Indicator 18: Home and Community Based Services for Youth With Severe Behavioral Health Problems

 

Why This Is Important

National estimates of children with serious emotional disturbance range from as low as 7% to as
high as 19% depending on the age grouping of the child. Children and adolescents with severe
behavioral health problems and their families often struggle to receive services and support that
enables the children to continue living at home and in their community. The more such services
can be provided, the more likely that families can be kept together and that the child will not
need to be placed in an out-of-home treatment setting.

 

 

Where We Stand

The chart displays the number of children who received each of three types of home and
community based services from the Children’s Behavioral Health Services Program (CBHS)
of Maine’s Department of Health & Human Services (DHHS) between 2000 and 2005. In all
three cases, the number served increased substantially over this period; the number who received
Habilitation services rose by 193%, those receiving Behavioral Health Services increased 14%
and children who accessed Targeted Case Management rose 257%.

Children’s Habilitation Services (MaineCare Section 24) are for children diagnosed with mental
retardation or autism, are provided in the child’s home or community, and focus mainly on
increased skill/physical development and behavior management. Children’s Behavioral Health
Services (Maine Care Section 65H) are also provided in the child’s home or community and focus
similarly on behavior management and increased skill/physical development. Targeted Case
Management identifies the medical, social, educational, and other needs of the children, locates
services and supports to meet those needs, and helps children and their families to access those
services.

Much of the growth in these services is attributable to the Risinger Settlement Agreement which
established these three services as entitlements for children who are eligible for MaineCare services
and can benefit from them. The Department remains committed to meeting all conditions of the
Settlement. In 2006 CBHS will focus on the quality, medical necessity and benefits/outcomes
these services demonstrate for children through a new MaineCare benefit (Child and Family
Behavioral Treatment Services - Section 65M) that will supplant In-Home Behavioral Services
with clinically strengthened treatment delivery that emphasize active parent involvement in the
child's treatment.  In addition, CBHS will will implement improved care management processes
for this service such as prior authorization and utilization review that could result in continued high
numbers of children and youth being served, but for a shorter duration and at less public cost.

 

Data Sources and Context

MaineCare Data prepared by DHHS Office of Quality Improvement.