SAN MAR TREATMENT FOSTER CARE
FOSTER PARENT HANDBOOK
Revised
April 2013
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Description of Handbook- pg.4
Brief History of San Mar- pg. 5-7
San Mar Programs- pg.8
San Mar Treatment Philosophy- pg.9
The San Mar Team- pgs. 10-11
Who is the Foster Child? - pg. 12
Services to the Biological Parent(s)/Legal Guardian- pg. 13
Who is the Biological Parent? - pg. 14
What should you tell your family, your friends and the community? - pg. 15
 What should you tell your children and the foster child?
Procedure for acceptance of children into treatment foster care- pgs. 16-19
State Requirements for Treatment Foster Parents- pg. 20
Recruitment, Selection and Qualifications of Treatment Foster Care Parents - pg. 21
 San Mar Adoptions Program- pg. 22
Treatment Foster Care Parent Responsibilities- pgs. 23-25
 School enrollment
 Meals
 Religious Involvement
 Mail Procedures
 Liability Insurance
Treatment Foster Care Parent Grievance Procedures- pgs. 26-27
Pre-Service and Annual Training- pgs. 28-30
 Maintaining your license
 Monthly support groups
 Facebook Page
 Treatment Foster Parent Annual Evaluation
Rate of Reimbursement for Care Provided- pgs. 31-35
 Use of monthly board payments
Example of monthly board payment budget- pg. 36
On Call emergency service- pg. 37
Incident reporting guidelines- pgs. 38-40
 Critical incidents
 General guidelines
Respite Care- pg. 41
 Record of free respite
Behavioral Management Policy for Treatment foster care providers - pgs. 42-48
Foster Youth Earnings- pg. 49
 Recommended Money Management Plan
Responsibilities of Working TFC Children- pg. 50
Payment of Health Care Costs- pg. 51
 Health examinations
Universal Precautions- pgs. 52-61
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 Infections- pgs. 52-54
 Influenza- pgs. 55-56
 Hepatitis B- pgs. 56-59
 Tuberculosis- pgs. 59-61
Use of Tobacco and Alcohol- pg. 62
Use of Weapons- pg. 62
Use of Motorcycles- pg. 62
Driving Licenses and Driving of Vehicles- pg. 63
Staff Contact List- pg. 64
Appendices- pgs. 65
 Foster parent job description- pgs. 66-69
 Purchase of care agreement- pgs. 70-73
 Pre-service training letter- pg. 74
 Pre-service training requirements- pgs.75-77
 Weekly Allowance- pg. 78
 Monthly Clothing Allowance - pg. 79
 Minimum Clothing Guidelines- pg. 80
 Confidentiality Agreement- pg. 81
 State Requirements for Reporting Incidents- pg. 82
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Treatment Foster Parent Handbook
Take a minute and think about why you want to become a
Professional Treatment Foster Parent:
Reasons not to proceed are:
You want a child to be a companion for your child or children
You want a permanent addition to the family
Reasons to continue are:
You have the time to work with a child or children
You have a willingness to learn how to care for difficult children
You have strength, enthusiasm and a great sense of humor
You have a love for children and have a desire to help a child in crisis
You have lots and lots of patience
This handbook has been developed to aid you in providing Treatment Foster Care in your home.
It contains the agency policies you will need to follow. We hope that your work as a Treatment
Foster Parent will be both a fulfilling and satisfying experience. We know that it will be the
hardest job you will ever love.
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HISTORY OF SAN MAR
1883-During the years following the Civil War, concern was expressed throughout the
Washington County community for the orphaned children. With no apparent place to live
other than the County Almshouses, children were living among the homeless adults.
Rather than a charitable institute, almshouses were
meant as punishment for “vagrants, beggars,
vagabonds, and other offenders.” And those
sentenced to the almshouse were required to wear
badges adorned with a “P” for pauper and essentially
work as inmates. According to historians, almshouses
persisted in our state until after 1940.
By 1883 an action plan was implemented as a group of prominent citizens came together to
form a new non-profit corporation, The Washington County Orphan’s Home. Together,
they were able to raise enough funds to purchase the property at 355 South Potomac Street
in Hagerstown, and to hire a superintendent and several other staff. In a report to the
board of managers in 1918 then superintendent, Walter Esmer noted “It was the first
successful attempt in the State of Maryland of the people of a county, without state
financial assistance, to care for their county’s dependent
children.”
On November 8, 1883, the first two children moved out of the
Almshouse and into the safety of the new orphanage, seven year
old Eddie and his five year old sister Edith. They were to become
the first of thousands to follow. That first year welcomed 69
children into care.
1885-Only two years later it became clear the majority of children in need were not
orphans. In the first of a series of adaptations to changing times and needs, the home
changed its name to “The Washington County Home for Orphan and Friendless Children”
and amended its charter,
expanding its purpose to provide
for orphans and destitute
children who came under the
organization’s care.
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1927-For the next 44 years the Home continued to provide care for children at the original
location in Hagerstown. Then in 1927 a move was made from the aging facility to a newly
constructed modern building located on 60 acres in the rural community of San Mar
located ten miles away.
1981-The name was officially changed to reflect the
move to the community of San Mar.
1987-In March, 1987 the board of managers made the
decision to specialize care to adolescent girls and to
increase the services offered. At the same time an
extensive renovation of the facility was completed.
1990-The Edward and Pauline Anderson Transitional Living Home is opened for girls
successfully completing the program in the main group home.
1991-San Mar is licensed as a Child Placement
Agency.
1992-Operating under the Child Placement Agency a
program of Treatment Foster Care is begun; whereas
the original intention of the program is to provide an
additional resource to girls completing the group
home. Children and youth may be placed into homes
without ever having been in any other San Mar program. Once again through the foster
care program, San Mar is able to provide care for both girls and boys.
1993- The Maryland State Department of Education licenses the San Mar Educational
Program.
1994-The San Mar Educational Program is upgraded to status as the San Mar School.
1997-On August 1, 1997 the Jack E. Barr Therapeutic Group Home opens. The program
has a capacity for 8 girls. By November 21, 1997 the program is operating at full capacity
where it will remain for a long time.
2002-On February 28, 2002, San Mar receives national
accreditation from the Council on Accreditation for all
residential, educational, and treatment foster care
programs operated by the organization.
2003-San Mar is full certified as meeting the Standards of
Excellence.
2004-The Maryland Department of Human Resources grants San Mar a license to operate
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as an Adoption agency. The organization is offered a $400,000 grant from the Department
of Juvenile Services to construct and operate a Shelter Care program for girls. The board
commits to conducting a capital campaign to raise 1.2 million dollars for matching funds
for the shelter and for a multi-purpose center to serve all the girls in care.
2005-San Mar is licensed as an Adoption Agency.
2006-On July 26, 2006 the Graff House opens and the first girl moves in. In September, the
organization is re-accredited by COA.
2010-San Mar’s Teen Mother and Infant program is licensed.
2011-Allegany Girl’s Home located in Cumberland, MD joins the San Mar Continuum of
Care.
San Mar honors former
residents with a luminary
display with each one
representing a child that we
have served since 1883.
They now number over
3000.
References:
Curtis, Jennifer. The Almshouse. http://www.marylandlife.com/articles/the-almshouse. May
2010
San Mar Children’s Home. http://www.sanmarhome.org/history.html
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SAN MAR PROGRAMS
The San Mar Group Home for girls: Founded in 1883 as an orphanage for boys and girls
in need, the home has provided care to hundreds of children and youth. Today, the home
operates to provide care to adolescent and preadolescent girls who have experienced the traumas
of abuse, molestation, and general family dysfunction. It is San Mar’s mission to enable these
girls to understand and address the issues they are facing and move forward to become
successful and productive members of society. The large group home provides care for 23 girls.
The Jack E. Barr Therapeutic Group Home for girls: Opened in August 1997, this
home for eight girls has quickly established a reputation for addressing the needs of those girls
needing more structure than what is available in the large group home. Services are very intense.
Girls completing this program may move directly into any of San Mar’s other programs as is
deemed appropriate by the treatment team.
The Edward and Pauline Anderson Transitional Living Home: Opened in 1990,
this Home serves three of the older girls who have completed the main residential program. It is
designed to prepare girls for life on their own, when they leave San Mar.
The San Mar Educational Program: It is the intention of San Mar for each girl to be
afforded a mainstream education in the public school system whenever possible. When such
participation is not possible or feasible due to either academic problems or behavioral
difficulties, the girl is then educated in San Mar’s on-grounds school program. San Mar is
licensed by the Maryland State Department of Education as a Type III school. Girls in the
program receive individual attention to their educational and behavioral needs.
The San Mar Treatment Foster Care Program for Boys and Girls: In 1991, San
Mar was licensed by the Department of Human Resources as a Licensed Child Placement
Agency. Shortly thereafter, a program of Treatment Foster Care was begun as a means of
initially providing nurturing and caring homes to girls no longer needing the high level of
structure provided by the group home. This quickly expanded to serve boys and younger girls
who had never been in residential care. San Mar recruits, trains, licenses, supports, and
encourages families willing to open their home and share their family with a child in need.
The Dr. Henry F. and Florence Hill Graff Shelter: (Name changed to Graff Home in June 2012)
San Mar’s newest program of shelter care provides a safe, temporary home for adolescent girls
while they await a pending court hearing or a more permanent placement. Girls will attend
school at the shelter while in care.
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SAN MAR TREATMENT PHILOSOPHY
PURPOSE
The purpose of all services at the San Mar Children’s Home is to provide a community of care to
girls and boys, from infancy to age 21, who have experienced the traumas of physical abuse,
sexual abuse, neglect, mental injury and/or general family dysfunction to face the issues of their
past and move towards becoming responsible and productive members of society.
PHILOSOPHY OF CARING
We believe that the family is God’s design for the rearing of children. When children and
families have difficulties, help must be given. Whenever possible, children should remain with
their parents. Only after every effort is made to work out the problems, and after it is determined
that the child’s welfare is in jeopardy if he or she continues to live with the family, should a
separation be made.
At the time of separation we believe that each child must have his or her total needs met.
Because of the traumatic experiences separation involves, professional help is needed to allow a
healthy processing of personal feelings and fears. We believe that a therapeutic family living
experience can provide an alternative to larger group living settings and offers a great potential
to effect positive change within a child. We further believe that most healthy families, with
strong training and ongoing support, are capable of learning how to provide a therapeutic
(healing) environment for a child in need..
Because of the significance of each child’s family unit, we believe that it should receive every
possible support to remain intact. Except in certain unusual circumstances, children and their
families should be helped to reunite. A youth is more likely to succeed in placement if it is
clearly understood where he or she will be living on a permanent basis. All of us have a need to
belong and children are no exception. Each child needs to be free to make permanent
relationships with caring people
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The San Mar Team
Ellen Savoy, LCSW-C, Program Director since August 2004. She has had the privilege of being
with the TFC program every day since its beginning in 1991. She’s worn all the hats recruiter/trainer, and case manager. Additionally she and her husband became adoptive parents in
1979 and foster parents in 1990. She is ready to support you in any way that she can. Ellen is a
graduate of the University of Maryland, School of Social Work.
Joel Bowers, LGSW, has been our first person of contact for new foster parents since the
summer of 2005. Coming to us with 25 years experience working in Child Protective Services in
Frederick County, MD, Joel is eager to stimulate your curiosity and make sure you get an
overview of the work we do and the tools you will need. He will spend the majority of time with
you as you get prepared to serve. He is a 1987 graduate of the University of Maryland, School of
Social Work.
Becky Carpenter, LSWA, is our Senior Case Manager and client intake coordinator. Working
with San Mar since 1998, Becky knows how to connect children with providers with similar
interests. Becky will help you understand the process we use to match children with families.
She’s our expert on the pre-placement process. Becky is a 1986 graduate of Mansfield
University, Mansfield, PA, with a degree in Social Work.
Stephen Pittman, LSWA, is a 2010 graduate of Shepherd University. He completed his
internship through San Mar and was hired on as a full time case manager in May of 2010. As the
resident male case manager, Stephen spends much of his time with the male clients of TFC. He
has organized father/son outings and always tries to remind us of the male role in this field and
the importance in incorporating the male clients into a historically female program.
Tiffany Pittman, LGSW, is a 2011 Masters graduate from Salisbury University. Tiffany has
been an employee with San Mar since May 2010 and also completed her Master’s level
internship at TFC.
Margaret Paul, LSWA, is a 2010 graduate of Shippensburg University with a degree in Social
Work. Before becoming an employee, Margaret was a student intern with us from January of
2010 until May of 2010 when she joined our staff as a valued team member.
Amanda James, LSWA, is a 2011 graduate of Shepherd University in Shepherdstown, WV,
with a degree in Social Work. She was also a student intern with San Mar Treatment Foster Care
during her senior year of college. She has been working with the TFC team as an employee since
early 2012.
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Dominic Gianninoto, LSWA, is a 2009 graduate of Shepherd University with a degree in Social
Work. He was a student intern in the foster care unit at the Washington County Department of
Social Services in Hagerstown before joining the San Mar Treatment Foster Care team on a parttime basis in 2012. As our census grows, we expect Dom to be joining us full-time. He also
works one-on-one with some of the young men in our program.
Bruce T. Anderson, LCSW, is the President and Chief Executive Officer of the San Mar
Children’s Home. It was Bruce who had the vision for San Mar to become a licensed child
placement agency. Since 1986 Bruce has been at the helm overseeing all of the unique programs
that San Mar offers to children and their families. Bruce continues to be a powerful advocate and
change agent, operating not only on our local campus but at the state level as well. Should you
ever have a concern or just desire to go up to the next level, don’t hesitate to contact Bruce.
Support Staff: Other very vital team members are our administrative personnel. Paul
Leatherman oversees our budget, Mary Clark pays our bills and Bobsy Price will pay you for
the valuable service you will provide a child through the San Mar Children’s Home, Treatment
Foster Care Program.
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WHO IS THE FOSTER CHILD?
A foster child can be male or female, any race, an infant or a
teenager, of gifted or below average intelligence, emotionally
stable or emotionally disturbed, physically healthy or medically
needy. In other words, in many ways a foster child is a child like
other children you know.
A child becomes a foster child usually because one or both parents temporarily cannot provide
for his or her basic needs or cannot provide a safe home environment. In essence, a foster child
may be a child who is caught up in unstable life circumstances. A foster child lives with a
family, a foster family, to whom he/she is not related and who is being paid to provide temporary
care. The foster child therefore has two families and often feels emotionally torn between these
families.
A foster child is in the care of not only a foster family but of agencies, institutions, courts,
bureaucracies, and social workers. Sometimes this situation becomes both confusing and
frightening to the child. A foster child may feel lost in the midst of the “system” or that no one
really cares. A child in these circumstances often feels that he/she has done something so wrong
that his/her parents no longer want to be his/her parents. This may or may not be true. A foster
child may feel like a second class person. In fact, most foster children, because of their unique
situation, intensely feel all the negatives that contribute to the stigma associated with their foster
child status.
In response to the past emotional hurts from abuse, neglect or abandonment, and the present
feelings of conflict which arise due to separation from family, each child needs a tremendous
amount of skillful care, daily support, and genuine attention. Frequently, children in foster care
have difficulty trusting adults. They may feel that you will not want to allow them to stay in
your home if they do not perform well. Some children may test your commitment to care for
them by challenging or intentionally not following your rules. Uncertainty about your motives
and loss of control over their own life circumstances may cause foster children to feel insecure
and worry about the future. In response to these many natural but negative feelings, a foster
child may act in ways that appear rejecting of your family, which may be upsetting to you and
your family members.
It is important to remember that we, as members of a treatment foster care team, are “sowing
seeds of hope.” Through the daily giving of structure, nurture, stability, and guidance, we give
to children something that cannot be taken away from them. It is through the experience of
living in a skilled, caring family, who are part of a caring community, which we add to the
chapters of each child’s life. We may have a little, or a profound, effect on the outcome of their
life story, but it is certain that we will have no effect if we do not take the risk to try.
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Services to the Biological Parent(s)/Legal Guardian:
It is the responsibility of San Mar staff and the placing agency worker to support children’s
relationships with their parents and other family members throughout the period of placement,
unless such efforts are expressly and legally prohibited. The biological parent(s) / legal guardian
are a key member of the treatment team and efforts will be made by San Mar to encourage and
invite his/her participation.
The procedure for acceptance of children into program outlines the initial communication
between the case manager and the biological parent/legal guardian. During this conversation, the
parent will be given an introduction to the program. The case manager will discuss with the
biological parent/legal guardian issues such as the parent’s feels towards separation,
permanency, participation in the treatment team and services available. Communication between
the case manager and the parent are coordinated through the case manager and will continue on a
monthly basis to ensure effective communication of all aspects of the child’s case.
Additional services to the biological parent/legal guardian, including parenting classes, substance
abuse counseling, clinical counseling, transportation, housing assistance, home health, medical,
dental, or day care will be outlined in the service plan recommended by the placing agency
worker. In support of this plan, San Mar treatment foster care staff will assist with securing
services, if necessary. These services will be coordinated in the community where the parent
resides, by the placing agency worker.
The treatment team including the biological parent/legal guardian, if appropriate, will meet on a
quarterly basis to review the child’s individual treatment plan. It is a goal of the program that this
process empowers the parent/legal guardian while they assist in determining the plan for their
child. The placing agency worker will alert the parent of scheduled court hearings where the
permanency plan is determined. This hearing takes place every six months.
Similar to the service provided to the child, visitation between the parent(s)/legal guardian and
their child will be scheduled through the placing agency worker and the case manager as
recommended in the individual treatment plan.
Depending upon each child’s history and current emotional state, the treatment team may
recommend that it would not be in the best interest of the child to maintain contact with their
parent(s). Recommendations for any limitation will be directed from San Mar to the placing
agency for request of court approval. Only in an instance where a child would not be safe or
where his/her treatment at San Mar would be compromised, would a biological parent not be
included in the treatment process.
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WHO IS THE BIOLOGICAL PARENT?
Note: The following description may apply to any member of a child’s extended family
or to any person designated as the child’s reunification resource or permanency plan.
At times it may seem that it is the fault of biological parents that children are in foster care.
Their inability to adequately care for their child is the reason that the child needs a stable home.
Biological parents may appear weak, irresponsible, uncaring, selfish, or cruel and therefore
entitled to few rights regarding their children. This is just not true. Even though at the time of
placement a parent may appear overwhelmed, immobilized, depressed, or emotionally unstable,
he or she may have shown significant strength in the past. Each of us has something we must
overcome, and for many biological parents of foster children this may include a life filled with:
early responsibilities; a difficult marriage; sexual abuse; a physically abusive father, mother or
spouse; unreasonable demands of other family members; limited education or vocational
training; inadequate housing; ill health; alcoholism; substance abuse; mental illness; or little or
no community resources for counseling or support.
The biological parents of foster children are persons who are experiencing difficult life
circumstances. Conflict within their own life, their family life, or their living situation, may
temporarily reduce their ability to provide care for their own child. Although the greatest
majority of the foster children who are referred to San Mar are court ordered into treatment foster
care, some are voluntarily placed by their biological parents who recognize their inability to care
for their child. The actual placement of the child can be a painful yet loving act for the biological
parent whether it is a voluntary or involuntary placement. At a time of extreme family stress, it
is somewhat of a comfort to know that their child will be skillfully cared for by a treatment foster
family.
If the parent is hospitalized, incarcerated, or simply does not visit the child, this does not affect
his or her “parental rights.” Intensive efforts should be made by the social service agency and
San Mar staff to determine the potential of the parent for future involvement in the life of the
child. The knowledge of the identity of the biological parent is not just a legal requirement, but a
necessity to the child’s identity and future personal growth.
In most cases, all contacts between biological parents and foster parents should be reported to the
child’s case manager to ensure proper documentation. Generally, contact between the biological
parent and child will be prearranged and confirmed in terms of location, time of visit, and
transportation arrangements. An aid to establishing a professional relationship with biological
parents is to imagine yourself in their exact life circumstances, and respect the honest efforts they
make to assert positive changes on their life situation.
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WHAT SHOULD YOU TELL YOUR FAMILY, YOUR
FRIENDS AND THE COMMUNITY?
As foster parents you will probably find that your neighbors, friends, relatives, and the playmates
of your foster child will be curious about the “new” child in your home. You may be uncertain
about how to answer questions or what to suggest to the child as appropriate responses to such
questions. Frequently, questions arise at school or other places in the community.
An honest and direct explanation is best. You can share your personal desire and motivation to
work as a treatment foster parent. You may want to share, in a general way, why San Mar asked
your specific family to work with this special child. There will be times and places where you
will be asked to give specific factual information regarding your foster child. Please refer all
such inquiries to your child’s case manager to avoid violating the confidentiality of certain
information regarding your child.
In some instances, it is very difficult to understand a child’s complicated family situation.
Knowing just what to say that will be helpful and reassuring can be tricky. Some children
become uncomfortable or even embarrassed when trying to answer delicate questions alone. The
child should be encouraged to turn to you or the case manager for assistance. Many foster
children need help to understand how their biological parents “fit into the picture” and the
reasons for their continued need for placement in treatment foster care.
WHAT SHOULD YOU TELL YOUR CHILDREN AND
THE FOSTER CHILD?
This is not always an easy question to answer. The recommended approach is to follow these
suggested guidelines:
1.
2.
3.
Make it clear to your own children that the new addition to your family has not
arrived to take anyone’s place. The child is living with your family because you
have chosen to be foster parents.
Without violating confidentiality, and in an age appropriate way, share as much
information about the new foster child with your children as they can handle.
Assure the foster child that he/she may tell others that he/she lives with you, but
does not have to answer other’s questions about his or her circumstances.
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PROCEDURE FOR ACCEPTANCE OF CHILDREN
INTO TREATMENT FOSTER CARE
Children that are accepted into Treatment Foster Care are in need of a higher level of treatment in
a family setting. Children that are referred to TFC have not been or would not be successful in a
regular foster care setting due to serious emotional, behavioral or psychological issues that they
are experiencing. They may be referred from a higher level of care such as a group home where
they have been experiencing sufficient success to warrant placement into a family setting. These
children are in need of structured daily schedules that are determined by trained TFC parents. All
of the children admitted into TFC have a DSM-IV diagnosis, but are able to safely participate in
family and community settings. Children from any portion of Maryland may be served although
State policy promotes the placement of children as close to their biological families as possible.
Children who receive chemical support, i.e., prescription medications to maintain behaviors are
appropriate placements.
The biological parents/legal guardians are important parts of the treatment team at San Mar.
They are encouraged to participate in the activities of the TFC program and treatment team. If
the treatment team suggests that it is appropriate, the case managers will assist the placing
agency worker in coordinating services to the biological parents/legal guardians. In some
instances, the treatment team will recommend that it be in the best interest of the child for
parental rights to be terminated, visitations to be ended or whatever else may be in the best
interest of the child.
Referrals to the program will be received from the different Departments of Social Services
throughout the state of Maryland and from Juvenile Justice and Mental Health agencies in
Maryland who have made the determination that the child is eligible for and suitable for
placement into TFC.
Referrals for possible placement are received by the TFC program and are reviewed to determine
if the referral is appropriate for the San Mar TFC program. Designated TFC staff will consider
culture, religion, language, biological children, distance of the foster home from the biological
family, race, ethnicity, experience of the TFC family, and the child’s conditions and behavior in
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delineating placement possibilities. Siblings are kept together as appropriate.
Per COMAR regulations, designated TFC staff will respond to the referring source within 14
working days as to the availability of an appropriate San Mar TFC family. If an appropriate TFC
is not available, designated TFC staff will so inform the referring source in writing. If an
appropriate TFC family is available, designated TFC staff will request, if not already received, a
Purchase of Care Referral, a current case plan, relevant medical records, psychological and/or
psychiatric evaluations, education information, an updated permanency plan and visitation plan.
Designated TFC staff will then contact the child’s placing agency and make arrangements to
meet with and interview the child. In such an interview the designated TFC staff will:










Assess the child’s appropriateness for placement in the San Mar TFC program
Provide the child with general information about the San Mar Children’s Home and TFC
program
The method of how a prospective TFC family is sought for the child
The types of TFC homes currently available for the child’s placement
The expectations that the child would adhere to while in the TFC program
Any other areas that the child may be interested in while considering the TFC home.
Should there be other children in the TFC home and if so, should they be younger or
older
Should the TFC home be located in a rural, suburban or urban setting
Should the home be a one or two parent TFC family
Should there be any pets or animals in the TFC home
When a TFC family has been deemed appropriate for the placement of a particular child,
designated TFC staff will meet with the prospective TFC family. At this meeting, TFC’s full and
complete knowledge of the child and his or her situation shall be shared with the prospective
family, including their right to fully review all written materials, to hear staff observations and
recommendations, to ask any questions they may have and to request additional information.
When a child is referred to your home, you are entitled to all the known background information
about them and their family relevant to the care of the child. If the background information
includes, for example, a child’s history of making false allegations of abuse, their social worker
tells you. The same is true if the parents or extended family are known to make false allegations
or seek inappropriate contact with foster parents. If the child is not previously known to the San
Mar TFC, the information may be limited. You may want to list additional questions you might
want to ask the social worker if you need more information.
The successful placement of a child in your home depends on all of us working together as a
team. It is good to view yourselves as becoming “professional foster parents” by becoming
parents who are able, as part of a team, to deal with children who express significant behavioral
and emotional issues. Foster parents, children’s DSS social workers, TFC case managers, parents
and the community all have important roles to play. It is essential to remember that the child is
also entitled to be involved and consulted as much as possible. To reach the goals set for the
child’s care, all the players must be involved in the planning and decision-making process.
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Planning is important because it focuses everyone involved on the issues, concerns and
problems, and because it ensures that the child’s needs are addressed fully and in a timely
fashion. Planning also helps to manage transition periods and to maintain continuity and
consistency in the child’s life and care.
Foster families should be realistic when deciding whether a child would prosper in their family,
and what supports or adjustments would be required. Your family should also recognize their
strengths and limitations. For example, some families are good at fostering older children, while
others do best with children who have particular types of interests or personality. The preplacement period is crucial to the success of the placement. This is the time for you to be open
with yourselves, the child’s social worker and your case manager about feelings and possible
doubts regarding the proposed placement. The decision to accept a child should involve all
members of your family. You will need sufficient time—particularly when there are special
issues involved such as aboriginal, disability or family concerns—to consider the adjustments
needed in your personal and family routines.
Keep in mind that you can say no to a placement, and you can discuss any concerns about a
particular placement with San Mar TFC. Such a discussion might lead to a decision not to place a
particular child in your home, or it could mean that further planning is needed prior to such a
placement.
If the TFC family chooses to move forward with the placement, after gaining the approval of the
placing agency, designated TFC staff will arrange for the TFC family to meet with the child at
his or her current location. The first visit with occur in conjunction with TFC staff.
If all parties are in agreement, a series of visits between the prospective TFC family and child
will occur. These will include day visits, overnight visits, and weekend visits as deemed
appropriate. The TFC family, TFC staff and placing agency staff will be in regular contact
during this phase so as to assess progress and the continuing appropriateness of the placement.
When all parties are in agreement, a date will be set for the child’s placement into the TFC home
and program.
The stronger the attachment between the child and the previous caregiver, the more important the
process of transferring attachment to the new caregiver becomes. In some instances, contact with
the previous caregiver is an important part of the process with the goal in mind of minimizing the
trauma to the child being placed. It is best if children are not moved while still in a state of shock
and denial. Pre-placement visits help to encourage a smoother transition by diminishing the
fears of the child. It also can have the necessary effect of initiating the child’s grieving process
over the loss of his or her previous placement. This can be manifested in various negative ways
such as non-compliance, anger, and so forth. It is also the beginning of the process of
transferring the child’s attachment from the previous caregiver to the present one. It is the time in
which the child begins to develop trust in his or her new caregiver. For foster children who have
issues with both trust and attachment, the pre-placement process is where the foundation of the
treatment foster care begins, the place where it is important that you be a professional foster
parent who works as a part of the team to begin the work of healing in the child.
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For similar reasons, TFC parents must be empowered to take on the full parental role from the
outset of the placement. Set rules and boundaries from the outset of the placement. Children may
be “stepped-down” from group care and are coming from environments with clear and consistent
rules, regulations and expectations and are best served by keeping a good structure in place.
Children being “stepped-up” in placement from the community or from regular foster care are
often in need of the structure and boundaries available to them in TFC from professional foster
parents.
The following are required for placement to take place:
 Medical Care Consent and Medical Care consent form-generic
 Consent for Release of Information
 Board of Education Release of Information
 Publicity Consent Form
 HIPAA form
As appropriate, during the visitation and transition phases, designated TFC staff will endeavor to
establish contact with the child’s biological family/reunification resource. Designated TFC staff
will share the following with them:
 A description of the San Mar TFC program
 The importance of their on-going participation in the treatment process and team
 Both their rights and their children’s rights while placed in TFC
 A description of the foster family that is a placement resource for their child
Service Delivery:
All children, biological parents(s)/legal guardians, and treatment foster parents, regardless of the
child’s permanency plan, will be provided the same services outlined above, as part of the San
Mar treatment foster care program.
Language spoken:
At least one Treatment Foster Parent will demonstrate effective communication in the language
of the child placed in care, and if this is not possible, the organization will provide an interpreter
to meet the child’s language needs, as needed.
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STATE REQUIREMENTS FOR
TREATMENT FOSTER CARE PARENTS
1. QUALIFICATIONS
- Compliance with all foster family approval regulations as specified in The Maryland
Code of Regulations 07.02.13.07.
- At least one Treatment Foster Care Provider must be available to the child on a twentyfour
(24) hour basis or available to respond to the child’s needs in case of an
emergency.
- Minimum of a high school diploma or equivalent including, but not limited to, life
experiences.
- Special training and/or work experience related to the problems of the specific foster
child placed.
- Access to reliable transportation.
- An operable telephone.
-Criminal Background Clearance and Child Protective Service Clearance
- A copy of the Treatment Foster Care Provider’s driving record
- A Child Support Services clearance
- At least 21 years of age
- Maryland resident
- Physical examination and TB test
- Fire Marshal inspection and approval of foster home
- Environmental Health approval of water and septic systems
- Proof of marriage and/or divorce status
- If married, must be married for at least 6 months
- CPR and First Aid certification
- Proof of adequate income
- Proof of home and auto insurance
- Four total references, including one by telephone, one in person and one reference from
school personnel if the family has a minor child enrolled in a public or private school
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RECRUITMENT, SELECTION AND QUALIFICATIONS
OF TREATMENT FOSTER CARE PARENTS
TFC parents play a number of roles while working with the children in the program—parent,
teacher, confidante, nurse, and advocate. The recruitment of qualified TFC providers is an ongoing effort performed by the San Mar TFC program. The goal of recruitment is to find and train
people willing to become “professional foster parents”, parents who are willing and able to work
as part of a team in dealing with children with traumatic pasts, attachment issues, and emotional
and behavioral problems. Recruitment is focused on the needs of the children currently in and
being referred to the TFC program. Medical, cultural, and geographic needs of children are
considered during the recruitment process. The program makes every effort to place children in
the homes of TFC providers who are of the same religion, culture, race, and language when
appropriate. The San Mar TFC program will recruit without regard to race, color, marital status,
religion, national origin, ancestry, gender, and physical handicap or medical condition within the
context of state and federal regulations.
San Mar TFC recognizes that current foster families and San Mar staff are invaluable resources
for finding new TFC families. These individuals are familiar with our agency and its policies and
goals. They are excellent ambassadors and recruiters for the program.
In order to reward the valuable contribution that current TFC families and San Mar staff can
make in the recruitment of new families, San Mar offers a $500 bonus to those who successfully
refer new foster families. The following guidelines must be followed in order to receive the
bonus:
 The referring party must either be a current San Mar employee or current San Mar
TFC provider. TFC staff is not eligible for the bonus.
 The referred family must clearly identify the current staff or provider as the
source of the referral
 If the referred family indicates more than one appropriate referring source, the
bonus will be equally divided among them.
 The total of the referral bonus is $500. After the referred family successfully
completes the pre-service training phase and is certified, San Mar will award $300
to the referring source. On the six month anniversary of the referred families’
certification, the remainder of the bonus will be paid to the referring source.
 The family referred to San Mar TFC cannot be a current employee of any of the
programs of the San Mar Children’s Home.
Per COMAR regulations, San Mar TFC will not recruit foster families who are active with other
private or public foster care agencies. If such a family were to inquire about being certified with
the San Mar TFC program, they would be required to resign from whatever program had
previously certified them as TFC providers. This prohibition extends to adult foster care
programs such as Project Home.
The State of Maryland has very specific regulations when it comes to any citizen of the State
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providing care to a child who is not their own. If a person is regularly caring for an unrelated
child in a residence other than the child’s own for any kind of payment, then that person must be
licensed as a child care provider by the Office of Child Care of the State of Maryland. This is
true whether the person receives money as payment or if one swaps child care with a friend, etc,
etc. Also, the State is quite clear in prohibiting Treatment Foster Care providers from being
licensed as child care providers whatsoever. This prohibition is based upon the needs of the TFC
child and the possible liability and safety issues with the day care child. In essence, this means
that a TFC provider cannot provide child care in their home, period. State law actually allows for
a $1000 per day fine for any violation of this regulation.
TFC providers will be selected based upon their ability to accept and carry out San Mar’s
treatment values and philosophy. TFC parents will also be selected based upon their ability and
agreement to uphold their responsibilities as outlined in the Treatment Foster Parent Job
Description and The Purchase of Care Agreement. Such qualities as commitment, “positiveness”,
“teachability”, willingness to work as part of the treatment team, sense of humor, enjoyment of
children/youth, flexibility, patience, the ability to adjust to challenging situations and “teachability” will be considered.
SAN MAR ADOPTIONS PROGRAM
The San Mar Children’s Home, in addition to be licensed as a Treatment Foster Care Program, is
fully licensed as an adoption agency. In accordance with state regulation, whenever a Treatment
Foster Care provider is licensed or certified by the San Mar TFC program, that family is
simultaneously licensed as an adoptive home. Permanency for children is the over arching goal
of the child welfare system and the San Mar Children’s Home Treatment Foster Care program.
Under certain circumstances, adoption by the Treatment Foster Care Provider(s) can be the
Permanency Plan of choice for a child in placement. The San Mar Treatment Foster Care
Program will provide adoption home studies, adoptive home safety inspections, and other
relevant documentation in pursuance of the permanency plan as a free service to the Treatment
Foster Family and TFC child. We will assist the family in their transition from Treatment Foster
Care providers to Adoptive Parents with case management services.
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TREATMENT FOSTER CARE PARENT
RESPONSIBILITIES
Treatment Foster Parents fulfill all “routine” parental functions and do so as part of a
professionally designed treatment plan. They serve the dual functions of foster parents and
treatment parents. The Treatment Foster Parent(s) are the primary change agents in the treatment
process and perform the following tasks:
- Assist in the development of treatment plans and assume primary responsibility for
implementing the in-home treatment specified in the treatment plan.
- Attend team meetings and training sessions.
- Demonstrate accountability for services through record keeping.
- Record child’s behavior and progress in targeted areas on a daily or weekly basis.
- Develop and maintain positive working relationships with resources in the community
such as schools, social service agencies, mental health professionals, and recreational
outlets.
- Assist in reunification efforts as specified by the treatment team in accordance with the
permanency plan.
- Assure the child’s access to medical care.
- Assist the child in maintaining contact and visitation with biological family, unless
otherwise indicated in the child’s treatment plan.
- Encourage a positive relationship between biological parents and child unless otherwise
indicated in the child’s treatment plan.
- Assist in family reunification efforts specified by the treatment team.
- Provide consultative services to the biological family regarding effective child behavior
management and the use of behavior management techniques.
- Provide information on community resources and services to the child’s biological
family.
- Provide transportation to therapy and psychiatry appointments and participate when
indicated.
Foster Parents are to provide:
- Nutritious meals and snacks;
- A pleasant, safe, and nurturing family atmosphere;
- An orderly daily schedule that promotes positive participation in appropriate school
and community activities;
- Basic personal needs and an allowance, as appropriate;
- The opportunity for religious observance in the faith of his/her choice; and
- Opportunities to participate in activities consistent with his/her ethnic and cultural
heritage.
SCHOOL ENROLLMENT
All children placed in treatment foster care will be involved in an educational program. Most
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children will attend the public school in the area of the foster home. The staff involved in the
enrollment procedure for a child will vary, depending on the child’s individual educational
needs. The treatment foster parents, the child’s case manager, the San Mar Director of
Education, and the Director of Treatment Foster Care may all need to be involved in the
enrollment process.
If the TFC provider wishes to enroll a child in a private school, permission must be obtained
from the child’s DSS agency and the provider will be responsible for the payment of any tuition.
After a review of a child’s school records, a decision will be made concerning how the child’s
school enrollment will be handled. It is important that treatment foster parents participate in this
process as directed. Do not proceed in any manner, however, without the authorization of the
child’s case manager or the Director of Treatment Foster Care.
MEALS
All children in treatment foster care should be served three meals each day. Generally,
mealtimes should be within one hour of 8:00 a.m., 12:00 noon, and 6:00 p.m. Children who are
unable to eat during these times should make other arrangements with their foster parents. A
light snack should be provided either after school or in the evening. Meals should be
nutritionally balanced. The food offered to foster children should be the same as the food eaten
by other members of the foster family. Foster parents should not consume any type of food in
front of the foster children that foster children are “not allowed” to eat.
In cases where a child requires a special diet, foster parents will be advised before making a
decision to work with the child.
REMEMBER, food cannot be withheld as a discipline at any time.
RELIGIOUS INVOLVEMENT
Children and youth admitted into any program of the San Mar Children’s Home, Inc. (San Mar)
are encouraged to participate in religious activities. San Mar is built upon the value base of the
Judeo-Christian ethic. Practices that flow from values that are antithetical to those of the
organization and are destructive to the individual will not be allowed (e.g. Satanism).
As surrogate, or alternate, families for children in treatment foster care, program staff and
treatment foster parents accept the responsibility to guide and support a child’s growth and
development. This includes intellectual, physical, emotional, social, and spiritual growth and
development. All children in treatment foster care should be encouraged to become involved in
a fellowship through the church of their choice. Religious involvement allows a child the
opportunity to connect with a caring community and form appropriate peer relationships.
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All treatment foster families are encouraged to attend church services with foster children to
allow the experience of participating in worship as a family unit.
MAIL PROCEDURES
All children in San Mar Treatment Foster Care homes will be allowed to send and receive mail.
San Mar TFC encourages children to be in contact with family and friends in the community.
Mail is not opened or censored unless therapeutically indicated. Receiving and sending mail to
family members, etc., is subject to structures applied by the local DSS or DJS or court system as
therapeutically indicated.
LIABILITY INSURANCE
The Department of Human Resources and/or the Social Services Administration of Maryland
does not provide liability insurance for treatment foster parents. TFC providers are required to
maintain such liability insurance on their own. This is in the form of homeowner’s or renter’s
insurance.
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TREATMENT FOSTER CARE PARENT GRIEVANCE
PROCEDURES
The San Mar Children’s Home understands that Treatment Foster Parents may have questions or
concerns regarding the Home’s actions involving the foster children placed in their care. The San
Mar Children’s Home provides the following grievance procedures to any treatment foster parent
who believes that he/she has been treated unjustly or who has a concern regarding service
delivery. The following procedures shall be followed:
1.
Within 10 days of the problem’s occurrence, the foster parent shall first attempt to speak
directly with the case manager for the foster child involved in the grievance. The foster parent
shall communicate his/her point of view calmly and clearly. The case manager must respond in
kind to the person within 5 working days of the filing of the grievance. If the foster parent does
not feel comfortable speaking directly to the case manager involved, he/she may go directly to
the Director of Treatment Foster Care.
2.
If the grievance is not resolved by the actions of step 1, the foster parent may request, in
writing on the grievance request form, (see attached), a conference with the program coordinator.
The Director of Treatment Foster Care must receive the request within 10 days of the onset of
the grievance procedure. All areas of the grievance form must be completed before it is
submitted to the Director of Treatment Foster Care.
3.
The Director of Treatment Foster Care must meet with the foster parent within 5 days of
receipt of the grievance form. A written response from the Director of Treatment Foster Care
concerning the grievance shall be given to the foster parent and case manager involved within 5
working days of the meeting with the foster parent.
4.
If the previous step does not adequately resolve the grievance, the foster parent may
request in writing a meeting with the Executive Director of the San Mar Children’s Home. This
written request must be made within 5 days of the receipt of the written report completed by the
Director of Treatment Foster Care. It should contain all written reports in the possession of the
foster parent relevant to the grievance.
5.
The Executive Director may use whatever means he/she deems appropriate (e.g., meeting
with all or some of the staff involved in the grieved problem, reading available reports, meeting
with the foster parent) that would assist in reaching a decision regarding the grieved matter.
6.
In the event that the grievance involves the Executive Director, the foster parent may ask
that the matter be brought instead to the attention of the Personnel Committee of the San Mar
Children’s Home Inc., Board of Managers. Any issues brought before this Committee must be
done in writing and done so through the office of the Executive Director in able to ensure that
proper procedures have been and are being followed.
7.
The Personnel Committee shall meet with the foster parent as soon as possible, but no
longer than 30 days from the submission to them of the written request for such a meeting. The
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foster parent must be sure to outline in detail and in writing the substance of the grievance prior
to the meeting in order to ensure a clear understanding of the problem by all committee
members. All previous listed material pertinent to the grievance shall be included in the request.
8.
After investigating the grievance brought before them, the Personnel Committee will
render a final decision on behalf of the Board of Directors. The Board of Directors is the ultimate
and final authority within the organizational structure of the San Mar Children’s Home.
9.
There is no further appeal within the San Mar Children’s Home.
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PRE-SERVICE AND ANNUAL TRAINING
Each prospective treatment foster parent shall complete a minimum of 30 hours of pre-service
training to achieve certification.
Each treatment foster parent shall complete a minimum of 24 hours of in-service training
annually. Each treatment foster parent shall document 2 hours of in-service training per month.
Maintaining Your License
To maintain your certification continuing education is mandatory. You will be required to
complete two hours of training every month that you are certified. Don’t panic….. Opportunities
for training are all around you. We will help you complete this training in the following ways:
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Case Specific Training; learning with your case manager about how to deal with
placement specific issues.
Foster Parent Support Groups-these are held on the second Thursday of every
month.
Book study groups sponsored by TFC.
Web-training (you can Google topics like: child development, foster parenting,
parenting hurting teens, health, children and recreation) – simply complete a
summary report of the material you studied with date and time.
Case Manager – individualized training materials related to the child placed in
your home- one hour per month
Books and videos in the San Mar library which is located in the hallway of the
TFC offices. Please let someone on the staff know if you are borrowing a book or
video. If there is a specific area you would like to know more about, let us know
and we will attempt to locate a resource for you.
Community based trainings sponsored by other local agencies can be used but
must be approved on a case by case basis.
Internet resources such as Youtube.com as approved by San Mar.
Movie nights at San Mar
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MONTHLY SUPPORT GROUPS FOR FOSTER
PARENTS
On the second Thursday of each month throughout the year, we hold support group meetings for
our TFC providers in which they can come together and share with each of their experiences. It
is a great learning opportunity to learn from your peers and to network with them. Attendance
and participation also counts towards yearly training requirements.
SAN MAR TFC PARENT
GROUP
San Mar TFC has initiated a Facebook group that is confidential and available only through
invitation. This group provides access to staff and other foster parents for training topics and
group discussion.
Policy Regarding Non-Completed Hours
TREATMENT FOSTER PARENT ANNUAL
PERFORMANCE EVALUATION
All Treatment Foster Parents will participate in an annual performance evaluation process. Many
of the skills needed to provide effective treatment foster care services are learned “on-the-job”. A
review of each provider’s progress and development provides documentation of performance
strengths, performance weaknesses, and an agreed upon plan for ongoing professional grown,
development, and improvement. The purpose of the evaluation is always to take inventory of the
past and to plan for the future. A Treatment Foster Parent’s willing and honest input into this
process can greatly enhance his or her own professional advancement and ability to help children
in need. All TFC providers will be asked to provide annual proof of auto insurance, home
insurance, and proof of income. Every two years, they will be asked to provide proof of physical
examinations and PPD tests and CPR and First Aid certification. Every three years, proof of
rabies vaccines for all pets is required.
At any time there is a significant change in the family’s status that may reflect upon their ability
to continue to meet eligibility requirements, an additional evaluation can be implemented by San
Mar staff.
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RATE OF REIMBURSEMENT FOR CARE PROVIDED
Each treatment foster family is reimbursed at the rates listed below as of April 2011. About one
half of this amount ($850.00) is the payment from the Board of Childcare. This money is to be
used to meet the needs of the child. This includes, but is not limited to, food, housing, utilities
used by the foster youth in the home, over-the-counter medication, transportation, fees required
for extracurricular activities (school trips), bedding, gifts for special occasions, toiletry and
personal care items, and allowances. Foster parents are expected to cover normal transportation
costs and any routine auxiliary costs relevant to the child’s well being. The other portion of the
reimbursement is the “difficulty of care” stipend ($700.00) for the specific treatment provided to
meet the individual child’s needs. This portion is considered your paycheck. These
reimbursement rates are subject to change without notice.
Each treatment foster family must submit a “Time-In-Care-Log” to San Mar each month. These
forms can be given to the case manager. The Time-In-Care-Log sheet must be postmarked no
later than the fifth business day of month for the logging of the child’s time in care for the
previous month in order to facilitate timely payment to the foster parent.
Foster payments are posted for direct deposit on approximately the 20th of the month for
services rendered during the previous month. If the 20th falls on a weekend or a holiday, foster
payments will be posted earlier, when possible. San Mar Children’s Home makes payment to its
TFC parents by direct deposit only.
A merit increase in the “difficulty of care” stipend is given to foster parents who have shown
professional growth, positive performance, and have been certified for twelve (12) months. Rates
will be determined annually by San Mar in response to State funding availability.
USE OF MONTHLY BOARD PAYMENTS
The San Mar Children’s Home acts in accordance with State of Maryland regulations as they
pertain to clothing allowances and weekly allowances. Below is a copy of the directive we have
received from the State. In the appendix, you will find the forms used by San Mar to track these
requirements. They are the Weekly Allowance Ledger and the Clothing Allowance Form.
Purpose
This policy directive details the guidelines for foster providers (regular, intermediate, treatment
foster parents, and group providers) to utilize the monthly board rate payment paid on behalf of
foster youth. This policy directive includes specific requirements for the clothing allowance to
meet the basic needs of youth and requirements for a weekly allowance for youth.
Background
Foster parents are partners of the Local Departments of Social Services in providing the
necessary care for children in need of a safe and stable home. During the 30 hours of pre-service
training, treatment foster parents are taught about their responsibilities in meeting the material
needs of the children in their care. COMAR 07.02.25.08 states that foster parents are to “provide
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daily essentials that are required for health, comfort, and good grooming of a child, including
proper clothing for the season.” The board rate amount has been increased over the past few
years to allow the foster parent to meet the actual costs of providing for the child(ren) in their
care. The United States Department of Agriculture estimates that it will cost $7,560 annually
($630.00 monthly) to raise a child.
Private foster care agencies (group providers and private treatment foster care agencies) submit
an annual budget to the DHR Office of Licensing and Monitoring and the Maryland Interagency
Rate Committee which outlines the cost for all services provided for each child in the program
including the cost for a clothing allowance. Private agencies provide clothing allowances to their
foster parents or youth on either a monthly or quarterly basis. Private agencies are provided
sufficient funds within their monthly payment amount as established by the IRC to cover the
approved clothing allowance for placements in their programs and are not eligible to receive
additional funds for this purpose from the local department.
Clothing allowances are set as a standardized portion of the monthly board rates issued to public
foster providers so that they may provide for the garments/personal care items required for each
child. The regular monthly foster care rate is expected to provide for the room, board, and
clothing needs of every child placed with a foster care provider. While Maryland does not
continually monitor the spending of the monthly board rate, it is expected that, at minimum, the
identified clothing allowance is used to provide the child with clothing and personal care items.
In addition to the monthly board rate, there is also an initial one-time clothing allowance,
categorized by the age of the child, which is available at the time of the initial removal and
placement to assist with meeting the clothing needs of the child upon initial entry into out-ofhome placement. This is only available to public resource parents. There may be special
circumstances such as graduation, proms, or medically-related circumstances when special
planning or even further assistance may be warranted and flex funds may be expended for these
situations.
Monthly Board Rate
Foster parents (including treatment foster parents) and group home providers receive a monthly
board rate for the care of the foster youth which is negotiated and established by the Maryland
Interagency Rates Committee. Per COMAR, the board rate is to be used to provide care for the
foster youth. Included in the monthly board rate are the following:
Food (including infant formula);
Housing;
Utilities used by the foster youth in the home;
Over-the-counter medication;
Transportation (not long distances specific to foster youth) and bus pass for older youth;
Fees required for extracurricular activities (school trips);
Bedding (pillow, sheets, comforter);
Gifts for special occasions (birthday and Christmas);
Toiletry and personal care items (hair care and styling, and feminine hygiene products, diapers);
Allowance.
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Clothing Allowance
The local department of social services is required to visit the child in the placement on a regular
basis per policy directive SSA# 09-9 Caseworker Visitation with Child in OHP. These inplacement visitations shall include a review by the caseworker of the clothing items available for
the child. Many foster parents go above and beyond the clothing allowance in providing for the
clothing and personal care needs of the child. While they are under no obligation to utilize the
other portion of the monthly board rate in this manner, they should be commended for
prioritizing the direct needs of the child in utilizing monetary support provided by the agency.
If the child is placed in a Residential Treatment Center, the RTC may bill the local department
for a monthly clothing allowance not to exceed $75. The caseworker must ensure that the funds
are expended for this purpose.
A. Entry
The case worker shall conduct an inventory of the child’s clothing at the time of entry into Out
of- Home Placement. The case worker shall use the Minimum Clothing and Personal Care
Guidelines (found in Appendix of this Handbook) when completing the inventory. After
completing the clothing inventory, the case worker shall communicate with the foster parents on
what items of clothing require purchasing.
At the time of placement in a foster home, the caseworker shall provide the foster parent with a
copy of the Minimum Clothing and Personal Care Guidelines. The caseworker shall also inform
the foster parent that meeting those guidelines will be discussed after a 60 day period.
A suitcase or canvas bag (such as a large duffel bag) to transport clothing is considered an
essential part of the things children in foster care should have. Plastic trash bags are not
acceptable under any circumstances. The local department shall ensure that every child that
enters out-of-home placement has a suitcase or duffel bag. This suitcase or bag shall travel with
the youth to each placement.
Private Foster Care Agencies shall provide initial clothing to youth that are placed through their
agency. Private agencies do not receive the one time clothing allowance. The local
department may use their own discretion to purchase clothing for youth placed in private foster
care agencies through the utilization of flex funds.
B. 60 Days in the Placement
At the first home visit after the child has been in the placement for at least 60 days, the
caseworker shall review the child’s available clothing items to determine if the child’s minimum
clothing needs have been addressed. If it is determined that minimum clothing needs are not
being met, the caseworker shall work with the foster parent to develop a Plan to meet Minimum
Clothing Guidelines. The plan covers a 90 day period which gives the foster parent up to 3
months of clothing allowance with which to satisfy the guidelines, if necessary. While the
foster parent shall be encouraged to meet these guidelines as soon as possible, consideration shall
be given to staying within the monthly clothing allowance.
C. General Standards
• Child Ownership of Clothing and Personal Items:
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Any item of clothing, personal hygiene or toys/electronics purchased for the foster youth belong
to the foster youth. These items may have been purchased by the foster family (including
extended family), donated or gifted. Regardless of how the child received the items, they are
the property/belongings of the youth and travel with the youth when a change in placement
occurs. At no time may a provider hold items belonging to the foster youth in exchange for
damages. The case worker when possible shall be equipped to move all items the day the
placement changes.
• Continual Replacement:
When a foster youth requires continuous replacements, all belongings are to travel with the youth
to each placement. At no time, for any reason, shall a case worker not allow a youth to bring all
belongings. If the youth has clothing or items that no longer fit or age appropriate it is the
youth’s discretion whether the items should be discarded.
• Encouragement of Specified Place for Clothing:
Foster providers are required to have the necessary furniture and sleeping arrangements for each
foster youth. Appropriate space for the youth to store clothing is required. At no time may the
youth store clothing worn on a regular basis in suitcases, laundry baskets or plastic containers.
• Discourage Hand Me Downs or Thrift Shop Items for Regular Clothing/Personal Needs:
Foster providers are discouraged from purchasing a foster youth’s clothing from thrift shops or
providing hand-me-down clothing. The Monthly Clothing Allowance which is part of the
monthly board payment allows the foster parent monies to purchase new items for the youth. A
foster provider may purchase a few items of used clothing for the foster youth, but this cannot be
the majority of the child’s wardrobe. All personal items shall be purchased new for the foster
youth and not shared by other members of the household or placement.
• All children shall be allowed to assist in picking out the clothing, as developmentally
appropriate. Older youth should be primarily responsible for the management and purchase of
clothing and personal care items as part of their independent living service agreement. All youth
should be permitted to select clothing that meets their own specific needs or ethnic or religious
requirements, including pregnant youth, Lesbian Gay Bisexual Transgender Questioning,
(LGBTQ) youth.
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Spending Money / Allowances / Savings
Each child / youth shall be given a minimum weekly allowance based on their age.
5 to 7 = $2
8 to 11 = $5
12 to 13 = $10
14 to 16 = $15
17 and above = $20
These amounts are minimum guidelines and may be increased depending on the child’s/youth’s
maturity, circumstances, and participation in household chore activities. The child’s case worker
shall be consulted as to the appropriate allowance amount. The Weekly Allowance Ledger can
be found in the Appendix of this handbook.
Allowances are not intended to cover items that would normally come out of the board rate such
as toiletries. Foster parents are encouraged to establish savings accounts for children and youth.
Monies in the accounts will accompany the child /youth upon their return home or to another
foster placement.
Foster parents are encouraged to assist the child /youth to purchase special occasion gifts for
their foster family and birth family, i.e. Mother’s/Father’s Day, religious holidays, birthdays, and
other special occasions.
34
Example of Monthly Board Payment Budget
Providers are given a monthly board rate of $850.00 to meet the needs of the child/youth in care.
This breaks down to $28.00 per day. Below is an example of the typical expenditures that
routinely are made from the board payment by a TFC provider, (this is exclusive of the
Difficulty of Care Payment):
Food & Personal Hygiene
(Hair cuts, over the counter medication)
$300.00
Shelter
(Provision of safe & clean environment,
Furnished bedroom, laundry services, food
preparation etc.)
$100.00
___________
Subtotal: $400.00
Utilities
Heat
Water
Disposal
Telephone
Computer Service
Cable
Insurances (home & auto)
Transportation
School Supplies
Entertainment
Clothing
Allowance (based on age)
$25.00
$10.00
$5.00
$20.00
$20.00
$20.00
___________
Subtotal: $100.00
$25.00
$100.00
$50.00
$50.00
$75.00 (required amount)
$50.00 (required amount based on age)
______________
Subtotal: $350.00
Total:
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$850.00
ON CALL EMERGENCY SERVICE
When a treatment foster parent has a question, a problem, or a concern on a weekday between 9
a.m. and 5 p.m., the case manager for your foster child or the Director of Treatment Foster Care
can be contacted at the San Mar office (240-625-9445) or directly at their cell phone number.
Cell phone numbers for all staff member are listed on the On Call Schedule. It is important that
we, as members of a treatment team, provide support to one another, especially in times of crisis.
Monday through Thursday you should contact your case manager at any time needed. On a
weekend or holiday, a Treatment Foster Care Staff person is assigned on call duty in the event
of an emergency. If the assigned worker cannot be reached, please call another worker on the
list until you are able to reach someone in person. Please make sure that you have been given a
copy of the On- Call Schedule telling you who the staff person assigned for that period of time
is. The On-Call schedule will be mailed to you and will also emailed to all those with email
addresses. On weekends, the person who is on call will be able to be reached by calling the 240625-9445, ext 200 number. Your call will be automatically forwarded to the on-call worker.
When to Call:
Treatment foster parents are expected to contact the office during regular business hours or the
on call staff when the office is not open when any of the following situations occur:
1.
2.
3.
4.
5.
6.
A foster child runs away or is missing for any reason.
A major medical problem exists.
A foster child requires emergency medical services.
A foster child is involved with the police or other legal authorities.
A foster child fails to return from a home visit.
A foster child returns from a home visit with bruises, injuries, or reports of physical or sexual
abuse or neglect.
7. An emergency, unusual or major problem develops.
36
Incident Reporting Guidelines
The following circular letter is from the State of Maryland which lists the guidelines for
reporting critical incidents:
“The Office of Licensing and Monitoring (OLM) has been experiencing frequent errors and
problems in reviewing incident reports. This information is a reminder of your responsibilities
regarding the reporting of Agency Emergencies as outlined in COMAR 07.01.05.08 A, which
states that the agency is to notify OLM by phone immediately and in writing within 48 hours of
the occurrence, of any of the following emergencies:
(a) The death of a child in foster care or receiving adoption services;
(b) Accident, assault, illness, or psychiatric episode of a child which requires
hospitalization or emergency medical care;
(c) Suspected incident of child abuse or neglect, including mental injury;
(d) Illegal activity leading to the incarceration of a child, parent, foster parent, guardian,
or adoptive parent; or
(e) Other occurrences which may affect the health, safety, or well-being of children in
care or receiving adoption services.”
The following list, which is also from the State of Maryland, lists the responsibilities of the
placement agency following a critical incident.
1. If the youth involved in the critical incident is a Department of Juvenile Justice (DJJ) youth,
a DJJ Incident Reporting Form must be completed within an hour of the incident and faxed to
the Investigations and Child Advocacy Unit at 410-333-4194. At the same time, the form
must also be faxed to the agency’s DJJ advocate, Bill Hoyle at 301-777-5976.
2. Any critical incident involving a Department of Social Services (DSS) youth must be sent to
the agency’s licensing agent, within 24 hours of the critical incident.
3. All critical incidents should have a Critical Incident Form (cover sheet) attached to the
Incident Form with the Executive Director’s, Director of Treatment Foster Care’s and the
case manager’s signature on it before the incident report is sent and filed in the youth’s file
(see attached).
4. Copies of critical incident report should be made.
 The original goes to the administration office or the Executive Director to sign. After
being signed, copied and send to the State, the original should be placed in the
youth’s file.
 A second copy is entered into the CQI matrix and filed for CQI purposes.
 A third copy is given to the appropriate Program Coordinator for internal review.
Therefore, it is imperative that you report critical incidents to your case manager and/or
the Director so that we can remain in compliance.
37
Critical Incidents:
1. Critical incidents include:
 Any occurrence that could endanger or require the immediate removal of the youth
for reasons of health or safety.
 The death of a child or staff.
 Medical or psychiatric hospitalization of a youth or staff on duty.
 Arrest of a youth.
 Life threatening injury or illness of youth or staff on duty.
 Employee charged with criminal behavior, including DUI (DJJ guidelines)
 Sexual offense committed by youth.
 Illegal use or possession of firearms by a youth, staff, or other individual involved
with the agency.
 Physical or sexual assault on or by youth.
 Physical, sexual or emotional abuse allegations (staff also must complete a child
abuse form and report allegation to Child Protective Services)
 Physical plant problem that renders a facility uninhabitable
 Riot or disturbance that results in bodily harm or property damage.
 Suicidal behavior by youth or staff on duty including attempts, gestures, and
ideations.
 Suspected illegal substance or paraphernalia discovered in/on youth or staff’s
possession.
 Use of force by youth or staff on duty.
 Incident involving law enforcement, fire department, or other emergency services at
school, work or San Mar property.
 Restraint. If a client is involved in a restraint, staff should note on the incident report
that proper restraint techniques were followed and that a life space interview occurred
or will occur.
 Locked door seclusion.
 Contraband – youth having cigarettes, matches, sharp objects, etc.
 Medication administration errors:
o Purposefully not taking medication – a youth has this right, but it must be
documented that a recommended dosage is not taken.
o Medication not available for the youth to take the prescribed dose.
o Youth takes the wrong medication.
o Youth takes the wrong dose of medication.
 Runaway from San Mar, school, work or while on a home visit.
 Property damage – fire, broken glass or furniture, etc.
General Guidelines:
1. Please make sure that program staff has given you copies of blank incident report forms. The
necessary forms can also be emailed to you for use on your home computer. Completed
forms can be submitted by email.
38
2. Foster parents and program staff must write all incident reports in bold print with black ink.
No colored pens or pencils can be used on any document that becomes part of the permanent
client record. The forms mail also be completed on a computer and emailed or faxed to San
Mar at 240-625-9446.
3. All reports need to be written legibly and neatly. Persons should write only in the space
given for reporting and then turn the sheet over if more space is required. The writer should
not write below the line where signatures go.
4. Foster parents and staff must print and sign their name on the designated lines. All reports
must be dated with the month, day and year. The time of the incident must also be noted on
the form in the space provided.
5. Foster parents and staff must indicate, by checking the box, if the incident is a daily or
critical incident.
6. Foster parents and staff must indicate, with a circle, the incident type and the consequence
given on the left side of the form.
7. If a youth receives chair time as a consequence for her/his behavior, an incident review form
(see attached) must be completed by the youth and attached to the completed incident report.
8. Incident reports should describe the event, what was said by staff /treatment foster parents
and clients and the consequence(s) given. If no consequence was given, then the report
should document that a consequence was not given. Staff should write enough details to
answer who, what, why, where, and what consequences were given. Staff do not have to
write a book, but should write enough that someone doesn’t have to go back to them for more
information.
9. Incident reports should not include statements by staff regarding what they think the client’s
issue or problem may be. Staff should never write, “I think (client) had an attitude because
she doesn’t like me.”
10. Only one client’s name can appear on each report. When writing the report, staff should use
initials only for clients. This way the report can be copied and not rewritten for each youth
involved. On the copy, staff can then write the client’s name at the top of the form and place
it in the appropriate file. Staff may use staff names on the forms.
11. If staff should make a mistake on the form, they should draw a single line through the word
so the word can still be seen. It is important that staff do not scribble or completely cover up
the mistake, just simply draw a line. Then, they should write error above the line to note
why this was done and initial the error. Staff should not use white out.
12. If foster parents or staff should have any questions, they should consult with the program
supervisor.
39
RESPITE CARE
Respite care is available to all treatment foster parents as temporary leave from treatment foster
parenting responsibilities. It is available for either scheduled or emergency reasons. Each foster
family accrues two days of free respite time per month for each San Mar treatment foster child in
the home. Children in regular foster care do not accrue free respite time. Respite time will
accrue over time unless utilized. It is transferable from one placement to the next. If you need
more respite than the free respite time you have accrued, you can take unpaid respite time.
A request for scheduled respite time should be made, in writing, to your case manager or the
Director of Treatment Foster Care two weeks in advance, except in the event of an emergency or
other extenuating circumstance. Respite will be provided on a care-available basis at the
discretion of San Mar. Respite care is a break from the responsibilities of caring for a treatment
foster child. Please note that respite is not to be used as a form of discipline for the treatment
foster child. It is a time for you to take a scheduled break from caring for the child(ren) or to
fulfill other responsibilities (e.g., attending a wedding, medical appointments, etc).
The respite provider is paid at a rate of $2.50 per hour or $50.00 for a 24 hour period. If a TFC
provider uses more than their total of accrued free respite hours, their monthly stipend will be
affected at the rates cited above.
The Director maintains a record of earned, free respite for each family. Consult with the Director
to ascertain how much such respite you have accrued. A similar record has been created for you
to monitor your free respite hours.
Record of Free Respite Hours:
Please remember you do not earn free respite until the youth has been in your home for a full
month. For example, if the child enters your home on May15th, you would begin receiving free
blocks for the month of June. This is not to say that you cannot use respite, it just will not be
free.
Note: Respite hours are calculated per child. If you are caring for two treatment foster children,
you will earn two days of free respite each month for each child. When a child leaves your home
and you still have a balance of free days, they can be applied to the next child that enters your
home.
Again, you can use any amount of respite time needed. If you choose not to use it, that is okay. It
just does not get redeemed (like a coupon from your favorite grocery store).
40
Behavior Management Policy for Treatment Foster Care Providers
Behavior modification is the form of discipline that is used in the Treatment Foster Care
Program. It is important that discipline or behavior modification is viewed as a building-up
process, a process of ego development. The goal of all discipline or behavior modification is to
help children develop self-discipline. Discipline should not be given in a disrespectful, hurtful,
vindictive or harmful manner. Foster parents should always treat each individual as having
intrinsic worth. Physical discipline of foster children is prohibited by State of Maryland policy.
It is the philosophy of San Mar that all children benefit from clear, consistent expectations and
limits. The first step in establishing good discipline is to make the limits and expectations within
your family clearly known to your foster child.
Appropriate discipline takes into account the natural and logical consequences of behavior. It is
helpful to look at what may be causing the child to act inappropriately before determining the
consequences for the inappropriate actions. A child who behaves inappropriately because he/she
is feeling upset may need to sit time-out; if frustration is the cause, work-time may be beneficial;
if manipulative, loss of privileges may be most effective; and when a child is deeply upset or
troubled, listening to his/her concerns and offering gentle guidance may be most needed.
It is very important that any behavioral consequences given be short-term and not physically or
emotionally hurt the child or appear demeaning to the child’s self image. Sarcasm and degrading
or backhanded comments which are intended to embarrass the child, will tear a person down and
should not be part of the discipline process, which is focused on building up the child. Many
children who enter our treatment foster care program have been emotionally hardened through
their life experiences. They can be capable of enduring physical and emotional pain without
much outward effect. It is through clear expectations, natural and logical consequences,
commitment to consistent discipline, and a sincere attitude of forgiveness of the person while
maintaining accountability for behavior, that the process of healing can begin.
Children are not permitted to carry out discipline on another child. Disagreements between
children cannot be resolved by allowing them to “fight it out.” Fighting only leads to more
fighting and, since children have a need to feel “safe,” fear and insecurity result when children
feel unprotected by the adults in their world. For the same reasons, youth are not allowed to act
out their aggressions on inanimate objects such as hitting pillows or punching bags. Studies have
shown that acting act violence contributes to continued violent actions.
PHYSICAL, CRUEL, AND VINDICTIVE PUNISHMENTS MAY NOT BE USED WITH
CHILDREN IN TREATMENT FOSTER CARE. Such types of punishment are strictly
prohibited by state regulation. Physical punishment includes any act that makes a child feel any
type of pain or discomfort. The following are examples of punishments that simply may NOT
be used:
1.
2.
Hitting, slapping or spanking with either a hand or an object of any sort.
Placing a strong substance in a child’s mouth such as pepper, soap, or Tabasco sauce.
41
3.
4.
5.
Tying or handcuffing a child.
Standing in one position for more than fifteen minutes at a time.
Making a child assume an uncomfortable position such as standing on one leg or bending
over.
6.
Remaining in “time-out” for more that one-half hour at a time or confinement to a
bedroom for more than fifty minutes.
7.
Physical exercise or calisthenics used solely as punishment.
8.
Excessive work that is too strenuous for the child or demeaning such as “scrubbing the
floor with a toothbrush.”
9.
Any punishment for bed-wetting or behavior related to toilet training.
10. * Denial of meals, clothing, or shelter.
Meals cannot be withheld or be different from the meals being consumed by the
foster family unless a special diet is medically recommended. Desserts cannot be
withheld as a form of discipline. If the family is having dessert, the foster child also is
given dessert.
11. Denial of communication or visits with the child’s biological family members.
(A violation of this policy can result in a report of possible abuse or neglect being made to the
local Child Protective Services by San Mar staff.)
Appropriate consequences for behavior:
All foster parents are trained to use a variety of behavior management techniques in order to
maintain structure in the home and to teach correct behavior in a positive atmosphere. There is
an emphasis placed on holding a youth responsible for his/her own behavior. The type of
behavior management used will vary depending on the age, maturity level, need and trust of the
individual.
The following are board-approved behavior management and disciplinary practices which
may be used:
There are times when children will not obey directions. Touching a youth who is upset (for
example, putting a hand on a shoulder to direct) may often inflame and worsen a situation.
Therefore, Treatment Foster Parents are taught not to touch a youth in distress. However, should
the behavior of an individual youth endanger either himself/herself or others, it may be necessary
to physically restrain him/her. In such instances it is important for properly trained foster parents
to hold him/her in a way that will not be degrading, and in a way that they can control his/her
movement without causing harm to the youth, themselves, or others. Holding an out-of-control
youth in a safe but firm manner may be reassuring and beneficial to the youth who has lost
control of his/her behavior. Youth often need to know that they are going to be all right and that
they will not be able to hurt anyone or anything. Physical restraint, when necessary, must always
be applied passively and for only the time period needed for the youth to regain control. Foster
parents must never take on the role of an aggressor when attempting to restrain a youth.
Treatment Foster Parents or treatment foster care staffs with satisfactory completion of the
appropriate training are the only ones who may perform restraints.
42
Time-Out:
Sometimes children need a cooling-off period. During time-out, the youth spends a set period of
time in an area with limited distractions, thereby eliminating those variables which may have
been reinforcing negative behavior. This technique is used for youth who may have difficulty
controlling anger and may need “space” to regain control. This technique allows the chance to
gain control for himself/herself without the intervention of others. A child should never be
isolated, locked in a room, or placed in an enclosed area such as a closet. Time-out may be
assigned by foster parents, or a youth may request a time-out period himself/herself. Time-out
should be limited to one minute for every year of age for a child (i.e., no more than seven
minutes for a seven-year-old.)
Work Time:
Youth may be given an amount of time to work around the house (over and beyond the normal
daily chores) after a significant behavior incident. Work time may also be given to offset
restitution charges (if the youth is not employed). Restitution for non-accidental damage or
defacing of property is required as it teaches accountability and responsibility for behavior.
When giving work time, foster parents must be clear and specific as to what is expected. Foster
parents will be responsible for checking the chore afterwards and at times may need to work
along with the youth or monitor the work as it is being done. Caution should be exercised when
giving work time if the foster parents have no intention of following through with checking the
chore, or accepting anything goes with the assigned task. This gives the youth the opportunity to
develop an unhealthy approach to expectations and follow-through.
Early Bedtime:
Early bedtime may be an appropriate intervention to modify behavior. Generally, children
should not be sent to bed more that one hour earlier that usual. A caution to be recognized by
treatment foster parents is that overuse of early bedtime may result in chaotic conditions at night
until others in the treatment foster home go to bed, or in the morning when children who have
gone to bed early are ready to arise earlier than usual.
Supervision:
Sometimes it is helpful to place a child on supervision for the day. This means that the child
must stay with the adult for the entire day. This technique can aid an unstable child to maintain
control and provide assurance that someone will be available to give help if needed.
Contracting:
Foster parents, with or without the assistance of foster care staff, may write a contract to address
particular behavior(s) or to “spell out” rules or guidelines. There should be concrete measurable
goals with incentives or “benchmarks” indicating progress. Contracts should be made by
including the youth in the process as much as possible. Contracts must be shared with the case
manager and/or other program staff.
Problem Solving:
Treatment foster care staff will work with foster parents to utilize specific problem solving
techniques in the event of a crisis or need for immediate decision-making. Problem-solving
43
techniques help one identify options, partialize tasks, and make informed decisions, encouraging
the youth to think of alternative solutions and their possible effects.
Awarding/Withholding Privileges:
Behavior may be modified by awarding or withholding privileges. Either technique should be
given in a consistent and immediate manner. All disciplinary actions taken to assist the child
must be logged in the treatment foster parent’s weekly observation log. When it seems
appropriate, privileges may be withheld as a consequence for violation of trust or other safety
violations. If a child is “grounded” (no privileges outside the home), it is important that the time
period be long enough to be meaningful to a child, but short enough for the child, given his or
her abilities, to complete. “Grounding” may not exceed two weeks without permission of the
child’s case manager or the Director of Treatment Foster Care. The terms must be clearly
explained to the child
Written Assignments:
Youth may be assigned to write essays as a consequence, as decided by their foster parents or
treatment foster care staff. Written assignments should be age-appropriate and geared to the
cognitive level of the child. Sentence writing may be given to younger children (no more than
100 sentences per assignment).
Summary of Discipline Techniques by Age:








Birth to 4 months: No discipline necessary
4 to 8 months: Mild verbal disapproval
8 months to 18 months: Structuring the home environment, distracting, ignoring, redirecting, verbal and nonverbal disapproval, physically moving or escorting, short-term
time out
3 years to 5 years: The preceding techniques with temporary time-out in a room, plus
natural consequences, restricting places where the child can misbehave, logical
consequences.
5 years to adolescence: The preceding techniques plus delay of a privilege, “I”
statements, and negotiation via family conferences
Adolescence: Logical consequences, “I” messages, family conferences about house rules
Natural consequences: Your child can learn good behavior from the natural laws of the
physical world, e.g., not dressing properly for the weather means the child may get cold
or wet; breaking a toy means it isn’t fun to play with anymore.
Discontinue any yelling: Yelling and screaming teach the child to yell back, you are
thereby legitimizing shouting matches. The child will respond better in the long run to a
pleasant, respectful tone of voice and words of diplomacy.
Guidelines for Giving Consequences:



Be un-ambivalent, mean what you say and follow through
Correct with love, talk to the child the way you want people to speak to you
Apply the consequences immediately
44





Make a one sentence comment about the rule when you punish the child
Ignore your child’s arguments while you are correcting him or her
Make the punishment brief
Follow the consequence with love and trust
Direct the punishment against the misbehavior, not the person
Paying Attention to Ignoring:
 What is it?
It is not looking at or talking to the child when the goal of the
child’s behavior is to create a reaction in the parent, usually a manipulative
attempt to gain attention
 Why ignore it?
To avoid reinforcing dysfunctional/unacceptable behavior,
to communicate disapproval nonverbally
 How to ignore it.
1. Identify the behavior you want to ignore
2. Give no attention whatsoever as long as this behavior
Continues
3. Acknowledge the child as soon as the behavior becomes
acceptable
4. If the child has a limited repertoire of acceptable
behaviors, with which to attract positive attention, then the
TFC parent must teach the child how to get needs met
through positive behavior

Limits to Ignoring: Never ignore behaviors that present the risk of harm to the
child or others and never ignore behaviors that threaten destruction of property.
 Look to see what the child is doing and wait for a natural pause
 Get the child’s attention
 Give the instruction in short and simple language
 Gently hold the child’s arm while you and/or the child complete the task
without talking
 If the child does not move to do it in 10 seconds, go to the child without
talking
 Praise any cooperation.
 This does not reward the behavior but also does not make a big deal about
the behavior and does reward any effort the child makes toward
cooperation
The following information was gained from the University of Maryland School of Social Work.
References are unavailable.
TEMPER TANTRUM MANAGEMENT:
1. Keep in mind this is not willful behavior, the child also does not like what he/she is doing,
behavior may be related to hunger, fatigue, illness or physical discomfort
Assess the present way you’re handling the tantrums, if a developmental delay exists, seek
help, evaluation and treatment
45
Reduce stress in the child’s life
 Maximize choices when possible
 Child proof the environment fully
 Praise and attend to cooperative behavior or any piece of behavior
you can praise
 Safeguard the child during the incident, stand by silently, and give
the message of “I can tolerate anger. Feelings are okay but I’m not
going to give in”
 Comfort or distract afterward
SPECIAL TIME:
 Parent picks time every day to devote exclusively to the child
 Child picks activity
 Parent labels it “special time” to child
 Pick a short enough period for it to be emotionally and practically possible and positive
 Do it daily even on special dates
 End on time, children have to learn how to stop
 Activity should be interactive.
 If child refuses, parent still sets time aside and follows child around. Child will eventually
interact during “special time”
TIME OUT:
 Use only for selected behaviors, generally aggressive behavior
 Do use for minor infractions of family rules or for normal accidents
 Pick a time-out place without interesting things to do or to look at
 One warning of ten words or less
 When aggression is the issue, no warnings issued
 Cite offense simply and clearly
 No discussion or negotiation
 Time out implies loss of freedom, interest and parent’s attention
 Use an objective time, shorter is better. One minute per year of age up to five minutes
 Do not spank, do not talk
 Afterwards, do not discuss it, clean slate
 Two purposes of time-out: to teach the child he has to learn to control his behavior if
he wants to be around others and to give you a chance to keep control of your own
behavior and emotions.
GIVING CHOICES:
 Always select choices you like. Never provide one you like and one you don’t because
the child will usually select the negative one
 Never give a choice unless you are willing to allow the child to experience the
consequences of that choice
 Never give choices when a child is in danger
 Never give choices unless you are willing to make the choice for the child in the event
46

he/she does not choose
Try to start your sentence with: “You are welcome to…….. or…….”
“Feel free to …….. or……………..”
“Would you rather…………or……”
LOGICAL CONSEQUENCES: Are the result of going against the rules of social cooperation.
 Express the rules of social living
 Are related to the misbehavior
 Separate the deed from the doer
 Are concerned with what will happen in the present
 Are given in a friendly way
 Permit choices
 Guidelines:
o With repeated misbehavior, increase the time of the consequence
o Phrase the choice respectfully
o Respect the child’s choice
o Say as little as possible, the goal is to let the child choose
o Make it clear when there is no choice
o Keep hostility out of your consequences
REFLECTIVE LISTENING
 Establish eye contact
 Listen to and define the feelings. Ask yourself what the child is feeling.
 State the feeling back to the child
 If you are not sure what the child is feeling, make an educated guess
 Once you understand reflective listening, you may want to use less structured statements
 Reflecting feelings in this way lets your child know you have heard the feelings and
meaning behind the words, the child’s underlying feelings are recognized, expressed and
accepted
DISCIPLINE SUMMARY:
Fair, firm, and consistent discipline is one of the most beneficial experiences a treatment foster
parent can give to a child. Holding a youth accountable to a known standard, while seeking to
help him/her accept responsibility for his/her actions, is an important aspect of the treatment
process. A large portion of a foster parent’s energies are directed to confronting inappropriate
behaviors and teaching the concept that all behavior results in consequences…positive behavior
results in positive consequences, negative behavior in negative consequences. Behavior
management is often very therapeutic.
47
FOSTER YOUTH EARNINGS
A challenge faced by all parents, including Treatment Foster Parents, is teaching children the
value of money and helping children to experience the wise use of their earnings. Delaying the
immediate gratification of a “spending spree” when money is available can be difficult for any
child, especially a child who may have experienced either a deprived or a “free spending” family
environment. Learning the careful use of money is essential for adolescents who are preparing
for eventual independence. The following guidelines are intended to help children to develop a
healthy attitude towards the use of their earnings.
Money which a child earns through employment shall not be applied to the general care of the
child.
Recommended Money Management Plan
A youth is encouraged to obtain employment, so that he/she can begin saving for their future.
When receiving income, San Mar recommends that 10% be kept by the youth, 45% be placed in
short term savings, and 45% be placed in long term savings.
All deposits and withdrawals from the youth’s accounts shall be recorded on a financial ledger.
The youth and foster parents will sign this form witnessing any changes in the financial status to
insure an accurate accounting of each youth’s finances.
48
RESPONSIBILITIES OF WORKING TFC CHILDREN
1.
2.
3.
4.
5.
6.
7.
8.
9.
The TFC youth should receive permission to become employed from the TFC Case
Manager
The TFC youth may work only on weekends and holidays during the school year. A
summer schedule is subject to approval by the TFC parents and Case Manager’
The child may work no earlier than 7:30 am or later than 10:00 pm unless approval is
given.
It is necessary to schedule working hours around therapy appointments, court dates,
Treatment Team Reviews and other necessary appointments
The TFC youth must work the schedule assigned by the job and must remain at the job
site during hours of employment
Transportation to and from the work site must be worked out with the TFC parents. TFC
youth may not ride in a motor vehicle driven by someone under the age of 21.
TFC youth may not quit a job without approval from the Case Manager and TFC parents.
Once approved, the TFC youth must give two weeks notice.
The majority of monies earned will be placed into a joint savings account with the name
of the TFC youth and Case Manager both on the account. The amount of savings will be
worked out with the Case Manager and TFC providers.
Money earned by the child in employment is not be used for the general care of the child.
49
PAYMENT OF HEALTH CARE COSTS
It is expected that ALL medical, dental, and optical services will be provided by a licensed health
professional who accept the HMO plan authorized by Medical Assistance for payment. San Mar
will not assume responsibility for payment of medical bills to professionals who do not accept
Medical Assistance.
Cash payment shall not be made to the service provider since Medical Assistance WILL NOT
reimburse cash payments. On a case by case basis, the local Department of Social Services may
choose to reimburse such costs. San Mar Children’s Home ordinarily is unable to reimburse for
any of these costs.
Exceptions to these procedures may only be granted by the Chief Executive Officer of San Mar
or his/her designee. In the case of an emergency, the on-call person must be contacted if time
and circumstances allow. However, the most important task in an emergency is to get the child
the required medical care as quickly as possible.
When a child is not eligible for Medical Assistance, it is usually because the child is covered by
another health-care plan. Frequently the child’s coverage is as a dependent on the plan of a
biological parent. Generally, such plans have some restrictions. The case manager for the child
will discuss the limitations of a child’s specific coverage with you. It is important that treatment
foster parents access all health care benefits available to each child.
HEALTH EXAMINATIONS
There are certain required health examinations for all children, in treatment foster care. The
following is the schedule for mandated routine exams:
ROUTINE PHYSICAL: Once every year
ROUTINE DENTAL: Once every six months, for children ages 3 and older
EYE EXAM: Once every year
SECOND MMR IMMUNIZATION (Measles, mumps, rubella): Upon admission if not received
prior to admission.
Since each child will have had some of the above examinations prior to placement with San Mar,
each treatment foster parent must contact their child’s case manager to determine which
examinations are needed. All health exams must be scheduled in a timely manner. Each child
should have all routine health exams completed within the first sixty days of placement.
50
Universal Precautions
Definition:
Universal precautions are those practices performed to prevent and control the transmission of
blood-borne pathogens. Universal precautions apply to tissue, blood and other body fluids
containing blood. Potential infections body fluids are referred to as sputum, vomits, sweat, tears,
urine, nasal secretions, feces, saliva that may not have visible blood, but offers the potential for
disease transmission.
Compliance Statement:
Universal precautions should be observed to prevent contact with blood or other potentially
infectious body fluids. All blood or other potential infectious body fluids should be considered
infectious.
1. All body fluids shall be considered infectious material.
2. The use of gloves is recommended any time you may come in contact with body
fluids.
3. Hands must be washed before donning and after removal of gloves. Any other
potentially contaminated skin areas must immediately be washed with soap and
water.
4. All body fluid spill or contaminated areas should be cleaned and disinfected
immediately.
5. All contaminated items are to be bagged. Double bagging may be necessary to
prevent soak through or leakage of fluid.
HOW ARE INFECTIONS SPREAD?
Infections can be transmitted from person to person through physical contact or just from being
in the same room. When children from different families attend child care, infections spread
easily. Children’s normal affectionate behavior is part of the reason. Toy sharing, hugging and
51
kissing are all quick ways to pass germs, but shouldn’t be discouraged. What should be
encouraged is better hygiene, especially hand washing.
We find three common kinds of infections in child care settings: respiratory infections, intestinal
tract infections and skin infections.
Respiratory infections are the most common childhood illnesses. These viruses and bacteria
live in the respiratory tract (lungs, nose, mouth, throat and connected passages). They’re in saliva
and nose secretions. Respiratory germs float through the air and are inhaled or settle in the eyes,
nose or mouth.
Colds and flu are examples of infections caused by germs that spread this way. Ear infections are
also caused by respiratory tract germs. Strep throat germs are spread when you sneeze or cough.
Runny noses also spread respiratory infections, especially if caregivers don’t wash their hands
after wiping noses.
Often, you don’t feel sick for the first few days of having a respiratory infection. However,
during that time, you can spread germs to others. For this reason, it’s best to practice good
hygiene all the time, not just when you or others are sick.
Intestinal infections include diarrhea and other illnesses. You can be infected by the intestinal
tract germs in bowel movements (or infect someone else!) if you don’t wash your hands after
you use the bathroom, after you change diapers or before handling or eating food. Unclean hands
easily pass germs along to food, toys or water.
The risk of spreading these germs (and the frequency of diarrhea) is greater in child care setting
where children are in diapers. Preventing the spread of these intestinal infections requires strict
hygiene practices.
Skin and scalp infections are caused by germs, fungus or parasites. They are spread by direct
physical contact and by using other people’s clothing or brushes and combs. Ringworm (which is
a fungus, not a worm), impetigo (a bacterial infection that causes crusty red sores on the face and
hands), and scabies and head lice (both small parasites) are spread by person-to-person contact.
HOW WE CAN PREVENT INFECTIONS
Everyone’s help is important to control infectious diseases. Parents, children, and caregivers
must work together to stop germs from spreading.
The first step to control infectious diseases is setting clear policies for the child care setting.
These policies should include:
Immunization: Children’s and adult’s immunizations should be up to date. Staff and children’s
files need to include this information. Children should be immunized against: diphtheria,
whooping cough (pertussis), tetanus, polio, measles, mumps, chicken pox, German measles
(rubella), and Haemophilus influenzae type b or Hib (which causes bacterial meningitis and
epiglottitis).
Illness: Neither children nor adults should be in the childcare setting when they are sick. The
program’s policies should clearly set out guidelines for when caregivers, center staff or children
are required to stay home. Guidelines help parents decide if their children should go to childcare.
Parents should arrange in advance to have alternative childcare available.
52
Communication: Both caregivers and parents should keep each other informed about the health
of each child, every day. In this way, infectious diseases can sometimes be stopped from
spreading.
Hygiene: Every setting needs clear policies and practices for infection control. These should
include hand washing, sanitation and food safety requirements.
Hand washing is the best defense against spreading germs. Everyone should wash their hands after
going to the toilet, changing a diaper, after caring for or cleaning up after someone who is sick, and
before preparing or eating food.
Hygienic diaper-changing routines prevent passing germs around. Their importance should be clear
to all those working with children in the child care setting, including parents.
Cleaning and sanitization of food preparation areas, bathrooms and toys with a recommended
sanitizing solution such as bleach/water are important. Staff and caregivers should understand food
safety practices to prevent food-borne illness.
Comprehensive HIV Prevention Messages for Young People:
HIV-related illness and death now have the greatest impact on young people. AIDS is a leading
cause of death among Americans 25- to 44-years-old. In this same age group, AIDS now
accounts on average for 1 in every 3 deaths among African-American men and 1 in 5 deaths in
African-American women. Between 1990 and 1995, AIDS incidence among people 13- to 25years-old rose nearly 20%. While AIDS incidence among both young gay and bisexual men and
young injecting drug users was relatively constant during this time period, AIDS incidence
among young heterosexual men and women rose more than 130%.
A study by the National Cancer Institute, confirms existing data that reveal that as each
generation comes of age, there is a substantial increase in the rate of infection as individuals
enter their late teens and early twenties, with infection rates peaking in the mid-to-late twenties.
Sustained and targeted prevention for each group entering young adulthood is what will keep
these waves from developing. As the lead federal agency for HIV prevention, CDC is
responsible for implementing public education programs to help stop the spread of HIV and
other sexually transmitted diseases (STDs).
A Balance of Prevention Messages is Needed--Including Abstinence and Condom Use
Behavioral science has shown that a balance of prevention messages is important for young
people. Total abstinence from sexual activity is the only sure way to prevent sexual transmission
of HIV infection. Despite all efforts, some young people may still engage in sexual intercourse
that puts them at risk for HIV and other STDs. For these individuals, the correct and consistent
use of latex condoms has been shown to be highly effective in preventing the transmission of
HIV and other STDs. Data clearly show that many young people are sexually active and that
they are placing themselves and their partners at risk for infection with HIV and other STDs.
These young people must be provided the skills and support they need to protect themselves.
53
Influenza
What is influenza?
Influenza, commonly called “the flu,” is a highly contagious infection of the nose, throat,
bronchial tubes, and lungs.
What is the infectious agent that causes influenza?
Influenza is caused by viruses that infect the respiratory tract. Two main types of influenza
viruses -- influenza type A and influenza type B -- cause the outbreaks and epidemics of
respiratory illness that occur almost every winter.
Influenza viruses are unusual because they are always changing. Influenza viruses can undergo
two types of changes. “Antigenic drift” is a series of changes, over time, which causes a gradual
evolution of the virus. Antigenic drift results in the emergence of new influenza strains. Different
strains circulating during each influenza season give rise to yearly outbreaks and epidemics.
“Antigenic shift” is an abrupt change that results in new forms (subtypes) of the virus. Antigenic
shift occurs only occasionally. When it does occur, large numbers of people, and sometimes the
entire population, are without protective immunity. This can result in a catastrophic worldwide
epidemic, called a pandemic, such as those that occurred in 1918, 1957, and 1968.
How do people get influenza?
Influenza viruses spread through the air, most often when an infected person sneezes, coughs, or
speaks. Influenza is highly contagious and is easily spread from person to person by droplets
from the nose or throat of an infected person.
What are the signs and symptoms of influenza?
Compared with most other viral infections of the respiratory tract, such as the common cold,
influenza infection often causes a more severe illness. Typical symptoms are:

Abrupt fever

Muscle aches

Severe tiredness

Cough
54

Sore throat

Runny or stuffy nose

Headache
Influenza also lingers longer than most other common respiratory infections, often lasting a week
or more. Influenza should not be confused with the so-called “stomach flu,” which is a catch-all
term for various digestive system problems caused by other microorganisms.
Who is at risk for influenza?
Anyone can get influenza, but the risk of complications is highest in these groups:

Persons aged 65 years and older

Residents of nursing homes and other long-term care facilities

Adults and children with long-lasting disorders of the lungs or heart, including children
with asthma

Adults and children with diabetes, kidney disease, or weakened immune systems

Women who will be in the second or third trimester of pregnancy during influenza season

Health-care workers, household members, and others who are in contact with persons at
high risk for influenza and influenza-related complications
How can influenza be prevented?
The best way to prevent influenza is to get a yearly flu vaccination. Influenza viruses change
over time, and each year the vaccine is updated to include the viruses that are most likely to
circulate in the upcoming influenza season. Therefore, people who need to be protected against
influenza should get a flu shot every year. Flu shots are 70%-90% effective in preventing
influenza in healthy adults. In elderly or chronically ill persons, influenza vaccine may be less
effective in preventing illness than in preventing serious complications and death.
Who should get vaccinated against influenza?
Anyone who wants to avoid influenza can get a flu shot. Flu shots are particularly recommended
for persons who are at high risk of having a serious complication when they get influenza. These
include:

All persons age 65 years and older

Persons of any age with certain long-term health problems that put them at increased risk
of influenza-related complications, hospitalization, and death

Care givers of high-risk persons and persons who live with persons at high risk
The best time to get a flu shot is between October and mid-November every year. However,
vaccinations can be given as early as September and well into December, even after influenza
begins appearing in a community.
Hepatitis B
What is hepatitis B?
Hepatitis B is a serious infection of the liver.
55
How do people get hepatitis B infection?
Hepatitis B virus is easily spread by direct contact with the blood or body fluids of an infected
person. For example, hepatitis B can be transmitted from an infected mother to her baby at birth,
through unprotected sex with an infected person, by sharing drug paraphernalia, and by
occupational contact with blood in a health-care setting. Hepatitis B is not spread through food or
water or by casual contact.
People can have hepatitis B (and spread the disease) without knowing it. Sometimes, people who
are infected with hepatitis B virus never recover fully from the infection. They carry the virus
and can infect others for the rest of their lives.
What are the signs and symptoms of hepatitis B?
Many persons who are infected with hepatitis B virus have no symptoms. Others become ill with
these symptoms:

Loss of appetite

Tiredness

Pain in muscles, joints, or stomach

Diarrhea or vomiting

Jaundice (yellowing of the skin and whites of the eyes)
What complications can result from hepatitis B?
Most infected persons clear the hepatitis B virus out of their systems completely in a few
months. In some people, especially infants and children, hepatitis B virus can cause chronic
(lifelong) liver infection. Chronic infection can lead to liver damage (cirrhosis), liver cancer, and
death.
How is hepatitis B diagnosed?
Hepatitis B can be diagnosed by a blood test.
Who is at risk for hepatitis B?
Anyone can get hepatitis B, but the risk is higher if a person:

Has sex with someone infected with hepatitis B virus

Has sex with more than one partner

Is a man who has sex with another man

Lives in the same house with someone who has lifelong hepatitis B virus infection

Has a job that involves contact with human blood

Injects illegal drugs

Is a patient or worker in a home for the developmentally disabled

Has hemophilia

Moves or travels often to areas where hepatitis B is common
56
Persons whose parents were born in some parts of China, Southeast Asia, Africa, the Amazon
Basin in South America, the Pacific islands, and the Middle East are also at high risk.
What is the treatment for hepatitis B?
There is no cure for hepatitis B. Treatment includes rest and proper diet.
How can hepatitis B be prevented?
Hepatitis B vaccine is the best protection against hepatitis B virus. The vaccine prevents both
hepatitis B virus infection and the chronic diseases related to hepatitis B. Three shots are needed
for complete protection. Hepatitis B vaccine is recommended for:

All newborn babies

All children 11-12 years of age who have not been vaccinated

Persons of any age whose behavior or job puts them at high risk for hepatitis B virus
infection
All pregnant women should be tested for hepatitis B virus early in their pregnancy. If the blood
test is positive, the baby should receive hepatitis B vaccine at birth, along with another shot
(hepatitis B immune globulin). If the blood test shows that the mother is not infected, vaccination
of the baby can be delayed until age 2-6 months. This delay responds to concerns that the small
amounts of mercury in the vaccine preservative thimerosal could pose a theoretical risk to
newborn infants, although no scientific evidence of harm caused by this level of exposure has
been reported. When a new hepatitis B vaccine that does not contain the preservative thimerosal
becomes available, newborn hepatitis B vaccination does not need to be delayed and can start at
birth.
Hepatitis B vaccine has been available since 1982 and has been shown to be very safe when
given to infants, children, and adults. More than 200 million doses of hepatitis B vaccine have
been administered in the United States, including more than 50 million doses administered to
infants and young children. The most common side effect from hepatitis B vaccination is
temporary pain at the injection site, occurring in about 3%-9% of children and adolescents and
13%-29% of adults. The second most commonly reported side effect is mild to moderate fever,
occurring in about 4%-7% of children and 1% of adults. Studies show that these side effects are
reported no more often among vaccinated persons than among persons not receiving vaccine.
There is no confirmed scientific evidence that hepatitis B vaccine causes chronic illness. Largescale hepatitis B immunization programs in the United States and abroad have observed no
associated between vaccination and serious adverse events, and surveillance in the United States
has shown no association between hepatitis B vaccination and the occurrence of serious adverse
events.
57
Tuberculosis (TB)

Tuberculosis (TB) is a serious, re-emerging bacterial illness that usually affects the lungs.

TB bacteria are spread from person to person through the air.

There are two forms of TB: 1) TB infection, and 2) TB disease (active TB). Most people
with TB have infection. People with TB infection have no symptoms and cannot spread
TB to others. People with TB disease have symptoms and can spread TB to others.

People with TB infection can take medicine to keep them from getting TB disease.
People with TB disease can usually be cured with anti-TB drugs. To be effective, the
drugs must be taken exactly as prescribed. Some new strains of TB are resistant to many
anti-TB drugs.

Preventing TB involves: 1) keeping people from becoming infected with TB, 2) keeping
people with TB infection from getting TB disease, 3) treating people with TB disease,
and 4) implementing precautions in institutional settings to reduce the risk of TB
transmission.
What is tuberculosis (TB)?
Tuberculosis, or TB, is an infectious disease that usually affects the lungs but that can attack
other parts of the body. There are two forms of TB: TB infection and TB disease (or active TB).
Most people with TB have TB infection.
Where is tuberculosis found?
Tuberculosis can be found everywhere worldwide.
How do people get tuberculosis?
Tuberculosis is spread from person to person through the air. People with TB disease of the lung
spray the bacteria into the air when they cough, sneeze, talk, or laugh. People nearby can breathe
in the bacteria and become infected. To become infected, a person usually needs to be exposed
for a long time to air containing many TB bacteria.
When a person breathes in TB bacteria, they lodge in the lungs and begin to multiply. From
there, the bacteria sometimes move through the blood to other parts of the body, such as the
kidneys, joints, and brain. In most cases, the infection is kept in check by the body’s immune
system. In about 10% of cases, however, the infection breaks out into active TB disease at some
point during the life of the infected person.
58
What is the difference between TB infection and TB disease?
In most people who become infected, the body’s immune system is able to fight the TB bacteria
and stop them from multiplying. The bacteria are not killed, but they become inactive and are
stored harmlessly in the body. This is TB infection. People with TB infection have no symptoms
and cannot spread the infection to others. However, the bacteria remain alive in the body and can
become active again later.
If an infected person’s immune system cannot stop the bacteria from multiplying, the bacteria
eventually cause symptoms of active TB, or TB disease. To spread TB to others, a person must
have TB disease.
Most people who have TB infection never develop TB disease. But some infected people are
more likely to develop TB disease than others. They include babies and children, persons with
weak immune systems, and persons with some other kinds of lung disease. These people should
take medicine to keep from developing TB disease. This is called preventive therapy.
What are the signs and symptoms of TB disease?
Symptoms of TB disease depend on where in the body the TB bacteria are multiplying. TB
bacteria usually multiply in the lungs. TB in the lungs can cause:

A bad cough that lasts longer than 2 weeks

Chest pain

Coughing up blood or sputum (phlegm from deep inside the lungs)

Other symptoms are: weakness or tiredness, weight loss, chills, fever, and night sweats
How soon after exposure do tuberculosis symptoms appear?
Most persons infected with TB bacteria never develop TB disease. If TB disease does develop, it
can occur 2 to 3 months after infection or years later. The chances of TB infection developing
into TB disease lessen as time passes.
59
How is tuberculosis diagnosed? TB infection is diagnosed by a skin test. A small needle is
used to put some fluid, called tuberculin, under the skin on the inside of the arm. After 2 to 3
days, the amount of skin swelling around the test area is measured. A positive reaction usually
means that the person has TB infection. TB disease is diagnosed by a chest x-ray or a test of a
sputum sample.
Who is at risk for TB infection?
Anyone can get TB infection, but some groups are more likely than others to be exposed and
thus get TB infection:








Persons with HIV infection or other diseases that weaken the immune system
Persons in close contact with someone who has TB disease
Homeless persons
Persons from countries were TB is common
Persons in nursing homes
Persons in prisons
Persons who inject drugs
Persons with medical conditions such as diabetes and certain types of cancer
What is the relationship between TB and HIV infection?
In many parts of the world, TB is a leading cause of death in persons with HIV infection. HIV
infection weakens the immune system and makes it harder to keep the TB infection in check.
Therefore, people with both TB infection and HIV infection are at very high risk of developing
TB disease. All HIV-infected persons need to find out if they have TB infection. If they do, they
need therapy to prevent the development of TB disease. If they have TB disease, they need antiTB medicine.
What complications can result from tuberculosis?
Complications include chronic weakening of the lungs, damage to other organs, and death.
What is the treatment for tuberculosis?
In most cases, TB disease can be cured with anti-TB drugs. To be effective, the drugs must be
taken exactly as prescribed. Treatment usually involves a combination of several different drugs.
Because TB bacteria die very slowly, anti-TB drugs must be taken for 6 months or longer.
Persons with TB disease must continue to take their medicine until all the bacteria are killed,
even if the symptoms of disease go away and they start to feel better. Not completing the full TB
treatment can be very dangerous. The disease will last longer, the person can continue to spread
the disease to others, and the rate of transmission will increase. Also, the TB bacteria can
become resistant to the drugs being used to kill them.
How can tuberculosis be prevented?

High-risk persons with TB infection must complete their preventive therapy medicines.

Persons with TB disease must take all of their anti-TB medicine exactly as prescribed.
Institutions must implement precautions to reduce the risk of TB transmission
60
USE OF TOBACCO AND ALCOHOL PRODUCTS
Use of tobacco products by foster children is prohibited as it is a violation of Maryland State
Law for any minor child to use or possess either tobacco or alcohol products. Any adult,
including a TFC provider, who purchases alcohol or tobacco products for a minor, or provides
tobacco products to a minor, can be criminally charged for those actions. As adult authority
figures and parents both program staff and treatment foster parents must be a positive role model
and support the law.
San Mar Children’s Home reserves the right to require alcohol or drug testing, on an as
needed basis and without prior notice.
USE OF WEAPONS
For the purpose of this policy, the term “weapon” includes, but is not limited to, the following:
CO2 pistols, pellet and BB guns, air guns, bows and arrows, crossbows, slingshots, rifles and
pistols of any caliber, shotguns, hunting knives, and martial arts paraphernalia such as “numchucks” and throwing stars. All weapons are dangerous when not handled properly and with
respect. Youth may not handle weapons or have weapons in their possession. Any weapons that
are brought into treatment foster home by a youth must be immediately confiscated and held by
the case manager. Children who have completed a certified hunter safety course and who have
proper supervision may be allowed to use weapons for hunting purposes. This will be judged on
a case by case basis.
USE OF MOTORCYCLES
Because of the unusual danger and severe liability that motorcycle riding presents, for youth
placed in a San Mar Program, the riding of any two or three wheeled motorized vehicle, as an
operator or passenger, is expressly forbidden unless special permission is received from the
placing agency. All staff must make a reasonable effort to assure that no youth is permitted to
operate or ride as a passenger on any two or three-wheeled motorized vehicle or a “four wheeler”
ATV vehicle. This policy should also be seen to apply to the use of snowmobiles and water craft.
61
DRIVING LICENSES AND DRIVING OF VEHICLES
GUIDELINES
1.
2.
3.
4.
5.
6.
7.
A youth in treatment foster care will be encouraged to save enough money to purchase a
vehicle and insurance before he or she obtains the actual drivers license.
Consideration may be given to waive this policy for a youth who will be discharged from
treatment foster care upon high school graduation.
No mini bikes, mopeds, or motorcycles may be purchased by youth in treatment foster
care.
In most cases, parents’ permission will be required.
In all cases, permission from the Department of Social Services will be required.
Foster parents are responsible to verify that any vehicle operated by a foster child is
insured to cover the foster child. A copy of the insurance policy must be submitted to San
Mar to provide this verification.
Foster children are not allowed to drive vehicles owned by the TFC family
Any exception to the above outlined procedure must be granted IN WRITING by the
Program Director.
62
STAFF CONTACT LIST
Phone: 301-733-9067 Fax: 240-625-9446
Ellen Savoy, Director of Treatment Foster Care:
Extension 220
[email protected]
Cell: 240-675-7150
Joel Bowers, Foster Home Care Recruiter/Trainer:
Extension 234
[email protected]
Cell: 240- 500-4646
Becky Carpenter, TFC Case Manager:
Extension 310
[email protected]
Cell: 301-302-3344
Tiffany Pittman, TFC Case Manager:
Extension 235
[email protected]
301-331-6883
Stephen Pittman, TFC Case Manager
Extension 231
[email protected]
240-625-2228
Margaret Paul, TFC Case Manager
Extension 232
[email protected]
240-675-7195
Amanda James, TFC case manager
Extension 238
[email protected]
240-500-4649
Dominic Gianninoto, TFC Case Manager
Extension 210
[email protected]
301-964-5556
Francie Hickerson, Clinical Supervisor:
63
APPENDICES
Foster parent job description- pgs. 65-68
Purchase of care agreement- pgs. 69-72
Pre-service training letter- pg. 73
Pre-service training requirements- pgs.74-76
Weekly Allowance- pg. 77
Monthly Clothing Allowance - pg. 78
Minimum Clothing Guidelines- pg. 79
Confidentiality Agreement- pg. 80
64
FOSTER PARENT JOB DESCRIPTION
TITLE:
TREATMENT FOSTER PARENT
SUPERVISOR:
Treatment Foster Care Case Manager
POSITION SUMMARY:
The role of the treatment foster parent is central to the Treatment Foster Care Program at San
Mar Children’s Home, Inc. Treatment foster parents are viewed as colleagues and team members
by program staff. The role of a treatment foster parent is to serve as an in-home treatment agent
and implement strategies that are specific to each child as determined by that child’s individual
treatment plan. Treatment foster parents also perform basic parenting responsibilities such as the
provision of nutrition, clothing, shelter, physical care, nurturance and acceptance of the child into
their family, supervision of the child, transportation to needed services, and compliance with
federal and state regulations pertaining to Treatment Foster Care.
QUALIFICATIONS & REQUIREMENTS:
Treatment foster parents must be at least 21 years of age. Single or married persons may apply
for treatment foster parent approval. Treatment foster parents must have an income that can
support their family without the additional income from Treatment Foster Care. Treatment foster
parents must have good communication and interpersonal skills, and openness to receiving
supervision in their own homes. Treatment foster parents must complete 30 hours of pre-service
training and 24 hours of annual training, and be able to work with the biological families of
children. An awareness of resources in the community for the child they are serving and a clear
ability to work cooperatively as partners with children, families, Placement Agency Workers and
San Mar Treatment Foster Care staff is required. Additionally, treatment foster parents must
have reliable transportation, an operable telephone, four personal references who have known the
couple for at least three years, criminal history clearance and Board of Health certification.
KNOWLEDGE, SKILLS & ABILITIES:
Treatment foster parents should demonstrate an ability to provide physical and emotional care to
children and adolescents. They should have knowledge of child and adolescent developmental
stages and the impact of abuse and neglect on maturation. Treatment foster parents should have
the ability to recognize and meet each child’s individual needs based on their experience in
providing care and supervision to children. They need to have knowledge of the importance of
accepting a child into their own home, as well as, letting the child go when treatment ends or is
completed. Treatment foster parents must have ability and a willingness to work as a team
member with other agency staff, biological parents/legal guardians, school personnel, therapists,
etc. They must have adequate physical and mental health, and display an ability to manage stress
that is inherent in the treatment foster parent profession. At least one of the treatment foster
parents in each couple must have adequate written skills to complete periodic evaluations of the
65
foster children in their home and on-going record keeping tasks for each child.
TEAM RESPONSIBILITIES:
Treatment foster parents will be expected to participate in treatment planning. Treatment parents
contribute vital input into treatment plans based on their observations of the child in the
environment of their treatment foster home. Treatment foster parents shall assume primary
responsibility for implementing the in-home treatment strategies specified in the youth’s
comprehensive treatment plan. It is expected that at least one treatment parent will attend team
meetings and other appointments required by the program or the child’s treatment plan. Both
treatment parents shall attend at least 24 hours of training annually. It is expected that treatment
foster parents will keep accurate and orderly records that will allow the tracking and evaluation
of the services provided in the treatment home. Treatment parents shall systematically record
information and document activities as required by the treatment team. When relevant to the
treatment plan, the treatment parent shall also keep a systematic record of the child’s behavior
and progress in targeted areas on at least a weekly, and preferably a daily, basis.
INDIVIDUAL RESPONSIBILITIES:
Treatment foster parents will be expected to fulfill the following responsibilities:
1. Provide a system of privileges, responsibilities and consequences through which children can
grow and develop self-control;
2. Provide a structured, secure environment designed to meet the child’s need for safety and
security;
3. Provide discipline and guidance that does not involve corporal punishment;
4. Help each child deal with the adjustment process and their feelings of separation from their
prior living environment;
5. Observe confidentiality of all information regarding children and the biological family
history;
6. Assist the case manager and other team members in the development of treatment plans for a
child or youth in their care and assume primary responsibility for implementing the in-home
treatment specified in the treatment plan;
7. Guide the child toward an achievement of goals as outlined in the child’s individual
treatment plan;
8. Attend team meetings and training sessions;
9. Keep a systematic record of a child’s behavior and progress in targeted areas on a daily basis;
10. Ensure a child access to medical and dental care, including accompanying the child to
medical and dental appointments and carrying out treatment prescribed by health care
providers, recording all medications administered in the child’s medication log as they are
given, and reporting significant information about the child’s health to San Mar staff as
necessary;
11. Maintain the child’s medical passport;
12. Provide for each child’s physical and emotional needs;
13. Provide recreational and enrichment activities that will promote the healthy development of
each child;
66
14. Monitor a child’s school attendance and progress, and attend parental conferences and
activities (note: foster parents cannot sign IEP’s as the child’s guardian unless they have been
officially appointed as the child’s surrogate school representative by the Board of Education);
15. Provide transportation services to and from medical, dental, and therapy appointments, work,
appropriate social events, scheduled meetings with relatives and friends, school functions,
and events scheduled by the agency; and ensure that the child has legal and safe
transportation to school;
16. Develop and maintain positive working relationships with resources in the community such
as schools, social service agencies, mental health professionals, and recreational outlets;
17. Attend and provide information at court hearings as requested by placement agency;
18. Demonstrate accountability for services provided through keeping all records required by
San Mar policy and submitting them to the child’s San Mar case manager according to the
agreed-upon schedule for such forms;
19. Assist a child in maintaining contact and visitation with the child’s biological family unless
otherwise indicated in the treatment plan, including helping the child visit with parents,
maintaining respect toward the child’s parents, and informing the child’s parents about
events and happenings in the child’s daily life;
20. Assist in reunification efforts as specified by the treatment team in accordance with the
permanency plan;
21. Support the cultural and religious heritage of the foster child, as appropriate;
22. Report any suspected child abuse or neglect immediately to the child’s San Mar TFC case
manager, on-call case manager, or other San Mar staff in accordance with agency policy;
cooperate in any investigation or review concerning such reports of abuse or neglect; and
give formal testimony if so required;
23. When a child’s whereabouts are unknown for two hours, notify the local law enforcement
authority and San Mar TFC staff immediately by phone call and within 48 hours by written
report; when the whereabouts of a younger child are unknown, notify San Mar immediately
24. Immediately notify San Mar TFC staff of all critical incidents including a foster child’s
injury, serious illness, incarceration, runaway, death, or suspected physical abuse, neglect, or
mental injury;
25. Within 48 hours, notify San Mar TFC staff of any changes in the foster parent’s household,
including: employment and child care arrangements, household composition, residence and
telephone number, health status, and stressful conditions which may affect the child’s
placement;
26. Obtain approval from the San Mar case manager and/or Director of Treatment Foster Care
for other adults to supervise the child when the foster parent is employed or otherwise not
available;
27. Whenever possible, offer at least 30 days’ written notice when requesting removal of a child
from the treatment foster home;
28. Comply with all state regulations and agency policies and procedures as outlined in the
treatment foster family Purchase of Care Agreement;
29. Provide swimming pool and hot tub safety, supervision, and security as required by law and
San Mar policy;
30. Secure all dangerous items within the home: prescription and non-prescription drugs,
dangerous household supplies, tools, and any other household items which are potentially
67
life-threatening or injurious to children, so that they are not accessible to children, and secure
all firearms in a locked cabinet with the key located in a place inaccessible to children;
31. If there is a pet in the home, educate the child as age-appropriate regarding the care and
grooming of the pet and provide for the safety of the child around the pet;
32. With the assistance of the case manager, maintain the financial ledger for the foster child;
33. Help maintain a record (scrapbook) for each child of his or her time in residence in their
treatment foster home (photographs, report cards, etc.);
34. Maintain their usual lifestyle and relationships within their own family while providing care
for a child;
35. Help all treatment foster parents understand the impact that Treatment Foster Care may have
on the household routines and overall home environment.
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PURCHASE OF CARE AGREEMENT
This is an agreement dated
between the San Mar Treatment Foster Care
(TFC) Program, licensed by the Maryland Department of Human Resources to provide
Treatment Foster Care, and
herein referred to as the Treatment
Family.
Whereas, the San Mar Treatment Foster Care Program wishes to purchase and the Treatment
foster family wishes to furnish the services listed below; and
Whereas, the services to be provided are 24 -hour treatment foster care including room, food,
clothing, transportation, parental guidance, treatment implementation; and
Whereas, the services referred to are professional in nature; and
Whereas, the treatment foster family will furnish the services described herein at the location of
their home which they own or lease at _____________________________________________,
herein called the premises, and found suitable for the operation of a treatment foster care home;
and
Whereas, the treatment foster family desires to establish and maintain a treatment foster home
for such child(ren) in said premises; and
Whereas, the San Mar Treatment Foster Care Program desires to utilize the services and
facilities of the treatment foster family by placing a child(ren) with them through the Treatment
Foster Care Program on the premises;
Now, therefore, San Mar Treatment Foster Care Program and the treatment foster family, in
consideration of the above statements and the further considerations set forth below; mutually
agree, each in consideration with the promises of the other, as follows:
I.
GENERAL POLICIES AND RESPONSIBILITIES OF THE TREATMENT
FOSTER FAMILY
1.
LIVING ARRANGEMENT
The treatment foster family agrees to make available necessary living space to
accommodate the children placed by San Mar Treatment Foster Care Program.
The accommodation to be provided shall include bedroom space, bathroom, and
home living areas.
2.
HEALTH CARE
The treatment foster family shall assume the responsibility for the day-to-day
medical care of the child. The managed care organization, to which the child is
assigned, in most cases, will cover the cost of the child’s medical needs. The need
for, and payment for, additional non-reimbursable services will be decided on a
pre-authorization basis by San Mar Treatment Foster Care Program.
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3.
PROVIDING ORDINARY NEEDS
The treatment foster family agrees to provide the child(ren) in the treatment foster
home with all ordinary needs, including but not limited to, food, clothing,
transportation, recreation, and cash allowances as they would their own children,
and in accordance with San Mar Treatment Foster Program policy.
4.
SUPERVISION
TFC children cannot be left in the care of anyone under the age of 18 at any time.
Any adult who will be caring for a foster child must be approved by the San Mar
case manager in advance. TFC children, regardless of age, are not permitted to
babysit for any other child at any time.
5.
PUNISHMENT
The treatment foster family agrees that corporal, degrading, vindictive
punishment or verbal abuse will not be used and that no child, including their
own, shall be placed in a position of administering discipline or regulating
privileges of another child. To participate in any of the above can result in
immediate termination of this agreement. The treatment foster family will abide
by the discipline policies of San Mar Treatment Foster Care Program and any and
all State/Federal regulations on discipline.
6.
TRAINING
The treatment foster family agrees to participate in individual and group training
sessions to meet the minimum agency requirement of 30 hours of pre-service
training and 24 hours of annual training. Training requirements can be met by
attending group sessions, supervisor-approved community training sessions, or by
individual (in home) approved sessions or self-guided study experiences.
The treatment foster family understands that families not meeting the Agency
requirements at the time of their annual evaluation will be subject to a conditional
approval status.
Treatment families are encouraged to attend as much training as possible. In
addition to the positive learning experiences, a great deal of networking between
families is accomplished at group trainings. This networking is beneficial to the
families and children served through the San Mar Treatment Foster Care Program.
7.
TRANSPORTATION
The treatment foster family agrees to make themselves and their foster child/ren
available for all appointments with San Mar Treatment Foster Care Program staff
deemed necessary either on the premises or at the Agency. The treatment foster
family is required to provide transportation for all necessary appointments
including physical and dental exams, school meetings, office visits, etc. San Mar
70
Treatment Foster Care Program staff will work in conjunction with the family to
see that each child’s needs are met.
8.
IMPLEMENTATION OF TREATMENT PLAN
The treatment foster family is expected to participate in the development of the
Comprehensive Treatment Plan. The treatment foster family shall adhere to the
goals put forth in the plan and shall implement the methods of the treatment
process as outlined in the plan. A copy of the Comprehensive Treatment Plan will
be provided to each treatment foster family by the San Mar Treatment Foster Care
Staff.
9.
REQUEST TERMINATING PLACEMENT
When the treatment foster family judges a placement situation to be unworkable,
they are requested to give 30 days written notice of termination of a placement,
circumstances permitting.
10.
PROFESSIONAL SERVICES
No professional services shall be scheduled or obtained for the child in care
except those authorized by San Mar Treatment Foster Care staff.
11.
DOCUMENTATION/LOG
The treatment foster family agrees to maintain a medical log on the children
placed in their care; monthly medication logs will be issued for this purpose. The
treatment foster family also agrees to maintain a weekly log on the children in
their care describing children’s behaviors, attitudes, and other areas of importance
as related to the treatment goals and the child’s overall adjustment to the program.
12.
INSURANCE
The treatment foster family shall keep in force, at all times, insurances for public
liability and auto liability with minimal limits of liability of one hundred thousand
dollars per occurrence, and shall annually provide the San Mar Treatment Foster
Care Program with updated certificate of insurance for the same. The
homeowner’s insurance of the treatment foster family covers damages caused by
foster children in their home. San Mar is not responsible for such damages.
13.
CONFIDENTIALITY
The treatment foster family agrees to abide by all policies and regulations
regarding client confidentiality as outlined by the San Mar Children’s Home, Inc.
policy.
14.
CHANGE IN FAMILY STATUS
This agreement is entered into under the assumption that the treatment foster
family’s size or number remains the same as at the time of the signing of this
agreement. Should there by any change in the family (i.e. size, address,
71
employment, finances, etc.), it shall be reported immediately to the Treatment
Foster Care case manager so that the change in status may be evaluated.
15.
CRIMINAL RECORD UPDATE
The treatment foster family agrees to keep the San Mar Treatment Foster Care
Program informed of any arrests or abuse allegations which involve family
members while this agreement is in force.
16.
INVOLVEMENT WITH OTHER AGENCIES
Treatment foster families who have entered into an agreement to provide
professional services with the San Mar Treatment Foster Care Program are
prohibited from contracting with any other agency for the purpose of providing
foster care services. The treatment foster family agrees that all contact with
referring agencies will be coordinated by a San Mar Treatment Foster Care
representative.
17.
STATEMENT OF RESPONSIBILITY
The treatment foster family agrees to act in accordance with these policies. It is
agreed that there will be no negligent, abusive, or detrimental actions toward any
foster child placed on their premises. In the event that such actions occur, the
treatment foster family must assume responsibility.
18.
REGULATORY COMPLIANCE
The treatment foster family agrees to comply with all regulations governing the
delivery of Treatment Foster Care services including, but not limited to,
guidelines of Maryland Department of Human Resources, Department of Social
Services, Department of Juvenile Services, and the San Mar Treatment Foster
Care Program.
19.
EVALUATION
The treatment foster family agrees to be evaluated annually to assess their ongoing compliance with this agreement.
72
San Mar Children’s Home: Treatment Foster Care
8504 Mapleville Road, Boonsboro, Maryland 21713
________________________________________________________________
Name of Treatment Foster Family
Date
Greetings Friends,
We at San Mar are excited that you desire to become a Professional Parent for the San Mar
Treatment Foster Care Program. Since day one, January 1, 1992, I’ve been involved in some
aspect of this program. I’ve had the privilege of working with dynamic folks who have touched
the lives of children and families. One of our first providers described this effort as “the hardest
job you will ever love”. Some days it will feel wonderful. Other times you will wonder what
you’ve gotten yourself into!
This year is an especially challenging time. At the state level the focus is to keep children at their
biological family’s home or at the least restrictive level of regular foster care. A big attempt is
being made to move children out of group care facilities. All of these efforts are changing the
work we do. Children being referred now have an extensive background of trauma. Older
children (14 and over) are returning to a family environment with few skills to help them
succeed. The amount of time we have to work with children is unpredictable. Young ones often
return home suddenly and we have no authority to stop them. Yet, our effort is needed. We are
each given a time to make a strong impression in the lives of these children and youth,
memories they will take into their adulthood, life-changing opportunities. If you are ready to
push your sleeves up and prepare for the challenge we welcome you.
When children enter care many systems are in place to assure their safety; placement agencies,
the court, and special advocates. Maryland watches over these children by establishing and
monitoring regulations for foster care, treatment foster care and all other levels of care. San Mar
assures that all care givers comply with these state regulations.
San Mar believes that the required pre-service training is most effective when it is done one on
one with families. In doing so… you learn about us, and we learn about you. But… this
approach can be cumbersome and requires us all to work together to assure that we’ve given you
the information you need to begin. I very much look forward to meeting you!
Ellen Savoy
73
PRE-SERVICE TRAINING REQUIREMENTS
Pre- Service Training Requirements: Thirty hours of training are needed before you become a
licensed Professional Parent. This consists of 6 hours- Overview, philosophy, education, legal
documentation for TFC providers, foster parent job description, abuse & neglect definitions,
purchase of service agreement, grievance process, and SAFE Families Home Study Questionnaires.
_[Tiffany Buckingham & Joel Bowers]
4 hours- Pre-Service Training Manual and completing answer booklet (individual assignment)
5 hours- TFC Handbook as a continuous resource. (Individual reading & on-going reference)
½ hour- Introducing the TFC Handbook [Dominic Gianninoto]
1 hour- Working as a team [Stephen Pittman]
1 hour-Policies & regulations; court involvement; permanency planning. [Margaret Paul]
1 hour- Documentation [Tiffany Buckingham]
e1you
ready
to begin?
Great! children
Your job
is to pre-placement
begin. The time
it will take to complete the
hourReferrals,
matching
tonow
families,
visits.
process isRespite
up to you.
As
your
schedule
allows,
San
Mar
staff
is
prepared
to give
you the training
care, what it is, how to secure it, incident reporting. [Becky
Carpenter]
you’ll
need.
1 hour- Finances: board of child care payment/difficulty of care payment, child/youth allowances,
non-reimbursements for property damage. [Amanda James]
One
of the
most important
of Professional
Providers is to document the work you do. You
½ hourMaintaining
your jobs
license
[Brenda Resh]
will
begin
now by documenting
your
own pre-service
training
process.[Ellen
You will
give this
1 hourMandated
reporting, crisis
response,
endings, and
grievances.
Savoy]
completed
document
to
me
at
the
end
of
your
pre-service
training.
6 hours- Attachment, managing challenging behaviors, & trauma. [Written material, DVD’s, and
website instruction]
1 hour- Professional Parenthood booklet [Individual reading]
1 hour- Last hour in your home. Types of children and youth that you hope to serve, looking at the
bedroom, understanding who resides in your home, reminder about changes to your household.
The process is set up with the following steps:
Step 1: Plan to meet with Joel at least three times for the purpose of…
 Gaining a greater understanding of the work, the overview of care through the
completion of the pre-service training manual and the overview of legal
documents.
 Abuse & neglect reporting, confidentiality, job description and purchase of
service agreement.
 Introduction to the provider handbook.
 Joel will give you documents to be completed– physicals, background
investigations, insurances and such.
 Brenda Resh will set up your file as these documents are submitted.
74
Joel Bowers 301-733-9067 ext. 234
[email protected]
Orientation Meeting Date: ________________________
___________________
1st session Date
Questions or Comments:
_______________
Place
_______________
Joel’s Signature
___________________
2nd session Date
_______________
Place
_______________
Joel’s Signature
_______________
Place
_______________
Joel’s Signature
Questions or Comments:
___________________
3rd session Date
Questions or Comments:
Step 2: You can meet with the staff in any order. They each have a vital training topic for you.
After each session please have them sign and date your pre-service training record.
Becky Carpenter 301-733-9067 ext.310
[email protected]
Training Topic: Types of children being referred, matching children with families,
the pre-placement process, respite.
Date of Meeting: _____________________
Staff Signature: ________________
Tiffany Pittman: 301-733-9067, ext 235 [email protected]
Training Topic: Documentation, all the paperwork that goes with our job.
Date of Meeting: _____________________
Staff Signature: ________________
Stephen Pittman: 301-733-9067 ext. 231
[email protected]
Training Topic: Working as a Team- who are the members / roles and responsibilities.
Date of Meeting: _____________________
Staff Signature: ________________
75
Margaret Paul: 301-733-9067, ext 232
[email protected]
Training Topic: Policies and regulations, all of the state requirements for what we do: the
laws, regulations and policies that govern what we do.
Date of Meeting: _____________________
Staff Signature: ________________
Amanda James: 301-733-9067, ext238
[email protected]
Training topic: Finances: getting paid, board of child care/difficulty of care payments,
allowances.
Date of Meeting: _____________________Staff Signature:___________________
Dominic Gianninoto: 301-733-9067, ext210
[email protected]
Training topic: Introduction of the TFC Foster Parent Handbook
Date of Meeting: _____________________ Staff signature: ___________________
Ellen Savoy 301-733-9067 ext. 220
[email protected]
Training Topic: Crisis response, mandating reporting, on-call support
Date of Meeting: ___________________
Staff Signature: ________________
Remember: Bring your completed pre-service training record with everyone’s signatures.
________________________________________________________________________
Feeling bogged down? At any time if it feels that the process has slowed down,
appointments have been cancelled, and /or sessions have not being completed, please
contact Joel Bowers or Ellen Savoy.
When all of your pre-service training has been completed and all of the other required documents
have been secured, San Mar will award you a certificate of licensure as a San Mar Professional
Treatment Parent!
76
Treatment Foster Care Program
8504 Mapleville Road, Boonsboro, Maryland 21713
301-733-9067 Fax (240) 625-9446
Weekly Allowance Ledger for children and youth in care
The DHR recommendation for allowances is: Age 5-7 = $2.00; 8-11 + $5.00; 12-13 = $10.00; 14-16 + $15.00 and 17 and above = $20.00
Please complete the following ledger on a monthly basis and turn it in to the case manager. Thank you.
Clients Name:
Date
Deposit
Withdraw/Items Purchased
Total
Signature
Parent
Age:
Week of:
Comments or concerns:
Signature of Case Manager: ______________________________
77
Signature
child
Date:_____
Treatment Foster Care Program
8504 Mapleville Road, Boonsboro, Maryland 21713
301-733-9067 Fax (240) 625-9446
Monthly Clothing Allowance
Of the board payment, seventy-five dollars is to be used as a clothing allowance. Please document how the $75.00 was spent or set aside for
clothing purchases. Call your case manager or the program director should you have any questions. Please complete this form monthly and turn
it in to the case manager.
Clients Name:
Date
Starting
amount
Withdraw/Items Purchased
Month of:
Total
Signature
Parent
Comments or concerns:
Signature of Case Manager: _________________________________
78
Date:
Signature
Child
Minimum Clothing and Personal Care Guidelines
BOYS
8 sets of underwear 8 undergarments
5 pairs of school pants or uniforms 2 dresses
5 sets of play clothes
1 pair dress pants, shirt, (tie if age applicable)
& belt
8 pair of socks
6 shirts (not undershirts)
1 pair tennis shoes – 1 pair non-canvas/dress shoes
– 1 pair of everyday school shoes
GIRLS
4 bras (as needed) and 8 underwear
5 pair’s pants for school or uniforms
3 sets of play clothes
1 dress or pants outfit suitable for a special event
2 sets of sleepwear, 1 robe, 1 pair of slippers
2 sets of sleepwear, 1 robe, 1 pair of slippers
1 bathing suit
1 bathing suit
6 blouses, light sweater or tops
8 pair of socks / stockings as appropriate
1 pair tennis shoes – 1 pair non-canvas/dress shoes
- 1 pair of everyday school shoes
Seasonal Wear
1 winter coat
1 light weight jacket
1 pair gloves & hat
1 pair boots
Rain gear / coat
Shorts, “T” shirts, sandals
1 winter coat
1 light weight jacket
1 pair gloves & hat
1 pair boots
Rain gear / coat
Shorts, “T” shirts, sandals
Minimum Clothing and Equipment Items for Infants Ages Birth to One Year
Equipment
2-4 Receiving Blankets
2 Regular Blankets
Crib
4 – 6 Crib Sheets
1 Stroller
1 Car seat
8 Bibs
2 Rattles and toys to stimulate the infant
Clothing
6 - 8 Undershirts
6– 8 Pajamas / Sleepers
6 Shirts
8 Pair socks
5 Every-day outfits
2 Dress-up outfits
2 Sweaters
1 Hat, scarf, and mittens
1 Sun hat
1 Snow suit
1 Pair shoes
1 Pair winter footwear
79
San Mar Children’s Home, Inc.
Confidentiality Agreement
This agreement is made on the ______ day of _____________, 2012, by and between the San Mar Children’s Home and
______________________________________________________
1. CONFIDENTIAL INFORMATION:
During my period of service as a treatment foster parent, San Mar may
disclose or cause to be disclosed to me, confidential information relating to the history of a foster child and his or her
biological families that is of a personal and sensitive nature. I recognize such information to be the property of San Mar and
I agree to hold such information in trust and solely for San Mar’s benefit and not to disclose such information to those
inside or outside of the organization, either during or after my service as a treatment foster parent, without the written
consent of an officer of San Mar.
I further understand that said confidential information may not be shared on any forms of Social Media.
2. TERMINATION OF SERVICE: This agreement shall continue to be in effect after the termination of my role as a
Treatment Foster Parent with the San Mar Children’s Home and shall remain in effect in perpetuity.
Upon leaving the San Mar Treatment Foster Care Program, I agree not to take with me, without first obtaining the written
consent of an officer of San Mar, any document or tangible evidence of confidential information or data belonging to or
under the control of San Mar, whether on disk, CD, recorded or hard copy, whether an original or a reproduction.
3. FORMER OBLIGATIONS: I will strictly adhere to any obligations, which I may have with former and current
employers insofar as the use or disclosure of confidential information is concerned.
4. CONSEQUENCES OF BREACH: I understand that any breach of this agreement is grounds for corrective action, up
to and including immediate dismissal by San Mar Children’s Home Treatment Foster Care Program.
Treatment Foster Parent
Date
Treatment Foster Parent
Date
Foster Home Trainer
Date
80
State requirements for Reporting Incidents
All Treatment Foster Care agencies are required by the Code of Maryland to submit Critical Incidents to
the Department of Human Resources within specific time periods.
San Mar must report the following incidents immediately by telelphone and within 48 hours with
documentation.
Accident, assault, illness or psychiatric episide of the child that requires hospitalization or
emergency medical care;
Suspected incident of child abuse or neglect; including mental injury;
Illegal activity leading to the incarceration of a child, parent, foster parent, guardian, or adoptive
Parent;
Other occurrences which may affect the health, safety, or well-being of children in care or
receiving adoption services; or
The death of a child in foster care.
Below is a list of ALL incidents that are considered CRITICAL. If the incident occurs during the week and after
hours call your case manager to report the incident either by leaving a message or speaking directly with your
case manager. If the incident occurs on the weekend call the on-call worker. You can do this by calling their cell
phone directly or calling the office (240-625-9445 ext 200) and you will be redirected to the on call worker.
Assault On Other Youth
Death Of Child
Injury To Youth Subject Of The Incident
Injury To Foster Parent/Staff
Theft
Automobile Accident
Sexual Misconduct
Possession Of Contraband
Fire Setting
Gang Involvement
Suicidal Ideation
Alcohol Use/Posession
Emergency Medical Treatment
Medical Event (Significant but Non-Emergency)
Ingestion Of Harmful Substance
Homicidal Attempt
Suspected abuse and/or neglect of youth
Assault On Foster Parent/Staff
Death Of Staff /Foster Parent While On Duty
Injury To Other Youth
Property Damage
Possible Violation Of Youth’s Rights
Awol
Police Involvement
Arrest
School Suspension (> 3days)
Injury To Self
Suicidal Attempt
Drug Use/Possession
Emergency Hospitalization
Emergency Petition
Homicidal Ideation
Restraint of youth
Fire Setting
PLEASE DO NOT DELAY IN CALLING SAN MAR!
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