Building Alaska’s Treatment Foster Care Continuum

Mother and child learning together at home

Creating a Collaborative Framework for Treatment Foster Homes

Recent legislation established a distinct treatment foster care license in Alaska, creating an opportunity to strengthen the continuum of care available to children and youth with significant behavioral, developmental, emotional, or medical needs.

The Coordinated Health & Complex Care Unit (CHCCU) within the Department of Family & Community Services (DFCS) will lead the development and implementation of this work. Rather than building the framework in isolation, CHCCU will work alongside state agencies, Child Placement Agencies (CPAs), Tribal and community partners, behavioral health providers, families, caregivers, and youth with lived experience.

The treatment foster home provisions take effect July 1, 2028.

Building Blocks

DFCS Treatment Foster Care Contact
dfcs.tfc@alaska.gov

What is Treatment Foster Care?

Treatment foster care (TFC) provides the stability and family-based environment of foster care while adding a structured, therapeutic level of support for children and youth whose needs cannot be adequately addressed in their community home. It can be either a step up or step down along the continuum of care that children and youth may access to support stability and quality of care.

The Continuum of Care

TFC caregivers receive additional training and ongoing support and work as part of a treatment team to implement individualized strategies within the home. Depending on the model and eligibility, treatment foster care can support children and youth across multiple systems and is intended to respond to their individual needs rather than being defined solely by custody status.

Treatment foster care is a treatment intervention within a continuum of care, not simply a higher level of traditional foster care.

How is Treatment Foster Care different from traditional foster care?

Traditional Foster Care

Provides safety, stability, supervision, and support in a family setting
Foster parents provide day-to-day care and supervision
Standard foster parent training and support
Services are generally coordinated through the child welfare system
Serves children involved with the child welfare system
Primarily supported through traditional foster care funding

Treatment Foster Care

Provides family-based care plus structured therapeutic support
Treatment foster parents provide care while implementing individualized treatment strategies
Enhanced preservice and ongoing specialized training and support
Services are delivered or coordinated through a broader treatment team/provider
Serves children with significant behavioral, emotional, developmental, or medical needs across systems
May require additional funding and service partnerships to support a higher level of care

Building the Framework Together

Alaska has a foundation for treatment foster care, with CPA's working alongside OCS to license their homes. Therapeutic Treatment Home (TTH) is the current Medicaid behavioral health service which serves children and youth with severe mental, emotional, or behavioral health needs who cannot be stabilized in a less restrictive setting.

CHCCU will work closely with our DFCS divisions, the Department of Health, Tribal Partners, CPA's, behavioral health providers, and other key stakeholders to develop this framework for a new license. Areas for collaborative exploration will include licensing requirements, provider standards, caregiver training, clinical oversight, care coordination, referral pathways, relationships between CPAs and treatment foster homes, funding and Medicaid pathways, quality and outcomes, and ongoing provider support. No single agency can build a comprehensive treatment foster care system. Alaska's model will be developed through shared expertise, partnership, and continuous stakeholder engagement.

CHCCU will lead implementation-- but Alaska will build this together.

CHCCU's role is to bring together the expertise, systems, agencies, providers, families, Tribal partners, and community organizations necessary to develop a treatment foster care framework that is practical, sustainable, clinically sound, and responsive to Alaska's children and communities. This broader continuum-of-care function makes a cross-system implementation approach essential.

1. Build an Alaska treatment foster care model grounded in best practice

Learn from states and communities that have established effective treatment foster care systems.

2. Strengthen the continuum of care

Create a meaningful home-based treatment option between outpatient services and higher levels of residential or psychiatric care.

3. Improve sustainability

Explore Medicaid and other sustainable funding mechanisms that can support staffing levels, training, clinical oversight, and services required by treatment foster care.

4. Strengthen provider capacity

Develop a framework that makes it possible for qualified organizations and caregivers to participate successfully.

5. Build a system that works across custody and service systems

Treatment foster care should be capable of supporting children involved with child welfare, juvenile justice, behavioral health and, when appropriate, children who remain in their family home.

Learning Before Building

CHCCU will begin implementation by gathering research, national best practices, existing treatment foster care models, Medicaid approaches, provider perspectives, caregiver experiences, and subject matter expertise.

This information will help Alaska identify what is working elsewhere, understand where existing systems can be strengthened, and determine what adaptations are necessary to meet the unique needs of Alaska's children, families, Tribal communities, providers, and geographic regions.

Building Treatment Foster Care Together: An Alaska Partner Summit

DFCS is partnering with The Alaska Mental Health Trust and local partners to host a summit in spring 2027.

The summit will create an opportunity for Alaska's existing child placement agencies and other partners to share expertise, identify opportunities and barriers, examine national models, and help shape the next phase of implementation.

What Stakeholders Can Expect Next

Here are key activities CHCCU will work to facilitate during implementation of the new Treatment Foster Care license. Timelines may change based on participation and key feedback from stakeholders.

Fall / Winter 2026

Listen & Learn

Research and national model review
Internal DFCS alignment
Cross-department coordination
Identify subject matter experts
Engage key partners

Spring 2027

Child Placement Agency Summit

Learn from providers
Identify opportunities and barriers
Begin collaborative design

Summer / Fall 2027

Design & Develop

Stakeholder workgroups
Draft regulatory concepts
Licensing framework
Provider standards
Training framework
Service/funding alignment
Medicaid planning

2027–2028

Build & Prepare

Regulations
Implementation guidance
Provider readiness
Training
Systems/process development

July 1, 2028

Implementation Target

Treatment foster care home provisions take effect

Group of diverse kids, hands of together for teamwork, community, togetherness and collaboration.

Building Something Better, Together

TFC gives Alaska an opportunity to strengthen an important part of its continuum of care for children and families.

The work ahead is to build a system that is safe, effective, sustainable, culturally responsive, and responsive to the realities faced by Alaska's children and communities.

DFCS is committed to approaching this work with curiosity, transparency, collaboration, and a willingness to learn from the people who know this system best.

We invite Alaska's communities, Tribal partners, providers, caregivers, families, young people, state agencies, and other stakeholders to help build what comes next.