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

Priority or Priorities:  ACES/Resiliency
Initiative(s): Trauma-Informed System of Care (THRIVE)
Outcome (s): Children and youth respected, safe and nurtured in their communities

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 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 Source and Context

MaineCare Data prepared by DHHS Office of Quality Improvement.