EFC Program Abstract

Oklahoma Human Services (OKDHS) strives to provide children with opportunities to gain HOPE and healing.

At no fault of their own, some children develop complex behavioral, medical, developmental and mental health needs that lessen their likelihood for success in traditional foster care.

In these cases, Enhanced Foster Care (EFC) can provide children in OKDHS or tribal custody with an elevated level of care that identifies their individual needs and uses a trauma informed approach to facilitate their healing.

EFC services are delivered in the context of two family-based care settings:

  • Enhanced Foster Care Services: These refer to child-specific services provided to kinship or traditional homes for children already placed in those settings, or about to be placed in one of these identified settings, including as a first placement.
  • Enhanced Foster Care Homes: These refer to pre-selected traditional foster homes, in which additional training is provided to the family to support the placement of children with no identified family-based placement transitioning from congregate care, acute or residential treatment. Additionally, children who meet the EFC service criteria and who are placed in shelter care – as evidenced by youth experiencing placement instability without an identified placement – or at risk of placement in shelter care can be placed in an EFC home.

True North goals are a set of priorities developed by OKDHS to guide the work of the agency in order to focus resources and improve collaboration and communication with stakeholders. Each of OKDHS’s divisions has approximately three to five focused True North goals in addition to eight agency-wide True North goals.

True North Child Welfare Services Goal 2: If children enter foster care, understand and meet their specific needs. This includes their need for safety, connections with family, community and culture, and addressing health, behavioral health, developmental, and educational needs.

EFC Service Elements

Enhanced Foster Care is individualized to the strengths and needs of the child and resource family. The standard services and supports listed below are provided to all children (and their families) receiving EFC.

  • Individualized Treatment Plan
  • Regular Team Meetings about Treatment
  • Monthly In-Home Quality Worker Visits
  • Weekly Individual Therapy for the child
  • Family Therapy
  • 24-Hour Crisis Intervention, including a Crisis Plan
  • Supplemental Foster Care Rate (Level 5 DOC)
  • Child and Adolescent Needs and Strengths Assessment (CANS)
  • Evidence-Based Treatment Models, when appropriate
  • EFC Service and Support Plan
  • Additional Training for Families Caring for Children with Complex Needs. These families will receive specific modules from Pressley Ridge, an evidence-based curriculum for foster parents.

Additional services and supports, listed below, are also available as needed.

  • Systems of Care – Service Coordination and Wraparound Treatment
  • Specialized Services (Developmental Disabilities Services, Medical, Occupational, etc.)
  • EFC Resource Parent Support Group

Child Eligibility Criteria

A child must meet at least one of the eligibility criteria below to receive EFC services; the resource parents) caring for the child must also agree to actively participate in the child’s treatment needs and planning. These criteria are more inclusive but informed by the programmatic criteria commonly used to determine eligibility for Therapeutic Foster Care.

The Child and Adolescent Needs and Strengths (CANS) assessment indicates the child would benefit from the EFC level of care.

  • The child experiences the onset of frequent placement moves from family-based settings due to the provider requesting change of placement or that the provider cannot meet the child’s behavioral health needs.
  • The child has a minimum of two elevated Child Behavioral Health Screeners (CBHS).
  • The child has a provisional or primary diagnosis from the most recent edition of
    “The Diagnostic and Statistical Manual of Mental Disorders” with a detailed description of the symptoms supporting the diagnosis.
  • The child’s conditions are directly attributed to a primary medical diagnosis of a severe behavioral and emotional health need and may also be attributed to a secondary medical diagnosis of a physical, developmental, intellectual, or social disorder that is supported alongside the mental health needs.
  • The child’s conditions are directly attributed to a mental illness or serious emotional disturbance, a medical issue, or a developmental or intellectual delay.
  • There is evidence that the child’s presenting problems require full integration of 24-hour crisis response, behavior management or intensive clinical interventions from professional staff to prevent the child from having to move from a family-based placement or to transition to a family-based setting from a higher level of care.
  • The child has other specific needs or factors that pertain to the child’s permanency, safety, and well-being, as approved by the Enhanced Foster Care Program Administrator.

EFC Referral Process

Enhanced Foster Care is available to any child in custody meeting criteria, including children entering custody in their first placement. Information obtained during the referral process is used to determine eligibility and to support individualized service planning for the child.

There are two referral pathways for children to be considered for EFC:

  • An Enhanced Foster Care Referral (Form 04EF003E) is completed for children currently or to be placed in an identified traditional or kinship home, and who are identified for EFC services and supports only; or
  • The Child Placement Interview is completed for children in need of an identified traditional home placement and meet the criteria for EFC services and support.

The Co-Neutrals’ initial round of EFC case reviews showed foster parents reporting that their treatment plans and wraparound services provided them with coping skills and therapeutic responses to help the children in their care work through heightened moments of emotional and mental stress and behavioral agitation. (From the latest Pinnacle Plan’ commentary).