Intensive In-Home Services

1. Service Definition

2. Services Provide

3. Eligibility Requirements

4. Out-of-Home

5. At Risk

3. Eligibility Requirements

Service Definition


Intensive In-Home (IIH) is a service for Children and Adolescents under age 21 that are intensive, time-limited interventions provided typically but not solely in the residence of a child who is at risk of being moved into an out-of-home placement or who is being transitioned back into the home setting from an out-of-home placement due to documented clinical needs of the child.

These Services Provide

• Crisis Treatment
• Individual Counseling
• Family Counseling
• Communication Skills Counseling (to assist child and parents to understand and practice appropriate problem-solving, anger management, and interpersonal interaction, etc.)
• Case Management Activities and Coordination with other required services
• 24-Hour Emergency Response

Eligibility Requirements

Effective September 1, 2011, a completed Independent Clinical Assessment will be required for those individuals up to the age of 21 through their local Community Services Board or Behavior Health Authority. Members of Intensive In-Home (IIH) Services must have the functional capability to understand and benefit from the required activities and counseling of this service. These services are rehabilitative and are intended to improve the child’s functioning. It is unlikely that individuals with severe cognitive and developmental delays/impairments would clinically benefit and meet the service eligibility criteria.

Individuals must demonstrate a clinical necessity arising from a severe condition due to mental, behavioral, or emotional illness that results in significant functional impairments in major life activities. Individuals must meet at least two of the following criteria on a continuing or intermittent basis:

1. Have difficulty in establishing or maintaining normal interpersonal relationships to such a degree that they are at risk of hospitalization or out-of-home placement because of conflicts with family or community; and/or

2. Exhibit such inappropriate behavior that repeated interventions by the mental health, social services, or judicial system are necessary; and/or

3. Exhibit difficulty in cognitive ability such that they are unable to recognize personal danger or recognize significantly inappropriate social behavior. For example is at risk for acting out in such a fashion that will cause harm to themselves or others.

Services shall be used when there is a risk of out-of-home placement, due to the clinical needs of the child, and either:

1. Services that are far more intensive than outpatient clinic care are required to stabilize the child in the family situation; or

2. The child’s residence, as the setting for services, is more likely to be successful than a clinic.

Out-of-Home

An out-of-home placement (one must be at risk of) is defined as one or more of the following:

• Level A or Level B group home
• Regular foster home (if currently residing with biological family and due to behavior problems is at risk of move to DSS custody)
• Treatment foster care placement (if currently residing with biological family or a regular foster family and due to behavior problems is at risk of removal to higher level of care) (IIH services would be provided to the child and the biological family or the foster family)
• Level C residential facility
• Emergency shelter (for child only, due to MH/behavioral problems),
• Psychiatric hospitalization
• Juvenile justice/incarceration placement (detention, corrections)

Home is defined as the family residence and includes a child living with natural parents, relatives, or a legal guardian, or the family residence of the child’s permanent or temporary foster care or pre-adoption placement. Children receiving Treatment Foster Care Case Management are not eligible for IIH services.

At-Risk

“At-Risk” is defined as one or more of the following:

• The child currently has escalating behaviors that have put them or others at immediate risk of physical injury.
• The parent or legal guardian is unable to manage the mental, behavioral or emotional problems in the home and is actively seeking alternate out of home placement.

If a child or adolescent has co-occurring mental health and substance abuse disorders, integrated treatment is allowed within IIH services as long as the treatment for the substance abuse condition is intended to positively impact the mental health condition.