IBHS Facts
This is the year IBHS was initiated in PA and BHRS was terminated as a program.
1999. Providers in the state had from 1999 to 2021 to become licensed as IBHS through OMHSAS (Office of Mental Health and Substance Abuse Services (extra credit if you knew this!)
A BHT requires this many hours of supervision per month if they work 38 hours per week
Four - if you work more than 37.5 hours per week (billable and NON-Billable) you need supervision that week for one hour.
True or False. Children with genetic disorders do not qualify for IBHS.
False - the medical necessity criteria for IBHS is not based on diagnosis or symptom - but specific behaviors that occur as a symptom of a diagnosis that is identified in the DSM IV with intensity and frequency with consistency over time.
Children need a ___________to verify they medically require IBHS services.
Written Order - the written order is the "prescription" for IBHS. The Written order does not give the recommendation for how much or how many months of services - but makes an overall recommendation for what the clinician thinks the child will need to make progress.
The H in IBHS represents?
HEALTH - this means the behaviors are intensive to the point they are impacting the child's health and daily functioning.
What is the sum of the number of fish Jack has had in his lifetime plus the program number of YAP Bedford.
110 - Jack has had 4 fish and the Bedford Program number is 106
The S in IBHS stands for?
SERVICES
The use of an ADOS will assist a team to identify what disorder?
Autism Spectrum Disorder - the ADOS (Autism Diagnostic Observation Scale) is a play-oriented assessment tool used for children that are showing some signs at early screenings or when concerns are noted by parents during states in development. Older children that are not developmentally in early play stages are typically not assessed with the ADOS.
The B in IBHS represents?
BEHAVIOR - these behaviors are INTENSE and not typically observed by other children in the same natural environment as the child.
True or False: Once a child is identified as eligible for IBHS, they remain eligible until the team feels they are ready to be discharged.
False - medical necessity criteria must be identified by the Managed Care Organizations psychiatrist. This is documented in the Assessment.
The I in IBHS represents?
INTENSIVE - Intensive behaviors are not typically displayed in other children in the same environment as the child you are supporting. This will include aggression, destruction of property, extreme hyperactivity, impulsiveness, emotionally irregular behaviors and dysregulation, lack of language and poor coping skills (to name a few.)
YAP became an IBHS provider in this year
2021 - YAP is doing pretty well for undergoing an entire program/regulation and systems change since 2021. Bravo YAP!
True or False. Children on the Autism Spectrum qualify for IBHS services all of the time.
False
True or False: Every State in the United States has a version of Intensive Behavioral Health Services available to children and families?
False - only 7 states (as of google today) offer Intensive Wrap Around services. Pennsylvania is thankfully one of them!
The long-time moto for BHTs (or TSSs) has been. . . "We work ourselves. . . . . "
"Out of a job!"
What year did BHRS become an active program in PA?
1989 - in the late 80's BHRS was first initiated in PA. Not all states provided Medicare funded supports and therapist to children, especially on the Autism Spectrum. Treatments for Autism were just becoming more well known (this was WAY before social media!). Some families moved to PA to access these services for their children when they learned they had been diagnosed with ASD.
Clinical Directors are required by regulation.
True or Falst: A child that qualifies for INTENSIVE BEHAVIORAL HEALTH SERVICES has needs that may be met by another service, including a teacher or school provided aid.
False: The child is only eligible for IBHS in school if the clinician can prove to the MCO that the needs of the child cannot be met by any other professional in the natural environment.
In order for a child to qualify for IBHS services, they must meet with a practitioner and obtain a written order. The written order will identify if the child has ________________ that indicate medical necessity for IBHS.
INTENSIVE BEHAVIORAL HEALTH needs.
This is the clinical term for ethically ending a relationship with a child after discharge or when staff change occurs.
Closure: Facilitating closure is a necessary process for BHTs and BCs to engage in with a child when there is going to be a separation. Preventing abandonment and re-occurring trauma to the child.
IBHS has historically been known as
BHRS
Behavioral Health Rehabilitative Services
True or False: The I in IBHS indicates Irregular behavior.
FALSE - INTENSIVE
Off task behavior is an indicator of medical necessity criteria for IBHS services? True or False
False - off task behavior can be prompted by a school provided aide. If the off-task behavior is prompted, and then another behavior is initiated in response that might include a medically necessary symptom, IBHS may be considered at this time. HOWEVER, this behavior must occur frequently, with intensity and over time.
Youth Advocate Programs provides what additional services in Bedford County (in addition to IBHS)
Truancy
Intellectual Disability/Developmental Disability Waiver Services
Supportive Employment (OVR)
True or False? After discharge or staff change, a relationship with the child outside of YAPs services is encouraged to ensure the child continues to make progress.
FALSE - NO, NO, NO. . . no. When this happens the therapeutic relationship is damaged and the child may experience regression, confusion or even over dependence on the clinician. There is also a risk of the family becoming dependent on the clinician to meet needs that can not otherwise be met by natural resources. Do NOT engage in these types of relationships.