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• State Health Policy

Community Alternatives to Psychiatric Residential Treatment Facilities for Children and Youth with Serious Emotional Disturbances

To help improve mental health services for children and youth, some states and communities have developed intensive home and community services for those with serious emotional disorders (SEDs). Mathematica has studied public financing mechanisms that states have used to pay for these intensive services. We examined key public strategies for funding home and community services for children with SED, as well as the Medicaid home and community-based service (HCBS) waiver, an approach that federal and state programs have been interested in using. 

Researchers identified benefits and drawbacks of HCBS waivers and other financing approaches for building home and community services as alternatives to residential care. They also assessed reasons states decide to seek HCBS waivers, as well as strategies they have used to combine different financing approaches to support community alternatives to residential care or out-of-home placements. Finally, the study examined financing methods likely to help sustain improvements in mental health services for youth with SED. 

Information for this study was gathered through key informant interviews with staff in 12 states and review of relevant reports. 

Publications

“Public Financing of Home and Community Services for Children and Youth with Serious Emotional Disturbances: Selected State Strategies” (June 2006) Executive Summary