Fiscal Year 2004 Proposed Budget

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DEPARTMENT OF HUMAN SERVICES
CHILD AND FAMILY COMMUNITY-BASED MENTAL HEALTH AND MENTAL RETARDATION/DEVELOPMENTAL DISABILITIES SERVICES (IN-HOME SERVICES TEAM)

PROGRAM MISSION: To prevent the progression of mental health and behavioral disorders and reduce the need for more restrictive placement of children by providing community-based, effective and high quality case management services and therapeutic and behavioral interventions.

• The Intensive In-Home Services Program treats children who display severe emotional disorders and reduces their need for more restrictive placement by providing a range of highly effective therapeutic interventions in the home setting. Services are provided until the child is able to successfully negotiate family and community life with less structure and support. The program offers intensive family therapy, behavioral coaching, and skill building, predominantly on an in-home basis, for children at risk of, or returning from, out-of-home placement. Family therapists are available 24 hours each day to resolve crises. Services are time-limited.

• The Children's Mental Retardation/Developmental Disabilities Program supports families whose children present behaviors or conditions associated with mental retardation and developmental disabilities by arranging, authorizing, coordinating, and linking families to various programs and services. The divisional case manager works directly with families and with community, state, and national resources to help families access the full range of available services. Services are individualized to meet specific needs and preferences of each child and family.

• The Behavior Intervention Services Program improves behavioral functioning and reduces the need for more restrictive placement of children and adults by providing behavioral consultation and intervention services. Consultation provides family-centered training to care providers of children and adults who exhibit self-injurious behavior, aggression, non-compliance, tantrums, etc. Parents are trained in behavioral management techniques to reduce the risk of child abuse and the need for a more restrictive placement.

SIGNIFICANT BUDGET HIGHLIGHTS:

• Personnel costs, non-personnel costs and FTE increases due to a reorganization within Child and Family Services in FY 2003. In FY 2002 the FTE count included only the Behavioral Intervention Services program. In FY 2003, 1.0 FTE was added with new state funding (Children's Case Management). The FY 2004 FTE count reflects reallocation of 2.0 FTEs from Child and Family Mental Health/Substance Abuse Treatment program; associated non-personnel costs were also reallocated.

• DHS staff and the Arlington Community Services Board are undergoing a comprehensive review of all mental health, mental retardation and substance abuse service client fees, and will be developing a new fee scale based on current service costs. The review will be completed by early February.

PERFORMANCE MEASURES:

Intensive In-Home Services Objective: To improve emotional functioning and prevent out-of-home placement in 85% of clients treated by providing therapeutic interventions in the home.

• Targets are internally set.

• Diminished level of savings from FY 2002 to FY 2003 is due to stringent Medicaid regulations limiting the number of referrals and staff turnover.

Children's MR/DD Case Management Objectives: (1) To provide individualized services that promote independence, community participation, self-determination, and increased choices for each consumer; (2) to provide community support services by obtaining authorization for 100 percent of Medicaid State Plan Option requests and submit authorizations for Medicaid Waiver services for all eligible consumers; and (3) to increase revenues available through the Medicaid program.

• Targets are internally set.

• Program for children began 4^th quarter FY 2002.

• Currently there are two Medicaid eligible clients in the program.

Behavior Intervention Services (BIS) Objective: To maintain or improve the current community placement for at least 95 percent of persons served through the use of effective behavioral interventions.

• Care providers are defined as those who supervise and or care for the individuals exhibiting the behaviors of concern.

• The past several years has shown an increase in the percentage of school-age children served from 75% to 93% of the total BIS caseload. Most of the school-age children served (68%) have been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD).

• 91% of the children range in ages from 3 to 10.

• BIS continues to serve children and adults with developmental and emotional delays/disabilities.

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