Home-Based Therapy

Gratiot Integrated Health Network

Program Description


Home-Based/Infant Mental Health

Service Codes: H0036, 9083X, T1016, T1017

Program Philosophy: Gratiot Integrated Health Network provides Home-Based/Infant Mental Health services that are designed to provide intensive services to children and their families with multiple service needs, who require access to an array of mental health services.  Treatment is based on the child’s need with the focus on the family unit.  The service style supports a strength-based approach, emphasizing assertive intervention, parent and professional teamwork, and community involvement with other service providers.

Program Goals: The goal of Home-Based/Infant Mental Health services is to support children and their families to more fully participate in their community.  Services promote normal development and healthy family functioning, support and preserve families, reunite families that have been separated, and reduce the usage of, or shorten the length of stay in, psychiatric hospitals and other substitute care settings.  Should the child be placed temporarily outside the home, Home-Based/Infant Mental Health Services are coordinated with other community agencies and individuals, as necessary and indicated, including interfacing with foster care homes, or residential or detention facilities, with the goal of returning the child to the home.

Services/Scope of Services: Home-Based Services are designed to restore or enhance social, psychological, or biophysical functioning of individuals/families via individual, family and/or group therapy; case management; crisis intervention; family collateral contacts; testing; and training in social skills and parenting skills. A person-centered treatment approach is used to help identify an individual’s and their family’s strengths dreams, goals and desires.

Population served includes consumers who are 21 years of age or under and have a primary diagnosis of a Severe Emotional Disturbance and/or Co-occurring disorder. In addition, children served by Home-Based Services are generally at risk of out-of-home placement and must have a CAFAS score of 80 or above.

Infant Mental Health Services provide supportive counseling to at risk parent(s) and children ages 0-3.  This service is provided in the consumer’s home. Counseling focuses on the parent-infant dyad, and their capacities for attachment.  The infant is the center of the intervention while supporting and nurturing the parent(s) as the primary caregiver in a non-judgmental, non-intrusive approach. Referrals can be made for other needed services and Crisis Intervention provided.

The programs provide services a minimum of 4 hours per month in locations that meet the needs of the persons served. Primarily services are delivered in the family’s home, but also the schools as appropriate; an agency office for group or individual/family sessions; and other community settings as agreed upon by the clinician and individual/family.

Services are provided Monday through Friday from 8:00 a.m. to 5:00 p.m. and by appointment.  Crisis Intervention, Access, and Customer Service activities are provided 24 hours a day, 7 days a week, allowing those who are accessing services to schedule an appointment, to allow for a message to be left for clinicians or Customer Service Staff, or in an emergency situation to access a crisis worker.

Services are initiated at the request of the parent or legal guardian of the child.  Information from referral sources will be accepted after proper consent for release of information is obtained. Services will not be denied based on an individual’s inability to pay for services.

Admission/Re-Admission Criteria:  The Access Coordinator, in conjunction with the program supervisor, is responsible for prioritizing the admission/readmission of eligible individuals based on the severity of needs.  Amount, scope, and duration of service provision is determined based upon evaluation of medical necessity and will be specified in the individual plan of service.  Medical necessity is determined based upon a thorough psychosocial assessment, standardized functional assessment tools (i.e. SIS, CAFAS, LOCUS, etc.), and the clinical judgment of trained professionals.  Based upon the aforementioned evaluation, individuals will be assigned a level of care benefit plan, specifying a minimum and maximum range of service units.  Exceptions to level of care benefit plans will be reviewed by the Utilization Management department.

It is the policy of Gratiot Integrated Health Network to provide services to all eligible individuals in a manner that is sensitive to the cultural and socio-economic needs of the individual in a nondiscriminatory and/or non-threatening manner.  Services are provided to eligible individuals without regard to race, religion, color, national origin, age, sex, marital status, sexual preference, handicap, juvenile justice status or any other protected status as required by law.  The agency endeavors to accommodate individuals with special needs, or refers to providers equipped to meet their needs.

Eligibility criteria for Home-Based/Infant Mental Health services include consumers up to age 21 and under who have/are:

  • a primary DSM-V diagnosis of Serious Emotional Disturbance or are at high risk for SED
  • co-occurring disorder
  • severely functionally impaired (i.e. a CAFAS score at or above 80)
  • primary residence in Gratiot County
  • Medical Necessity (clinically appropriate; necessary to meet needs; consistent with diagnosis, symptomatology and functional impairments; in the least restrictive environment; and consistent with clinical standards of care)
  • the ability to benefit from generally accepted Home-Based/Infant Mental Health practices
  • a willingness to participate in treatment planning
  • consent to treatment from parent or legal guardian

Home-Based/Infant Mental Health services may also be provided to an adult beneficiary who is a parent for whom it is determined services would be the treatment modality that would best meet the needs of the adult beneficiary and the child.  This would include a parent who has a diagnosis within the current DSM or ICD that results in a care-giving environment that places the child at-risk for serious emotional disturbance.

When individuals are found to be ineligible for services, they are given the reason(s) and are directed to alternative or more appropriate services.  In addition, when applicable, the family/support system and/or the referral source are informed as to the reason for ineligibility.  Assistance in contacting alternative services is available upon request.

Transition/Discharge Criteria:  An individual may be transitioned or discharged from Home-Based/Infant Mental Health Services when one or more of the following occur:

  • Successful completion of the goals set forth in the Family Centered Plan of Service
  • Individual request
  • Lack of individual participation in treatment
  • Individual requires a different level or type of service based on medical necessity
  • Individual/family no longer meets established eligibility criteria

When an individual is discharged or removed from the program for aggressive and/or assaultive behavior, follow-up will occur within 72 hours to insure linkage to appropriate care.

Regardless of discharge status, any individual may reapply for services by contacting GIHN.