Intensive In-Community Services
- Intensive In-Community Services are flexible, multi-purpose, in-home/community clinical support for parents/caregivers/guardians and children/youth with behavioral and emotional challenges who ar receiving case management, MRSS, or Out-of-home services. The purpose of these interventions is to strengthen the family, to provide family stability and to preserve the family constellation in the community setting. These services are flexible both as to where and when they are provided based on the family's needs. They may be provided as a component of the mobile Response Stabilization System. This family-driven treatment is based on targeted needs as identified in the ISP/ICP treatment plan. The ISP/ICP/treatment pla also includes specific interventions(s) with target dates for accomplishement of goals that focus on the resorative functioning of the child/youth with the intention of:
- Stabilizing the child/youth's b ehavior(s) that led to the crisis
- Preventing/reducing the need for inpatient hospitalization,
- Preventing the movement of the child/youth's residence
- Preventing the need for out-of-home living arrangements.
The services provided will also facilitate a child/youth's transition from an intensive treatment setting back to his/her community. They are designed to be time limited in nature with the objective of helping the youth and family transition to longer term communtiy based mental health services which are congruent with their treatment needs when needed. Interventions will be delivered with the goal of diminishing the intensity of treatment over time. The following are some of the possible interventions that may be implemented.:
A. Individual and family therapy
B. Clinical consultation/evaluation
C. Child/Youth behavioral management
D. Family counseling/psychoeducation
E. Allied Therapies
F. Behavioral Assistance
Intensive-In Community Programs require the provision of an array of services delivered to the child/youth and his/her family by a community-based, mobile, multidisciplinary tam of professions and paraprofessionals. Services are designed to be maximally flexible in supporting the child/youth and his/her parents/guardians/caregivers at the time of day when the services are most needed and when the family may be most receptive to therapeutic intervention and skills training.
Services are designed to meet the unique needs of the child/youth, based on his/her cultural values and norms and to use the strengths of the family in the treatment process. Services may be provided through agencies or individual practitioners at home or in the community (including the school). Intensive In-Community Services encompass a broad array of interventions ranging from clinical therapy to behavioral assistance. Services may include assistance with addressing basic needs as well as a comprehensive integrated program of clinical rehabilitation services to support improved behavioral, social, educational and vocational functioning. In general, this program will provide children/youth and their families with services such as psychoeducation, negotiation and conflict resolution skill training, effective coping skills, healthy limit-setting, stressmanagement, self care, budgeting, symptom/medication management, and developing or building on skills that would enhance self-fulfillment, education and potential employability. Services are less structured and more flexible than intensive outpatient program services.
Admission and Exclusion Criteria
The child/youth must meet 1, 2, 3 and 4 and at least one from 5 through 8
1. The child/youth young adult is betweent he ages of 5 until their 21st birthday. Special consideration will be given to children under 5.
2. The youth is enrolled in a DCSOC case management entity which could include CMO, UCM, YCM, or MRSS.
3. The child youth is in need of external clinical and social support in order to remain stable outside of an inpatient or residential environment, or to transition to living in the community form a more restrictive setting.
4. The DCSOC Assessment and other relevant information indicate that a comprehensive, integrated program of clinical and psychosocial rehabilitation services is needed to support improved functioning at aless restictive level of care.
The child/youth meets any ONE of the following:
5. The child/youth demonstrates symptoms consistent with a DSM IV (Axis I-V) diagnosis that, by history, has required periodic psychiatric hospitalization or residential treatment and/or could potentially require hospitalization or residential treatment.
6. The child/youth has a behavioral or emotional disorder that interferes with her/his ability to maintain family, school, social or work responsibilities unless clinical/social/restorative/rehabilitative services are provided.
7. The child/youth has stabilized during an acute hospital, residential and/or crisis intervention, but would benefit from transitional or stabilization services in the community in order to reintegrate.
8. The individual and family's treatment needs exceed that which can be met through routine outpatient services.
PSYCHOSOCIAL, OCCUPATIONAL,, CULTURAL AND LINGUISTIC FACTORS may change the risk assessment and should be considered when making level of care decisions
Any of the following criteria is sufficient for exclusion from this level of care:
1. The DCSOC Assessment and other relevant information indicate that the child/youth does not need the intensive in-community level of care, as they need either a less intensive therapeutic service or a more intensive therapeutic service.
2. The child/youth's parent/guardian/custodian does not voluntarily consent to treatment andthere is no court order requireing such treatment.
3. The Behavioral symptoms are the result of a medical condition that warrants a medical setting for treatment, as determined and documented by the youth's promary care physician and/or CSA Medical Director. (Performcare)
4. The child/youth has a sole diagnosis is Substance Abuse and there are no identied, co-occurring emotional or behavioral disturbances, which would potentially benefit from Intensive In-community services.
5. The child/youth has a sole diagnosisof Autism and there are no co-occurring DSM IV Axis I Diagnoses, or symptoms/behaviors consistent with DSM IV Axis Diagnosis.
6. youth requires specialized therapeutic services, ie. applied behavioral analysis, which consist of more than 4 clinical hours a week; trauma focused cognitive behavioral therapy.
7. The chil/youth hasa sole diagnosis ofMentl Retardation/Cognitive Impairment and there are no co-occurring DSM IV Axis I Diagnoses, or symptoms/bhaviors consistent with a DSM IV Axis I Diagnosis.
8. The youth is not a resident of New Jersey. For minors who are under 18 years of age, the residency of the parent or legal guardian shall determine the residence of the minor.
CONTINUED STAY CRITERIA AND DISCHARGE CRITERIA ARE AVAILABLE ON PERFORMCARE WEBSITE UNDER PROVIDER TAB.