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Library: Policy

340:75-7-301. Enhanced foster care (EFC) general

Revised 9-15-23

(a) EFC purpose.  EFC is a service category developed to respond to the complex behavioral, medical, developmental, and mental health needs of children by stabilizing placement for a child in a family-based setting or by supporting children who need additional services to be successful in a family-based settings.  EFC services are:

(1) child-specific services provided to kinship or traditional resource homes for children already placed in those settings; and

(2) designed for traditional homes in which additional training is provided to the family to support the placement of children transitioning from congregate care, acute or residential treatment, or children who are placed in shelter care or are at risk of placement in shelter care.

(b) Eligibility.  EFC is available to any child in Oklahoma Human Services (OKDHS) or tribal custody meeting service criteria.  Information obtained during the referral process is used to determine eligibility and to support individualized service planning for the child.

(1) A child meets at least one of the following eligibility criteria to receive EFC, the:

(A)  Child and Adolescent Needs and Strengths (CANS) Assessment indicates the child would benefit from EFC.  The CANS Assessment is conducted by a third-party qualified person, per Oklahoma Administrative Code (OAC) 340:75-13-16 and 340:75-14-1;

(B)  onset of frequent placement moves from family-based settings due to the provider requesting change of placement or because the provider cannot meet the child's behavioral health needs;

(C)  child has a minimum of two elevated Child Behavioral Health Screeners;

(D)  child has a provisional or primary diagnosis from the most recent edition of "The Diagnostic and Statistical Manual of Mental Disorders," except for V codes and adjustment disorders, with a detailed description of the symptoms supporting the diagnosis;

(E)  child's conditions are directly attributed to a primary medical diagnosis of a severe behavioral and emotional health need and may also be attributed to a secondary medical diagnosis of a physical, developmental, intellectual, or social disorder that is supported alongside the mental health needs;

(F)  child's conditions are directly attributed to a mental illness or serious emotional disturbance, a medical issue, or a developmental or intellectual delay;

(G) evidence  the child's presenting problems require full integration of a 24-hour crisis response, behavior management, or intensive clinical interventions from professional staff to prevent the child from having to move from a family-based placement or to transition to a family-based setting from a higher level of care; or

(H) the child has specific needs or factors that pertain to the child's permanency, safety, and well-being, as approved by the EFC programs administrator.

(2) The resource parent caring for the child agrees to participate in the child's treatment needs and planning actively.

(c) Training.  All resource parents receiving EFC services are required to complete a supplemental EFC training determined by OKDHS and any child-specific training dependent on the child's individual needs, in addition to the agency required pre-service training.

(d) EFC homes.  EFC homes are approved, per OAC 340:75-7-10.1 through 340:75-7-18, and after:

(1) undergoing assessment;

(2) finishing   the supplemental EFC training;

(3) demonstrating a willingness and capacity to provide the level of supervision the child requires or needs on an ongoing basis;

(4) agreeing to participate in a child's treatment needs and planning actively; and

(5) receiving approval from the regional field manager.


Revised 9-15-23

1.  Enhanced foster care (EFC) referral.

(1) EFC is requested for a child already placed in a family-based placement by completing Form 04EF003E, Enhanced Foster Care Referral, and submitting the form via email to the applicable regional EFC mailbox listed on Form 04EF003E.  The child's assigned child welfare (CW) specialist or the resource specialist assigned to the home completes this referral.

(2) EFC is requested for a child who is in need of a new placement by completing the unified placement request and submitting via email to the applicable regional EFC mailbox listed on Form 04EF003E.

(3) EFC program staff reviews the referral request and collaborate with the child's assigned CW specialist, resource specialist, and service provider to initiate services.

(4) EFC program staff is responsible for uploading the EFC Referral into the child’s case in the document management system.

2.  EFC training.

(1) Child-specific EFC resource parents complete a supplemental EFC training within 90-calendar days of the child’s EFC approval. 

(2)  EFC resource homes complete supplemental EFC training prior to approval as an EFC home and taking a placement.

(3) The resource family’s assigned resource specialist is responsible for enrolling the resource family in the supplemental EFC training.

(4) Additional child-specific training may be required dependent upon the child's individual needs.  The regional EFC program staff works with specialized programs and the Child Welfare Services (CWS) Clinical Team to ensure the family is connected to the necessary training.  The EFC Service and Support Plan outlines the child-specific training requirements.

3.  EFC homes.

(1) EFC home recruitment includes both currently approved resources and new EFC homes.

(2) CWS staff engages previously closed traditional and therapeutic foster care homes to reopen as EFC homes.

(3) Targeted recruitment includes collaborative efforts with the Foster Care and Adoption Association of Oklahoma and other external partners.

(4) Form 04EF002E, Enhanced Foster Care Assessment Addendum, is completed for all identified EFC homes.  The regional field manager uses the addendum to make final determination on the conversion and approval of an EFC Home.  Form 04EF002E is completed when a resource home requests  consideration for approval as an EFC home

(5) A kinship or traditional home receiving EFC services for a specific child placed in the home is not automatically approved  as an EFC home for other children who meet EFC criteria.  The regional field manager approves these situations on a case-by-case basis.

4.  EFC overfills.  No more than two children receive EFC services in any given resource home, except to maintain placement of a sibling group when each child meets EFC criteria.  A third placement requiring EFC services requires an overfill request approved by the Foster Care and Adoptions deputy director and regional deputy director using Form 04FC021E, Resource Overfill Assessment.

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