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The Landscape of In-Home & Community Services for Children

The Landscape of In-Home & Community Services for Children

by Katrina Ringrose
http://drme.org/blog/2016-12-13

Many families who struggle to meet the needs of their children with behavioral health challenges are unaware of the intensive in-home and community services they may be eligible to receive.  Or, they may be too intimidated by the complicated systems that provide these necessary services.  There are many types of behavioral health services and the services and providers available to a child and family are based on the child and family’s individual needs. 

Services can take place while the child is living at home – providers may come into the home, or may see the child for outpatient appointments at a clinic or hospital. Another option is for the child to receive services during an inpatient stay at a hospital or residential treatment facility. Services should be provided in the “least restrictive environment,” which means children will receive treatment within their normal daily setting (such as home, school and the community) whenever possible.

A child receiving either inpatient or outpatient services may be eligible to have a targeted case manager. This is a person who helps children and families identify their needs, access services, and monitor the effectiveness of those services.  This person is a liaison between families and their providers.

For in-home and community services there are two options to consider.  There are services that are skill-focused, like Rehabilitative and Community Services (RCS), which are primarily appropriate for children with developmental disabilities. There is also in-home intensive therapy for children and families, to assist them in learning interventions to more effectively manage behavior and mental health symptoms. This second option is accessible to children with developmental disabilities, mental health issues, or both.

How to Access Services

For Targeted Case Management services, families can contact providers directly in their community.  Often, families learn about providers in their area from schools or other parents.  You can find more information about Targeted Case Management online - http://www.maine.gov/dhhs/ocfs/cbhs/services/case-management.html.

Once a family begins working with a Targeted Case Manager, they can identify the services that are needed. The Targeted Case Manager helps the family make a referral to KEPRO (http://www.qualitycareforme.com/resources/faqs/) to determine if their child is eligible, and once determined to be eligible, to assist in matching the child and family to a provider to begin services.

To learn about providers in your area, visit: http://www.maine.gov/dhhs/ocfs/cbhs/provider-list/home.html.

Common Barriers

Once a child and family are working with a Targeted Case Manager and have made referrals for the most appropriate in-home and community services, there may be additional barriers to overcome.  Many families may wait a long time to be matched with a provider.  Unfortunately, we are aware of families waiting over six months to receive these services. This is particularly a problem in rural areas of Maine.

Another barrier is that a child may be matched with a provider, but the provider can only partially meet the needs.  For example, the child may require 20 hours of in-home support and the provider can only deliver 10 hours. 

We are also aware that providers may develop the treatment plan and associated services based on their agency’s capacity, not the needs of the child and their family. This is problematic because the lack of statewide resources cannot be accurately reported. Another problem is that the provider may not be indicating that the child is only partially served, depriving the child of the ability to find another provider to fulfill the remaining needed hours of service.

Unfortunately, many children who do not receive the in-home and community services may end up requiring more restrictive treatment, like inpatient and residential care. This is more costly, more difficult for children, and often hard for families, so we want to see as many kids served safely and effectively in the community as possible.

What You Can Do

  • Contact Disability Rights Maine 1.800.452.1948.
  • Communicate with your Targeted Case Manager about your child’s and family’s needs frequently.
  • Ask your Targeted Case Manager to document your conversations and provide this update to KEPRO often.
  • Contact KEPRO’s Member Service Liaison http://www.qualitycareforme.com/members/member-resources/.
  • If your child is only receiving partial services, ask your Targeted Case Manager to put them back on the referral list with KEPRO.

Disability Rights Maine