Rosie D.
Reforming the Mental Health System in Massachusetts

What are Home-Based Services?

Home-based services, sometimes referred to as wraparound services, constitute a well-established behavioral health intervention for children – an intervention designed to meet children’s needs in their birth, foster or adoptive homes, or in the communities where they live.  The planning and provision of home-based services require a specific, individualized process that focuses on the strengths and needs of the child and the importance of the family in supporting the child.  Home-based services incorporate several discrete clinical interventions, including, at a minimum, comprehensive strength-based assessments, mobile crisis services, case management or care coordination, clinical teams, and individualized supports, including behavioral specialists.

The Commonwealth is developing an array of home-based services that can be delivered to children in their homes or in other community settings.  These are strength-based, individualized services that focus on the needs of children and their families.  They are designed to help children succeed at home, and avoid unnecessary hospitalization or residential placements.

A single care manager will work with families to identify a child’s needs and goals, select and oversee a single care planning team, and coordinate all services under one care plan.  The families actively participate in the planning process and guide the treatment decisions.

Under the Court’s order in Rosie D. several discrete home-based services will be available to children with SED.  These services include:

  • Intensive care coordination involves a single care coordinator, a single care planning team, and a single care plan that guide the provision of all mental health and related support services.

  • A comprehensive home-based assessment includes an in-depth review of past records and treatment, a home visit, multiple interviews with family members, teacher and other collaterals, and leads to a strength-based assessment of the child and his or her needs.

  • Family training and support provides a family partner to assist families in     participating in the wraparound planning process, accessing services, and navigating child-serving agencies.

  • Mobile crisis intervention will be available 24/7 to provide short-term emergency care in the home to evaluate and treat a child in crisis, without the necessity to go to an emergency room or medical facility.

  • Crisis stabilization provides staff and treatment in the home or another community setting for up to seven days.

  • In-home behavioral services address challenging behaviors in the home and community.  A behavioral therapist writes and monitors a behavioral management plan with the family, while a behavioral aide works with the family to implement the plan in the home and in the community.

  • In-home therapy services address social or emotional issues.  A mental health therapist provides counseling and therapy to the child and family.  The therapist may be assisted by an aide who provides support the child in the home, school or community/recreational settings.

  • Therapeutic Mentoring helps a child develop independent living, social and communication skills, as well as providing education, training and support services for children and their families.

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