dental, or Vision services, the Contractor shall notify the
Department's Caseworker or Caseworker's Chain of Command for assistance; and
v. In the event the Contractor has any questions or concerns regarding the prescribed
recommendations for follow-up treatment, the Contractor shall raise these
concerns/questions with the Department and the Department will assist the Contractor
with a resolution.
B) Behavioral Health Services.
i. The Contractor shall ensure that Behavioral Health Services are available and provided
to each Child as needed by a STAR Health Network Provider (Network Provider).
II. A Behavioral Health Provider must be an employee or subcontractor of the Contractor.
iii. The Contractor shall access Medicaid through STAR Health for Medicaid Covered
Behavioral Health Services.
iv. The Contractor shall use community resources to obtain Behavioral Health Services not
covered by Medicaid.
v. In the event that community resources are not available for Behavioral Health Services
and/or Medicaid does not cover the services, the Contractor shall be financially
responsible for providing Behavioral Health Services.
vi. The Contractor shall ensure that all Behavioral Health Services provided to children are
properly documented within the Health Passport's Behavioral Health Module.
vii. The Contractor shall comply with Department procedures to request access to the
Health Passport for its employees that are not Network Providers.
viii. Effectiveness of Behavioral Health Services:
a. The Contractor shall ensure that Behavioral Health Providers are providing
Behavioral Health Services that are consistent with the following, where applicable:
(1) The Child's Plan of Service;
(2) The Contractor's Service Plan for the Child;
(3) The Permanency Goal for the Child;
i.
documented.
c. The Contractor must have procedures for ensuring Behavioral Health Providers are
with
11
RC'o----------------------------------------------------------P~ae4

Form 2282CX
July 2009
incorporated into this Contract by reference, may be accessed at:

http://www.dshs.state.tx.us/mhprograms/psychotropicMedicationFosterChildren.shtm.
ii. If a Child is prescribed psychotropic medications and the Contractor has
questions/concerns about the medication regimen for the Child, the Contactor shall
request assistance from a STAR Health Service Manager by calling 1-866-912-6283. If
additional assistance or clarification is needed, contact the Department's Caseworker or
the caseworker's Chain of Command.
iii. If a Child is prescribed psychotropic medications the Contractor Is required to ensure
that a physician in the STAR Health Network evaluates the need for continued
treatment with the medication at a minimum of every three (3) months.
12.
Routine 24-Hour Child Care.

A) Food. The Contractor shall:
1. Provide food in accordance with requirements of Minimum Standards.
II. Ensure that each Child receives fresh fruits, vegetables, and dairy products at least
once a day.
iii. Ensure that children have input into meal planning.
B) Clothing and Personal Items.
i. The Contractor shall maintain an inventory of the Child's clothing and Personal Items
that are of substantial value and/or sentimental value by:
a. Completing an inventory of clothing and Personal Items at admission.
b. Updating the inventory of clothing and Personal Items quarterly and at discharge for
a planned discharge and within thirty (30) days after an Unplanned Discharge;
c. Ensuring that the Child (when age and developmentally able) and the Contractor's
staff sign and date the clothing and personal item inventory, except when the
clothing and personal item inventory is completed after an Unplanned Discharge;
d. Sending the clothing and personal item inventory with the Department Caseworker
or other Department designee at discharge for planned discharges; and
e. Providing the Department with the clothing and personal item inventory within thirty
(30) days after an Unplanned Discharge.
II. The Contractor shall provide each Child with Appropriate Clothing as defined In
Attachment B.
iii. The Contractor shall allow children to label their clothes with the Child's name or
initials.
iv. The Contractor shall provide each Child with appropriate items necessary to meet their
hygiene and personal grooming needs by:
a. Making Grooming Products available so that each Child is able to maintain good
hygiene and grooming practices;
b. Ensuring that Grooming Products meet each Child's ethnic hygiene and individual
hair care needs;
c. Ensuring sufficient hot water is available for daily baths or showers; and
uccmcm as
to ensure
a bed,
mattresses and other furnishings necessary to meet the Child's needs. The Contractor
shall ensure that the items be kept clean and in good repair.

Form 2282CX
July 2009
Standards.
13.
Discipline and Crisis Management.

A) Discipline. The Contractor shall:
i. Use appropriate authority and Discipline practices as necessary to set limits for
behavior and help each Child develop the capacity for self-control; and
ii. Develop and Implement Discipline policies that consistent with the TAC and Minimum
Standards at:
http://www.dfps.state.tx.us/Child Care/Child care Standards and Regulations/default
:.M.P
a. The Contractor shall not use, give permission to use, or threaten to use physical
Discipline with any Child.
b. The Contractor shall not threaten the Child with loss of visits with family or siblings
as a punishment or deterrent to behavior.
c. The Contractor shall not threaten the Child with loss of placement as a punishment
or deterrent to behavior.
d. The Contractor shall not use unproductive work as a form of punishment (40 TAC,
748.2305 and 749.1955).
B) De-Escalation and Crisis Management. The Contractor shall:
I. Ensure that all de-escalation techniques are exhausted before utilizing more restrictive
and Intrusive behavior intervention or Emergency Behavior Intervention.
ii. Utilize developmentally and age appropriate Emergency Behavior Intervention
techniques, as described in Minimum Standards, to resolve emergencies.
Iii. Manage the home/Facility and milieu in a manner that minimizes disruption during a
crisis.
lv. Develop and implement Emergency Behavior Intervention policies that are consistent
with the TAC and Minimum Standards at:
http://www.dfps.state.tx.us/Child Care/Child Care Standards and Regulations/default
.asp.
14.
Educational and Vocational Activities.

A) Educational Activities.
I. The Contractor shall ensure that each school-aged Child placed with the Contractor
pursuant to this Contract:
a. Enrolls the Child in an accredited Texas public school within three (3) school days of
placement unless an exception is granted by DFPS;
b. Attends a school accredited by the Texas Education Agency (TEA) unless the
Contractor has received an exception to this requirement from the Department's
caseworker as approved in writing from the Assistant Commissioner for CPS, or
his/her designee.
c. Provides written verification of the Child's enrollment to the Department's
of
lnu.r!nn
notificatlc:ms not
is placed In a residential Facility:

a. If the Child is three (3) years of age or older, notify the school district in which the
t--::oru,,.., is
or

Form 2282CX
July 2009
where the Child resides. The contents of the Education Portfolio must, where
appropriate, include:
a. School enrollment documentation: Birth certificate, Social Security number,
Immunizations, and withdrawal notice from the last school;
b. Special education documentation: Admission, Review & Dismissal team meeting
notes, Individual Education Plan (IEP), Documents related to section 504 of the
Rehabilitation Act of 1973 regarding reasonable accommodations, Full Individual
Evaluation and/or other diagnostic assessments;
c. Report cards, progress reports, and/or IEP progress reports;
d. Transcripts;
e. Standardized test results: TAKS/SOAA/LDAA;
f. Referrals, notices, or correspondences; and
g. School pictures.
v. The Contractor shall make the Education Portfolio readily available to the Department
for each school-age Child on any visit with the Child or otherwise, if requested.
vi. The Contractor shall document that the report card and progress reports are discussed
with each school-age Child.
vii. The Contractor shall provide the Child's Education Portfolio to the Department at the
time a school-age Child is discharged from the Contractor's care regardless of whether
the discharge is a planned or an Unplanned Discharge. The Contractor must ensure the
following for a school-age Child:
a. The most current educational documents and records are in each Child's Education
Portfolio.
b. The Child's Education Portfolio includes the Child's current school withdrawal
paperwork.
viii. The Contractor shall minimize disruptions to a Child's education by scheduling therapy
and other appointments outside school hours, whenever possible.
B) Post-Secondary Educational and Vocational Activities.
i. The Contractor shall provide vocational training, support services and activities,
including job readiness, skills training apprenticeships and trade skills, and vocational
training opportunities that are required at 16 years of age and/or as developmentally
appropriate, so each Child:
a. Has access to appropriate vocational activities and community education programs;
and
b. Receives the assistance needed to maximize the benefit of these activities.
ii. The Contractor must guide and assist the Child in accessing and completing documents
when required for the State-Paid Tuition Fee Waiver and Education and Training
Voucher (ETV) Program if there is a need by the Child.
C) ECI Program. The Contractor shall:
I. Ensure the Caregiver fully participates in the Child's ECI evaluation and process for
developing an Individualized Family Service Plan (IFSP) for ECI services;
re1a1tea to

Form 2282cx
July 2009
the Texas Administrative Code], including the rights to file a complaint, participate
in mediation, and/or request a due process hearing; and
iii. Ensure the Caregiver provides written consent for the Child's ECI information to be
entered into the Child's Health Passport.
15.
Routine Recreational Activities. The Contractor shall:

A) Provide recreational activities such as indoor, outdoor, school, community and religious or
spiritual activities for children served under this Contract that are age-appropriate, varied,
and are of interest to the Child;
B) Ensure that children participating in recreational activities are, at a minimum, are
Supervised In accordance with Minimum Standards and Service Level requirements
contained in Attachment C;
C) Intervene, as necessary, to reduce the risk of and occurrence of any and all Injuries; and
D) Ensure that children have input into the types of recreational activities in which they wish
to participate.
16.
Travel. The Contractor shall:

A) Provide or arrange all travel necessary to ensure a Child's access to all necessary Medical,
Dental and Vision care for each Child, including behavioral healthcare services,
recreational, educational and after-school activities, family visits, court hearings,
Preparation for Adult Living (PAL) activities, Permanency Conferences, CPS Transition Plan
Meetings, Family Group Conferences, Circles of Support Conferences, and any other
services necessary to fulfill the tasks on a Child's Plan of Service.
B) A Contractor who Is licensed as a CPA shall arrange and facilitate sibling visits when
siblings are at different placements within the same CPA unless the sibling visits are:
I. Prohibited by court order;
II. Contrary to the best interest of the children as reflected in any of the Plans of Service
of the siblings; or
iii. Discouraged by a mental health professional treating any of the siblings.
17.
Cultural Competence. The Contractor shall:

A) Provide the Contracted Components of care with a high level of Individual and
Organizational Cultural Competence as defined in Attachment B.
B) Provide services and activities to children of various cultures, races, ethnic backgrounds,
and religions in a manner that recognizes and affirms their worth, protects and preserves
their dignity, and ensures equity of service delivery.
C) Provide ongoing education in the form of training, workshops, and other educational
opportunities to help staff and Caregivers understand the impact race, culture, and ethnic
identity has on themselves and others and how they Impact services to children and
families.
B) Meetings as required by the court;

C) Preparation for Adult Living (PAL) activities, consistent with the Child's CPS Transition Plan,
If applicable. The Contractor must obtain written prior approval from DFPS PAL Staff to
the PAL
a
In
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Form 2282CX
July 2009
19.
Maintaining Connections. The Contractor shall:

A) Make a good faith effort to ensure that children are able to preserve desired and
appropriate Connections to his/her own cultural identity and community, Including
religious/spiritual, family, school, and appropriate organizations through on-site or off-site
means.
B) Document all good faith efforts to maintain the Child's Connections.
20.
Providing Testimony. The Contractor shall:

A) Ensure that the Contractor's employees and Subcontractors appear and testify in judicial
proceedings, depositions and administrative hearings relating to a Child, at the request of
the Department; and
B) To the extent possible, notify, and/or assist the Department in locating, past employees or
Subcontractors when past employees or Subcontractors are needed to appear and testify in
accordance with this subsection. The Contractor is responsible for the cost associated with
the requirements of this subsection.
21.
Least Restrictive Setting. The Contractor shall provide all services in a manner that
safeguards the health, welfare and safety of the children In the least restrictive setting
possible.
PROGRAM REQUIREMENTS
22.
Facility Licensure. The Contractor shall:

A) Comply with Minimum Standards for any child-care license Issued by the Department to
the Contractor for services provided under this Contract;
B) Comply with the operating or regulatory agency's regulations if the Contractor is a Facility
operated or regulated by one of the state agencies specified in 40 TAC 700.1321(e);
C) Comply with all applicable Service Levels as contained in Attachment C and the Contracted
Components of Care described In sections 8-21 of this Contract; and
D) Ensure that all staff providing direct services to the Child comply with state professional
laws pertaining to the services provided including laws pertaining to licensure and
confidentiality.
23.
Contractor Support and Supervision of Foster Families. The Contractor shall:

A) Develop and Implement a plan, In accordance with DFPS policy, for providing support
services as needed to the Contractor's foster families where children placed by the
Department are residing;
that a Contractor's
to assist and support
as
required In section 32 of this Contract.

Department upon request;
Have supervisor/Case Manager services available twenty-four (24) hours a day to the

Form 2282CX
July 2009
F) Maintain documentation of all contact with foster families;

G) Approve and use as Foster Parents only U.S. citizens, permanent residents, or other
qualified aliens as defined in 8 U.S.C. 1641(b);
H) Distribute the Texas Health Steps materials at https://secure.thstepsproducts.com/ to
verified foster homes at least annually, including:
i. Texas Health Steps Checkup Brochure EPSDT-05;
II. Texas Health Steps Wallet cards EPSDT-08;
iii. Appointment Education Brochure EPSDT-16;
iv. case Management for Children and Pregnant Women Brochure CM1-182;
I) Avoid financial and other conflicts of interest by prohibiting the following individuals from
being a Foster Parent verified by the Contractor however, such persons may be verified as
Foster Parents by other CPAs:
i. Any person authorized to sign this Contract on behalf of the Contractor, or any board
member, officer, or employee of the CPA;
li. Any Individual or person working In the day-to-day operations of the Contractor, either
through the Contractor's employ or pursuant to a contractual arrangement between the
individual and the Contractor;
iii. An owner of the agency; and
lv. A member of the governing body;
J) Distribute HHSC information to Foster Parents regarding the Medicaid Medical
Transportation Program described at:
http://www.dfps.state.tx.us/documents/PCS/2009-05-26 MTP Memo.pdf.
24.
Criminal Background Checks for Contractor Employees, Subcontractors and

Volunteers.
The Department reserves the right to conduct criminal Background Checks on the Contractor's
employees, Subcontractors, volunteers, and all individuals who have direct contact with
children in DFPS care or who have access to their records.
25.
Departmental Right of Placement.

A) The Department reserves the right to place children only in those facilities that it believes
can meet the needs of the Child. No part of this Contract shall be construed as a
commitment, obligation, or any legal duty on behalf of by the Department to place a
particular Child, any Child, or a specified number of children with the Contractor.
B) The Contractor shall comply with the Department's placement processes, Including timely
data entry of vacancies into the Department's Child Placement Vacancy Database. The
Contractor shall not engage in practices used to circumvent these placement processes.
No part of this Contract shall be construed to create any legal or equitable right on behalf
of the Contractor to receive any such placements or to continue any particular placements.
C) The Contractor shall comply with all applicable federal and state laws, including the
Mu!tiethnlc Placement Act, as amended
the
Adoption Act of 1996
26.
Removal and Discharge of Children.

A)
Contractor shall
all reasonable attempts to meet the needs of

C)
D)
E)
F)
G)
Form 2282CX
July 2009
Injurious behaviors that are inappropriate for the program of service and requires a
placement in another setting.
i. If the Contractor provides the Department with documentation from a physician that
the Child poses a danger to self or others, to facilitate admission to a hospital, the
Department shall remove the Child within twenty-four (24) hours. Admission of the
Child to a hospital by the Contractor serves as documentation of the need for a more
secure setting. The Contractor shall immediately inform the Department's Caseworker
of the admission and shall state whether the Contractor is willing to accept placement
of the Child upon discharge from the hospital.
ii. If the Contractor provides the Department with documentation from a Psychiatrist,
licensed Psychologist, physician, LCSW or LPC showing that the Child consistently
exhibits behavior that cannot be managed within licensed programmatic services, the
Department shall remove the Child within fourteen (14) calendar days. The
Department shall immediately communicate with the Contractor and staff the Child's
circumstances to determine a plan for moving the Child to ensure the Child's safety and
that of others.
The Contractor shall notify the Department Caseworker within twenty-four (24) hours of
the Child's placement in jail or juvenile detention and shall state whether the Contractor is
willing to accept placement of the Child upon the Child's release from jail or juvenile
detention. If the Contractor is not willing to accept placement of the Child upon the Child's
release, the Department shall, within twenty-four (24) hours of receipt of notification from
the Contractor, remove the Child placed by the Department.
If the Contractor provides other documentation to the Department that it is no longer in
the Child's best interest to remain at the Contractor's Facility, or that the Contractor cannot
meet the needs of the Child, the Department shall remove the Child within thirty (30)
calendar days. This documentation shall be signed by the Contractor's Executive Director,
Licensed Child-Care Administrator, Licensed Child-Placing Agency Administrator or
designated employee, other than the Contractor's case Manager. The Department shall
immediately communicate with the Contractor and staff the Child's circumstances to
determine a plan for moving the Child to ensure the Child's safety and best interests and
those of others. The Department shall remove the Child as quickly as is necessary. The
Department may immediately remove the Child.
For Contractors licensed as GROs providing emergency care services, if the Contractor
wishes to discharge a Child pursuant to subsection 26.D) of this section, the Department
shall have up to ten (10) calendar days to remove the Child. In the case of other
emergency placements, if the Contractor notifies the Department within the first thirty (30)
calendar days of the placement, the Department shall have up to ten (10) calendar days to
remove the Child.
If the Contractor discharges a Child placed by the Department except as stated above, it
constitutes a breach of this Contract.
Not later than thirty (30) calendar days after the Contract is executed, the Contractor shall
Contract
I.
Upon the effective date of any type of discharge of a Child, the Contractor shall make
available to the Department:
L

Form 2282cx
July 2009
5. Education Portfolio.
ii. Upon the effective date of a planned discharge of a Child 1 the Contractor shall/ in
addition to the items identified in paragraph 26.H)i. of this subsection/ make available
to the Department the following:
1. Gift/personal possession inventory including books, toys, and money; and
2. Clothing inventory.
iii. Within thirty (30) days after an Unplanned Discharge, the Contractor shall provide the
Department with the following:
1. Gift/personal possession inventory Including books, toys, and money;
2. Clothing inventory; and
3. Updates to the Education Portfolio.
27.
Use of Department Forms.

A) Non-emergency placements. For children at the Moderate Service Level or higher, the
Department shall complete and provide to the Contractor at, or prior to, placement the
Common Application for Placement of Children in Residential Child Care (Form 2087) as the
uniform assessment form and application for admission. The Contractor shall accept
children for placement by the Department only after receiving completed Form 2085-FC,
Form 2085-B and/or 2085-C and/or 2085-D as appropriate and, If at the Moderate Service
Level or higher, Form 2087 and Form 2089. If the Department's worker attempts to place
a Child at the Moderate Service Level or higher without a copy of a current Form 2089, the
Contractor may, but is not required to, accept the Child for seventy-two (72) hours after
having the Department's caseworker sign the Department's Form 2089-C.
B) Emergency Placements. The Department shall attempt to complete and provide to the
Contractor at, or prior to, placement the Common Application for Placement of Children In
Residential Child care (Form 2087) as the uniform assessment form and application for
admission. The form may be incomplete but shall contain all available Information.
Alternatively, the Department may provide to the Contractor the Alternative Application for
Placement of Children in Residential Child Care (Form 2087ex). In either case, Form 2087
shall be completed and provided to the Contractor at the time the Child's placement is
changed from an emergency to a non-emergency placement. The Contractor shall accept
Form 2087 or Form 2087ex as the uniform assessment form and application for admission
for placement of Department children. The Contractor shall accept children for placement
by the Department only after receiving completed Form 2085-FC, completed Form 2085-B,
and/or 2085-C and/or 2085-D, and (complete or Incomplete) Form 2087 or 2087ex.
C) Unaccompanied Emergency Placements. In the event an unaccompanied Child in the care
of the Department presents for emergency placement, the Contractor may accept the Child
for placement and shall immediately notify the Department to determine Department
instructions and to initiate documentation. The Department shall complete the required
forms within the next working day but may immediately move the Child.
D) Use of Forms at Admission.
t
shall accept children for nll:'lrPrnPt'lt
Department will complete the Form 2087 within

following the Contractor's written request for it.
Department will make available to the Contractor Forms
calendar days
Texas Dept of Famity

Form 2282cx
July 2009
determined at the time of placement, the Contractor will be compensated at the

basic rate.
iii. At the time of admission and any placement change, the Department's Caseworker
shall provide the caregiver and the Child a copy of the CPS Rights of Children and
Youth In Foster Care.
a. The Caseworker will review the CPS Rights of Children and Youth in Foster Care with
the Child and Caregiver.
b. The Child and caregiver will sign and date the CPS Rights of Children and Youth in
Foster care.
c. Upon receipt from the caseworker, the Contractor will maintain a copy of the signed
CPS Rights of Children and Youth in Foster Care in the Child's record.
E) Disclosure of Medical Information. The Department's amended forms 2085-FC and 2085-B,
2085-C, and 2085-D are intended to enable the Contractor to obtain and disclose health
information on a Child when it is necessary while still complying with the federal Health
Insurance Portability and Accountability Act of 1996 (HIPAA). If circumstances arise where
It is not possible for the Contractor to do so, the Contractor should work with the
Department's Caseworker, Chain of Command and the DFPS Residential Contract Manager
to obtain such additional permissions as are necessary.
F) Medical Consent.
I. The Contractor shall follow the requirements of the Medical Consent for Children In
DFPS Conservatorship and Youth Consenting to Medical Care policy, pertaining to
residential child-care providers at http://www.dfps.state.tx.us/PCS/residential.asp,
incorporated herein by this reference.
ii. The Medical Consenter is authorized to access, receive, and review all the Child's
medical records. Furthermore, the medical consenter may authorize the release of the
Child's medical records to the extent necessary to obtain services for the Child.
iii. The Contractor shall ensure that all Foster Parents and employees who are eligible to
serve as Medical Consenters under "How DFPS Establishes the Medical Consenter",
have access to and complete computer-based training on Informed Consent.
iv. The Contractor shall ensure that all Foster Parents and employees who are eligible to
serve as Medical Consenters, as stated above, follow the requirements within DFPS
policy regarding "Responsibilities of Medical Consenters and back up Medical
Consenters".
G) CPS Transition Plan. The Contractor shall coordinate with CPS for children 16 years of age
and older regarding:
i. The use of the CPS Transition Plan, Form 2500, as appropriate, at
http:Uwww.dfps.state.tx.us/Child Protectionaransitional Uving/forms.asp; and
ii. The provision of information available at
http://www.dfps.state.tx.us/Child Protection/Transitional Uving/default.asp related to:
a. Aftercare services, benefits and provider contacts;
b. Educational Supports, Services and Benefits;
to
and
h. Other region-specific services available.

C)
D)
E)
F)
Form 2282CX
July 2009
the state, the Contractor must obtain prior written approval for the Child's travel as
provided in 40 TAC 700.1340.
If the travel is within the State and for more than three (3) calendar days (seventy-two
(72) consecutive hours); the Contractor must obtain prior written approval from the
Department's Caseworker or DFPS staff in the Caseworker's Chain of Command.
Prior to allowing any trip, activity or visit with a non-related person, excluding Intermittent
Alternate Care, for a period of time exceeding forty-eight ( 48) consecutive hours, the
Contractor shall obtain written approval from the Department's Caseworker or
Caseworker's Chain of Command.
Written approval for travel and visits is not required when:
i. The Department's Caseworker arranges for the Child to visit with members of the
Child's family or relatives; or
ii. The Department's Caseworker authorizes the Child to travel in specified circumstances
(usually routine trips or visits).
When the Contractor desires to take a Child outside of the country, the Contractor shall
follow Department policies and procedures including the completion of Form 2069,
Caregiver Declaration Regarding Out-of-Country Travel.
29.
Written Approvals.
A) Prior to moving a Child from one foster home to another foster home the Contractor must
obtain written approval from the Departments Caseworker or Chain of Command. In the
event of an emergency, and If prior approval cannot be obtained, the Department shall be
notified of the move within twenty-four (24) hours. The Department shall respond to
requests for approval within ten (10) calendar days of receiving a proper request.
B) Prior to requesting Department staff to sign Contractor-developed forms, the Contractor
must receive written approval from the Residential Contract Manager Indicating legal
approval by the Department.
30.
Disaster and Emergency Response Plan.

A) The Contractor must maintain at all times a written disaster and emergency response plan,
policies and procedures to address internal and external emergencies and disasters that
include, but are not limited to acts of nature (such as flood, hurricane, fires, and
tornadoes), chemical or hazardous material spills, critical equipment failure, weapons of
mass destruction events, and acts of terrorism.
B) In the event of an emergency requiring evacuation or quarantine, the Contractor shall be
responsible for maintaining the safety and placement of all children in Its care. All staff
and Subcontractors of the Contractor must be aware of the disaster plan requirements and
be prepared to fulfill their role in executing the plan.
C) The disaster and emergency response plan and procedures must address the following:
i. Mandatory evacuation if directed by local officials;
ii. Emergency evacuation;
c. Food;
d. Transportation;

Form 2282CX
July 2009
vii. Identification, location and tracking of children;

viii. Protection and/or recovery of children's records and important paperwork (including
electronic records, placement information, medical authorizations, Medicaid cards, STAR
Health cards, and Education Portfolio);
ix. The provision of regular and crisis-response services to children during and after a
disaster, Including:
a. Methods for ensuring that services such as, but not limited to, crisis counseling are
provided to meet the crisis-related needs of the children in care during and after the
disaster;
b. Methods for ensuring that medical services are provided to children throughout the
disaster. Such services Include, but are not limited to, providing children with
medication as prescribed (Including Insulin and asthma-related treatments),
emergency care, and Medical Care for children with Primary Medical Needs (as
defined in Attachment B); and
c. Plans for maintaining the services, as required by a court order and/or the Child's
Service Plan, for the children In care after the disaster.
x. Communication with DFPS and CPS, Including:
a. Identifying (name, telephone numbers) two emergency contacts designated by the
Contractor who will be available to DFPS at all times In the event of an emergency
or disaster;
b. Contacting CPS to provide Information on the location and condition of children in
care who have been evacuated as soon as the children reach their evacuation
destination by contacting CPS through one of the following methods:
(1) During times when mass evacuation of part of Texas is anticipated, DFPS will
enable an online reporting feature on the DFPS public website at:
http://www.dfps.state.tx.us.
{2) In situations when DFPS has enabled this online reporting feature and the
Contractor has access to the internet, the Contractor should use this method to
make the evacuation notification; or
(3) In situations where the online reporting feature is not enabled or if the
Contractor does not have access to the internet, the evacuation notification can
be made by calling the DFPS abuse/neglect hotline at 1-800-252-5400.
c. Contractors with multiple facilities and CPAs must contact CPS once per day, at a
minimum (unless otherwise instructed by DFPS), to provide information concerning
the children in their care until all children are accounted for; and
d. CPA's must have methods through which their homes can contact CPA
administration to inform them of the location and condition of children in care as
soon as possible upon reaching an evacuation destination.
xi. Post-disaster activities {including emergency power, food, water, and transportation);
xli. Plans for return after an evacuation;
remains current and Is reviewed at least every two
Methods to ensure the disaster
and at each r~:~~-~:~~v;;l

maintain a copy of each home's Cllsas1ter

Form 2282CX
July 2009
disruption of the care of the children placed with the Contractor. In no event shall this section
be construed to prohibit the Department, or its designees, from making unannounced visits to
the Contractor's facilities or to a foster home verified by a CPA.
32.
Performance Measures. Contractor performance evaluation is based on the assessment of

the output and outcome measures as described in this section and in Attachment F,
compliance with Contract requirements, compliance with Minimum Standards, compliance with
Attachment C and/or Contract Monitoring performed by Department staff. DFPS staff,
representatives, or the Service Level Monitor shall review the Child's Service Plan to measure
the progress of the Child In achieving applicable goals. The Contractor shall comply with the
following performance measures:
A) Contract Output Measures as defined in Attachment F.
i. Output #1. The Contractor makes regular updates to the CPS Child Placement Vacancy
Database.
if. Output #2. Each Child's Education Portfolio is up-to-date.
B) Contract Outcome Measure as defined in Attachment F.
Outcome. Children are safe in care.
FINANCIAL REQUIREMENTS
33.
Service Level Unit Rates.

A) HHSC periodically determines Service Level unit rates (daily rates) in accordance with its
Cost-finding Methodology. The daily rates In effect during the term of this Contract are
contained in Attachment A.
B) The Department requires that a minimum dollar amount of the daily rate paid by the
Department be remitted by the Contractor to foster families to pay for the basic Child
maintenance costs of children placed pursuant to this Contract. The required remittances
are set forth in Attachment A. If HHSC Implements a change in the Service Level rates, the
Department will change those minimum dollar amounts in Attachment A.
C) The Contractor must comply with Chapter 2251 of the Texas Government Code.
34.
Conditions of Payment. All payments shall be made to the Contractor after deducting any
known previous overpayment made by the Department. The Department Is not obligated to
pay for unauthorized services or to pay more than Is consistent with federal and state
regulations.
A) The Contractor shall be compensated only once for residential child-care services delivered
under this Contract. The Contractor shall not bill for or retain any additional compensation
for such services from the Department or any other entity.
B) The Contractor shall not be reimbursed for vandalism or damage caused by deliberate acts
D) The Department shall pay for the calendar day of placement, but not for the calendar day
of discharge. If the Child is discharged on the day of placement, the Contractor shall not

Form 2282cx
July 2009
(http:Uwww.dfps.state.tx.ys/Handbooks/default.asp), now incorporated by this reference.

F) The Department shall give the Contractor notice in writing at least thirty (30) calendar
days prior to the effective date of any change that affects payments to the Contractor.
G) Contractors must seek payment or adjustment to payments in accordance with the time
limit specified in 45 CFR 95.1 (Code of Federal Regulations). This subpart establishes a
two-year (eight quarter) time limit for a State to claim Federal financial participation in
expenditures under State plans approved under Title IV-E and TANF. Any bill or amended
bill, which is submitted to DFPS later than seven quarters after the end of the quarter of
the expense, will not be processed unless DFPS determines that submission for payment of
the bill to the federal government can be executed In a proper and timely fashion.
35.
Contractor Payments/Refunds to the Department. The Contractor shall:

A) Be responsible for any Monitoring/audit exception or other payment irregularity regarding
this Contract or subcontract; and
B) Be responsible for the timely and proper collection and reimbursement to the Department
of any amount paid in excess of the proper payment amount within ninety (90) days of
determination of overpayment.
36.
Accounting Records. The Contractor agrees to maintain all financial and statistical
information using the accrual method of accounting In accordance with 1 TAC 355.7101(6).
The Contractor's treatment of accounting records must reflect the application of Generally
Accepted Accounting Principles (GAAP) approved by the American Institute of Certified Public
Accountants (AICPA).
37.
Insurance.
A) The Contractor shall provide insurance for direct delivery of services under this Contract.
The Contractor shall obtain and furnish proof of the following bonding and insurance
coverage within forty-eight (48) hours of the award of the Contract and at such other times
as may be specified by the Department. The required coverages are:
i. Dishonesty bonding under a commercial crime policy or business services bonding at a
$10,000 minimum;
ii. For independent homes General liability insurance having a minimum limit of $300,000
per occurrence and $600,000 aggregate; and
iii. For all other child-care facilities Commercial general liability coverage insurance with a
minimum limit of $300,000 per occurrence and $600,000 aggregate.
B) The Contractor shall purchase coverage with Insurance companies or carriers rated for
financial purposes "B" or higher whose policies cover risks located In the State. All bonds,
policies, and coverage shall be maintained during the entire term of the Contract.
C) In the event the Contractor is unable to comply with subsection 37.A) of this section, the
Contractor shall provide the Residential Contract Manager with two (2) written denial
letters from different insurance companies
the Contractor's attempts to obtain
of this
on an
Is
to
the Contractor shall provide the Residential Contract Manager with the documentation
required in subsection
of this section, to demonstrate the Contractor's compliance

Form 2282cx
July 2009
change to the policy or bond.

38.
Pay Roll Taxes.

The Contractor is responsible for all payroll taxes and benefits for its employees.
39.
Prohibition of Sale or Transfer of Accounts Receivable. The Contractor shall not sell, or
transfer ownership of any payments due to the Contractor under this Contract to any third
party or financial intermediary if such transaction would result in such payments being made
by the Department to the third party. This section shall not prohibit collateral assignment of
such payments for the purpose of secured lending arrangements in the ordinary course of
business.
ADMINISTRATIVE
40.
Applicable Statutes, Regulations, Policies and Procedures.

A) The Contractor must comply with all laws, regulations, requirements and guidelines
applicable to a Contractor providing services to the State of Texas as these laws,
regulations, requirements and guidelines currently exist and as they are amended
throughout the term of this Contract.
B) In maintaining financial records and in preparing cost reports, the Contractor shall remain
in compliance with 48 CFR 31 as applicable, Office of Management and Budget (OMB)
Circulars A-21, A-87, A-102, A-110, and A-122, and 40 TAC 732.240-256 as applicable.
http://lnfo.sos.state.tx.us/pls/pub/readtac$ext.ViewTAC?tac_view=5&ti=1&pt=15&ch=355
&sch=H&ri=Y.
C) The Contractor shall comply with all applicable state and federal statutes and rules In effect
at the time such services are rendered, including the following:
i. Federal Financial Participation (FFP) requirements in accordance with Titles 45 and 48
of the Code of Federal Regulations and federal circulars, as amended;
ll. State and federal anti-discrimination laws, including without limitation:
a. Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.);
b. Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794);
c. Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.);
d. Age Discrimination Act of 1975 (42 U.S.C. 6101-6107);
e. Title IX of the Education Amendments of 1972 (20 U.S.C. 1681-1688);
f. Food Stamp Act of 1977 (7 U.S.C. 2011 et seq.); and
g. The HHS agency's administrative rules, as set forth In TAC, to the extent applicable
to this Agreement.
(1) The Contractor agrees to comply with all amendments to the above-referenced
laws, and all requirements Imposed by the regulations issued pursuant to these
on

iii.
iv.
v.
vi.
vii.
Form 2282cx
July 2009
themselves fluently in English. The Contractor agrees to ensure that its policies
do not have the effect of excluding or limiting the participation of persons in its
programs, benefits, and activities on the basis of national origin. The Contractor
also agrees to take reasonable steps to provide services and information, both
orally and in writing, in appropriate languages other than English, in order to
ensure that persons with limited English proficiency are effectively informed and
can have meaningful access to programs, benefits, and activities.
(3) The Contractor agrees to comply with Executive Order 13279, and its
Implementing regulations at 45 CFR Part 87 or 7 CFR Part 16. These provide in
part that any organization that participates In programs funded by direct
financial assistance from the United States Department of Agriculture or the
United States Department of Health and Human Services shall not, in providing
services, discriminate against a program beneficiary or prospective program
beneficiary on the basis of religion or religious belief.
(4) Upon request, the Contractor will provide HHSC Civil Rights Office with copies of
all of the Contractor's civil rights policies and procedures.
(5) The Contractor must notify HHSC's Civil Rights Office of any civil rights
complaints received relating to its performance under this Agreement. This
notice must be delivered no more than ten (10) calendar days after receipt of a
complaint. Notice provided pursuant to this section must be directed to:
HHSC Civil Rights Office
701 W. 51st Street, Mail Code W206
Austin, Texas 78751
Phone Toll Free (888) 388-6332
Phone: (512) 438-4313
TIY Toll Free: (877) 432-7232
Fax: (512) 438-5885
Health and Safety Code section 85.115 relating to workplace and confidentiality
guidelines regarding AIDS and HIV;
Immigration Reform and Control Act of 1986 regarding employment verification and
retention of verification forms for any individuals who will perform any labor or services
under this Contract;
All state and federal licensing and certification requirements, health and safety
standards, and regulations prescribed by the United States Department of Health and
Human Services Department;
All applicable standards, orders or regulations issues pursuant to the Clean Air Act ( 42
USC 7401 et seq.) and the Federal Water Pollution Control Act as amended (33 USC
1251 et seq.);
Mandatory standards and policies relating to energy efficiency which are contained in
the state energy conservation plan issued in compliance with the Energy Policy and
Conservation Act (Public Law 94-163); and
of Records.

Form 2282cx
July 2009
A) The Contractor agrees to maintain comprehensive and legible records of all actions
performed by any Contractor's personnel furnishing services under this Contract. The
Contractor shall maintain financial, programmatic, and supporting documents, statistical
records and other records pertinent to claims or cost reports submitted and/or services
delivered during the Contract Period for a minimum of five (5) years after the termination
of the Contract Period. If any litigation, claim, or monitoring/audit involving these records
begins before the five (5) year period expires, the Contractor shall keep the records and
documents for not less than five (5) years and until all litigation, claims, or
monitoring/audit findings are resolved. The case Is considered resolved when a final order
Is issued in litigation, or a written agreement is entered into between the Department and
the Contractor.
B) The Contractor shall provide any records and information concerning the Child to the
Department upon verbal request in emergency situations. Upon verbal request from DFPS,
the Contractor must submit legible records and Information within the Department's
specified timeframe. Emergency requests for records can Include, but are not limited to,
the need to review the Child's Service Level in order to make a placement change, court
ordered requests, or attorney requests.
C) The Contractor shall provide any records and information concerning the Child to the
Department upon request. The Contractor must forward legible records and information to
the Department within fourteen (14) calendar days. Information could Include, but Is not
limited to documentation of face-to-face visits with the Child by the Contractor's case
Manager staff, the Child's Service Plan, documentation of services provided to a Child,
Discipline logs, medical and dental logs, educational documentation, and narratives. The
Contractor shall not dispose of such records before giving the Department written notice of
its intent to dispose of such records.
D) The Contractor shall provide the STAR Health contractor (Superior/Integrated Mental
Health Services) the following information for specific children for the purposes of a
Psychotropic Medication Utilization Review (PMUR) upon written request by Superior:
i. Physician notes (last 3 months);
ii. Medication logs (last 3 months); and
iii. The most recent psychological evaluation.
E) In the event the Contractor receives a written request for information from the Star Health
contractor (Superior/Integrated Mental Health Services) that does not involve PMUR as
identified in subsection 41.D) of this section , the Contractor shall advise the Star Health
contractor (Superior/Integrated Mental Health Services) to contact the child's caseworker
or chain of command for assistance.
F) The Contractor shall provide the STAR Health contractor (Superior/Integrated Mental
Health Services) the following information for specific children for the purposes of a
Psychotropic Medication Utilization Review (PMUR) upon written request by Superior:
i. Physician notes (last 3 months),
li. Medication logs (last 3 months), and
psychological
most
to contact
or
H) All records received or created by the Contractor that are identifiable to children referred
by the Department are confidential and may be disclosed to third parties only with the prior
\Alt"!lfft:n rt"\nc:.<:>nr of
or
consents
by the

I)
J)
K)
L)
42.
Form 2282CX
July 2009
Information or other similar legal process, the Contractor will provide the Department with
prompt notice of such request so that the Department may seek an appropriate protective
order and/or consent to the Contractor's disclosure of the requested records.
The Contractor shall establish a method to ensure the confidentiality of records and other
information relating to children according to applicable federal and state law, rules, and
regulations. The Department shall have an absolute right of access to, and copies of, Child
case records or other information relating to children served under this Contract.
The Contractor shall ensure that any staff designated by the Contractor and approved by
DFPS for access to the Health Passport must comply with all operative restrictions of the
Health Passport user agreement as it exists now or may later be amended, including the
following:
i. Not to share information from the Health Passport with anyone without a direct need to
know the information for purposes of providing health care, including behavioral health
care, services to the Child;
ii. To share only the minimum amount of information from the Health Passport as is
necessary to aid in the provision of health care, including behavioral health care,
services to the Child;
ill. To be responsible for maintaining the physical security and confidentiality of Health
Passport information that the user may view on a computer, print to paper or copy or
download to other formats. People who do not need the information should not have
physical access to it;
iv. To limit access to Health Passport records to those children who are served by the
Contractor or with whom the Authorized User has a relationship for which Health
Passport access is authorized; and
v. Not to share passwords. If the Contractor becomes aware that a password has been
shared, he or she Is required to notify Superior HealthPian Network within 24 hours so
that a new password can be assigned.
The Contractor shall advise Authorized Users that DFPS may restrict or deny access to the
Health Passport if they are in violation of the user agreement or terms and conditions of
the Contract.
The provisions of this section shall remain in full force and effect following termination of or
cessation of the services performed under the terms of this Contract.
Intermittent Alternate Care. Child-Placing Agencies and Independent Foster Homes that are
permitted to use Intermittent Alternate Care must do so pursuant to the requirements
contained in Attachment D, which is attached hereto and incorporated herein by this reference.
The Department may allow contracted Child-Placing Agencies and Independent Foster Homes
to utilize Intermittent Alternate Care to:
A) Provide Foster Parents additional supports for meeting child-care responsibilities;
B) Increase the retention of Foster Parents;
C) Decrease the number of moves children experience; and
care.
f.
Maintain at all times at least one active electronic

address for the rC>r'""'r\r
of Contract-related communications from the Department. It is the Contractor's
'""""'"'l'\'""'"" 11 'tu to
address for Contract-related information. The

Form 2282cx
July 2009
iii.
Notify the Department within twenty-four (24) hours after the Contractor determines
that a Child placed by the Department with the Contractor is a danger to self or others
and requires a placement in another setting, or has been incarcerated or placed in
juvenile detention;
iv. Notify the Department within twenty-four (24) hours, when the Contractor knows that
a Child placed by the Department and In the Contractor's care requires hospitalization;
v. Notify the Department of any Serious Incident, including but not limited to, run away,
death, and abuse neglect and/or exploitation, within the timeframe mandated by
Minimum Standards. The Contractor may report Serious Incidents to the Department's
Statewide Intake at 1-800-252-5400 to meet the requirements of this subsection;
vi. Within ten (10) calendar days, notify the Department by completing the Department's
form 4732 when a person formerly employed by the Department is hired, as required
by law. The Contractor shall obtain this form by contacting the assigned Residential
Contract Manager;
vii. Within ten (10) calendar days, notify the Residential Contract Manager of any
significant change affecting the Contractor, including, but not limited to, the addition,
replacement, or termination of the Administrator or Board President; any change In
ownership of the Facility by completing the Department's Form 1513; a change in the
Contractor's status as a for-profit or non-profit entity; any change to the Contractor's
admissions policy, and significant changes to the scope and coverage of the services
provided by the Contractor and/or Subcontractor under this Contract;
viii. Within ten (10) calendar days, notify the Residential Contract Manager if there are
Service Level issues which cannot be resolved by the Department's third-party
contractor or payment issues which cannot be resolved by the applicable regional
foster care billing coordinator;
ix. Within forty-eight ( 48) hours of an identified breach of confidentiality of children's
information, notify the Residential Contract Manager;
x. Notify the school regarding any change that will affect the Child's attendance to school
and, where possible the length of time a Child may be absent;
xi. Notify the residential.passportaccess@dfps.state.tx.us email box within 48 hours of
any additions or deletions of Health Passport Authorized Users;
xll. Notify the Department in writing within ten (10) calendar days if the Contractor
receives a formal complaint or lawsuit filed against it regarding noncompliance with
any statutes or regulations.
xili. Notify the Child's CPS Caseworker when a Voluntary Extended Foster Care Agreement
or Voluntary Return to Foster Care Agreement has not been received for a Child 18 to
22 years of age participating in either one of these programs. Efforts made to obtain
copies of these agreements should be documented in the Child's record; and
xiv. Notify a Child's CPS caseworker when a Child is 16 years of age or older, If at the time
of updating the Child's Service Plan, the Contractor is not aware of a plan for the Child
to enroll in or receive PAL Life Skills training classes.
to
court
when
Is an
be
immediate threat to the health, safety or well-being of a Child, after the Contractor
provides notice or requests removal under section 26 of this Contract. However,
rgnnnv'::U to
In a

Form 2282cx
July 2009
with less than thirty (30) days notice when the discharge is not for one of the reasons
in paragraph 43.B)ii. of this subsection. The discharge document shall describe the
Department's reasons for the discharge and the reasons for discharging with less than
thirty (30) days notice;
iv. Keep the Contractor informed of any significant changes in the Child's circumstances
in a timely manner including legal status, family situation, and factors related to the
Child's Permanency Goal;
v. Notify the Contractor when it knows that funds for this Contract will be reduced or
eliminated as referenced in section 51 of this Contract; and
vi. Notify the Contractor within ten ( 10) calendar days when a request for a Service Level
evaluation will not be forwarded to the Service Level Monitor.
44.
Reporting. The Contractor shall accurately complete cost reports, time studies, Internal
Control Structure Questionnaires (ICSQs), Contract Monitoring surveys, and any other reports
required and requested by the Department within time frames specified by DFPS. The
Contractor must submit annual cost reports as required by 1 TAC 355.7101-7103.
45.
Cost Report Training. The Contractor acknowledges and agrees that individual(s)
responsible for preparing the Contractor's cost reports shall:
A) Attend HHSC cost report training In compliance with 1 TAC 355.7101 prior to submitting
an annual cost report; and
B) Attach a copy of the preparer's training certificate to each completed cost report.
46.
Authority of Department Staff. Department staff are not authorized to sign forms
developed by the Contractor unless those forms have received prior approval by an attorney
for the Department. The Department is not bound by unauthorized staff actions in signing
such forms. Department staff are permitted to sign the written Service Plan referenced in
Attachment C of this Contract, sign documents as witnesses, and sign documents
acknowledging receipt of information from Contractors.
47.
Notices of Department Funding. The Contractor shall place notices acknowledging the
funding it receives from the Department in all of its literature and information published on its
website that describes services provided under this Contract, in the same font size as the
majority of the other descriptive material. This notice will also appear in the Contractor's
annual financial re ort if an is issued.
CONTRACT MONITORING
48.
Assessments of Physical Facilities and Operations. The Contractor shall allow periodic
assessments of its physical facilities and operations, which may include specific foster homes,
and operations shall be
a
The Contractor's physical
related documentation for compliance with contractual and statutory/regulatory

requirements.
Service
a periodic Service Level compliance review to

Form 2282cx
July 2009
Levels after the thirty (30) calendar-day period for correction. Upon receipt of notification
from the Department, the Contractor will not be paid more than the Service Level daily unit
rate as determined by the Service Level Monitor. The Contractor will not be paid at a rate
higher than the Service Level rate until the Contractor receives notice from the
Department. The Service Level Monitor will indicate to the Department that all contracted
services are being met and the Department will subsequently notify the Contractor. This is
not a limitation on other remedies that DFPS may pursue.
C) Acceptance of funds under this Contract acts as acceptance of the authority of the State
Auditor's Office, HHSC Office of Inspector General, or any successor agency to audit or
investigate the expenditure of funds under this Contract or any, and all subcontracts. The
Contractor further agrees to cooperate fully with the State Auditor's Office and/or HHSC.
The Contractor will ensure that this clause concerning the authority to audit funds received
indirectly by Subcontractors through the Contractor and the requirement to cooperate is
included in any subcontract it awards.
OTHER PROVISIONS
SO.
Precedence of Contractor Compliance. The terms of the Contract shall prevail over less
stringent licensing regulations or other state or federal regulations.
51.
Contract Contingency. This Contract is at all times contingent upon the availability and
receipt of state or federal funds that the Department has allocated to this Contract. If funds
for this Contract become unavailable during any budget period, this Contract may be
immediately terminated or reduced at the discretion of the Department.
52.
Transfers, Assignments and Subcontracting.

A) The Contractor shall not transfer or assign this Contract without prior written approval from
the Department.
B) The Contractor shall obtain prior written approval from DFPS prior to entering into any
subcontract for child care services or therapy.
C) The Contractor shall require any Subcontractors to abide by all the terms and conditions of
this Contract.
D) The Contractor shall not in any way be relieved of any responsibility under this Agreement
by any subcontract.
53.
Contract Changes, Amendments and Renewals.

A) Changes and Amendments. Except as provided in subsection 53. C) of this section, no
change, modification, or amendment to the Contract will be effective until approved in
writing by the Department and the Contractor. This Contract together with any approved
amendment(s) to this Contract shall be the controlling instrument in case of any dispute
C) Unilateral Amendments. The Department reserves the right to make unilateral

amendments to this Contract. A unilateral amendment will be effective upon the
Contractor's receipt of a copy of the amendment signed by the Department. DFPS reserves
execute a
to:
Rco-------------------------------------------------------------~..age24

Form 2282cx
July 2009
iii. Correct an obvious clerical error in the Contract;

iv. Change Contract and resource numbers;
v. Change the recorded license number of any license needed under this Contract in order
to reflect the correct number as Issued by the licensing authority;
vi. Update Service Level descriptions or daily rates; or
vii. Comply with a court order or judgment.
54.
55.
Remedies. In addition to, or Instead of, all other actions authorized under this Contract, the
Department, based on information from Monitoring or other verifiable sources, may take any
other actions deemed reasonable by the Department to ensure compliance with the terms and
conditions of this Contract. Such actions Include, but are not limited to, the following:
A) The Department may require the Contractor to take specific corrective actions in order to
maintain compliance with Service Levels, applicable federal or state regulations, and the
terms and conditions of this Contract. The Contractor's failure to comply with the specific
corrective actions may be grounds for the Department to suspend or terminate the
Contract, in whole or in part. The Contractor must respond in writing to the Contract
corrective action plan and must address each correction in writing. The Contractor must
submit Its written response to the Department for review and approval. Upon receipt of
the Department's approval, the Contractor shall implement the requirements of the
Contract corrective action plan and shall maintain compliance with the Contract corrective
action plan. Failure to comply or maintain compliance with the Contract corrective action
plan may be grounds for the exercise of further remedies set forth in this section;
B) Recover payments paid to the Contractor or impose remedies based on Monitoring/audit
findings of violations of Contract requirements;
C) Temporarily or permanently remove any or all children subject to the terms of this
Contract;
D) Suspend and/or limit any further placements of children, and place conditions on any such
suspensions and/or limitations of placements;
E) Suspend, place into abeyance, or remove any of the Contractor's contractual rights, in
whole or in part; and
F) In addition to any other right to suspend or terminate contained in this Contract, the
Department reserves the right to suspend or terminate this Contract, in whole or in part
and conduct a new solicitation and/or enter into a new Contract for the same or similar
services.
Provisions for Suspension or Termination of Contract and Dispute Resolution.
A) If the Contractor fails to provide services according to the terms and conditions of this
Contract, the Department may immediately, upon written notice of default to the
Contractor, suspend or terminate all or any part of the Contract.
B) Either party may terminate this Contract by giving thirty (30) calendar days written notice
to the other party, after which the Contract will terminate at the end of the thirty (30)
f"::llil:>r'll't::\1" day
period.
in
to nrnt'\ll"\lf'"
or nrn.utn
by the Department to new homes. The respective accrued interests or obligations incurred
to date of termination must be settled equitably. This equitable settlement shall occur in
,."""" 112 ""'"" with 40 TAC 732.270-271
date
Contract
nru:.rn.r:onr
Rco-------------------------------------------------------------~age

E)
F)
G)
H)
Form 2282cx
July 2009
of the expiration or termination of the Contract; however, In the event this is not possible,
the Contractor will continue to provide care for the children in accordance all terms and
conditions of this Contract. The Department will reimburse the Contractor for any care
provided after the date of Contract termination or Contract expiration until all children are
removed from the Contractor's care.
The Department shall terminate this Contract if the Contractor is found liable for or has a
contract, license, certificate, or permit of any kind revoked for Medicaid fraud.
The Department shall suspend or terminate this Contract if the Contractor's license,
certificate, contract, permit, registration, or other approval (any of which are required to
operate and to provide the services under this Contract) has been suspended or terminated
by the applicable federal or state governmental authority, or by any applicable
governmental entity named in Chapter 531 of the Texas Government Code.
If this Contract is terminated or suspended for any reason, Department and the State of
Texas shall not be liable to the Contractor for any damages, claims, losses, or any other
amounts arising from or related to any such termination. However, the Contractor may be
entitled to the remedies provided in Government Code, Chapter 2260.
Contract Dispute Resolution.
I. DFPS and the Contractor must use the dispute resolution process provided for in
Chapter 2260 of the Texas Government Code to attempt to resolve any claim for breach
of Contract made by the Contractor.
ii. Neither the occurrence of an event, nor the pendency of a claim constitutes grounds for
the suspension of performance by the Contractor, in whole or in part.
56.
INDEMNIFICATION. THE CONTRACTOR SHALL INDEMNIFY THE DEPARTMENT,

DEPARTMENT OFFICERS, AGENTS, REPRESENTATIVES, AND EMPLOYEES FROM AND
AGAINST ALL CLAIMS, ACTIONS, SUITS, DEMANDS, PROCEEDINGS, COSTS, DAMAGES,
LOSSES, OR LIABILITIES RESULTING FROM ANY ACTS OR OMISSIONS OF THE
CONTRACTOR OR CONTRACTOR'S AGENTS, EMPLOYEES, REPRESENTATIVES,
VOLUNTEERS, OR SUBCONTRACTORS IN THE EXECUTION OR PERFORMANCE OF THIS
CONTRACT. THE CONTRACTOR SHALL PAY THE FULL AMOUNT OF ANY RESULTING
COSTS WITHIN TEN (10) CALENDAR DAYS AFTER THE RECEIPT OF WRITTEN NOTICE
FROM DFPS, AND SHALL COORDINATE ANY DEFENSE WITH THE TEXAS ATTORNEY
GENERAL.
57.
Force Majeure. The Contractor will be excused from the obligations of this Contract to the
extent that performance is delayed or prevented by any circumstances (except financial)
reasonably beyond the Contractor's control. Such delays or failures to perform shall extend
the period of performance at the discretion of DFPS. The Contractor shall inform the
Department in writing of proof of force majeure within three (3) business days or otherwise
waive this right as a defense. The Contractor agrees that breach of this provision entitles
DFPS to any and all available remedies.
Copyrights and Use of Information.

A)
B)
C)
D)
E)
F)
Form 2282cx
July 2009
Form 2031, Signature Authority Designation;

Form 2033RCC, Subcontractor Documentation Form;
Form 2033a-RCC, Subcontractor Process;
Forms 4732/4732addem, Request for Determination of Ability to Contract;
Form 4733, Certifications or Form 4733GOV 1 Certifications for Governmental Entities, as
applicable; and
Form 9007 RCC, Internal Control Structure Questionnaire (ICSQ) for Residential Child
care.
60.
Certifications. The Contractor acknowledges Its continuing obligation to comply with the
requirements of the following certifications contained in its proposal, and will immediately
notify DFPS of any changes in circumstances affecting these certifications:
A) Federallobbying;
B) Debarment and suspension;
C) Drug Free Workplace;
D) Child support; and
E) Anti-trust.
61.
List of Attachments. The following documents are attached hereto and incorporated herein
by this reference:
Attachment A- 24-Hour Residential Child Care Rates

Attachment B- Residential Child Care Contract Glossary
Attachment C- Service Level Descriptions
Attachment D- Intermittent Alternate Care
Attachment E-Special Terms and Conditions
Attachment F- Performance Measures
62.
General Release. The acceptance by the Contractor or its assignees of the final payment
under this Contract, whether by voucher, judgment of any court of competent jurisdiction, or
any other administrative means, shall constitute and operate as a general release to the State
from all claims of and liability to the Contractor arising out of the performance of this Contract.
63.
Waiver. One or more waivers by the Department of any covenant, term or condition of this
Contract shall not be construed as a waiver of a subsequent breach of the same covenant,
term or condition, and any such waiver shall not be deemed to be a waiver of any other or
subsequent breach and shall not be construed to be a modification of the terms of the Contract
The consent or approval by the Department shall not be construed as a waiver of a subsequent
breach of the same covenant, term or condition. The consent or approval by the Department
to any act of the other party requiring such consent or approval shall not be deemed to waive
or render unnecessary consent to or approval of any subsequent similar act.
65.

Form 2282cx
July 2009
Term. This Contract is effective Seotember 1. 2009 through August 31. 2010.
Texas Department of Family and Protective
Contractor: Southwest Key Programs, Inc.
=~4WLt
Printed Name:
Colleen McCall
Printed Name:
Juan Jose Sanchez
Printed Title:
Director of Field
Printed Title:
Executive Director
AUG 182009
Date
,
I {2,t'(f DOf
Date

Form 2282cx
July 2009
Attachment "A"
24-Hour Residential Child-Care Rates
The following rates will be effective through the Contract term:
~"'
'"." _., u.
"U
Rate Structure
~: !.J!~~~:
Basic CPA
Basic Foster Family
Basic Facility
Moderate CPA
Moderate Foster Family_
Moderate Facility
Specialized CPA
Specialized Foster Family
Specialized Facility
Intense CPA
FY 2010 Rata
...
. " ~.'f.~~
i$39.52
$22.15
$42.18
l$71.91
l$38.77
$96.17
$95.79
l$49.85
l$138.25
Intense Facility
$175.66
$88.62
$242.85
Emergency Care Services
l$115.44
Intense Foster Family
-J~i ~]~~~
The amounts below are the minimum amounts that a Child-Placing Agency must reimburse Its foster
families for children receiving services under a Contract with the Department.
Moderate
S eciallzed
Intense
lnlmum Dallr Amount to be

Reimbursed to a Futer Pam
22.15
38.77
49.85
88.62
Rcc-------~-----------=----------------------------------=--Page29of59


Attachment "B"
Form 2282cx
July 2009
Residential Child-Care Contract Glossary

This Attachment contains a list of terms and their definitions as used in the Contract.
Appropriate Clothing: Clothing that, at a minimum, is:

i. In sufficient quantity such that there are an adequate number of the following: T-shirts,
undershirts, underwear, bras, socks, shoes, pants, shirts, skirts, blouses, coats/jackets,
sweaters, pajamas, shorts and other clothing necessary for a Child to partake in daily
activities;
ii. Gender and age-appropriate;
iii. Proportionate to the Child's size;
iv. In good condition, and is not worn-out with holes or tears (not intended by the manufacturer
to be part of the item of clothing);
v. Clean and washed on a regular basis;
vi. Fits comfortably;
vii. Is similar to clothing worn by other children in their community; and
viii.Adequate to protect children against natural elements, such as rain, snow, wind, cold, sun and
insects.
Authorized User: An employee approved by the Contractor and identified to the Department who
has been granted access to view information in the Health Passport.
Background Checks: Searches of different databases that are conducted on an individual. There
are three types of Background Checks: criminal history checks conducted by the Department of Public
Safety for crimes committed in the State, criminal history checks conducted by the FBI for crimes
committed anywhere in the U.S., and central registry checks conducted by DFPS. The central
registry is a database of people who have been found by Child Protective Services, Adult Protective
Services, or Licensing to have abused or neglected a Child. (40 TAC 745.611)
Basic Living Skills: Skills necessary to care for oneself and to function in the community. Basic
Living Skills include, but are not limited to, grocery shopping, food planning and preparation,
maintenance of living environment, laundry, personal hygiene, utilization of transportation systems,
personal identification documents, personal finance, and budgeting.
Behavioral Health Services: Services for the treatment of mental, emotional, or substance related
disorders.
Caregiver: A person whose duties include the supervision, guidance, and protection of a Child or
children.
Case Manager: A person who provides casework services to children in residential care. Casework
on
coordination
a
Caseworker: A
the conservatorship of the State. When the
approval
or .., ....,ru!,~:::u,r.n
Child,s Caseworker, the Contractor may utilize the Caseworker's Chain of Command if the Contractor
is unable to contact the Caseworker.
Rcc---------------------------------------------------------------P.age


Attachment "8"
Form 2282cx
July 2009
Caseworker, Supervisor, Program Director, Program Administrator and Regional Director. The
Department Chain of Command is identified by the district/region in which the Caseworker is housed.
Child: A person eligible for services under this Contract from birth through the end of the month in
which the Child turns 22 years of age.
Child-care Services: Services that meet a Child's basic need for shelter, nutrition, clothing,
nurture, socialization and interpersonal skills, care for personal health and hygiene, supervision,
education, and service planning.
Child Placement Vacancy Database: The DFPS internet website used by Contractors to report
vacancies and by the Department to assist in finding placements.
Child's Plan of Service: The Department's developed plan that addresses the services that will be
provided to each foster Child to meet the Child's specific needs while in Substitute Care.
Chronic Physical Condition: A disease or disabling condition of the body, of a bodily tissue or of an
organ which will last or is expected to last for at least 12 months; that results, or without treatment,
may result in limits to one or more major life activities; and that requires health and related services
of a type or amount beyond those generally required by children. Such a condition may exist with
accompanying developmental, mental, behavioral, or emotional conditions, but is not solely a delay In
intellectual development or solely a mental, behavioral and/or emotional condition.
Connections: Relationships children have with extended family members, previous foster families,
schools, communities, tribes/tribal customs, religious/religions observances, and other social
networks.
Contract Period: The beginning date through the ending date specified in the term of the original
Contract, including Contract renewals and/or Contract extensions.
Contracted Components of Care: In addition to the requirements set forth In Attachment C and
sections 8 through 21 of this Contract, services documented in the Child's Plan of Service and within
the scope of the Contractor's license, provided directly, or procured on behalf of the Child.
Components of care include, but not limited to the provision of routine 24-hour child-care, behavior
counseling and supervision, educational and vocational activities, routine recreational activities,
medical and dental care, travel, and activities that may require the Contractor's participation.
Covered Behavioral Health Services: Behavioral Health Services allowable and reimbursed
through the Child's Medicaid benefits.
CPS Transition Plan: A plan to address the issues that are important for all children 16 and older
as they prepare to leave care and enter the adult world. The plan helps the Child 1 providers and
are net=ae!a
Cultural Competence:
people of various cultures, races, ethnic backgrounds, and religions In a manner that recognizes,
values, affirms, and respects the worth of the individuals and protects and preserves their dignity.
Designated Victim: A


Attachment "8"
Form 2282cx
July 2009
made or, if an Administrative Review is requested, only after the disposition Is Upheld by the
decision. Reference section 7710 of the LPPH.
Discipline: A form of guidance that is constructive or educational in nature and appropriate to the
Child's age, development, situation, and severity of behavior.
Educational Supports, Services and Benefits: State and Federal regulations regarding children in
OFPS substitute care that enable them to access services, such as counseling, mentorlng/tutorlng,
driver's education, graduation items, college Tuition and Fee Waiver information and verification
letters, and Education and Training Voucher.
Education and Training Voucher (ETV) Program: A federally-funded (Chafee) and stateadministered program. Under this program, children ages 16 to 23 years old may be eligible for up to
$5,000.00 financial assistance per year to help them reach their post-secondary educational goals.
Education Portfolio: The updated and maintained separate education binder that contains
important school documents and Is designed to follow school-age children to each placement. This
allows for the review of the most current educational records and documentation by school officials,
Residential Child-Care Contractors, Foster Parents, Kinship Caregivers, and the children.
Emergency Behavior Intervention: An intervention used in an emergency situation, including
personal restraint, mechanical restraint, emergency medication, and seclusion.
Extended Foster Care: A program for children 18 to 22 years old who are eligible, and have signed
an agreement, to participate in this program and are:
i. Enrolled and participating full time in a high school program leading toward a diploma and the
Child Is under age 22;
ii. Accepted for admission to a college, or vocational program, that does not begin immediately
and the Child is under age 21. In this situation, the Child's eligibility is extended three and a
half months after the end of the month in which the Child receives his/her high school diploma
or GED certificate; or
iii. Enrolled and participating full time in vocational or technical training classes, including GED
classes, and scheduled to graduate before reaching his/her 21st birthday. These children can
remain in care to complete vocational-technical training classes regardless of whether or not
the Child has received a high school diploma or GED certificate. (40 TAC 700.316)
Facility: Any Residential Child-Care operation including Child-Placing Agencies, Independent Foster
Homes, General Residential Operations, and Residential Treatment Centers.
Foster Care Maintenance Payments:
A) Payments to cover the cost of (and the cost of providing) food, clothing, shelter, dally supervision,
a
with
a Child, and
B) In cases where:
i. A Child placed In a foster home or child-care institution Is the parent of a son or daughter who
Is in the same home or institution, and


Attachment "8"
Form 2282cx
July 2009
the cost of the items described in that subsection with respect to such son or daughter. (42
USC, Chapter 7, section 675 (4))
Foster Parent: A person receiving foster care maintenance payments from a CPA. This term does
not apply to Contractor staff from other programs and Intermittent Alternate Care providers. This
term is specific to Child-Placing Agency programs.
Grooming Products: Items/products provided to the Child to meet their personal and ethnic needs,
Including, but not limited to, haircuts, hair care products, hair care accessories, sensitive skin
products, hypoallergenic products, and necessary headdress, where applicable.
Health Passport: An electronic health information system for the medical Information of children in
the care or custody of DFPS.
Individual Cultural Competence: The knowledge, skill or attribute one has relative to cultures
other than his/her own, that is observable in the consistent patterns of an individual's behavior,
interaction and work related activities over time, which contributes to the ability to effectively meet
the needs of children and families receiving services.
Individual Education Plan (IEP): A written statement for each Child with a disability that is
developed, reviewed, and revised according to the requirements of Individuals with Disabilities
Education Act (IDEA).
Initial Authorized Service Level: The first Basic, Moderate, Specialized, or Intense Service Level
determined by the third-party contractor and based on information regarding the Child's service
needs.
Interdisciplinary Team: A team of professionals that includes representation from at least three
disciplines of study.
Intermittent Alternate Care: A planned alternative 24-hour care provided for a Child by a licensed
Child-Placing Agency or Independent Foster Home as part of the agency or home's regulated child
care and that lasts more than 72 consecutive hours.
Kinship (Relative) Caregivers: Unlicensed caregivers whom the court has approved for a Child's
placement because they are related to the Child by blood, marriage, or adoption (relative); or have a
significant, long-standing relationship with the Child's family (fictive kin).
Managing Conservator: A person responsible for a Child as the result of a district court order
pursuant to the Texas Family Code Chapter 153. (TAC 700.501(9))
treatment, and management of illness and the preservation of
Medically Complex or Medically Fragile: A

Condition.
which are the minimum requirements for permit holders and

Form 2282cx

Attachment "8"
July 2009
Monitoring: Monitoring is a systematic examination of the physical site, financial statements,

records, and procedures of a Contractor. It involves many of the techniques and procedures used in
auditing, but differs both in scope and purpose. Functioning properly, the Monitoring process serves
as an early warning system, detecting potential problem areas before they become severe and
providing plans for corrective action.
Network Provider: Providers participating in the STAR Health network.
Newborn: For the purposes of Texas Health Steps requirements, a Newborn is any Child under one
year of age.
Organizational Cultural Competence: A set of values, behaviors, attitudes, and practices within a
system, organization, program or among Individuals, which enables staff and volunteers to work
effectively with children and families from other cultures. Furthermore, it refers to the staff's ability
to honor and respect the beliefs, language, interpersonal styles, and behaviors of Individuals and
families receiving services.
Permanency Planning: The identification of services for a Child (and usually to the Child's family),
the specification of the steps to be taken and the time frames for taking those steps so as to achieve
the following goals:
i. A safe and permanent living situation for the Child;
ii. A committed family for the Child;
iii. An enduring and nurturing family relationship that can meet the Child's needs;
iv. A sense of security for the Child; and
v. A legal status for the child that protects the rights of the Child.
(40 TAC 700.1201 and CPS policy 6200)
Permanency Goal: A Permanency Goal must be one of the following:
I. Family preservation;
ii. Family reunification;
iii. Alternative family placement with long-term commitment consisting of:
a. Adoption and care by a relative;
b. Permanent conservatorship and care by a relative
c. Adoption and care by an unrelated family;
d. Permanent conservatorship and care by an unrelated family;
e. care by a foster family with DFPS having permanent Conservatorship
f. Care in some other family arrangement with DFPS having permanent conservatorship; or
iv. Another planned living arrangement with support of a family consisting of:
a. Preparation for independent living, for children who are at least 16 years old and have no
developmental disability; or
b. Preparation for adult living with community assistance in the most integrated setting, for
children who are at least 18 years old and who have a developmental disability. (40 TAC
Personal Items:
.............. but are not
radios, and COs and electronics.
Preparation for Adult Living (PAL) Activities: Benefits and services provided to children in DFPS-
at
RC'c-----------------------------------------------------------~~ae34


Attachment "B"
Form 2282CX
July 2009
H. Life Skills training In core areas including financial management;

Iii. Job readiness and life decisions/responsibility;
iv. Educational/Vocational services;
v. Transitional Living Allowance (TLA) up to $1000 (distributed in increments up to $500 per
month for children who participate in PAL Life Skills training, to help children with initial startup costs in adult living);
vi. After care Room and Board (ACRB) assistance, based on need, up to $500 per month for rent,
utility deposits, food, etc. (not to exceed $3000 of accumulated payments per Child);
vii. case management to help children with self sufficiency planning and resource coordination;
viii.Teen conferences;
ix. Leadership development activities; and
x. Additional supportive services, based on need and availability of funds, such as mentoring
services and driver's education.
Primary Medical Needs: Specialized care and services needed by children who are Medically
Complex or Medically Fragile.
Programmatic Services: Types of services licensed and regulated by the DFPS Licensing Division,
which include Child-care Services, Treatment Services, Emergency Care Services, Transitional Living
Program, Assessment Services Program, Therapeutic Camp Services, and Respite Child-care Services
(40 TAC 748.61, 749.61 and 750.61).
Psychiatrist: A licensed physician with advanced training in the diagnosis and treatment of mental
and emotional disorders.
Psychologist: A person who holds a license to engage in the practice of psychology issued under
Occupations Code 501.252.
Reason to Believe (RTB): A finding of RTB means that a preponderance of evidence indicates
abuse/neglect/exploitation occurred. If any allegation disposition Is RTB, the overall case disposition
Is RTB.
Residential Child Care: The care, custody, supervision, assessment, training, education, or
treatment of an unrelated Child or children for 24 hours a day that occurs in a place other than the
Child's own home.
Return to Care:
A) A program designed for children 18 to 22 years old who are eligible and sign an agreement to
participate in this program. Eligible participants must have been in DFPS conservatorship at the
time they turned 18 years old (or were on run away status at the time they turned 18 years old
and their conservatorship case had not been dismissed), who want to return to foster care, and
t Attend
or a
course and have not reached their 22nd birthday;
a
4
..,..,.,nf'tu:e
B) The Return to Care program does not Include

over
are nu.or"''""'"
or living In the homes of Foster Parents, and the Foster Parents are not receiving a foster care
(40 TAC 745.601, 745.615, and 749.2653)
care of


Attachment "B"
Form 2282cx
July 2009
Serious Incident: Any non-routine occurrence that has an impact on the care, supervision, or
treatment of a Child or children. This includes, but is not limited to, suicide attempts, injuries
requiring medical treatment, runaways, commission of a crime, and allegations of abuse or neglect or
abusive treatment.
Service Level Monitor: The Contractor engaged by the Department to monitor the Contractor's
performance and documentation related to the Service Level requirements set forth in Attachment C.
Service Levels: An authorized structure that categorizes the Child's needs into a graduated scale
from minimal intervention to severe intervention. (TAC 700.2301-2407)
Service Management: A clinical service performed by the STAR Health contractor
(Superior/Integrated Mental Health Services) to facilitate development of a health care service plan
and coordination of clinical services among a member's primary care physician and specialty
providers to ensure members with special health care needs have access to, and appropriately utilize,
medically necessary covered services.
Service Plan: The Contractor's developed plan that addresses the services that will be provided to a
Child to meet the Child's specific needs while placed in the Contractor's care.
Social Skills: Skills necessary to function in the community. Social Skills Include, but are not
limited to, the ability to communicate with others, knowledge of community resources, scheduling
and attending medical appointments, job Interviewing, cultural competency, and the ability to interact
in various social situations.
Special Immigrant Juvenile Status: A designation that enable eligible undocumented children in
DFPS conservatorship to become permanent residents under the terms and conditions of U.S.
Immigration and Customs Enforcement.
STAR Health: A comprehensive managed health care system for Children in the conservatorship of
DFPS, young adults up to age 22 with a voluntary foster care agreement and young adults up to age
21 who are eligible for transitional Medicaid (left foster care following their 18th birthday).
Subcontractor: A person or entity that delivers part or all of the programmatic services of the
primary Contractor and Is not an employee of the primary Contractor. There is an agreement
between the two persons and/or two entitles whereby the primary Contractor authorizes the person
or entity (Subcontractor) to deliver the service. There does not have to be any payment for services
for the relationship to be considered a subcontract. For purposes of residential Contracts,
Subcontractors include Behavioral Health providers (excluding Behavioral Health Services provided by
Psychiatrists), Foster Parents, direct service providers, and management service providers. Examples
of subcontracted management services could include nutritional or case management services.
hrr\n~lr"rt-c:: that
as accounting/billing/payroll
or
a
of
Substitute Care:
care
to a.
I. Child in the Department's managing conservatorship who has been placed
a living situation
outside the Child's own home in order to protect the Child from abuse or neglect; or
of
and
to
in the
18
Rcc-------------------------------------------------------------~age


Attachment "B"
Form 2282cx
July 2009
Superior HealthPian Network: The organization responsible for managing STAR Health.
Supervise (children): Awareness of and responsibility for a Child's ongoing activity. Supervision
requires Caregivers to have knowledge of program and children's needs and to be accountable for
service delivery. The operation is responsible for providing the degree of supervision indicated by a
Child's age, developmental level; and physical, emotional, and social needs.
Texas Health Steps: A children's program under Medicaid which provides medical and dental
preventive care and treatment to Medicaid-enrolled children from birth to 21 years of age.
Tuition and Fee Waiver: A waiver of tuition and fees at state supported colleges, universities and
vocational schools for eligible children who are in DFPS conservatorship:
i. On or after their 18th birthday; or
ii. The day they receive their high school diploma or its equivalent; or
iii. At age 14 or older are eligible for adoption. (Texas Education Code, 54.211.)
Unplanned Discharge: A discharge where the Department has not provided the Contractor
advance notice of removal.
Upheld: A finding of RTB was sustained through an administrative review.


Attachment "C"
Form 2282cx
July 2009
Service Level Descriptions

700.2301. BASIC SERVICE LEVEL
The Basic Service Level consists of a supportive setting, preferably in a family, that is designed to
maintain or improve the child's functioning including:
1)
Routine guidance and supervision to ensure the child's safety and sense of security;
2)
Affection, reassurance, and involvement in activities appropriate to the child's age and
development to promote the child's well-being;
3)
Contact, in a manner that Is deemed in the best Interest of the child, with family members and
other persons significant to the child to maintain a sense of identity and culture; and
4)
Access to therapeutic, habllitative, and medical intervention and guidance from professionals or
paraprofessionals, on an as-needed basis, to help the child maintain functioning appropriate to
the child's age and development.
700.2303. CHARACTERISTICS OF A CHILD THAT NEEDS BASIC SERVICES
A child needing basic services is capable of responding to limit-setting or other interventions. The
children needing basic services may include:
1)
A child whose characteristics include one or more of the following:
A. Transient difficulties and occasional misbehavior;
B. Acting out In response to stress, but episodes of acting out are brief; and
C. Behavior that is minimally disturbing to others, but the behavior is considered typical for
the child's age and can be corrected.
2)
A child with developmental delays or mental retardation whose characteristics include minor to
moderate difficulties with conceptual, social, and practical adaptive skills.
700.2321. MODERATE SERVICE LEVEL
1)
The Moderate Service Level consists of a structured supportive setting, preferably in a family, in
which most activities are designed to improve the child's functioning including:
A. More than routine guidance and supervision to ensure the child's safety and sense of
security;
B. Affection, reassurance, and involvement in structured activities appropriate to the child's
age and developmc;!nt to promote the child's well being;
C. Contact, in a manner that is deemed in the best Interest of the child, with family members
and other persons significant to the child to maintain a sense of identity and culture; and
D. Access to therapeutic, habilitative, and medical intervention and guidance from
professionals or paraprofessionals to help the child attain or maintain functioning
appropriate to the child's age and development.
In addition to the description in subsection 1) of this section, a child with primary medical or
2)
habilitative needs may require Intermittent interventions from a skilled caregiver who has
demonstrated competence.
700.2323. CHARACTERISTICS OF A CHILD WHO NEEDS MODERATE SERVICES
A
Occasional physical aggression;

Minor self-injurious actions; and


Attachment "C"
Form 2282cx
July 2009
A.
3)
4)
Substance abuse to the extent or frequency that the child is at-risk of substantial
problems; and
B. A historical diagnosis of substance abuse or dependency with a need for regular
community support through groups or similar interventions.
A child with developmental delays or mental retardation whose characteristics include:
A. Moderate to substantial difficulties with conceptual, social, and practical adaptive skills to
include daily living and self-care; and
B. Moderate Impairment In communication, cognition, or expressions of affect.
A child with primary medical or habilitative needs, whose characteristics include one or more of
the following:
A. Occasional exacerbations or intermittent interventions in relation to the diagnosed medical
condition;
B. Limited dally living and self-care skills;
C. Ambulatory with assistance; and
D. Daily access to on-call, skilled caregivers with demonstrated competency.
700.2341. Specialized Service Level

1) The Specialized Service Level consists of a treatment setting, preferably In a family, in which
caregivers have specialized training to provide therapeutic, habilitative, and medical support and
interventions including:
A.
2)
24-hour supervision to ensure the child's safety and sense of security, which includes close
monitoring and increased limit setting;
B. Affection, reassurance, and Involvement In therapeutic activities appropriate to the child's
age and development to promote the child's well being;
C. Contact, In a manner that Is deemed In the best interest of the child, with family members
D. Therapeutic, habilitative, and medical intervention and guidance that is regularly scheduled
and professionally designed and supervised to help the child attain functioning appropriate
to the child's age and development.
habilitatlve needs may require regular interventions from a caregiver who has demonstrated
competence.
700.2343 CHARACTERISTICS OF A CHILD THAT NEEDS SPECIALIZED SERVICES

A child needing specialized services has severe problems In one or more areas of functioning. The
children needing specialized services may Include:
1)
A. Unpredictable non-violent, anti-social acts;
B. Frequent or unpredictable physical aggression;
C. Being markedly withdrawn and Isolated;
D. Major self-injurious actions to Include recent suicide attempts; and
3)
B. A primary diagnosis of substance abuse or dependency.

A child with developmental delays or mental retardation whose characteristics include one or
more of the following:
Texas
Dept of Family

Attachment "C"
Form 2282cx
July 2009
Lack of motivation or the inability to complete self-care activities or participate in social

activities;
D. Inability to respond appropriately to an emergency; and
E. Multiple physical disabilities including sensory impairments.
A child with primary medical or habilitative needs whose characteristics include one or more of
the following:
A. Regular or frequent exacerbations or interventions in relation to the diagnosed medical
condition;
B. Severely limited daily living and self-care skills;
C. Non-ambulatory or confined to a bed; and
D. Constant access to on-site, medically skilled caregivers with demonstrated competencies in
the interventions needed by children in their care.
C.
4)
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Attachment "C"
Form 2282cx
July 2009
700.2361 INTENSE SERVICE lEVEL

1)
The Intense Service Level consists of a high degree of structure, preferably in a family, to limit
the child's access to environments as necessary to protect the child. The caregivers have
specialized training to provide intense therapeutic and habilitative supports and interventions
with limited outside access, including:
A. 24-hour supervision to ensure the child's safety and sense of security, which includes
frequent one-to-one monitoring with the ability to provide immediate on-site response.
B. Affection, reassurance, and involvement in therapeutic activities appropriate to the child's
C. Contact, in a manner that is deemed in the best interest of the child, with family members
and other persons significant to the child, to maintain a sense of identity and culture;
D. Therapeutic, habilitative, and medical intervention and guidance that is frequently
scheduled and professionally designed and supervised to help the child attain functioning
more appropriate to the child's age and development; and
E. Consistent and frequent attention, direction, and assistance to help the child attain
stabilization and connect appropriately with the child's environment.
In addition to the description in subsection 1) of this section, a child with developmental delays
2)
or mental retardation needs professionally directed, designed and monitored interventions to
enhance mobility, communication, sensory, motor, and cognitive development, and self-help
skills.
3)
habilitative needs requires frequent and consistent interventions. The child may be dependent
on people or technology for accommodation and require interventions designed, monitored, or
approved by an appropriately constituted interdisciplinary team.
700.2363 CHARACTERISTICS OF A CHILD THAT NEEDS INTENSE SERVICES
A child needing intense services has severe problems in one or more areas of functioning that present
an imminent and critical danger of harm to self or others. The children needing intense services may
include:
1)
A. Extreme physical aggression that causes harm;
B. Recurring major self-injurious actions to include serious suicide attempts;
C. Other difficulties that present a critical risk of harm to self or others; and
D. Severely impaired reality testing, communication skills, cognitive, affect/ or personal
hygiene.
2)
A child who abuses alcohol, drugs, or other conscious-altering substances whose characteristics
Include a primary diagnosis of substance dependency in addition to being extremely aggressive
or self-destructive to the point of causing harm.
3)
A. Impairments so severe in conceptual, social, and practical adaptive skills that the child's
to actively
the
is limited and requires constant one-to-one
A child with
or
an '""'"""""c"'t
risk whose characteristics include one or more of the following:
A. Frequent acute exacerbations and chronic, intensive interventions in relation to the
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Attachment "C"
Form 2282cx
July 2009
100 Supervision
B100 BASIC SERVICE LEVEL SUPERVISION
B100.01 The caregiver provides a supportive setting, preferably a family that Is designed to
maintain or improve the child's functioning by establishing clear rules appropriate to the
developmental and functional levels of the child.
B100.02 The caregiver establishes a clear system of rewards and consequences.
B100.03 The caregiver supervises a child through guidance to ensure the child's safety and sense of
security.
M100 Moderate Service Level supervision
The caregiver provides supervision that Is required at the Basic Service Level
M100.01 The caregiver provides more than routine supervision with additional structure and
support, preferably in a family-like setting. The supervision should include structured daily
routines with limit setting.
M100.02 For a child with developmental delays, mental retardation, primary medical or habilitative
needs, the caregiver provides regular daily supervision.
M100.03 For a child with primary medical or habilitative needs the caregiver provides, as
appropriate, intermittent interventions that typically consist of verbal guidance, assistance,
and monitoring from a caregiver.
S100 Specialized Service Level Supervision
In addition to the supervision required at the Moderate Service Level:
S100.01 The provider has a written policy statement describing how supervision Is provided and
explaining how the program is structured to stabilize or improve the child's functioning.
S100.02 The provider has specialized training to provide therapeutic and habllitative support and
Interventions in a treatment setting.
S100.03 The provider has an adequate number of caregivers available at all time to meet a child's
needs, taking into account the child's age, medical, physical and mental condition, and
other factors that affect the amount of supervision required.
S100.04 The provider has written plans for the direct, continuous observation of a child who
presents a significant risk of harm to self or others.
S100.05 For a child with developmental delays or mental retardation the caregiver provides close
daily supervision.
S100.06 For a child with primary medical or habllitative needs the caregiver provides constant
1100 Intense Service Level Supervision

In addition to the supervision required at the Specialized Service Level;
1100.01 The
training to provide intense therapeutic and habilitative

treatment


Attachment "C"
Form 2282CX
July 2009
1100.02 An adequate number of caregivers are available to provide twenty-four hour supervision.
1100.03 For a child with developmental delays or mental retardation the caregiver provides twentyfour hour supervision.
1100.04 For a child with primary medical or habilitative needs the caregiver provides twenty-four
hour close supervision and, as appropriate, frequent and continuous interventions which
typically consist of hands-on physical intervention, assistance, and monitoring from a
caregiver.


Attachment "C"
Form 2282cx
July 2009
101 Child-To-Caregiver Ratios

8101 BASIC SERVICE LEVELS- The child-to-caregiver ratio must meet the applicable licensing
standards.
M101 MoDERATE SERVICE lEVELS- The child-to-caregiver ratio must meet the applicable licensing
standards.
S101 SPECIALIZED SERVICE LEVELS- The child-to-caregiver ratio must meet the applicable licensing
standards.
S101.01 There must be a written staffing plan documenting the ability to provide awake caregivers
throughout the night whenever necessary to meet the needs of a particular child.
1101 INTENSE SERVICE LEVEL CHILD-TO-CAREGIVER RAnos
1101.01 During all waking hours the caregiver's child-to-caregiver ratio must be no more than 5 to
1.
1101.02 During sleep hours the caregiver's child-to-caregiver ratio must meet the applicable
licensing standards.
1101.03 There are enough caregivers, to provide24-hour supervision to ensure the child's safety
and sense of security, which includes frequent one-to-one monitoring with the ability to
provide immediate on-site response.
1101.04 The staffing patterns and assignments are documented in writing. The documentation
includes the child-to-caregiver ratios, hours of coverage, and plans for providing backup
caregivers in emergencies.
1101.05 The written staffing plan documents the ability to provide 1 to 1 child to caregiver ratio for
twenty-four hours whenever necessary to meet the needs of a particular child.
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Attachment "C"
Form 2282cx
July 2009
200 - Medical
8200 BASIC SERVICE LEVEL MEDICAL AND DENTAL SERVICES
8200.01 The caregiver arranges for medical and dental services as determined by an agreement
between the caregiver and FPS. The medical and dental services include routine services,
annual check-ups, and services that are medically necessary.
8200.02 The caregiver documents in the child's record that the child received these services.
8200.03 The caregiver ensures that all the medications the child needs are administered as
prescribed by the physician.
M200 MODERATE SERVICE LEVEL MEDICAL AND DENTAL SERVICES
The caregiver arranges for or ensures the same medical and dental services that are required at the
Basic Service Level.
M200.01 For a child, receiving psychotropic medication, a physician, as often as clinically necessary
and appropriate, must monitor the child's condition.

M200.02 For a child, with developmental disabilities, mental retardation, primary medical or
habilitative needs, the caregiver arranges, as appropriate, for licensed nursing services,
assistance with mobility, and routine adjustment or replacement of medical equipment.
S200 SPECIALIZED SERVICE LEVEL MEDICAL AND DENTAL
The provider arranges for or ensures the same medical and dental services that are required at the
Moderate Service Level.
S200.01 The provider has a written plan, agreement, or contract with medical personnel to provide
routine medical, nursing and psychiatric services based on the needs of the child as
identified in the child's service plan. The plan or agreement for medical, nursing and
psychiatric services shall include provisions for timely access to services in emergencies.
The plan or agreement must also be sufficient to ensure appropriate monitoring of chronic
but stable physical illnesses.
S200.02 For a child with developmental disabilities, mental retardation, primary medical or
habilitative needs the provider also arranges, as appropriate, for: consistent and frequent
medical attention; a skilled caregiver to provide medical assistance; an on-call nurse to be
available; assistance with mobility; and administering of life-support medications and
treatments.
1200 Intense Service Level medical and dental services
Specialized Service Level.
1200.01 In addition, the provider has a written plan, agreement, or contract with medical personnel
to
on-call medical, nursing and psychiatric services based on the
appropriate monitoring of chronic

1200.02 For a child with developmental disabillties1 mental retardation, primary medical or
habilitative needs, the provider also arranges, as appropriate, for twenty-four hour medical
or
24 hour availability of nursing, medical, and psychiatric services;
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Attachment "C"
Form 2282cx
July 2009
300-Recreation
8300 Basic Service Level recreational and leisure-time services
8300.01 The caregiver ensures that opportunities to participate in community activities, such as
school sports or other extracurricular school activities, church activities, or local social
events, are available to the child.
8300.02 The caregiver organizes family activities that identify, recognize and reinforce the support
that is available to the child.
M300 MODERATE SERVICE LEVEL RECREATIONAL AND LEISURE-TIME SERVICES
In addition to the recreation and leisure-time services required at the Basic Service Level also:
M300.01 The caregiver arranges and supervises structured daily routines for the child that Includes
recreational and leisure-time activities.
M300.02 The caregiver ensures the activities are designed to meet the child,s therapeutic,
developmental, and medical needs.
M300.03 The caregiver documents the daily routine and the recreational and leisure-time activities
the child participated in.
M300.04 The caregiver allows enough flexibility in the daily routine and the activities for the child to
manage his time based on his individual goals.
M300.05 The caregiver provides activities that are modified to meet any restrictions or limitations,
due to a child,s developmental disability, mental retardation, or medical condition.
S300 SPECIALIZED SERVICE LEVEL RECREATIONAL AND LEISURE-TIME SERVICES
In addition to the recreation and leisure time-services required at the Moderate Service Level:
5300.01 The structured dally routine and the recreational and leisure-time activities are designed to
address the needs of the children in care.

5300.02 The therapeutic value of each activity based on the child's service plan is documented.
5300.03 If the child has primary medical or habilitative needs, recreational and leisure-time
activities may require medical and physical supports.

1300 INTENSE SERVICE LEVEL RECREATIONAL AND LEISURE-TIME SERVICES
In addition to the recreation and leisure-time services required at the Specialized Service Level,
1300.01 An interdisciplinary team of professionals who are qualified to address the child,s individual
needs designs an individualized service plan. The individual recreation plan must specify
the structured daily routine and the recreational and leisure-time activities and must be
included in the child,s service plan.
1300.02 If the child has primary medical or habilitative needs, the recreational and leisure-time
activities may require 1-to-1 medical and physical supports.


Attachment "C"
Form 2282CX
July 2009
400 - Education
B400 BASIC SERVICE LEVEL EDUCATIONAL SERVICES
B400.01 Access to a free and appropriate education
within the limits of state and federal law is

arranged and ensured for each child.
8400.02 Reasonable support and assistance will be provided for each child who qualifies as a special
education student under the Individual with Disabilities Education Act to ensure that the
appropriate educational and related services, Including Early Childhood Intervention, are
available In the least restrictive environment appropriate. This may Include the necessity to
participate in the Admission, Review and Dismissal Committee to develop the Individual
Education Plan explaining how the student will be educated.
B401 BASIC, MODERATE, SPECIALIZED AND INTENSE SERVICE LEVELS SCHOOLING
A child needs:
B401.01 a public school accredited by the Texas Education Agency (TEA);
B401.02
a special "nonpublic-school" with an educational program approved by TEA;
B401.03
a private or other nonpublic school accredited under the requirements of the Texas Private
School Accreditation Commission (TPSAC) a private or other nonpublic school that has
applied for accreditation under the requirements of TPSAC.
M400 MODERATE SERVICE LEVEL EDUCATIONAL SERVICES
In addition to the educational services required at the Basic Service Level,

M400.01
Additional structure and educational support is provided.
5400 SPECIALIZED SERVICE LEVEL EDUCATIONAL SERVICES
In addition to the educational services required at the Moderate Service Level.

The caregiver must coordinate the child's educational and related services with the child's
service plan, and document their consistency.
5400.02 The caregiver must designate a liaison with the child's school.
5400.03 The caregiver must document the liaison's involvement in the child's schooling.
5400.04 The caregiver must document a written description of the relationship between the
provider and the school district; or a written agreement between the provider and the
school district outlining the responsibilities of each party; and including procedures for
resolving conflicts.
5400.01
1400 INTENSE SERVICE LEVEL EDUCATIONAL SERVICES
In addition to the educational services required at the Specialized Service Level,

1400.01
One to one support, as appropriate, is provided by caregivers knowledgeable and trained

in the
to
needs and to encourage the child to


Attachment "C"
Form 2282CX
July 2009
500- Casework and Support Services

8500 BASIC SERVICE LEVEL CASEWORK AND SUPPORT SERVICES
Services that are designed to maintain and improve the child's functioning are provided in a family
setting.
8500.01 Assistance and support in developing or maintaining social skills appropriate to the child's
age and development Is provided.
8500.02 Affection, reassurance and involvement in activities appropriate to the child's age and
development to promote the child's well being must be provided.
8500.03 Support in helping the child adjust to the current placement must be provided.
8500.04 Access to therapeutic, habilitative and medical support addressing the child's particular
needs, as specified in the child's service plan must be provided. If therapeutic habilitative
and medical support services are provided, they must be documented.
M500 MODERATE SERVICE LEVEL CASEWORK AND SUPPORT SERVICES
In addition to the casework and support services that are required at the Basic Service Level,
additional structure and support Is provided in a family-like setting.
M500.01 The provider also ensures that all caregivers receive support and direction from someone
who is qualified to supervise their functioning as a caregiver.

M500.02 The provider also ensures completion of a diagnostic assessment on each child within 30
M500.03
M500.04
M500.05
M500.06
M500.07
days of admission. The assessment must address the child's strengths and needs In the
following areas: physical; psychological; behavioral; family; social; and educational.
The provider ensures provision of intermittent therapeutic, habilitative and medical
interventions in an environment designed to help the child attain or maintain functioning
The provider also ensures provision of individual, group, and family therapy for those
children who need therapy by professional therapists or counselors or paraprofessional
staff under the direct supervision of professional therapists or counselors.
The provider also ensures documentation of the provider's philosophy and program model
governing therapeutic interventions and treatments and ensures that the therapeutic or
habilitative program addresses the child's individual needs.
The provider ensures a written schedule of structured daily routines that is consistent with
the provider's programs of therapeutic support.
If the child qualifies for substance abuse services, the provider arranges for a substance
abuse assessment and intensive therapeutic interventions. The therapeutic interventions
may be provided on an outpatient basis and may include individual, family, or group
therapy.
5500 SPECIALIZED SERVICE LEVEL CASEWORK AND SUPPORT SERVICES
In addition to the casework and support services that is required at the Moderate Service Level,
5500.01
5500.02
children who need therapy, must be provided.

5500.03 If the child qualifies for substance abuse services, the provider arranges for the child to
participate in a substance abuse treatment program. The program may be either


Attachment "C"
Form 2282cx
July 2009
1500 INTENSE SERVICE LEVEL CASEWORK AND SUPPORT SERVICES

In addition to the casework and support services required at the Specialized Service Level,
1500.01 The child is provided with frequent and intense therapeutic, habilitative and medical
interventions that are individually designed to stabilize the child's condition.
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Attachment "C"
Form 2282CX
July 2009
501 - Service Plans

8S01 BASIC SERVICE LEVEL SERVICE PLAN REQUIREMENTS
8S01.01 A service plan must be developed within 30 calendar days of the child's admission.
8S01.02 The service plan must be based on the child's plan for permanency.
8S01.03 The service plan must identify strengths and document strategies to address the child's
medical and dental needs, developmental, educational and vocational needs, Including life
skills appropriate to the child's age and development, family contact needs; social needs;
and emotional needs.
8S01.04 The caregiver and the child, as appropriate, actively participate in the development,
implementation, and periodic review of the service plan.
BS01.0S The provider must periodically review service plans according to the appropriate licensing
standard.
MS01 MODERATE SERVICE LEVEL SERVICE PLAN REQUIREMENTS
In addition to the service plan requirements at the Basic Service Level,

The provider must have a case manager to coordinate implementation of the service plan.
The provider must develop a service plan based on the diagnostic needs assessment for
each child within 30 calendar days of the child's admission. This plan must include:
(A) An estimate of the length of time the child will remain in care;
(B) A description of the goals of service;
(C) Specific Instructions for caregivers;
(D) A transition plan; and
(E) Documentation of:
(i) The plan having been shared with the child and the child's parents or managing
conservator; and
(li) The child's care to date.
MS01.03 The provider must, when reviewing a service plan:
(A) Evaluate the services to date that have been provided to the child in each domain or
function; and
(B) Identify any additional need that has arisen since the previous service plan was
developed.
MS01.01
MS01.02
5S01 SPECIALIZED SERVICE LEVEL SERVICE PLAN REQUIREMENTS
In addition to the service plan requirements at the Moderate Service Level,

An initial service plan for each child is developed within 72 hours of the child's admission.
The diagnostic needs assessment and service plan for each child are developed by an
interdisciplinary team or a full-time staff member with three years of experience in treating
children with similar characteristics who has a master's degree in a mental health field
from an accredited college or university and is licensed as a therapist or counselor or has a
5S01.01
5S01.02
1501 INTENSE SERVICE LEVEL SERVICE PLAN REQUIREMENTS
In
to
at
expand the service plan to cover all of the child's waking hours and include:
IS01.01 A description of the emotional, behavioral, and physical conditions that require intense


Attachment "C"
Form 2282CX
July 2009
1501.03 A description of the special treatment program and other services and activities that are
planned to help the child achieve and maintain a condition allowing a lower Service Level;
1501.04 Criteria for re-evaluating the child's condition after 90 days and deciding whether to
continue the placement at the Intense Service Level; continue the placement at a lower
Service Level; transfer the child to a less restrictive setting; or refer the child to an
inpatient hospital; and,
1501.05 The provider must ensure that an interdisciplinary team of professionals develop, review,
and supervise each child's service plan.
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Attachment "C"
Form 2282CX
July 2009
502 Training
8502 BASIC CARE LEVEL TRAINING REQUIREMENTS
8502.01 Each family unit must receive at least
20 hours of training every year to help them

understand the needs and characteristics of children in care provide the care and
emotional support that children need and appropriately manage children's behavior. Note:
First-aid and cardiopulmonary-resuscitation training cannot be counted toward meeting
this annual training requirement. However, hours earned renewing First-aid and
cardiopulmonary resuscitation may be counted toward the annual requirement.
M502 MODERATE SERVICE LEVEL TRAINING REQUIREMENTS
In addition to the training requirements at the Basic Service Level,

M502.01 Each caregiver must receive pre-service training in areas appropriate to the needs and
characteristics of children In care.
M502.02
The number of hours of annual training required at the Moderate Service Level is 30 hours
per caregiver. These hours of training must help the caregiver understand the provider's
therapeutic and habilitative treatment modalities service programming and behavior
management programs.
M502.03
All caregivers who administer psychotropic medications must receive training on
psychotropic medications.
A licensed physician, a registered nurse, or a pharmacist must conduct Training on
psychotropic medication.
M502.05 The trainer assesses each participant, after the psychotropic medication training, to ensure
that the participant has learned the course content.
M502.06 The training course provided to caregivers includes Identification of the psychotropic
medications; basic pharmacology (the actions and side effects of, and possible adverse
reactions to, various medications); techniques and methods of administering medications;
and related policies and procedures.
M502.04
Note: The training received on psychotropic medication may be counted toward the annual training
requirement. A provider will be exempt from this training requirement if the provider has a written
policy statement specifying that the provider does not accept or maintain children on psychotropic
medications.
S502 SPECIALIZED SERVICE LEVEL TRAINING REQUIREMENTS
In addition to the training requirements at the Moderate Service Level,

S502.01
New caregivers without previous experience in a residential chlldcare may not be assigned
sole responsibility for any child until the new caregiver has been supervised for at least 40
care to
minimum of one year
to the population that
serve, such as children with primary medical needs, pervasive development disorders,
mental retardation, emotional disorders and physical disabilities, may permit new
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Attachment "C"
Form 2282cx
July 2009
S502.03 Caregivers in foster homes verified by child-placing agencies must meet the following
requirements: for homes with two or more caregivers, each caregiver must receive at least
30 hours of training; OR for homes with one caregiver, the caregiver must receive at least
50 hours of training.
503 Personnel
8503 BASIC SERVICE LEVEL PERSONNEL REQUIREMENTS
Providers must ensure that all caregivers and staff members meet all appropriate licensing and
contract requirements.
M503 MODERATE SERVICE LEVEL PERSONNEL REQUIREMENTS
In addition to the personnel requirements at the Basic Service Level, the provider must also meet the
following requirements:
M503.01 The staff includes at least one case manager.
M503.02 The casework and clinical supervisory staff have at least one year of experience In
providing services to children who have been removed from their homes.
M503.03 Each staff member with primary administrative and clinical responsibility for managing the
therapeutic interventions and programs:

Is a psychiatrist; or
Is a psychologist; or
Has a master's degree In social work or another field of human services, and Is an
appropriately licensed and qualified paraprofessional or professional under the
program model governing the provider's therapeutic Interventions and treatments;
or
Has a bachelor's degree In social work or another field of human services, and at
least three years of experience In providing care to children who have been
removed from their homes; or
(A)
(B)
(C)
(D)
(E)
Has a bachelor's degree in a field other than human services, and at least five years
of experience in providing care to children who have been removed from their
homes, including at least two years of clinical supervisory experience.
M503.04 Professional therapists, or paraprofessional staff under the direct supervision of
professional therapists, conduct interventions, such as individual, group, and family

therapy.
M503.05 The provider documents the treatment-plan strategies developed for, and the hours of
therapeutic services and types of Intervention provided to, the children in care.
M503.06 The provider documents the number of paraprofessional or professional staff scheduled to
provide
M503.07
M503.08 The provider has a professional-staffing plan that: includes a detailed description of the
qualifications, responsibilities, and authority of every paraprofessional or professional

,,..r~:;,...,. ...,.., whether
such position Is filled on a
or
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M503.09

Attachment "C"
Form 2282cx
July 2009
The provider has ensured that the professional-staffing plan assigns responsibilities for
conducting diagnostic assessments, developing and reviewing service plans, and providing
treatment services.
S503 SPECIAUZED SERVICE LEVEL PERSONNEL REQUIREMENTS
In addition to the personnel requirements at the Moderate Service Level,

The provider arranges for interventions such as individual, group, and family therapy to be
conducted by professional therapists; or behavior or medical intervention as directed by
the service plan.
S503.01
1503 INTENSE SERVICE LEVEL PERSONNEL REQUIREMENTS
In addition to the personnel requirements at the Specialized Service Level,

1503.01 The provider ensures that a physician recommends and approves services at the time of
the Initial diagnosis and at each review.
1503.02
The individual treatment program Is developed by an interdisciplinary team to address the

child's intense needs.
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Attachment "0"
Form 2282CX
July 2009
Intermittent Alternate Care

Intermittent Alternate Care is a planned alternative 24-hour care provided for a Child by a licensed
Child-Placing Agency or Independent foster home as part of the agency or home's_regulated child
care. The purpose of Intermittent Alternate care is to provide relief to the primary caregiver. For
the purpose of this Contract, an Intermittent Alternate care episode is one that lasts for more than
72 hours. Any episode lasting fewer than 72 hours is not considered Intermittent Alternate care.
A) The Department may allow contracted Child-Placing Agencies and Independent Foster Homes to
utilize Intermittent Alternate care to:
i.
Provide Foster Parents additional supports for child-care responsibilities;
ii. Increase the retention of Foster Parents;
iii. Decrease the number of moves children experience; and
iv. Promote the overall development and permanency needs for children in foster care.
B) Child-Placing Agencies and Independent Foster Homes that are permitted to use Intermittent
Alternate care must do so according to the following guidelines:
I. For the purpose of this Contract, an Intermittent Alternate Care episode is one that lasts more
than 72 hours;
ii. Intermittent Alternate care may not last for longer than 14 days for each Child;
iii. If Intermittent Alternate Care is needed for more than 14 days, the Contractor must contact
the Department's Caseworker or the Caseworker's supervisor as soon as it is determined the
Child needs Intermittent Alternate Care for more than 14 days in order to secure a new
placement for the Child;
iv. When a Child completes an Intermittent Alternate Care episode, the Child may not return to
Intermittent Alternate Care for at least 10 days;
v. A foster home providing Intermittent Alternate Care services must allow a minimum of 10 days
between the completion of one Intermittent Alternate Care episode and the beginning of the
next episode, unless the home is verified exclusively to provide Intermittent Alternate Care
(CPS Policy 7462.2); and
vi. The Department reserves the right to permit an increased length of stay when it determines
that it is in the Child's best interest and has been approved in writing by the CPS Supervisor or
designee.
C) When providing Intermittent Alternate Care, contracted Child-Placing Agencies and Independent
Foster Homes must:
i. Document the appropriateness of the Intermittent Alternate Care provider to ensure the health
and safety of all children in Intermittent Alternate Care;
II. Ensure that Intermittent Alternate care Is not detrimental to the Child;
Approve each episode of Intermittent Alternate care their
and each
one of
uses
v, Ensure that applicable Ucenslng

Standards are
vi. Ensure that each Child receiving Intermittent Alternate care services In one of the Contractor's
homes Is provided with appropriate sleeping arrangements. This includes comfortable bedding
and living arrangements that are behavioral 1 gender and age appropriate, Appropriate
Rcc--------------------------------------------------------------=IPage

a.
b.
c.
d.
e.
f.
g.
h.
I.

Attachment "D"
Form 2282cx
July 2009
Medical Care that is currently being provided;

Psychiatric care that is currently being provided;
The Child's medication regimen and Instructions;
Psychological care that is currently being provided;
Sleeping information;
Discipline instructions;
Relevant appointments such as family and sibling visits;
Other pertinent information that would benefit the Intermittent Alternate Care provider;
and
Any expectations that the Contractor may have of the Intermittent Alternate Care provider.
D) The Contractor must ensure that all Intermittent Alternate care providers used by the Contractor
are within one of the following categories:
i. Foster Parents verified by DFPS or a licensed Child-Placing Agency;
li. Foster Parents licensed by the DFPS Child-Care Licensing Division;
iii. Facilities that provide residential Child-Care Services and have been licensed or verified
through the DFPS Child-Care Licensing Division;
iv. Businesses that have a Home and Community-Support Services Certificate from or are verified
though the Texas Department of Aging and Disability Services (DADS); or
v. An approved individual who meets a minimum set of requirements. These requirements
include:
a. Criminal Background Checks on all individuals or persons living in the home age 14 years
of age and older;
b. Background Checks on all household members age 14 years old and older;
c. Proof of current Infant/child/adult CPR and first aid certification for the provider;
d. Proof of negative tuberculosis tests for all household members; and
e. Agrees to follow the Contractor's Discipline and confidentiality policies. (CPS policy 7462.1)
Rcc---------------------------------------------------------------Page


Attachment "E"
Form 2282cx
July 2009
Special Terms and Conditions
This page is Intentionally left blank.
RC'c-=-------------------------------------------------------~,age57of59

Form 2282cx
July 2009
Attachment "F"
Performance Measures
Contract Output Measures.
Output #1: The Contractor makes regular updates to the CPS Child Placement Vacancy
Database.
Output Performance Period: Contractor performance for this output is determined for each
month of the Contract Period, either wholly or partially, depending on the Contract start and end
dates.
Output Indicator: Percentage of business days that the Contractor updated its own information
in the CPS Child Placement Vacancy Database.
Output Target: 90%
Purpose: The purpose of this measure is to evaluate the Contractor's success providing reliable
placement vacancy information to the Department.
Data Source: CPS Child Placement Vacancy Database
Methodology:
The numerator is the number of business days reviewed where the Contractor updated or
confirmed placement vacancies.
The denominator is the number of business days reviewed.
Divide the numerator by the denominator. Multiply by 100 and state as a percentage.
Output #2: Each Child's Education Portfolio is up-to-date.

Output Performance Period: Contractor performance for this output is determined annually
but measured throughout the Contract Period.
Output Indicator: Percentage of school-age children in conservatorship for 30 calendar days or
more whose Education Portfolios are updated within 15 calendar days of all events requiring a
portfolio change.
Output Target: 90%
Purpose: The purpose of this measure is to evaluate the Contractor's success providing current
education information as described in section 14.A)iv. of this Contract to successive Caregivers,
the Department, and other necessary
in
to
meet
Data Source:
Contract Monitoring report (from records review)

Letters to the Contractor (from records review)

Form 2282cx
July 2009
Attachment "F"
Methodology:
The numerator is the number of documented reviews of Education Portfolios for school-age
children in conservatorship 30 calendar days or more where all portfolio changes are made within
15 calendar days of events requiring a portfolio change.
The denominator is the number of documented reviews of Education Portfolios for school-age
children in conservatorship 30 calendar days or more.
Contract Outcome Measure.

Outcome: Children are safe In care.
Outcome Performance Period: Contractor performance for this outcome is determined for one
or more of the following performance periods, wholly or partially, depending on the Contract start
and end dates: September 1 through November 30, December 1 through February 28, March 1
through May 31, and June 1 through August 31.
Outcome Indicator: Percentage of children under age 18 in contracted Residential Child-Care
placements and in DFPS managing conservatorship who are not determined to be Designated
Victims resulting in a Reason to Believe (RTB) disposition Upheld during the performance period.
Outcome Target: 100%
Purpose: The purpose of this measure is to evaluate the Contractor's success protecting children
in its care. This outcome directly relates to DFPS' mission to protect children from abuse/neglect
and to one of the federal outcomes measured by the Child and Family Services Review (CFSR) of
the US Heath and Human Services Administration for Children and Families.
Data Source: Information Management Protecting Adults and Children In Texas (IMPACT);
Information used for the performance period:
Facility (operation) as described In 40 TAC 745.37(3)(A)-(I), with an active Contract;
Number of DFPS placements in the contracted Facility that were active at any point
during the performance period; and
Number of Designated Victims at the Facility for which a disposition of RTB was Upheld.
Methodology: The numerator is the number of children who are/were In DFPS managing
conservatorship, placed with the Contractor, and Designated Victims determined by a Residential
Child-Care Licensing (RCCL) investigation, for which a disposition of RTB was Upheld during the
performance period.
The denominator is the total number of children in DFPS managing conservatorship placed with
the Contractor during the performance
Texas Dept. of Family

Purchased Client Services Contract

Amendment
Contract
Amendment
May2009
Form 9077
#I)
This AMENDMENT (Amendment) of contract

(Agreement or Contract) is entered
into by and between the Texas Department of Family and Protective Services, (DFPS or the
Department), and Southwest Key Programs, Inc. (Contractor).
I. Purpose
Section 53.A) of the Agreement stipulates that the Contract may only be modified through a
written
a
and si
both parties. DFPS procured
for
services and has been amended
Contract under
times. Both DFPS and the Contractor agree that Contract Sections 4.B) and 4.C) are amended
to reference the amended Contract Sections 6.F): Contract Sections 4.B), 4.C), and 4.D) are
amended to correct the reference to Section 40.F): Contract Section 6 added Section 6.F) to
include Contractor compliance related to Intense Foster Family Care Services; Contract Section
14.A)i.a.b.c. is amended to correct language; Contract Sections 41.D) and 41.F) and 41.E) and
41.G) are duplicate of which 41.F) and 41.G) will be deleted from Contract Section 41.
II. Effect of Amendment on Contract

A.
Unless otherwise modified, the terms and conditions of the Contract shall remain in full force
and effect.
B. This Amendment modifies Sections 4.B); 4.C); 4.D); 6; 14.A)i.a.b.c. and 41.A) through L) of
the Contract by deleting these terms in their entirety.
C. The deleted language of Sections 4.B); 4.C); 4.D); 6; 14.A)i.a.b.c. and 41.A) through J) of
the Contract noted above shall now read:
4. Applicable Contract Provisions.
This Contract contains the terms applicable to all
residential Child-Care Service contracts including those with Child-Placing Agencies
(CPA), Independent Foster Homes, Residential Treatment Centers (RTC) and General
Residential Operations (GRO).
B)
If the Contractor is a Residential Child-Care Facility, other than a CPA or
Independent Foster Home, sections 6.B), 6.C), 6.D), 6.F) 16.B), 23, 25.C),
40.G), and 42, of this Contract are not applicable.
If the Contractor is an Independent Foster Home, sections 6.B), 6.C), 6.D), 6.F)
C)
16.B), 23, 25.C), and 40.G) of this Contract are not applicable.
D)
If the Contractor is a GRO providing Emergency Care Services, sections 6, 10,
16.B), 23, 25.C), 40.G), and 42 of this Contract are not applicable.
6. Contracted Service Levels. The Contractor agrees to and acknowledges the following:
DFPS will determine the minimum services
by the Contractor to each
A)
will
the
Child based on the Child's level of need. The

C)
D)
E)
F)

Amendment
CPA's requesting an Initial Authorized Service Level within the first forty-five
(45) days of admitting a Child may be paid the new initial Service Level rate up
to sixty (60) days in the past when the following conditions are met:
i.
The retroactive initial Service Level must be submitted for authorization to
the Service Level Monitor within forty-five (45) days of admitting a Child
who does not have an Initial Authorized Service Level;
ii.
Upon admission to the CPA, the Child must remain in the same foster
home or have been in Intermittent Alternate Care within the same CPA
that is requesting the Initial Authorized Service Level; and
iii.
The Child:
a.
Remained less than thirty (30) days in a general residential
operation providing emergency care services placement immediately
prior to placement with a CPA; or
b.
The Child was placed in any other setting.
CPAs serving children at Specialized and Intense Service Levels must:
i.
Be licensed to provide treatment services; and
ii.
Before placing a Child with a Specialized or Intense Service Level, ensure
that the foster home, in which the Child will be placed, is verified to
provide treatment service(s) appropriate to the Child's needs.
If a Contractor disagrees with the Service Level determination by the Service
Level Monitor and the Contractor chooses to appeal the determination, the
Contractor must utilize the administrative and peer review processes through
the Service Level Monitor. These processes are outlined on the Service Level
Monitor's website at: http://www.yft.org.
The Contractor shall comply with the Department's Intense Foster Family Care
Services policy and procedures.
14. Educational and Vocational Activities.

A)
Educational Activities.
i.
The Contractor shall ensure that:
a)
Each school-aged Child placed with the Contractor pursuant to this
Contract is enrolled in an accredited Texas public school within three
(3) school days of placement unless an exception is granted by
DFPS;
b)
Each school-aged Child placed with the Contractor pursuant to this
Contract attends a school accredited by the Texas Education Agency
(TEA) unless the Contractor has received an exception to this
requirement from the Department's Caseworker as approved in
writing from the Assistant Commissioner for CPS, or his/her
designee.
c)
Written verification of the Child's enrollment is provided to the
Department's Caseworker within five (5) calendar days of the
enrollment.
May 2009
Form 9077

B)
C)
May 2009
Form 9077

Amendment
final order is issued in litigation, or a written agreement is entered into between

the Department and the Contractor.
The Contractor shall provide any records and information concerning the Child
to the Department upon verbal request in emergency situations. Upon verbal
request from DFPS, the Contractor must submit legible records and information
within the Department's specified timeframe. Emergency requests for records
can include, but are not limited to, the need to review the Child's Service Level
in order to make a placement change, court ordered requests, or attorney
requests.
The Contractor shall provide any records and information concerning the Child
to the Department upon request. The Contractor must forward legible records
and information to the Department within fourteen {14) calendar days.
Information could include, but is not limited to documentation of face-to-face
visits with the Child by the Contractor's Case Manager staff, the Child S Service
Plan, documentation of services provided to a Child, Discipline logs, medical and
dental logs, educational documentation, and narratives. The Contractor shall
not dispose of such records before giving the Department written notice of its
intent to dispose of such records.
The Contractor shall provide the STAR Health contractor (Superior/Integrated
Mental Health Services) the following information for specific children for the
purposes of a Psychotropic Medication Utilization Review (PMUR) upon written
request by Superior:
i.
Physician notes (last 3 months);
ii.
Medication logs (last 3 months); and
111.
The most recent psychological evaluation.
In the event the Contractor receives a written request for information from the
Star Health contractor (Superior/Integrated Mental Health Services) that does
not involve PMUR as identified in subsection 41.D) of this section , the
Contractor shall advise the Star Health contractor (Superior/Integrated Mental
Health Services) to contact the child's caseworker or chain of command for
assistance.
All records received or created by the Contractor that are identifiable to children
referred by the Department are confidential and may be disclosed to third
parties only with the prior written consent of the Department or within the
scope of consents permitted by the Medical Consenter. The Contractor will take
reasonable measures to secure confidential records and prevent the destruction
and/or disclosure of such records. In the event the Contractor receives any
request or demand for disclosure of confidential records by oral questions,
documents subpoenas, civil investigative demand, interrogatories requests for
information or other similar legal process, the Contractor will provide the
Department with prompt notice of such request so that the Department may
seek an appropriate protective order and/or consent to the Contractor's
disclosure of the requested records.
The Contractor shall establish a method to ensure the
1
D)
E)
F)


Amendment
May 2009
Form 9077
ii.
I)
J)
To share only the minimum amount of information from the Health

Passport as is necessary to aid in the provision of health care, including
behavioral health care, services to the Child;
To be responsible for maintaining the physical security and confidentiality
iii.
of Health Passport information that the user may view on a computer,
print to paper or copy or download to other formats. People who do not
need the information should not have physical access to it;
iv.
To limit access to Health Passport records to those children who are
served by the Contractor or with whom the Authorized User has a
relationship for which Health Passport access is authorized; and
v.
Not to share passwords. If the Contractor becomes aware that a
password has been shared, he or she is required to notify Superior
HealthPian Network within 24 hours so that a new password can be
assigned.
The Contractor shall advise Authorized Users that DFPS may restrict or deny
access to the Health Passport if they are in violation of the user agreement or
terms and conditions of the Contract.
The provisions of this section shall remain in full force and effect following
termination of or cessation of the services performed under the terms of this
contract.
The parties to Contract
#lllffiiJI have duly executed this Amendment to be effective January
1, 2010.
Texas Department of Family
/)
/J
Contractor
/l
Signa e
Printed Name: Colleen McCall
Printed Title: Director of Field
Date
Date
file:///H|/FY10 AMENDMENTS SCANNED/CHRIS UNILATERAL AMEND/Southwest Key Programs Inc. - Contract
From: CHAPPELL, CHRISTOPHER B

Sent: Thursday, February 11, 2010 4:32 PM
To: 'Hector Zuniga (213 : Harlingen)'
Cc: Alexia Rodriguez (100 : Admin)
Subject: Southwest Key Programs, Inc. - Contract #23393175: Unilateral Amendment #2
Dear Mr. Zuniga:
This is to notify you that the Purchased Client Services Contract Amendment (Amendment) sent to you on November 23, 2009
contained a clerical error and will be corrected with the following revisions:
In Section I. Purpose, the Amendment indicated the Contract had been "amended 1 times" prior to that Amendment. Such
Contract between you and DFPS had, in fact, not been previously amended. DFPS is revising this language by redacting the and
has been amended 1 times phrase from the Amendment. No further action is necessary on your part.
This Unilateral Amendment is effective upon your receipt of this email. The Department of Family and Protective Services
apologizes for any confusion this clerical error may have caused. If you have additional questions regarding this Amendment or
your Contract, please contact me.
Sincerely,
Chris Chappell, LCSW
Residential Contracts Manager
DFPS - RCM (MC 278-5)
3635 S.E. Military Drive
San Antonio, TX 78223
Office: (210) 337-3177
Fax: (210) 304-7738
file:///H|/FY10 AMENDMENTS SCANNED/CHRIS UNILATERAL AMEND/Southwest Key Programs Inc. - Contract 2/12/2010 9:55:12 AM
TEXAS DEPARTMENT OF FAMILY AND PROTECTIVE SERVICES
COMMISSIONER
Anne Heiligenstein
July 6, 2010
ELECTRONIC MAIL
Juan Jose Sanchez
Executive Director
Southwest Key Programs, Inc.
23011 Rio Rancho Rd.
Harlingen, TX 78552
RE:
Unilateral Amendment to FY10 Residential Child Care Contract;

Southwest Key Programs, Inc.; Contract #23393175; Amendment #3
Dear Mr. Sanchez:

This letter represents a unilateral amendment as per RCC 53.C.iii. of the Residential Contract and is
effective the date in which you receive this notice. Due to the complete legal name, as registered with the
Texas Secretary of State, not being used for Contract #23393175 on the following forms, the complete legal
name has been entered by Residential Child Care Contracts. The legal name used for all contract forms is
Southwest Key Programs, Inc. Billing will not be disrupted as a result of this change.
4732 - Request for Determination of Ability to Contract

2033a - RCC Subcontractor Process
Section 53. Contract Changes, Amendments and Renewals

C) Unilateral Amendments. The Department reserves the right to make unilateral amendments to
this Contract. A unilateral amendment will be effective upon the Contractors receipt of a copy of the
amendment signed by the Department. DFPS reserves the right to execute a unilateral amendment
when necessary to:
ii. Change the name of the Contractor in order to reflect the Contractors name as recorded by the
Texas Secretary of State
If you have any questions regarding this change, please contact me at (210) 337-3177 or email
christopher.chappell@dfps.state.tx.us.
Sincerely,
Christopher Chappell, LCSW
Christopher Chappell, LCSW
Residential Contract Manager
cc: Lisa Jernigan-Graham, Section Manager Residential Child Care Contracts
3635 S. E. Military Drive, San Antonio, TX 78223

Office: 210-337-3177 Fax: 210-304-7738
Form 2282cx
June 2010


Contract Number
Facility Number
Provider Enrollment
Number
23393175
-=====~~-------
Resource Number
23884439
-==~~~~-------
General Residential
-=-88=-0=-8:::..8=-=3=---------- Facility License Type _O=..:p:.. ::e:..::.r.:=a:..::.t=-=o:..:n::___ _ _ __
530-08-0062
Renewal Number
GENERAL CONDITIONS
1.
Contracting Parties. Pursuant to its authority under Texas Human Resources Code (HRC)
40.058, the Texas Department of Family and Protective Services, (Department or DFPS),
and Southwest Key Programs, Inc., an independent contractor, (Contractor), enter into this
contract (Contract). This Contract, along with all Attachments, constitutes the entire and
complete agreement between the parties. In this Contract, all references to the Department
shall include the Texas Health and Human Services Commission (HHSC) and any other
agency named in Chapter 531 of the Texas Government Code to the extent that HHSC has
transferred DFPS' functions related to this Contract to itself or to such other agency
pursuant to HHSC authority in Texas Government Code 531.0055, or any other statutory
authority of HHSC. When acting in such capacity, HHSC or such other agency is an
authorized agent acting on behalf of DFPS.
2.
Governing Law. This Contract shall be construed in accordance with the laws of the State
of Texas (State). Unless otherwise mutually agreed, the venue will be in State District
Court, Travis County, Texas, and resulting payments shall be due and payable in Travis
County, Texas. This Contract shall not be construed to waive any rights, duties, or
immunities that either party has under the laws of the State of Texas and the United States.
3.
Purpose. The purpose of the residential child-care contract is to establish the

qualifications, standards, and terms of delivering specified services to Children in contracted
care, to set the terms and conditions of operations and payment, and to specify the method
of ensuring delivery of contracted services. The goal of residential child care is to protect
the well-being of the Child, enhance the Child's functional abilities in a 24-hour residential
child-care setting, and prepare the Child for his/her Permanency Goal, by providing the
following services as appropriate:
A) Child-Care and Treatment Services;
B) Service Planning for educational, recreational, vocational, transitional and experiential
learning activities;
C) Behavioral Health, diagnostic assessment, and health/preventive health care services;
D) Supervision for all activities and services while in the Contractor's care;
Continuity of care
of
services
in
Form 2282cx
June 2010


B) If the Contractor is a Residential Child-Care Facility, other than a CPA or Independent
Foster Home, sections 6.B), 6.C), 6.D), 6.F), 16.B), 23, 25.C), 34. B), 34. C), 4l.G), 43,
44.A), xvii, xviii, xix, xx and 48.B) of this Contract are not applicable.
C) If the Contractor is an Independent Foster Home, sections 6.B), 6.C), 6.D), 6.F), 16.B),
23, 25.C), 34.B), 34.C), 41.G), 44.A) xvii, xviii, xix, xx and 48.B) of this Contract are
not applicable.
D) If the Contractor is a GRO providing Emergency Care Services, in addition to the terms
in 4.B), sections 6, and 10, of this Contract are not applicable.
E) The Contractor must comply with the special terms and conditions set forth in
Attachment E.
5.
Contractor Warranty. By accepting the Child, the Contractor warrants that:

B) It will accept the Service Level unit rates described in section 34 of this Contract as
6.
Contracted Service Levels. The Contractor agrees to and acknowledges the following:
A) DFPS will determine the minimum services provided by the Contractor to each Child
based on the Child's level of need. The Department will designate the level of need as
Basic, Moderate, Specialized, or Intense, as described in Attachment C. The Contractor
shall provide services to Children authorized at the Basic, Moderate and Specialized
Service Levels, and shall maintain full compliance with the associated Service Levels as
described in Attachment C for each Child placed with the Contractor.
Monitor (third party contractor) within the first forty-five ( 45) days of admitting a Child
who has not had an Initial Authorized Service Level during the current paid foster care
stay. All other requests for Service Level evaluations must be directed to the Child's
Caseworker, who will forward any approved requests to the Service Level Monitor.
C) CPAs requesting an Initial Authorized Service Level within the first forty-five ( 45) days of
admitting a Child may be paid the new initial Service Level rate up to sixty (60) days in
the past when the following conditions are met:
i. The retroactive initial Service Level must be submitted for authorization to the
Service Level Monitor within forty-five ( 45) days of admitting a Child who does not
have an Initial Authorized Service Level;
ii. Upon admission to the CPA, the Child must remain in the same foster home or have
been in Intermittent Alternate Care within the same CPA that is requesting the Initial
Authorized Service Level; and
HL
Child

Form 2282cx
June 2010

These processes are outlined on the Service Level Monitor's website at:
http://www. yft. org.
F) The Contractor shall comply with the Department's Intense Foster Family Care Services
policy and procedures, if applicable.
7.
Voluntary Extended Foster Care or Return to Foster Care. Children 18 to 22 years of

age who meet eligibility criteria and voluntarily agree to participate in the Extended Foster
Care or Return to Foster Care programs, as defined in applicable sections of 40 TAC
700.316 and 700.346, are also eligible for Medicaid, and may be served under the terms
of this Contract once approved by the Department.
A) The Contractor shall offer assistance to the Child in maintaining documentation such as
school transcripts or pay stubs to demonstrate that any such Child 18 to 22 years of age
is qualified to remain in Extended Foster Care or Return to Care.
B) The Contractor shall assist the Child in the completion of the Voluntary Extended Foster
Care Agreement, Form 2540 during the following time periods:
i. Within the thirty (30) days preceding the Child's 18th birthday, when possible; and
ii. When this is not possible, no later than the 30th day after the Child's 18th birthday.

8.
Basic Living and Social Skills. The Contractor shall ensure for all Children that
Caregivers:
A) Teach Basic Living and Social Skills;
B) Maximize opportunities for learning through the use of Experiential Life Skills Activities;
C) Provide access to Experiential Life Skills Activities provided by community resources; and
D) Promote the ability to appropriately care for themselves and function in the community.
9.
Children's Rights. The Contractor shall:

A) Cooperate with Child Protective Services (CPS) to ensure all Children have been given a
placement, and for CPAs, at the time of any placement changes to a new foster home;
D) Provide services to Children who are deaf or hard of hearing that ensure effective
communication. When providing services to a Child who is deaf or hard of hearing,
contact a Deafness Resource Specialist from the Department for Assistive and
Rehabilitative Services (DARS) for assistance in determining how best to ensure effective
communication. \.!..!..l:~~~~=~=~=~-"!.!.J~L.,IC.~~~~~!::!.Lb~~:J;!.'

Form 2282cx
June 2010

iii. Provide guidance and support to Children 18 to 22 years of age to enable them to
assume primary responsibility for implementing Service Plan strategies designed to
meet their needs and achieve their goals;
iv. Develop a Service Plan in accordance with the requirements contained in Attachment
C under the sections entitled "Casework and Support Services" and "Service Plans";
v. Ensure that the Service Plan incorporates and is consistent with:
a. Permanency Planning and Permanency Goals identified by the Department;
b. Any behavioral goals established by the Department;
c. Components of a Child's Individual Education Plan (IEP) and the Individual
Transition Plan (ITP) that are both developed by the school's Admission, Review,
and Dismissal (ARD) committee, if appropriate;
d. Components of the CPS Transition Plan for Children 16 to 22 years of age to
include results of the Anseii-Casey Life Skills Assessment when applicable;
e. The Early Childhood Education (ECI) Individual Family Service Plan (IFSP) if
applicable; and
vi. Ensure that the Service Plan includes services to assist a Child to transition to a new
living arrangement or to new provider services, if applicable.
D) Service Management. The Contractor shall:
i. Ensure every Child is enrolled and each Caregiver participates in Service
Management when the STAR Health contractor (Superior/Integrated Mental Health
Services) determines the child meets the criteria for the program; and
ii. Request coordination services from STAR Health Service Management prior to
requesting a placement change for a child with Primary Medical Needs.
11.
Behavioral Health and Healthcare Services.

A) Medical, Dental and Vision Services.
i. The Contractor shall ensure access to necessary Medical, Dental, and Vision
services;
ii. The Contractor shall for all Children provide access to Texas Health Steps Medical
Checkups in the following manner:
a. Within fourteen (14) days of entry into DFPS conservatorship for a Child under
one (1) year of age;
b. Within twenty one (21) days of entry into DFPS conservatorship for a Child one
(1) year of age and older; and
c. Every thirteen (13) months from the date of the Child's last Medical checkup.
iii. The Contractor shall for all Children provide access to Texas Health Steps Dental
Checkups in the following manner:
a. Within sixty (60) days of a Child's entry into DFPS conservatorship; and
b. Every seven (7) months from the date of a Child's last Dental Checkup.
iv. The Contractor shall access Medicaid through STAR Health for covered Medical,
Dental, and Vision
available to

Form 2282cx
June 2010

B) Behavioral Health Services.
i. The Contractor shall ensure that Behavioral Health Services are available and
provided to each Child as needed by a STAR Health Network Provider (Network
Provider).
ii. A Behavioral Health Provider must be an employee or subcontractor of the
Contractor.
iii. The Contractor shall access Medicaid through STAR Health for Medicaid Covered
iv. The Contractor shall use community resources to obtain Behavioral Health Services
not covered by Medicaid.
v. No later than the third (3rd) business day after a Child's Caregiver receives a STAR
Health Denial Letter, the Contractor shall email a scanned copy of the denial letter
and the date of such receipt to the Department's Caseworker or Caseworker's
Chain of Command and the Regional Well-being Specialist.
vi. In the event that community resources are not available for Behavioral Health
Services and/or Medicaid does not cover the services, the Contractor shall be
financially responsible for providing Behavioral Health Services.
vii. The Contractor shall ensure that all Behavioral Health Services provided to Children
are properly documented within the Health Passport's Behavioral Health Module.
viii.The Contractor shall comply with Department procedures to request access to the
Health Passport for its employees that are not Network Providers.
ix. Effectiveness of Behavioral Health Services:
a. The Contractor shall ensure that Behavioral Health Providers are providing
Behavioral Health Services that are consistent with the following, where
applicable:
(1) The Child's Plan of Service;
(2) The Contractor's Service Plan for the Child;
(3) The Permanency Goal for the Child;
(4) The CPS Transition Plan;
(5) The Psychological evaluation and/or psychiatric evaluation; and
(6) Desired outcomes, including, but not limited to improvement in selfregulation and functioning.
b. The Contractor shall ensure that Behavioral Health Services provided are
properly documented.
c. The Contractor must have procedures for ensuring Behavioral Health Providers
are providing services in accordance with paragraph ll.B)ix, of this subsection.
C) Psychotropic Medications.
i. The Psychotropic Medication Utilization Parameters for Foster Children
(Parameters), developed by the Department of State Health Services shall be used,
where applicable, in the treatment and care of Children served under this Contract.
The Parameters, now incorporated into
Contract by

Form 2282cx
June 2010

12.

A) Food. The Contractor shall:
i. Provide food in accordance with requirements of Minimum Standards.
ii. Ensure that each Child receives fresh fruits, vegetables, and dairy products at least
once a day.
111. Ensure that Children have input into meal planning.
i. The Contractor shall maintain an inventory of the Child's clothing and Personal
Items that are of substantial medical, monetary, or sentimental value by:
a. Completing an inventory of clothing and Personal Items at admission;
b. Updating the inventory of clothing and Personal Items quarterly and at
discharge;
c. Ensuring that the Child (when age and developmentally able) and the
Contractor's staff or Caregiver signs and dates the clothing and Personal Item
inventory;
d. Sending the clothing and Personal Item inventory with the Department
Caseworker or other Department designee at discharge.
ii. The Contractor shall provide each Child with Appropriate Clothing as defined in
Atta<::hment B.
iii. The Contractor shall allow Children to label their clothes with the Child's name or
initials.
iv. The Contractor shall provide each Child with appropriate items necessary to meet
their hygiene and personal grooming needs by:
a. Making Grooming Products available so that each Child is able to maintain good
hygiene and grooming practices;
b. Ensuring that Grooming Produds meet each Child's ethnic hygiene and
individual hair care needs;
c. Ensuring sufficient hot water is available for daily baths or showers; and
d. Providing training/education as necessary to ensure each Child understands the
concepts of personal hygiene and grooming and what each child needs to do on
a daily basis to achieve and maintain good hygiene and grooming.
C) Room, Board, and Furnishings. The Contractor shall:
i. Provide each Child with a bed, sheets, towels, blankets, bedspreads, pillows,
mattresses and other furnishings necessary to meet the Child's needs. The
Contractor shall ensure that the items are kept dean and in good repair.
ii. Ensure that Children have personal storage space for their clothing and Personal
Items. The Contractor shall provide Children who are able to look after their own
needs with individual storage space in their bedrooms for clothing and Personal
Items.
iii. Provide behavioral, gender and age appropriate living arrangements for each Child,
with the exception of
groups,
in ::u,rnrn
Form 2282cx
June 2010


b. The Contractor shall not threaten the Child with loss of visits with family or
siblings as a punishment or deterrent to behavior.
c. The Contractor shall not threaten the Child with loss of placement as a
punishment or deterrent to behavior.
d. The Contractor shall not use unproductive work as a form of punishment (40
TAC, 748.2305 and 749.1955).
B) De-Escalation and Crisis Management. The Contractor shall:
i. Ensure that all de-escalation techniques are exhausted before utilizing more
restrictive and intrusive behavior intervention or Emergency Behavior Intervention;
ii. Utilize developmentally and age appropriate Emergency Behavior Intervention
techniques, as described in Minimum Standards, to resolve emergencies;
iii. Manage the home/Facility and milieu in a manner that minimizes disruption during
a crisis; and
iv. Develop and implement Emergency Behavior Intervention policies that are
consistent with the Minimum Standards at:
http:l/www.dfps.state.tx.us/Child Care/Child Care Standards and Regulations/de
fault.asp.
14.

i. The Contractor shall ensure that:
a. Each school-aged Child is enrolled in an accredited Texas public school within
three (3) school days of placement unless an exception has been granted in
writing by the Child's Caseworker;
b. Each school-aged Child attends a school accredited by the Texas Education
Agency (TEA) unless the Contractor has received an exception to this
requirement from the Child's Caseworker that has been approved in writing by
the Assistant Commissioner for CPS, or designee;
c. Each Child between three (3) and five (5) years of age:
(1.) Attends a pre-kindergarten program offered through the public school or
an early childhood education program offered through Head Start; if
available, in the local community of the Child's caregiver, unless an
exception has been granted from the Child's Caseworker that has been
approved in writing by the Assistant Commissioner for CPS; or
(2.) May attend a private, early childhood education program or prekindergarten program paid for by the Contractor or caregiver, if an
exception, has been granted by the Department's Caseworker; and
d. Written verification of the Child's enrollment is provided to the Department's
Caseworker within five (5) calendar days of the Child's enrollment.
ii. The Department may at any time, require that a Child attend the local public
schooL

Form 2282cx
June 2010

b. Special education documentation: Admission, Review & Dismissal (ARD) team
meeting notes, Individual Education Plan (IEP), Documents related to section
504 of the Rehabilitation Act of 1973 regarding reasonable accommodations,
Full Individual Evaluation and/or other diagnostic assessments;
c. Report cards, progress reports, and/or IEP progress reports;
d. Transcripts;
e. Standardized test results: TAKS/TAKS-Accommodated/TAKS-Modified;
f. Referrals, notices, or correspondences; and
g. School pictures.
v. The Contractor shall make the Education Portfolio readily available to the
Department for each school-age Child on any visit with the Child or otherwise, if
requested.
vi. The Contractor shall ensure and document that the report card and progress
reports are discussed with each School-Age Child.
vii. The Contractor shall provide the Child's Education Portfolio to the Department at
the time a School-Age Child is discharged from the Contractor's care. For each
School-Aged Child, the Contractor must ensure:
a. The most current educational documents and records are in the Child's
Education Portfolio.
b. The Child's Education Portfolio includes the Child's current school withdrawal
paperwork.
viii.The Contractor shall minimize disruptions to a Child's education by scheduling
therapy and other appointments outside school hours, whenever possible.
B) Post-Secondary Educational and Vocational Activities.
i. The Contractor shall provide vocational training, support services and activities,
including job readiness, skills training apprenticeships and trade skills, and
vocational training opportunities that are required at 16 years of age and/or as
developmentally appropriate, so each Child:
a. Has access to appropriate vocational activities and community education
programs; and
b. Receives the assistance needed to maximize the benefit of these activities.
ii. The Contractor must guide and assist the Child in accessing and completing
documents when required for the State-Paid Tuition Fee Waiver and Education and
Training Voucher (ETV) Program if there is a need by the Child.
C) ECI Program. For each Child who is younger than three (3) years of age, the
Contractor shall:
i. Refer each Child to ECI services when the Caregiver has concerns about a Child's
developmental needs;
ii. Facilitate the continuation of ECI services to each Child who was receiving ECI
services prior to placement;
iiL Ensure the
fully
Form 2282cx
June 2010


to the identification, evaluation, placement, or provision of ECI services, the
Caregiver may exercise the Caregiver's rights under the ECI rules of the Texas
Department of Assistive and Rehabilitative Services (DARS) which are
referenced in Part 2, Chapter 108 of Title 40 of the TAC, including 40 TAC
108.111, procedures for filing complaints; 108.113, investigation and
resolution of complaints and 108.123, opportunity for a hearing; and
v. Ensure the Caregiver provides written consent for the Child's ECI information to be
15.

A) Provide recreational activities such as indoor, outdoor, school, community and religious
or spiritual activities for Children served under this Contract that are age-appropriate,
varied, interactive with peers, and are of interest to the Child;
B) Ensure that Children participating in recreational activities are, at a minimum,
supervised in accordance with Minimum Standards and Service Level requirements
C) Intervene, as necessary, to reduce the risk of injuries; and
D) Ensure that Children have input into the types of recreational activities in which they
wish to participate.
16.
Travel. The Contractor shall:

A) Provide or arrange all travel necessary to ensure a Child's access to all necessary
Medical, Dental and Vision care for each Child, including Behavioral Health Services,
recreational, educational and after-school activities, family visits, court hearings,
Preparation for Adult Living (PAL) activities, Permanency Conferences, CPS Transition
Plan Meetings, Family Group Conferences, Circles of Support Conferences, and any
other services necessary to fulfill the tasks on a Child's Plan of Service.
B) A Contractor who is licensed as a CPA shall arrange and facilitate sibling visits when
siblings are at different placements within the same CPA unless the sibling visits are:
i. Prohibited by court order;
ii. Contrary to the best interest of the Children as reflected in any of the Plans of
Service of the siblings; or
iii. Discouraged by a mental health professional treating any of the siblings.
17.

A) Provide the Contracted Components of Care with a high level of Individual and
B) Provide services and activities to Children of various cultures, races, ethnic
backgrounds, and religions in a manner that recognizes and affirms their worth,
protects and preserves their dignity, promotes and encourages the development of a
and

Form 2282cx
June 2010

Plan, if applicable. The Contractor shall obtain written prior approval from DFPS PAL
Staff to utilize the PAL Life Skills Independent Study Guide for a Child in Substitute
Care and in order for the Child to receive credit for completion of the guide; and
D) Any other meetings and activities required by the Department or a court having
jurisdiction over the Child and necessary to ensure that the Contractor is complying
with a Child's Plan of Service.
19.
20.
21.
Maintaining Connections.
The Contractor shall make and document good faith efforts to ensure that Children are
able to preserve desired and appropriate Connections to the Child's own cultural identity
and community, including religious/spiritual, family, school, and appropriate organizations
throu h on-site or off-site means.
Providing Testimony. The Contractor shall:
A) Ensure that the Contractor's employees and Subcontractors appear and testify in
judicial proceedings, depositions and administrative hearings relating to a Child, at the
request of the Department; and
B) To the extent possible, notify, or assist the Department in locating, past employees or
Subcontractors when past employees or Subcontractors are needed to appear and
testify in accordance with this subsection. The Contractor is responsible for the cost
associated with the requirements of this subsection.
Least Restrictive Setting. The Contractor shall provide all services in a manner that
safeguards the health, welfare and safety of the Children in the least restrictive setting
possible.
22.
Facility Licensure. The Contractor shall:

A) Comply with Minimum Standards for any child-care license issued by the Department
to the Contractor for services provided under this Contract;
B) Comply with the operating or regulatory agency's regulations if the Contractor is a
Facility operated or regulated by one of the state agencies specified in 40 TAC
700.1321(e);
C) Comply with all applicable Service Levels as contained in Attachment C and the
Contracted Components of Care described in sections 8-21 of this Contract; and
D) Ensure that all staff providing direct services to the Child comply with state
professional laws pertaining to the services provided including laws pertaining to
licensure and confidentiality.
Contractor Support and Supervision of Foster Families.

Form 2282cx
June 2010

Contractor's direct Caregivers;
E) Develop and implement a written plan for contacting foster homes within seven (7)
calendar days following a placement to assess:
i. Whether the Child's needs are being met in the foster home; and
ii. How the Child is adjusting to the foster home;
H) Distribute the Texas Health Steps materials at https://secure.thstepsproducts.com/ to
verified foster homes at least annually, including:
i. Texas Health Steps Checkup Brochure EPSDT-05;
ii. Texas Health Steps Wallet Cards EPSDT-08;
iii. Appointment Education Brochure EPSDT-16;
iv. Case Management for Children and Pregnant Women Brochure CM1-182;
I) Avoid financial and other conflicts of interest by prohibiting the following individuals
from being a Foster Parent verified by the Contractor however, such persons may be
verified as Foster Parents by other CPAs:
i. Any person authorized to sign this Contract on behalf of the Contractor, or any
board member, officer, or employee of the CPA;
ii. Any individual or person working in the day-to-day operations of the Contractor,
either through the Contractor's employ or pursuant to a contractual arrangement
between the individual and the Contractor;
iii. An owner of the agency; and
iv. A member of the governing body;
J) Distribute HHSC information to Foster Parents regarding the Medicaid Medical
http://www.dfps.state.tx.us/documents/PCS/2009-05-26 MTP Memo.pdf.
24.
Background History Checks and Department Right of Removal.

A) The Department reserves the right to conduct background history checks on the
Contractor's employees, Subcontractors, volunteers, and all individuals who have
direct contact with Children in DFPS care or who have access to their records.
B) The Department reserves the right, in its sole discretion, to require by written notice
that the Contractor immediately:
i. Not use any individual who has direct contact with children or has access to their
records; or
ii. Immediately remove any such person from engaging in such contact or having
such access.
25.
Form 2282cx
June 2010


Multiethnic Placement Act, as amended by the Interethnic Adoption Act of 1996 ( 42
USC Chapter. 21 1996b), the Indian Child Welfare Act (25 USC Chapter 21 1915),
the Adoption and Safe Families Act of 1997 (42 USC Sec. 629 et seq. and Sec. 670 et
seq.); the Adam Walsh Child Protection and Safety Act of 2006 (42 USC 671) and
comparable state laws regarding placement of Children.
26.

A) The Contractor shall make all reasonable attempts to meet the needs of the Child in
the Contractor's care in order to prevent placement disruption. The Department, as
managing conservator, may remove a Child whenever the Department determines it is
in the best interest of the Child.
B) The Contractor shall document the Contractor's efforts and attempts to prevent
placement disruptions.
C) The Department shall remove a Child placed by the Department when notified by the
Contractor that the Child poses a danger to self or others or exhibits volatile or selfinjurious behaviors that are inappropriate for the program of service and requires a
i. If the Contractor provides the Department with documentation from a physician
that the Child poses a danger to self or others, to facilitate admission to a hospital,
the Department shall remove the Child within twenty-four (24) hours. Admission
of the Child to a hospital by the Contractor serves as documentation of the need for
a more secure setting. The Contractor shall immediately inform the Department's
Caseworker of the admission and shall state whether the Contractor is willing to
accept placement of the Child upon discharge from the hospital.
ii. If the Contractor provides the Department with documentation from a Psychiatrist,
licensed Psychologist, physician, LCSW or LPC showing that the Child consistently
exhibits behavior that cannot be managed within licensed programmatic services,
the Department shall remove the Child within fourteen (14) calendar days. The
Department shall immediately communicate with the Contractor and staff the
Child's circumstances to determine a plan for moving the Child to ensure the
Child's safety and that of others.
D) The Contractor shall notify the Department Caseworker within twenty-four (24) hours
of the Child's placement in jail or juvenile detention and shall state whether the
Contractor is willing to accept placement of the Child upon the Child's release from jail
or juvenile detention. If the Contractor is not willing to accept placement of the Child
upon the Child's release, the Department shall, within twenty-four (24) hours of
receipt of notification from the Contractor, remove the Child placed by the
Department.
E) If the Contractor provides other documentation to the Department that it is no longer
in the Child's best interest to remain at the Contractor's Facility, or that the Contractor
the Child,
Child within
cannot meet the

Form 2282cx
June 2010

(10) calendar days to remove the Child.
G) If the Contractor discharges a Child placed by the Department except as stated above,
it constitutes a breach of this Contract.
H) Not later than thirty (30) calendar days after the Contract is executed, the Contractor
shall notify the Department's Residential Contract Manager in writing of the
Contractor's designated employee(s) who may approve discharges as described in this
section.
I) The Contractor shall provide to the Department the following information and items
that belong to the Child for each discharge:
i. Upon the effective date of the discharge, the Child's:
a. Medications;
b. Medicai/Healthcare Items;
c. Service Plan;
d. Clothing and Personal Items;
e. Most recent clinical records such as psychological evaluations and psychological
testing;
f. Updated clothing and Personal Items inventory;
g. Education Portfolio; and
h. ECI Individual Family Service Plan (IFSP), if applicable_,_
ii. Within fifteen (15) calendar days after the discharge, the Child's:
a. Discharge summary; and
b. Updates to the Child's Education Portfolio.
J) Within five (5) calendar days of the Contractor's receipt from the Department of the
Form 2085-FC authorizing the placement of a Child with the Contractor, the Receiving
Contractor shall provide a copy of that Form 2085-FC and a written request to the
Discharging Contractor for:
i. Information not already received that is referenced in Minimum Standards 40 TAC
749.1371, 749.1373, 748.1437 and 748.1439, updates to the Education
Portfolio, and a copy of the ECI Individual Family Service Plan (IFSP), if applicable;
and
ii. An opportunity, if necessary, to communicate with the Discharging Contractor
about the needs of the Child.
K) Following the discharge of a Child from the Contractor's care and after the receipt by
the Discharging Contractor of a written request from the Receiving Contractor, along
with a copy of the Form 2085-FC authorizing such placement, the Discharging
Contractor:
i. Is authorized by DFPS to release the information referenced in 26 J);
ii. Must provide the Receiving Contractor all of the required items referenced in 26 J)
within fifteen (15) days of discharge; and
iii. Must, if requested, provide the Receiving Contractor the opportunity to
communicate with the Contractor about the
of the Child

Form 2282CX
June 2010

Child for seventy-two (72) hours after having the Department's Caseworker sign the
Department's Form 2089-C.
B) Emergency Placements. The Department shall attempt to complete and provide to the
Contractor at, or prior to, placement the Common Application for Placement of
Children in Residential Child Care (Form 2087) as the uniform assessment form and
application for admission. The form may be incomplete but shall contain all available
information. Alternatively, the Department may provide to the Contractor the
Alternative Application for Placement of Children in Residential Child Care (Form
2087ex). In either case, Form 2087 shall be completed and provided to the Contractor
at the time the Child's placement is changed from an emergency to a non-emergency
placement. The Contractor shall accept Form 2087 or Form 2087ex as the uniform
assessment form and application for admission for placement of Department Children.
The Contractor shall accept Children for placement by the Department only after
receiving completed Form 2085-FC, completed Form 2085-B, and/or 2085-C and/or
2085-D, and (complete or incomplete) Form 2087 or 2087ex.
C) Unaccompanied Emergency Placements. In the event an unaccompanied Child in the
care of the Department presents for emergency placement, the Contractor may accept
the Child for placement and shall immediately notify the Department to determine
Department instructions and to initiate documentation. The Department shall
complete the required forms within the next working day but may immediately move
the Child.
i. The Contractor shall accept Children for placement by the Department only after
receiving completed Form 2085-FC, completed 2085-B and/or 2085-C and/or
2085-D, and (complete or incomplete) Form 2087 or 2087ex.
ii. The Department shall complete and provide to the Contractor either Form 2087 or
2087ex.
a. The Department will complete the Form 2087 within thirty (30) calendar days
b. The Department will make available to the Contractor Forms 2085-FC, 2085-B,
2085-C, and 2085-D, 2087ex, and 2089 to provide to the Department's workers
for completion.
c. With the exception of retroactive initial Service Level authorization requests, as
described in section 6 of this Contract, when the Child's Service Level has not
been determined at the time of placement, the Contractor will be compensated
at the basic rate.
iii. At the time of admission and any placement change, the Department's Caseworker
shall provide the Caregiver and the Child a copy of the CPS Rights of Children and
Youth in Foster Care.
a. The Caseworker will review the CPS Rights of Children and Youth in Foster
Care with the Child

Form 2282cx
June 2010

i.
The Contractor shall follow the requirements of the Medical Consent for Children in
residential child-care providers at http://www.dfps.state.tx.us/PCS/residential.asp,
ii. The Medical Consenter is authorized to access, receive, and review all the Child's
medical records. Furthermore, the medical consenter may authorize the release of
the Child's medical records to the extent necessary to obtain services for the Child.
iii. The Contractor shall ensure that all Foster Parents and employees who are eligible
to serve as Medical Consenters under "How DFPS Establishes the Medical
Consenter", have access to and complete computer-based training on Informed
Consent.
iv. The Contractor shall ensure that all Foster Parents and employees who are eligible
to serve as Medical Consenters, as stated above, follow the requirements within
DFPS policy regarding "Responsibilities of Medical Consenters and back up Medical
Consenters".
G) CPS Transition Plan. The Contractor shall coordinate with CPS for Children 16 years of
age and older regarding:
i. The use of the CPS Transition Plan, Form 2500, as appropriate, at
http://www .dfps. state. tx. us/Child Protection/Transitiona I Living/forms. asp;
ii. Maintaining a copy of the Child's Voluntary Extended Foster Care Agreement Form
2540 or Return to Care Agreement Form 2560 in the Child's record; and
iii. The provision of information available at
http://www .dfps. state. tx. us/Child Protection/Transitiona I Livinq/default.asp
related to:
a. Aftercare services, benefits and provider contacts;
c. Extended Care and Return to Care information;
d. Preparation for Adult Living (PAL) services;
e. Texas Foster Care Handbook for Youth;
f. Transitional Medicaid and STAR Health;
g. Information related to the Child's Special Immigrant Juvenile Status, if
applicable; and
iv. The provision of information about Transition Service Centers available under the
"contacts link" at: http://www.dfps.state.tx.us/txyouth/default.asp
28.
Approval for Travel and Visits.

A) The Contractor shall develop and maintain a written policy regarding overnight travel
and overnight visits.
B) When the Contractor wishes to take a Child in the Department's conservatorship
the state, the Contractor must obtain prior written approval for
Form 2282CX
June 2010


circumstances (usually routine trips or visits).
F) When the Contractor desires to take a Child outside of the country, the Contractor
shall follow Department policies and procedures including the completion of Form
2069, Caregiver Declaration Regarding Out-of-Country Travel.
29.
Written Approvals.
A) Prior to moving a Child from one foster home to another foster home the Contractor
shall obtain written approval from the Department's Caseworker or Chain of Command.
In the event of an emergency, and if prior approval cannot be obtained, the Contractor
shall notify the Department of the move within twenty-four (24) hours. The
Department shall respond to requests for approval within ten (10) calendar days of
receiving a proper request.
B) Prior to requesting Department staff to sign Contractor-developed forms, the
Contractor must receive written approval from the Residential Contract Manager
indicating legal approval by the Department.
30.

A) The Contractor must maintain at all times a written disaster and emergency response
plan, policies and procedures to address internal and external emergencies and
disasters that include, but are not limited to acts of nature (such as flood, hurricane,
fires, and tornadoes), chemical or hazardous material spills, critical equipment failure,
weapons of mass destruction events, and acts of terrorism.
B) In the event of an emergency requiring evacuation or quarantine, the Contractor is
responsible for maintaining the safety and placement of all Children in its care. All
staff and Subcontractors of the Contractor must be aware of the disaster plan
requirements and be prepared to fulfill their role in executing the plan.
i. Mandatory evacuation if directed by local officials;
ii. Emergency evacuation;
iii. Emergency response;
iv. Disaster planning training for all staff and Caregivers;
v. Arrangements for adequate provision of:
a. Staffing;
b. Shelter;
c. Food;
d. Transportation;
e. Medication;
f. Supplies;
g. Emergency Equipment; and
h. Emergency Services.
the
Contact information

Form 2282CX
June 2010

asthma-related treatments), emergency care, and Medical Care for Children
with Primary Medical Needs (as defined in Attachment B); and
c. Plans for maintaining the services, as required by a court order and/or the
Child's Service Plan, for the Children in care after the disaster.
x. Communication with DFPS and CPS, including:
a. Identifying (name, telephone numbers) two emergency contacts designated
by the Contractor who will be available to DFPS at all times in the event of an
emergency or disaster;
b. Contacting CPS to provide information on the location and condition of
Children in care who have been evacuated as soon as the Children reach their
evacuation destination by contacting CPS through one of the following
methods:
(1.) During times when mass evacuation of part of Texas is anticipated,
DFPS will enable an online reporting feature on the DFPS public website
at: http://www.dfps.state.tx.us.
(2.) In situations when DFPS has enabled this online reporting feature and
the Contractor has access to the internet, the Contractor should use this
method to make the evacuation notification; or
(3.) In situations where the online reporting feature is not enabled or if the
Contractor does not have access to the internet, the evacuation
notification can be made by calling the DFPS abuse/neglect hotline at 1800-252-5400.
c. Contractors with multiple facilities and CPAs must contact CPS once per day,
at a minimum (unless otherwise instructed by DFPS), to provide information
concerning the Children in their care until all Children are accounted for; and
d. CPA's must have methods through which their homes can contact CPA
administration to Inform them of the location and condition of Children in care
as soon as possible upon reaching an evacuation destination.
xi. Post-disaster activities (including emergency power, food, water, and
transportation);
xii. Plans for return after an evacuation;
xiii.Methods to ensure the disaster plan remains current and is reviewed at least
every two (2) years and when changes in administration, construction, or
emergency phone numbers occur; and
xiv. Child-Placing Agencies must provide a copy of their disaster plan to foster
parents and ensure that each home has a written disaster plan, which will be
updated as necessary and at each re-evaluation required by Minimum Standard
749.2801(b). The CPA will maintain a copy of each home's disaster plan in its
records.
3L
Access to Children. The Contractor shall, at all times, permit access to all Children
Form 2282cx
June 2010


B) Maintain an email address for NYTD updates; and
C) Complete the NYTD survey within forty five (45) days after the Child's
33.
17th
birthday.
Contract Performance. Contractor performance evaluation is based on the assessment

of the output and outcome measures outlined in this section and contained in Attachment
F, compliance with the terms and conditions of this Contract, including all Attachments,
and, compliance with Minimum Standards, as indicated by Department records and
Contract Monitoring performed by Department staff. The Contract Performance measures
are:
A) Contract Output Measures as defined in Attachment F:
i. Output # 1. The Contractor makes regular updates to the CPS Child Placement
Vacancy Database.
ii. Output #2. Each Child's Education Portfolio is up-to-date.
111. Output #3. Stabilize the Child's placement.
B) Contract Outcome Measure as defined in Attachment F:
Outcome. Children are safe in care.
34.

A) HHSC periodically determines Service Level unit rates (daily rates) in accordance with
its Cost-finding Methodology. The daily rates in effect during the term of this Contract
are contained in Attachment A.
Department be remitted by the Contractor to Foster Parents to pay for the basic Child
maintenance costs of Children placed pursuant to this Contract. The required
reimbursements are set forth in Attachment A. If HHSC implements a change in the
Service Level rates, the Department will change those minimum dollar amounts in
Attachment A.
C) Foster Parent Minimum Reimbursement Funds are all payments of funds received by
the Contractor from the Department that constitute the minimum amounts that the
Contractor must pass through to reimburse a Foster Parent for services already
provided according to the rates set forth in this Contract. For any and all such Foster
Parent minimum Reimbursement Funds, the Contractor:
i. Shall hold , maintain, manage, and account for such funds in a fiduciary capacity,
without limitation because such funds are held for the sole purpose of
disbursement by the Contractor to the applicable Foster Parents;
ii. Shall not directly, indirectly, or collaterally pledge, assign, or otherwise attach,
without limitation, as security or collateral to any financial instrument or other
obligation any such funds that the Contractor has received, will receive, or may

Form 2282cx
June 2010

compensation for such services from the Department or any other entity.
B) The Contractor shall not be reimbursed for vandalism or damage caused by deliberate
acts of destruction by a Child placed with the Contractor.
C) The Department shall pay the Contractor the Service Level daily rate for each Child
placed by the Department and receiving services in accordance with the Child's Plan of
Service (including Permanency Planning goals), licensing standards, Contract terms,
and Service Level standards.
D) The Department shall pay for the calendar day of placement, but not for the calendar
day of discharge. If the Child is discharged on the day of placement, the Contractor
shall not be reimbursed for that day.
E) If a Child is away from the Contractor's Facility without prior authorization, and if the
Department's Caseworker or the Caseworker's supervisors and the Contractor agree in
writing that the Child should return to the Facility, then the Contractor may keep the
placement open for the Child. Reimbursement for reserve bed days shall be permitted
in accordance with 40 TAC 700.323 and the policies established by the Department
(http://www.dfps.state.tx.us/Handbooks/default.asp), now incorporated by this
reference.
F) The Department shall give the Contractor notice in writing at least thirty (30) calendar
days prior to the effective date of any change that affects payments to the Contractor.
G) Contractors shall seek payment or adjustment to payments in accordance with the
time limit specified in 45 CFR 95.1 (Code of Federal Regulations). This subpart
establishes a two-year (eight quarter) time limit for a State to claim Federal financial
participation in expenditures under State plans approved under Title IV-E and TANF.
Any bill or amended bill, which is submitted to DFPS later than seven quarters after the
end of the quarter of the expense, will not be processed unless DFPS determines that
submission for payment of the bill to the federal government can be executed in a
proper and timely fashion.
36.

A) Be responsible for any Monitoring/audit exception or other payment irregularity
regarding this Contract or subcontract; and
B) Be responsible for the timely and proper collection and reimbursement to the
Department of any amount paid in excess of the proper payment amount within ninety
(90) days of determination of overpayment.
37.
information using the accrual method of accounting in accordance with 1 TAC 355.7101(6).
Accepted Accounting
(GAAP) approved
American Institute of
Form 2282cx
June 2010


with a minimum limit of $300,000 per occurrence and $600,000 aggregate.
B) The Contractor shall purchase coverage with insurance companies or carriers rated for
financial purposes "B" or higher whose policies cover risks located in the State. All
bonds, policies, and coverage shall be maintained during the entire term of the
Contract.
C) In the event the Contractor is unable to comply with subsection 38.A) of this section,
the Contractor shall provide the Residential Contract Manager with two (2) written
denial letters from different insurance companies evidencing the Contractor's attempts
to obtain and inability to obtain the requisite insurance. The Contractor shall provide
this information to the Residential Contract Manager within ten (10) days of the award
of the Contract.
i. The Contractor shall also attempt to obtain the insurance required in subsection
38.A) of this section, on an annual basis. If the Contractor is not able to obtain
insurance, the Contractor shall provide the Residential Contract Manager with the
documentation required in subsection 38.C) of this section, to demonstrate the
Contractor's compliance with this section.
ii. Subsection 38.C) of this section is in addition to the requirements for obtaining a
license contained in 42 HRC 42.049(c).
D) All required insurance policies shall include an endorsement stating that the
Department shall be given thirty (30) calendar days written notice prior to cancellation
of or material change to the policy or bond.
39.
40.
Pay Roll Taxes.

The Contractor is res onsible for all a roll taxes and benefits for its em lo ees.
Prohibition of Sale or Transfer of Accounts Receivable. The Contractor shall not sell,
or transfer ownership of payments due to the Contractor under this Contract to any third
party or financial intermediary if such transaction would result in such payments being
made by the Department to the third party. This section does not prohibit collateral
assignment of such payments for the purpose of secured lending arrangements in the
ordinary course of business.
ADMINISTRATIVE
41.

B) In maintaining financial records and in preparing cost reports, the Contractor shall
CFR 1

Form 2282cx
June 2010

d.
e.
f.
g.
Age Discrimination Act of 1975 (42 U.S.C. 6101-6107);

Title IX of the Education Amendments of 1972 (20 U.S.C. 1681-1688);
Food Stamp Act of 1977 (7 U.S.C. 2011 et seq.); and
The HHS agency's administrative rules, as set forth in TAC, to the extent
applicable to this Agreement.
(1) The Contractor agrees to comply with all amendments to the above-referenced
laws, and all requirements imposed by the regulations issued pursuant to these
laws. These laws provide in part that no persons in the United States may, on
the grounds of race, color, national origin, sex, age, disability, political beliefs,
or religion, be excluded from participation in or denied any aid, care, service or
other benefits provided by Federal or State funding, or otherwise be subjected
to discrimination.
(2) The Contractor agrees to comply with Title VI of the Civil Rights Act of 1964,
and its implementing regulations at 45 CFR Part 80 or 7 CFR Part 15,
prohibiting a contractor from adopting and implementing policies and
procedures that exclude or have the effect of excluding or limiting the
participation of Children in its programs, benefits, or activities on the basis of
national origin. Applicable state and federal civil rights laws require contractors
to provide alternative methods for ensuring access to services for applicants
and recipients who cannot express themselves fluently in English. The
Contractor agrees to ensure that its policies do not have the effect of excluding
or limiting the participation of persons in its programs, benefits, and activities
on the basis of national origin. The Contractor also agrees to take reasonable
steps to provide services and information, both orally and in writing, in
appropriate languages other than English, in order to ensure that persons with
limited English proficiency are effectively informed and can have meaningful
access to programs, benefits, and activities.
(3) The Contractor agrees to comply with Executive Order 13279, and its
implementing regulations at 45 CFR Part 87 or 7 CFR Part 16. These provide in
part that any organization that participates in programs funded by direct
financial assistance from the United States Department of Agriculture or the
United States Department of Health and Human Services shall not, in providing
services, discriminate against a program beneficiary or prospective program
beneficiary on the basis of religion or religious belief.
( 4) Upon request, the Contractor will provide HHSC Civil Rights Office with copies of
all of the Contractor's civil rights policies and procedures.
(5) The Contractor must notify HHSC's Civil Rights Office of any civil rights
complaints received relating to its performance under this Agreement. This
notice must be delivered no more than ten (10) calendar days after receipt of a
complaint. Notice provided pursuant to this section must be directed to:

Form 2282CX
June 2010
D)
E)
F)
G)
42.
standards, and regulations prescribed by the United States Department of Health

and Human Services Department;
vi. All applicable standards, orders or regulations issues pursuant to the Clean Air Act
(42 USC 7401 et seq.) and the Federal Water Pollution Control Act as amended (33
USC 1251 et seq.);
vii. Mandatory standards and policies relating to energy efficiency which are contained
in the state energy conservation plan issued in compliance with the Energy Policy
and Conservation Act (Public Law 94-163); and
viii. Standards and requirements concerning deinstitutionalization of Children found at
Health and Safety Code 321.002 and 42 USC 675(5)(A).
The Contractor shall provide a drug-free workplace within the meaning of the Federal
Drug-Free Workplace Act (41 USC 702 et seq.).
The Contractor shall comply with the Fair Labor Standards Act (FLSA) (29 U.S.C. 201
et seq.) regarding minimum wages, overtime pay, recordkeeping, and child labor.
The Contractor shall not use any funding under this Contract to influence the outcome
of elections or the passage or defeat of any legislative measures.
Foster care maintenance payments must be expended for items that are provided by
foster parents and facilities in accordance with 42 USC 675(4).
Retention, Access, and Confidentiality of Records.

A) The Contractor agrees to maintain comprehensive and legible records of all actions
Contractor shall maintain financial, programmatic, and supporting documents,
statistical records and other records pertinent to claims or cost reports submitted
and/or services delivered during the Contract Period for a minimum of five (5) years
after the termination of the Contract Period. If any litigation, claim, or
monitoring/audit involving these records begins before the five (5) year period expires,
the Contractor shall keep the records and documents for not less than five (5) years
and until all litigation, claims, or monitoring/audit findings are resolved. A case is
considered resolved when a final order is issued in litigation and the order cannot be
appealed, or a written agreement resolving all issues is entered into between the
Department and the Contractor.
Department upon verbal request in emergency situations. Upon verbal request from
DFPS, the Contractor must submit legible records and information within the
Department's specified timeframe. Emergency requests for records can include, but
are not limited to, the need to review the Child's Service Level in order to make a
placement change, court ordered requests, or attorney requests.
Department upon request. The Contractor must forward legible records and
to
Form 2282cx
June 2010

F)
G)
H)
I)
Health contractor (Superior/Integrated Mental Health Services) that does not involve
PMUR as identified in subsection 42.D) of this section , the Contractor shall advise the
STAR Health contractor (Superior/Integrated Mental Health Services) to contact the
child's caseworker or chain of command for assistance.
All records received or created by the Contractor that are identifiable to Children
referred by the Department are confidential and may be disclosed to third parties only
with the prior written consent of the Department or within the scope of consents
permitted by the Medical Consenter. The Contractor will take reasonable measures to
secure confidential records and prevent the destruction and/or disclosure of such
records. In the event the Contractor receives any request or demand for disclosure of
confidential records by oral questions, documents subpoenas, civil investigative
demand, interrogatories requests for information or other similar legal process, the
Contractor will provide the Department with prompt notice of such request so that the
Department may seek an appropriate protective order and/or consent to the
Contractor's disclosure of the requested records.
The Contractor shall establish a method to ensure the confidentiality of records and
other information relating to Children according to applicable federal and state law,
rules, and regulations. The Department shall have an absolute right of access to, and
copies of, Child case records or other information relating to Children served under this
Contract.
The Contractor shall ensure that any staff designated by the Contractor and approved
by DFPS for access to the Health Passport must comply with all operative restrictions
of the Health Passport user agreement as it exists now or may later be amended,
including the following:
i. Not to share information from the Health Passport with anyone without a direct
need to know the information for purposes of providing health care, including
behavioral health care, services to the Child;
ii. To share only the minimum amount of information from the Health Passport as is
iii. To be responsible for maintaining the physical security and confidentiality of Health
Passport information that the user may view on a computer, print to paper or copy
or download to other formats. People who do not need the information should not
have physical access to it;
iv. To limit access to Health Passport records to those Children who are served by the
v. Not to share passwords. If the Contractor becomes aware that a password has
been shared, he or she is required to notify Superior HealthPian Network within 24
hours so that a new password can be assigned.
The Contractor shall advise Authorized Users that DFPS may restrict or deny access to
Intermittent Alternate Care.

that are
to use Intermittent

Form 2282cx
June 2010

C) Decrease the number of moves Children experience; and
D) Promote the overall development and permanency needs for Children in foster care.
44.
Notifications.
A) The Contractor shall:
i.
Maintain at all times at least one active electronic mail (email) address for the
receipt of Contract-related communications from the Department. It is the
Contractor's responsibility to monitor this email address for Contract-related
information. The Contractor shall notify the Residential Contract Manager and the
Residential Contract Mailbox (Residential Contracts@dfps.state.tx.us) with any
updated email address within five (5) calendar days of the change;
At a minimum, give the Department the amount of written notice required by
ii.
section 26 of this Contract before discharging a Child placed by the Department;
iii.
Notify the Department within twenty-four (24) hours after the Contractor
determines that a Child placed by the Department with the Contractor is a danger
to self or others and requires a placement in another setting, or has been
incarcerated or placed in juvenile detention;
iv.
Notify the Department within twenty-four (24) hours, when the Contractor knows
that a Child placed by the Department and in the Contractor's care requires
hospitalization;
Notify the Department of any Serious Incident, including but not limited to, run
v.
away, death, and abuse neglect or exploitation, within the timeframe mandated by
Minimum Standards. The Contractor may report Serious Incidents to the
Department's Statewide Intake at 1-800-252-5400 to meet the requirements of
this subsection;
Notify the Department within ten (10) calendar days, and complete the
vi.
Department's Form 4732 when a person formerly employed by the Department is
hired, as required by law. The Contractor shall obtain this form by contacting the
assigned Residential Contract Manager;
vii. Notify the Residential Contract Manager within ten (10) calendar days, of any
significant changes affecting the Contractor's residential child care program,
including but not limited to, the addition, replacement, or termination of the
Administrator or Board President; any change in ownership of the Facility; a
change in the Contractor's status as a for-profit or non-profit entity; any change to
the Contractor's admissions policy and significant changes to the scope and
coverage of the services provided by the Contractor or Subcontractor under this
Contract;
viii. Notify the Residential Contract Manager within ten (10) calendar days, if there are
contractor or payment issues which cannot be resolved by the applicable regional
care

Form 2282cx
June 2010

xiv.
Notify in writing the Child's CPS Caseworker or Chain of Command within forty
eight ( 48) hours when a Voluntary Extended Foster Care Agreement signed by the
Child has not been completed within ten (10) calendar days prior to the Child's
18th birthday; or a Voluntary Return to Foster Care Agreement has not been
received for a Child 18 to 22 years of age participating in one of these programs.
Efforts made to obtain copies of these agreements should be documented in the
Child's record;
xv. Notify the Department's Caseworker or Caseworker's Chain of Command within
thirty (30) calendar days when a Child 18 to 22 years of age is not participating in
school, work or other activity which qualifies the Child for Extended Foster Care or
Return to Foster Care;
xvi. Notify a Child's CPS Caseworker when a Child is 16 years of age or older, if at the
time of updating the Child's Service Plan, the Contractor is not aware of a plan for
the Child to enroll in or receive PAL Life Skills training classes;
xvii. Notify the Department of a foster home application to a Child Placing Agency made
by a Relative or Fictive Kin family by entering required data into the DFPS Child
Care Licensing Public and Provider Website within two (2) business days of when
the application was accepted at:
https://www.dfps.state.tx.us/Child Care/Search Texas Child Care/ppFacilitylogin.
asp
xviii. Notify the Department of reasons why a Relative or Fictive Kin family that applied
to be a foster home is not verified by entering required data into the DFPS Child
Care Licensing Public and Provider website within two (2) business days of
determining that the home will not be verified;
xix. Notify the Department of the relationship between a Relative, Fictive Kin, or
unrelated foster parent verified by the Child Placing Agency and all Children in
DFPS conservatorship placed in the foster home by entering or updating required
data into the DFPS Child Care Licensing Public and Provider website within two (2)
business days of any such change; and
xx. Notify each Child's Caseworker or Chain of Command in writing within two (2)
business days of the verification of a Relative or Fictive kin family and submit a
copy of the foster parent's Home Screening to each Child's Caseworker.
B) The Department shall:
Provide the Contractor with thirty (30) calendar days written notice when
i.
planning a discharge from placement except as provided below or in the case of a
Contractor providing emergency care services where a five (5) calendar day
notice is required;
ii. Not be required to provide notice for removal when court ordered, when there is
an immediate threat to the health, safety or well-being of a Child, after the
Contractor provides notice or requests removal under section 26 of this Contract.
in a Child's best
However, when the Department determines the removal to
Form 2282cx
June 2010


v.
vi.
Notify the Contractor when it knows that funds for this Contract will be reduced or
eliminated as referenced in section 52 of this Contract; and
Notify the Contractor within ten (10) calendar days when a request for a Service
Level evaluation will not be forwarded to the Service Level Monitor.
45.
Reporting. The Contractor shall accurately complete cost reports, time studies, Internal
Control Structure Questionnaires (ICSQs), Contract Monitoring surveys, and any other
reports required and requested by the Department within time frames specified by DFPS.
The Contractor must submit annual cost reports as required by 1 TAC 355.7101-7103.
46.
A) Attend HHSC cost report training in compliance with 1 TAC 355. 7101 prior to
submitting an annual cost report; and
47.
Authority of Department Staff. Department staff are not authorized to sign non-DFPS
forms unless those forms have received prior approval by an attorney for the Department.
The Department is not bound by unauthorized staff actions in signing such forms.
Department staff are permitted to sign the written Service Plan referenced in Attachment
C of this Contract, sign documents as witnesses, and sign documents acknowledging
receipt of information from Contractors.
48.
Notices of Department Funding.

A) The Contractor shall place notices acknowledging the funding it receives from the
Department in all of its literature and information published on its website that
describes services provided under this Contract, in the same font size as the
majority of the other descriptive material. This notice will also appear in the
Contractor's annual financial report, if any is issued.
B) The Contractor's foster parent recruitment activities must not emphasize payment
as the rima incentive for becomin a foster arent.
CONTRACT MONITORING
49.
Assessments of Physical Facilities and Operations. The Contractor shall allow

periodic assessments of its physical facilities and operations, which may include specific
foster homes, by a DFPS employees or DFPS authorized representatives. The Contractor's
physical facilities and operations shall be approved by the Department based on
assessments prior to and during the Contract Period.
Departmental Monitoring and Auditing.

Form 2282cx
June 2010

the Service Level daily unit rate as determined by the Service Level Monitor. The
Contractor will not be paid at a rate higher than the Service Level rate until the
Contractor receives notice from the Department. The Service Level Monitor will
indicate to the Department that all contracted services are being met and the
Department will subsequently notify the Contractor. This is not a limitation on other
remedies that DFPS may pursue.
C) Acceptance of funds under this Contract acts as acceptance of the authority of the
State Auditor's Office, HHSC Office of Inspector General, or any successor agency to
audit or investigate the expenditure of funds under this Contract or any, and all
subcontracts. The Contractor further agrees to cooperate fully with the State Auditor's
Office and/or HHSC. The Contractor will ensure that this clause concerning the
authority to audit funds received indirectly by Subcontractors through the Contractor
and the requirement to cooperate is included in any subcontract it awards.
OTHER PROVISIONS
51.
Precedence of Contractor Compliance. The terms of the Contract shall prevail over
less stringent licensing regulations or other state or federal regulations.
52.
receipt of state or federal funds that the Department has allocated to this Contract. If any
such funds for this Contract become unavailable during any budget period, this Contract
may be immediately terminated or reduced at the discretion of the Department.
53.
Transfers, Assignments and Subcontracting.

A) The Contractor shall not transfer or assign this Contract without prior written approval
from the Department.
B) The Contractor shall obtain prior written approval from DFPS prior to entering into any
subcontract for child care services or therapy. The Department's approval of the
Contractor's use of any subcontractor is conditioned upon the extent that any
subcontract does not conflict with any requirements of this Contract. The Department
does not agree to any part of any subcontract to the extent that the subcontract
modifies, limits, or waives any of the duties of the Contractor to DFPS under this
Contract.
C) The Contractor must include a term in all proposed subcontracts that incorporates this
Contract by reference and binds the Subcontractor to all the requirements, terms, and
conditions of this Contract as well as explicitly holds that this Contract controls in the
event of any conflict with the subcontract.
D) The Contractor remains fully responsible for compliance with all obligations under the
Form 2282CX
June 2010


reserves the right to execute a unilateral amendment when necessary to:
i. Incorporate new or revised federal, State, or Department laws, regulations, rules,
or policies;
ii. Change the name of the Contractor in order to reflect the Contractor's name as
recorded by the Texas Secretary of State;
iii. Correct an obvious clerical error in the Contract;
iv. Change Contract and resource numbers;
v. Change the recorded license number of any license needed under this Contract in
order to reflect the correct number as issued by the licensing authority;
vi. Update Service Level descriptions or daily rates; or
55.
Remedies. In addition to, or instead of, all other actions authorized under this Contract,
the Department, based on information from Monitoring or other verifiable sources, may
take any other actions deemed reasonable by the Department to ensure compliance with
the terms and conditions of this Contract. Such actions include, but are not limited to, the
following:
A) The Department may require the Contractor to take specific corrective actions in order
to maintain compliance with Service Levels, applicable federal or state regulations, and
the terms and conditions of this Contract. The Contractor's failure to comply with the
specific corrective actions may be grounds for the Department to suspend or terminate
the Contract, in whole or in part. The Contractor must respond in writing to the
Contract corrective action plan and must address each correction in writing. The
Contractor must submit its written response to the Department for review and
approval. Upon receipt of the Department's approval, the Contractor shall implement
the requirements of the Contract corrective action plan and shall maintain compliance
with the Contract corrective action plan. Failure to comply or maintain compliance
with the Contract corrective action plan may be grounds for the exercise of further
remedies set forth in this section;
B) Recover payments paid to the Contractor or impose remedies based on
Monitoring/audit findings of violations of Contract requirements;
C) Temporarily or permanently remove any or all Children subject to the terms of this
Contract;
D) Suspend and/or limit any further placements of Children, and place conditions on any
such suspensions and/or limitations of placements;
E) Suspend, place into abeyance, or remove any of the Contractor's contractual rights, in
Department reserves the right to suspend or terminate this Contract, in whole or in
part and conduct a new solicitation and/or enter into a new Contract for the same or
services.
Form 2282cx
June 2010

D)
E)
F)
G)
H)
57.
Child placed by the Department to new homes. The respective accrued interests or
obligations incurred to date of termination must be settled equitably. This equitable
settlement shall occur in compliance with 40 TAC 732.270-271 within six (6) months
from the date of Contract termination.
Upon termination or expiration of this Contract, the Department will work with the
Contractor to transfer the Department's Children from the Contractor's Facility as
efficiently as possible. The goal will be to remove all the Department's Children by the
effective date of the expiration or termination of the Contract; however, in the event
this is not possible, the Contractor will continue to provide care for the Children in
accordance all terms and conditions of this Contract. The Department will reimburse
the Contractor for any care provided after the date of Contract termination or Contract
expiration until all Children are removed from the Contractor's care.
The Department shall terminate this Contract if the Contractor is found liable for or has
a contract, license, certificate, or permit of any kind revoked for Medicaid fraud.
The Department shall suspend or terminate this Contract if the Contractor's license,
certificate, contract, permit, registration, or other approval (any of which are required
to operate and to provide the services under this Contract) has been suspended or
terminated by the applicable federal or state governmental authority, or by any
applicable governmental entity named in Chapter 531 of the Texas Government Code.
If this Contract is terminated or suspended for any reason, Department and the State
of Texas shall not be liable to the Contractor for any damages, claims, losses, or any
other amounts arising from or related to any such termination. However, the
Contractor may be entitled to the remedies provided in Government Code, Chapter
2260.
Contract Dispute Resolution.
i. DFPS and the Contractor must use the dispute resolution process provided for in
Chapter 2260 of the Texas Government Code to attempt to resolve any claim for
breach of Contract made by the Contractor.
ii. Neither the occurrence of an event, nor the pendency of a claim constitutes
grounds for the suspension of performance by the Contractor, in whole or in part.
INDEMNIFICATION. THE CONTRACTOR SHALL DEFEND, INDEMNIFY AND HOLD

HARMLESS THE STATE OF TEXAS, DEPARTMENT, ITS OFFICERS AND EMPLOYEES,
FROM ANY CLAIMS, ACTIONS, SUITS, DEMANDS, PROCEEDINGS, COSTS,
DAMAGES, AND LIABILITIES INCLUDING WITHOUT LIMITATION, ATTORNEY'S
FEES AND COURT COSTS CONNECTED WITH ANY ACTS OR OMISSIONS OF THE
CONTRACTOR OR ANY AGENT, EMPLOYEE,, SUBCONTRACTOR OR SUPPLIERIN THE
EXECUTION OR PERFORMANCE OF THIS CONTRACT. THE CONTRACTOR MUST
COORDINATE ANY DEFENSE WITH THE TEXAS ATTORNEY GENERAL AS REQUESTED
BY DFPS. THIS PARAGRAPH IS NOT INTENDED TO AND SHALL NOT BE
CONSTRUED TO REQUIRE THE CONTRACTOR TO INDEMNIFY OR HOLD HARMLESS
STATE OR THE DEPARTMENT FOR ANY CLAIMS OR LIABILITIES RESULTING
Form 2282cx
June 2010


59.
Copyrights and Use of Information. The Contractor, in developing, copying, and

disseminating reports or other information under this Contract, shall retain all rights to
copyright, use, reproduce, and distribute any material written or produced by the
Contractor that is the subject of this Contract. When the Contractor develops materials
using funds from this Contract, the Contractor must grant the Department and the federal
government a royalty-free, non-exclusive, and irrevocable license or right to reproduce,
translate, publish, use, disseminate, and dispose of such materials and to authorize others
to do so for governmental purposes.
60.
Exhibits. The following documents are incorporated into this Contract:

A) Form 2031, Signature Authority Designation;
B) Form 2033RCC, Subcontractor Documentation Form;
C) Form 2033a-RCC, Subcontractor Process;
D) Forms 4732, Request for Determination of Ability to Contract;
E) Form 4733, Certifications or Form 4733GOV, Certifications for Governmental Entities,
as applicable; and
F) Form 9007 RCC, Internal Control Structure Questionnaire (ICSQ) for Residential Child
Care.
61.
Certifications. The Contractor acknowledges its continuing obligation to comply with the
requirements of the following certifications contained in its proposal, and will immediately
notify DFPS of any changes in circumstances affecting these certifications:
A) Federal lobbying;
B) Debarment and suspension;
C) Drug Free Workplace;
D) Child support; and
E) Anti-trust.
62.
List of Attachments. The following documents are attached hereto and incorporated
herein by this reference:
Attachment A - 24-Hour Residential Child Care Rates
Attachment B- Residential Child Care Contract Glossary
Attachment C - Service Level Descriptions
Attachment D - Intermittent Alternate Care
Attachment E-Special Terms and Conditions
Attachment F- Performance Measures
63.
under this Contract, whether by voucher, judgment of any court of competent jurisdiction,
or any other administrative means, constitutes and operates as a general release to the
State from all
and
to
Contractor
out

Form 2282cx
June 2010

65.
Survival of Obligations. All obligations and duties of the parties hereunder not fully
performed as of the expiration or earlier termination of the term of this Contract shall
survive the expiration or earlier termination of the term hereof.
66.
Severability. If any part of any clause or provision of this Contract is illegal, invalid, or
unenforceable under present or future laws, then it is the intention of the parties that the
remainder of this Contract shall not be affected and that, to the extent of any such
invalidity, illegality, or unenforceability, there be added as a part of this Contract a clause
or provision of similar terms as may be legally possible in order to make the prior intent of
such clause or provision legal, valid, and enforceable.
67.
Limitation on Authority
The Contractor shall have no authority to act for or on behalf of the Department or the
State of Texas except as expressly provided for in this Contract; no other authority power
or use is granted or implied. The Contractor may not incur any debts, obligations,
expenses, or liabilities of any kind on behalf of the State of Texas or the Department.
68.
Term. This Contract is effective SeQtember 1, 2010 through August 31, 2011.
Texas Department of Family and

Protective Services:
Contractor: Southwest Key Programs, Inc.
Signatu
Printed Name:
Colleen McCall
Printed Name:
Juan Jose Sanchez
Printed Title:
Director of Field
Printed Title:
Executive Director
Date
Date

Form 2282cx
June 2010
Attachment "A"
Rate Structure
FY 2010-FY 2011 Rates
Basic CPA
l$39.52
!$22.15
!$42.18
Basic Foster Family

Basic Facility
$71.91
$38.77
$96.17
Moderate CPA
Moderate Foster Family
Moderate Facility
Specialized CPA
$95.79
$49.85
$138.25

Intense CPA
Intense Facility
l$175.66
$88.62
$242.85
$115.44
The amounts below are the minimum amounts that a Child-Placing Agency must reimburse its foster
families for Children receiving services under a Contract with the Department.
Service Level
Basic
Moderate
Specialized
Intense
Minilni.Jrn Qaily Amount to be

Reimbursed to a Foster Family
$22.15
$38.77
$49.85
$88.62


Attachment "8"
Form 2282CX
June 2010


activities;
vi. Comfortably fitting;
viii.Adequate to protect children against natural elements, such as rain, snow, wind, cold, sun and
insects.
Anseii-Casey Life Skills Assessment: An assessment of a Child's independent living skills designed
to be completed by both the Child and the Caregiver. The Child and Caregiver results are combined
into a report which provides an indication of the skill level and readiness of the Child to live
independently and creates the opportunity for the Caregiver and Child to talk about the Child's life
skills.
Background History Checks: Searches of different databases that are conducted on an individual.
There are three types of Background History Checks: criminal background checks conducted by the
Department of Public Safety for crimes committed in the State, criminal history checks conducted by
the FBI for crimes committed anywhere in the U.S., and central registry checks conducted by DFPS.
The central registry is a database of people who have been found by Child Protective Services, Adult
Protective Services, or Licensing to have abused or neglected a Child (40 TAC 745.611).
Behavioral Health Services: Services for the treatment of
rnanr"'
emotional, or


Attachment "8"
Form 2282cx
June 2010
the Child's Caseworker, the Contractor may utilize the Caseworker's Chain of Command if the
Contractor is unable to contact the Caseworker.
Chain of Command: The administrative structure used in the event the Contractor is unable to
communicate with the Child's Caseworker. The typical Department Chain of Command is as follows:
Child and Children: A person(s) eligible for services under this Contract from birth through the end
of the month in which the Child turns 22 years of age.
Child-Care Services: Services that meet a Child's basic need for shelter, nutrition, clothing,
Child Placement Vacancy Database: The DFPS internet website used by Contractors to report, or
confirm, the number of available openings, including applicable characteristics, and used by the
Department to assist in finding placements. At:
https://qawww.dfps.state.tx.us/Child Care/Search Texas Child Care/ppFaci!ityLogin.asp
Select: Update Provider Vacancies
Connections: Relationships Children have with extended family members, previous foster families,
schools, communities, tribes or tribal customs, religions or religious observances, and other social
networks.
Contract Period: Time period of the beginning date through the ending date specified in the term of
the original Contract, including Contract renewals or Contract extensions.
Contracted Components of Care: In addition to the requirements set forth in Attachment C and
sections 8 through 21 of this Contract, services documented in the Child's Plan of Service and within
the scope of the Contractor's license, provided directly or procured on behalf of the Child.
Covered Behavioral Health Services: Medicaid allowable Behavioral Health Services eligible to be
paid in response to claims processed through the Child's Medicaid health plan .


Attachment "8"
Form 2282cx
June 2010
made or, if an Administrative Review is requested, only after the disposition is "Upheld" by the
decision of the Administrative Review body(Reference section 7710 of the LPPH).
Discharging Contractor: The individual or legal entity designated by and contracting with DFPS that
provided Residential Child Care to or was responsible for the care of a Child prior to the Child's
placement with the Receiving Contractor.
DFPS Child Care Licensing Public and Provider Website:
https:!/www.dfps.state.tx.us/child care/Search Texas Child Care/ppFacilitylogin.asp
Educational Supports, Services and Benefits: State and Federal regulations regarding Children
in DFPS substitute care that enable them to access services, such as counseling, mentoring/tutoring,
Education and Training Voucher (ETV) Program: A federally-funded (Chafee) and stateadministered program. Under this program, Children ages 16 to 23 years old may be eligible for up to
important school documents and is designed to follow school-age children to each placement. This
Residential Child-Care Contractors, Foster Parents, Kinship Caregivers, and the children.
personal restraint, mechanical restraint, emergency medication, and seclusion.
Experiential Life Skills Activities: Activities which engage the Child in learning new skills,
attitudes, and ways of thinking through hands-on learning opportunities. Experiential life-skills
training is tailored to a Child's skills and abilities and may include training in practical activities that
include grocery shopping, meal preparation and cooking, using public transportation, performing
basic household tasks, balancing a checkbook, and managing personal finances.
http://www.dfps.state.tx.us/PCS/Residential Contracts/default.asp
Extended Foster Care up to October 1, 2010:
A program for Children 18 to 22 years old who are eligible, and have signed an agreement to
participate in this program and are:
A) Enrolled and regularly attending full time a high school or a program leading toward a high school
month


Attachment "8"
Form 2282cx
June 2010
D) Enrolled in and attending full time a vocational or technical training program and expected to
complete the program before the Child's 21st birthday. Eligibility is extended until the end of the
month the Child completes or withdraws from the program, or the end of the month in which the
Child turns 21 years old.
Extended Foster Care on or after October 1, 2010:

A program for Children 18 to 22 years old who are eligible, and have signed an agreement to
participate in this program. In addition to the eligibility criteria for Extended Foster Care up to
October 1, 2010 above, a Child who turns 18 years of age on or after October 1, 2010, while in the
conservatorship of DFPS, or who is continuing to receive Extended Foster Care services under the
Extended Foster Care up to October 1, 2010 definition above on or after October 1, 2010, is
eligible for Extended Foster Care services through the end of the month in which the Child reaches
the age limit referenced in A) through E), so long as sufficient documentation is provided on a
periodic basis as required by the terms of the Child's Extended Foster Care Agreement to
demonstrate that the Child is:
A) Regularly attending high school or enrolled in a program leading toward a high school diploma or
GED up to the Child's 22nd birthday;
B) Regularly attending an institution of higher education or a post-secondary vocational or technical
program up to the Child's 21st birthday. The.se Children can remain in care to complete
vocational-technical training classes regardless of whether or not the Child has received a high
school diploma or GED certificate. (40 TAC 700.316)
C) Actively participating in a program or activity that promotes, or removes barriers to employment
up to the Child's 21st birthday;
D) Employed for at least 80 hours per month up to the Child's 21st birthday; or
E) Incapable of doing any of the above due to a documented medical condition up to the Child's 21st
birthday. (40 TAC 700.316)
Facility: Any Residential Child-Care operation including Child-Placing Agencies, Independent Foster
Homes, General Residential Operations, and Residential Treatment Centers.
A) Payments to cover the cost of (and the cost of providing) food, clothing, shelter, daily supervision,
school supplies, a Child's personal incidentals, liability insurance with respect to a Child, and
reasonable travel to the Child's home for visitation. In the case of institutional care, such term
shall include the reasonable costs of administration and operations of such institution as are
necessarily required to provide the items described in the preceding sentence;
B) In cases where:
i. A Child placed in a foster home or child-care institution is the parent of a son or daughter who
is in the same home or institution, and
ii. Payments described in subsection A) are being made under this part with respect to such
Child, the foster care maintenance payments made with respect to such Child as otherwise
amounts as
care maintenance n::~,.trn"'

and Intermittent


Attachment "8"
Form 2282cx
June 2010
Grooming Products: Items or products provided to the Child to meet their personal and ethnic
needs, including, but not limited to: haircuts, hair care products, hair care accessories, sensitive skin
Head Start: A national program that promotes school readiness by enhancing the social and
cognitive development of Children through the provision of educational, health, nutritional, social and
other services to enrolled Children and families. Caregivers may locate Head Start
programs at local address, city, or zip code through Head Start locator
http://eclkc.ohs.acf.hhs.gov/hslc/HeadStartOffices.
Health Passport: An electronic health information system for the medical information of children in
Healthy Racial and Ethnic Identity: A healthy sense of racial and ethnic identity is exemplified by
an individual who:
A) Identifies as a member of a particular racial/ethnic group or groups;
B) Has generally positive attitudes about being a member of that group, but also has a balanced
view of the strengths and challenges associated with it;
C) Affiliates with members of his or her own group but is also generally accepting of people from
other groups; and
D) Is able to cope successfully with perceived or real racism and discrimination and has possibly
shown some effective strategies for dealing with it.
the needs of children and families receiving services.
needs.
Child-Placing Agency or Independent Foster Home as part of the agency or home's regulated child
care
72 consecutive


Attachment "B"
Form 2282cx
June 2010
Medicai/Healthcare Items: Medically necessary equipment, medical/surgical items, and personal

devices or items prescribed or purchased for a Child to augment or enhance communication or speech
functioning, vision, dental function or physical/medical functioning.
Minimum Standards: DFPS rules which are the minimum requirements for permit holders and
which are enforced by DFPS to protect the health, safety, and well being of children. DFPS provides
publications that contain the Minimum Standards and guidelines for compliance for each type of
operation.
records and procedures of a Contractor. It involves many of the techniques and procedures used in
National Youth in Transition Database: The data collection system developed by the
Administration for Children and Families (ACF) to track the independent living services provided to
Children and to develop outcomes that measure the States' performance in preparing Children for
their transition from foster care to independent living. More information is available at:
http://www.dfps.state.tx.us/Child Protection/Transitional Livinq/nytd.asp
National Youth in Transition Survey: The survey developed to collect data for the National Youth
in Transition Database. Children and their caregivers complete the National Youth in Transition
Survey utilizing a computer with access to the internet.
Network Provider: A Healthcare or behavioral Healthcare Provider enrolled and participating in the
STAR Health network.
Newborn: For the purposes of Texas Health Steps requirements, a Newborn is any Child under one
year of age.
system, organization, program or among individuals, which enables staff and volunteers to work
to honor and respect the beliefs, language, interpersonal styles, and behaviors of individuals and
Permanency Goal: The Department's permanency goals are subcategories of the four goals
identified by the Texas Family Code 263.3026. The categories are as follows:
Family Reunification;
Adoption by a relative or suitable individual (Relative/Kinship Adoption or Unrelated Adoption);
Permanent
to a relative or suitable individual


Attachment "8"
Form 2282cx
June 2010
iv. A sense of security for the Child; and

v. A legal status for the child that protects the rights of the Child.
(40 TAC 700.1201 and CPS policy 6200)
Personal Items: All objects and other materials in possession of the Child upon admission, given as
a gift, prescribed for the Child, purchased by or for the Child, or purchased using the Child's Medicaid
or other benefits, which include, but are not limited to, medication, Medicai/Healthcare Items, toys,
money, gift cards, allowances, televisions, radios, and CDs and electronics.
Preparation for Adult Living (PAL) Activities: Benefits and services provided to children in DFPSpaid Substitute Care who are age 16 or older and likely to remain in foster care until at least age 18,
who can qualify for services up to their 21st birthday. Services and benefits may include:
i. Anseii-Casey Life Skills Assessment to assess strengths and needs in life skills;
ii. Life Skills training in core areas including financial management;
iii. Job readiness and life decisions/responsibility;
iv. Ed ucationa 1/vocationa I services;
v. Transitional Living Allowance (TLA) up to $1000 (distributed in increments up to $500 per
vi. After Care Room and Board (ACRB) assistance, based on need, up to $500 per month for rent,
vii. Case management to help children with self sufficiency planning and resource coordination;
viii. Teen conferences;
ix. Leadership development activities; and
x. Additional supportive services, based on need and availability of funds, such as mentoring
Primary Medical Needs: A Child with Primary Medical Needs is one who cannot live without
mechanical supports or the services of others because of non-temporary, life-threatening conditions
(40 TAC 748.61, 749.61 and 750.61).
which include Child-Care Services, Treatment Services, Emergency Care Services, Transitional Living
Program, Assessment Services Program, Therapeutic Camp Services, and Respite Child-Care Services
(40 TAC 748.61, 749.61 and 750.61).
Receiving Contractor:
received
Form


Attachment "8"
Form 2282cx
June 2010
treatment of an unrelated Child or children for 24 hours a day that occurs in a place other than the
Child's own home.
Return to Care:
A) A program designed for Children 18 to 22 years old who are eligible and sign an agreement to
and their conservatorship case had not been dismissed), and want to return to foster care, and:
i. Attend high-school or a program leading toward a high school diploma and have not reached
their 22nd birthday;
ii. Are enrolled at or within 30 days of placement in a course of instruction to prepare for the
GED and have not reached their 21st birthday;
iii. Attend and, within two years, complete a certified vocational or technical program and have
not reached their 21st birthday; or
iv. Return on a break from college or a technical or vocational program for at least one month,
but no more than 4 months and have not reached their 21st birthday. (40 TAC 700.316)
B) The return to Care program does not include Children over 18 years old who are overnight visitors
or living in the homes of Foster Parents, and the Foster Parents are not receiving a foster care
payment for the care of these Children. (40 TAC 745.601, 745.615, and 749.2653)
School-Age Children: Children eligible for Pre-Kindergarten through 12th Grade.
treatment of a Child or children. This includes, but is not limited to, suicide attempts, injuries
abusive treatment.
from minimal intervention to severe intervention. {TAC 700.2301-2407)
(Superior/Integrated Mental Health Services) to facilitate development of a health care service plan
and coordination of clinical services among a member,s primary care physician and specialty
providers to ensure members with special health care needs have access to, and appropriately utilize,
medically necessary covered services.
Service Plan: The Contractor's developed plan that addresses
to meet
Special Immigrant Juvenile Status: A


Attachment "8"
Form 2282cx
June 2010
STAR Health Denial Letter: A letter informing a Child's caregiver that a request for service
authorization from a Medical, Dental, Vision or Behavioral Health care provider will be or has been
either denied or reduced in full or in part. The letter should also describe the process for appealing
any such determination.
Subcontractor: A person or entity that delivers part or all of the services required of the primary
Contractor under this contract and is not an employee of the primary Contractor. There is an
agreement between the two persons and/or two entities whereby the primary Contractor authorizes
the person or entity (Subcontractor) to deliver the service. There does not have to be any payment
for services for the relationship to be considered a subcontract. For purposes of residential Contracts,
Psychiatrists), Foster Parents, direct service providers, and management service providers. Examples
of subcontracted management services could include nutritional or case management services.
Subcontracts that purely provide support and ancillary services, that are not directly related to the
services required of the Contractor and that are not compensated based upon any sort of fee or
revenue sharing arrangement related to the Contractor's payments from DFPS such as
accounting/billing/payroll services or janitorial services are not required to have prior approval or a
waiver of the right of approval in writing by the Department.
Substitute Care: The residential care and support provided to a:
i. Child in the Department's managing conservatorship who has been placed in a living situation
ii. Child who has turned 18 years of age and has voluntarily agreed to participate in the
Department's Extended Foster Care program or Return to Care program and meets the
requirements of such.
Texas Health Steps: A children's program under Medicaid which provides medical and dental
preventive care and treatment to Medicaid-enrolled children from birth to 21 years of age.
Treatment Services: A specialized type of child-care services designed to treat and/or support


Attachment "8"
Form 2282cx
June 2010

Voluntary Extended Foster Care Agreement Form 2540: The Department's form which
documents the Child's agreement to voluntarily remain in Foster Care and outlines the categories of
activity which qualify a Child to remain in Foster Care.
Voluntary Return to Foster Care Agreement Form 2560: The Department's form which
documents a Child's agreement to voluntarily return to Foster Care and outlines the categories of
activity which qualify a Child to return to Foster Care.
Well-being Specialists: DFPS liaisons to Superior HealthPian, the company that operates the
provider network for STAR Health, a Medicaid managed care health care program for Children in DFPS
conservatorship and young adults who have aged out of care. Contact information for regional Wellbeing Specialists can be found at: http://www.dfps.state.tx.us/About/Renewai/CPS/medical.asp


Attachment "C"
Form 2282cx
June 2010

maintain or improve the child's functioning including:
1)
Routine guidance and supervision to ensure the child's safety and sense of security;
2)
Affection, reassurance, and involvement in activities appropriate to the child's age and
development to promote the child's well-being;
3)
Contact, in a manner that is deemed in the best interest of the child, with family members and
other persons significant to the child to maintain a sense of identity and culture; and
4)
Access to therapeutic, habilitative, and medical intervention and guidance from professionals or
paraprofessionals, on an as-needed basis, to help the child maintain functioning appropriate to
the child's age and development.
A child needing basic services is capable of responding to limit-setting or other interventions. The
children needing basic services may include:
1)
B. Acting out in response to stress, but episodes of acting out are brief; and
C.
Behavior that is minimally disturbing to others, but the behavior is considered typical for
the child's age and can be corrected.
2)
A child with developmental delays or mental retardation whose characteristics include minor to
1)
which most activities are designed to improve the child's functioning including:
A. More than routine guidance and supervision to ensure the child's safety and sense of
security;
B. Affection, reassurance, and involvement in structured activities appropriate to the child's
professionals or paraprofessionals to help the child attain or maintain functioning
2)
habilitative needs may require intermittent interventions from a skilled caregiver who has
700.2323. CHARACTERISTICS OF A CHILO WHO NEEDS MODERATE SERVICES


Attachment "C"
Form 2282cx
June 2010
A.
3)
4)
Substance abuse to the extent or frequency that the child is at-risk of substantial
problems; and
A child with developmental delays or mental retardation whose characteristics include:
A. Moderate to substantial difficulties with conceptual/ social, and practical adaptive skills to
B. Moderate impairment in communication, cognition, or expressions of affect.
A child with primary medical or habilitative needs 1 whose characteristics include one or more of
the following:
condition;
B. Limited daily living and self-care skills;
D. Daily access to on-call 1 skilled caregivers with demonstrated competency.
700.2341. Specialized Service Level

1) The Specialized Service Level consists of a treatment setting, preferably in a family, in which
A.
2)
24-hour supervision to ensure the child's safety and sense of security, which includes close
C. Contact, in a manner that is deemed in the best interest of the child 1 with family members
and professionally designed and supervised to help the child attain functioning appropriate
to the child's age and development.
habilitative needs may require regular interventions from a caregiver who has demonstrated
competence.

A child needing specialized services has severe problems in one or more areas of functioning. The
children needing specialized services may include:
1)
A. Unpredictable non-violent 1 anti-social acts;
B. Frequent or unpredictable physica1 aggression;
C.
Being markedly withdrawn and isolated;
D. Major self-injurious actions to include recent suicide attempts; and

Form 2282cx
June 2010

activities;
A child with primary medical or habilitative needs whose characteristics include one or more of
the following:
condition;
C.
Non-ambulatory or confined to a bed; and
the interventions needed by children in their care.
C.
4)

Attachment "C"


Attachment "C"
Form 2282CX
June 2010
700.2361 INTENSE SERVICE LEVEL

1)
the child's access to environments as necessary to protect the child. The caregivers have
A. 24-hour supervision to ensure the child's safety and sense of security, which includes
and other persons significant to the child, to maintain a sense of identity and culture;
scheduled and professionally designed and supervised to help the child attain functioning
more appropriate to the child's age and development; and
E. Consistent and frequent attention, direction, and assistance to help the child attain
stabilization and connect appropriately with the child's environment.
2)
In addition to the description in subsection 1) of this section, a child with developmental delays
or mental retardation needs professionally directed, designed and monitored interventions to
enhance mobility, communication, sensory, motor, and cognitive development, and self-help
skills.
3)
habilitative needs requires frequent and consistent interventions. The child may be dependent
A child needing intense services has severe problems in one or more areas of functioning that present
an imminent and critical danger of harm to self or others. The children needing intense services may
include:
1)
D. Severely impaired reality testing, communication skills, cognitive, affect, or personal
hygiene.
2)
A child who abuses alcohol, drugs, or other conscious-altering substances whose characteristics
include a primary diagnosis of substance dependency in addition to being extremely aggressive
3)
A. Impairments so severe in conceptual, social, and practical adaptive skills that the child's


Attachment "C"
Form 2282cx
June 2010
100 Supervision
8100 BASIC SERVICE LEVEL SUPERVISION
8100.01 The caregiver provides a supportive setting, preferably a family that is designed to
maintain or improve the child's functioning by establishing clear rules appropriate to the
developmental and functional levels of the child.
8100.02 The caregiver establishes a clear system of rewards and consequences.
8100.03 The caregiver supervises a child through guidance to ensure the child's safety and sense of
security.
8100.04 The Caregiver provides regular daily supervision. The Caregiver will consider the following
primary factors that impact supervision: Time, environment, activities, caregivers,
admission and service plans, age of child, high-risk behaviors and any other factors
important in assessing supervision.
8100.05 The Caregiver provides a proper balance between supervision, autonomy and
independence.
M100 Moderate Service Level supervision

The caregiver provides supervision that is required at the Basic Service Level
M100.01 The caregiver provides more than routine supervision with additional structure and
M100.02 For a child with developmental delays, mental retardation, primary medical or habilitative
needs, the caregiver provides regular daily supervision.
M100.03 For a child with primary medical or habilitative needs the caregiver provides, as
and monitoring from a caregiver.
S100 Specialized Service Level Supervision
S100.01 The provider has a written policy statement describing how supervision is provided and
explaining how the program is structured to stabilize or improve the child's functioning.
S100.02 The provider has specialized training to provide therapeutic and habilitative support and
interventions in a treatment setting.
S100.03 The provider has an adequate number of caregivers available at all time to meet a child's
taking into account the child's age, medical, physical and mental condition, and


Attachment "C"
Form 2282cx
June 2010
1100 Intense Service Level Supervision

1100.01 The caregiver has specialized training to provide intense therapeutic and habilitative
support and interventions in a highly structured treatment setting with little outside
access.
1100.02 An adequate number of caregivers are available to provide twenty-four hour supervision.
1100.03 For a child with developmental delays or mental retardation the caregiver provides twentyfour hour supervision.
1100.04 For a child with primary medical or habilitative needs the caregiver provides twenty-four
hour close supervision and, as appropriate, frequent and continuous interventions which
typically consist of hands-on physical intervention, assistance, and monitoring from a
caregiver.


Attachment "C"
Form 2282cx
June 2010

8101 BASIC SERVICE LEVELS -
The child-to-caregiver ratio must meet the applicable licensing
standards.
M101 MODERATE SERVICE LEVELS-
standards.
S101 SPECIALIZED SERVICE LEVELS-
standards.
S101.01
There must be a written staffing plan documenting the ability to provide awake caregivers
throughout the night whenever necessary to meet the needs of a particular child.
1101 INTENSE SERVICE LEVEL CHILD-TO-CAREGIVER RATIOS

1101.01
During all waking hours the caregiver's child-to-caregiver ratio must be no more than 5 to
1.
1101.02
During sleep hours the caregiver's child-to-caregiver ratio must meet the applicable
1101.03
There are enough caregivers, to provide24-hour supervision to ensure the child's safety
1101.04
The staffing patterns and assignments are documented in writing. The documentation
1101.05
The written staffing plan documents the ability to provide 1 to 1 child to caregiver ratio for
twenty-four hours whenever necessary to meet the needs of a particular child.


Attachment "C"
Form 2282cx
June 2010
200 - Medical
8200.01 The caregiver arranges for medical and dental services as determined by an agreement
8200.02 The caregiver documents in the child's record that the child received these services.
8200.03 The caregiver ensures that all the medications the child needs are administered as
8200.04 The caregiver ensures children are taught age and developmentally appropriate sex
education. This can include reproductive health, healthy romantic relationships, being
sexually responsible, provide access to appropriate pregnancy prevention information and
discuss sexually transmitted infections
The caregiver arranges for or ensures the same medical and dental services that are required at the
M200.01 For a child, receiving psychotropic medication, a physician, as often as clinically necessary
and appropriate, must monitor the child's condition.
M200.02 For a child, with developmental disabilities, mental retardation, primary medical or
5200 SPECIALIZED SERVICE LEVEL MEDICAL AND DENTAL
5200.01 The provider has a written plan, agreement, or contract with medical personnel to provide
routine medical, nursing and psychiatric services based on the needs of the child as
identified in the child's service plan. The plan or agreement for medical, nursing and
psychiatric services must include provisions for timely access to services in emergencies.
5200.02 For a child with developmental disabilities, mental retardation, primary medical or
treatments.
1200 Intense Service Level medical and dental services


Attachment "C"
Form 2282cx
June 2010
or nursing supervision; 24 hour availability of nursing, medical, and psychiatric services;

and 1 to 1 supervision during the provision of medical and dental services.


Attachment "C"
Form 2282cx
June 2010
300-Recreation
8300 Basic Service Level recreational and leisure-time services
8300.01 The caregiver ensures that opportunities to participate in community activities, such as
events, are available to the child.
8300.02 The caregiver organizes family activities that identify, recognize and reinforce the support
that is available to the child.
M300.01 The caregiver arranges and supervises structured daily routines for the child that includes
M300.02 The caregiver ensures the activities are designed to meet the child's therapeutic,
M300.03 The caregiver documents the daily routine and the recreational and leisure-time activities
the child participated in.
M300.04 The caregiver allows enough flexibility in the daily routine and the activities for the child to
M300.05 The caregiver provides activities that are modified to meet any restrictions or limitations,
due to a child's developmental disability, mental retardation, or medical condition.
S300.01 The structured daily routine and the recreational and leisure-time activities are designed to
address the needs of the children in care.

S300.02 The therapeutic value of each activity based on the child's service plan is documented.
S300.03 If the child has primary medical or habilitative needs, recreational and leisure-time

An interdisciplinary team of professionals who are qualified to address the child's individual
included in the child's service plan.
1300.02 If the child has primary medical or habilitative needs, the recreational and leisure-time
1300.01


Attachment "C"
Form 2282cx
June 2010
400- Education
B400.02

arranged and ensured for each child.
Reasonable support and assistance will be provided for each child who qualifies as a special
education student under the Individual with Disabilities Education Act to ensure that the
appropriate educational and related services, including Early Childhood Intervention, are
available in the least restrictive environment appropriate. This may include the necessity to
participate in the Admission, Review and Dismissal Committee to develop the Individual
Education Plan explaining how the student will be educated.
A child needs:
B401.01 a public school accredited by the Texas Education Agency (TEA);
B401.02
B401.03

M400.01
S400 SPECIALIZED SERVICE LEVEL EDUCATIONAL SERVICES

The caregiver must coordinate the child's educational and related services with the child's
S400.02 The caregiver must designate a liaison with the child's school.
S400.03 The caregiver must document the liaison's involvement in the child's schooling.
S400.04 The caregiver must document a written description of the relationship between the
S400.01
I400 INTENSE SERVICE LEVEL EDUCATIONAL SERVICES

I400.01
One to one support, as appropriate, is provided by caregivers knowledgeable and


Attachment "C"
Form 2282cx
June 2010
500 - Casework and Support Services

Services that are designed to maintain and improve the child's functioning are provided in a family
setting.
8500.01 Assistance and support in developing or maintaining social skills appropriate to the child's
age and development is provided.
8500.02 Affection, reassurance and involvement in activities appropriate to the child's age and
development to promote the child's well being must be provided.
8500.03 Support in helping the child adjust to the current placement must be provided.
8500.04 Access to therapeutic, habilitative and medical support addressing the child's particular
needs, as specified in the child's service plan must be provided. If therapeutic habilitative
additional structure and support is provided in a family-like setting.
M500.01
M500.02
M500.03
M500.04
M500.05
M500.06
M500.07
The provider also ensures that all caregivers receive support and direction from someone
The provider also ensures completion of a diagnostic assessment on each child within 30
days of admission. The assessment must address the child's strengths and needs in the
interventions in an environment designed to help the child attain or maintain functioning
children who need therapy by professional therapists or counselors or paraprofessional
habilitative program addresses the child's individual needs.
If the child qualifies for substance abuse services, the provider arranges for a substance
therapy.
S500 SPECIALIZED SERVICE LEVEL CASEWORK AND SUPPORT SERVICES
In addition to the
and
services that is
at


Attachment "C"
Form 2282cx
June 2010

1500.01 The child is provided with frequent and intense therapeutic, habilitative and medical
interventions that are individually designed to stabilize the child's condition.


Attachment "C"
Form 2282cx
June 2010
501 -Service Plans

8501 BASIC SERVICE LEVEL SERVICE PLAN REQUIREMENTS
8501.01 A service plan must be developed within 30 calendar days of the child's admission.
8501.02 The service plan must be based on the child's plan for permanency.
8501.03 The service plan must identify strengths and document strategies to address the child's
8501.04
8501.05
medical and dental needs, developmental, educational and vocational needs, including life
skills appropriate to the child's age and development, family contact needs; social needs;
The caregiver and the child, as appropriate, actively participate in the development,
The provider must periodically review service plans according to the appropriate licensing
standard.
M501 MODERATE SERVICE LEVEL SERVICE PLAN REQUIREMENTS

M501.01
M501.02
M501.03
each child within 30 calendar days of the child's admission. This plan must include:
(A) An estimate of the length of time the child will remain in care;
(B) A description of the goals of service;
(C) Specific instructions for caregivers;
(D) A transition plan; and
(E)
Documentation of:
(i) The plan having been shared with the child and the child's parents or managing
conservator; and
(ii) The child's care to date.
The provider must, when reviewing a service plan:
(A)
Evaluate the services to date that have been provided to the child in each domain or
function; and
(B) Identify any additional need that has arisen since the previous service plan was
developed.
5501 SPECIALIZED SERVICE LEVEL SERVICE PLAN REQUIREMENTS

An initial service plan for each child is developed within 72 hours of the child's admission.
The diagnostic needs assessment and service plan for each child are developed by an
children with similar characteristics who has a master's degree in a mental health field
S501.01
S501.02


Attachment "C"
Form 2282cx
June 2010
planned to help the child achieve and maintain a condition allowing a lower Service Level;
1501.04 Criteria for re-evaluating the child's condition after 90 days and deciding whether to
Service Level; transfer the child to a less restrictive setting; or refer the child to an
and supervise each child's service plan.


Attachment "C"
Form 2282cx
June 2010
502 Training
8502.01 Each family unit must receive at least 20 hours of training every year to help them
understand the needs and characteristics of children in care provide the care and
emotional support that children need and appropriately manage children's behavior. Note:
First-aid and cardiopulmonary-resuscitation training cannot be counted toward meeting
this annual training requirement. However, hours earned renewing First-aid and
cardiopulmonary resuscitation may be counted toward the annual requirement.
8502.02 When a foster parent is absent from the home for an extended time for military service or
employment, training requirements may be adjusted, consistent with Minimum Standards

749.951.

M502.01 Each caregiver must receive pre-service training in areas appropriate to the needs and
characteristics of children in care. At the conclusion of pre-service training, every foster
family must have an individualized annual foster family training plan based on the
population of children that the foster family serves.
M502.02 The number of hours of annual training required at the Moderate Service Level is 30 hours
M502.03 All caregivers who administer psychotropic medications must receive training on
M502.04 A licensed physician, a registered nurse, or a pharmacist must conduct Training on
M502.05 The trainer assesses each participant, after the psychotropic medication training, to ensure
that the participant has learned the course content.

M502.06 The training course provided to caregivers includes Identification of the psychotropic
medications; basic pharmacology (the actions and side effects of, and possible adverse
reactions to, various medications); techniques and methods of administering medications;
and related policies and procedures.
Note: The training received on psychotropic medication may be counted toward the annual training
requirement. A provider will be exempt from this training requirement if the provider has a written
policy statement specifying that the provider does not accept or maintain children on psychotropic


Attachment "C"
Form 2282cx
June 2010
minimum of one year relevant experience to the population that the Caregiver would
serve, such as children with primary medical needs, pervasive development disorders,
mental retardation/ emotional disorders and physical disabilities/ may permit new
Caregivers to be waived from the 40-hour supervision requirement.
5502.02 All caregivers must receive 50 hours of training each year with the exception of caregivers
in foster homes verified by child-placing agencies 1
5502.03 Caregivers in foster homes verified by child-placing agencies must meet the following
requirements: for homes with two or more caregivers/ each caregiver must receive at least
30 hours of training; OR for homes with one caregiver, the caregiver must receive at least
30 hours of training.
503 Personnel
M503.01
The staff includes at least one case manager.
M503.02
The casework and clinical supervisory staff have at least one year of experience in
providing services to children who have been removed from their homes.
M503.03
Each staff member with primary administrative and clinical responsibility for managing the
(A)
(B)
(C)
(D)
(E)
MS03.06
M503.07
Has a master's degree in social work or another field of human services, and is an
appropriately licensed and qualified paraprofessional or professional under the
program model governing the provider's therapeutic interventions and treatments;
or
Has a bachelor/s degree in social work or another field of human services, and at
least three years of experience in providing care to children who have been
removed from their homes; or
Has a bachelor's degree in a field other than human services, and at least five years
of experience in providing care to children who have been removed from their
homes, including at least two years of clinical supervisory experience.
to


Attachment "C"
Form 2282cx
June 2010
M503.08
The provider has a professional-staffing plan that: includes a detailed description of the
position; indicates whether each such position is filled on a full-time, part-time, or
consulting basis; and specifies the frequency and hours of service for each position.
M503.09
The provider has ensured that the professional-staffing plan assigns responsibilities for
treatment services.
S503 SPECIALIZED SERVICE LEVEL PERSONNEL REQUIREMENTS

The provider arranges for interventions such as individual, group, and family therapy to be
the service plan.
S503.01

The provider ensures that a physician recommends and approves services at the time of
the initial diagnosis and at each review.
1503.01
1503.02
The individual treatment program is developed by an interdisciplinary team to address the

child's intense needs.


Attachment "D"
Form 2282cx
June 2010

Child-Placing Agency or independent foster home as part of the agency or home's_regulated child
care. The purpose of Intermittent Alternate Care is to provide relief to the primary Caregiver. For
the purpose of this Contract, an Intermittent Alternate Care episode is one that lasts for more than
72 hours. Any episode lasting fewer than 72 hours is not considered Intermittent Alternate Care.
A) The Department may allow contracted Child-Placing Agencies and Independent Foster Homes to
utilize Intermittent Alternate Care to:
i.
iii. Decrease the number of moves children experience; and
iv. Promote the overall development and permanency needs for children in foster care.
B) Child-Placing Agencies and Independent Foster Homes that are permitted to use Intermittent
Alternate Care must do so according to the following guidelines:
i. For the purpose of this Contract, an Intermittent Alternate Care episode is one that lasts more
than 72 hours;
ii. Intermittent Alternate Care may not last for longer than 14 days for each Child;
next episode, unless the home is verified exclusively to provide Intermittent Alternate Care;
and
designee.
C) When providing Intermittent Alternate Care, contracted Child-Placing Agencies and Independent
Foster Homes must:
and safety of all children in Intermittent Alternate Care;
ii. Ensure that Intermittent Alternate Care is not detrimental to

a.
b.
c.
d.
e.
f.
g.
h.
i.

Attachment "D"
Form 2282cx
June 2010
Medical Care that is currently being provided;

The Child's medication regimen and instructions;
and
D) The Contractor must ensure that all Intermittent Alternate Care providers used by the Contractor
ii. Foster Parents licensed by the DFPS Child-Care Licensing Division;
include:
of age and older;
c. Proof of current infant/child/adult CPR and first aid certification for the provider;


Attachment "E"
This page is intentionally left blank.
Form 2282cx
June 2010


Attachment "F"
Form 2282cx
June 2010
Database.
Performance Period: Contractor performance for this output is determined for each month of
the Contract Period, either wholly or partially, depending on the Contract start and end dates.
Indicator: Percentage of business days that the Contractor updated its own information in the
CPS Child Placement Vacancy Database.
Target: 90%
Methodology:
confirmed placement vacancies in the Child Placement Vacancy Database.
To access the database and a list of State holidays select Update Provider Vacancies at:
https://qawww.dfps.state.tx.us/Child Care/Search Texas Child Care/ppFacilityLogin.asp

Performance Period: Contractor performance for this output is determined annually but
measured throughout the Contract Period.
Indicator: Percentage of school-age children in conservatorship for 30 calendar days or more
whose Education Portfolios are updated within 15 calendar days of all events requiring a portfolio
change.
Target: 90%
Purpose: The purpose of this measure is to evaluate the Contractor's success providing current
education information as described in section 14.A)iv. of this Contract to successive Caregivers,

Form 2282cx
June 2010
Attachment "F"
Methodology:
The numerator is the number of documented reviews of Education Portfolios for school-age
children in conservatorship 30 calendar days or more where all portfolio changes are made within
15 calendar days of events requiring a portfolio change.
The denominator is the number of documented reviews of Education Portfolios for school-age
children in conservatorship 30 calendar days or more.
Output #3: Stabilize the Child's placement.

Performance Period: Contractor performance for this output is determined for one or more of the
following performance periods, wholly or partially, depending on the Contract start and end dates:
September 1 through November 30, December 1 through February 28, March 1 through May 31,
and June 1 through August 31.
Indicator: Average length of stay for children who left a placement during the period, excluding
certain reasons for discharge.
Target: Baseline data will be collected statewide during the contract period to establish future
targets.
Purpose: The purpose of this measure is to determine the Contractor's ability to meet a child's
needs without changing placements.
Data Source: IMPACT
Methodology: Methodologies vary by facility type and are detailed below.
Methodology for CPA: The denominator is the count of all children who left a placement during
the period, except those discharged for the following reasons:
Caretaker moved
Court ordered, including emancipation
Child placed in adoption
Child placed with family, including other relatives and siblings
Level of care raised or lowered to a level not included in this contract
Child moved to a less restrictive setting, based on Residential Child Care's Living
Arrangement Scoring
The numerator is the sum of the number of days in placement for all children included in the
denominator. Divide the numerator by the denominator to calculate the average length of
placement.

Form 2282cx
June 2010
Attachment "F"
placement.
Methodology for GRO-Basic Child Care, GRO-Emergency Shelter, Independent Foster

Family Home, Independent Foster Group Home: The denominator is the count of all children
who left a placement during the period, except those discharged for the following reasons:
Court ordered, including emancipation
Child placed with family, including other relatives and siblings
Level of care raised or lowered to a level not included in this contract
Child moved to a less restrictive setting/ based on Residential Child Care's Living
Arrangement Scoring
placement.
Contract Outcome Measure.
Outcome: Children are safe in care.
Performance Period: Contractor performance for this outcome is determined for one or more of
the following performance periods, wholly or partially, depending on the Contract start and end
dates: September 1 through November 30, December 1 through February 28, March 1 through
May 31, and June 1 through August 31.
Indicator: Percentage of children under age 18 in contracted Residential Child-Care placements
and in DFPS managing conservatorship who are not determined to be Designated Victims resulting
in a Reason to Believe (RTB) disposition Upheld during the performance period.
ITarget:
100%
Purpose: The purpose of this measure is to evaluate the Contractor's success protecting children
in its care. This outcome directly relates to DFPS' mission to protect children from abuse/neglect
and to one of the federal outcomes measured by the Child and Family Services Review (CFSR) of
the US Heath and Human Services Administration for Children and Families.
Data Source: Information Management Protecting Adults and Children in Texas (IMPACT);
information used for the performance period:
Facility (operation) as described in 40 TAC 745.37(3)(A)-(I) 1 with an active Contract;
Number of DFPS placements in the contracted Facility that were active at any point
during the performance period; and
Number of Designated Victims at the Facility for which a disposition of RTB was Upheld.


Amendment
Contract #23393:f75
Amendment
May 2009
Form 9077
#iJ
This AMENDMENT (Amendment) of contract #23393iis (Agreement or Contract) is

entered into by and between the,-ex~~ [)~l'':lr~rn~ntof ~amily and Protective Services,
(DFPS or the Department), and Soutllwest~KE!V>Pr*>Ciramsiinc~ (Contractor).
I. Purpose
Section 54 of the Agreement stipulates that the Contract may be modified through a written
amendment mutually agreed upon and signed by both parties. DFPS procured this Contract
under 530-08-0062 for Residential Child Care services.
Both DFPS and the Contractor agree to execute this amendment in order to implement
changes to the Texas Health Steps requirements, to clarify the exceptions for educational
participation by children and to remove the requirement to submit an Form 4732 ten days
after hiring a person formerly employed by the Department.
II. Effect of Amendment on Contract

A. Unless otherwise modified, the terms and conditions of the Contract shall remain in full
force and effect.
B. This Amendment modifies Section 11 A) ii and iii of the Contract by deleting them in full
and replacing themwith the language below. Section 11 A) ii and iii shall now read:
11. Behavioral Health and Healthcare Services.

ii. The Contractor shall provide access to Texas Health Steps Medical Checkups
in the following manner:
a. For all Children, an initial Texas Health Steps Medical Checkup within 30
days of entry into DFPS conservatorship;
b. For all Children, a subsequent Texas Health Steps Medical Checkup as
soon after the child's birthday as practical but not later than the child's
next birthday, unless required more frequently by the Child's medical
provider;
c. For Children under thirty-six (36) months of age, Texas Health Steps
Medical Checkups in accordance with the Texas Health Steps Periodicity
Schedule
d. For all Children, provided by a licensed health care practitioner who is
in Texas
as a Texas
and


Amendment
May 2009
Form 9077
working under the supervision of a licensed dentist who is enrolled in

Texas Medicaid as a Texas Health Steps provider; and
d. For children with Primary Medical Needs, request written documentation
from the child's primary care physician (PCP) if the child is unable to
attend Texas Health Steps Dental Checkups in accordance with required
timeframes.
C. This amendment modifies Section 14 of the Contract in part and shall now read:
14. Educational and Vocational Activities.

i. The Contractor shall ensure that:
b. Each school-aged Child attends a school accredited by the Texas
Education Agency (TEA) unless the Contractor has received a written
exception to this requirement from the Child's Caseworker or
Caseworker's chain of command;
c. Each Child three (3) four (4) and five (5) years of age:
(1.) Attends a pre-kindergarten program offered through the public
school or an early childhood education program offered through
Head Start; if available, in the local community of the Child's
caregiver, unless an exception has been granted from the Child's
Caseworker or Caseworker's chain of command;
D. This amendment modifies Section 44 of the contract by deleting Subsection 44.A(vi) in
its entirety.
The parties to Contract
April 1. 2011.
have duly executed this Amendment to be effective
Signature
Printed Name: Colleen McCall
Printed Title: Director of Field
Signatu
Printed Name: Juan Jose Sanchez
Printed Ti~ Executive Director
Date
Date
~-a
-1
3'

Form 2282cx
June 2011
Contract Number
23393175
Resource Number
23884439
Facility Number
880883
Facility License
Type
GRO CCS
Provider
Enrollment Number
530-08-0062
Renewal Number
I GENERAL CONDITIONS
L
1.
Contracting Parties.
'I
Pursuant to its authority under Texas Human Resources Code (HRC)

40.058, the Texas Department of Family and Protective Services, (Department or DFPS), and
Southwest Key Programs, Inc. (Contractor), enter into this contract (Contract). This Contract,
along with all Attachments, constitutes the entire and complete agreement between the
parties. In this Contract, all references to the Department will include the Texas Health and
Human Services Commission (HHSC) and any other agency named in Chapter 531 of the
Texas Government Code to the extent that HHSC has transferred DFPS' functions related to
this Contract to itself or to such other agency pursuant to HHSC authority in Texas
Government Code 531.0055, or any other statutory authority of HHSC. When acting in such
capacity, HHSC or such other agency is an authorized agent acting on behalf of DFPS.
2.
Governing Law. This Contract will be construed in accordance with the laws of the State of
Texas (State). Unless otherwise mutually agreed, the venue will be in State District Court,
Travis County, Texas, and resulting payments will be due and payable in Travis County, Texas.
This Contract shall not be construed to waive any rights, duties, or immunities that either
party has under the laws of the State of Texas and the United States.
3.
Independent Contractor. Contractor will serve as an independent contractor in providing

services under this Contract. Contractor's employees will not be construed as employees of
DFPS or the State of Texas. Contractor has sole authority and responsibility to employ,
discharge, and otherwise control its employees and contractors. Contractor is responsible for
providing all necessary unemployment and workers' compensation insurance for the
Contractor's employees.
4.
Purpose. The purpose of the residential child-care contract is to establish the qualifications,
standards, and terms of delivering specified services to Children in contracted care, to set the
terms and conditions of operations and payment, and to specify the method of ensuring
delivery of contracted services. The goal of residential child care is to protect the well-being of
the Child, enhance the Child's functional abilities in a 24-hour residential child-care
Goal, by providing the following services as
and prepare the Child for his/her

5.
Form 2282cx
June 2011
Contract
Contract contains
terms
to
Residential Child-Care Service contracts including those with Child-Placing Agencies (CPA) and
General Residential Operations (GRO).
A) If the Contractor is a CPA, all terms of the Contract apply.
B) If the Contractor is a Residential Child-Care Facility, other than a CPA, Sections 7.B), 7.C),
7.D), 7.F), 17.B), 24), 26.C), 31. C).x,d, 31 C) xiv, 34. A) iv, 34. A) v., 35. B), 35. C),
41.G), 43, 44.A) xvi, xvii, xviii, xix and 48.B) of this Contract are not applicable.
C) If the Contractor is a GRO providing Emergency Care Services, in addition to the terms in
5.B), Sections 7, and 11, of this Contract are not applicable.
D) The Contractor must comply with the special terms and conditions set forth in Attachment
E.
6.
Contractor Representation. By accepting the

Contractor represents
B) It will accept the Service Level unit rates described in Section 35 of this Contract as
7.
Contracted Service levels. The Contractor agrees to and acknowledges the following:
A) DFPS will determine the minimum services provided by the Contractor to each Child based
on the Child's level of need. The Department will designate the level of need as Basic,
IV1oderate, Specialized, or Intense, as described in Attachment C. The Contractor must
provide services to Children authorized at the Basic, Moderate and Specialized Service
Levels, and must maintain full compliance with the associated Service Levels as described
in Attachment C for each Child placed with the Contractor.
Monitor (third party contractor) within the first 45 days of admitting a Child who has not
had an Initial Authorized Service Level during the current paid foster care stay. All other
requests for Service Level evaluations must be directed to the Child's Caseworker, who wiil
forward any approved requests to the Service Level Monitor.
C) CPAs requesting an Initial Authorized Service Level within the first 45 days of admitting a
Child may be paid the new initial Service Level rate up to 60 days in the past when the
following conditions are met:
i.
The retroactive initial Service Level must be submitted for authorization to the
Service Level Monitor within 45 days of admitting a Child who does not have an
Initial Authorized Service Level;
ii.
Upon admission to the CPA, the Child must remain in the same foster home or have
been in Intermittent Alternate Care within the same CPA that is requesting the Initial
Authorized Service
and
The

F)
8.
Form 2282cx
June 2011
The Contractor must comply with the Department's Intense Foster Family Care Services
policy and procedures, if applicable.
Voluntary Extended Foster Care or Return to Foster Care. Children 18 to 22 years of

age who meet eligibility criteria and voluntarily agree to participate in the Extended Foster
Care or Return to Foster Care programs, as defined in applicable Sections of 40 TAC
700.316 and 700.346, are also eligible for Medicaid, and may be served under the terms of
this Contract once approved by the Department.
A) The Contractor must offer assistance to the Child in maintaining documentation such as
school transcripts or pay stubs to demonstrate that any such Child 18 to 22 years of age is
qualified to remain in Extended Foster Care or Return to Care.
B) The Contractor shall assist the Child in the completion of the Voluntary Extended Foster
Care Agreement, Form 2540 during the following time periods:
i.
Within the 30 days preceding the Child's 18 1h birthday, when possible; and
ii.
When this is not possible, no later than the 30th day after the Child's 18th birthday.

9.
Basic living and Social Skills. The Contractor must ensure for all Children that Caregivers:
B) Maximize opportunities for learning through the use of Experiential Life Skills Activities;
C) Provide access to Experiential Life Skills Activities provided by community resources; and
D) Promote the ability to appropriately care for themselves and function in the community.
10.
Children's Rights. The Contractor must:

A) Cooperate with Child Protective Services (CPS) to ensure all Children have been given a
placement, and for CPAs, at the time of any placement changes to a new foster home;
D) Provide services to Children who are deaf or hard of hearing that ensure effective
communication. When providing services to a Child who is deaf or hard of hearing, contact
a Deafness Resource Specialist from the Department for Assistive and Rehabilitative
Services (DARS) for assistance in determining how best to ensure effective

Form 2282cx
June 2011
iv.
a
requirements
C under the Sections entitled "Casework and Support Services" and "Service Plans";
v.
Ensure that the Service Plan incorporates and is consistent with:
a.
Permanency Planning and Permanency Goals identified by the Department;
b.
Any behavioral goals established by the Department;
c.
Components of a Child's Individual Education Plan (IEP) and the Individual
Transition Plan (ITP) that are both developed by the school's Admission,
Review, and Dismissal (ARD) committee, if appropriate;
d.
Components of the CPS Transition Plan for Children 16 to 22 years of age to
include results of the Ansell-Casey Life Skills Assessment when applicable;
e.
The Early Childhood Education (ECI) Individual Family Service Plan (IFSP) if
applicable; and
vi.
Ensure that the Service Plan includes services to assist a Child to transition to a new
living arrangement or to new provider services, if applicable.
i.
Ensure every Child is enrolled and each Caregiver participates in Service
Management when the STAR Health contractor (Superior/Cenpatico) determines the
Child meets the criteria for the program; and
ii.
Request coordination services from STAR Health Service Management prior to
requesting a placement change for a Child with Primary Medical Needs.
12.
Behavioral Health and Healthcare Services.

i.
The Contractor must ensure access to necessary Medical, Dental, and Vision services.
ii.
The Contractor will provide access to Texas Health Steps Medical Checkups in the
following manner:
a.
For all Children, an initial Texas Health Steps Medical Checkup within 30 days of
entry into DFPS conservatorship;
b.
For all Children, unless required more frequently by the Child's medical
provider, a subsequent Texas Health Steps Medical Checkup must be scheduled
one year after the previous checkup and no later than the child's next birthday;
c.
For Children under 36 months of age, Texas Health Steps Medical Checkups in
accordance with the Texas Health Steps Periodicity Schedule
d.
e.
For all Children, provided by a licensed health care practitioner who is enrolled
in Texas Medicaid as a Texas Health Steps provider; and
For Children with Primary Medical Needs, request written documentation from
the Child's Primary Care
(PCP) if the Child is unable to attend Texas
Health Steps Medical Checkups in accordance with required timeframes.
Contractor shall
access to Texas
Dental

iv.
v.
vi.
vii.
viii.
B)
Form 2282cx
June 2011
the Child's Primary Care Physician (PCP) if the Child is unable to attend Texas
Health Steps Dental Checkups in accordance with required timeframes.
The Contractor shall access Medicaid through STAR Health for covered Medical,
Dental, and Vision services available to Children;
No later than the third business day after a Child's Caregiver receives a STAR Health
Denial Letter, the Contractor will email a scanned copy of the denial letter and the
date of such receipt to the Department's Caseworker or Caseworker's Chain of
Command and the Regional Well-being Specialist;
In the event that neither community nor Medicaid resources are available to fund
recommended Medical, Dental, or Vision services, as soon as practicable but no later
than the third business day, the Contractor shall notify the Department's
Caseworker or Caseworker's Chain of Command for assistance; and
In the event the Contractor has any questions or concerns regarding the prescribed
recommendations for follow-up treatment, the Contractor will raise these
concerns/questions with the Department and the Department will assist the
Contractor with a resolution.
If a Child is hospitalized for medical needs, the Contractor must provide support for
the Child in accordance with the Child's medical needs and supervisory requirements,
including relief as needed for the Child's foster parent.

i.
The Contractor shall ensure that Behavioral Health Services are available and
provided to each Child as needed by a STAR Health Network Provider (Network
Provider).
ii.
A Behavioral Health Provider must be an employee or subcontractor of the
Contractor, unless the court orders the Department to provide behavioral health
services for the Child from a Non-Network Provider.
iii.
The Contractor shall access Medicaid through STAR Health for Medicaid Covered
Behavioral Health Services, unless the court orders the Department to provide
behavioral health services for the Child from a Non-Network Provider.
iv.
The Contractor must use community resources to obtain Behavioral Health Services
not covered by Medicaid.
v.
No later than the third business day after a Child's Caregiver receives a STAR Health
Denial Letter, the Contractor will email a scanned copy of the denial letter and the
date of such receipt to the Department's Caseworker or Caseworker's Chain of
Command and the Regional Well-being Specialist.
In the event that community resources are not available for Behavioral Health
vi.
vii. The Contractor will ensure that all Behavioral Health Services provided to Children
are
documented within the Health Passport's Behavioral Health Module.
The Contractor shall
with
to

C)
Form 2282cx
June 2011
Psychotropic Medications.
The Psychotropic Medication Utilization Parameters for Foster Children (Parameters)
must be used, where applicable, in the treatment and care of Children served under
this Contract. The Parameters, now incorporated into this Contract by reference,
may be accessed at:
i.
ii.
iii.
13.
If a Child is prescribed psychotropic medications and the Contractor has

questions/concerns about the medication regimen for the Child, the Contactor shall
request assistance from a STAR Health Service Manager by calling 1-866-912-6283.
If additional assistance or clarification is needed, contact the Department's
Caseworker or the Caseworker's Chain of Command.
If a Child is prescribed psychotropic medications the Contractor is required to ensure
that a physician in the STAR Health Network evaluates the need for continued
treatment with the medication at a minimum of every 3 months.

A) Food. The Contractor must:
i.
Provide food in accordance with requirements of Minimum Standards.
ii.
Ensure that each Child receives fresh fruits, vegetables, and dairy products at least
once a day.
111.
Ensure that Children have input into meal planning.
i.
The Contractor will maintain an inventory of the Child's clothing and Personal Items
that are of substantial medical, monetary, or sentimental value by:
a.
Completing an inventory of clothing and Personal Items at admission;
b.
Updating the inventory of clothing and Personal Items quarterly and at
discharge;
c.
Ensuring that the Child (when age and developmentally able) and the
Contractor's staff or Caregiver signs and dates the clothing and Personal Item
inventory;
d.
Sending the clothing and Personal Item inventory with the Department
Caseworker or other Department designee at discharge.
ii.
The Contractor must provide each Child with Appropriate Clothing as defined in
Attachment B.
iii.
The Contractor shall allow Children to label their clothes with the Child's name or
initials.
The Contractor shall provide each Child with
items necessary to meet
needs
of Family
Services
Pm!t>rthc~<>
ii.
iii.
14.
Form 2282cx
June 2011
Ensure that Children have personal storage space for their clothing and Personal
Items. The Contractor shall provide Children who are able to look after their own
needs with individual
space in their bedrooms for clothing and Personal
Items.
Provide behavioral, gender and age appropriate living arrangements for each Child,
with the exception of sibling groups, where appropriate, in accordance with Minimum
Standards.

i.
Use appropriate authority and Discipline practices as necessary to set limits for
ii.
Develop and implement Discipline policies consistent with the TAC and Minimum
Standards at:
http://www.dfps.state.tx.us/Child Care/Child Care Standards and Regulations/defa
ult.asp.
a.
The Contractor must not use, give permission to use, or threaten to use
physical Discipline with any Child.
b.
The Contractor must not threaten the Child with loss of visits with family or
siblings as a punishment or deterrent to behavior.
c.
The Contractor must not threaten the Child with loss of placement as a
d.
The Contractor must not use unproductive work as a form of punishment (40
TAC, 748.2305 and 749.1955).
B) De-Escalation and Crisis Management. The Contractor must:
i.
Ensure that all de-escalation techniques are exhausted before utilizing more
restrictive and intrusive behavior intervention or Emergency Behavior Intervention;
ii.
Utilize developmentally and age appropriate Emergency Behavior Intervention
iii.
Manage the home/Facility and milieu in a manner that minimizes disruption during a
crisis; and
iv.
Develop and implement Emergency Behavior Intervention policies that are consistent
with the Minimum Standards at:
A)
Educational Activities.
i.
a.
Each School-Aged Child is enrolled in an accredited Texas public school within
three school days of placement unless an
has been
Child's

Form 2282cx
June 2011
may
any
a
In compliance with the Texas Education Code 29.012, the Contractor will make the
following notifications not later than the third calendar day after the date a Child is
placed in a residential Facility:
If the Child is three years of age or older, notify the school district in which the
a.
Facility is located; or
b.
If the Child is younger than three years of age, notify the local ECI program.
iv.
The Contractor will ensure that the Education Portfolio is maintained and updated for
each School-Age Child in the Contractor's care. The Education Portfolio should be
kept where the Child resides. The contents of the Education Portfolio must, where
appropriate, include:
a.
School enrollment documentation: Birth certificate, Social Security number,
Immunizations, and withdrawal notice from the last school;
b.
Special education documentation: Admission, Review & Dismissal (ARD) team
meeting notes, Individual Education Plan (IEP), Documents related to Section
504 of the Rehabilitation Act of 1973 regarding reasonable accommodations,
Full Individual Evaluation and/or other diagnostic assessments;
c.
Report cards, progress reports, and/or IEP progress reports;
d.
Transcripts;
e.
Standardized test results: TAKS/TAKS-Accommodated/TAKS-Modified;
f.
Referrals, notices, or correspondences; and
g.
School pictures.
v.
The Contractor will make the Education Portfolio readily available to the Department
for each School-Age Child on any visit with the Child or otherwise, if requested.
vi.
The Contractor will ensure and document that the report card and progress reports
are discussed with each School-Age Child.
vii. The Contractor will provide the Child's Education Portfolio to the Department at the
time a School-Age Child is discharged from the Contractor's care. For each SchoolAged Child, the Contractor must ensure:
a.
The most current educational documents and records are in the Child's
Education Portfolio.
b.
The Child's Education Portfolio includes the Child's current school withdrawal
paperwork.
viii. The Contractor shall minimize disruptions to a Child's education by scheduling
therapy and other appointments outside school hours, whenever possible.
Post-Secondary Educational and Vocational Activities.
i.
The Contractor shall provide or facilitate access to vocational training, support
services and activities, including job readiness, skills training apprenticeships and
trade skills, and vocational training opportunities that are
by the Child's Plan
Service and CPS Transition Plan at 16 years of age
iii.

ii.
iii.
iv.
v.
vi.
16.
Form 2282cx
June 2011
Ensure that a referral to ECI is made if the Child's caseworker or PCP has determined
a referral is necessary;
Facilitate the continuation of ECI services to each Child who was receiving ECI
services prior to placement;
Ensure the Caregiver fully participates in the Child's ECI evaluation and process for
developing an Individualized Family Service Plan (IFSP) for ECI services;
Ensure the Caregiver performs the following duties related to the Child's participation
in the ECI Program:
a.
To the extent the Caregiver consents to the Child's recommended and
additional ECI Program services, the Caregiver fully participates in and supports
such services;
b.
To the extent the Caregiver declines to consent to any of the Child's
recommended and additional ECI Program services, the Caregiver must
immediately submit a detailed written report to the Child's DFPS Caseworker or
their chain of command explaining why such declined services are not in the
best interest of the Child;
c.
To the extent the Caregiver disagrees or has a concern with any matter related
to the identification, evaluation, placement, or provision of ECI services, the
Caregiver may exercise the Caregiver's rights under the ECI rules of the Texas
Department of Assistive and Rehabilitative Services (DARS) which are
referenced in Part 2, Chapter 108 of Title 40 of the TAC, including 40 TAC
108.111, procedures for filing complaints; 108.113, investigation and
resolution of complaints and 108.123, opportunity for a hearing; and
Ensure the Caregiver provides written consent for the Child's ECI information to be

A) Provide recreational activities such as indoor, outdoor, school, community and religious or
spiritual activities for Children served under this Contract that are age-appropriate, varied,
interactive with peers, and are of interest to the Child;
B) Ensure that Children participating in recreational activities are, at a minimum, supervised
in accordance with Minimum Standards and Service Level requirements contained in
Attachment C;
C) Intervene/ as necessary, to reduce the risk of injuries; and

A)
B)
C)
Form 2282cx
June 2011
Provide the Contracted Components of Care with a high level of Individual and
Provide services and activities to Children of various cultures, races, ethnic backgrounds,
and religions in a manner that recognizes and affirms their worth, protects and preserves
their dignity, promotes and encourages the development of a Healthy Racial and Ethnic
Identity, and ensures equity of service delivery.
Provide ongoing education in the form of training, workshops, and other educational
opportunities to help staff and Caregivers understand the impact race, culture, and ethnic
identity has on themselves and others and how they impact services to Children and
families.
19.
Contractor Participation. The Contractor must participate in:

A) Conferences required by the Department which include but are not limited to, medical,
school, Family Group Conferences, Permanency Conferences, Circles of Support
Conferences, CPS Transition Plan Meetings, STAR Health Case Conferences and legal
staffings;
C) Preparation for Adult Living (PAL) activities, consistent with the Child's CPS Transition
Plan, if applicable. The Contractor shall obtain written prior approval from DFPS PAL Staff
to utilize the PAL Life Skills Independent Study Guide for a Child in Substitute Care and in
order for the Child to receive credit for completion of the guide; and
jurisdiction over the Child and necessary to ensure that the Contractor is complying with a
Child's Plan of Service.
20.
A) The Contractor will make and document good faith efforts to ensure that Children are able
to preserve desired and appropriate Connections to the Child's own cultural identity and
community, including religious/spiritual, family, school, and appropriate organizations
through on-site or off-site means.
B) The Contractor will initiate personal contact with a Child's sibling who is in foster care at
least one time per month in a meeting face-to-face if siblings are placed within the same
region or by twice monthly telecommunication (if separated by regions) during which the
parties discussion and actions are not directed by the Contractor. Exceptions to this
requirement include when sibling contact is:
i.
Prohibited by court order;
ii.
Contrary to the best interest of the Children as reflected in any of the Plans of
Service of the siblings; or

Form 2282cx
June 2011
23.
24.
Facility Licensure. The Contractor must:

A) Comply with Minimum Standards for any child-care license issued by the Department to
the Contractor for services provided under this Contract;
B) Comply with the operating or regulatory agency's regulations if the Contractor is a Facility
operated or regulated by one of the state agencies specified in 40 TAC 700.1321(e);
C) Comply with all applicable Service Levels as contained in Attachment C and the Contracted
Components of Care described in Sections 9-22 of this Contract; and
D) Ensure that all staff providing direct services to the Child comply with state professional
laws pertaining to the services provided including laws pertaining to licensure and
confidentialit .
Contractor Support and Supervision of Foster Families. The Contractor must:
A) Develop and implement a plan, in accordance with DFPS policy, for providing support
services as needed to the Contractor's foster families where Children placed by the
B) Ensure that a Contractor's Case Manager is available at all times to assist and support
Foster Parents providing services to Children who are receiving Treatment Services as
defined in Minimum Standards;
C) Develop and implement a written plan to quarterly monitor foster homes for compliance
with Minimum Standards and Service Level standards as contained in Attachment C and as
required in Section 34 of this Contract. The Contractor shall make this plan available to
the Department upon request;
D) Have supervisor/Case Manager services available 24 hours a day to the Contractor's direct
Caregivers;
E) Develop and implement a written plan for contacting foster homes within seven calendar
days following a placement to assess:
i.
Whether the Child's needs are being met in the foster home; and
ii.
How the Child is adjusting to the foster home;
H) Distribute the Texas Health Steps materials at
https://secure.thstepsproducts.com/default.asp to verified foster homes at least annually,
including:
i.
Texas Health Steps Checkup Brochure EPSDT-05;
ii.
Texas Health Steps Wallet Cards EPSDT-08;
iii.
Appointment Education Brochure EPSDT-16;
iv.
Case Management for Children and Pregnant Women Brochure CM1-182;
I) Avoid financial and other conflicts of interest by prohibiting the following individuals from
a Foster Parent verified by the Contractor however, such persons may be verified as
Parents
other CPAs

25.
Form 2282cx
June 2011
Background History Checks and Department Right of Removal.

The Department reserves the right to conduct background history checks on the
Contractor's employees, Subcontractors, volunteers, and all individuals who have direct
contact with Children in DFPS care or who have access to their records.
B) The Department reserves the right, in its sole discretion, to require by written notice that
the Contractor immediately:
i.
Not use any individual who has direct contact with Children or has access to their
records; or
ii.
Immediately remove any such person from engaging in such contact or having such
access.
I A)
26.

A) The Department reserves the right to place Children only in those facilities that it believes
can meet the needs of the Child. No part of this Contract may be construed to create any
commitment, obligation, or any legal duty on behalf of the Department to place or
continue a placement of a particular Child, any Child, or a specified number of Children
with the Contractor. Placement is always at the sole discretion of the Department.
B) The Contractor must comply with the Department's placement processes, including regular
data entry or updates of vacancy status into the Department's Child Placement Vacancy
Database, referenced in Attachment F, Methodology for Output Measure #1. The
Contractor shall not engage in practices used to circumvent these placement processes.
No part of this Contract shall be construed to create any legal or equitable right on behalf
of the Contractor to receive any such placements or to continue any particular placements.
C) The Contractor must comply with all applicable federal and state laws, including the
Multiethnic Placement Act, as amended by the Interethnic Adoption Act of 1996 ( 42 USC
Chapter. 21 1996b), the Indian Child Welfare Act (25 USC Chapter 21 1915), the
Adoption and Safe Families Act of 1997 (42 USC Sec. 629 et seq. and Sec. 670 et seq.);
the Adam Walsh Child Protection and Safety Act of 2006 ( 42 USC 671) and comparable
state laws regarding placement of Children.
27.

A) The Contractor will make all reasonable attempts to meet the needs of the Child in the
Contractor's care in order to prevent placement disruption. The Department, as managing
conservator, may remove a Child whenever the Department determines it is in the best
interest of the Child.
B) The Contractor shall document the Contractor's efforts and attempts to prevent placement
disruptions.
C) The Department will remove a Child placed by the Department when notified by the
Contractor that the Child poses a danger to self or others or exhibits volatile or selfinjurious behaviors that are inappropriate for the program of service and
a
in another

Form 2282cx
June 2011
placement in jail or juvenile detention and shall state whether the Contractor is willing to
placement of the Child upon the Child's release from jail or juvenile detention. If
the Contractor is not willing to accept placement of the Child upon the Child's release, the
Department shall, within 24 hours of receipt of notification from the Contractor, remove
the Child placed by the Department.
If the Contractor provides other documentation to the Department that it is no longer in
the Child's best interest to remain at the Contractor's Facility, or that the Contractor
cannot meet the needs of the Child, the Department will remove the Child within 30
calendar days. This documentation must be signed by the Contractor's Executive Director,
Licensed Child-Care Administrator, Licensed Child-Placing Agency Administrator or
designated employee, other than the Contractor's Case Manager. The Department will
immediately communicate with the Contractor and staff the Child's circumstances to
determine a plan for moving the Child to ensure the Child's safety and best interests and
those of others. The Department will remove the Child as quickly as is necessary. The
Department may immediately remove the Child.
F) For Contractors licensed as GROs providing emergency care services, if the Contractor
wishes to discharge a Child pursuant to Subsection 27.E) of this Section, the Department
shall have up to 10 calendar days to remove the Child.
G) If the Contractor discharges a Child placed by the Department except as stated above, it
constitutes a breach of this Contract.
H) Not later than 30 calendar days after the Contract is executed, the Contractor must notify
the Department's Residential Contract Manager in writing of the Contractor's designated
employee{s) who may approve discharges as described in this Section.
I) The Contractor shall provide to the Department the following information and items that
belong to the Child for each discharge:
i.
Upon the effective date of the discharge, the Child's:
a.
Medications;
b.
Medicai/Healthcare Items;
c.
Service Plan;
d.
Clothing and Personal Items;
e.
Most recent clinical records such as psychological evaluations and psychological
testing;
f.
Updated clothing and Personal Items inventory;
g.
Education Portfolio; and
h.
ECI Individual Family Service Plan (IFSP), if applicable.
ii.
Within 15 calendar days after the discharge, the Child's:
a.
Discharge summary; and
b.
Updates to the Child's Education Portfolio.
Within five calendar days of the Contractor's receipt from the Department of the Form
2085-FC authorizing the placement of a Child with the
the Receiving
must
a copy of that Form 2085-FC and a

iii.
28.
Form 2282cx
June 2011
Must, if requested, provide the Receiving Contractor the opportunity to communicate i

with the Contractor about the needs of the Child within three days of such request.
Use of Department Forms.

A) Non-emergency placements. For Children at the Moderate Service Level or higher, the
Department will complete and provide to the Contractor at, or prior to, placement the
Common Application for Placement of Children in Residential Child Care (Form 2087) as
the uniform assessment form and application for admission. The Contractor shall accept
Children for placement by the Department only after receiving completed Form 2085-FC,
Form 2085-B and/or 2085-C and/or 2085-D as appropriate and, if at the Moderate Service
Level or higher, Form 2087 and Form 2089. If the Department's Caseworker attempts to
place a Child at the Moderate Service Level or higher without a copy of a current Form
2089, the Contractor may, but is not required to, accept the Child for 72 hours after
having the Department's Caseworker sign the Department's Form 2089-C.
B) Emergency Placements. The Department will attempt to complete and provide to the
Contractor at, or prior to, placement the Common Application for Placement of Children in
Residential Child Care (Form 2087) as the uniform assessment form and application for
admission. The form may be incomplete but will contain all available information.
Alternatively, the Department may provide to the Contractor the Alternative Application
for Placement of Children in Residential Child Care (Form 2087ex). In either case, Form
2087 shall be completed and provided to the Contractor at the time the Child's placement
is changed from an emergency to a non-emergency placement. The Contractor shall
accept Form 2087 or Form 2087ex as the uniform assessment form and application for
admission for placement of Department Children. The Contractor shall accept Children for
placement by the Department only after receiving completed Form 2085-FC, completed
Form 2085-B, and/or 2085-C and/or 2085-D, and (complete or incomplete) Form 2087 or
2087ex.
1 C)
Unaccompanied Emergency Placements. In the event an unaccompanied Child in the care
I
of the Department presents for emergency placement, the Contractor may accept the
Child for placement and shall Immediately notify the Department to determine Department
instructions and to initiate documentation. The Department shall complete the required
forms within the next working day but may immediately move the Child.
i.
receiving completed Form 2085-FC, completed 2085-B and/or 2085-C and/or 2085D, and (complete or incomplete) Form 2087 or 2087ex.
ii.
The Department will complete and provide to the Contractor either Form 2087 or
2087ex.
a.
The Department will complete the Form 2087 within 30 calendar days following
the Contractor's written request for it.
b.
The Department will make available to the Contractor Forms 2085-FC, 2085-B,
and
and 2089 to
the
1

Form 2282cx
June 2011
are
information on a Child when it is necessary while still complying with the federal Health
Insurance Portability and Accountability Act of 1996 (HIPAA). If circumstances arise
where it is not possible for the Contractor to do so, the Contractor should work with the
Department's Caseworker, Chain of Command and the DFPS Residential Contract Manager
to obtain such additional permissions as are necessary.
F) Medical Consent.
i.
The Contractor must follow the requirements of the Medical Consent for Children in
residential child-care providers at http://www .dfps.state. tx. us/PCS/residential.asp,
ii.
The Medical Consenter is authorized to access, receive, and review all the Child's
medical records. Furthermore, the medical consenter may authorize the release of
the Child's medical records to the extent necessary to obtain services for the Child.
iii.
The Contractor shall ensure that all Foster Parents and employees who are eligible to
serve as Medical Consenters under "How DFPS Establishes the Medical Consenter",
have access to and complete computer-based training on Informed Consent.
iv.
The Contractor shall ensure that all Foster Parents and employees who are eligible to
serve as Medical Consenters, as stated above, follow the requirements within DFPS
policy regarding "Responsibilities of Medical Consenters and back up Medical
Consenters".
G) CPS Transition Plan. The Contractor shall coordinate with CPS for Children 16 years of age
and older regarding:
i.
The use of the CPS Transition Plan, Form 2500, as appropriate, at
http://www.dfps.state.tx.us/Child Protection/Transitional Living/forms.asp;
ii.
Maintaining a copy of the Child's Voluntary Extended Foster Care Agreement Form
2540 or Return to Care Agreement Form 2560 in the Child's record; and
iii.
The provision of information available at
http://www.dfps.state.tx.us/Child Protection/Transitional Living/default.asp related
to:
a.
Aftercare services, benefits and provider contacts;
b.
Educational Supports, Services and Benefits;
c.
Extended Care and Return to Care information;
d.
Preparation for Adult Living (PAL) services;
e.
Texas Foster Care Handbook for Youth;
f.
Transitional Medicaid and STAR Health;
g.
Information related to the Child's Special Immigrant Juvenile Status, if
applicable; and
Other

D)
E)
F)
Form 2282cx
June 2011
Prior to allowing any trip, activity or visit with a non-related person, excluding Intermittent
Alternate Care, for a period of time exceeding 48 consecutive hours, the Contractor must
obtain written approval from the Department's Caseworker or Caseworker's Chain of
Command.
Written approval for travel and visits is not required when:
i.
The Department's Caseworker arranges for the Child to visit with members of the
Child's family or relatives; or
ii.
The Department's Caseworker authorizes the Child to travel in specified
circumstances (usually routine trips or visits).
When the Contractor desires to take a Child outside of the country, the Contractor shall
follow Department policies and procedures including the completion of Form 2069,
Caregiver Declaration Regarding Out-of-Country Travel.
30.
Written Approvals.
A) Prior to moving a Child from one foster home to another foster home the Contractor must
obtain written approval from the Department's Caseworker or Chain of Command. In the
event of an emergency, and if prior approval cannot be obtained, the Contractor must
notify the Department of the move within 24 hours. The Department will respond to
requests for approval within 10 calendar days of receiving a proper request.
B) Prior to requesting Department staff to sign Contractor-developed forms, the Contractor
must receive written approval from the Residential Contract Manager indicating legal
approval by the Department.
31.

A) The Contractor must maintain at all times a written disaster and emergency response
plan, policies and procedures to address internal and external emergencies and disasters
that include, but are not limited to acts of nature (such as flood, hurricane, fires, and
tornadoes), chemical or hazardous material spills, critical equipment failure, weapons of
mass destruction events, and acts of terrorism.
responsible for maintaining the safety and placement of all Children in its care. All staff
and Subcontractors of the Contractor must be aware of the disaster plan requirements and
be prepared to fulfill their role in executing the plan.
i.
Mandatory evacuation if directed by local officials;
ii.
Emergency evacuation;
iii.
Emergency response;
iv.
Disaster planning training for all staff and Caregivers;
v.
Arrangements for adequate provision of:
Staffing;
a.
b.

after the disaster;

Methods for ensuring that medical services are provided to Children throughout
the disaster. Such services include, but are not limited to, providing Children
with medication as prescribed (including insulin and asthma-related
treatments), emergency care, and Medical Care for Children with Primary
Medical Needs (as defined in Attachment B); and
c.
Plans for maintaining the services, as required by a court order and/or the
Communication with DFPS and CPS, including:
a.
Identifying (name, telephone numbers) two emergency contacts designated by
the Contractor who will be available to DFPS at all times in the event of an
emergency or disaster;
b.
Contacting CPS to provide information on the location and condition of Children
in care who have been evacuated as soon as the Children reach their
evacuation destination by contacting CPS through one of the following methods:
(1)
During times when mass evacuation of part of Texas is anticipated, DFPS
will enable an online reporting feature on the DFPS public website at:
http://www.dfps.state.tx.us.
(2)
In situations when DFPS has enabled this online reporting feature and
the Contractor has access to the internet, the Contractor should use this
method to make the evacuation notification; or
(3)
In situations where the online reporting feature is not enabled or if the
Contractor does not have access to the internet, the evacuation
notification can be made by calling the DFPS abuse/neglect hotline at 1800-252-5400.
c.
Contractors with multiple facilities and CPAs must contact CPS once per day, at
a minimum (unless otherwise instructed by DFPS), to provide information
concerning the Children in their care until all Children are accounted for; and
d.
CPA's must have methods through which their homes can contact CPA
administration to inform them of the location and condition of Children in care
as soon as possible upon reaching an evacuation destination.
Post-disaster activities (including emergency power, food, water, and
transportation);
Plans for return after an evacuation;
Methods to ensure the disaster plan remains current and is reviewed at least every
two years and when changes in administration, construction, or emergency phone
numbers occur; and
Child-Placing Agencies must provide a copy of their disaster
to foster
and ensure that each home has a written disaster plan, which will be updated as
necessary and at each re-evaluation
Minimum Standard
b.
x.
xi.
xii.
xiii.
xiv.
Form 2282cx
June 2011

Form 2282cx
June 2011
If such individual is an employee of the CASA, review for a valid court order; and
If such individual is a CASA volunteer, review for a valid court order and a
notification letter of volunteer assignment and acceptance, that clarifies the
individual's appointment to the Child; or
111.
Review that the individual is named on the Child's Contact List.
D) If Contractor or Caregiver cannot readily determine the identity or authority of an
individual appointed by a court of competent jurisdiction, then the Contractor or Caregiver
should obtain approval from the Child's case worker or chain of command prior to granting
the individual access to the Child.
i.
ii.
33.
National Youth in Transition Database (NYTD). The Contractor shall assist Children and
support the necessary activities, including on-going computer access required for:
A) Children turning 17 years of age through September 30, 2011 to:
i.
Register with NYTD
ii.
Maintain an email address for NYTD updates; and
111.
Complete the NYTD survey within 45 days after the Child's 17th birthday;
B) Children who previously took the NYTD Survey at 17 years of age to:
i.
Maintain an email address to receive NYTD updates; and
ii.
Enter NYTD contact updates to the Texas Youth Connection Website
www.texasyouthconnection.org.
34.
Contract Performance. Contractor performance evaluation is based on the assessment of

the output and outcome measures outlined in this Section and contained in Attachment F,
compliance with the terms and conditions of this Contract, including ail Attachments, and,
compliance with Minimum Standards, as indicated by Department records and Contract
Monitoring performed by Department staff. The Contract Performance measures are:
A) Contract Output Measures as defined in Attachment F:
i.
Output #1. The Contractor makes regular updates to the CPS Child Placement
Vacancy Database.
ii.
Output #2. Each Child's Education Portfolio is up-to-date.
iii.
Output #3. The Child's placement is stabilized.
iv.
Output #4 Children in substitute care move toward permanency. (CPAs only)
v.
Output #5 Children placed with a Contractor remain in the care of the Contractor.
(CPAs only)
B)
Contract Outcome Measures as

i.
Outcome #1 Children are
Children are
iii.
Children are
are
defined in Attachment F:
safe in care.
safely maintained in their
maintained in their "''"'"' '"'"''"1able
0

Form 2282cx
June 2011
Entry into PMET

Reporting Period
Performance Period
Sept, Oct, Nov
December 1-30
First Quarter
March 1-30
Dec, Jan, Feb
Second Quarter
Third Quarter
Mar, Apr, May
June 1-30
Jun, Jul, Aug
September 1-30
Fourth Quarter
iv. Maintaining documentation for each performance period and in a manner which
allows for testing the validity of the results reported.
35.

A) HHSC periodically determines Service Level unit rates (daily rates) in accordance with its
Cost-finding Methodology. The daily rates in effect during the term of this Contract are
contained in Attachment A.
Department be remitted by the Contractor to Foster Parents to pay for the basic Child
maintenance costs of Children placed pursuant to this Contract. The required
reimbursements are set forth in Attachment A. If HHSC implements a change in the
Service Level rates, the Department will change those minimum dollar amounts in
Attachment A.
C) Foster Parent Minimum Reimbursement Funds are all payments of funds received by the
Contractor from the Department that constitute the minimum amounts that the Contractor
must pass through to reimburse a Foster Parent for services already provided according to
the rates set forth in this Contract. For any and all such Foster Parent minimum
Reimbursement Funds, the Contractor must:
i.
Hold, maintain, manage, and account for such funds in a fiduciary capacity, without
limitation because such funds are held for the sole purpose of disbursement by the
Contractor to the applicable Foster Parents;
ii.
Not directly, indirectly, or collaterally pledge, assign, or otherwise attach, without
limitation, as security or collateral to any financial instrument or other obligation any
such funds that the Contractor has received, will receive, or may receive under this
Contract; and
iii.
Disburse such funds only to the applicable Foster Parents not later than 10 days after
the date such funds are received by the Contractor.
with Chapter 2251 of the Texas Government Code, the Contractor must
D)
'""""'""' owed to subcontractors within 10 business
of the Contractor's

Form 2282cx
June 2011
by the Department and receiving services in accordance with the Child's Plan of Service
(including Permanency Planning goals), licensing standards, Contract terms, and Service
Level standards.
The Department shall pay for the calendar day of placement, but not for the calendar day
of discharge. If the Child is discharged on the day of placement, the Contractor will not be
reimbursed for that day.
E) If a Child is away from the Contractor's Facility without prior authorization, and if the
Department's Caseworker or the Caseworker's supervisors and the Contractor agree in
writing that the Child should return to the Facility, then the Contractor may keep the
placement open for the Child. Reimbursement for reserve bed days must be permitted in
accordance with 40 TAC 700.323 and the policies established by the Department
(http://www.dfps.state.tx.us/Handbooks/default.asp), now incorporated by this reference.
F) The Department shall give the Contractor notice in writing at least 30 calendar days prior
to the effective date of any change that affects payments to the Contractor.
G) Contractors must seek payment or adjustment to payments in accordance with the time
limit specified in 45 CFR 95.1 (Code of Federal Regulations). This subpart establishes a
two-year (eight quarter) time limit for a State to claim Federal financial participation in
expenditures under State plans approved under Title IV-E and TANF. Any bill or amended
bill, which is submitted to DFPS later than seven quarters after the end of the quarter of
the expense, will not be processed unless DFPS determines that submission for payment
of the bill to the federal government can be executed in a proper and timely fashion.
37.

A) Be responsible for any Monitoring/audit exception or other payment irregularity regarding
this Contract or subcontract; and
B) Be responsible for the timely and proper collection and reimbursement to the Department
of any amount paid in excess of the proper payment amount within 90 days of
determination of overpayment.
38.
information using the accrual method of accounting in accordance with 1 TAC 355.7101(6).
Accepted Accounting Principles (GAAP) approved by the American Institute of Certified Public
Accountants (AICPA).
39.
Insurance.
A) The Contractor shall provide insurance for direct delivery of services under this Contract.
The Contractor shall obtain and furnish proof of the following bonding and insurance
coverage within 48 hours of the award of the Contract and at such other times as may be
specified by the Department. The required coverages are:
Dishonesty bonding under a commercial crime policy or business services
at
$
and

Form 2282cx
June 2011
documentation required in Subsection 39.C) of this Section, to demonstrate the

Contractor's compliance with this Section.
ii.
Subsection 39.C) of this Section is in addition to the requirements for obtaining a
license contained in 42 HRC 42.049(c).
D) All required insurance policies shall include an endorsement stating that the Department
shall be given 30 calendar days written notice prior to cancellation of or material change
to the policy or bond.
40.
Taxes.
DFPS is not responsible for any state, local, or federal taxes. The Contractor must comply with
all federal (including but not limited to payroll taxes), state and local tax laws.
ADMINISTRATIVE
41.

B) In maintaining financial records and in preparing cost reports, the Contractor shall remain
in compliance with 48 CFR 31 as applicable, Office of Management and Budget (OMB)
Circulars A-21, A-87, A-102, A-110, and A-122, and 40 TAC 732.240-256 as applicable.
http: 1/info.sos.state.tx. us/pls/pub/readtac$ext. ViewTAC?tac view= 5&ti =40&pt= 19&ch= 7
32&sch=L&ri=Y
C) The Contractor shall comply with all applicable state and federal statutes and rules in
effect at the time such services are rendered, including the following:
i.
Federal Financial Participation (FFP) requirements in accordance with Titles 45 and 48
of the Code of Federal Regulations and federal circulars, as amended;
ii.
State and federal anti-discrimination laws, including without limitation:
a.
Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.);
b.
Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794);
c.
Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.);
d.
e.
f.
g.
The HHS agency's administrative rules, as set forth in TAC, to the extent
( 1)
The Contractor agrees to comply with all amendments to the abovereferenced
and ail
the

iii.
iv.
v.
vi.
Form 2282cx
June 2011
to services for applicants and recipients who cannot express themselves

fluently in English. The Contractor agrees to ensure that its policies do
not have the effect of excluding or limiting the participation of persons in
its programs, benefits, and activities on the basis of national origin. The
Contractor also agrees to take reasonable steps to provide services and
information, both orally and in writing, in appropriate languages other
than English, in order to ensure that persons with limited English
proficiency are effectively informed and can have meaningful access to
programs, benefits, and activities.
(3)
The Contractor agrees to comply with Executive Order 13279, and its
implementing regulations at 45 CFR Part 87 or 7 CFR Part 16. These
provide in part that any organization that participates in programs
funded by direct financial assistance from the United States Department
of Agriculture or the United States Department of Health and Human
Services shall not, in providing services, discriminate against a program
beneficiary or prospective program beneficiary on the basis of religion or
religious belief.
Upon request, the Contractor will provide HHSC Civil Rights Office with
( 4)
copies of all of the Contractor's civil rights policies and procedures.
(5)
The Contractor must notify HHSC's Civil Rights Office of any civil rights
complaints received relating to its performance under this Agreement.
This notice must be delivered no more than 10 calendar days after
receipt of a complaint. Notice provided pursuant to this Subsection must
be directed to:
701 W. 51st Street, Mail Code W206
Austin, Texas 78751
Phone: (512) 438-4313
TTY Toll Free: (877) 432-7232
Fax: (512) 438-5885
Health and Safety Code Section 85.115 relating to workplace and confidentiality
guidelines regarding AIDS and HIV;
Immigration Reform and Control Act of 1986 regarding employment verification and
retention of verification forms for any individuals who will perform any labor or
services under this Contract;
Ail state and federal licensing and certification requirements, health and safety
standards, and regulations prescribed by the United States Department of Health and
Human Services Department;
All applicable standards, orders or regulations issues pursuant to the Clean Air Act
USC 7401 et seq.) and the Federal Water Pollution Control Act as amended

Form 2282cx
June 2011
Contractor shall maintain financial, programmatic, and supporting documents, statistical
records, documentation to support performance measures, and other records pertinent to
claims or cost reports submitted and/or services delivered during the Contract Period for a
minimum of five years after the termination of the Contract Period. If any litigation, claim,
or monitoring/audit involving these records begins before the five year period expires, the
Contractor must keep the records and documents for not less than five years and until all
litigation, claims, or monitoring/audit findings are resolved. A case is considered resolved
when a final order is issued in litigation and the order cannot be appealed, or a written
agreement resolving all issues is entered into between the Department and the
Contractor.
Department upon verbal request in emergency situations. Upon verbal request from
DFPS, the Contractor must submit legible records and information within the Department's
specified timeframe. Emergency requests for records can include, but are not limited to,
the need to review the Child's Service Level in order to make a placement change, court
ordered requests, or attorney requests.
Department upon request. The Contractor must forward legible records and information
to the Department within 14 calendar days. Information could include, but is not limited
to documentation of face-to-face visits with the Child by the Contractor's Case Manager
staff, the Child's Service Plan, documentation of services provided to a Child, Discipline
logs, medical and dental logs, educational documentation, and narratives.
D) The Contractor shall provide the STAR Health contractor (Superior/Cenpatico) the
following information for specific Children for the purposes of a Psychotropic Medication
Utilization Review (PMUR) upon written request by Superior:
i.
Physician notes (last three months);
ii.
Medication logs (last three months); and
111.
In the event the Contractor receives a written request for information from the STAR
Health contractor (Superior/Cenpatico) that does not involve PMUR as identified in
Subsection 42.D) of this Section, the Contractor shall advise the STAR Health contractor
(Superior/Cenpatico) to contact the Child's caseworker or chain of command for
assistance.
F) All records received or created by the Contractor that are identifiable to Children referred
are confidential and may be disclosed to third
with the
by the
the

Form 2282cx
June 2011
Health Passport user agreement as it exists now or may later be amended, including the
following:
i.
Not to share information from the Health Passport with anyone without a direct need
to know the information for purposes of providing health care, including behavioral
health care, services to the Child;
ii.
To share only the minimum amount of information from the Health Passport as is
iii.
To be responsible for maintaining the physical security and confidentiality of Health
Passport information that the user may view on a computer, print to paper or copy or
download to other formats. People who do not need the information should not have
physical access to it;
iv.
To limit access to Health Passport records to those Children who are served by the
v.
Not to share passwords. If the Contractor becomes aware that a password has been
shared, he or she is required to notify Superior within 24 hours so that a new
password can be assigned.
I) The Contractor shall advise Authorized Users that DFPS may restrict or deny access to the
Health Passport if they are in violation of the user agreement or terms and conditions of
the Contract.
J) The provisions of this Section shall remain in full force and effect following termination of
or cessation of the services performed under the terms of this Contract.
K) The Contractor will provide access to all records and information concerning the Child to
properly identified individuals appointed by a court of competent jurisdiction (Volunteer or
Court Appointed Special Advocates (CASA), guardians ad litem, and attorneys ad litem).
i.
Such records and information may include, but is not limited to, documentation of
face-to-face visits with the Child by the Contractor's Case Manager staff, the Child's
Service Plan, documentation of services provided to a Child, Discipline logs, medical
and dental information, educational documentation, and narratives.
In order to assess that an individual who is accessing records and information is
ii.
appointed by a court of competent jurisdiction, a Contractor or Caregiver should:
If such individual is an employee of the CASA, review for a valid court order;
a.
and
b.
individual's appointment to the Child.
iii.
If Contractor or Caregiver cannot readily determine the identity or authority of an
individual appointed by a court of competent jurisdiction, then Contractor or
Caregiver should obtain approval from the Child's caseworker or chain of command
to
access to records or information.
THE CONTRACTOR MUST NOT DISPOSE OF RECORDS BEFORE PROVIDING THE DEPARTMENT'S

44.
Form 2282cx
June 2011
Notifications.
A) The Contractor must:
i.
Maintain at all times at least one active electronic mail (email) address for the receipt
of Contract-related communications from the Department. It is the Contractor's
responsibility to monitor this email address for Contract-related information. The
Contractor shall notify the Residential Contract Manager and the Residential Contract
Mailbox (Residential Contracts@dfps.state.tx.us) with any updated email address
within five calendar days of the change;
At a minimum, give the Department the amount of written notice required by Section
ii.
27 of this Contract before discharging a Child placed by the Department;
iii.
Notify the Department within 24 hours after the Contractor determines that a Child
placed by the Department with the Contractor is a danger to self or others and
requires a placement in another setting, or has been incarcerated or placed in
juvenile detention;
Notify the Department within 24 hours, when the Contractor knows that a Child
iv.
placed by the Department and in the Contractor's care requires hospitalization;
v.
Notify the Department of any Serious Incident, including but not limited to, run
away, death, and abuse neglect or exploitation, within the timeframe mandated by
Minimum Standards. The Contractor may report Serious Incidents to the
Department's Statewide Intake at 1-800-252-5400 to meet the requirements of this
Subsection;
vi.
Notify the Residential Contract Manager within 10 calendar days, of any significant
changes affecting the Contractor's residential child care program, including but not
limited to, the addition, replacement, or termination of the Administrator or Board
President; any change in ownership of the Facility; a change in the Contractor's
status as a for-profit or non-profit entity; any change to the Contractor's admissions
policy and significant changes to the scope and coverage of the services provided by
the Contractor or Subcontractor under this Contract;
vii. Notify the Residential Contract Manager within 10 calendar days, if there are Service
Level issues which cannot be resolved by the Department's third-party contractor or
payment issues which cannot be resolved by the applicable regional foster care
billing coordinator;
viii. Notify the Residential Contract Manager within 48 hours of an identified breach of
confidentiality of Children's information;
ix.
Notify the school regarding any change that will affect the Child's attendance to
school and, where possible the length of time a Child may be absent;
x.
Notify in writing the Child's Caseworker or Chain of Command of upcoming ARD team
meetings within five business days of the Contractor's receipt of a written ARD team
meeting notice;
xi
Notify the residential

xvi.
Form 2282cx
June 2011
the Child to enroll in or receive PAL Life Skills training classes;

Notify the Department of a foster home application to a Child Placing Agency made
by a Relative or Fictive Kin family by entering required data into the DFPS Child Care
Licensing Public and Provider Website within two business days of when the
application was accepted at:
https://www.dfps.state.tx.us/Child Care/Search Texas Child Care/ppFacilityLogin.a
~
xvii.
Notify the Department of reasons why a Relative or Fictive Kin family that applied to
be a foster home is not verified by entering required data into the DFPS Child Care
Licensing Public and Provider website within two business days of determining that
the home will not be verified;
xviii. Notify the Department of the relationship between a Relative, Fictive Kin, or
unrelated foster parent verified by the Child Placing Agency and all Children in DFPS
conservatorship placed in the foster home by entering or updating required data into
the DFPS Child Care Licensing Public and Provider website within two business days
of any such change; and
xix. Notify each Child's Caseworker or Chain of Command in writing within two business
days of the verification of a Relative or Fictive kin family and submit a copy of the
foster parent's Home Screening to each Child's Caseworker.
B) The Department will:
i.
Provide the Contractor with 30 calendar days written notice when planning a
discharge from placement except as provided below or in the case of a Contractor
providing emergency care services where a five calendar day notice is required;
ii.
Not be required to provide notice for removal when court ordered, when there is an
immediate threat to the health, safety or well-being of a Child, after the Contractor
provides notice or requests removal under Section 27 of this Contract. However,
when the Department determines the removal to be in a Child's best interest, they
will make every effort to afford the Child and the Contractor reasonable notice;
iii.
When requested by the Contractor, provide the Contractor with a discharge
document signed by the DFPS Program Director responsible for the Child or, at the
Department's discretion, a higher management level if the Department wishes to
discharge a Child with less than 30 days notice when the discharge is not for one of
the reasons in Section 44.B)ii. of this Subsection. The discharge document shall
describe the Department's reasons for the discharge and the reasons for discharging
with less than 30 days notice;
iv.
Keep the Contractor informed of any significant changes in the Child's circumstances
in a timely manner including legal status, family situation, and factors related to the
Child's Permanency Goal;
the

B)
Form 2282cx
June 2011
an annual cost report; and

Attach a copy of the preparer's training certificate to each completed cost report.
47.
Authority of Department Staff. Department staff are not authorized to sign non-DFPS
forms unless those forms have received prior approval by an attorney for the Department.
The Department is not bound by unauthorized staff actions in signing such forms. Department
staff are permitted to sign the written Service Plan referenced in Attachment C of this
Contract, sign documents as witnesses, and sign documents acknowledging receipt of
information from Contractors.
48.
Notices of Department Funding.

A) The Contractor must place notices acknowledging the funding it receives from the
Department in all of its literature and information published on its website that describes
services provided under this Contract, in the same font size as the majority of the other
descriptive material. This notice will also appear in the Contractor's annual financial
report, if any is issued.
B) The Contractor's foster parent recruitment activities must not emphasize payment as the
rimar incentive for becomin a foster arent.
CONTRACT MONITORING
49.
Assessments of Physical Facilities and Operations. The Contractor shall allow periodic
assessments of its physical facilities and operations, which may include specific foster homes,
by a DFPS employees or DFPS authorized representatives. The Contractor's physical facilities
and operations shall be approved by the Department based on assessments prior to and
during the Contract Period.
50.

A) The Contractor acknowledges and agrees that Department employees and/or
representatives shall review the services provided and any related documentation for
compliance with contractual and statutory/regulatory requirements.
B) DFPS' Service Level Monitor will complete a periodic Service Level compliance review to
determine the level of services that are actually being provided by the Contractor. When
there are deficiencies, the Service Level Monitor provides the Contractor 30 calendar days
for correction beginning with the date that the Service Level Monitor first determined that
the Contractor was not meeting the contracted Service Levels. The Service Level Monitor
will issue a final letter indicating the Contractor's non-compliance with the Service Levels
after the 30 calendar-day period for correction. Upon receipt of notification from the
Department, the Contractor will not be paid more than the Service Level daily unit rate as
determined by the Service Level Monitor. The Contractor will not be paid at a rate higher
than the Service Level rate until the Contractor receives notice from the
The
the
that all contracted

Protective Services
Form 2282cx
June 2011
funds under this Contract or any subcontract. Contractor will ensure that this clause
concerning the authority to audit funds received indirectly by subcontractors through
Contractor and the requirement to cooperate is included in any subcontract it awards.
Failure to enforce any provision of the Contract does not constitute a waiver of that
revision or an other revision of the Contract.
OTHER PROVISIONS
51.
Precedence of Contractor Compliance. The terms of the Contract shall prevail over less
stringent licensing regulations or other state or federal regulations.
52.
Comptroller Status. Contractor agrees that should the Texas Comptroller of Public Accounts
ever place the Contractor on "vendor hold" or "not in good standing," then the Department will
apply all payments under this Contract directly toward eliminating any of Contractor's debts or
delinquencies to the State of Texas.
53.
54.
receipt of state or federal funds that the Department has allocated to this Contract. If any
I such funds for this Contract become unavailable during any budget period, this Contract may
be immediately terminated or reduced at the discretion of the Department.
Subcontracting. Contractor will be responsible to DFPS for any subcontractor's performance
under this Contract.
A) Subcontractors providing services under the Contract will meet the same requirements
and level of experience as required of Contractor. No subcontract under the Contract will
relieve Contractor of responsibility for ensuring the requested services are provided. If
Contractor uses a subcontractor for any or all of the work required, the following
conditions will apply:
i.
Contractors planning to subcontract all or a portion of the work to be performed will
identify the proposed subcontractors and keep a record available to DFPS upon
request.
ii.
Subcontracting will be solely at Contractor's expense.
iii.
DFPS retains the right to check subcontractor's background
iv.
Contractor will be the sole contact for DFPS and Contractor will list a designated
point of contact for all Department inquiries.
B) Contractor will include a term in all proposed subcontracts that incorporates this Contract
by reference and binds subcontractor to all the requirements, terms, and conditions of this
Contract related to the service being provided by the subcontractor. Contractor will also
include terms that explicitly hold that this Contract controls in the event of any conflict
with a subcontract. DFPS approval of Contractor's use of any subcontractor is conditioned
of the
upon the extent that any subcontract does not conflict with any
ncr<Mt::><>n DFPS

Form 2282cx
June 2011
secured lending arrangements in the ordinary course of business.

56.
Vendor Performance. Pursuant to Section 2155.144 (K) of the Texas Government Code and
20.108 of the Texas Administrative Code, state agencies are required to report vendor
performance on any purchase of $25,000 or more from contracts administered by the Texas
Comptroller of Public Accounts or any other purchase made through an agency's delegated
authority or a purchase made pursuant to the authority in Government Code, Title 10, Subtitle
D or a purchase exempt from Texas Comptroller of Public Accounts' procurement rules and
procedures. DFPS reports vendor performance by means of the Vendor Performance Tracking
System (VPTS), which can be accessed online at:
DFPS may use the VPTS to determine best value when awarding contracts in instances where
past performance is included as a factor in the evaluation of a vendor for award.
57.

A) Changes and Amendments. Except as provided in Subsection 57.C) of this Section, no
change, modification, or amendment to the Contract will be effective until approved in
writing by the Department and the Contractor.
B) Contract Renewals. The Contract is renewable upon mutual agreement of the parties and
subject to the conditions in 40 TAC 700.2501-2505, 40 TAC 732.230, and the terms of
this Contract.
Contractor's receipt of a copy of the amendment signed by the Department. DFPS
i.
Incorporate new or revised federal, State, or Department laws, regulations, rules, or
policies;
ii.
Change the name of the Contractor in order to reflect the Contractor's name as
recorded by the Texas Secretary of State;
iii.
Correct an obvious clerical error in the Contract;
iv.
Change Contract and resource numbers;
v.
Change the recorded license number of any license needed under this Contract in
order to reflect the correct number as issued by the licensing authority;
vi.
Update Service Level descriptions or daily rates; or
vii.
with a court order or
Department, based on information from Monitoring or other verifiable sources, may take any
other actions deemed reasonable by the Department to ensure compliance with the terms and
conditions of this Contract. Such actions include, but are not limited to, the following:
The
may require the Contractor to take
corrective actions in order to

Form 2282cx
June 2011
D) Suspend and/or limit any further placements of Children, and place conditions on any such
suspensions and/or limitations of placements;
Suspend, place into abeyance, or remove any of the Contractor's contractual rights, in
Department reserves the right to suspend or terminate this Contract, in whole or in part
and conduct a new solicitation and/or enter into a new Contract for the same or similar
services.
59.

A) If the Contractor fails to provide services according to the terms and conditions of this
Contract, the Department may immediately, upon written notice of default to the
Contractor, suspend or terminate all or any part of the Contract.
B) Either party may terminate this Contract by giving 30 calendar days written notice to the
other party, after which the Contract will terminate at the end of the 30 calendar day
notice period. Nothing in this Subsection may be construed to prohibit immediate
suspension or termination of this Contract pursuant to this Section.
C) At the end of the Contract term or other contract termination, the Contractor shall, in
good faith and in reasonable cooperation with the Department, aid in the transition to any
new arrangement or provider of services, including the orderly transition of each Child
placed by the Department to new homes. The respective accrued interests or obligations
incurred to date of termination must be settled equitably. This equitable settlement must
occur in compliance with 40 TAC 732.270-271 within six months from the date the
Contract has ended or is otherwise terminated in accordance with this Contract.
D) Upon termination or expiration of this Contract, the Department will work with the
efficiently as possible. The goal will be to remove all the Department's Children by the
effective date of the expiration or termination of the Contract; however, in the event this
is not possible, the Contractor will continue to provide care for the Children in accordance
all terms and conditions of this Contract. The Department will reimburse the Contractor
for any care provided after the date of Contract termination or Contract expiration until all
Children are removed from the Contractor's care.
E) The Department will terminate this Contract if the Contractor is found liable for or has a
contract, license, certificate, or permit of any kind revoked for Medicaid fraud.
F) The Department will suspend or terminate this Contract if the Contractor's license,
certificate, contract, permit, registration, or other approval (any of which are required to
operate and to provide the services under this Contract) has been suspended or
terminated by the applicable federal or state governmental authority, or by any applicable
governmental entity named in Chapter 531 of the Texas Government Code.
If this Contract is terminated or suspended for any reason, Department and the State of
Texas
not be liable to
Contractor for any
any other

Form 2282cx
June 2011
AND LIABILITIES INCLUDING WITHOUT LIMITATION, ATTORNEY'S FEES AND COURT

COSTS CONNECTED WITH ANY ACTS OR OMISSIONS OF THE CONTRACTOR OR ANY
AGENT, EMPLOYEE, , SUBCONTRACTOR OR SUPPLIERIN THE EXECUTION OR
PERFORMANCE OF THIS CONTRACT. THE CONTRACTOR MUST COORDINATE ANY
DEFENSE WITH THE TEXAS ATTORNEY GENERAl AS REQUESTED BY DFPS. THIS
SECTION IS NOT INTENDED TO AND SHAll NOT BE CONSTRUED TO REQUIRE THE
CONTRACTOR TO INDEMNIFY OR HOLD HARMLESS THE STATE OR THE DEPARTMENT
FOR ANY CLAIMS OR LIABILITIES RESUlTING FROM NEGLIGENT ACTS OR OMISSIONS
OF DFPS OR ITS EMPLOYEES.
61.
Prohibition on Non-compete Restrictions. Contractor will not require any employees or

subcontractors to agree to any conditions, such as non-compete clauses or other contractual
arrangements, that would limit or restrict such persons or entities from employment or
contracting with other providers (including DFPS).
62.
limitation on Use of DFPS Seal and Name. Contractor may not use the DFPS seal in any
form or manner without the prior written approval of the Department. Contractor also may not
use the name of DFPS to imply any endorsement, approval, or sponsorship of Contractor's
goods or services by DFPS.
63.
Force Majeure. The Contractor will be excused from the obligations of this Contract to the
extent that performance is delayed or prevented by any circumstances (except financial)
reasonably beyond the Contractor's control. Such delays or failures to perform shall extend
the period of performance at the discretion of DFPS. The Contractor must inform the
Department in writing of proof of force majeure within three business days or otherwise waive
this right as a defense. The Contractor agrees that breach of this provision entitles DFPS to
any and all available remedies.
64.
Buy Texas. In accordance with Texas Government Code 2155.4441, the State of Texas
requires that during the performance of a contract for services, Contractor will purchase
products and materials produced in the State of Texas when available at a price and time
comparable to products and materials produced outside the state.
65.

copyright, use, reproduce, and distribute any material written or produced by the Contractor
that is the subject of this Contract. When the Contractor develops materials using funds from
this Contract, the Contractor must grant the Department and the federal government a
and irrevocable license or right to reproduce, translate,
such materials and to authorize
do so

Protective Services
Form 2282cx
June 2011
knowingly rendered an erroneous certification, DFPS may pursue all available remedies in
accordance with Texas and U.S. law. Contractor further agrees that it will provide immediate
written notice to DFPS if at any time Contractor learns that any of the certifications provided
for this contract were erroneous when submitted or have since become erroneous by reason of
changed circumstances. If the Contractor cannot certify the accuracy of all certification
statements, then Contractor must provide written notice to DFPS detailing which
statements it cannot certify and why. Contractor acknowledges its continuing obligation
to comply with the requirements of all certifications, and will immediately notify DFPS of any
changes in circumstances affecting these certifications.
A) Certification Regarding Lobbying. State and federal law place restrictions on the use of
state and federal funds in regard to lobbying. The Contractor certifies, to the best of its
knowledge and belief, that:
i.
In accordance with 31 U.S.C. 1352, no federal appropriated funds have been paid
or will be paid, by or on behalf of the Contractor, to any person for influencing or
attempting to influence an officer or employee of an agency, a Member of Congress,
an officer or employee of Congress, or an employee of a Member of Congress in
connection with the awarding of any federal contract, the making of any federal
grant, the making of any federal loan, the entering into of any cooperative
agreement, and the extension, continuation, renewal, amendment, or modification of
any federal contract, grant, loan, or cooperative agreement.
If any funds other than federal appropriated funds have been paid or will be paid to
ii.
any person for influencing or attempting to influence an officer or employee of any
agency, a Member of Congress, an officer or employee of Congress, or an employee
of a Member of Congress in connection with this federal contract, grant, loan, or
cooperative agreement, the undersigned will complete and submit Standard FormLLL, Disclosure Form to Report Lobbying, in accordance with its instructions.
iii.
The Contractor will require that the language of this certification be included in the
award documents for subcontracts and that all subcontractors will certify and disclose
accordingly.
iv.
Payments of appropriated or other funds to Contractor under any resulting
agreement are not prohibited by Texas Government Code 556.005 or 556.008.
B) Suspension, Ineligibility, and Voluntary Exclusion. Executive Orders 12549 and
12689 require DFPS to screen each covered Contractor to determine whether each has a
right to obtain a contract in accordance with federal regulations on debarment,
suspension, ineligibility, and voluntary exclusion. Contractor certifies the following:
i.
That Contractor is, to the best of its knowledge and belief, not debarred, suspended,
declared ineligible, or voluntarily excluded from participation in this solicitation or
any resulting contract.
ii.
That Contractor will not knowingly enter into any subcontract with a person who is
debarred, suspended, declared ineligible, or voluntarily excluded from participation in
this covered transaction, unless authorized by DFPS or the U.S.
of
Health and Human Services.

ii.
Form 2282cx
June 2011
an ongoing
awareness program to nrnrrn
The dangers of drug abuse in the workplace;
The grantee's policy of maintaining a drug-free workplace;
Any available drug counseling, rehabilitation, and employee assistance
programs; and
d.
The penalties that may be imposed upon employees for drug abuse violations
occurring in the workplace;
iii.
Making it a requirement that each employee to be engaged in the performance of the
grant be given a copy of the statement required by Sub-Section (D)(i);
iv.
Notifying the employee in the statement required by Sub-Section (D)(1) that, as a
condition of employment under the grant, the employee willa.
Abide by the terms of the statement; and
b.
Notify the employer in writing of his or her conviction for a violation of a
criminal drug statute occurring in the workplace no later than five calendar days
after such conviction;
v.
Notifying the agency in writing, within ten calendar days after receiving notice under
Sub-Section (D)(iv)(b) from an employee or otherwise receiving actual notice of such
conviction. Employers of convicted employees must provide notice, including position
title, to every grant officer or other designee on whose grant activity the convicted
employee was working, unless the federal agency has designated a central point for
the receipt of such notices. Notice will include the identification number(s) of each
affected grant;
vi.
Taking one of the following actions, within 30 calendar days of receiving notice under
Sub-Section (D)(iv)(b), with respect to any employee who is so convicteda.
Taking appropriate personnel action against such an employee, up to and
including termination, consistent with the requirements of the Rehabilitation Act
of 1973, as amended; or
b.
Requiring such employee to participate satisfactorily in a drug abuse assistance
or rehabilitation program approved for such purposes by a federal, state, or
local health, law enforcement, or other appropriate agency;
c.
Making a good faith effort to continue to maintain a drug-free workplace.
Anti-Trust Certification. Pursuant to 15 U.S.C. Sec. 1, et seq. and Tex. Bus. & Comm.
Code Sec. 15.01, et seq., Contractor certifies that neither the Contractor nor the firm,
corporation, partnership, or institution represented by the Contractor, or anyone acting for
such a firm, corporation, or institution has violated the anti-trust laws of this state, federal
anti-trust laws, nor communicated directly or indirectly the bid made to any competitor or
any other person engaged in such line of business.
Deceptive Trade Practices. Contractor certifies that it has not been found guilty or liable
of a Deceptive Trade Practices Act or any unfair business practice either in an
administrative hearing or court suit within the last five years. Contractor certifies that it
has no officers
have served as officers of other entities who have
a.
b.
c.

Form 2282cx
June 2011
certifies that it has not given, offered to give, and does not intend to give at any time, any
economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor,
or service to any public servant or employee in connection with a contract.
68.
list of Attachments. The following documents are attached hereto and incorporated herein
by this reference:
Attachment A 24-Hour Residential Child Care Rates
Attachment B - Residential Child Care Contract Glossary
Attachment C - Service Level Descriptions
Attachment D - Intermittent Alternate Care
Attachment E - Special Terms and Conditions
Attachment F - Performance Measures
69.
under this Contract, whether by voucher, judgment of any court of competent jurisdiction, or
any other administrative means, constitutes and operates as a general release to the State
from all claims of and liability to the Contractor arising out of the performance of this Contract.
70.
Waiver. One or more waivers by the Department of any covenant, term or condition of this
Contract shall not be construed as a waiver of a subsequent breach of the same covenant,
term or condition, and any such waiver shall not be deemed to be a waiver of any other or
subsequent breach and shall not be construed to be a modification of the terms of the Contract
The consent or approval by the Department shall not be construed as a waiver of a subsequent
breach of the same covenant, term or condition. The consent or approval by the Department
to any act of the other party requiring such consent or approval shall not be deemed to waive
71.
unenforceable under present or future laws, then it is the intention of the parties that the
remainder of this Contract shall not be affected and that, to the extent of any such invalidity,
there be added as a part of this Contract a clause or provision of
as may be legally possible in order to make the prior intent of such clause or
valid, and enforceable.
Department or the State of Texas except as expressly provided for in this Contract; no other
authority power or use is granted or implied. The Contractor may not incur any debts,
obligations, expenses, or liabilities of any kind on behalf of the State of Texas or the
Department.
I
1
of Family
wm''"'""'""' Services
Printed Name:
Printed Name:
Printed Title:
Printed Title:
Date
Form 2282CX
June 2011


Attachment "A"
Form 2282cx
June 2011

Rate Structure
Basic CPA
l$39.52
Basic Foster Family
$22.15
Basic Facility
l$42.18
Moderate CPA
l$71.91

nty
l$38.77
Specialized CPA
$95.79
$49.85
l$138.25
~tense CPA
l$175.66
$96.17
Intense Facility
l$88.62
$242.85
$115.44

Form 2282cx
June 2011

Attachment "8"
Anseii-Casey Life Skills Assessment: An assessment of a Child's independent living skills designed
to be completed by both the Child and the Caregiver. The Child and Caregiver results are combined
into a report which provides an indication of the skill level and readiness of the Child to live
independently and creates the opportunity for the Caregiver and Child to talk about the Child's life
skills.
activities;
viii.Adequate to protect Children against natural elements, such as rain, snow, wind, cold, sun and
insects.
Basic living Skills: Skills necessary to care for oneself and to function in the community. Basic
identification documents, personal finance, and budgeting.
Behavioral Health Services: Services
the treatment of
or substance related


Attachment "B"
Form 2282cx
June 2011
iv.
v.
vi.
Developing and updating of service plans;

Stewarding direct contact with Children and the foster parents or other caregivers; and
Performing any additional activities that may consist of planning and coordination of services
to Children and the foster families based on current needs and functioning;
C) Orientating, assessing, and verifying foster parents; and
D) Monitoring and providing support services to foster parents, including the initiation of
development plans, corrective actions, or adverse actions.
Case Management Services: Any service referenced in the Case Manager definition or in services
referenced in the 40 TAC 749.663 or 748.561.
Caseworker: A DFPS employee who provides casework services to Children in Substitute Care
under the conservatorship of the State. When the Contract requires approval from or notification of
the Child's Caseworker, the Contractor may utilize the Caseworker's Chain of Command if the
Contractor is unable to contact the Caseworker.
communicate with the Child's Caseworker. The typical Department Chain of Command is as follows:
Connections: Relationships Children have with extended family members, previous foster families,
communities, tribes or tribal customs, religions or religious observances, and other social
networks.


Attachment "B"
Form 2282cx
June 2011
paid in response to claims processed through the Child's Medicaid health plan.
CPS Transition Plan: A plan to address the issues that are important for all Children 16 and older
as
prepare to leave care and enter the adult world. The plan helps the Child, providers and
Caseworkers identify what services are needed to accomplish goals and it is incorporated into the
Cultural Competence: The ability of individuals and systems to provide services effectively to
people of various cultures, races, ethnic backgrounds, and religions in a manner that recognizes,
Designated Victim: A Child determined as such by an investigation resulting in a disposition of
Reason to Believe (RTB) and entered in the data system (Reference Section 6610 of the Licensing
Policy and Procedures Handbook (LPPH)). A Designated Victim will be counted when the disposition is
decision of the Administrative Review body (Reference Section 7710 of the LPPH).
DFPS Child Care licensing Public and Provider Website:
in DFPS substitute care that enable them to access services, such as counseling, mentoring/tutoring,
Education and Training Voucher (ETV) Program: A federally-funded (Chafee) and stateadministered program. Under this program, Children ages 16 to 23 years old may be eligible for up to
school documents and is designed to follow School-Age Children to each placement. This
Residential Child-Care Contractors, Foster Parents, Kinship Caregivers, and the Children.


Attachment "B"
Form 2282cx
June 2011
Extended Foster Care: A program for Children 18 to 22 years old who are eligible, and have signed
an agreement to participate in this program. A Child who turns 18 years of age while in the
conservatorship of DFPS, is eligible for Extended Foster Care services through the end of the month in
which the Child reaches the age limit referenced in A) through F), so long as sufficient documentation
is provided on a periodic basis as required by the terms of the Child's Extended Foster Care
Agreement to demonstrate that the Child is:
GED up to the Child's 22nd birthday.
program up to the Child's 2
birthday. These Children can remain in care to complete
D) Employed for at least 80 hours per month up to the Child's 21st birthday;
birthday; or (40 TAC 700.316)
F) Accepted for admission to a college or vocational program that does not begin immediately. In
this case, the Child's eligibility is extended three and a half months after the end of the month in
which the Child receives his/her high school diploma or Graduate Equivalency Diploma (GED)
certificate.
Extracurricular Activities: Outside the regular academic curriculum, including athletic, social, and
cultural events.
Face-to-Face: A meeting held in person as opposed to videoconferencing or any other similar form
of technology.
Facility: Any Residential Child-Care operation including Child-Placing Agencies and General
Residential Operations.
In cases where:
A Child placed in a foster home or child-care institution is the parent of a son or daughter who
the same home or
and


Attachment "B"
Form 2282cx
June 2011
programs at local address, city/ or zip code through Head Start locator
Health Passport: An electronic health information system for the medical information of Children in
Healthy Racial and Ethnic Identity: A healthy sense of racial and ethnic identity is exemplified by
an individual who:
A) Identifies as a member of a particular racial/ethnic group or groups;
B) Has generally positive attitudes about being a member of that group, but also has a balanced
view of the strengths and challenges associated with it;
C) Affiliates with members of his or her own group but is also generally accepting of people from
other groups; and
D) Is able to cope successfully with perceived or real racism and discrimination and has possibly
shown some effective strategies for dealing with it.
the needs of Children and families receiving services.
needs.
of study.


Attachment "8"
Form 2282cx
June 2011
Kinship (Relative) Caregivers: Unlicensed Caregivers whom the court has approved for a Child's
because they are related to the Child; or have a Fictive Kin relationship to the Child.
to the Texas Family Code Chapter 153. (TAC 700.501(9))
Medical Care: The prevention, treatment, and management of illness and the preservation of
mental and physical well being through the services offered by the medical and allied health
professions.
functioning, vision, dental function or physical/medical functioning.
Minimum Standards: DFPS rules which are the minimum requirements for permit holders and
which are enforced by DFPS to protect the health, safety, and well being of Children. DFPS provides
publications that contain the Minimum Standards and guidelines for compliance for each type of
operation.
records and procedures of a Contractor. It involves many of the techniques and procedures used in
in Transition Database. Children and their Caregivers complete the National Youth in Transition
organization, program or among individuals, which enables staff and volunteers to work
with children and families from other cultures. Furthermore, it refers to the staff's
the
behaviors
and


Attachment "8"
Form 2282cx
June 2011
C) Permanent Managing Conservatorship to a relative or suitable individual (Relative/Kinship

Conservatorship or Unrelated Conservatorship);
D) Another planned permanent living arrangement (Foster Family - DFPS Conservatorship, Other
Family DFPS Conservatorship, Independent Living or Community Care).
A) A safe and permanent living situation for the Child;
B) A committed family for the Child;
C) An enduring and nurturing family relationship that can meet the Child's needs;
D) A sense of security for the Child;
A legal status for the child that protects the rights of the Child; and
F) In the case of a Child whose permanency goal is another planned, permanent living
arrangement, a connection to a caring adult who will be supportive into adulthood during and
after the transition to independent living.( 40 TAC 700.1201 and CPS policy 6200)
Personal Contact: A meeting, either face-to-face or by telecommunication, during which the
parties' discussion and actions are not directed.
or other benefits, which include, but are not limited to, medication, Medicai/Healthcare Items, toys,
money, gift cards, allowances, televisions, radios, and CDs and electronics.
Preparation for Adult living (PAL) Activities: Benefits and services provided to Children in
DFPS-paid Substitute Care who are age 16 or older and likely to remain in foster care until at least
age 18, who can qualify for services up to their 21st birthday. Services and benefits may include:
A) Anseii-Casey Life Skills Assessment to assess strengths and needs in life skills;
B) Life Skills training in core areas including financial management;
C) Job readiness and life decisions/responsibility;
D) Educational/vocational services;
E) Transitional Living Allowance (TLA) up to $1000 (distributed in increments up to $500 per
F) After Care Room and Board (ACRB) assistance, based on need, up to $500 per month for rent,
utiiity deposits, food, etc. (not to exceed $3000 of accumulated payments per Child);
G) Case management to help Children with self sufficiency planning and resource coordination;
H) Teen conferences;
development activities; and
based on need and
of
such as


Attachment "8"
Form 2282cx
June 2011
which include Child-Care Services, Treatment Services, Emergency Care Services, Transitional Living
Assessment Services Program, and Respite Child-Care Services {40 TAC 748.61, 749.61
).
Reason to Believe (RTB}: A finding of RTB means that a preponderance of evidence indicates
abuse/neglect/exploitation occurred. If any allegation disposition is RTB, the overall case disposition
is RTB.
Receiving Contractor: Any individual or legal entity designated by and contracting with DFPS, after
having received the Form 2085-FC, to provide or be responsible for the Residential Child Care of the
Child.
Relative: A person connected to a Child by blood, marriage, or adoption.
treatment of an unrelated Child or Children for 24 hours a day that occurs in a place other than the
Child's own home.
Return to Care:
A) A program designed for Children 18 to 22 years old who are eligible and sign an agreement to
and their conservatorship case had not been dismissed), and want to return to foster care, and:
i. Attend high-school or a program leading toward a high school diploma and have not reached
their 22nd birthday;
ii. Are enrolled at or within 30 days of placement in a course of instruction to prepare for the
GED and have not reached their 21st birthday;
iii. Attend and, within two years, complete a certified vocational or technical program and have
not reached their 21st birthday; or
iv. Return on a break from college or a technical or vocational program for at least one month,
but no more than 4 months and have not reached their 21st birthday. (40 TAC 700.316)
The return to Care program does not include Children over 18 years old who are overnight visitors
in the homes of Foster Parents, and the Foster Parents are not receiving a foster care
the care of these Children. ( 40 TAC
and


Attachment "8"
Form 2282cx
June 2011
(Superior/Cenpatico) to facilitate development of a health care service plan and coordination of
clinical services among a member's primary care physician and specialty providers to ensure
members with special health care needs have access to, and appropriately utilize, medically
necessary covered services.
Service Plan: The Contractor's developed plan that addresses the services that will be provided to a
Child to meet the Child's specific needs while placed in the Contractor's care.
Social Skills: Skills necessary to function in the community. Social Skills include, but are not
limited to, the ability to communicate with others, knowledge of community resources, scheduling
and attending medical appointments, interviewing for a job, cultural competency, and the ability to
interact in various social situations.
Special Immigrant Juvenile Status: A designation that enable eligible undocumented Children in
STAR Health Denial Letter: A letter informing a Child's Caregiver that a request for service
Subcontractor: A person or entity that delivers part or all of the services required of the primary
Contractor under this contract and is not an employee of the primary Contractor. There is an
agreement between the two persons and/or two entities whereby the primary Contractor authorizes
the person or entity (Subcontractor) to deliver the service. There does not have to be any payment
for services for the relationship to be considered a subcontract. For purposes of residential Contracts,
Foster Parents, direct service providers, and management service providers. Examples
of subcontracted management services could include nutritional consultation or services oversight.
DFPS does not allow Contractors to subcontract for Case Management services. In accordance with
Section 54 C) of this contract, DFPS will not approve the use of any subcontractor for Case
Services. Subcontracts that purely provide support and ancillary services that are not
the Contractor and that are not


Attachment "8"
Form 2282cx
June 2011
Superior: The organization responsible for managing STAR Health.

Supervise (children}: Awareness of and responsibility for a Child's ongoing activity. Supervision
Texas Health Steps: A Children's program under Medicaid which provides medical and dental
preventive care and treatment to Medicaid-enrolled Children from birth to 21 years of age.
Trauma Informed Care (TIC} Training: Child-centered, strength-based instruction that considers
the unique culture, experiences and beliefs of the child and ensures that training participants
understand and can apply the following:
A) The impact that traumatic experiences have on the lives of Children;
B) The symptoms of childhood trauma;
C) How to understand a Child's personal trauma history;
D) How to recognize the Child's trauma triggers; and
E) How to respond in ways that improve a Child's ability to trust, to feel safe, and to adapt to
changes in the Child's environment.
Children with Emotional Disorders, Mental Retardation, Pervasive Developmental Disorder, and
Primary Medical Needs as described in 40 TAC 748.61.
vocational schools for eligible Children who are in DFPS conservatorship:
A) On or after their 18th birthday; or
B) The day they receive their high school diploma or its equivalent; or
C) At age 14 or older are eligible for adoption. (Texas Education Code, 54.211.)
documents the Child's agreement to voluntarily remain in Foster Care and outlines the categories of
activity which qualify a Child to remain in Foster Care.
Voluntary Return to Foster Care Agreement Form 2560: The


Attachment "C"
Form 2282cx
June 2011

maintain or improve the Child's functioning including:
1)
Routine guidance and supervision to ensure the Child's safety and sense of security;
Affection, reassurance, and involvement in activities appropriate to the Child's age and
development to promote the Child's well-being;
3)
Contact, in a manner that is deemed in the best interest of the Child, with family members and
other persons significant to the Child to maintain a sense of identity and culture; and
4)
paraprofessionals, on an as-needed basis, to help the Child maintain functioning appropriate to
the Child's age and development.
A Child needing basic services is capable of responding to limit-setting or other interventions. The
Children needing basic services may include:
1)
A Child whose characteristics include one or more of the following:
the Child's age and can be corrected.
2)
A Child with developmental delays or mental retardation whose characteristics include minor to
1)
which most activities are designed to improve the Child's functioning including:
A.
More than routine guidance and supervision to ensure the Child's safety and sense of
security;
B. Affection, reassurance, and involvement in structured activities appropriate to the Child's
age and development to promote the Child's well being;
C. Contact, in a manner that is deemed in the best interest of the Child, with family members
and other persons significant to the Child to maintain a sense of identity and culture; and
professionals or paraprofessionals to help the Child attain or maintain functioning
appropriate to the Child's age and development.
In addition to the description in Subsection 1) of this Section, a Child with primary medical or
demonstrated


Attachment "C"
Form 2282cx
June 2011
A.
3)
4)
Substance abuse to the extent or frequency that the Child is at-risk of substantial
problems; and
A Child with developmental delays or mental retardation whose characteristics include:
B.
Moderate impairment in communication, cognition, or expressions of affect.
A Child with primary medical or habilitative needs, whose characteristics include one or more of
the following:
condition;
700.2341. SPECIALIZED SERVICE LEVEL

A.
2)
24-hour supervision to ensure the Child's safety and sense of security, which includes close
B. Affection, reassurance, and involvement in therapeutic activities appropriate to the Child's
and professionally designed and supervised to help the Child attain functioning appropriate
to the Child's age and development.
competence.

A Child needing specialized services has severe problems in one or more areas of functioning. The
Children needing specialized services may include:
1)
A. Unpredictable non-violent, anti-social
B.
or unpredictable physical aggression;
C. Being markedly withdrawn and isolated;
actions to include recent suicide

C.
4)

Attachment "C"
Form 2282cx
June 2011

E.
Multiple physical disabilities including sensory impairments.
A Child with primary medical or habilitative needs whose characteristics include one or more of
the following:
condition;
the interventions needed by Children in their care.


Attachment "C"
Form 2282cx
June 2011

1)
the Child's access to environments as necessary to protect the Child. The caregivers have
A. 24-hour supervision to ensure the Child's safety and sense of security, which includes
and other persons significant to the Child, to maintain a sense of identity and culture;
scheduled and professionally designed and supervised to help the Child attain functioning
more appropriate to the Child's age and development; and
E. Consistent and frequent attention, direction, and assistance to help the Child attain
stabilization and connect appropriately with the Child's environment.
2)
In addition to the description in Subsection 1) of this Section, a Child with developmental
delays or mental retardation needs professionally directed, designed and monitored
interventions to enhance mobility, communication, sensory, motor, and cognitive development,
and self-help skills.
3)
habilitative needs requires frequent and consistent interventions. The Child may be dependent
A Child needing intense services has severe problems in one or more areas of functioning that
present an imminent and critical danger of harm to self or others. The Children needing intense
services may include:
1)
hygiene.
2)
A Child who abuses alcohol, drugs, or other conscious-altering substances whose characteristics
A Child with developmental delays or mental retardation whose characteristics include one or
A.


Attachment "C"
Form 2282cx
June 2011
100 Supervision
8100.01 The Caregiver provides a supportive setting, preferably a family that is designed to
maintain or improve the Child's functioning by establishing clear rules appropriate to the
developmental and functional levels of the Child.
8100.02 The Caregiver establishes a clear system of rewards and consequences.
8100.03 The Caregiver supervises a Child through guidance to ensure the Child's safety and sense
of security.
admission and service plans, age of Child, high-risk behaviors and any other factors
independence.
M100 MODERATE SERVICE LEVEL SUPERVSION

The Caregiver provides supervision that is required at the Basic Service Level
M100.01 The Caregiver provides more than routine supervision with additional structure and
M100.02 For a Child with developmental delays, mental retardation, primary medical or habilitative
needs, the Caregiver provides regular daily supervision.
M100.03 For a Child with primary medical or habilitative needs the caregiver provides, as
and monitoring from a Caregiver.
S100 SPECIALIZED SERVICE LEVEL SUPERVISION
explaining how the program is structured to stabilize or improve the Child's functioning.
5100.02 The provider has specialized training to provide therapeutic and habilitative support and
S100.03
has an
number of caregivers available at all time to meet a Child's
account the Child's age,
and mental
of Family
Services
1-'rm<>rrn,,

Attachment "C"
Form 2282cx
June 2011
1100 INTENSE SERVICE LEVEL SUPERVISION

1100.01 The Caregiver has specialized training to provide intense therapeutic and habilitative
access.
1100.02 An adequate number of caregivers are available to provide 24-hour supervision.
1100.03 For a Child with developmental delays or mental retardation the caregiver provides 24hour supervision.
1100.04 For a Child with primary medical or habilitative needs the caregiver provides 24-hour close
supervision and, as appropriate, frequent and continuous interventions which typically
consist of hands-on physical intervention, assistance, and monitoring from a caregiver.


Attachment "C"
Form 2282CX
June 2011

8101 BASIC SERVICE LEVELS -
standards.
M101 MODERATE SERVICE LEVELS-
standards.
S101 SPECIALIZED SERVICE LEVELS
-The child-to-caregiver ratio must meet the applicable licensing
standards.
S101.01
throughout the night whenever necessary to meet the needs of a particular Child.
1101.01
During all waking hours the child-to-caregiver ratio must be no more than 5 to 1.
1101.02 During sleep hours the Caregiver's child-to-caregiver ratio must meet the applicable
1101.03 There are enough caregivers, to provide 24-hour supervision to ensure the Child's safety
1101.04 The staffing patterns and assignments are documented in writing. The documentation
1101.05 The written staffing plan documents the ability to provide 1 to 1 child to caregiver ratio for
24 hours whenever necessary to meet the needs of a particular Child.


Attachment "C"
Form 2282cx
June 2011
200 - Medical
8200.01 The Caregiver arranges for medical and dental
8200.02
8200.03
8200.04
services as determined by an agreement

The Caregiver documents in the Child's record that the Child received these services.
The Caregiver ensures that all the medications the Child needs are administered as
The Caregiver ensures Children are taught age and developmentally appropriate sex
The Caregiver arranges for or ensures the same medical and dental services that are required at the
M200.01
For a Child, receiving psychotropic medication, a physician, as often as clinically necessary

and appropriate, must monitor the Child's condition.
M200.02
For a Child, with developmental disabilities, mental retardation, primary medical or

habilitative needs, the caregiver arranges, as appropriate, for licensed nursing services/
S200 SPECIALIZED SERVICE LEVEL MEDICAL AND DENTAL
routine medical/ nursing and psychiatric services based on the needs of the Child as
identified in the Child's service plan. The plan or agreement for medical, nursing and
S200.02 For a Child with developmental disabilities, mental retardation, primary medical or
treatments.
INTENSE SERVICE lEVEL MEDICAL AND DENTAL SERVICES


Attachment "C"
Form 2282cx
June 2011
nursing supervision; 24-hour availability of nursing, medical, and psychiatric services; and
1 to 1 supervision during the provision of medical and dental services.


Attachment "C"
Form 2282cx
June 2011
300-Recreation
8300 BASIC SERVICE LEVEL RECREATIONAL AND LEISURE-TIME SERVICES
8300.01 The Caregiver ensures that opportunities to participate in community
8300.02
activities, such as
events, are available to the Child.
The Caregiver organizes family activities that identify, recognize and reinforce the support
that is available to the Child.
M300.01 The Caregiver arranges and supervises structured daily routines for the Child that includes
M300.02 The Caregiver ensures the activities are designed to meet the Child's therapeutic,
M300.03 The Caregiver documents the daily routine and the recreational and leisure-time activities
the Child participated in.
M300.04 The Caregiver allows enough flexibility in the daily routine and the activities for the Child to
M300.05 The Caregiver provides activities that are modified to meet any restrictions or limitations,
due to a Child's developmental disability, mental retardation, or medical condition.
S300 SPECIAliZED SERVICE LEVEL RECREATIONAL AND LEISURE-TIME SERVICES
The structured daily routine and the recreational and leisure-time activities are designed to
address the needs of the Children in care.
S300.02 The therapeutic value of each activity based on the Child's service plan is documented.
S300.03 If the Child has primary medical or habilitative needs, recreational and leisure-time
S300.01
I300.01 An interdisciplinary team of professionals who are qualified to address the Child's individual
included in the Child's service plan.
1300.02 If the Child has primary medical or habilitative needs, the recreational and leisure-time


Attachment "C"
Form 2282cx
June 2011
400- Education
8400 BASIC SERVICE LEVEL EDUCATIONAL SERVICES
8400.01 Access to a free and appropriate education

arranged and ensured for each Child.
8400.02 Reasonable support and assistance will be provided for each Child who qualifies as a
special education student under the Individual with Disabilities Education Act to ensure
that the appropriate educational and related services, including Early Childhood
Intervention, are available in the least restrictive environment appropriate. This may
include the necessity to participate in the Admission, Review and Dismissal Committee to
develop the Individual Education Plan explaining how the student will be educated.
8401 BASIC, MODERATE, SPECIALIZED AND INTENSE SERVICE LEVELS SCHOOLING
A Child needs:
8401.01 a public school accredited by the Texas Education Agency (TEA);
8401.02
8401.03

M400.01
S400 SPECIAliZED SERVICE LEVEL EDUCATIONAL SERVICES

The Caregiver must coordinate the Child's educational and related services with the Child's
5400.02 The Caregiver must designate a liaison with the Child's school.
S400.03 The Caregiver must document the liaison's involvement in the Child's schooling.
S400.04 The Caregiver must document a written description of the relationship between the
5400.01
1400 INTENSE SERVICE LEVEL EDUCATIONAl SERVICES

1400.01


Attachment "C"
Form 2282cx
June 2011

Services that are designed to maintain and improve the Child's functioning are provided in a family
setting.
8500.01 Assistance and support in developing or maintaining social skills appropriate to the Child's
8500.02 Affection, reassurance and involvement in activities appropriate to the Child's age and
development to promote the Child's well being must be provided.
8500.03 Support in helping the Child adjust to the current placement must be provided.
8500.04 Access to therapeutic, habilitative and medical support addressing the Child's particular
needs, as specified in the Child's service plan must be provided. If therapeutic habilitative
M500.01
M500.02
M500.03
M500.04
M500.05
M500.06
M500.07
The provider also ensures completion of a diagnostic assessment on each Child within 30
days of admission. The assessment must address the Child's strengths and needs in the
interventions in an environment designed to help the Child attain or maintain functioning
Children who need therapy by professional therapists or counselors or paraprofessional
habilitative program addresses the Child's individual needs.
If the Child qualifies for substance abuse services, the provider arranges for a substance
therapy.
services
at the Moderate


Attachment "C"
Form 2282cx
June 2011
I500 INTENSE SERVICE lEVEL CASEWORK AND SUPPORT SERVICES
ISOO.Ol The Child is provided with frequent and intense therapeutic, habilitative and medical
interventions that are individually designed to stabilize the Child's condition.


Attachment "C"
Form 2282cx
June 2011
501 -Service Plans

8501.01 A service plan must be developed within 30 calendar days of the Child's admission.
8501.02 The service plan must be based on the Child's plan for permanency.
8501.03 The service plan must identify strengths and document strategies to address the Child's
skills appropriate to the Child's age and development, family contact needs; social needs;
8501.04 The caregiver and the Child, as appropriate, actively participate in the development,
8501.05 The provider must periodically review service plans according to the appropriate licensing
standard.

each Child within 30 calendar days of the Child's admission. This plan must include:
A.
An estimate of the length of time the Child will remain in care;
B.
A description of the goals of service;
C.
Specific instructions for caregivers;
D.
A transition plan; and
E.
Documentation of:
i. The plan having been shared with the Child and the Child's parents or managing
conservator; and
ii. The Child's care to date.
M501.03 The provider must, when reviewing a service plan:
A.
Evaluate the services to date that have been provided to the Child in each domain or
function; and
B.
Identify any additional need that has arisen since the previous service plan was
developed.
M501.01
M501.02
S501 SPECIALIZED SERVICE LEVEl SERVICE PLAN REQUIREMENTS

An initial service plan for each Child is developed within 72 hours of the Child's admission.
The diagnostic needs assessment and service plan for each Child are developed by an
team or a full-time staff member with three years of
in treating
Children with similar characteristics who has a master's
in a mental health field
5501.01
S501.02


Attachment "C"
Form 2282cx
June 2011
planned to help the Child achieve and maintain a condition allowing a lower Service Level;
1501.04 Criteria for re-evaluating the Child's condition after 90 days and deciding whether to
Service Level; transfer the Child to a less restrictive setting; or refer the Child to an
and supervise each Child's service plan.


Attachment "C"
Form 2282cx
June 2011
502 Training
understand the needs and characteristics of Children in care provide the care and
emotional support that Children need and appropriately manage Children's behavior.
Note: First-aid and cardiopulmonary-resuscitation training cannot be counted toward meeting this
annual training requirement. However, hours earned renewing First-aid and cardiopulmonary
resuscitation may be counted toward the annual requirement.
749.951.
8502.03 Each direct care staff and foster parent must receive trauma informed care training
annually. Each newly hired direct care staff and each verified foster parent must receive
trauma informed care training within 60 days of hire or foster home verification.
Certification of completed trauma informed care training must be placed in staff and foster
parent records containing the training staff signature, completion date and number of
hours. Trauma Informed Care training is available at no cost at the following website:
Note: No minimum hours of trauma informed care training is required. For family units, hours earned
for trauma informed care training may be counted towards the annual training requirement. For
caregivers, hours earned for trauma informed care training may be counted towards pre-service
training requirements.

M502.01 Each Caregiver must receive pre-service training in areas appropriate to the needs and
characteristics of Children in care. At the conclusion of pre-service training, every foster
population of Children that the foster family serves.
M502.03 All Caregivers who administer psychotropic medications must receive training on
medications.


Attachment "C"
Form 2282cx
June 2011
policy statement specifying that the provider does not accept or maintain Children on psychotropic
medications.

S502.01
5502.02
5502.03
New Caregivers without previous experience in a residential childcare may not be assigned
sole responsibility for any Child until the new caregiver has been supervised for at least 40
hours while conducting direct child-care duties. An experienced Caregiver must be
physically available to each new caregiver at all times, until the new Caregiver acquires the
supervised experience. The provider must document the supervised child-care experience
of every caregiver who provides direct care to Children. Documented verification of a
serve, such as Children with primary medical needs, pervasive development disorders,
All Caregivers must receive 50 hours of training each year with the exception of caregivers
in foster homes verified by child-placing agencies,
Caregivers in foster homes verified by child-placing agencies must meet the following
requirements: for homes with two or more caregivers, each Caregiver must receive at
least 30 hours of training; OR for homes with one Caregiver, the Caregiver must receive at
least 30 hours of training.
503 Personnel
M503.01
M503.02
providing services to Children who have been removed from their homes.
M503.03 Each staff member with primary administrative and clinical responsibility for managing the
interventions and programs:
A.


Attachment "C"
Form 2282CX
June 2011

therapy.
therapeutic services and types of intervention provided to, the Children in care.
provide therapeutic interactions.

M503.07 The provider has enough appropriately qualified paraprofessional or professional staff
available on a full-time, part-time, or consulting basis to assess and address the needs of
all the Children in care.

M503.09 The provider has ensured that the professional-staffing plan assigns responsibilities for
treatment services.

S503.01 The provider arranges for interventions such as individual, group, and family therapy to be

the service plan.

1503.02 The individual treatment program is developed by an interdisciplinary team to address the
Child's intense needs.


Attachment "D"
Form 2282cx
June 2011

Child-Placing Agency as part of the agency or home's regulated child care. The purpose of
Intermittent Alternate Care is to provide relief to the primary Caregiver. For the purpose of this
Contract, an Intermittent Alternate Care episode is one that lasts for more than 72 hours. Any
episode lasting fewer than 72 hours is not considered Intermittent Alternate Care.
A) The Department may allow contracted Child-Placing Agencies to utilize Intermittent Alternate Care
to:
i.
iii. Decrease the number of moves Children experience; and
iv. Promote the overall development and permanency needs for Children in foster care.
B) Child-Placing Agencies that are permitted to use Intermittent Alternate Care must do so according
to the following guidelines:
than 72 hours;
and
designee.
When providing Intermittent Alternate Care, contracted Child-Placing Agencies must:
and safety of all Children in Intermittent Alternate Care;
Ensure that Intermittent Alternate Care is not detrimental to the Child;
'""'()"'"'each
of Intermittent Alternate Care in their homes and each time


Attachment "D"
Form 2282cx
June 2011
b. Psychiatric care that is currently being provided;
c. The Child's medication regimen and instructions;

d.
e.
f.
g.
h.
i.

and
include:
of age and older;


Attachment "E"
Form 2282cx
June 2011


Attachment "F"
Form 2282cx
June 2011
Database.
Performance Period: Contractor performance for this output is determined for each month of
the Contract Period, either wholly or partially, depending on the Contract start and end dates.
I Indicator:
Percentage of business days that the Contractor updated its own information in the
Target: 90%
Purpose: The purpose of this measure is to evaluate the Contractor/s success providing reliable
I

Methodology:
nttr::s / /oavN:\N~dtos~state,tx.us/Chi!d Care/Search Texas Child Care/ooFaolitvLooin,a;;p
Performance Period: Contractor performance for this output is determined for one or more of
Indicator: Percentage of School-Age Children in DFPS conservatorship for 30 calendar days or
more whose Education Portfolios are updated within 30 calendar days of all items requiring a
portfolio change.
Target: 100%


Attachment "F"
Form 2282cx
June 2011
The numerator is the total number of School-Age Children with updated Education Portfolios as
described in the Data Source.
The denominator is the total number of School-Age Children as described in the Data Source.
Output #3: The Child's placement is stabilized.

1 September 1 through November 30, December 1 through February 29, March 1 through May 31,
and June 1 through August 31.
Indicator: Average length of stay for Children who left a placement during the performance
period, excluding certain reasons for discharge as described in the methodology.
targets.
Purpose: The purpose of this measure is to determine the Contractor's ability to meet a Child's
---------------------------------------------------------------------------~
Data Source: Information Management Protecting Adults and Children in Texas (IMPACT)
Methodology for CPA: The denominator is the count of all Children who left a placement during
the period, except those discharged for the following reasons:
Caregiver moved
Court ordered emancipation/legally married
Child placed with relatives/fictive kin
Child placed in closer proximity to parent/relative
Foster home transferred to other CPA; Child remains in home
Exceeds 14 day limitation of being away from placement
The numerator is the sum of the number of days in placement for all Children included in the


Attachment "F"
Form 2282cx
June 2011
placement.
Methodology for GRO-Basic Child Care or GRO-Emergency Shelter: The denominator is the
count of all Children who left a placement during the period, except those discharged for the
I following reasons:
I
Court ordered emancipation/legally married
Child placed with relatives/fictive kin
Child placed in closer proximity to parent/relative
Not least restrictive
Exceeds 14 day limitation of being away from placement
Not verified/licensed to serve
placement.
(The following output applies only to Child Placing Agencies. )
Output #4: Children in substitute care move toward permanency.

Indicator: Percentage of Children placed with the Contractor who experience two or fewer
placements while in the care of the Contractor.
targets.
Purpose: The purpose of this measure is to evaluate the Contractor's effectiveness to provide
the Child stability by working with the Child, DFPS and the foster family to minimize placement
changes.


Attachment "F"
Form 2282cx
June 2011
I Performance Period:
Contractor performance for this output is determined for one or more of

Indicator: Percentage of discharged Children who do not experience a discharge initiated by the
Contractor, with the exception of specific reasons determined to be, generally, in the best interest
of the Child.
targets.
1
Purpose: The purpose of this measure is to reduce unplanned discharges of Children by the CPA.
Methodology:
To determine the numerator, obtain the number of placement discharges initiated by the
Contractor. Exclude those discharges for the specific reasons determined to be in the best
interest of the Child. Subtract this from the total number of placement discharges. The
denominator is the total number of placement discharges. Divide the numerator by the
denominator. Multiply by 100, and state as a percentage.
Contract Outcome Measures.

Outcome #1: Children are safe in care.
II
j Indicator: Percentage of Children under age 18 in contracted Residential Child-Care placements

1
and in DFPS Managing Conservatorship who are not determined to be Designated Victims
resulting in a Reason to Believe (RTB) disposition Upheld during the performance period.
I Target: 100%
Purpose: The purpose of this measure is to evaluate the Contractor's success protecting Children
in its care. This outcome directly relates to DFPS' mission to protect Children from abuse/neglect
of the federal outcomes measured
the Child and
Services Review

Form 2282cx
June 2011

Attachment "F"
performance period.
The denominator is the total number of Children in DFPS managing conservatorship placed with
I the Contractor during the performance period.
Divide the numerator by the denominator. Subtract the result from one (1) to obtain the
complimentary 'Children not Designated Victims' measurement. Multiply by 100 and state as a
percentage.
Outcome #2: Children are safely maintained in their placement.

I Indicator: Percentage and rate of Emergency Behavioral Interventions (EBis) that do not result
I in a Reportable Injury to Children in care.
I targets.
Purpose: The purpose of this measure is to monitor the Contractor's safe use of EBis for
Children in care.
Data Sources:
Performance Management Evaluation Tool {PMET)
Number of times EBis were used that resulted in Reportable Injuries to Children
during the performance period
Number of times EBis were used during the performance period
Information Management Protecting Adults and Children in Texas (IMPACT); information used for
the performance period: Total of the number of days of all Children in care during the
Percentage
The numerator is the total number of times EBis were used as described in the Data
resuited in a Reportable Injury to a Child during the performance period.
The denominator Is the total number of times EBis were used as
in the Data


Attachment "F"
Form 2282cx
June 2011

I dates: September 1 through November 30, December 1 through February 29, March 1 through
1 May 31, and June 1 through August 31.
Indicator: Percentage and rate of Emergency Behavioral Interventions (EBis), excluding short
I personal restraints, that result in a Non-Reportable Injury to Children in care.

I
targets.
Purpose: The purpose of this measure is to monitor the Contractor's safe use of EBis for
Children in care.
Data Sources:
Performance Management Evaluation Tool (PMET)
Number of times EBis, excluding short personal restraints, were used that resulted
in Non-Reportable Injuries to Children during the performance period.
Number of times EBis, excluding short personal restraints, were used during the
performance period.
Information Management Protecting Adults and Children in Texas (IMPACT); information used for
the performance period: Total of the number of days of all Children in care during the
performance period.
Methodology:
Percentage
The numerator is the total number of times EBis were used as described in the Data Source, and
resulted in a Non-Reportable Injury to a Child during the performance period.
The denominator is the total number of times EBis were used as described in the Data Source,
during the performance period.
Divide the numerator by the denominator. Multiply by 100, and state as a percentage.
Rate
The numerator is the total number of times EBis were used as described in the Data Source, and
resulted in a Non-Reportable Injury to a Child during the performance period.


Attachment "F"
Form 2282cx
June 2011
Indicator: Percentage of Children in care seven or more days who have a Relative or Fictive Kin,
excluding parents and siblings, identified as appropriate for contact by DFPS and have at least one
provider-initiated contact during the performance period.
targets.
Purpose: The purpose of this measure is to assess the Contractor's ability to help the Child
maintain beneficial Connections with Relatives, and Fictive Kin, other than the parents or siblings.
Data Source: Contractor self-report to Performance Management Evaluation Tool (PMET)
Number of unduplicated Children in the Contractor's care seven or more days who had
at least one Personal Contact during the performance period which was initiated by the
Contractor, with a Relative or Fictive Kin, other than a parent or sibling, identified by
DFPS as appropriate for contact.
(numerator)
Number of unduplicated Children in the Contractor's care seven or more days who had
at least one Relative or Fictive Kin, other than a parent or sibling, identified by DFPS as
appropriate for contact.
(denominator)
Methodology: Divide the numerator by the denominator. Multiply by 100, and state as a
percentage.
Outcome #5: Children benefit from routine recreational activities, including extracurricular
activities.
' Performance Period: Contractor performance for this outcome is determined annually but
measured throughout the contract period.
Indicator: Percentage of Children who routinely participate in one or more recreational activities,
as described in Section 16 of this contract.
of Family
PmlAr:tivA Services
Form 9077
February 2012

Amendment
Contract #23393175
Amendment
#!
This AMENDMENT (Amendment) of contract #23393175 (Contract) is entered into by and

between the Texas Department of Family and Protective Services (DFPS or the
Department) and Southwest Key programs, Inc. (Contractor).
1. Purpose
Section
of the Contract stipulates that the Contract may only be modified through a
written amendment mutually agreed upon and signed by both parties. DFPS procured this
Contract under 530-08-0062 for
services and has been amended Q. times.
{Residential Child-Care Contract Glossary); and to clarify Performance Measure

requirements for Output #4 and Outcome #2 (Attachment F).
2. Effect of Amendment on Contract

A.
Unless otherwise modified, the terms and conditions of the Contract shall remain in
full force and effect.
B.
This Amendment modifies Section

Section 25.C) to the Contract.
of the Contract by adding the reference to
5. Applicable Contract Provisions

B) If the Contractor is a Residential
Sections 7.B),
7.
17.
34.A)v., 35.
41
of the Contract not
c.
other than a CPA,

31
31
of Family
Pml'AdivA Services

Amendment
Form 9077
February 2012
any
Child 18 to 22 years of age is qualified to remain in Extended
Foster Care or Return to Care.
B) The Contractor shall assist the Child in the completion of the Voluntary
Extended Foster Care
Form 2540
during
the folloNing time periods:
i.
Within 30 days preceding the Child's 18*' birthdat, when possible; and
H-:IJ.1hen this is not possible, no later than the 30*' da'( after the Child's
-!&*'birthday.
C) If a Child seeks to Return for Extended Foster Care during or after
participating in a Trial Independence period and has not yet turned 21 years
of age, the Contractor shall direct the Child to contact their regional DFPS
Preparation for Adult Living (PAL) staff.
http:l/www.dfps.state.tx.us/Child Protection/Preparation For Adult Living/
D.
This Amendment modifies Section 10 of the Contract in part by amending Section

10.A) which shall now read:
10. Children's Rights. The Contractor must:
A) Cooperate with Child Protective Services (CPS) to ensure all Children have
been given a written copy of the CPS Rights of Children and Youth in Foster
Care upon request. and at the time of placement, and for CPAs, at the time
of any placement changes to a new foster home;
E.
This Amendment modifies Section 25 of the Contract in part by adding Section

25.C} which shall now read:
28. Use of Department Forms.
of Family

Amendment
PmiAdi'J" Services
ii.
Form 0077
February 2012
Maintaining a copy of the Child's Voluntary Extended Foster Care

Agreement Form 2540 ~::::.....:'-'-'-"""'-".:..:.:::.~~=...:.=...:....L~.!J.l:.J'-""1:!...!..;~:::!.!...!..!-W:::.:..
~
in the Child's
and
iii. The provision of information available at
.asp related to:

a. Aftercare services,
and provider contacts;
c. Extended Care and Return~ for Extended Foster Care information;
d. Preparation for Adult Living (PAL) services;
e. Texas Foster Care Handbook for Youth;
f. Transitional Medicaid andSTAR Health;
g. Information related to the Child's Special Immigrant Juvenile Status,
if applicable; and
G.
This Amendment modifies Section 39 of the Contract in part by amending Section

39.A) which shall now read:
39. Insurance.
A). The Contractor shall provide insurance for direct delivery of services under
this Contract. The Contractor shall obtain and furnish proof of the following
bonding and insurance coverage .vithin 48 hours of the award of the
Contract at the time of Contract execution and at such other times as may
be specified by the Department. The required coverages are:
i. Dishonesty bonding under a commercial crime policy or business
services bonding at a $10,000 minimum; and
ii. For all other child-care facilities Commercial general liability coverage
insurance with a minimum limit of $300,000 per occurrence and
$600,000 aggregate.
H.
This Amendment modifies Section
of the Contract in part and shall now read:
55. Assignments.
Contractor will refrain from
transfer~ or assignffi any portion of this
Contract without prior written approval from DFPS. Contractor may
collaterally
its right to receive
for the services provided by
Contractor. Contractor must give written notice to DFPS at least 10 working
in advance
Contractor will not
otherwise encumber any interest In or
to
of
57. Contrad
Texas
of Family
and Pmt,Arli'""' Services

Amendment
Form 9077
February 2012
Contract Renewals. The Contract is renewable upon mutual agreement of

the
and subject to the conditions In 40 TAC 700.2501-2505, 40
TAC 732.2Q}G, and the terms of this Contract.
J.
This Amendment modifies Attachment !2 of the Contract by deleting the definitions

for Return to Care and Voluntary Return to Foster Care Agreement Form 2560 in its
entirety,
three new
and by deleting the definitions for
Subcontractor and Substitute Care and replacing it with the language below:
Subcontractor: A person or entity that delivers part or all of the programmatic

services required of the primary Contractor under this contract and is not an
employee of the primary Contractor. There is an agreement between the two
persons and/or two entities whereby the primary Contractor authorizes the person
or entity (Subcontractor) to deliver the service. There does not have to be any
payment for services for the relationship to be considered a subcontract.
does not allow Contractors to subcontract for Case Management services. DFPS
retains the right to disapprove of the use of any subcontractor. For purposes of
residential Contracts, Subcontractors include Behavioral Health providers
(excluding Behavioral Health SeN ices provided b; PS'fChiatrists), Foster Parents,
direct service providers, and management service providers. E>mmples of
subcontracted management services could include nutritional consultation or
services O't'ersight. DFPS does not allow Contractors to subcontract for Case
Management services the following:
Therapy Cthe provision of assistance and guidance in resolving personal,

social. or psychological problems and difficulties through a collaborative

B)
K.
Form9077
February 2012

Amendment
Child who has turned 18 years of age and has voluntarily agreed to
participate in the Departmenes Extended Foster Care program or Return to
Care program and meets the requirements of such.
This Amendment modifies Attachment f of the Contract in part by amending the

language for Output #4 and Outcome #2 and replacing it with the language below:
Output #4: Children in substitute care move toward permanency.

Performance Period: Contractor performance for this output is determined for
one or more of the following performance periods, wholly or partially, depending on
the Contract start and end dates: September 1 through November 30, December
1 through February 29, March 1 through May 31, and June 1 through August 31.
Indicator: Percentage of times Children placed with the Contractor wfT&
experience two or fewer placements while in the care of the Contractor in any one
Target: Baseline data will be collected statewide during the contract period to
establish future TO>rr,.:l1rC
this measure is to evaluate the Contractor's
DFPS


Amendment
Form 9077
February 2012
The denominator is the

number of Children ~~.!...!..!..>"'-'-""""""-"'~="" placed with
the Contractor at any time during the performance period.
Divide the numerator by the denominator. Multiply by 100, and state as a

Performance Period: Contractor performance for this outcome is determined for
one or more of the following performance periods, wholly or partially, depending on
the Contract start and end dates: September 1 through November 30, December
1 through February 29, March 1 through May 31, and June 1 through August 31.
Indicator: Percentage and rate of Emergency Behavioral Interventions (EBls) that
do not result in a Reportable Injury to Children in care.
Target: Baseline data will be collected statewide during the contract period to
establish future targets.
Purpose: The purpose of this measure is to monitor the Contractor's safe use of
EBis for Children in care.
Data Sources:
Performance Management Evaluation Tool (PMET)
Number of times EBis were used, including short personal restraints, that
resulted in Reportable Injuries to Children during the performance period
Number of times EBis were used, including short personal restraints, during
the performance period
Information Management Protecting Adults and Children in Texas (IMPACT);
information used for the performance period: Total of the number of days of all
Children in care during the performance period.
Methodology:
Percentage
The numerator is the total number of times EBis were used as described in the
Data Source, and resulted in a Reportable Injury to a Child during the performance
The denominator is the total number of times EBis were used as described in the
the n.:>1rtnrrn"'n
Data
Texas
of Family
and Pm!<>di'v<> Services

Amendment
Form 9077
February 2012
Divide the numerator by the denominator. Divide by 100, and state as a rate per
100 care
Texas Department of Family

Signature
Printed Name: Colleen Me Call
Title: Director Of Field
Contractor:

Contract Number
Facility Number
Provider
Enrollment Number
Form 2282cx
June 2012
23393175
Resource Number
Facility License
_8-=-8-=-0-=-8=-8=-3=------ Type
530-08-0062
Renewal Number
23884439
General Residential
Operation I CCS
0
GENERAL CONDITIONS
1.
Contracting Parties. Pursuant to its authority under Texas Human Resources Code
(HRC) 40.058, the Texas Department of Family and Protective Services, (Department
or DFPS), and Southwest Key Programs, Inc. (Contractor), enter into this contract
(Contract). This Contract, along with all Attachments, constitutes the entire and
complete agreement between the parties. In this Contract, all references to the
Department will include the Texas Health and Human Services Commission (HHSC) and
any other agency named in Chapter 531 of the Texas Government Code to the extent
that HHSC has transferred DFPS' functions related to this Contract to itself or to such
other agency pursuant to HHSC authority in Texas Government Code 531.0055, or any
other statutory authority of HHSC. When acting in such capacity, HHSC or such other
agency is an authorized agent acting on behalf of DFPS.
2.
Governing Law and Venue. This Contract will be construed in accordance with the
laws of the State of Texas (State). Venue will be in a court of competent jurisdiction in
Travis County, Texas.
3.
Independent Contractor. Contractor will serve as an independent contractor in

providing services under this Contract. Contractor's employees will not be construed as
employees of DFPS or the State of Texas. Contractor has sole authority and
responsibility to employ, discharge, and otherwise control its employees and
contractors. Contractor is responsible for providing all necessary unemployment and
workers' compensation insurance for the Contractor's employees.
4.
Purpose. The purpose of the residential child-care contract is to establish the

qualifications, standards, and terms of delivering specified services to Children in
contracted care, to set the terms and conditions of operations and payment, and to
specify the method of ensuring delivery of contracted services. The goal of residential
child care is to protect the well-being of the Child, enhance the Child's functional
abilities in a 24-hour residential child-care setting, and prepare the Child for his/her
Goal, by providing the following services as appropriate:
Child-Care and Treatment

Form 2282cx
June 2012
5.
Applicable Contract Provisions. This Contract contains the terms applicable for
Residential Child-Care Service contracts including those with Child-Placing Agencies
(CPA) and General Residential Operations (GRO).
A) If the Contractor is a CPA, all terms of the Contract apply.
B) If the Contractor is a Residential Child-Care Facility, other than a CPA, Sections
7.B), 7.C), 7.D), 7.F), 21.C), 25), 26.E), 27.C), 32. C). x, d., 32. C) xiv, 35. A) i.d,
36.B), 36.C), 42.G), 44, 45.B) xvi, xvii, xviii, 49.B) and Output #4 in Attachment F
of this Contract are not applicable.
C) If the Contractor is a GRO providing Emergency Care Services, in addition to the
terms in S.B), Sections 7, and 11, of this Contract are not applicable.
D) If the Contractor is a Governmental Entity, Sections 39, 40, 58, 61.H)i, 63, and 72,
of this Contract are not applicable.
6.
Contractor Representation. By accepting the Child, the Contractor represents that:

A) It has the expertise and is licensed to provide programmatic services to meet the
Child's current needs based on the background information provided by the
Department;
B) It will accept the Service Level unit rates described in Section 36 of this Contract as
C) It will deliver services and meet requirements in a manner that meets high
standards of professional quality.
7.
Contracted Service Levels. The Contractor agrees to and acknowledges the

following:
A) DFPS will determine the minimum services provided by the Contractor to each Child
based on the Child's level of need. The Department will designate the level of need
as Basic, Moderate, Specialized, or Intense, as described in Attachment C. The
Contractor must provide services to Children authorized at the Basic, Moderate
and Specialized Service Levels, and must maintain full compliance with the
associated Service Levels as described in Attachment C for each Child placed with
the Contractor.
B) A CPA may submit a request for a Service Level evaluation directly to the Service
Level Monitor (third party contractor) within the first 45 days of admitting a Child
who has not had an Initial Authorized Service Level during the current paid foster
care stay. All other requests for Service Level evaluations must be directed to the
Caseworker, who will forward any approved requests to the Service Level Monitor.
C) CPAs requesting an Initial Authorized Service Level within the first 45 days of
admitting a Child may be paid the new initial Service Level rate up to 60 days in the
past when the following conditions are met:
L
The retroactive initial Service Level must be submitted for authorization to the
Service Level Monitor within 45
of
a Child who does not have

E)
F)
8.
Form 2282cx
June 2012
the foster home in which the Child will be placed is verified to provide
Treatment Service(s) appropriate to the Child's needs.
If a Contractor disagrees with the Service Level determination by the Service Level
Monitor and the Contractor chooses to appeal the determination, the Contractor
must utilize the administrative and peer review processes through the Service Level
Monitor. These processes are outlined on the Service Level Monitor's website at:
http://www.yft.org.
The Contractor must comply with the Department's Intense Foster Family Care
Services policy and procedures, if applicable.
Voluntary Extended Foster Care and Return for Extended Foster Care. Children
18 to 22 years of age who meet eligibility criteria and voluntarily agree to participate in
the Extended Foster Care program, as defined in applicable Section of 40 TAC 700.316,
are also eligible for Medicaid, and may be served under the terms of this Contract once
approved by the Department.
A) The Contractor must offer assistance to the Child in maintaining documentation
such as school transcripts or pay stubs to demonstrate that any such Child 18 to 22
years of age is qualified to remain in Extended Foster Care.
B) The Contractor shall assist the Child in the completion of the Voluntary Extended
Foster Care Agreement, Form 2540 upon request by CPS.
C) If a Child seeks to Return for Extended Foster Care during or after participating in
the Trial Independence period and has not yet turned 21 years of age, the
Contractor shall direct the Child to contact the regional DFPS Preparation for Adult
Living (PAL) staff.
http://www.dfps.state.tx.us/Child Protection/Preparation For Adult Living/PAL co
ordinators.asp

9.
Basic Living and Social Skills. The Contractor must ensure for all Children that
Caregivers:
B) Maximize opportunities for learning through the use of Experiential Life Skills
Activities;
C) Provide access to Experiential Life Skills Activities provided by community
resources; and
D) Promote the ability to appropriately care for themselves and function in the
community.
10.
Children's Rights. The Contractor must:
Provide services to Children who are deaf or hard of

When

Form 2282cx
June 2012
(http: 1/www .dars.state. tx. us/dhhs/providers/specialists. asp).

11.
Assessment, Service Planning and Coordination.

A) Diagnostic Assessment. The Contractor will provide diagnostic assessments as
defined in Attachment C, Section M500.02.
B) The Contractor shall coordinate with the Department or a Preparation for Adult
Living (PAL) Contract provider for completion of the Casey Life Skills Assessment by
a Child's Caregiver.
C) Service Planning and Coordination. The Contractor shall:
i.
Develop/ coordinate and implement a Service Plan that addresses the services
that will be provided to a Child to meet each Child's specific needs;
ii.
Provide guidance and support to Children 16 to 18 years of age to enable
them to_assume progressively greater responsibility for implementing Service
Plan strategies designed to meet their needs and achieve their goals;
iii.
Provide guidance and support to Children 18 to 22 years of age to enable
them to assume primary responsibility for implementing Service Plan
strategies designed to meet their needs and achieve their goals;
iv.
Develop a Service Plan in accordance with the requirements contained in
Attachment C under the Sections entitled "Casework and Support Services"
and "Service Plans";
v.
Ensure that the Service Plan incorporates and is consistent with:
a.
Permanency Planning and Permanency Goals identified by the
Department;
b.
Any behavioral goals established by the Department;
c.
Components of a Child's Individual Education Plan (IEP) and the
Individual Transition Plan (ITP) that are both developed by the school's
Admission, Review, and Dismissal (ARD) committee, if appropriate;
d.
Components of the CPS Transition Plan for Children 16 to 22 years of age
to include results of the Casey Life Skills Assessment when applicable;
e.
The Early Childhood Education (ECI) Individual Family Service Plan
(IFSP) if applicable;
vi.
Ensure that the Service Plan includes services to assist a Child to transition to
a new living arrangement or to new provider services, if applicable;
vii. Provide a copy of the Service Plan to the Caseworker or Caseworker's Chain of
Command within ten days of completion; and
viii. Document date the Service Plan was shared with Caseworker or Caseworker's
Chain of Command.
i.
Ensure every Child is enrolled and each Caregiver participates in Service
Management when the STAR Health contractor (Superior/Cenpatico)
determines the Child meets the criteria for the program; and
to
coordination services from STAR Health Service

c.
iv.
v.
vi.
scheduled one year after the previous checkup and no later than the
child's next birthday;
For Children under 36 months of age, Texas Health Steps Medical
Checkups in accordance with the Texas Health Steps Periodicity
Schedule:
For all Children, provided by a licensed health care practitioner who is

enrolled in Texas Medicaid as a Texas Health Steps provider; and
e.
For Children with Primary Medical Needs, request written documentation
from the Child's Primary Care Physician (PCP) if the Child is unable to
attend Texas Health Steps Medical Checkups in accordance with required
timeframes.
The Contractor shall provide access to Texas Health Steps Dental Checkups in
the following manner:
a.
For all Children who are under six months of age upon entry into DFPS
conservatorship, within 30 days of becoming six months of age;
b.
For all Children six months of age or older, within 60 days of entry into
DFPS conservatorship;
c.
For all Children, a subsequent checkup must be obtained six months after
the month in which the Child received the previous checkup;
d.
For all Children six to 35 months of age who have been determined by a
Texas Health Steps provider to be at risk for early tooth decay, dental
checkups as frequently as required, as determined by the Child's Texas
Health Steps provider;
e.
For all Children, provided by a licensed dentist who is enrolled in Texas
Medicaid as a Texas Health Steps provider or a dental hygienist who is
working under the supervision of a licensed dentist who is enrolled in
Texas Medicaid as a Texas Health Steps provider; and
f.
For Children with Primary Medical Needs, request written documentation
from the Child's Primary Care Physician (PCP) if the Child is unable to
attend Texas Health Steps Dental Checkups in accordance with required
timeframes.
The Contractor shall access Medicaid through STAR Health for covered Medical,
Dental, Vision and Pharmacy services available to Children;
No later than the third business day after a Child's Caregiver receives a STAR
Health Denial Letter, the Contractor will email a scanned copy of the denial
letter and the date of such receipt to the Caseworker or Caseworker's Chain
of Command and the Regional Well-being Specialist;
In the event that neither community nor Medicaid resources are available to
fund recommended Medical, Dental, Vision or Pharmacy services, as soon as
practicable but no later than the third business day, the Contractor shall
the Caseworker or
Chain of Command for
d.
iii.
Form 2282cx
June 2012


ii.
Form 2282cx
June 2012
A Behavioral Health Provider must be an employee or subcontractor of the

Contractor, unless the court orders the Department to provide behavioral
health services for the Child from a Non-Network Provider.
iii.
The Contractor shall access Medicaid through STAR Health for Medicaid
Covered Behavioral Health Services, unless the court orders the Department
to provide behavioral health services for the Child from a Non-Network
Provider.
iv.
The Contractor must use community resources to obtain Behavioral Health
Services not covered by Medicaid.
v.
No later than the third business day after a Child's Caregiver receives a STAR
Health Denial Letter, the Contractor will email a scanned copy of the denial
letter and the date of such receipt to the Caseworker or Caseworker's Chain
of Command and the Regional Well-being Specialist.
In the event that community resources are not available for Behavioral Health
vi.
vii. The Contractor will ensure that all Behavioral Health Services provided to
Children are properly documented within the Health Passport's Behavioral
Health Module.
viii. The Contractor shall comply with Department procedures to request access to
the Health Passport for its employees that are not Network Providers.
ix.
Effectiveness of Behavioral Health Services:
a.
The Contractor shall ensure that Behavioral Health Providers are
providing Behavioral Health Services that are consistent with the
following, where applicable:
(1)
The Child's Plan of Service;
(2)
The Contractor's Service Plan for the Child;
(3)
The Permanency Goal for the Child;
(4)
The CPS Transition Plan;
(5)
The Psychological evaluation and/or psychiatric evaluation; and
(6)
Desired outcomes, including, but not limited to improvement in
self-regulation and functioning.
b.
The Contractor shall ensure that Behavioral Health Services provided are
properly documented.
c.
The Contractor must have procedures for ensuring Behavioral Health
Providers are providing services in accordance with 12.B)ix.
C) Psychotropic Medications.
i.
The Psychotropic Medication Utilization Parameters for Foster Children
(Parameters) must be used, where applicable, in the treatment and care of
Children served under this Contract. The Parameters, now incorporated into
this Contract by reference, may be accessed at:

Form 2282cx
June 2012
a.
b.
ii.
13.
Name and date of birth of Child;

Reason for the visit;
c. Date of examination;
d. Procedures completed;
e. Examination results;
f.
Recommended follow up treatment and scheduled appointments, if any;
g. Medications and changes to medications;
h. The Child's refusal to accept medical treatment, if applicable;
i.
Documentation of the circumstances of an injury or medical incident,
including date and time of the incident;
j.
Documentation of whether the appointment was a Texas Health Steps
Medical or Dental Checkup as described in 12.A) ii and 12.A) iii above;
and
k. Documentation that a child with Primary Medical Needs (PMN) had a
medical examination within seven days before or three days after the date
of placement; or
The Contractor has the option of using the DFPS template for this purpose,
which can be accessed at the following link:
http://www.dfps.state.tx.us/application/Forms/showFile.aspx?NAME=2403.doc

A) Food. The Contractor must:
i.
Provide food in accordance with requirements of Minimum Standards.
ii.
Ensure that each Child receives fresh fruits, vegetables, and dairy products at
least once a day.
111.
Ensure that Children have input into meal planning.
i.
The Contractor will maintain an inventory of the Child's clothing and Personal
Items that are of substantial medical, monetary, or sentimental value by:
a.
Completing an inventory of clothing and Personal Items at admission;
b.
Updating the inventory of clothing and Personal Items quarterly and at
discharge;
c.
Ensuring that the Child (when age and developmentally able) and the
Contractor's staff or Caregiver signs and dates the clothing and Personal
Item inventory;
d.
Sending the clothing and Personal Item inventory with the Caseworker or
other Department designee at discharge.
ii.
The Contractor must provide each Child with Appropriate Clothing as defined
in Attachment B.
iii.
The Contractor shall allow Children to label their clothes with the Child's name
or initials.
The Contractor shall

ii.
iii.
14.
15.
Form 2282cx
June 2012
mattresses and other furnishings necessary to meet the Child's needs. The
Contractor shall ensure that the items are kept clean and in good repair.
Ensure that Children have personal storage space for their clothing and
Personal Items. The Contractor shall provide Children who are able to look
after their own needs with individual storage space in their bedrooms for
clothing and Personal Items.
Provide behavioral, gender and age appropriate living arrangements for each
Child, with the exception of sibling groups, where appropriate, in accordance
with Minimum Standards.

i. Use appropriate authority and Discipline practices as necessary to set limits for
ii. Develop and implement Discipline policies consistent with the TAC and Minimum
Standards at:
http://www.dfps.state.tx.us/Child Care/Child Care Standards and Requlatio
ns/default.asp.
a.
The Contractor must not use, give permission to use, or threaten to use
physical Discipline with any Child.
b.
The Contractor must not threaten the Child with loss of visits or any type
of contact with family or siblings as a punishment or deterrent to
behavior.
c.
The Contractor must not threaten the Child with loss of placement as a
d.
The Contractor must not use unproductive work as a form of punishment
(40 TAC, 748.2305 and 749.1955).
B) De-Escalation and Crisis Management. The Contractor must:
i.
Ensure that all de-escalation techniques are exhausted before utilizing more
restrictive and intrusive behavior intervention or Emergency Behavior
Intervention;
ii.
Utilize developmentally and age appropriate Emergency Behavior Intervention
iii.
Manage the home/Facility and milieu in a manner that minimizes disruption
during a crisis; and
iv.
Develop and implement Emergency Behavior Intervention policies that are
consistent with the Minimum Standards at:
http://www.dfps.state.tx.us/Child Care/Child Care Standards and Regulatio
ns/default.asp.
School

Form 2282cx
June 2012
a. Attends a pre-kindergarten program offered through the Public School or

an early childhood education program offered through Head Start, if
available, in the local community of the Child's Caregiver, unless an
exception has been granted by the Child's Caseworker or Caseworker's
Chain of Command;
b. May attend a private, early childhood education program or prekindergarten program paid for by the Contractor or Caregiver, if an
exception has been granted by the Caseworker or Caseworker's Chain of
Command;
v.
Written verification of the Child's enrollment is provided to the Caseworker
within five calendar days of the Child's enrollment;
vi.
In compliance with the Texas Education Code 29.012, if the Child is three
years of age or older, the Contractor will provide written notice to the school
district in which the Facility is located, not later than the third calendar day
after the date a Child is placed in a residential Facility.
a. For this written notice, the Contractor should reference the Texas
Education Code 29.012 and include the following minimum information:
(1)
Name and date of birth of Child;
(2)
Name of CPA and Foster Family or GRO;
(3)
Address of location where Child resides; and
( 4)
Contact information for the representative of the CPA or GRO who
is submitting such notice; or
b. The Contractor also has the option of using the DFPS template for this
purpose, which can be accessed at:
http://www.dfps.state.tx.us/documents/PCS/CPA notice to ISD sample
etter.doc; and
vii. The Contractor shall minimize disruptions to a Child's education by scheduling
therapy, and other appointments, outside of school hours, whenever possible.
viii. The Department may at any time require that a Child attend the local Public
School.
B) Education Portfolio. The Contractor shall ensure that:
i.
The Education Portfolio is maintained and updated for each School-Age Child in
the Contractor's care. The Education Portfolio should be kept where the Child
resides. The contents of the Education Portfolio must, where appropriate,
include:
a. School enrollment documentation: Birth certificate, Social Security
number, Immunizations, and withdrawal notice from the last school;
b. Special education documentation: Admission, Review & Dismissal (ARD)
team meeting notes, Individual Education Plan (IEP), documents related to
Section 504 of the Rehabilitation Act of 1973 regarding reasonable
accommodations, Full Individual Evaluations and/or other diagnostic

Form 2282cx
June 2012
School-Age Child is discharged from the Contractor's care. For each SchoolAged Child, the Contractor must ensure:
a.
The most current educational documents and records are in the Child's
Education Portfolio;
b.
The Child's Education Portfolio includes the Child's current school
withdrawal paperwork;
C) Post-Secondary Educational and Vocational Activities. The Contractor shall:
i.
Provide or facilitate access to post-secondary education, vocational or
technical training, support services and activities, including job readiness,
skills training, and apprenticeship program opportunities that are required by
the Child's Plan of Service and CPS Transition Plan at 16 years of age and/or
as developmentally appropriate, so each Child:
a.
Has access to appropriate community vocational activities, including
services provided by the local Texas Workforce Solutions offices (if
available in the area) and post-secondary education programs; and
b.
Receives the assistance needed to maximize the benefit of these
activities;
ii.
Guide and assist the Child in accessing and completing documents when
required for the State-Paid Tuition Fee Waiver and Education and Training
Voucher (ETV) Program if there is a need by the Child;
D) Driver License. The Contractor shall:
i.
Ensure that the following are made available to Children to facilitate driver
license fee waiver-residency affidavit requirements:
a. A DFPS Foster Youth Driver License Fee Waiver Letter;
b. A Texas Department of Public Safety (DPS) Texas Residency Affidavit
(Form DL-5), which is completed and signed by the Child and a
Representative; and
c. For Children under age 18, a Representative to accompany the Child to
the DPS driver license office to provide acceptable proof of residency; and
ii. Inform Children who have applied for a driver license of the need to notify DPS of
a new address change within 30 days of a change in placement.
E) ECI Program. The Contractor shall for each Child who is younger than three years
of age:
i.
Provide, in compliance with the Texas Education Code 29.012, written notice
to the local ECI program not later than the third calendar day after the date a
Child is placed in a residential Facility. For this written notice, the Contractor
should reference the Texas Education Code 29.012 and include the following
minimum information:
a. Name and date of birth of Child;
b. Name of CPA and Foster Family or GRO;
c. Address of location where child
and
d. Contact information for the
of the CPA or GRO who is


vi.
vii.
viii.
Form 2282cx
June 2012
Ensure the Caregiver fully participates in the Child's ECI evaluation and
process for developing an Individualized Family Service Plan (IFSP) for ECI
services;
Ensure the Caregiver performs the following duties related to the Child's
participation in the ECI Program:
a.
To the extent the Caregiver consents to the Child's recommended and
additional ECI Program services, the Caregiver fully participates in and
supports such services;
b.
To the extent the Caregiver declines to consent to any of the Child's
recommended and additional ECI Program services, the Caregiver must
immediately submit a detailed written report to the Caseworker or their
Chain of Command explaining why such declined services are not in the
best interest of the Child;
c.
To the extent the Caregiver disagrees or has a concern with any matter
related to the identification, evaluation, placement, or provision of ECI
services, the Caregiver may exercise the Caregiver's rights under the ECI
rules of the Texas Department of Assistive and Rehabilitative Services
(DARS) which are referenced in Part 2, Chapter 108 of Title 40 of the
TAC, including 40 TAC 108.111, procedures for filing complaints;
108.113, investigation and resolution of complaints and 108.123,
opportunity for a hearing; and
Ensure the Caregiver provides written consent for:
a.
The Child's ECI information to be entered into the Child's Health
Passport; and
b.
The Child's Caseworker and Caseworker's Chain of Command to directly
access ECI records from the ECI program if necessary.
16.

A) Provide recreational activities such as indoor, outdoor, school, community and
religious or spiritual activities for Children served under this Contract that are ageappropriate, varied, interactive with peers, and are of interest to the Child;
B) Ensure that Children participating in recreational activities are, at a minimum,
supervised in accordance with Minimum Standards and Service Level requirements
C) Intervene, as necessary, to reduce the risk of injuries; and
D) Ensure that Children have input into the types of recreational activities in which
they wish to participate.
17.
Travel. The Contractor shall provide or arrange all travel to ensure the Child's access
to:
A) Behavioral Health, Medical, Dental, Vision, and Pharmacy
educational and after-school

C)
Form 2282cx
June 2012
protects and preserves their dignity, promotes and encourages the development of
a Healthy Racial and Ethnic Identity, and ensures equity of service delivery.
Provide ongoing education in the form of training, workshops, and other educational
opportunities to help staff and Caregivers understand the impact race, culture, and
ethnic identity has on themselves and others and how they impact services to
Children and families.
19.
Contractor Participation. The Contractor shall participate in:

A) Conferences required by the Department which include but are not limited to,
medical, school, Family Group Conferences, Permanency Conferences, Circles of
Support Conferences, CPS Transition Plan Meetings, STAR Health Case Conferences
and legal staffings;
C) Preparation for Adult Living (PAL) activities, consistent with the Child's CPS
Transition Plan, if applicable. The Contractor shall obtain written prior approval
from DFPS PAL Staff to utilize the PAL Life Skills Independent Study Guide for a
Child in Substitute Care and in order for the Child to receive credit for completion of
the guide; and
jurisdiction over the Child and necessary to ensure that the Contractor is complying
with a Child's Plan of Service.
20.
The Contractor shall make and document good faith efforts to ensure that Children are
able to preserve desired and appropriate Connections to the Child's own cultural identity
and community, including religious/spiritual, Family Members, school, and appropriate
organizations through on-site or off-site means.
21.
Contact with Siblings. The Contractor shall:

A) Initiate Personal Contact between a Child and a Child's sibling(s) who is/are in foster
care at least one time per month in a Face-to-Face meeting if siblings are separated
but within 100 miles of each other; or
B) Initiate Personal Contact between a Child and a Child's sibling(s) who is/are in foster
care by initiating twice monthly Telecommunications if separated by more than 100
miles during which the Child and their siblings discussion and actions are not
directed by the Contractor.
C) If licensed as a CPA, arrange and facilitate sibling visits when siblings are at different
placements within the same CPA.
D) Exceptions to A), B), and C) above include the following:
L
Prohibited by court order;
Contrary to the best interest of the Children as reflected in any of the Plans of
Service of the Child or the Child's

23.
Form 2282cx
June 2012
Least Restrictive Setting. The Contractor will provide all services in a manner that
safeguards the health, welfare and safety of the Children in the least restrictive setting
ossible.
24. Facility Licensure. The Contractor shall:
A) Comply with Minimum Standards for any child-care license issued by the Department
to the Contractor for services provided under this Contract;
B) Comply with the operating or regulatory agency's regulations if the Contractor is a
Facility operated or regulated by one of the state agencies specified in 40 TAC
700.1321(e);
C) Comply with all applicable Service Levels as contained in Attachment C and the
Contracted Components of Care described in Sections 9-23 of this Contract; and
D) Ensure that all staff providing direct services to the Child comply with state
professional laws pertaining to the services provided including laws pertaining to
licensure and confidentiali .
25. Contractor Support and Supervision of Foster Families. The Contractor shall:
A) Develop and implement a plan, in accordance with DFPS policy, for providing support
services as needed to the Contractor's foster families where Children placed by the
B) Ensure that a Contractor's Case Manager is available at all times to assist and
support Foster Parents providing services to Children who are receiving Treatment
Services as defined in Minimum Standards;
C) Develop and implement a written plan to quarterly monitor foster homes for
compliance with Minimum Standards and Service Level standards as contained in
Attachment C and as required in Section 35 of this Contract. The Contractor shall
make this plan available to the Department upon request;
D) Have supervisor/Case Manager services available 24 hours a day to the Contractor's
direct Caregivers;
E) Develop and implement a written plan for contacting foster homes within seven
calendar days following a placement to assess:
i.
Whether the Child's needs are being met in the foster home; and
ii.
How the Child is adjusting to the foster home;
qualified aliens as defined in 8 U.S.C. 164l(b);
H) Distribute the Texas Health Steps materials at

J)
Form 2282cx
June 2012
Distribute HHSC information to Foster Parents regarding the Medicaid Medical

http://www .dfps.state. tx. us/documents/PCS/2009-05- 26 MTP Memo.pdf.
26. Background History Checks and Department Right of Removal.

A) The Department reserves the right to conduct background history checks on the
Contractor's employees, Subcontractors, volunteers, and all individuals who have
direct contact with Children in DFPS care or who have access to their records.
B) The Department reserves the right, in its sole discretion, to require by written notice
that the Contractor immediately:
i.
Not use any individual who has direct contact with Children or has access to
their records; or
ii.
Immediately remove any such person from engaging in such contact or having
such access.
C) The Contractor shall ensure initial and subsequent 24-month Background History
Checks (Checks) are performed in compliance with Minimum Standards, including:
i.
Submitting initial Checks timely;
ii.
Submitting subsequent 24-month Checks before their due date;
iii.
Ensuring employees, volunteers, Contractors, and caregivers are not present at
the facility if the Checks are submitted past the due date; and
Timely complying with any DFPS Centralized Background Check Unit
iv.
requirements when there is a relevant Check for a particular employee,
volunteer, Contractor, or Caregiver, which includes but is not limited to
restrictions on employee actions like not transporting Children or not being the
sole Caregiver for Children, or submitting complete requests for risk
evaluations timely.
D) If during a Federal audit there is a finding that Checks are not being performed by
the Contractor within the timeframes required by Minimum Standards and Contract,
this finding can result in a disallowance of Title IV-E funds claimed on behalf of the
Child. In addition to any other remedy under this Contract, DFPS can require the
Contractor to reimburse DFPS for such disallowances, including disallowed costs
related to foster care maintenance payments, administrative costs, and interest.
E) A Contractor who is licensed as a CPA must notify relative foster parent applicants
(including Relatives and Fictive Kin) about the following background check
Requirements referenced in TAC 745.651 and 745.693 by providing written notice
of the following requirements:
i.
Check is conducted on applicants prior to the CPA verifying the foster family as
a foster home;
iL
Certain criminal convictions will preclude applicants from becoming a foster
and/or adoptive parent, as described in the Criminal History Convictions and
chart:

Form 2282cx
June 2012
to place or continue a placement of a particular Child, any Child, or a specified

number of Children with the Contractor. Placement is always at the sole discretion
of the Department.
B) The Contractor must comply with the Department's placement processes, including
regular data entry or updates of vacancy status into the Department's Child
Placement Vacancy Database, referenced in Attachment F, Methodology for Output
Measure # 1. The Contractor shall not engage in practices used to circumvent these
placement processes. No part of this Contract shall be construed to create any legal
or equitable right on behalf of the Contractor to receive any such placements or to
continue any particular placements.
C) The Contractor must comply with all applicable federal and state laws, including the
Multiethnic Placement Act, as amended by the Interethnic Adoption Act of 1996 ( 42
USC Chapter. 21 1996b), the Indian Child Welfare Act (25 USC Chapter 21 1915),
the Adoption and Safe Families Act of 1997 (42 USC Sec. 629 et seq. and Sec. 670
et seq.); the Adam Walsh Child Protection and Safety Act of 2006 (42 USC 671)
and comparable state laws regarding placement of Children.
28. Removal and Discharge of Children.

A) The Contractor shall make all reasonable attempts to meet the needs of the Child in
the Contractor's care in order to prevent placement disruption. The Department, as
managing conservator, may remove a Child whenever the Department determines it
is in the best interest of the Child.
B) The Contractor shall document the Contractor's efforts and attempts to prevent
placement disruptions.
C) The Department shall remove a Child placed by the Department when notified by the
Contractor that the Child poses a danger to self or others or exhibits volatile or selfinjurious behaviors that are inappropriate for the program of service and requires a
i.
If the Contractor provides the Caseworker and Caseworker's Chain of
Command with documentation from a physician that the Child poses a danger
to self or others, to facilitate admission to a hospital, the Department will
remove the Child within 24 hours. Admission of the Child to a hospital by the
Contractor serves as documentation of the need for a more secure setting. The
Contractor must immediately inform the Caseworker and Caseworker's Chain of
Command of the admission and shall state whether the Contractor is willing to
accept return of the Child upon discharge from the hospital.
If the Contractor provides the Caseworker and Caseworker's Chain of
ii.
Command with documentation from a Psychiatrist, licensed Psychologist,
physician, LCSW or LPC showing that the Child consistently exhibits behavior
that cannot be managed within licensed programmatic services, the
Department will remove the Child within 14 calendar days. The Department
communicate with the Contractor and staff the Child's

Form 2282cx
June 2012
Licensed Child-Placing Agency Administrator or designated employee, other than the

Contractor's Case Manager. The Department will immediately communicate with the
Contractor and staff the Child's circumstances to determine a plan for moving the
Child to ensure the Child's safety and best interests and those of others. The
Department will remove the Child as quickly as is necessary. The Department may
immediately remove the Child.
F) For Contractors licensed as GROs providing emergency care services, if the
Contractor wishes to discharge a Child pursuant to Subsection 28.E) of this Section,
the Department shall have up to 10 calendar days to remove the Child.
G) If the Contractor discharges a Child placed by the Department except as stated
above, it constitutes a breach of this Contract.
H) Not later than 30 calendar days after the Contract is executed, the Contractor must
notify the Department's Residential Contract Manager in writing of the Contractor's
designated employee(s) who may approve discharges as described in this Section.
I) The Contractor shall provide to the Caseworker and Caseworker's Chain of Command
the following information and items that belong to the Child for each discharge:
i.
Upon the effective date of the discharge, the Child's:
a.
Medications;
b.
Medicai/Healthcare Items;
c.
Service Plan;
d.
Clothing and Personal Items;
e.
Most recent clinical records such as psychological evaluations and
psychological testing;
f.
Updated clothing and Personal Items inventory;
g.
Personal Documents;
h.
Up-to-date Education Portfolio; and
i.
ECI Individual Family Service Plan (IFSP), if applicable.
ii.
Within 15 calendar days after the discharge, the Child's:
a.
Discharge summary;
b.
Updates to the Child's Education Portfolio; and
c.
Any other information or items that belong to the Child that were not
provided to the Department at the time of discharge.
J) Within five calendar days of the Contractor's receipt from the Department of the
Form 2085-FC authorizing the placement of a Child with the Contractor, the
Receiving Contractor must provide a copy of that Form 2085-FC and a written
request to the Discharging Contractor for:
i.
Information not already received that is referenced in Minimum Standards 40
TAC 749.1371, 749.1373, 748.1437 and 748.1439, updates to the Education
Portfolio, and a copy of the ECI Individual Family Service Plan (IFSP), if
applicable; and
ii.
An opportunity, if necessary, to communicate with the Discharging Contractor
about the needs of the Child.

Form 2282cx
June 2012
29. Use of Department Forms.

A) Non-emergency placements. For Children at the Moderate Service Level or higher,
the Department will complete and provide to the Contractor at, or prior to,
placement the Common Application for Placement of Children in Residential Child
Care (Form 2087) as the uniform assessment form and application for admission.
receiving completed Form 2085-FC, Form 2085-B and/or 2085-C and/or 2085-D as
appropriate and, if at the Moderate Service Level or higher, Form 2087 and Form
2089. If the Caseworker attempts to place a Child at the Moderate Service Level or
higher without a copy of a current Form 2089, the Contractor may, but is not
required to, accept the Child for 72 hours after having the Caseworker sign the
Department's Form 2089-C.
B) Emergency Placements. The Department will attempt to complete and provide to
the Contractor at, or prior to, placement the Common Application for Placement of
Children in Residential Child Care (Form 2087) as the uniform assessment form and
application for admission. The form may be incomplete but will contain all available
information. Alternatively, the Department may provide to the Contractor the
Alternative Application for Placement of Children in Residential Child Care (Form
2087ex). In either case, Form 2087 shall be completed and provided to the
Contractor at the time the Child's placement is changed from an emergency to a
non-emergency placement. The Contractor shall accept Form 2087 or Form 2087ex
as the uniform assessment form and application for admission for placement of
Department Children. The Contractor shall accept Children for placement by the
Department only after receiving completed Form 2085-FC, completed Form 2085-B,
and/or 2085-C and/or 2085-D, and (complete or incomplete) Form 2087 or 2087ex.
C) Unaccompanied Emergency Placements. In the event an unaccompanied Child in the
care of the Department presents for emergency placement, the Contractor may
accept the Child for placement and shall immediately notify the Department to
determine Department instructions and to initiate documentation. The Department
shall complete the required forms within the next working day but may immediately
move the Child.
i.
The Contractor shall accept Children for placement by the Department only
after receiving completed Form 2085-FC, completed 2085-B and/or 2085-C
and/or 2085-D, and (complete or incomplete) Form 2087 or 2087ex.
ii.
The Department will complete and provide to the Contractor either Form 2087
or 2087ex.
a.
The Department will complete the Form 2087 within 30 calendar days
b.
The Department will make available to the Contractor Forms 2085-FC,
2085-B, 2085-C, and 2085-D, 2087ex, and 2089 to provide to the
..,.,,.v.orc for
Foster

Form 2282cx
June 2012
the signed CPS Rights of Children and Youth in Foster Care in the Child's
record.
E) Disclosure of Medical Information. The Department's amended forms 2085-FC and
2085-B, 2085-C, and 2085-D are intended to enable the Contractor to obtain and
disclose health information on a Child when it is necessary while still complying with
the federal Health Insurance Portability and Accountability Act of 1996 {HIPAA). If
circumstances arise where it is not possible for the Contractor to do so, the
Contractor should work with the Caseworker, Caseworker's Chain of Command, and
the DFPS Residential Contract Manager to obtain such additional permissions as are
necessary.
F) Medical Consent.
i.
The Contractor must follow the requirements of the Medical Consent for
Children in DFPS Conservatorship and Youth Consenting to Medical Care policy,
pertaining to residential child-care providers at
htto://www.dfps.state.tx.us/PCS/Residential Contracts/default.asp
ii.
The Medical Consenter is authorized to access, receive, and review all the
Child's medical records. Furthermore, the medical consenter may authorize the
release of the Child's medical records to the extent necessary to obtain services
for the Child.
iii.
The Contractor shall ensure that all Foster Parents and employees who are
eligible to serve as Medical Consenters under "How DFPS Establishes the
Medical Consenter", have access to and complete computer-based training on
Informed Consent.
iv.
The Contractor shall ensure that all Foster Parents and employees who are
eligible to serve as Medical Consenters, as stated above, follow the
requirements within DFPS policy regarding "Responsibilities of Medical
Consenters and back up Medical Consenters".
G) CPS Transition Plan. The Contractor shall coordinate with CPS for Children 16 years
of age and older regarding:
i.
The use ofthe CPS Transition Plan, Form 2500, as appropriate, at
http://www.dfps.state.tx.us/Application/Forms/showFile.aspx?Name=2500.doc
ii.
Maintaining a copy of the Child's Voluntary Extended Foster Care Agreement
Form 2540 and Trial Independence: Ability to Return for Extended Foster Care
Form 2532 in the Child's record;
iii.
The provision of information available at
http://www .dfps.state. tx. us/Child Protection/Transitiona I Livinq/default.asp
related to:
a.
Aftercare services, benefits and provider contacts;
b.
Educational Supports, Services and Benefits;
c.
Extended Care and Return for Extended Foster Care information;
d.
for Adult
Handbook

Form 2282cx
June 2012
A)
The Contractor shall develop and maintain a written policy regarding overnight travel
and overnight visits.
B) When the Contractor wishes to take a Child in the Department's conservatorship
outside the state, the Contractor must obtain prior written approval for the Child's
travel as provided in 40 TAC 700.1340.
C) If the travel is within the State and for more than three calendar days (72
consecutive hours); the Contractor must obtain prior written approval from the
Caseworker or Caseworker's Chain of Command.
D) Prior to allowing any trip, activity or visit with a non-related person, excluding
Intermittent Alternate Care, for a period of time exceeding 48 consecutive hours, the
Contractor must obtain written approval from the Caseworker or Caseworker's Chain
of Command.
E) Written approval for travel and visits is not required when:
i.
The Caseworker arranges for the Child to visit with members of the Child's
family or relatives; or
ii.
The Caseworker authorizes the Child to travel in specified circumstances
(usually routine trips or visits).
F) When the Contractor desires to take a Child outside of the country, the Contractor
shall follow Department policies and procedures including the completion of Form
2069, Caregiver Declaration Regarding Out-of-Country Travel.
31. Written Approvals.

A) Prior to moving a Child from one foster home to another foster home the Contractor
must obtain written approval from the Caseworker or Chain of Command. In the
event of an emergency, and if prior approval cannot be obtained, the Contractor
must notify the Department of the move within 24 hours. The Department will
respond to requests for approval within 10 calendar days of receiving a proper
request.
B) Prior to requesting Department staff to sign Contractor-developed forms, the
Contractor must receive written approval from the Residential Contract Manager
indicating legal approval by the Department.
32. Disaster and Emergency Response Plan.
A) The Contractor must maintain at all times a written disaster and emergency
response plan, policies and procedures to address internal and external emergencies
and disasters that include, but are not limited to acts of nature (such as flood,
hurricane, fires, and tornadoes), chemical or hazardous material spills, critical
equipment failure, weapons of mass destruction events, and acts of terrorism.
responsible for maintaining the safety and placement of all Children in its care. All
staff and Subcontractors of the Contractor must be aware of the disaster plan
to fulfill their role in
the
and be

Form 2282cx
June 2012
f.
Supplies;
g.
Emergency Equipment; and
h.
Emergency Services.
vi.
Contact information for the Caseworker and the Caseworker's supervisor;
vii. Identification, location and tracking of Children;
viii. Protection and/or recovery of Children's records and important paperwork
(including but not limited to electronic records, placement information, medical
authorizations, Medicaid cards, STAR Health cards, and Education Portfolio);
ix. The provision of regular and crisis-response services to Children during and
after a disaster, including:
a.
Methods for ensuring that services such as, but not limited to, crisis
counseling are provided to meet the crisis-related needs of the Children in
care during and after the disaster;
b.
Methods for ensuring that medical services are provided to Children
throughout the disaster. Such services include, but are not limited to,
providing Children with medication as prescribed (including insulin and
asthma-related treatments), emergency care, and Medical Care for
Children with Primary Medical Needs (as defined in Attachment B); and
c.
Plans for maintaining the services, as required by a court order and/or the
x. Communication with DFPS and CPS, including:
Identifying (name, telephone numbers) two emergency contacts
a.
designated by the Contractor who will be available to DFPS at all times in
the event of an emergency or disaster;
b.
Contacting CPS to provide information on the location and condition of
Children in care who have been evacuated as soon as the Children reach
their evacuation destination by contacting CPS through one of the
following methods:
(1)
During times when mass evacuation of part of Texas is anticipated,
DFPS will enable an online reporting feature on the DFPS public
website at: http://www.dfps.state.tx.us.
(2)
In situations when DFPS has enabled this online reporting feature
and the Contractor has access to the internet, the Contractor
should use this method to make the evacuation notification; or
(3)
In situations where the online reporting feature is not enabled or if
the Contractor does not have access to the internet, the
evacuation notification can be made by calling the DFPS
abuse/neglect hotline at 1-800-252-5400.
c.
Contractors with multiple facilities and CPAs must contact CPS once per
day, at a minimum (unless otherwise instructed by DFPS) 1 to provide
information concerning the Children in their care until all Children are
accounted
and

Form 2282cx
June 2012
749.2801(b). The CPA will maintain a copy of each home's disaster plan in its
records.
33. Access to Children. The Contractor will, at all times, permit access to all Children
placed by the Department in the care of the Contractor to the Department, its
employees, its designees, its third-party contractor for the Texas Service Level System
and its employees, and properly identified individuals appointed by a court of competent
jurisdiction (Volunteer or Court Appointed Special Advocates (CASA), guardians ad litem,
and attorneys ad litem).
A) All parties will exercise their right of access in a reasonable manner and attempt to
plan and coordinate such visits in cooperation with the Contractor and in a manner
that minimizes disruption of the care of the Children placed with the Contractor.
B) This Section will not be construed to prohibit the Department or its designees from
making unannounced visits to the Contractor's facilities or to a foster home verified
by a CPA.
C) In order to assess that an individual is appointed by a court of competent
jurisdiction, a Contractor or Caregiver should:
i.
If such individual is an employee of the CASA, review for a valid court order;
and
ii.
individual's appointment to the Child; or
111.
Review that the individual is named on the Child's Contact List.
D) If Contractor or Caregiver cannot readily determine the identity or authority of an
individual appointed by a court of competent jurisdiction, then the Contractor or
Caregiver should obtain approval from the Child's case worker or Chain of Command
prior to granting the individual access to the Child.
34. National Youth in Transition Database (NYTD). The Contractor shall:
A) Assist Children and support the necessary activities, including on-going computer
access required for Children turning 17 years of age between October 1, 2013
through September 30, 2014 to:
i.
Register with NYTD prior to turning 17 years of age;
ii.
Maintain an email address for NYTD updates; and
rrr.
Complete the NYTD survey within 45 days after the Child's 17th birthday;
B) Assist Children who previously took the NYTD Survey at 17 years of age anytime
between October 1, 2010 and September 30, 2011 and who have been selected to
take the survey through a random selection at 19 years of age, to:
i.
Maintain an email address to receive NYTD updates;
ii.
Enter NYTD contact updates to the Texas Youth Connection Website
'f::lf::!:L.~~:Y.Qib!1IJLQJJDill~lQ.!l&rY; and
either:

Form 2282cx
June 2012
c.
d.
ii.
B)
Output #3. The Child's placement is stabilized;

Output #4 Children in substitute care experience minimum moves (CPAs
only);
e. Output #5 Children placed with a Contractor remain in the care of the
Contractor.
Contract Outcome Measures as defined in Attachment F:
a. Outcome #1. Children are safe in care;
b. Outcome #2. Children are able to maintain healthy Connections with
Family Members who can provide a positive influence in their lives (PMET);
c. Outcome #3. Children are able to maintain connections to siblings
(PMET);
d. Outcome #4. Children benefit from routine recreational activities,
including extracurricular activities.
Be responsible for collecting and reporting performance measure data for Sections
35.A)i.b., 35.A)ii.b., and 35.A)ii.c. by:
i.
Ensuring registration of an account in the Performance Management Evaluation
Tool (PMET) system, at least 30 days after the provision of the first service if
an account has not already been established;
ii.
Reporting the results for each Performance Period into the PMET system;
iii.
Operating in accordance with the PMET instructions found at
https://www.dfps.state.tx.us/application/PCSPMET and select Help > PMET
User Guide;
iv.
Complying with report date time frames by entering into the PMET system
within 30 days of the end of the Performance Period in accordance with the
table below
First Quarter
Sept, Oct, Nov
December 1-30
Second uarter
Dec Jan Feb
March 1-30
Third Quarter
Mar, Apr, May
June 1-30
Fourth Quarter
Jun, Jul, Aug
September 1-30
v.
Maintaining documentation for each performance period and in a manner which
allows for testing the validity of the results reported; and
C) Acknowledge that Performance Measures are subject to changes on an annual basis
and DFPS may compute new baselines for some measures and may revise the
indicators, targets, data sources, or methodologies for the measures at any time
during the contract period. If at any time changes to the measures are necessary
due to changes in federal or state laws, rules or regulation, the performance of the
Contractor will be measured under the new requirements.

Form 2282cx
June 2012
Foster Parent Minimum Reimbursement Funds are all payments of funds received by
the Contractor from the Department that constitute the minimum amounts that the
Contractor must pass through to reimburse a Foster Parent for services already
provided according to the rates set forth in this Contract. For any and all such
Foster Parent minimum Reimbursement Funds, the Contractor must:
i.
Hold, maintain, manage, and account for such funds in a fiduciary capacity,
without limitation because such funds are held for the sole purpose of
disbursement by the Contractor to the applicable Foster Parents;
ii.
Not directly, indirectly, or collaterally pledge, assign, or otherwise attach,
without limitation, as security or collateral to any financial instrument or other
obligation any such funds that the Contractor has received, will receive, or
may receive under this Contract; and
iii.
Disburse such funds only to the applicable Foster Parents not later than 10
days after the date such funds are received by the Contractor.
D) In compliance with Chapter 2251 of the Texas Government Code, the Contractor
must make any payments owed to subcontractors within 10 business days of the
Contractor's receipt of applicable funds from the Department.
C)
37.
Conditions of Payment. DFPS will authorize payments to be made to the Contractor

after deducting any known previous overpayment made by the Department to the
Contractor. The Department is not obligated to pay for unauthorized services or to pay
more than is consistent with federal and state regulations.
A) The Contractor shall be compensated one time for residential child-care services
delivered under this Contract. The Contractor shall not bill for or retain any
additional compensation for such services from the Department or any other entity.
DFPS shall recover additional compensation from the Contractor.
B) The Contractor shall not be reimbursed for vandalism or damage caused by
deliberate acts of destruction by a Child placed with the Contractor.
C) The Department shall pay the Contractor the Service Level daily rate for each Child
placed by the Department and receiving services in accordance with the Child's Plan
of Service (including Permanency Planning goals), licensing standards, Contract
terms, and Service Level standards.
D) The Department shall pay for the calendar day of placement, but not for the
calendar day of discharge. If the Child is discharged on the day of placement, the
Contractor will not be reimbursed for that day.
E) If a Child is away from the Contractor's Facility without prior authorization, and if
the Caseworker or the Caseworker's supervisors and the Contractor agree in writing
that the Child should return to the Facility, then the Contractor may keep the
placement open for the Child. Reimbursement for reserve bed days must be
permitted in accordance with 40 TAC 700.323 and the policies established by the
Department\~~UL~UL~~~~~~~~~~~~~~~~,

Form 2282cx
June 2012
the expense, will not be processed unless DFPS determines that submission for
payment of the bill to the federal government can be executed in a proper and
timely fashion.
38.

A) Be responsible for any Monitoring/audit exception or other payment irregularity
regarding this Contract or subcontract; and
B) Be responsible for the timely and proper collection and reimbursement to the
Department of any amount paid in excess of the proper payment amount within 90
days of when it has been determined that an overpayment has been made to the
Contractor.
39.
information using the accrual method of accounting in accordance with 1 TAC
355. 7101(6). The Contractor's treatment of accounting records must reflect the
application of Generally Accepted Accounting Principles (GAAP) approved by the
American Institute of Certified Public Accountants (AICPA).
40.
Insurance.
A) The Contractor shall provide insurance for direct delivery of services under this
Contract. The Contractor shall obtain and furnish proof of the following bonding and
insurance coverage at the time of the Contract execution and at such other times as
may be specified by the Department. The required coverages are:
Dishonesty bonding under a commercial crime policy, business services
i.
bonding or equivalent insurance coverage at a $10,000 minimum per
occurrence;
ii.
Commercial General Liability insurance, or equivalent insurance coverage,
including but not limited to, liability with minimum combined bodily injury
(including death) and property damage limits of $300,000 per occurrence and
$600,000 aggregate; and
iii.
Professional Liability insurance or equivalent insurance coverage for licensed
or certified persons who render professional services, with minimum limits of
$300,000 per occurrence, and $600,000 aggregate.
B) The Contractor shall purchase coverage with insurance companies or carriers rated
for financial purposes "B" or higher whose policies cover risks located in the State.
All bonds, policies, and coverage shall be maintained during the entire term of the
Contract.
C) All required insurance policies shall include an endorsement stating that the
Department shall be given 30 calendar days written notice prior to cancellation of or
material change to the policy or bond.
ADMINISTRATIVE

B)
C)
Form 2282cx
June 2012

In maintaining financial records and in preparing cost reports, the Contractor shall
remain in compliance with 48 CFR 31 as applicable, Office of Management and
Budget (OMB) Circulars A-21, A-87, A-102, A-110, and A-122, and 40 TAC
732.240-256 as applicable.
http: 1/info.sos.state.tx. us/pls/pub/readtac$ext. ViewTAC?tac view- 5&ti -40&pt-19
&ch=732&sch=L&ri=Y
The Contractor shall comply with all applicable state and federal statutes and rules
in effect at the time such services are rendered, including the following:
i.
Federal Financial Participation (FFP) requirements in accordance with Titles 45
and 48 of the Code of Federal Regulations and federal circulars, as amended;
ii.
State and federal anti-discrimination laws, including without limitation:
a.
Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.);
b.
Section 504 of the Rehabilitation Act of 1973 (29 U.S. C. 794);
c.
Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.);
d.
e.
f.
g.
The HHS agency's administrative rules/ as set forth in TAC, to the extent
(1)
The Contractor agrees to comply with all amendments to the
above-referenced laws, and all requirements imposed by the
regulations issued pursuant to these laws. These laws provide in
part that no persons in the United States may, on the grounds of
race, color, national origin 1 sex, age, disability, political beliefs 1 or
religion, be excluded from participation in or denied any aid, care,
service or other benefits provided by Federal or State funding, or
otherwise be subjected to discrimination.
(2)
The Contractor agrees to comply with Title VI of the Civil Rights
Act of 1964, and its implementing regulations at 45 CFR Part 80
or 7 CFR Part 15, prohibiting a Contractor from adopting and
implementing policies and procedures that exclude or have the
effect of excluding or limiting the participation of Children in its
programs, benefits, or activities on the basis of national origin.
Applicable state and federal civil rights laws require Contractors to
provide alternative methods for ensuring access to services for
applicants and recipients who cannot express themselves fluently
in English. The Contractor agrees to ensure that its policies do
not have the effect of excluding or limiting the participation of
persons in its programs, benefits, and activities on the basis of
national origin. The Contractor also agrees to take reasonable
to
services and
both orally and in


(4)
Form 2282cx
June 2012
Upon request, the Contractor will provide HHSC Civil Rights Office
with copies of all of the Contractor's civil rights policies and
procedures.
(5)
The Contractor must notify HHSC's Civil Rights Office of any civil
rights complaints received relating to its performance under this
Agreement. This notice must be delivered no more than 10
calendar days after receipt of a complaint. Notice provided
pursuant to this Subsection must be directed to:
701 W. 51st Street/ Mail Code W206
Austin, Texas 78751
Phone: (512) 438-4313
TTY Toll Free: (877) 432-7232
Fax: (512) 438-5885
iii.
Health and Safety Code Section 85.115 relating to workplace and
confidentiality guidelines regarding AIDS and HIV;
Immigration Reform and Control Act of 1986 regarding employment
iv.
verification and retention of verification forms for any individuals who will
perform any labor or services under this Contract;
v.
All state and federal licensing and certification requirements, health and safety
standards, and regulations prescribed by the United States Department of
Health and Human Services Department;
vi.
All applicable standards, orders or regulations issues pursuant to the Clean Air
Act (42 USC 7401 et seq.) and the Federal Water Pollution Control Act as
amended (33 USC 1251 et seq.);
vii. Mandatory standards and policies relating to energy efficiency which are
contained in the state energy conservation plan issued in compliance with the
Energy Policy and Conservation Act (Public Law 94-163); and
viii. Standards and requirements concerning deinstitutionalization of Children
found at Health and Safety Code 321.002 and 42 USC 675(5)(A).
D) The Contractor shall provide a drug-free workplace within the meaning of the
Federal Drug-Free Workplace Act (41 USC 702 et seq.).
E) The Contractor shall comply with the Fair Labor Standards Act (FLSA) (29 U.S.C.
201 et seq.) regarding minimum wages, overtime pay, recordkeeping, and child
labor.
F) The Contractor shall not use any funding under this Contract to influence the
outcome of elections or the passage or defeat of any legislative measures.
G) Foster care maintenance payments must be expended for items that are provided
by foster parents and facilities in accordance with 42 USC 675(4).
43.
Retention, Access, and Confidentiality of Records.

B)
C)
D)
E)
F)
Form 2282cx
June 2012
Contractor.
The Contractor shall provide any and all records and information concerning the
Child to the Department upon verbal request in emergency situations. Upon verbal
request from DFPS, the Contractor must submit legible records and information
within the Department's specified timeframe. Emergency requests for records can
include, but are not limited to, the need to review the Child's Service Level in order
to make a placement change, court ordered requests, or attorney requests.
The Contractor shall provide any and all records and information concerning the
Child to the Department upon written request. The Contractor must forward legible
records and information to the Department within 14 calendar days of receipt of
request.
The Contractor shall provide the STAR Health contractor (Superior/Cenpatico) the
following information for specific Children for the purposes of a Psychotropic
Medication Utilization Review (PMUR) upon written request by Superior:
i.
Physician notes (last three months);
ii.
Medication logs (last three months); and
111.
In the event the Contractor receives a written request for information from the
STAR Health contractor (Superior/Cenpatico) that does not involve PMUR as
identified in Subsection 43.D) of this Section, the Contractor shall advise the STAR
Health contractor (Superior/Cenpatico) to contact the Caseworker or Caseworker's
Chain of Command for assistance.
All records received or created by the Contractor that are identifiable to Children
referred by the Department are confidential and may be disclosed to third parties
only with the prior written consent of the Department or within the scope of
consents permitted by the Medical Consenter. The Contractor will take reasonable
measures to secure confidential records and prevent the destruction and/or
disclosure of such records. In the event the Contractor receives any request or
demand for disclosure of confidential records by oral questions, documents
subpoenas, civil investigative demand, interrogatories requests for information or
other similar legal process, the Contractor will provide the Department with prompt
notice of such request so that the Department may seek an appropriate protective
order and/or consent to the Contractor's disclosure of the requested records.
The Contractor shall establish a method to ensure the confidentiality of records and
other information relating to Children according to applicable federal and state law,
rules, and regulations. The Department shall have an absolute right of access to,
and copies of, Child case records or other information relating to Children served
under this Contract.
The Contractor shall ensure that any staff designated by the Contractor and
approved by DFPS for access to the Health Passport must comply with all operative
restrictions of the Health Passport user agreement as it exists now or may later be
including the following:
share intr>rrr:::~ti

Form 2282cx
June 2012
Health Passport access is authorized; and

Not to share passwords. If the Contractor becomes aware that a password
has been shared, he or she is required to notify Superior within 24 hours so
that a new password can be assigned.
I) The Contractor shall advise Authorized Users that DFPS may restrict or deny access
to the Health Passport if they are in violation of the user agreement or terms and
conditions of the Contract.
J) The provisions of this Section shall remain in full force and effect following
termination of or cessation of the services performed under the terms of this
Contract.
K) The Contractor will provide access to all records and/or information concerning the
Child to properly identified individuals appointed by a court of competent
jurisdiction which are volunteers or employees of Court Appointed Special
Advocates (CASA), guardians ad litem, and attorneys ad litem.
i.
Such records and information may include, but is not limited to,
documentation of face-to-face visits with the Child by the Contractor's Case
Manager staff, the Child's Service Plan, documentation of services provided to
a Child, Discipline logs, medical and dental information, educational
documentation, and narratives-:ii.
In order to assess that an individual who is accessing records and information
is appointed by a court of competent jurisdiction, a Contractor or Caregiver
should:
If such individual is an employee of the CASA, review for a valid court
a.
order; and
If such individual is a CASA volunteer, review for a valid court order and
b.
a notification letter of volunteer assignment and acceptance, that clarifies
the individual's appointment to the Child.
If Contractor or Caregiver cannot readily determine the identity or authority of
iii.
an individual appointed by a court of competent jurisdiction, then Contractor
or Caregiver should obtain approval from the Caseworker or Chain of
Command prior to granting access to records or information.
L) The Contractor may release or otherwise use a photo or image of a Child under the
following circumstances:
i.
Before the Contractor may release or otherwise use a photo or image of a
Child, the following conditions must occur:
It is in the best interest of the Child, poses no threat to the Child's health
a.
or safety, and the use is not for any commercial use, publicity, pecuniary
benefit, or similar gain for the Contractor or any other party;
b.
No reference is made to the fact the Child is in the conservatorship of
DFPS, and the use does not stigmatize the Child in any way;
c.
The Child approves of the release or use; and
to release or otherwise use
a
or
Permission is received
of
v.

Form 2282cx
June 2012
students published in the local newspaper, a group photo of a scout troop

distributed to all the troop members and posted on a community youth
center bulletin board, photos of the sports team posted in a school
showcase, or other similar publication.
iii.
Any other release or use of photo or images of a Child, must be approved in
writing by the Caseworker or Chain of Command.
M) The Contractor shall not provide the Common Application for Placement of Children
in Residential Child Care (Form 2087), or the Alternative Application for Placement
of Children in Residential Care (Form 2087ex) as referenced in Section 29.D) to a
Public School and will ensure that documents and information in the Education
Portfolio are kept confidential and only shared with school personnel as necessary to
facilitate school activities.
N) THE CONTRACTOR MUST NOT DISPOSE OF RECORDS BEFORE PROVIDING
THE DEPARTMENT'S RESIDENTIAL CONTRACT MANAGER WRITTEN NOTICE
OF ITS INTENT TO DISPOSE OF RECORDS AND RECEIVING WRITTEN
APPROVAL FROM THE DEPARTMENT'S RESIDENTIAL CONTRACT MANAGER.
44.
Intermittent Alternate Care. Child-Placing Agencies that are permitted to use

Intermittent Alternate Care must do so pursuant to the requirements contained in
Attachment D, which is attached and incorporated by this reference. The Department
may allow contracted Child-Placing Agencies to utilize Intermittent Alternate Care to:
A) Provide Foster Parents additional supports for meeting child-care responsibilities;
B) Increase the retention of Foster Parents;
C) Decrease the number of moves Children experience; and
D) Promote the overall development and permanency needs for Children in foster care.
45.
Notifications. The Contractor shall:

A) Maintain at all times at least one active electronic (email) address for the receipt of
Contract-related communications from the Department. It is the Contractor's
responsibility to monitor this email address for Contract-related information. The
Contractor shall notify the Residential Contract Manager and the Residential
Contract Mailbox (Residential Contracts@dfps.state.tx.us) with any updated email
address within five calendar days of the change;
B) In addition to Minimum Standards notifications:
i.
Give the Caseworker and Caseworker's Chain of Command the amount of
written notice required by Section 28 of this Contract before discharging a
Child placed by the Department;
ii.
Notify the Caseworker and Caseworker's Chain of Command within 24 hours
after the Contractor determines that a Child placed by the Department with
the Contractor is a danger to self or others and requires a placement in
another
or has been
detention;
the Caseworker
24

Form 2282cx
June 2012
change to the Contractor's admissions policy and significant changes to the

scope and coverage of the services provided by the Contractor or
Subcontractor under this Contract;
vi.
Notify the Residential Contract Manager within 10 calendar days, if there are
contractor or payment issues which cannot be resolved by the applicable
regional foster care billing coordinator;
vii. Notify the Residential Contract Manager within 48 hours of an identified breach
of confidentiality of Children's information;
viii. Notify the school the same day of any change that will affect the Child's
attendance at school and, where possible the length of time a Child may be
absent;
ix.
Notify in writing, the Caseworker or Caseworker's Chain of Command, within
three business days of the date that the Contractor or the Caregiver initially
receives notice of the following meeting(s) related to the Child:
a. Upcoming ARD team meetings; and
b. Any meetings regarding student disciplinary actions that may lead to inschool or out-of-school suspension, expulsion, or placement at an
alternative education setting;
x.
Notify the residential.passportaccess@dfps.state.tx.us email box within 48
hours of any additions or deletions of Health Passport Authorized Users;
Notify the Residential Contact Manager in writing within 10 calendar days if
xi.
the Contractor receives a formal complaint or lawsuit filed against it regarding
noncompliance with any statutes or regulations;
xii. Notify in writing the Child's Caseworker and Caseworker's Chain of Command
within 48 hours when a Voluntary Extended Foster Care Agreement signed by
the Child has not been completed within 10 calendar days prior to the Child's
18th birthday or a Voluntary Extended Foster Care Agreement has not been
received for a Child 18 to 22 years of age participating in Extended Foster
Care. Efforts made to obtain a copy of the signed agreement should be
documented in the Child's record;
xiii. Notify the Caseworker and Caseworker's Chain of Command within 30
calendar days when a Child 18 to 22 years of age is not participating in school,
work or other activity which qualifies the Child for Extended Foster Care or
Return for Extended Foster Care;
xiv. Notify the Child's Caseworker and Caseworker's Chain of Command when a
Child is 16 years of age or older, if at the time of updating the Child's Service
Plan, the Contractor is not aware of a plan for the Child to enroll in or receive
PAL Life Skills training classes;
xv.
Notify the Department of a foster home application to a Child Placing Agency
made by a Relative or Fictive Kin family by entering required data into the
DFPS Child Care
Public and Provider Website within two business

Form 2282cx
June 2012
xviii. Notify each Child's Caseworker and Caseworker's Chain of Command in writing
within two business days of the verification of a Relative or Fictive Kin Family
Member and submit a copy of the Foster Home Screening to each Child's
Caseworker and Caseworker's Chain of Command.
C) Except as otherwise provided for in this Contract, DFPS will:
i.
Provide the Contractor with 30 calendar days written notice when planning a
discharge from placement or in the case of a Contractor providing emergency
care services where a five calendar day notice is required;
ii.
Not be required to provide notice for removal when court ordered, when there
is an immediate threat to the health, safety or well-being of a Child, after the
Contractor provides notice or requests removal under Section 28 of this
Contract. However, when the Department determines the removal to be in a
Child's best interest, they will make every effort to afford the Child and the
Contractor reasonable notice;
iii.
When requested by the Contractor, provide the Contractor with a discharge
document signed by the DFPS Program Director responsible for the Child or, at
the Department's discretion, a higher management level if the Department
wishes to discharge a Child with less than 30 days notice when the discharge
is not for one of the reasons in Subsection ii above. The discharge document
shall describe the Department's reasons for the discharge and the reasons for
discharging with less than 30 days notice;
iv.
Keep the Contractor informed of any significant changes in the Child's
circumstances in a timely manner including legal status, family situation, and
factors related to the Child's Permanency Goal;
Notify the Contractor when it knows that funds for this Contract will be
v.
reduced or eliminated as referenced in Section 54 of this Contract; and
Notify the Contractor within 10 calendar days when a request for a Service
vi.
Level evaluation will not be forwarded to the Service Level Monitor.
46.
Reporting. The Contractor shall accurately complete cost reports, time studies,
Internal Control Structure Questionnaires (ICSQs), Contract Monitoring surveys, and
any other reports required and requested by the Department within time frames
specified by DFPS. The Contractor must submit annual cost reports as required by 1
TAC 355. 7101-7103.
47.
A) Attend HHSC cost report training in compliance with 1 TAC 355.7101 prior to
submitting an annual cost report; and
48.
Authority of Department Staff.

B)
Form 2282cx
June 2012
Contractor's annual financial report, if any is issued.

The Contractor's foster parent recruitment activities must not emphasize payment
as the rimar incentive for becomin a foster arent.
CONTRACT MONITORING
50.
Assessments of Physical Facilities and Operations. The Contractor shall allow

periodic assessments of its physical facilities and operations, which may include specific
foster homes, by DFPS employees or DFPS authorized representatives. The Contractor's
physical facilities and operations shall be approved by the Department based on
assessments prior to and during the Contract Period.
51.

A) The Contractor acknowledges and agrees that Department employees and/or
representatives shall review the services provided and any related documentation
for compliance with contractual and statutory/regulatory requirements.
B) DFPS' Service Level Monitor will complete a periodic Service Level compliance
review to determine the level of services that are actually being provided by the
Contractor. When there are deficiencies, the Service Level Monitor provides the
Contractor 30 calendar days for correction beginning with the date that the Service
Level Monitor first determined that the Contractor was not meeting the contracted
Service Levels. The Service Level Monitor will issue a final letter indicating the
Contractor's non-compliance with the Service Levels after the 30 calendar-day
period for correction. Upon receipt of notification from the Department, the
Contractor will not be paid more than the Service Level daily unit rate as
determined by the Service Level Monitor. The Contractor will not be paid at a rate
higher than the Service Level rate until the Contractor receives notice from the
Department. The Service Level Monitor will indicate to the Department that all
contracted services are being met and the Department will subsequently notify the
Contractor. This is not an exclusive remedy and DFPS reserves the right to pursue
other remedies for noncompliance with this Section.
C) Right to Audit. Contractor will cooperate fully in any review conducted by DFPS or
its authorized representatives related to services provided under this Contract.
DFPS has the authority to monitor, inspect, assess, and review the fiscal,
contractual, or program performance of the Contractor, including all information
related to any services provided under this Contract or billed to DFPS. Contractor
will remedy any weaknesses, deficiencies, program noncompliance, or audit
exceptions found as a result of a review by DFPS or its authorized representatives in
a timely manner. In addition to all other remedies authorized under this Contract,
the Department based on information from an audit, may take any other actions
deemed reasonable by the Department to ensure compliance with the terms and
conditions of this Contract or to
an issue identified
an audit.
OTHER PROVISIONS

Form 2282cx
June 2012
53.
Comptroller Status. Contractor agrees that should the Texas Comptroller of Public
Accounts ever place the Contractor on "vendor hold" or "not in good standing," then the
Department will apply all payments under this Contract directly toward eliminating any
of Contractor's debts or delinquencies to the State of Texas.
54.
Funds Availability. This Contract is at all times contingent upon the availability and
receipt of state or federal funds that the Department has allocated to this Contract. If
any such funds for this Contract become unavailable during any budget period, this
Contract may be immediately terminated or reduced at the discretion of the
Department.
55.
Subcontracting. Contractor will be responsible to DFPS for any subcontractor's

performance under this Contract.
A) Subcontractors providing services under the Contract will meet the same
requirements and level of experience as required of Contractor. No subcontract
under the Contract will relieve Contractor of responsibility for ensuring the requested
services are provided. If Contractor uses a subcontractor for any or all of the work
required, the following conditions will apply:
i.
Contractors planning to subcontract all or a portion of the work to be
performed will identify the proposed subcontractors and keep a record
available to DFPS upon request.
ii.
Subcontracting will be solely at Contractor's expense.
DFPS retains the right to conduct a Background History Check on the
iii.
subcontractor.
iv.
Contractor will be the sole contact for DFPS to address any issue that may
arise with a subcontractor and will provide DFPS a designated point of contact
for this purpose.
B) Contractor will include a term in all proposed subcontracts that incorporates this
Contract by reference and binds subcontractor to all the requirements, terms, and
conditions of this Contract related to the service being provided by the
subcontractor. Contractor will also include terms that explicitly hold that this
Contract controls in the event of any conflict with a subcontract. DFPS approval of
Contractor's use of any subcontractor is conditioned upon the extent that any
subcontract does not conflict with any requirements of the Contract between DFPS
and Contractor.
C) DFPS retains the right to disapprove of the use of any subcontractor under this
Contract.
D) DFPS does not allow Contractors to enter into subcontracts for Case Management
Services.
E) Contractors will submit form 2033-RCC at least annually listing all subcontracted
entities for
Direct Service
and
Services.

Form 2282cx
June 2012
not assign or otherwise encumber any interest in or rights to payments of funds that
Contractor must pass through to other individuals or entities per the requirements of
this Contract. This Section does not prohibit collateral assignment of payments for the
purpose of secured lending arrangements in the ordinary course of business.
58.
Vendor Performance. Pursuant to Section 2155.144 (K) of the Texas Government

Code and 20.108 of the Texas Administrative Code, state agencies are required to
report vendor performance on any purchase of $25,000 or more from contracts
administered by the Texas Comptroller of Public Accounts or any other purchase made
through an agency's delegated authority or a purchase made pursuant to the authority
in Government Code, Title 10, SubtitleD or a purchase exempt from Texas Comptroller
of Public Accounts' procurement rules and procedures. DFPS reports vendor
performance by means of the Vendor Performance Tracking System (VPTS), which can
be accessed online at:
http://www. window .state. tx. us/procurement/proq/vendor performance/
DFPS may use the VPTS to determine best value when awarding contracts in instances
where past performance is included as a factor in the evaluation of a vendor for award.
59.

A) Changes and Amendments. Except as provided in Subsection 59.C) of this Section,
no change, modification, or amendment to the Contract will be effective until
approved in writing by the Department and the Contractor.
B) Contract Renewals. The Contract is renewable upon mutual agreement of the
parties and subject to the conditions in 40 TAC 700.2501-2505, 40 TAC
732.203, and the terms of this Contract.
Contractor's receipt of a copy of the amendment signed by the Department. DFPS
i.
Incorporate new or revised federal, State, or Department laws, regulations,
rules, or policies;
ii.
Change the name of the Contractor in order to reflect the Contractor's name
as recorded by the Texas Secretary of State;
iii.
Correct an obvious clerical error in the Contract;
iv.
Change Contract and resource numbers;
v.
Change the recorded license number of any license needed under this Contract
in order to reflect the correct number as issued by the licensing authority;
vi.
Update Service Level descriptions or daily rates; or
60.
Remedies. In addition to, or instead of1 all other actions authorized under this
the
on information from
or other verifiable

Form 2282cx
June 2012
implement the requirements of the Contract Corrective Action Plan and must
maintain compliance with the requirements of the Corrective Action Plan. Failure to
comply or maintain compliance with the Contract Corrective Action Plan may be
grounds for the exercise of further remedies set forth in this Section;
C) Recover excessive payments or impose remedies based on Monitoring/audit findings
of violations of Contract requirements;
D) Temporarily or permanently remove any or all Children subject to the terms of this
Contract;
E) Suspend and/or limit any further placements of Children, and place conditions on
any such suspensions and/or limitations of placements;
F) Suspend, place into abeyance, or remove any of the Contractor's contractual rights,
in whole or in part; and
G) Suspend or terminate this Contract, in whole or in part.
61.

A) If the Contractor fails to provide services according to the terms and conditions of
this Contract, the Department may immediately, upon written notice of default to
the Contractor, suspend or terminate all or any part of the Contract.
B) Either party may terminate this Contract by giving 30 calendar days written notice
to the other party, after which the Contract will terminate at the end of the 30
calendar day notice period. Nothing in this Subsection may be construed to prohibit
immediate suspension or termination of this Contract pursuant to this Section.
C) At the end of the Contract term or other contract termination, the Contractor shall,
in good faith and in reasonable cooperation with the Department, aid in the
transition to any new arrangement or provider of services, including the orderly
transition of each Child placed by the Department to new homes. The respective
accrued interests or obligations incurred to date of termination must be settled
equitably. This equitable settlement must occur in compliance with 40 TAC
732.270-271 within six months from the date the Contract has ended or is
otherwise terminated in accordance with this Contract.
D) Upon termination or expiration of this Contract, the Department will work with the
efficiently as possible. The goal will be to remove all the Department's Children by
the effective date of the expiration or termination of the Contract; however, in the
event this is not possible, the Contractor will continue to provide care for the
Children in accordance all terms and conditions of this Contract. The Department
will reimburse the Contractor for any care provided after the date of Contract
termination or Contract expiration until all Children are removed from the
Contractor's care.
E) The Department will terminate this Contract if the Contractor is found liable for or
has a contract, license, certificate, or permit of any kind revoked for Medicaid fraud.
The
will
or terminate this Contract if the Contractor's

ii.
iii.
62.
Form 2282cx
June 2012
resolution process provided for in Chapter 2260 of the Texas Government

Code and 40 TAC 732.401-32 to attempt to resolve any claim for breach of
Contract made by the Contractor.
For governmental entities, DFPS and the Contractor must use the
Governmental Dispute Resolution Act as provide for in Texas Government
Code Chapter 2009.
During a dispute resolution under this Subsection, the Contractor shall
continue to be bound by the terms and conditions in this Contract.
DFPS Information Security Requirements.

A) Contractor must comply with the following:
i.
DFPS Contractor Information Security Standards located at:
http://www .dfps.state. tx. us/documents/PCS/Contractor Information Security.
pdf
ii.
Health and Human Services Enterprise Information Security Standards and
Guidelines;
iii.
Title 1, Texas Administrative Code, Sections 202.1 and 202.3-.28;
iv.
Texas Human Resources Code, Section 40.005;
v.
Texas Family Code, Section 161.006(a)-(b);
vi.
Texas Family Code, Section 162.018;
vii. Texas Family Code, Subchapter C, Sections 261.201-.203;
viii. Texas Family Code, Section 264.408;
ix.
Texas Family Code, Section 264.511;
x.
Texas Health and Safety Code, Section 85.115; and
Title 40, Texas Administrative Code, Subchapter B, Sections 700.201-.209.
xi.
B) Contractor must comply with the following, as applicable:
i.
The Federal Information Security Management Act of 2002 (FISMA);
ii.
Publication 1075 - Tax Information Security Guidelines for Federal, State and
Local Agencies;
iii.
NIST Special Publication 800-53 Revision 3 -Recommended Security Controls
for Federal Information Systems and Organizations; and
iv.
NIST Special Publication 800-47 - Security Guide for Interconnecting
Information Technology Systems.
C) In addition to the requirements expressly stated in this Section, Contractor must
comply with any other State or Federal law, regulation, or administrative rule
relating to the specific DFPS program area that Contractor supports.
D) Upon reasonable notice, Contractor must provide, and cause its subcontractors and
agents to provide, DFPS or its designee, prompt, reasonable, and adequate access
to any information security records, books, documents, and papers that are directly
pertinent to the performance of the Contract including, but not limited to:
Contractor information
and

Form 2282cx
June 2012
confidential data transfers and the handling and disposal of Personally Identifiable
Information (PII). Acceptable forms of written compliance may be, but are not
limited to:
i. Statement on Auditing Standards No.70, Service Organizations (SAS-70) Report;
ii. General Security Controls Audit;
iii. Application Controls Audit;
iv. Vulnerability Assessment; and
v. Network/Systems Penetration Test.
63
INDEMNIFICATION. THE CONTRACTOR SHALL DEFEND, INDEMNIFY AND HOLD

HARMLESS THE STATE OF TEXAS, DEPARTMENT, ITS OFFICERS AND EMPLOYEES,
FROM ANY CLAIMS, ACTIONS, SUITS, DEMANDS, PROCEEDINGS, COSTS,
DAMAGES, AND LIABILITIES INCLUDING WITHOUT LIMITATION, ATTORNEY'S
FEES AND COURT COSTS CONNECTED WITH ANY ACTS OR OMISSIONS OF THE
CONTRACTOR OR ANY AGENT, EMPLOYEE,, SUBCONTRACTOR OR SUPPLIER IN
THE EXECUTION OR PERFORMANCE OF THIS CONTRACT. THE CONTRACTOR
MUST COORDINATE ANY DEFENSE WITH THE TEXAS ATTORNEY GENERAL AS
REQUESTED BY DFPS. THIS SECTION IS NOT INTENDED TO AND SHALL NOT BE
CONSTRUED TO REQUIRE THE CONTRACTOR TO INDEMNIFY OR HOLD
HARMLESS THE STATE OR THE DEPARTMENT FOR ANY CLAIMS OR LIABILITIES
RESULTING FROM NEGLIGENT ACTS OR OMISSIONS OF DFPS OR ITS
EMPLOYEES.
64.
Prohibition on Non-compete Restrictions. Contractor will not require any employees

or subcontractors to agree to any conditions, such as non-compete clauses or other
contractual arrangements that would limit or restrict such persons or entities from
employment or contracting with other providers (or DFPS).
65.
Limitation on Use of DFPS Seal and Name. Contractor may not use the DFPS seal in
any form or manner without the prior written approval of the Department. Contractor
also may not use the name of DFPS to imply any endorsement, approval, or sponsorship
of Contractor's goods or services by DFPS.
66.
Force Majeure. The Contractor will be excused from the obligations of this Contract to
the extent that performance is delayed or prevented by any circumstances (except
financial) reasonably beyond the Contractor's control. Such delays or failures to
perform shall extend the period of performance at the discretion of DFPS. The
Contractor must inform the Department in writing of proof of force majeure within three
business days or otherwise waive this right as a defense. The Contractor agrees that
breach of this provision entitles DFPS to any and all available remedies.

Form 2282cx
June 2012
68.

copyright, use, reproduce, and distribute any material written or produced by the
Contractor that is the subject of this Contract. When the Contractor develops materials
using funds from this Contract, the Contractor must grant the Department and the
federal government a royalty-free, non-exclusive, and irrevocable license or right to
reproduce, translate, publish, use, disseminate, and dispose of such materials and to
authorize others to do so for governmental purposes.
69.
Exhibits. The following documents are incorporated into this Contract:

A) Form 2031, Signature Authority Designation;
B) Form 2033RCC, Subcontractor Documentation Form;
C) Form 2033a-RCC, Subcontractor Process;
D) Forms 4732, Request for Determination of Ability to Contract
E) Form 9007 RCC, Internal Control Structure Questionnaire (ICSQ) for Residential
Child Care.
70.
Certifications. The certifications enumerated below represent material facts upon

which DFPS relies when contracting for services. If the Department later determines
that Contractor knowingly rendered an erroneous certification, DFPS may pursue all
available remedies in accordance with Texas and U.S. law. Contractor further agrees
that it will provide immediate written notice to DFPS if at any time Contractor learns
that any of the certifications provided for this contract were erroneous when submitted
or have since become erroneous by reason of changed circumstances. If the
Contractor cannot certify the accuracy of all certification statements, then
Contractor must provide written notice to DFPS detailing which statements it
cannot certify and why. Contractor acknowledges its continuing obligation to comply
with the requirements of all certifications, and will immediately notify DFPS of any
changes in circumstances affecting these certifications.
A) Certification Regarding Lobbying. State and federal law place restrictions on the
use of state and federal funds in regard to lobbying. The Contractor certifies, to the
best of its knowledge and belief, that:
i.
In accordance with 31 U.S.C. 1352, no federal appropriated funds have been
paid or will be paid, by or on behalf of the Contractor, to any person for
influencing or attempting to influence an officer or employee of an agency, a
Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with the awarding of any federal contract,
the making of any federal grant, the making of any federal loan, the entering
into of any cooperative agreement, and the extension, continuation, renewal,
amendment, or modification of any federal contract, grant, loan, or
cooperative agreement.
If any funds
than federal

Form 2282cx
June 2012
Suspension, Ineligibility, and Voluntary Exclusion. Executive Orders 12549,

13224 and 12689 require DFPS to screen each covered Contractor to determine
whether each has a right to obtain a contract in accordance with federal regulations
on debarment, suspension, ineligibility, and voluntary exclusion. Contractor certifies
the following:
i.
That Contractor is, to the best of its knowledge and belief, not on the specially
designated nationals list or debarred, suspended, declared ineligible, or
voluntarily excluded from participation in this solicitation or any resulting
contract.
That Contractor will not knowingly enter into any subcontract with a person
ii.
who is on the specially designated nationals list or debarred, suspended,
declared ineligible, or voluntarily excluded from participation in this covered
transaction, unless authorized by DFPS or the U.S. Department of Health and
Human Services or U.S. Treasury Department, as applicable.
That Contractor will include this Section regarding debarment, suspension,
iii.
ineligibility, and voluntary exclusion, and the specially designated nationals list
without modification in any subcontracts or solicitations for subcontracts.
C) Child Support. Under Texas Family Code Section 231.006, the vendor or applicant
certifies that the individual or business entity named in this contract, bid, or
application is not ineligible to receive the specified grant, loan, or payment and
acknowledges that this contract may be terminated and payment may be withheld if
this certification is inaccurate.
D) Drug-Free Workplace Certification. Contractor certifies that it will or will
continue to provide a drug-free workplace by:
Publishing a statement notifying employees that the unlawful manufacture,
i.
distribution, dispensing, possession, or use of a controlled substance is
prohibited in the grantee's workplace and specifying the actions that will be
taken against employees for violation of such prohibition;
ii.
Establishing an ongoing drug-free awareness program to inform employees
abouta. The dangers of drug abuse in the workplace;
b. The grantee's policy of maintaining a drug-free workplace;
c.
Any available drug counseling, rehabilitation, and employee assistance
programs; and
d. The penalties that may be imposed upon employees for drug abuse
violations occurring in the workplace;
iii.
Making it a requirement that each employee to be engaged in the performance
of the grant be given a copy of the statement required by Sub-Section (D)(i);
iv.
Notifying the employee in the statement required by Sub-Section (D)(1) that,
as a condition of employment under the grant, the employee willa. Abide by
terms of the
and
b. Notify the
B)

Form 2282cx
June 2012
a.
Taking appropriate personnel action against such an employee, up to and

including termination, consistent with the requirements of the
Rehabilitation Act of 1973, as amended; or
b. Requiring such employee to participate satisfactorily in a drug abuse
assistance or rehabilitation program approved for such purposes by a
federal, state, or local health, law enforcement, or other appropriate
agency;
c. Making a good faith effort to continue to maintain a drug-free workplace.
E) Anti-Trust Certification. Pursuant to 15 U.S.C. Sec. 1, et seq. and Tex. Bus. &
Comm. Code Sec. 15.01, et seq., Contractor certifies that neither the Contractor
nor the firm, corporation, partnership, or institution represented by the Contractor,
or anyone acting for such a firm, corporation, or institution has violated the antitrust laws of this state, federal anti-trust laws, nor communicated directly or
indirectly the bid made to any competitor or any other person engaged in such line
of business.
F) Deceptive Trade Practices. Contractor certifies that it has not been found guilty
or liable of a Deceptive Trade Practices Act or any unfair business practice either in
an administrative hearing or court suit within the last five years. Contractor certifies
that it has no officers who have served as officers of other entities who have been
found guilty or liable of a Deceptive Trade Practices Act or any unfair business
practice either in an administrative hearing or court suit within the last five years.
Contractor represents and warrants that within the last five years it has not been
found guilty or liable of any investigation or proceeding by any federal or state
securities regulator under any federal or state securities laws or regulations.
G) Prohibited Responses and Contracts. Pursuant to Texas Government Code
2155.004-006, Contractor certifies that the individual or business entity named in
this form is eligible_to receive the specified contract and acknowledges that any
contract concerning this certification may be terminated and payment withheld if
this certification is inaccurate.
H) Financial Interests and Gifts. Contractor certifies that neither Contractor nor
any person or entity that will participate financially in a contract has received
compensation from DFPS for participation in preparation of specifications for a
contract. Contractor certifies that it has not given, offered to give, and does not
intend to give at any time, any economic opportunity, future employment, gift,
loan, gratuity, special discount, trip, favor, or service to any public servant or
employee in connection with a contract.
71.
List of Attachments. The following documents are attached hereto and incorporated
herein by this reference:
Attachment A 24-Hour Residential Child Care Rates
Attachment B Residential Child Care Contract Glossary
Attachment C Service Level
Attachment D
E

B)
Form 2282cx
June 2012
Contract shall not be construed as a waiver of a subsequent breach of the same

covenant, term or condition, and any such waiver shall not be deemed to be a
waiver of any other or subsequent breach and shall not be construed to be a
modification of the terms of the Contract The consent or approval by the
Department shall not be construed as a waiver of a subsequent breach of the same
covenant, term or condition. The consent or approval by the Department to any act
of the other party requiring such consent or approval shall not be deemed to waive
This Contract shall not be construed to waive any rights, duties, or immunities that
either party has under the laws of the State of Texas and the United States.
74.
unenforceable under present or future laws, then it is the intention of the parties that
the remainder of this Contract shall not be affected and that, to the extent of any such
invalidity, illegality, or unenforceability, there be added as a part of this Contract a
clause or provision of similar terms as may be legally possible in order to make the prior
intent of such clause or provision legal, valid, and enforceable.
75.
Limitation on Authority. The Contractor will have no authority to act for or on behalf
of the Department or the State of Texas except as expressly provided for in this
Contract; no other authority power or use is granted or implied. The Contractor may
not incur any debts, obligations, expenses, or liabilities of any kind on behalf of the
State of Texas or the Department.
76.
Survivability. Termination for any reason does not release the Contractor from
performance, liability or obligation in the Contract that is expressly stated to survive
such termination or by its nature would be intended to be applicable following any such
termination, which includes but is not limited to confidentiality, indemnification,
transition, records, audit, dispute resolution, invoice, and continuing to provide care for
a Child after termination as provided for in Section 61 of this Contract.
77.
Entire Agreement. This Contract constitutes the entire legal and binding agreement
between the parties, who have duly authorized, executed, and delivered this Contract in
accordance with its terms. The undersigned representatives have the authority to
execute and agree to this Contract on behalf of their respective represented party.
78.
Term. This Contract is effective September 1, 2012 through August 31, 2014
unless terminated sooner as provided for in this Contract.
Texas Department of
Services: ()
Contractor:
Sputpwest KeJrograms, Inc.
/
//
.


Attachment "A"
Form 2282cx
June 2012

bstructure
CPA
Basic Foster Family
t$39.52
$22.15
Basic Facility
l$42.18
Moderate CPA
$71.91
$38.77
$96.17

Moderate Facility
Specialized CPA
l$95.79
!$49.85
'$138.25
Intense CPA
$175.66
$88.62
$242.85
Intense Facility
are Services
,, .
Service Level
.
'
Basic
Moderate
Specialized
Intense
'
'
Minimum Daily Amount tC) be

Reimbursed to a Foster Family
5
$38.77
$49.85
$88.62

Form 2282cx
June 2012

Attachment "B"
Aging-Out Seminars: Seminars that focus on transitioning foster Children residing in DFPS licensed
or verified foster care ages 15 V2 to 18 by offering opportunities on an annual basis to enhance a
youth's knowledge about the DFPS-Transitional Living Services (TLS) programs, benefits, resources
and other relevant life skills topics.
activities;
viii.Adequate to protect Children against natural elements, such as rain, snow, wind, cold, sun and
insects.
Behavioral Health Services: Services for the treatment of
or substance related


Attachment "8"
Form 2282cx
June 2012
iv.
v.
vi.
Developing and updating of service plans;

Stewarding direct contact with Children and the foster parents or other caregivers; and
Performing any additional activities that may consist of planning and coordination of services
to Children and the foster families based on current needs and functioning;
C) Orientating, assessing, and verifying foster parents; and
D) Monitoring and providing support services to foster parents, including the initiation of
development plans, corrective actions, or adverse actions.
Case Management Services: Any service referenced in the Case Manager definition or in services
referenced in the 40 TAC 749.663 or 748.561.
Caseworker: A DFPS employee who provides casework services to Children in Substitute Care
under the conservatorship of the State. When the Contract requires approval from or notification of
the Caseworker, the Contractor may utilize the Caseworker's Chain of Command if the Contractor is
unable to contact the Caseworker.
Casey Life Skills Assessment: An assessment of a Child's independent living skills designed to be
completed by both the Child and the Caregiver. The Child and Caregiver results are combined into a
report which provides an indication of the skill level and readiness of the Child to live independently
and creates the opportunity for the Caregiver and Child to talk about the Child's life skills.
communicate with the Caseworker. The typical Department Chain of Command is as follows:
education 1 and service planning.
https://qawww.dfps.state.tx.us/Child Care/Search Texas Child Care/ppFacilityLogin.asp
provided to each foster Child to meet the Child's
needs while in Substitute Care.


Attachment "8"
Form 2282cx
June 2012
Corrective Action Plan: Specific corrective actions required of the Contractor by the Department in
order to maintain compliance with Service Levels, applicable federal or state regulations, and the
terms and conditions of this Contract.
paid in response to claims processed through the Child's Medicaid health plan.
CPS Transition Plan: A plan to address the issues that are important for all Children 16 and older
as they prepare to leave care and enter the adult world. The plan helps the Child, providers and
Caseworkers identify what services are needed to accomplish goals and it is incorporated into the
Cultural Competence: The ability of individuals and systems to provide services effectively to
people of various cultures, races, ethnic backgrounds, and religions in a manner that recognizes,
Designated Victim: A Child determined as such by an investigation resulting in a disposition of
Reason to Believe (RTB) and entered in the data system (Reference Section 6610 of the Licensing
Policy and Procedures Handbook (LPPH)). A Designated Victim will be counted when the disposition is
decision of the Administrative Review body (Reference Section 7710 of the LPPH).
Direct Service Delivery: Service providers who have direct access to providing services, supervision
or delivery of treatment components as referenced in the Residential Child Care Contract Components
of Care
DFPS Child Care Licensing Public and Provider Website:
in DFPS substitute care that enable them to access
such as


Attachment "8"
Form 2282cx
June 2012
Residential Child-Care Contractors, Foster Parents, Kinship Caregivers, and the Children.

personal restraint, mechanical restraint, emergency medication/ and seclusion.
Experiential life Skills Activities: Activities which engage the Child in learning new skills,
attitudes, and ways of thinking through hands-on learning opportunities. Experiential life-skills
training is tailored to a Child's skills and abilities and may include training in practical activities that
include grocery shopping, meal preparation and cooking, using public transportation, performing
basic household tasks, balancing a checkbook, and managing personal finances.
http://www.dfps.state.tx.us/PCS/Residential Contracts/default.asp
Extended Foster Care: A program for Children 18 to 22 years old who are eligible, and have signed
an agreement to participate in this program. A Child who turns 18 years of age while in the
conservatorship of DFPS, is eligible for Extended Foster Care services through the end of the month in
which the Child reaches the age limit referenced in A) through E), so long as sufficient documentation
is provided on a periodic basis as required by the terms of the Child's Extended Foster Care
Agreement to demonstrate that the Child is:
GED up to the Child's 22nd birthday.
program up to the Child's 21st birthday. These Children can remain in care to complete
D) Employed for at least 80 hours per month up to the Child's 21st birthday; or
birthday.(40 TAC 700.316)
Extracurricular Activities: Outside the regular academic curriculum, including athletic, social, and
cultural events.
Face-to-Face: A meeting held in person as opposed to videoconferencing or any other similar form
of technology.
Facility: Any Residential Child-Care operation including Child-Placing Agencies and General
Residential Operations.
Family Member(s): For the purposes of this contract, a person who is a Relative or Fictive Kin of
the
in
relation to
to meet the child's


Attachment "B"
Form 2282cx
June 2012
i. Required information (see TAC 749.2447)

ii. An assessment of the information obtained to determine whether the applicant meets the
requirements for verification; and
iii. An evaluation of the information obtained in order to make recommendations about the
applicant's capacity to work with children, including but not limited to age, gender, special
needs, and number of children (Minimum Standards and TAC749.2445).

B) In cases where:
i. A Child placed in a foster home or child-care institution is the parent of a son or daughter who
is in the same home or institution, and
ii. Payments described in Subsection A) are being made under this part with respect to such
Child, the foster care maintenance payments made with respect to such Child as otherwise
determined under Subsection A) shall also include such amounts as may be necessary to cover
the cost of the items described in that Subsection with respect to such son or daughter. (42
USC, Chapter 7, Section 675 (4))
Foster Parent: A person receiving foster care maintenance payments from a CPA. This term does
not apply to Contractor staff from other programs and Intermittent Alternate Care providers. This
term is specific to Child-Placing Agency programs.
programs at local address, city, or zip code through Head Start locator
Health Passport: An electronic health information system for the medical information of Children in
Healthy Racial and Ethnic Identity: A
sense
and ethnic


Attachment "B"
Form 2282cx
June 2012
Historically Underutilized Business (HUB): A minority or women-owned business as defined by

Texas Government Code, Chapter 2161.
the needs of Children and families receiving services.
needs.
Child-Placing Agency as part of the agency or home's regulated child care and that lasts more than
72 consecutive hours.
Kinship (Relative) Caregivers: Unlicensed Caregivers whom the court has approved for a Child's
placement because they are related to the Child, or have a Fictive Kin relationship to the Child.
Management Services: Peripheral services that do not include core programmatic components but
include support of these services; which includes, but is not limited to the provision of quality
assurance, performance improvement, oversight, monitoring, service-related policy and procedure
development/enhancement, development of corrective action plans, performance evaluation, disaster
emergency response plan development.
pursuant to the Texas Family Code Chapter 153. (TAC 700.501(9))
Medical Care: The prevention, treatment, and management of illness and the preservation of
mental and physical well-being through the services offered by the medical and allied health
professions.
function or


Attachment "8"
Form 2282cx
June 2012
in Transition Database. Children and their Caregivers complete the National Youth in Transition
Non-Public School: A school that is not a Public School; however is accredited by the TEA for the
purposes of contracting and providing special education classes.
system, organization, program or among individuals, which enables staff and volunteers to work
to honor and respect the beliefs, language, interpersonal styles, and behaviors of individuals and
Performance Management Evaluation Tool (PMET): An Internet-based data collection and
reporting system for DFPS Contractors to self-report performance measure data.
Permanency Goal: The Department's permanency goals are subcategories of the four goals
identified by the Texas Family Code 263.3026. The categories are as follows:
A) Family Reunification;
B) Adoption by a relative or suitable individual (Relative/Kinship Adoption or Unrelated Adoption);
C) Permanent Managing Conservatorship to a relative or suitable individual (Relative/Kinship
Conservatorship or Unrelated Conservatorship);
D) Another planned permanent living arrangement (Foster Family- DFPS Conservatorship, other
Family DFPS Conservatorship, Independent Living or Community Care).
A safe and permanent living situation for the
A committed
for the
which the
Texas Dept. of Famity


Attachment "8"
Form 2282cx
June 2012
Personal Documents: Identification documents provided to the Child. At 16 years of age, a Child
is provided with a certified copy of their birth certificate, social security card, and Texas identification
card. At 18 years of age, a Child is provided with a certified copy of their birth certificate, social
security card, and Texas identification card, immunization records, information contained in their
health passport, proof of enrollment in Medicaid, and information about a Medical Power of Attorney.
These documents are required to be provided per the Texas Family Code 264.014 and Patient
Protection and Affordable Care Act (P.L. 111-148)
or other benefits, which include, but are not limited to, medication, Medicai/Healthcare Items,
luggage, toys, money, gift cards, allowances, televisions, radios, and CDs and electronics.
Preparation for Adult Living (PAL) Activities: Benefits and services provided to Children in
DFPS-paid Substitute Care who are age 16 or older and likely to remain in foster care until at least
age 18, who can qualify for services up to their 21st birthday. Services and benefits may include:
A) Casey Life Skills Assessment to assess strengths and needs in life skills;
B) Life Skills training in core areas including financial management;
C) Job readiness and life decisions/responsibility;
D) Educational/vocational services;
E) Transitional Living Allowance (TLA) up to $1000 (distributed in increments up to $500 per
F) After Care Room and Board (ACRB) assistance, based on need, up to $500 per month for rent,
G) Case management to help Children with self-sufficiency planning and resource coordination;
H) Teen conferences;
I) Leadership development activities; and
J) Additional supportive services, based on need and availability of funds, such as mentoring
Primary Care Physician (PCP): Primary Care Physician is a physician or provider who has been
designated by STAR Health to provide a Medical Home to Members and who is responsible for
providing initial and primary care to patients, maintaining the continuity of patient care, and initiating
referral for care.
Primary Medical Needs: A Child with Primary Medical Needs is one who cannot live without
mechanical supports or the services of others because of non-temporary, life-threatening conditions
(40 TAC 748.61, 749.61 and 750.61).
Programmatic Services:
which include Child-Care ._.,nm-ac


Attachment "8"
Form 2282cx
June 2012
Reason to Believe (RTB): A finding of RTB means that a preponderance of evidence indicates
abuse/neglect/exploitation occurred. If any allegation disposition is RTB, the overall case disposition
is RTB.
Receiving Contractor: Any individual or legal entity designated by and contracting with DFPS, after
having received the Form 2085-FC, to provide or be responsible for the Residential Child Care of the
Child.
Relative: A person connected to a Child by blood, marriage, or adoption.
Representative: A foster parent, caregiver (including kinship caregiver), or Residential Child Care
provider who, for purposes of the Texas Residency Affidavit, confirms that the Child resides or
receives services at the address provided on the DPS Form DL-5.
treatment of an unrelated Child or Children for 24 hours a day that occurs in a place other than the
Child's own home.
Return for Extended Foster Care: Young adults who were in DFPS managing conservatorship
when turning 18 years of age and left care on turning 18 or later for a period of Trial Independence
(TI) can return to participate in Extended Foster Care if eligibility criteria are met and there is an
available placement.
School-Age Children: Children eligible for Pre-Kindergarten through 12th Grade.
treatment of a Child or Children. This includes, but is not limited to, suicide attempts, injuries
abusive treatment.
(Superior/Cenpatico) to facilitate development of a health care service plan and coordination of
clinical services among a member's primary care physician and specialty providers to ensure
members with special health care needs have access to, and appropriately
necessary covered services.
interact in various social situations.


Attachment "8"
Form 2282cx
June 2012
Special Immigrant Juvenile Status: A designation that enable eligible undocumented Children in
STAR Health Denial Letter: A letter informing a Child's Caregiver that a request for service
Substitute Care: The residential care and support provided to a:
A) Child in the Department's managing conservatorship who has been placed in a living situation
B) Child who has turned 18 years of age and has voluntarily agreed to participate in the
Department's Extended Foster Care program and meets the requirements of such.
Telecommunications: The transmission, emission, or reception of voice and/or data through any
medium by wire, radio, other electrical electromagnetic or optical means. Telecommunications
includes all aspects of transmitting information, such as telephone, text messaging,
videoconferencing, and any type of communication via the internet including Voice Over Internet
Protocol (VOIP), e-mail, social networking, instant messaging, and wireless data exchange.
Texas Health Steps: A Children's program under Medicaid which provides medical and dental
preventive care and treatment to Medicaid-enrolled Children from birth to 21 years of age.
Therapy: The provision of assistance and guidance in resolving personal, social, or psychological
problems and difficulties through a collaborative process that facilitates progress toward mutually
determined treatment goals and objectives. Therapy is provided by a trained professional who
demonstrates competence in the ability to appropriately use treatment modalities for individuals,
families and groups.
Trauma Informed Care {TIC) Training:


Attachment "8"
Form 2282cx
June 2012
Children with Emotional Disorders, Mental Retardation, Pervasive Developmental Disorder, and
Primary Medical Needs as described in 40 TAC 748.61.
Trial Independence: Trial independence (TI) is a period of time that allows a Young Adult who was
in DFPS managing conservatorship when turning 18 years of age to leave care on turning 18 or later
for up to six months or up to 12 months with a court order for this, to see if he or she can live
independently. If necessary, the Young Adult can return to foster care during this period for Extended
Foster Care if eligibility criteria are met.
vocational schools for eligible Children who are in DFPS conservatorship:
A) On or after their 18th birthday; or
B) The day they receive their high school diploma or its equivalent; or
C) At age 14 or older are eligible for adoption. (Texas Education Code, 54.211.)
documents the Child's agreement to voluntarily remain in Foster Care after their 18th birthday and
outlines the categories of activity which qualify a Child to remain in Foster Care.
Well-being Specialists: DFPS liaisons to Superior, the company that operates the provider network
for STAR Health, a Medicaid managed care health care program for Children in DFPS conservatorship
and young adults who have aged out of care. Contact information for regional Well-being Specialists
can be found at: http://www.dfps.state.tx.us/About/Renewai/CPS/medical.asp


Attachment "C"
Form 2282cx
June 2012

700.2301.
BASIC SERVICE LEVEL
maintain or improve the Child's functioning including:
1)
Routine guidance and supervision to ensure the Child's safety and sense of security;
2)
Affection, reassurance, and involvement in activities appropriate to the Child's age and
development to promote the Child's well-being;
3)
Contact, in a manner that is deemed in the best interest of the Child, with family members and
other persons significant to the Child to maintain a sense of identity and culture; and
4)
paraprofessionals, on an as-needed basis, to help the Child maintain functioning appropriate to
the Child's age and development.
700.2303.
CHARACTERISTICS OF A CHILD THAT NEEDS BASIC SERVICES
A Child needing basic services is capable of responding to limit-setting or other interventions. The
Children needing basic services may include:
1)
the Child's age and can be corrected.
2)
A Child with developmental delays or mental retardation whose characteristics include minor to

1)
which most activities are designed to improve the Child,s functioning including:
A.
More than routine guidance and supervision to ensure the Child,s safety and sense of
security;
B. Affection, reassurance, and involvement in structured activities appropriate to the Child's
professionals or paraprofessionals to help the Child attain or maintain functioning
2)
700.2323. CHARACTERISTICS OF A CHILD WHO NEEDS MODERATE SERVICES


Attachment "C"
Form 2282cx
June 2012
A.
3)
4)
Substance abuse to the extent or frequency that the Child is at-risk of substantial
problems; and
A Child with developmental delays or mental retardation whose characteristics include:
B. Moderate impairment in communication, cognition, or expressions of affect.
A Child with primary medical or habilitative needs, whose characteristics include one or more of
the following:
condition;
700.2341. SPECIALIZED SERVICE LEVEL

A.
2)
24-hour supervision to ensure the Child's safety and sense of security, which includes close
and professionally designed and supervised to help the Child attain functioning appropriate
to the Child's age and development.
competence.

A Child needing specialized services has severe problems in one or more areas of functioning. The
Children needing specialized services may include:
1)
A. Unpredictable non-violent, anti-social acts;
B. Frequent or unpredictable physical aggression;
C. Being markedly withdrawn and isolated;
D.
actions to include recent suicide

Form 2282cx
June 2012

activities;
A Child with primary medical or habilitative needs whose characteristics include one or more of
the following:
condition;
the interventions needed by Children in their care.
C.
4)

Attachment "C"


Attachment "C"
Form 2282cx
June 2012

1)
the Child's access to environments as necessary to protect the Child. The caregivers have
A. 24-hour supervision to ensure the Child's safety and sense of security, which includes
and other persons significant to the Child, to maintain a sense of identity and culture;
scheduled and professionally designed and supervised to help the Child attain functioning
more appropriate to the Child's age and development; and
E. Consistent and frequent attention, direction, and assistance to help the Child attain
stabilization and connect appropriately with the Child's environment.
2)
In addition to the description in Subsection 1) of this Section, a Child with developmental
delays or mental retardation needs professionally directed, designed and monitored
interventions to enhance mobility, communication, sensory, motor, and cognitive development,
and self-help skills.
3)
habilitative needs requires frequent and consistent interventions. The Child may be dependent
A Child needing intense services has severe problems in one or more areas of functioning that
present an imminent and critical danger of harm to self or others. The Children needing intense
services may include:
1)
hygiene.
2)
A Child who abuses alcohol, drugs, or other conscious-altering substances whose characteristics
3)
A Child with developmental delays or mental retardation whose characteristics include one or
A. Impairments so severe in
skills that the Child's
to
constant one-to-one


Attachment "C"
Form 2282cx
June 2012
100 Supervision
8100.01 The Caregiver provides a supportive setting, preferably a family that is designed to
maintain or improve the Child's functioning by establishing clear rules appropriate to the
developmental and functional levels of the Child.
8100.02 The Caregiver establishes a clear system of rewards and consequences.
8100.03 The Caregiver supervises a Child through guidance to ensure the Child's safety and sense
of security.
admission and service plans, age of Child, high-risk behaviors and any other factors
independence.
M100 MODERATE SERVICE LEVEL SUPERVISION

The Caregiver provides supervision that is required at the Basic Service Level
M100.01 The Caregiver provides more than routine supervision with additional structure and
M100.02 For a Child with developmental delays, mental retardation, primary medical or habilitative
needs, the Caregiver provides regular daily supervision.
M100.03 For a Child with primary medical or habilitative needs the caregiver provides, as
and monitoring from a Caregiver.
S100 SPECIALIZED SERVICE LEVEL SUPERVISION
explaining how the program is structured to stabilize or improve the Child's functioning.
S100.02 The provider has specialized training to provide therapeutic and habilitative support and
S100.03 The provider has an adequate number of caregivers available at all time to meet a Child's
into account the Child's age,
and mental
and
5100.05
5100.06


Attachment "C"
Form 2282cx
June 2012
1100 INTENSE SERVICE LEVEL SUPERVISION

1100.01 The Caregiver has specialized training to provide intense therapeutic and habilitative
access.
1100.02 An adequate number of caregivers are available to provide 24-hour supervision.
1100.03 For a Child with developmental delays or mental retardation the caregiver provides 24hour supervision.
1100.04 For a Child with primary medical or habilitative needs the caregiver provides 24-hour close
supervision and, as appropriate, frequent and continuous interventions which typically
consist of hands-on physical intervention, assistance, and monitoring from a caregiver.


Attachment "C"
Form 2282cx
June 2012

8101 BASIC SERVICE LEVELS
standards.
M101 MoDERATE SERVICE LEVELS-
standards.
S101 SPECIALIZED SERVICE LEVELS
standards.
S101.01
throughout the night whenever necessary to meet the needs of a particular Child.

1101.01
During all waking hours the child-to-caregiver ratio must be no more than 5 to 1.
1101.02
During sleep hours the Caregiver's child-to-caregiver ratio must meet the applicable
1101.03
There are enough caregivers, to provide 24-hour supervision to ensure the Child's safety
1101.04
The staffing patterns and assignments are documented in writing. The documentation
1101.05
The written staffing plan documents the ability to provide 1 to 1 child to caregiver ratio for
24 hours whenever necessary to meet the needs of a particular Child.


Attachment "C"
Form 2282cx
June 2012
200 - Medical
8200.01 The Caregiver arranges for medical and dental
services as determined by an agreement

8200.02 The Caregiver documents in the Child's record that the Child received these services.
8200.03 The Caregiver ensures that all the medications the Child needs are administered as
8200.04 The Caregiver ensures Children are taught age and developmentally appropriate sex
The Caregiver arranges for or ensures the same medical and dental services that are required at the
M200.01
For a Child, receiving psychotropic medication, a physician, as often as clinically necessary

and appropriate, must monitor the Child's condition.
M200.02
For a Child, with developmental disabilities, mental retardation, primary medical or

5200 SPECIALIZED SERVICE LEVEL MEDICAL AND DENTAL
routine medical, nursing and psychiatric services based on the needs of the Child as
identified in the Child's service plan. The plan or agreement for medical, nursing and
S200.02 For a Child with developmental disabilities, mental retardation, primary medical or
treatments.
1200 INTENSE SERVICE LEVEL MEDICAL AND DENTAL SERVICES
1200.02


Attachment "C"
Form 2282cx
June 2012
nursing supervision; 24-hour availability of nursing, medical, and psychiatric services; and
1 to 1 supervision during the provision of medical and dental services.


Attachment "C"
Form 2282cx
June 2012
300-Recreation
8300 BASIC SERVICE LEVEL RECREATIONAL AND LEISURE-TIME SERVICES
8300.01 The Caregiver ensures that opportunities to participate in community
activities, such as
events, are available to the Child.
8300.02 The Caregiver organizes family activities that identify, recognize and reinforce the support
that is available to the Child.
M300.01 The Caregiver arranges and supervises structured daily routines for the Child that includes
M300.02 The Caregiver ensures the activities are designed to meet the Child's therapeutic,
M300.03 The Caregiver documents the daily routine and the recreational and leisure-time activities
the Child participated in.
M300.04 The Caregiver allows enough flexibility in the daily routine and the activities for the Child to
M300.05 The Caregiver provides activities that are modified to meet any restrictions or limitations,
due to a Child's developmental disability, mental retardation, or medical condition.
S300.01 The structured daily routine and the recreational and leisure-time activities are designed to
address the needs of the Children in care.
S300.02 The therapeutic value of each activity based on the Child's service plan is documented.
S300.03 If the Child has primary medical or habilitative needs, recreational and leisure-time
1300.01 An interdisciplinary team of professionals who are qualified to address the Child's individual
included in the Child's service plan.
1300.02 If the Child has primary medical or habilitative needs, the recreational and leisure-time


Attachment "C"
Form 2282cx
June 2012
400- Education

arranged and ensured for each Child.
B400.02 Reasonable support and assistance will be provided for each Child who qualifies as a
special education student under the Individual with Disabilities Education Act to ensure
that the appropriate educational and related services, including Early Childhood
Intervention, are available in the least restrictive environment appropriate. This may
include the necessity to participate in the Admission, Review and Dismissal Committee to
develop the Individual Education Plan explaining how the student will be educated.
A Child needs:
B401.01 a Public School accredited by the Texas Education Agency (TEA);
B401.02
B401.03

M400.01
S400 SPECIALIZED SERVICE LEVEL EDUCATIONAL SERVICES

S400.01 The Caregiver must coordinate the Child's educational and related services with the Child's
S400.02 The Caregiver must designate a liaison with the Child's school.
S400.03 The Caregiver must document the liaison's involvement in the Child's schooling.
S400.04 The Caregiver must document a written description of the relationship between the
1400 INTENSE SERVICE LEVEL EDUCATIONAL SERVICES
In addition to the educational services required at the Specialized Service

1400.01
One to one
O>ULHJUI


Attachment "C"
Form 2282cx
June 2012

Services that are designed to maintain and improve the Child's functioning are provided in a family
setting.
8500.01 Assistance and support in developing or maintaining social skills appropriate to the Child's
8500.02 Affection, reassurance and involvement in activities appropriate to the Child's age and
development to promote the Child's well being must be provided.
8500.03 Support in helping the Child adjust to the current placement must be provided.
8500.04 Access to therapeutic, habilitative and medical support addressing the Child's particular
needs, as specified in the Child's service plan must be provided. If therapeutic habilitative
M500.01
M500.02
MS00.03
M500.04
M500.05
M500.06
M500.07
The provider also ensures completion of a diagnostic assessment on each Child within 30
days of admission. The assessment must address the Child's strengths and needs in the
interventions in an environment designed to help the Child attain or maintain functioning
Children who need therapy by professional therapists or counselors or paraprofessional
habilitative program addresses the Child's individual needs.
If the Child qualifies for substance abuse services, the provider arranges for a substance
therapy.
In addition to the casework and
5500.01
5500.03
services that is
at the Moderate Service


Attachment "C"
Form 2282cx
June 2012

1500.01 The Child is provided with frequent and intense therapeutic, habilitative and medical
interventions that are individually designed to stabilize the Child's condition.


Attachment "C"
Form 2282cx
June 2012
501- Service Plans

8501.01 A service plan must be developed within 30 calendar days of the Child's admission.
8501.02 The service plan must be based on the Child's plan for permanency.
8501.03 The service plan must identify strengths and document strategies to address the Child's
skills appropriate to the Child's age and development, family contact needs; social needs;
8501.04 The caregiver and the Child, as appropriate, actively participate in the development,
8501.05 The provider must periodically review service plans according to the appropriate licensing
standard.

M501.01 The provider must have a case manager to coordinate implementation of the service plan.
M501.02 The provider must develop a service plan based on the diagnostic needs assessment for
each
A.
B.
C.
D.
E.
Child within 30 calendar days of the Child's admission. This plan must include:
An estimate of the length of time the Child will remain in care;
A description of the goals of service;
Specific instructions for caregivers;
A transition plan; and
Documentation of:
i. The plan having been shared with the Child and the Child's parents or managing
conservator; and
ii. The Child's care to date.
M501.03 The provider must, when reviewing a service plan:
A.
Evaluate the services to date that have been provided to the Child in each domain or
function; and
B.
Identify any additional need that has arisen since the previous service plan was
developed.
S501 SPECIALIZED SERVICE LEVEL SERVICE PLAN REQUIREMENTS

S501.01 An initial service plan for each Child is developed within 72 hours of the Child's admission.
S501.02 The diagnostic needs assessment and service plan for each Child are developed by an
Children with similar characteristics who has a master's
in a mental health field
from an accredited
and
or
1501.02


Attachment "C"
Form 2282cx
June 2012
planned to help the Child achieve and maintain a condition allowing a lower Service Level;
1501.04 Criteria for re-evaluating the Child's condition after 90 days and deciding whether to
Service Level; transfer the Child to a less restrictive setting; or refer the Child to an
and supervise each Child's service plan.


Attachment "C"
Form 2282cx
June 2012
502 Training
understand the needs and characteristics of Children in care provide the care and
emotional support that Children need and appropriately manage Children's behavior.
Note: First-aid and cardiopulmonary-resuscitation training cannot be counted toward meeting this
annual training requirement. However, hours earned renewing First-aid and cardiopulmonary
resuscitation may be counted toward the annual requirement.
749.951.
8502.03 Each direct care staff must receive trauma informed care training annually. Each newly
hired direct care staff must receive trauma informed care training within 60 days of hire or
foster home verification. Certification of completed trauma informed care training must be
placed in staff and foster parent records containing the training staff signature, completion
date and number of hours. Trauma Informed Care training is available at no cost at the
following website: http://www.fostercaretx.com/about-us/centene-corporation/training/.
Note: No minimum hours of trauma informed care training is required. Hours earned for trauma
informed care training may be counted towards pre-service training requirements.

M502.01 Each Caregiver must receive pre-service training in areas appropriate to the needs and
characteristics of Children in care. At the conclusion of pre-service training, every foster
population of Children that the foster family serves.
M502.03 All Caregivers who administer psychotropic medications must receive training on
M502.04 A licensed physician, a registered nurse, or a pharmacist must conduct Training on
M502.05 The trainer assesses each
after the psychotropic medication training, to ensure
that the
has learned the course content.
M502.06


Attachment "C"
Form 2282cx
June 2012

New Caregivers without previous experience in a residential childcare may not be assigned
sole responsibility for any Child until the new caregiver has been supervised for at least 40
hours while conducting direct child-care duties. An experienced Caregiver must be
physically available to each new caregiver at all times, until the new Caregiver acquires the
supervised experience. The provider must document the supervised child-care experience
of every caregiver who provides direct care to Children. Documented verification of a
serve, such as Children with primary medical needs, pervasive development disorders,
S502.02 All Caregivers must receive 50 hours of training each year with the exception of caregivers
in foster homes verified by child-placing agencies,
S502.03 Caregivers in foster homes verified by child-placing agencies must meet the following
requirements: for homes with two or more caregivers, each Caregiver must receive at
least 30 hours of training; OR for homes with one Caregiver, the Caregiver must receive at
least 30 hours of training.
S502.01
503 Personnel
M503.01
M503.02
providing services to Children who have been removed from their homes.
M503.03
Each staff member with primary administrative and clinical responsibility for managing the
A.
B.
C.
Has a master's degree in social work or another field of human services, and is an
licensed and qualified
under the
the


Attachment "C"
Form 2282cx
June 2012

therapy.
therapeutic services and types of intervention provided to, the Children in care.
provide therapeutic interactions.

M503.07 The provider has enough appropriately qualified paraprofessional or professional staff
available on a full-time, part-time, or consulting basis to assess and address the needs of
all the Children in care.

M503.09 The provider has ensured that the professional-staffing plan assigns responsibilities for
treatment services.

S503.01 The provider arranges for interventions such as individual, group, and family therapy to be
the service plan.

1503.02 The individual treatment program is developed by an interdisciplinary team to address the
Child's intense needs.


Attachment "D"
Form 2282cx
June 2012

Child-Placing Agency as part of the agency or home's regulated child care. The purpose of
Intermittent Alternate Care is to provide relief to the primary Caregiver. For the purpose of this
Contract, an Intermittent Alternate Care episode is one that lasts for more than 72 hours. Any
episode lasting fewer than 72 hours is not considered Intermittent Alternate Care.
A) The
to:
i.
ii.
iii.
iv.
Department may allow contracted Child-Placing Agencies to utilize Intermittent Alternate Care
Increase the retention of Foster Parents;
Decrease the number of moves Children experience; and
Promote the overall development and permanency needs for Children in foster care.
B) Child-Placing Agencies that are permitted to use Intermittent Alternate Care must do so according
to the following guidelines:
than 72 hours;
the Caseworker or the Caseworker's supervisor as soon as it is determined the Child needs
Intermittent Alternate Care for more than 14 days in order to secure a new placement for the
Child;
and
designee.
C) When providing Intermittent Alternate Care, contracted Child-Placing Agencies must:

and safety of all Children in Intermittent Alternate Care;
ii. Ensure that Intermittent Alternate Care is not detrimental to the Child;
Approve each
of Intermittent Alternate Care in their homes and each time one of their
uses Intermittent Alternate Care for Child

b.
c.
d.
e.
f.
g.
h.
i.

Attachment "D"
Form 2282cx
June 2012

The Child's medication regimen and instructions;
and
include:
of age and older;


Attachment "E"
Form 2282cx
June 2012


Attachment "F"
Form 2282cx
June 2012

Database.
dates: September 1 through November 30, December 1 through February 28/29, March 1 through
Indicator: Percentage of business days that the Contractor updated its own information in the
Target: 90%
Methodology:
https://gawww.dfps.state.tx.us/Child Care/Search Texas Child Care/ppFacilityLogin.asp

dates: September 1 through November 30, December 1 through February 28/29, March 1
Indicator: Percentage of School-Age Children in DFPS conservatorship for 30 calendar days or
more whose Education Portfolios are updated within 30
of all items requiring a
education needs.


Attachment "F"
Form 2282cx
June 2012
Data Source:
Performance Management Evaluation Tool (PMET): information reported by the Contractor:
i.
Number of School-Age Children in DFPS care for 30 calendar days or more whose
Education Portfolios were updated within 30 calendar days of all items listed in Section
15.B)i requiring a portfolio change during the performance period.
ii.
Number of School-Age Children in DFPS care for 30 calendar days or more.
Methodologv:
The numerator is the total number of School-Age Children with updated Education Portfolios as
described in the Data Source.
The denominator is the total number of School-Age Children as described in the Data Source.
Output #3: The Child's placement is stabilized.

September 1 through November 30, December 1 through February 28/29, March 1 through May
31, and June 1 through August 31.
Indicator: Average length of stay for Children who left a placement during the performance
period, excluding certain reasons for discharge as described in the methodology.
targets.
Purpose: The purpose of this measure is to determine the Contractor's ability to meet a Child's
Methodology for CPA: The denominator is the count of all placements that ended during the
period, except those ended for the following reasons:
i. Caregiver moved
ii. Court ordered emancipation/legally married
iii. Child
in adoption
Child
with
closer


Attachment "F"
Form 2282cx
June 2012
iii. Child placed in adoption

iv. Child placed with relatives/fictive kin
v. Child placed in closer proximity to parent/relative
vi. Not least restrictive
vii. Exceeds 14 day limitation of being away from placement
viii.Not verified/licensed to serve
The numerator is the sum of the number of days in placement for all placements included in the
placement.
Methodology for GRO-Basic Child Care or GRO-Emergency Shelter: The denominator is the
count of all placements that ended during the period, except those ended for the following reasons:
i. Court ordered emancipation/legally married
ii. Child placed in adoption
iii. Child placed with relatives/fictive kin
iv. Child placed in closer proximity to parent/relative
v. Not least restrictive
vi. Exceeds 14 day limitation of being away from placement
vii. Not verified/licensed to serve
The numerator is the sum of the number of days in placement for all placements included in the
placement.
Output #4: Children in substitute care experience minimum moves.

CPAs.
This output only applies to
Performance Period: Contractor performance for this output is determined annually but
measured throu hout the Contract eriod.
Indicator: Percentage of times Children placed with the Contractor experience two or fewer
placements while in any one unbroken episode of care.
targets.
Purpose: The purpose of this measure is to evaluate the Contractor's effectiveness to provide
the Child stability by working with the Child, DFPS and the foster family to minimize placement
changes.
Data Source: IMPACT


Attachment "f"
Form 2282cx
June 2012
Output #5: Children placed with a Contractor remain in the care of the Contractor
Indicator: Percentage of discharged Children who do not experience a discharge initiated by the
Contractor, with the exception of specific reasons determined to be, generally, in the best interest
of the Child.
targets.
Purpose: The purpose of this measure is to reduce unplanned discharges of Children initiated by
the Contractor.
Data Source: IMPACT
Methodology:
The numerator is the number of placement discharges initiated by the Contractor during the
performance period, excluding those discharges for the specific reasons determined to be in the
best interest of the Child.
The denominator is the total number of placement discharges during the performance period.
Contract Outcome Measures.

Outcome #1: Children are safe in care.
Indicator: Percentage of Children under age 18 in contracted Residential Child-Care placements
and in DFPS Managing Conservatorship who are not determined to be Designated Victims
Upheld
the
period.
in a Reason to Believe


Attachment "F"
Form 2282cx
June 2012
Data Source: IMPACT; information used for the performance period:

i. Facility (operation) as described in 40 TAC 745.37(3)(A)-(I), with an active Contract;
ii. Number of DFPS placements in the contracted Facility that were active at any point during
the performance period; and
iii. Number of Designated Victims at the Facility for which a disposition of RTB was Upheld.
Methodology: The numerator is the number of Children who are/were in DFPS Managing
Conservatorship, placed with the Contractor, and Designated Victims determined by a Residential
Child-Care Licensing (RCCL) investigation, for which a disposition of RTB was Upheld during the
performance period.
The denominator is the total number of Children in DFPS managing conservatorship placed with
the Contractor during the performance period.
Divide the numerator by the denominator. Subtract the result from one (1) to obtain the
complimentary 'Children not Designated Victims' measurement. Multiply by 100 and state as a
percentage.
Outcome #2: Children are able to maintain healthy Connections with caring Family Members
who can provide a positive influence in their lives.
Indicator: Percentage of Children in care seven or more days who have at least one Personal
Contact during the performance period with a Family Member, excluding parents and siblings,
identified as appropriate for contact by DFPS.
targets.
Purpose: The purpose of this measure is to assess the Contractor's ability to help the Child
maintain beneficial Connections with Family Members, other than the parents or siblings.
Data Source: PMET: information reported by the Contractor:
i.
Number of unduplicated Children in the Contractor's care seven or more days who had at
one Personal Contact initiated
the Contractor
the
with


Attachment "F"
Form 2282cx
June 2012
Outcome #3: Children are able to maintain connections to siblings.

Indicator: Percent of Children in care who have at least monthly Personal Contact with each
sibling in foster care, as described in Section 21 of this Contract.
targets.
Purpose: The purpose of this measure is to evaluate the Contractor's ability to help the Child
maintain connections with siblings who are also in foster care. This relates to Item 13 of the Child
and Family Services Review (CFSR) of the US Health and Human Services Administration for
Children and Families.
Data Source: Performance Management Evaluation Tool (PMET); information reported by the
Contractor:
Number of Children under age 18 who have had at least one Face-to-Face contact with
i.
each sibling placed within 100 miles, or at least two Telecommunications contacts with
each sibling placed more than 100 miles away, for each month during the performance
period.
Number of Children under age 18 who are part of a sibling group for each month during
ii.
the performance period. Exceptions to this include when sibling contact is prohibited
by court order, contrary to the best interest of the Child as reflected in any of the Plans
of Service of a sibling, or for reasons determined and documented by a mental health
professional treating the sibling who should not visit.
Methodology:
The numerator is the number of Children who are part of a sibling group and had the specified
contact(s) each month, as stated in the Data Source.
The denominator is the number of Children who are part of a sibling group, as stated in the Data
Source.

Attachment "F"
Form 2282cx
June 2012
Purpose: The purpose of this measure is to determine the extent to which the Contractor is
helping Children participate in a regular schedule of varied recreational activities they enjoy.
Data Sources:
i.
Contract Monitoring - Children interviewed at monitoring determined to have
participated in one or more routine recreational activities (numerator).
ii.
Integrated Management and Reporting for Contracts (iMARC) - Number of Children
identified as a statistically valid sample and interviewed (denominator).
Methodology: Divide the numerator by the denominator. Multiply by 100, and state as a
percentage.
TExAsDEPARTMENTOFFAMJLY AND PROTECTIVE SERVICES
COMMISSIONER
John J. Specia, Jr.
January 14, 2013

ELECTRONIC MAIL
Juan Sanchez
6002 Jain Lane
Austin, Texas 78721
RE:
FY 2013 Unilateral Amendment; Amendment #1

Contract# 23393175
Dear Mr. Sanchez:

Under Contract Term 59.C.i. of the Residential Child-Care Contract, this email serves
as a unilateral amendment to incorporate new or revised federal , State, or Department
laws, regulations, rules or policies.
Contract Term 42 .C.ii.b. is amended to read, Sections 504 and 508 of the Rehabilitation
Act of 1973 (29 U.S.C. 794): this Contract may be subject to HHS EIR Accessibility
Requirements. If Contractor must comply with HHS EIR Accessibility Requirement,
Contractor must follow terms and conditions at:
http://architecture.hhsc.state.tx.us/myweb/Accessibility/docs/HHSUniformEIRAccessibili
tyCiause.doc
This unilateral amendment is effective upon receipt of this email and will not affect
billing . No further action is necessary on your part.
Sincerely,
Beatrice Ramirez-Martinez, BA
Residential Contract Manager
3635 SE MILITARY DRIVE + SAN ANTONIO, TEXAS 78223 + (21 0) 337-3273

An Equal Opportunity Employer and Provider

Contracts TDFPS and SWK

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Texas Dept of Family

and Protective Services

Residential Child-Care Contract

Facility License Type

agent acting on behalf of DFPS.

Texas Dept of Family

Residential Child-Care Contract

B) If the Contractor is a Residential Child-Care Facility, other than a CPA or Independent

Contractor Warranty. By accepting the Child, the Contractor warrants that:

Texas Dept of Family

Residential Child-Care Contract

Voluntary Extended Foster Care or Return to Foster Care.

CONTRACTED COMPONENTS OF CARE

Children's Rights. The Contractor shall:

Assessment, Service Planning and Coordination.

C) Service Management. The Contractor

Texas Dept of Family

Residential Child-Care Contract

Texas Dept of Family

Residential Child-Care Contract

incorporated into this Contract by reference, may be accessed at:

Routine 24-Hour Child Care.

Texas Dept of Family

Residential Child-Care Contract

Discipline and Crisis Management.

Educational and Vocational Activities.

is placed In a residential Facility:

Texas Dept of Family

Residential Child-Care Contract

Texas Dept of Family

Residential Child-Care Contract

Routine Recreational Activities. The Contractor shall:

Travel. The Contractor shall:

Cultural Competence. The Contractor shall:

B) Meetings as required by the court;

Texas Dept of Family

Residential Child-Care Contract

Maintaining Connections. The Contractor shall:

Providing Testimony. The Contractor shall:

Facility Licensure. The Contractor shall:

Contractor Support and Supervision of Foster Families. The Contractor shall:

required In section 32 of this Contract.

Texas Dept of Family

Residential Child-Care Contract

F) Maintain documentation of all contact with foster families;

Criminal Background Checks for Contractor Employees, Subcontractors and

Departmental Right of Placement.

Removal and Discharge of Children.

Texas Dept of Family

Residential Child-Care Contract

Texas Dept of Family

Residential Child-Care Contract

Use of Department Forms.

Department will complete the Form 2087 within

Texas Dept of Famity

Residential Child-Care Contract

determined at the time of placement, the Contractor will be compensated at the

Texas Dept of Family

Residential Child-Care Contract

Disaster and Emergency Response Plan.

Texas Dept of Family

Residential Child-Care Contract

vii. Identification, location and tracking of children;

and at each r~:~~-~:~~v;;l