ESBD_File_235902_Package 1 - Evaluation and Treatment.docx

Jaime Masters, Commissioner Open Enrollment For

Evaluation and Treatment Services Enrollment Number: HHS0009678

Enrollment Period Opens: April 25, 2021

Enrollment Period Closes: August 31, 2026 NIGP Class/Item Code:

961-75

Texas Department of Family and Protective Services Evaluation and Treatment Services Open Enrollment Number: HHS0009678

Addendum #1 – June 17, 2021

TABLE OF CONTENTS

1. GENERAL INFORMATION

1.1 Introduction. The Health and Human Services Commission (HHSC) on behalf of the Department of Family and Protective Services (DFPS or Department) Child Protective Services (CPS) is issuing this Open Enrollment to enter into contracts with qualified Applicants for Evaluation and Treatment Services.

1.2 Point of Contact. The sole point of contact for questions and communications for this Open Enrollment is Delayne Williams at delayne.williams@dfps.texas.gov.

1.3 Open Enrollment HHS and ESBD Enrollment Posting, Amendments and Announcements. HHSC Procurement and Contracting Services (PCS) will post all official communication on behalf of DFPS for this Open Enrollment on the HHS Enrollment and Electronic State Business Daily (ESBD) site at:

HHS Enrollment (https://apps.hhs.texas.gov/pcs/openenrollment.cfm) ESBD (http://www.txsmartbuy.com/sp)

1.3.1 DFPS reserves the right to revise this Open Enrollment at any time, including the closing date of this Open Enrollment. Applicants must comply with any changes, amendments, or clarifications posted to the HHS Enrollment and ESBD site by HHSC PCS.

1.3.2 It is the responsibility of the potential Applicant to check the HHS Enrollment and ESBD site periodically for any updates to this Open Enrollment and to comply with these requirements. The Applicant’s failure to periodically check the HHS Enrollment and ESBD site will in no way release them from any responsibility or additional costs to meet the requirements of complying with the Open Enrollment and resulting Contract.

1.4 Open Enrollment Schedule

Table 1 - Procurement Schedule

1.4.1 DFPS may adjust the closing date for this Open Enrollment for a specific Region to meet DFPS’ and its clients’ needs. Furthermore, DFPS may re-open this Open Enrollment and the enrollment period, to add a specific Region to meet DFPS’ needs.

1.4.2 All Adjustments to this Open Enrollment will be posted on the HHS Enrollment and ESBD site (See Section 1.3).

1.5 Open Enrollment Background

1.5.1 DFPS Mission. The mission of DFPS is to promote safe and healthy families and protect children and vulnerable adults from abuse, neglect, and exploitation.

1.5.2 CPS Purpose. The purpose of the Child Protective Services (CPS) Program is to keep children safe while partnering with parents and other family members, the community, and our providers to achieve permanency and improve child well-being.

1.6 Eligible Applicants. To be eligible to receive a Contract award through this Open Enrollment, Applicants must comply with the following:

1.6.1 Submit an Evaluation and Treatment Services Application and Required Forms (See Section 5.1).

1.6.2 Not be debarred from receiving any federal or state funds at the time of the Contract award.

1.6.3 Be legally authorized to do business in the State of Texas and determined to be "Active" by the Texas Comptroller of Public Accounts. Applicants can check their status at:

https://mycpa.cpa.state.tx.us/coa/search.do.

1.6.4 Accept the requirements of this Open Enrollment by executing the Application in Section 5.1.

1.7 Open Enrollment Application Contract Documents

The Applicant, if awarded a Contract for this Open Enrollment, will be referred to as a “Contractor,” and agrees to comply with this Open Enrollment, the Evaluation and Treatment Services Contract executed between the Parties, DFPS Vendor Uniform Terms and Conditions, and DFPS Vendor Supplemental and Special Conditions for Regional Contracts, which are located on the DFPS public website, Doing Business With DFPS, Contracting Forms: https://www.dfps.state.tx.us/Doing_Business/forms.asp

1.7.1 If awarded a Contract, the Applicant will execute an Evaluation and Treatment Services Contract prepared by DFPS.

1.7.2 The Contract term will begin no sooner than September 1, 2021 and will end on August 31, 2026.

1.8 Delegation of DFPS Authority. State and federal laws generally limit DFPS’s ability to delegate certain decisions and functions to a Contractor, including but not limited to policy-making and final decision-making authorities on the acceptance or rejection of services provided under a Contract.

1.9 Texas Public Information Act. Any information submitted to DFPS in response to this Open Enrollment is subject to public disclosure in accordance with the Texas Public Information Act (the Act), and Government Code Chapter 552. DFPS will process any request for information comprising all or part of any information submitted to DFPS by the Applicant in accordance with the Act.

If an Applicant claims that information contained in any materials submitted to DFPS is exempt from required public disclosure under the Act, the Applicant must clearly identify such information and the applicable exemptions in the Act and explain in detail why such exemption is applicable.

For information concerning the application of the Act’s provisions to Applicant's Application and proprietary information, Applicants may consult the following:

Attorney General’s website: http://www.oag.state.tx.us, http://www.oag.state.tx.us/open/index.shtml Public Information Handbook: https://www.texasattorneygeneral.gov/files/og/publicinfo_hb.pdf

1.10 Use of Ideas by the State of Texas. DFPS reserves the right to use any and all ideas presented in an application unless the Applicant presents a valid legal case that such ideas are a trade secret or confidential information and identifies the information as such in its application.

An applicant may not object to the use of ideas that are not the Applicant’s intellectual property and so designated in the application that are known to DFPS before the submission of the application, are in the public domain through no fault of DFPS or become properly known to DFPS after application submission through other sources or through acceptance of the application.

1.11 Copyright Restrictions. DFPS will not consider any application that bears a copyright.

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2.

STATEMENT OF WORK

2.1. DFPS Mission

The mission of DFPS is to protect children, the elderly, and people with disabilities from abuse, neglect, and exploitation by working with clients, families, and communities.

2.2. Program Purpose

The purpose of the Child Protective Services (CPS) Program is to keep children safe and practice in a way that ensures safety, permanency and well-being for the children and youth we serve. CPS focuses on children and their families and seeks active involvement of the children’s parents and other family members, and the community to solve problems that lead to abuse or neglect. The objectives of CPS are to:

2.2.1. Prevent further harm to children and to keep children with their families when possible;

2.2.2. Provide permanence for children in substitute care by resolving danger or enhancing parental protective factors and returning children to their families;

2.2.3. Provide permanence for children who cannot return to their families.

2.3. Contract Goals and Objectives

DFPS seeks to Contract with qualified providers for Evaluation and Treatment Services to assist CPS in achieving program purpose and objectives.

2.3.1. Contract Goals

A. Provide Evaluation and Treatment Services to families and caregivers who DFPS has identified as being at risk for child abuse and neglect or are in DFPS conservatorship in order to enhance protective factors in the family and prevent child maltreatment.

B. Aid children in the development of skills to manage and overcome trauma resulting from incidents of abuse or neglect.

2.3.2. Contract Objectives

A. Assess the parental actions of parents/caregivers to provide clinically guided behavioral health care services to overcome trauma, re-establish healthy relationships, and to ensure child safety and basic and developmental needs are met.

B. Provide clinically guided behavioral health care services that address parent/caregiver actions that are imperative to child safety and the developmental/emotional needs of children.

C. Provide clinically guided behavioral health care services to aid children and youth toward developing skills to overcome trauma and re-establish healthy relationships with parents/caregivers and others (siblings, other relatives, teachers, etc.).

2.4. Contracted Evaluation and Treatment Services

DFPS purchases the following direct client services to meet the individual need for evaluation and treatment.

2.4.1 Evaluation Services

A. Psychosocial Assessment (A psychosocial assessment is required in order to provide treatment services.)

B. Psychological Services (Evaluation & Testing)

2.4.2 Treatment Services

A. Individual Counseling B. Group Counseling C. Family Counseling

2.4.3 Support Services (Required at DFPS Request)

A. Court Related Services B. Diagnostic Consultation C. Translator and Interpreter Services

2.5 Service Delivery Areas

2.5.1 The open enrollment for Evaluation and Treatment Services is released on a statewide basis; however, contracts are awarded on a regional basis. The Contract is for the DFPS Regions which can be located in Package 2 Application and Required Forms. Some regions are further divided into specific service delivery areas referred to as catchment areas.

A. The Contractor must provide services within the contracted service delivery area selected when properly authorized and as requested by DFPS.

B. Service hours must be flexible and include afternoon, evening, and weekend hours to accommodate working clients. The Contractor must accommodate school age children by scheduling services at times that do not interfere with school attendance and participation in school activities, preferably outside of school hours. See Package 2 Application and Required Forms.

The Contractor must coordinate a therapeutic location for services.

C. Services provided outside of the Contractor's location must be requested and approved in writing by the CPS caseworker as documented in the Comments Section of the Valid Service Authorization, Form 2054 (Form 2054), in referral information received from the CPS caseworker, or email, etcetera. Alternate acceptable and billable locations are as follows:

2.5.2 In-office services consist of services provided in the Contractor’s office or satellite office, as applicable.

2.5.3 Out-of-office services consist of services delivered in a location other than the Contractor's primary or satellite office or the client's home.

2.5.4 Home-based services consist of services provided in the client's home.

2.5.5 Telehealth services consist of services provided that involve direct face-to-face interactive video communication between the client and the provider. In order to provide telehealth services, the Contractor must also provide either In-Office, Out-of-Office, or Home-based services in the same region(s) and counties in which they are electing to provide telehealth services.

A. Contractor must provide telehealth services in compliance with standards established by the respective licensing or certifying board of the professional providing the services.

B. Telephone conversations, chart reviews, electronic mail messages, and fax transmissions alone do not constitute a telehealth interactive video service and DFPS will not reimburse such as telehealth services.

C. The audio/visual fidelity and clarity and field of view of the telehealth service must be functionally equivalent to an evaluation performed on a client when the provider and client are both at the same physical location.

D. Telehealth services are reimbursed at the same rate as In-Office services. See Fee Tables in Section 3.3.2 Fee Schedules.

2.6 Eligible Population

2.6.1 Contractor must provide services must to individuals and families (clients) referred directly by CPS staff.

2.6.2 Clients referenced in this document include:

A. Children, youth, parents, or caregivers involved in an open CPS case (does not include contracted placements);

B. Children not served under the foster care Medicaid model (Star Health); and C. Involuntary clients.

2.7 Client Characteristics

Contractor must be prepared to serve individuals with characteristics including, but not limited to the following.

2.7.1 Children with behavioral or emotional problems due to abuse or neglect;

2.7.2 Children who need help adjusting to separation from parents, family, siblings, community, or need help adjusting to returning to parents after any placement outside the home or in paid foster care; or

2.7.3 Parents or caregivers who are responsible for the care of abused and neglected children and need these services as a means of preventing future abuse or neglect.

2.8 Service Authorization and Referral Process

CPS will refer Clients who receive services under this contract through a Service Authorization (Form 2054), whether services are billable to DFPS or Texas Medicaid (including Traditional Fee-for-Service or a Medicaid Managed Care Organization).

2.8.1 Authorization Form

Only services authorized on a Valid Service Authorization, Form 2054 may be billed (see Glossary for additional information).

A current Form 2054 and Referral Form K-903-2036 must be received prior to services being rendered.

A. Contractor must maintain Form 2054 authorizing the service and Referral Form K-903-2036 in each client's record as basis for payment from DFPS.

B. The following claims will be subject to non-payment or collection if payment has already been made:

1) Service types not authorized.

2) Services delivered by a person not meeting the minimum qualifications or not having received prior DFPS approval.

3) Service claims that exceed the number of units or fall outside the timeframes specified on Form 2054.

4) Medicaid eligible without an acceptable denial.

2.8.2 Referral Information

A. Contractor must not provide service without a valid 2054 Service Authorization and Referral Form K-903-2036. Contractor must receive client background information prior to service delivery. Additional background information can be shared in a variety of documents, including but not limited to a child plan, family plan, court report, prior reports, or assessments. Contractor may obtain additional information verbally from the referring CPS caseworker.

B. Contractor must follow any case specific instruction provided in the Comments Section of the Form 2054 or in the referral documents.

2.8.3 Initiating Services

A. Contractor must make initial contact within 72 hours of receipt of the 2054 and Referral Form K-903-2036. When this timeframe cannot be met, the Contractor must notify the CPS caseworker of reason and maintain documentation in the client's record. This includes, but is not limited to:

1) If a service location, date and time cannot be agreed upon; or

2) If a client is non-cooperative.

B. Contractor must provide the authorized service(s) within ten (10) business days of receipt of the 2054 and Referral Form K-903-2036. When this timeframe cannot be met, the Contractor must notify the CPS caseworker of the reason and maintain documentation in the client's record.

C. It is anticipated that emergencies may occur requiring a need for immediate services. Contractor must work closely with CPS to expedite service delivery as requested, at no additional cost to DFPS or the client.

D. In some cases, the information provided at referral may have changed. If unable to reach the client for any reason, Contractor must do all of the following:

1) document each contact attempt including the method of contact used;

2) contact the CPS caseworker requesting alternate or updated client contact information; and document this request.

2.9 Service Description

All aspects of service provision must reflect the diversity of the communities being served to ensure that services to children and families are culturally and linguistically competent. Service providers must have:

2.9.1 A thorough understanding of the individual and family's culture, including traditions and societal norms within the community where they will be receiving services;

2.9.2 An understanding of the impact of oppression on the lives of populations served;

2.9.3 Adequate language skills to serve the needs of substantially limited-English-speaking communities and also the hearing- and visually-impaired communities; and

2.9.4 An understanding of the full range of sexual orientations, currently summarized as LGBTQQIAP (lesbian, gay, bisexual, transgender, queer, questioning, intersex, ally and pansexual).

2.9.5 Contractor must conduct all services with sensitivity to the following areas including, but not limited to:

A. Age B. Gender C. Disability D. Medical/Psychiatric History/Functioning E. Level of Education F. Development/Disability Needs Contractors must fully comply with the Americans with Disabilities Act and the Rehabilitation Act of 1973. Under these laws, Contractors must provide reasonable accommodations to qualified individuals with disabilities, unless doing so would provide undue hardship.

2.9.6 Client Orientation to Services

Contractor must provide the client with an informational packet in the client's primary or preferred language consisting of the following Contractor information:

A. Description of services offered B. Hours of operation C. After hours emergency contact D. Local community's behavioral health care crisis response information E. Client's rights, programs rules, and privacy protections F. Client Orientation Acknowledgement Form 5624 G. The Contractor must ensure that the clients sign and date the completed orientation Form 5624 and files the form in the client file. Form 5624 is available on the DFPS website at the following link.

https://www.dfps.state.tx.us/Doing_Business/Purchased_Client_Services/Regional_CPS_Contracts/forms.asp

2.10 Evaluation Services

Evaluation services are systematic determinations involving an array of methods to aid in the identification of conditions and events that have directly correlated to child safety and risk of abuse and neglect. The primary purpose of evaluation, in addition to gaining insight into the client's history and current functioning, or existing initiatives, is to enable reflection and assist in the identification of future change.

2.10.1 Psychosocial Assessment

A Psychosocial Assessment is a face-to-face mental health assessment conducted by a clinician with a current and valid license to operate in the state of Texas.

Contractor must generate the psychosocial assessment from the information gathered during the Intake and Initial Assessment and review of referral documents and other documents provided by the CPS caseworker.

The client will initially be referred for a Psychosocial Assessment in order to determine if Treatment or Psychological Services are recommended, and, if so, which services would be beneficial, the frequency, and the duration.

Psychosocial assessments identify cognitive-behavioral issues that interfere with the parental protective actions to provide child/children safety and will include the identification of the cognitive and behavioral effects of child abuse and trauma on the child/children within the family. In addition, the assessments include the identification of interventions needed to meet the child/children's basic and developmental needs; and concerns from the child's perspective that interfere with safety, permanency, well-being and daily activities.

The psychosocial assessment consists of the Intake and Initial Assessment.

A. Intake The Intake is completed at the onset of the parent/caregiver/child's first face-to-face meeting with the provider. The intake gathers information pertinent to the parent/caregiver's strengths, diminished protective actions, and concerns. The Contractor's intake procedures and techniques must be sufficient to respond to the presenting issues and provide appropriate substantiation for the resulting conclusions and recommendations used to develop the Treatment Plan.

1) Required for all Intakes: The Intake consists of the following information obtained from the client/family:

a. The names of household members and familial relationships with the client;

b. Employer and work hours of household members;

c. Child's name, school/daycare's grade, hours and days of attendance;

d. Each member's Medicaid, if applicable;

e. The age and gender of all household members;

f. The preferred language spoken in the home;

g. The individual/family's cultural and religious affiliations;

h. The issues identified in the CPS client referral form (Form #K-903-2036);

i. The identification of parent and child concerns, what is working well within the family and what needs to happen or change to enhance family functioning;

j. The identification of parent/caregiver strengths, diminished protective capacities and unmet needs of the child;

k. The parent/caregiver perception of family issues and problems directly resulting in their CPS involvement or child in care with CPS;

l. The parent(s)/caregiver(s) willingness to address and problem solve family/parenting issues identified, and other family members they may be able to engage for support;

m. The parent(s)/caregiver(s) safety plan to ensure protection of their child/children from abuse or neglect;

n. The parent(s)/caregiver(s) report on family domestic violence, substance use and mental health conditions within present and extended families; and

o. The parent(s)/caregiver(s) perception on how the family is meeting the basic and developmental needs of the child/children, identifying danger, risks, and concerns related to child/children's developmental levels and functional levels.

2) Additional considerations if attachment/bonding issues between parent/caregiver and child or siblings are identified:

a. Early relationship losses and demonstrated resolution of losses;

b. Identify the actions needed to demonstrate trust, internal controls, reciprocal relationships, self-esteem and self-worth;

c. Modulation of affect as demonstrated in parent/caregiver/child relationships;

d. Identification of pro-social behaviors and attitudes, as well as responses to external structure and societal rules and demonstration of these actions;

e. Identification of distorted thinking patterns and correction of thinking errors and patterns resulting in pro-social behaviors and actions; and

f. Any other clinically recommended actions and services.

2.10.2 Initial Assessment

A. The identified issues are prioritized by the clinician in order of:

1) child safety;

a. individual safety;

b. family safety; and

c. family strengthening.

2) These identified issues must be addressed in the initial or subsequent treatment plans developed by the client's treatment team, which is composed of:

a. parent(s)/caregiver(s)/child;

b. family and other significant support identified by the family;

c. CPS caseworker;

d. clinician(s) providing individual and family therapy;

e. psychologist/psychiatrist; and

f. other specialty providers involved in aiding the family.

2.10.3 Report Content Requirements

The CPS caseworker must receive a complete typewritten report within ten (10) business days of a client participating in the initial face-to-face session.

2.10.4 Parent/Caregiver Report must include but is not limited to the following components:

A. Reason for referral: a summary of the events resulting in the individual's involvement with CPS from the client's perspective and as reported by CPS caseworker.

1) The caseworker's concerns and recommendations consisting of:

a. Current Status: Must include a description of the individual's current emotional and interpersonal functioning and problems. This must include information about present living situation; pertinent family; medical conditions and prescribed medications; employment; and educational and vocational functioning.

b. History: must include a thorough summary of the individual's level of functioning.

i. In relationships (family/marital/extended family)

ii. Medical/psychiatric histories (hospitalizations, suicide attempts/gestures)

iii. Medical conditions/surgeries, and medications for chronic/crisis conditions

iv. Criminal history

v. Substance usage history consisting of first use of substances, frequency of use, substance abuse treatment, and longest period of substance abstinence

vi. Employment and occupational history

vii. Military history

c. Clinical summary: a statement of parenting actions (strengths and weaknesses) and identified treatment issues ranked in order of priority.

i. Diagnostic Impression per current Diagnostic and Statistical Manual for Mental Disorders (DSM).

ii. Recommendations of appropriate interventions or any additional psychological testing, psychiatric evaluation or other specialty services that may be needed.

iii. Date and manner in which the report was submitted to the CPS caseworker.

iv. Date, signature and credential(s) of the performing provider.

B. Child Report: must include but is not limited to the following components:

1) A description of the circumstances that led to the child's referral.

2) The child's criminal history, if applicable.

3) A description of the child's strengths, weaknesses and behaviors, including appropriate and maladaptive behavior, and any high-risk behavior posing a risk to self or others.

4) Any history of physical, sexual, or emotional abuse or neglect.

5) Current mental health and substance abuse status, including available results of any psychological or psychiatric evaluations, mental health and substance abuse history.

6) The child's current developmental level of functioning and developmental history.

7) The child's current educational level, any school problems, and school history.

8) A description of the child's home environment and family functioning.

9) Child's skills and special interests.

10) The services planned to address the child's needs, including long-range goals and objectives.

11) A statement of the child's perception of the home environment, substitute care placement or Parental Child Safety Placements.

12) For children under age 5, current Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood.

13) Recommendations of appropriate interventions or any additional psychological testing, psychiatric evaluation or other specialty services that may be needed.

14) Date and manner in which the report was submitted to the CPS caseworker.

15) Date, signature and credential(s) of the performing provider.

2.10.5 Client Record Documentation Requirements

Contractor must maintain the following information in the client's file.

A. Beginning and ending time supporting the unit(s) of service billed. The unit(s) of service consists of the length of time spent conducting the psychosocial assessment (intake and initial assessment), and B. A copy of the Psychosocial Assessment Report submitted to the CPS caseworker.

See additional Client Record Documentation Requirements in subsection 2.14.

2.10.6 Billing Requirements

A. Contractor must only bill for actual time spent face to face with the client to complete the Intake and Initial Assessment, up to a maximum of three (3) hours, billed under service authorization code 86U, Psychosocial Assessment.

B. Contractor may bill up to one (1) unit for writing a comprehensive report, billed under service authorization code 86U, Psychosocial Assessment.

C. Contractor must not bill more than a maximum of four (4) units total, which includes up to 3 hours maximum for completing the intake and initial assessment with the client and only 1 hour for writing the report.

D. Contractor must bill based on number of units authorized and provided. Billing increments are:

1) 1 hour = 1 unit

2) 45 minutes = .75 unit

3) 30 minutes = .50 unit

4) 15 minutes = .25 unit

E. Refer to Invoicing Procedure for Psychological and Treatment Services for details on billing, located on the DFPS website at URL https://www.dfps.state.tx.us/Doing_Business/Purchased_Client_Services/Regional_CPS_Contracts/forms.asp

1) Refer to Section 3.2.2 Fee Schedules.

2) DFPS unit of service rate is based on the site of service delivery and is payable as either in office or out of office, home-based, or telehealth.

2.11 Psychological Services

These services must consist of a private face-to-face, one-on-one evaluation and testing that determines the client's level of functioning, developmental levels, protective capacities, identified client needs, IQ, and overall cognitive and emotional functioning.

2.11.1 Psychological Evaluation

A. Provider must conduct a formal face-to-face individualized clinical interview and assessment (in the client's native language or the language that the client is most comfortable speaking or understanding) to determine the client's level of functioning.

B. Provider must review all documents provided by the CPS caseworker.

2.11.2 Psychological Testing

A. These services include the use of standardized psychometric tools aiding in diagnosis and treatment recommendations. Psychological testing is most useful in determining developmental level, IQ, and overall cognitive and emotional functioning.

B. A Licensed Psychologist, Licensed Psychological Associate- LPA or Provisional Licensed Psychologist -PLP under the supervision of a Licensed Psychologist may perform Psychological Evaluation and Psychological Testing.

C. The clinician must provide an oral report to the CPS caseworker and the client to explain and interpret the test results.

2.11.3 Report Content Requirements

The CPS caseworker must receive a complete typewritten report within ten (10) business days of the client's initial appointment. The report must include but is not limited to the following components:

A. Pertinent information regarding the client’s condition to substantiate the need for services including, but not limited to the following:

1) Reason for the evaluation

2) History of the present illness

3) Past psychiatric history

4) History of alcohol and other substance use

5) General medical history

6) Developmental, psychosocial and sociocultural history

7) Relationship history

8) Parenting history

9) Employment, occupational and military history

10) Legal history

11) Family history of psychiatric disorder

12) Mental status examination

13) Behavioral observations during the session

B. Client specific test results including, but not limited to the following:

1) The name of the tests that were performed (e.g., Wechsler Adult Intelligence Scale-Revised [WAIS-R], Rorschach, Minnesota Multiphasic Personality Inventory [MMPI])

2) The location at which the test was performed

3) The name and credentials of each provider involved in the preparation, administration and interpretation of the test

4) The interpretation of the test, which must include narrative descriptions of the findings

5) The treatment being recommended, including how the test results affect the prescribed treatment

6) Any recommendation for further testing, including an explanation that substantiates its necessity

7) Recommendations to CPS for client's Plan of Service

2.11.4 Client Record Requirements

The Contractor must maintain the following information in the client's file:

A. Beginning and ending time supporting face-to-face time spent with the client by each service provider-type (Licensed Psychologist or Licensed Psychological Associate-LPA or Provisional Licensed Psychologist-PLP) involved in the service delivery including, but not limited to:

1) Administering test(s) in a private face-to-face setting with client;

2) Interpreting test results, reporting the test, integrating the test; and

3) A typewritten comprehensive report based on the integrated data.

B. Original testing material, including scoring of test(s) C. Documentation from clinical interview D. Rationale or extenuating circumstances that prevented the provider from completing the testing, such as, but not limited to, the client’s condition requiring testing over two (2) days; client did not return to complete tests, or the client’s condition which precluded completion of the testing See additional Client Record Documentation Requirements in subsection 2.14.

2.11.5 Billing Requirements

A. For a complete Psychological Evaluation, Contractor may bill for actual time documented in section 2.11.4.A up to a maximum of six (6) units of service billed in fifteen (15) minute increments.

B. Contractor must bill based on number of units authorized and provided. Billing increments are:

1) 1 hour = 1 unit

2) 45 minutes = .75 unit

3) 30 minutes = .50 unit

4) 15 minutes = .25 unit

C. Refer to Invoicing Procedures for Psychological and Treatment Services located on the DFPS website.

https://www.dfps.state.tx.us/Doing_Business/Purchased_Client_Services/Regional_CPS_Contracts/forms.asp

D. Refer to Section 3.2.2 Fee Schedules.

E. DFPS unit of service rate is based on the site of service delivery and is payable as either in office, out of office, or telehealth.

F. In order to be compensated for the time spent with the client, Contractor must provide an explanation of the rationale or extenuating circumstance that kept the test from being completed. This includes, but not limited to the following:

1) Situations in which the client's condition required a face-to-face interview or testing over a 2-day period; and

2) Client did not return; or

3) The client's condition precluded the completion of the test.

2.12 Treatment Services

2.12.1 Recommendations from the Psychosocial Assessment or Psychological Evaluation serve as a foundation for treatment services. A Psychosocial Assessment is required in order to provide Treatment services. Treatment services include Individual, Family, and Group Counseling.

The prioritized goals for treatment are as follows:

A. Prevent or reduce the occurrence of abuse and neglect.

B. Assist children and their families in overcoming the effects of abuse and neglect.

C. Provide parent(s)/caregiver(s) with the knowledge and skills needed to change behaviors that affect their ability to protect their children effectively and appropriately.

D. Assist CPS caseworkers in the development of service plans that enhance the diminished parent(s)/caregiver(s)' protective capacities to ensure child safety.

2.12.2 Individual Counseling

Individual counseling consists of private, face-to-face counseling between a client and a clinician to help the client meet his or her treatment goals.

A. Individual Counseling Requirements

1) Client Counseling sessions must be clinically guided by an established individualized treatment plan.

2) Documentation of sessions must include identified obstacles hindering client's participation, and the clinician's assessment of progress or lack thereof correlated to the treatment goals.

3) The clinician must include clinically recommended strategies to aid the client in developing skills to overcome obstacles and engage resistant clients in treatment.

B. Record Documentation Requirements The following information must be maintained in the client's file.

1) Beginning and ending time supporting the unit(s) of service billed. The units of service consist of the length of time spent face to face with the client conducting the counseling session.

2) A copy of the Monthly Progress Report submitted to the CPS caseworker.

See additional Client Record Documentation Requirements in subsection 2.14.

C. Billing Requirements Individual counseling sessions are billed using a per-client and per-hour basis billed in 15-minute increments.

1) Contractor must bill based on number of units authorized and provided. Billing increments are:

a. 1 hour = 1 unit

b. 45 minutes = .75 unit

c. 30 minutes = .50 unit

d. 15 minutes = .25 unit

2) Refer to Invoicing Procedures for Psychological and Treatment Services located on the DFPS website.

https://www.dfps.state.tx.us/Doing_Business/Purchased_Client_Services/Regional_CPS_Contracts/forms.asp

3) Refer to Section 3.2.2 Fee Schedules.

4) DFPS unit of service rate is based on the site of service delivery and is payable as either in-office, out-of-office, home based, or telehealth.

2.12.3 Group Counseling

Group Counseling consists of counseling services provided simultaneously to at least two (2) unrelated individuals to help meet individualized treatment goals.

A. Examples of groups may include the following:

1) Sexual Abuse Therapy

2) Anger Management

3) Attachment and Separation

4) Teen Groups

a. Parenting Teenagers

b. Teenage Parents

5) Family Education or Support Groups

a. Communication skills groups; parent-to-parent communication, and parent-to-child communications

b. Coping skills groups, which includes homemaker, problem solving, decision-making, budgeting, etc.

c. Family-Child education groups; learning to play with children, setting healthy boundaries, learning effective and healthy strategies for disciplining children

6) Special Needs & Education Groups

a. Children with developmental delays consisting of treatment or training to caregivers to assist or support children with developmental delays, not including child day care services

b. Programs for children with intellectual and developmental disabilities consisting of treatment or training to caregivers to assist and support children with intellectual and developmental disabilities, not including child day care services

c. Counseling for foster or pre-adoptive parents consisting of counseling to foster or adoptive parents to support and stabilize placements of children in care and prevent disruptions

d. Other groups as requested by CPS

B. Group Counseling Requirements

1) Group counseling must use evidence-based curricula.

2) Group content must be organized and designed for complete delivery within a series of group sessions. Group members must be allowed to enter a series of sessions at any time.

3) Recommended group size is:

a. between 5-12 unrelated individuals, and

b. no more than twenty (20) for education groups.

4) The Contractor must provide the site for the group.

5) The Contractor must maintain a participant sign-in log.

6) The Contractor must document all cancelled groups. Documentation must include all of the following:

a. Reason for cancellation; and

b. Date, time and method of cancellation notification.

C. Client Record Documentation Requirements The following information must be maintained in the client's file.

1) Beginning and ending time supporting the unit(s) of service billed. The units of service consist of the length of time spent conducting the group counseling session.

2) A copy of the Monthly Progress Report submitted to the CPS caseworker.

See additional Client Record Documentation Requirements in subsection 2.14.

D. Billing Requirements Group counseling sessions are billed using a per-group and per-hour basis billed in 15-minute increments.

1) Contractor must bill based on number of units authorized and provided. Billing increments are:

a. 1 hour = 1 unit

b. 45 minutes = .75 unit

c. 30 minutes = .50 unit

d. 15 minutes = .25 unit

2) Refer to Invoicing Procedures for Psychological and Treatment Services located on the DFPS website at:

https://www.dfps.state.tx.us/Doing_Business/Purchased_Client_Services/Regional_CPS_Contracts/forms.asp

3) Refer to Section 3.2.2 Fee Schedules.

4) DFPS unit of service rate is based on the site of service delivery and is payable as either in-office, out-of-office, or telehealth.

2.12.4 Family Counseling

A. Counseling is provided simultaneously to two (2) or more members of a family to meet family treatment goals. The family group may include parent/caregivers, children, and any other individuals who share a household, without regard to whether they are related to each other.

NOTE: In the event that a family member is unable to attend the first session, the clinician must schedule an appointment with the family member prior to the completion of the family treatment plan.

B. Family Counseling Requirements

The clinician's first family session must consist of a family assessment, attended by all family members identified by CPS in the referral, which serves as a foundation for the development of a Family Treatment Plan.

C. Client Record Documentation Requirements

The Contractor must maintain the following information in the client's file:

1) Beginning and ending time supporting the unit(s) of service billed. The units of service consist of the length of time spent conducting the counseling session.

2) A copy of the Monthly Progress Report submitted to the CPS caseworker.

3) A copy of the Family Treatment Plan.

See additional Client Record Documentation Requirements in subsection 2.14.

D. Billing Requirements

Family counseling billing must be under the name of the oldest Medicaid eligible family member in attendance. If no family member is Medicaid eligible, billing must be under the oldest family member's name.

1) Contractor must bill based on number of units authorized and provided. Billing increments are:

a. 1 hour = 1 unit

b. 45 minutes = .75 unit

c. 30 minutes = .50 unit

d. 15 minutes = .25 unit

2) Refer to Invoicing Procedures for Psychological and Treatment Services located on the DFPS website.

https://www.dfps.state.tx.us/Doing_Business/Purchased_Client_Services/Regional_CPS_Contracts/forms.asp

3) Refer to Section 3.2.2 Fee Schedules.

4) DFPS unit of service rate is based on the site of service delivery and is payable as either in-office, out-of-office, home based, or telehealth.

2.12.5 Treatment Plan

A. A Treatment Plan is a clinically guided course of delivered services founded on evaluation recommendations and aimed at promoting changes in attitudes and behaviors leading to enhance protective capacities of parents/caregivers to ensure child/children safety, permanency and well-being.

B. Treatment Plan Requirements Contractor must develop an Initial Treatment Plan based on the Intake and Initial Assessment and referral information received from the CPS caseworker.

Mutual agreement is preferred, and clinical recommendations are noted in the report.

1) A typewritten Initial Treatment Plan must be developed from evaluation recommendations within the first two (2) counseling sessions.

a. The Initial Treatment Plan for Individual Counseling must include the following components.

i. Identification of issues from the specific evaluations and assessments (psychosocial/psychological/psychiatric) with recommended issues to be addressed with agreement between the client and CPS caseworker;

ii. Ranking by priority of identified issues with measurable goals, objectives and strategies resulting in a detailed plan for services and treatment activities discussed with the client and CPS caseworker;

iii. Substantiation of clinically recommended modalities with projected duration and frequency;

iv. Clearly defined discharge goals that indicate treatment can be successfully accomplished;

v. A copy of the initial treatment plan must be submitted to the client and CPS caseworker within ten (10) business days of the completed treatment plan; and

vi. Date, signature and credential(s) of the performing provider.

b. The Initial Treatment Plan for Family Counseling must include the following components:

i. Identifying family roles;

ii. Relationship issues among each family member;

iii. Recommended behavior changes for each family member;

iv. Clinical assessment and recommendations for family;

v. Family Treatment Plan; and

vi. Date, signature and credential(s) of the performing provider.

2) A typewritten Updated Treatment Plan must be completed at each three (3) month interval or when changes in treatment are clinically recommended and discussed with the client and CPS caseworker.

a. The content of the Updated Treatment Plan (Individual or Family) must include the following:

i. New or revised goals, objectives and strategies resulting in a detailed plan for services and treatment activities discussed with the client and CPS caseworker;

ii. Status on prior goals, objectives and strategies (progress, lack of progress, obstacles) with clinically substantiated recommendations for changes, modifications or additions; and

iii. Date, signature and credential(s) of the performing provider.

b. A copy of the updated treatment plan must be submitted to the client and CPS caseworker within ten (10) business days of the completed treatment plan.

c. Date and manner in which the report was provided to the client and submitted to the CPS caseworker.

C. Treatment Services Monthly Progress Report

1) A Monthly Progress Report is a typewritten, comprehensive summary including a clinical assessment identifying progress, obstacles, and recommendations. The Monthly Progress Report must provide information directly related to client(s) participation or lack thereof established by treatment goals and objectives. CPS will use information provided in this report to assess child safety or report client progress to the court.

2) Monthly Report Requirements

a. A typewritten Monthly Progress Report is required for clients participating in one (1) or more individual, group, or family counseling or education sessions.

b. The CPS caseworker must receive the Monthly Progress report by the tenth (10th) business day of the month following the month of service.

c. The report must include, but is not limited to the following components:

i. Name of client(s)

ii. Dates of session(s)

iii. Location of session(s); if out-of-office, home-based or telehealth, briefly describe how provider ensures a therapeutic environment

iv. Type of service(s) provided (individual, group, family counseling, group education)

v. Missed appointments and reasons

vi. Current goals of treatment including a detailed summary describing client's progress/participation or lack thereof in meeting goals identified in the current Treatment Plan

vii. As appropriate, recommendation for closure, early termination, or extension of services

viii. Date and manner in which the report was submitted to the CPS caseworker

ix. Date, signature and credential(s) of the performing provider

3) Additional report requirements for Group Sessions include:

a. Attendance dates and session topic

b. Detailed summary of client's participation

c. A detailed description of the client's ability to process and implement new information

d. Changes in client's behaviors and conditions that demonstrate enhanced or diminished protective actions contributing to child safety

e. Any significant occurrences, such as disruptive behaviors, inattentiveness, or other information useful in case planning.

D. Treatment Services Closure Summary Report This report describes a discharge from Treatment Services that has been discussed in advance with the client and CPS caseworker. Mutual agreement is preferred, and clinical recommendations are noted in the report.

1) Contractor must submit a typewritten Closure Summary Report for each client indicating service will not continue in the following month.

2) The CPS caseworker must receive the Closure Summary Report within ten (10) business days following the month of service.

3) The report must include, but is not limited to the following components:

a. Name of client;

b. A detailed summary describing client's participation or lack thereof in meeting treatment goals identified in current Treatment Plan(s);

c. Reason for case closure and clinical recommendations;

d. Date, signature and credential(s) of the performing provider; and

e. Date and manner that the Closure Summary Report is submitted to the CPS caseworker.

2.13 Support Services

2.13.1 Support Services are an array of services that aid in ensuring child safety, permanency and well-being. Support Services include:

A. Court Related Services B. Diagnostic Consultation C. Translator and Interpreter Services

2.13.2 Contractor must provide Support Services upon CPS request.

2.13.3 Court Related Services

A. This involves testimony in judicial and administrative proceedings only at the request of CPS. To the extent possible, Contractor must also assist CPS in locating Contractor's past employees, agents, volunteers, consultants or subcontractors when CPS requires past employees, agents, volunteers, consultants or subcontractors to appear and testify.

DFPS purchases Court Related Services when legally necessary.

B. Service Requirements

1) Preparation The Contractor and its…