Community Based Treatment Alternatives for Children

MASSACHUSETTS

Grant Information


Name of Grantee

Executive Office of Health and Human Services

Title of Grant

Building and Financing Sustainable Systems of Care:
A Feasibility Study and Development Grant for Community Based Alternatives for Children with SED in Massachusetts

Type of Grant

Community Based Treatment Alternatives for Children

Amount of Grant

$100,000

Year Original Funding Received

2003

Contact Information


Abigail Josephs, Project Coordinator
Executive Office of Health & Human Services
One Ashburton Place, Room 1109
Boston, MA 02108
617–727–7600
abigail.josephs@state.ma.us

Subcontractor(s)

University of Massachusetts Medical School, Center for Health Policy & Research

Target Population(s)


Children with serious emotional disturbance (SED) in out-of-home placement or imminently at risk for such placement.

Goals


  • Evaluate the feasibility of expanding community treatment alternatives for children with SED.
  • Identify replicable models of community treatment alternatives based on a review of best practices.

Activities


  • Map and analyze the program capacity and current spending for the target population.
  • Conduct a survey to determine the percentage of children that can reasonably and safely be treated in community settings.
  • Conduct a legal analysis of current service and reimbursement options, including relevant Medicaid laws and laws governing the target population, to determine which services can be provided and reimbursed with matched Medicaid funds.
  • Determine the type of waiver authority needed to broaden covered services.
  • Review the evidence-based best practices among wraparound programs and analyze reimbursement methodologies and cost data associated with community treatment.

Abstract


The project will evaluate the financial feasibility of expanding community treatment alternatives for children with SED. State staff will define the population of children currently served in out-of-home placement by systematically evaluating State agency expenditures for children with SED. In particular, the project will evaluate (1) the inpatient and residential services provided by other State agencies, and (2) State and local special education expenditures for children in residential placements pursuant to a behavior diagnosis on their Individualized Education Plan (IEP). A clinical analysis of children in out-of-home placements to determine the "universe" of children that could be safely served in a community setting will also be conducted.

The project will also evaluate the services currently provided and reimbursable as State Plan Services under existing Medicaid guidelines and those community services that are "state only" funded. In addition, the project team will evaluate regulations or other limitations that apply to the population to determine the legal feasibility of applying for a 1915(c) waiver to serve children with SED. Other efforts to redeploy state funding or to use grant resources to expand community treatment alternatives for children with SED will be explored.

Finally, the Commonwealth will convene an interagency public-private group to evaluate community program models to determine the programmatic and financial structures that will provide the most effective and replicable community treatment alternatives for children with SED. This group will involve providers from all settings, families, medical and psychiatric professionals, and individuals from the special education system.

An interagency policy group, composed of senior staff from the relevant State agencies, will also meet regularly to ensure that the project coordinates with other efforts to address the needs of children with SED. Families and providers will be involved through specific workgroups and focus groups and frequent reporting to the Mental Health Commission for Children.