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Refuge House Form Directory

A home is in the heart of every child.

Draft versions for demonstration and coordination purposes

Package Development

Basic Foster Family Home

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TBRI® Complete Resource Guide
Comprehensive interactive guide combining TBRI® Overview, Treatment Model, and Education Plan with brand styling and enhanced navigation
Complete Guide
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Logic Model (T3C Basic Foster Family Home)
Visual logic model depicting inputs, activities, outputs, and outcomes for T3C Basic Foster Family Home Support Services with TBRI® framework and CQI process
Logic Model
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CQI Model (T3C Basic Foster Family Home)
Continuous Quality Improvement cycle (Plan-Do-Study-Act) for monitoring and improving TBRI®-based services with quarterly review process and outcome tracking
CQI Model

Mental and Behavioral Health Support

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Treatment Model (T3C Mental & Behavioral Health)
Comprehensive treatment model framework integrating TBRI® with clinical interventions for children with DSM-5 diagnoses requiring intensive therapeutic support
Treatment Model
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Logic Model (T3C Mental & Behavioral Health)
Service package specific logic model per T3C Blueprint requirements, incorporating TBRI® principles with enhanced therapeutic components and 90-day review cycles
Logic Model
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CQI Model (T3C Mental & Behavioral Health)
Continuous Quality Improvement model designed for monitoring and improving therapeutic services with enhanced quality metrics and PDSA cycle framework
CQI Model

IDD/ASD Support Services

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Treatment Model (T3C IDD/Autism Support Services)
Comprehensive treatment model framework integrating TBRI® with developmental interventions for children with IDD/ASD requiring specialized therapeutic support
Treatment Model
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Logic Model (T3C IDD/Autism Support Services)
Service package specific logic model per T3C Blueprint requirements, incorporating TBRI® principles with enhanced developmental and behavioral supports and 90-day review cycles
Logic Model
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CQI Model (T3C IDD/Autism Support Services)
Continuous Quality Improvement model designed for monitoring and improving developmental services with enhanced quality metrics and PDSA cycle framework
CQI Model

Short Term Assessment Services

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Treatment Model (T3C Short Term Assessment Services)
Comprehensive treatment model framework integrating TBRI® with time-limited assessment protocols for children requiring intensive evaluation and placement planning
Treatment Model
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Logic Model (T3C Short Term Assessment Services)
Service package specific logic model per T3C Blueprint requirements, incorporating TBRI® principles with focused assessment activities and outcome tracking
Logic Model
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CQI Model (T3C Short Term Assessment Services)
Continuous Quality Improvement model designed for monitoring and improving assessment services with quality metrics and PDSA cycle framework
CQI Model

Treatment Foster Family Care

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Treatment Model (T3C Treatment Foster Family Care)
Comprehensive treatment model framework integrating TBRI® with intensive therapeutic interventions for children requiring specialized treatment foster care services
Treatment Model
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Logic Model (T3C Treatment Foster Family Care)
Service package specific logic model per T3C Blueprint requirements, incorporating TBRI® principles with enhanced therapeutic components and specialized foster care supports
Logic Model
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CQI Model (T3C Treatment Foster Family Care)
Continuous Quality Improvement model designed for monitoring and improving treatment foster care services with enhanced quality metrics and PDSA cycle framework
CQI Model

Substance Use Support Services

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Treatment Model (T3C Substance Use Support Services)
Comprehensive treatment model framework integrating TBRI® with recovery-oriented interventions for children and youth with substance use disorders requiring specialized support and monitoring
Treatment Model
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Logic Model (T3C Substance Use Support Services)
Service package specific logic model per T3C Blueprint requirements, incorporating TBRI® principles with recovery-enhanced therapeutic components and substance use treatment coordination
Logic Model
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CQI Model (T3C Substance Use Support Services)
Continuous Quality Improvement model designed for monitoring and improving substance use support services with recovery-specific quality metrics and PDSA cycle framework
CQI Model

Resource Guides

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Caseload Point System & Staffing Ratios
Interactive caseload monitoring dashboard with point calculator, team overview, and comprehensive T3C staffing ratio reference for blended service packages
All
Staff Tools
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Continued Stay Review Quick Reference Guide (New)
Comprehensive compliance guide for Mental Health & IDD/Autism packages with step-by-step procedures, clinical criteria, and emergency protocols
MHIDDSUTFFC
Compliance Guide
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Crisis Decision Tool (help.refugehouse.org)
Interactive 24/7 decision support tool for foster parents and treatment teams to navigate medical, behavioral, safety, and psychiatric emergencies with step-by-step guidance and emergency contacts
All
Crisis Support
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Kinship Caregiver Resource Dashboard (Draft)
User-friendly portal for kinship families providing access to essential resources, benefit information, and support tools with mobile-first design
Basic
Resource Portal
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Staff Support Dashboard for Kinship Placements (Draft)
Comprehensive tool for staff supporting kinship placements with real-time information, benefit navigation, and case management resources
Basic
Staff Tools
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Youth Transition Support Dashboard (Draft)
Engaging, mobile-first platform for youth ages 14-22 to track transition progress, access resources, and plan for independence
All
Youth Portal
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Staff Transition Support Dashboard (Draft)
Comprehensive case management tool for transition specialists supporting youth aging out of care with T3C compliance tracking
All
Staff Tools
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Pregnant & Parenting Youth Resource Dashboard (Draft)
Interactive, youth-friendly support portal for pregnant and parenting youth in foster care with comprehensive resources, benefit enrollment, and crisis support
All
Youth Support

Intake and Placement

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Placement Inquiry Workflow (Draft)
Comprehensive multi-step workflow for managing foster care placement inquiries from initial contact through final placement
All
Intake
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Placement Workflow (New)
Handles immediate placement tasks within the first 24-72 hours, including safety, health, and documentation.
All
Placement
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Admission Assessment (New)
Comprehensive 30-day assessment with TBRI® components, package-specific evaluations, and regulatory compliance tracking.
All
Assessment

Service Planning

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Enhanced Continued Stay Confirmation (Draft)
60/90-day confirmation form for specialized service packages per T3C Blueprint requirements
MHIDDSUTFFC
Service Planning
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Service Authorization Tracking (Draft)
Comprehensive tracking system for service authorization requests, approvals, denials, and alternative arrangements with financial oversight
All
Authorization
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CANS 3.0 Integration Section (Draft)
Child welfare service plan component for CANS assessment integration, domain scoring, and service modifications based on assessment results
All
Assessment Integration
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Package-Specific Monitoring Dashboard (Draft)
Adaptive monitoring dashboard that provides specialized tracking for all service packages with data visualization and alerts
MHIDDSUSTASSTFFC
Monitoring
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Foster Home Credential Verification (Draft)
Comprehensive verification system for foster home credentials, compliance tracking, training requirements, and quarterly review management
All
Credential Verification
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Service Plan Review and Approval (New)
Comprehensive multi-tab form for managing service plan reviews, approvals, and participant input.
All
Service Planning
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STASS Assessment Progress Tracking (New)
Track assessment activities, timeline, and package recommendations for Short-Term Assessment placements.
STASS
Assessment
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STASS Transition Planning (New)
Coordinate transition from STASS to ongoing service package with placement and service continuity.
STASS
Transition
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TFFC Step-Down Planning (New)
365-day countdown, readiness assessment, and transition planning for Treatment Foster Care step-down.
TFFC
Transition
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Recovery Progress Tracker (New)
Track sobriety milestones, treatment engagement, and recovery indicators with non-punitive documentation.
SU
Recovery

Aftercare Forms

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Contact Log Entry Form (Draft)
Comprehensive logging system for tracking all client interactions and communications
All
Documentation
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Service Refusal Documentation (Draft)
Formal documentation process for recording when clients decline offered services
All
Legal
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Aftercare Services Plan (Draft)
Comprehensive planning tool for developing individualized aftercare service strategies
BasicMHIDDSUTFFC
Planning
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Aftercare Monitoring Dashboard (New)
Dashboard for tracking children in aftercare status with summary statistics and data table.
BasicMHIDDSUTFFC
Monitoring

Foster Homes

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Foster Home Quarterly Review (Draft)
Comprehensive quarterly review integrating T3C credentialing requirements, training compliance, placement summaries, and TBRI® implementation evaluation
All
Foster Home Management
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Foster Home Credentialing Assessment (New)
Comprehensive assessment for foster family home credentialing, including eligibility, training, TBRI®, and specialized modules.
All
Credentialing

General Forms

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Quick Phone Contact Widget (Draft)
Streamlined interface for capturing essential contact information during phone interactions
All
Communication

© 2025 Refuge House. All forms are draft versions for evaluation purposes.

A home is in the heart of every child.