Visitation and Continuing Contact with Children
F.  Could the verbiage be changed in this item? Many scenarios make this impossible or impractical. "More than half of contacts made with child shall be in placement setting" ... Suggest it be reworded to say that more than 6 of these contacts shall be in placement setting.  Otherwise, if we see the child in the office 10 times in a month, We need to do 6 home visits that month.  We're sure the intent here is that more than half the minimum required face-to-face contacts shall be in the placement setting.  Otherwise it would surely discourage seeing the child in places other than the placement setting in order to keep the number of home visits required to a reasonable number. Suggest it read “More than one half of the minimum required contacts the licensee makes with a child in any calendar year shall be conducted in the child’s placement setting.”

G.1. "... 7 days between ... contacts".  While we understand and agree with the intent here, this will be very difficult to monitor and pose real practical problems from time to time.  Suggest an exception, if child is placed during the last seven days of the month, 2 visits may occur within 7 days, to be no closer than 24 hours apart. This would satisfy the DMAS requirement of two visits in a month that are necessary to bill for Medicaid TFC Case Management.

9.               Service Plans
B.2. "Within 45 days ... an individualized service plan and an individualized comprehensive treatment plan."  The use of the conjunction 'and' implies two plans.  Would be a little less confusing to state 'an individualized service plan or individualized service and treatment plan' to distinguish the Service Plan from the Service/Treatment Plan.

C.  "in .. case of short-term foster care placement ... shall develop and implement plan within 72 hours."  Is this intended to apply to programs offering respite care to bio families from the community?  If so, then the requirement to have a full-blown service plan written in 72 hours will greatly discourage agencies from developing or continuing this service.  The purpose of these programs is to offer families temporary respite and relief, not to treat their child which would be difficult in so short a period of time.  It takes our staff at least one full day to write the initial comprehensive service plan.

10.           Quarterly Progress Summaries

11.           Discharge from care

12.           Case Record Requirements ... mixes all three sets of records (client, provider & birth family)
A.& O. The regulation proposed in A. requires a separate case file for the child’s birth parents whereas the regulation proposed in O. states if services are provided to the child’s birth family a file shall be maintained. O. goes on to state the child’s birth family file may be separate or combined with the child’s file. Could we receive clarification on what seem to be contradictory requirements? N.1-10 Child's file: Items 1 thru 10 are a little confusing as organized here.  For instance it is not clear which items address required content for the face sheet (1 only or 1 thru 5)

P. "... file on each adoptive family"  In typical foster to adopt situations, it has always been confusing as to whether one or two files for the provider are required.  Only one seems needed.

Q. "Narrative Case notes ..." Would seem better to put this section under the Child's file section.

R.  Would seem better to put these final rules above in the general rules section for all records/files.

13.           Behavior Support & Crisis Intervention

Part VII

Article I

Permanent Foster Care 22VAC-40-131-400

1.               Applicability

2.               Children placed in Permanent Foster Care
This section appears to apply only to custodial agencies.  TFC and other non-custodial foster care programs facilitate placements in Permanent Foster Homes which they have approved, but do no legal or other work (Agreements etc.) related specifically to the permanency issue.  Suggest guidance to clarify this fact here and in the adoption section below.

Article 2

Short-Term Foster Care 22VAC-4-131-410

1.               Applicability –

2.               Children Placed in Short-term Foster Care
-Pleased to see short term foster care being considered and addressed. C. Concern how the licensee shall inform the provider of the child’s treatment and service plan at the time of placement of the child if they are a community based youth who doesn’t currently reside in foster care custody and show on weekends. Suggest defining difference of short term placements from short term foster care services, and allowing current guidance material for short term placements to be entered as regulation in these standards, without requiring a variance for programs admitting short term placements or respite placements to youth not permanently placed in foster care.

Article 3

Independent Living Arrangements

1.               Applicability

2.               Youth placed in Independent Living Arrangements

Article 4

Treatment Foster Care 22VAC40-131-460

1.               Applicability

2.               Children Placed in Treatment Foster Care
B.4.c. Regulation proposed “Provides for at least one full time professional staff AND part time staff whose hours are equivalent to a full time position.” Should this regulation read “Provides for at least one full time professional staff OR part-time staff whose hours are equivalent to a full time position?

D.Regulation as proposed requires a written plan for back-up emergency care if placement disrupts. Suggest this be met through a general statement such as “another approved home provider within the agency. The requirement of another specific home would be unrealistic as the needs of children placed in a provider home fluctuate as does foster home provider capacity.

Article 5

Adoption

1.               Applicability

2.               Fees for Adoption Applications and Services

3.               Adoption Counseling and Services for Birth Parents

4.               Involuntary Termination of Parental Rights

5.               Provisions for Adopting Children with Special Needs
A. Assume here that the custodial agency has the responsibility to register child with the Adoption Resource Exchange.  Should be clarified.

B.  Most TFC agencies that do adoption do foster to adopt.  Parents are approved as TFC/foster parents first but willing or can be talked into adopting the placed child if the fit is right.  Their primary interest is not first in adoption and therefore it would seem to be inappropriate to register them with the Exchange.  There are a few parents whose interest is primarily in adoption and it would be totally appropriate to register them on the Exchange.  Can this be clarified here?

6.               Selecting an Adoptive Home

7.               Adoption Placement Agreement

8.               Placements requiring Legal Risk Agreement

9.               Adoptive Placement of Children over one year of age;  additional provisions

10.           Parental Placement Adoption Services

11.           Parent-recommended Homes for Adoptive Placements

12.           Post-placement responsibility for Adoptive Home Placements

13.           Intercountry Placement Adoptions

14.           Interlocutory Orders of Adoption

15.           Subsequent Adoptive Placements

Intercept Youth Services applauds all of the individuals who put time, energy, sweat and tears into the rewrite of these regulations many times over since 1989. I appreciate the improved balance and realistic view of our work, and look forward to the assistance of strong guidance material that will continue to help shape the workability of these regulations so the intent of the regulations to protect and serve children well in foster care is honored. Thank you for considering my comments