Indicator: Home Care of Youth With Severe Behavioral Health Problems
- Home Care of Youth With Severe Behavioral Health Problems
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Why This is ImportantNational 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 those 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 three types of home and community based services from the Children’s Behavioral Health Services (CBHS) program of Maine’s Department of Health & Human Services (DHHS) between 2003 and 2007. Overall, the number of children served increased substantially over this 5-year period. The total number who received in-home and community based Habilitation Services and Behavioral Health Services rose from 2,590 to 3,256 a gain of + 666 or 26%, while children who accessed Targeted Case Management Services increased from 6,368 to 7,904, a gain of +1,536 or 24%.
Targeted Case Management Services identify 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. 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 are designed for children and youth with a mental health diagnosis who have emotional and behavioral treatment needs. Beginning in 2006 Behavioral Health home and community based services underwent a major change.
Now known as Child & Family Behavioral Treatment Service (MaineCare Section 65M) and Community Based Treatment for Children without Permanency (Section 65N) addresses an identified need for intensive in home services for children who did not respond to traditional outpatient services or needed a step down from out of home services (residential and hospital). The new Behavioral Health Treatment Service 65M&N is designed as a brief treatment model, typically 6 months in duration, to be delivered by an independently licensed clinician and a bachelor’s level behavioral health professional as a team, in the child’s home and community with significant parental participation. These services supplant the former Behavioral Health service (65H) with clinically strengthened treatment and care management processes. They include prior authorization and utilization review that focus on client outcomes, and improved management of program capacity that can serve eligible children for a shorter but more intensive duration, at less public cost.
Much of the growth in these services is attributable to the 2000 Risinger Settlement Agreement which established these services as entitlements for children and youth who are eligible for MaineCare services and can benefit from them. The terms of the Risinger Settlement focused on reducing an eligible child’s waiting time for these services. In January 2008 the Department was released from reporting responsibilities to the US District Court, having been deemed to be in full compliance with the terms of the Agreement. Compliance with Risinger fulfills Children’s Behavioral Health Services number one priority for the past several years.
Data Source and Context
MaineCare Data prepared by DHHS Office of Quality Improvement.
