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CQI Model

A home is in the heart of every child.

T3C Substance Use Support Services

T3C Substance Use Support Services

Continuous Quality Improvement Model

Recovery-Oriented Package-Specific CQI Process per T3C Blueprint Requirements

Substance Use CQI Framework

This CQI model is specifically designed for monitoring and improving recovery-oriented services for youth with substance use disorders.
Uses Basic Foster Family Home TBRI foundation with enhanced recovery metrics, relapse response tracking, and non-punitive intervention monitoring.

Substance Use Support Services CQI Cycle

PLAN

Beginning of 90-Day Cycle
Tier 1 (Basic):
  • Review TBRI Logic Model
  • Set TBRI®-aligned goals
  • Plan family engagement
SU-Specific:
  • Review recovery progress and goals
  • Plan SU treatment coordination
  • Set recovery milestones per T3C
  • Schedule SU-qualified therapy sessions
  • Plan trigger management interventions
  • Review human trafficking screening compliance

DO

Days 1-75
Tier 1 (Basic):
  • Implement TBRI Connecting
  • Provide predictable routines
  • Document services
SU-Specific:
  • Deliver weekly individual therapy (SU-qualified)
  • Implement non-punitive relapse response
  • Coordinate substance use treatment services
  • Conduct drug screening as clinical tool
  • Develop trigger management and coping skills
  • Maintain substance-free environment
  • Connect to recovery community resources
  • Complete CANS 3.0 every 90 days

STUDY

Days 76-85
Tier 1 (Basic):
  • Review data
  • Analyze TBRI fidelity
  • Identify trends
SU-Specific:
  • Analyze CANS 3.0 recovery-related scores
  • Review recovery progress trends
  • Evaluate relapse patterns and responses
  • Assess treatment engagement metrics
  • Review drug screening patterns (clinical)
  • Analyze crisis intervention effectiveness
  • Evaluate step-down readiness

ACT

Days 86-90
Tier 1 (Basic):
  • Adjust TBRI approach
  • Enhance supports
  • Update training
SU-Specific:
  • Modify treatment modality/frequency as needed
  • Update relapse response protocols
  • Enhance trigger management strategies
  • Adjust recovery support intensity
  • Plan step-down to Basic or aftercare
  • Document Program Director 90-day review
  • Track post-discharge stability outcomes

Substance Use
Logic Model

TBRI® Foundation
+ Recovery-Oriented
Non-Punitive
90-Day Review Cycle

Substance Use CQI Timeline

Beginning of 90-Day Cycle

Program Director, Treatment Director, CQI Coordinator

  • • Review SU service delivery
  • • Set recovery targets
  • • Plan SU treatment coordination
  • • Schedule therapy sessions
  • • Review human trafficking screening

Days 1-75

Therapists, Case Managers, Foster Parents

  • • TBRI® implementation
  • • Weekly individual therapy
  • • SU treatment services
  • • Drug screening (clinical)
  • • Relapse response per protocol
  • • Recovery community connections

Days 76-85

CQI Coordinator, Treatment Director

  • • Compile recovery data
  • • Analyze CANS 3.0 results
  • • Review recovery trends
  • • Analyze relapse patterns
  • • Evaluate treatment engagement
  • • Assess step-down readiness

Days 86-90

Full SU CQI Team

  • • Recovery team meeting
  • • Review all SU outcomes
  • • Adjust treatment plans
  • • Update relapse protocols
  • • Plan step-down/aftercare
  • • Track discharge outcomes

Substance Use CQI Metrics

Logic Model ComponentSU-Specific MetricsTarget/ThresholdReview Frequency
T3C Compliance• CANS assessments within timeline
• Substance use assessments within 30 days
• 90-day Service Plan reviews completed
• Staffing ratios maintained		100%
100%
100%
100%		Monthly
Therapeutic Services• Weekly therapy attendance (SU-qualified)
• SU treatment engagement
• Family therapy participation
• MAT coordination (when applicable)		95%+
Per recommendation
As indicated
Per clinical need		Weekly tracking
Monthly review
Recovery Progress• Recovery progress documented
• Relapse response within protocol
• Trigger management skill development
• CANS score improvement		100% of cases
100%
Measurable progress
Improvement trend		Monthly
Per incident
Quarterly
Substance Use Monitoring• Drug screening completion per protocol
• Screening results as clinical indicator
• Substance use frequency trend
• Non-punitive response verification		Per protocol
Documented
Decreasing
100%		Per screening
Monthly review
Placement Stability• Placement stability rate
• Unplanned placement changes
• Foster parent retention (SU trained)
• Substance-free environment compliance		85%+
<15%
90%+
100%		Monthly
Quarterly
Crisis Management• Crisis incident frequency
• Crisis response time
• De-escalation success rate
• Relapse-related crisis tracking		Decreasing trend
<1 hour
≥85%
Documented		Per incident
Monthly analysis
Post-Discharge Stability• 30-day recovery stability
• 60-day recovery stability
• 90-day recovery stability
• No re-entry to care		90%+
85%+
80%+
90%+		Per discharge
Quarterly aggregate

Relapse Response Analysis

Non-Punitive Review - Relapse as Treatment Issue

Review Components:

Relapse Frequency
Track patterns over time (clinical data)
Trigger Identification
Document preceding circumstances
Response Protocol Adherence
Verify non-punitive approach used
Treatment Adjustment
What changes were made post-relapse

Recovery Progress Indicators:

Increasing recovery periods
Positive trajectory
Faster return to stability
Treatment effectiveness
Stable but not improving
Treatment adjustment needed
Escalating pattern
Intensive review needed

Program Director - SU Responsibilities

  • • Oversee SU service package delivery per T3C Blueprint
  • • Monitor TBRI® implementation in recovery context
  • • Review 90-day continued stay criteria
  • • Provide written confirmations within 15 business days
  • • Lead SU-specific CQI reviews
  • • Approve Logic Model modifications based on recovery outcomes

Treatment Director - SU Specific

  • • Supervise SU-qualified licensed therapists
  • • Oversee substance use treatment coordination
  • • Review relapse response protocol adherence
  • • Monitor non-punitive approach implementation
  • • Coordinate MAT services when appropriate
  • • Approve step-down transitions and aftercare plans

Licensed Therapists - SU Team

  • • Provide weekly individual therapy (SU-qualified)
  • • Coordinate substance use treatment services
  • • Implement non-punitive relapse response
  • • Develop trigger management and coping skills
  • • Conduct family therapy addressing SU impacts
  • • Document recovery progress per T3C

Case Managers - SU Enhanced

  • • Implement TBRI® in recovery-supportive context
  • • Coordinate SU services (1:15 ratio)
  • • Ensure therapy attendance (95%+ weekly)
  • • Connect to recovery community resources
  • • Support foster parents with SU awareness
  • • Navigate STAR Health for SU services

Substance Use CQI Outcomes

🌱 Recovery Progress

Achieved through trauma-informed, non-punitive treatment and relapse support

🏠 Placement Stability

Supported by trained foster parents and recovery-focused environment

🤝 Treatment Engagement

Maintained through connection, non-judgment, and comprehensive services

🔗 Community Connection

Established through recovery resources, aftercare, and sustained support

TBRI® is a registered trademark of the Karyn Purvis Institute of Child Development at Texas Christian University

"A home is in the heart of every child."

Last Revised: December 10, 2025