Guide to Community Based Intensive Services for Children and Adolescents (CBHI and BHCA)

In everyday terms, when we say a child has a severe mental health issue, we’re talking about emotional or behavioral challenges that go far beyond typical childhood ups and downs. These issues are persistent, intense, and disrupt your child’s ability to function in daily life—at home, in school, and with friends. Early identification and treatment are crucial. Without treatment, these symptoms can affect a child’s development and become worse as they grow into adulthood. However, with the right help which often includes therapy, medication, and family support, many children can learn to manage their symptoms and thrive.

Here in Massachusetts, there are two state-wide initiatives which aim to address the needs of severe mental health issues for children. The first is called the Children’s Behavioral Health Initiative (CBHI). This MassHealth-based program is designed to support children and adolescents through age 21 with significant behavioral, emotional and mental health needs. The goal of CBHI is to identify and treat these symptoms and work with you and your child in your home using a comprehensive team to access services necessary for success in home, school and community.

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Who can refer my child for CBHI Services?

Your child’s primary care provider, or a licensed mental health professional can refer a child for services. A parent or legal guardian can also directly contact behavioral health providers to inquire about CBHI by visiting the Massachusetts Behavioral Health Access (MBHAccess).  The first step in the process is for your child to undergo an assessment which will determine if they meet medical necessity for CBHI services. If your child qualifies, their treatment may include all or some of the following services:

Intensive Care Coordination (ICC) 

This is a care coordinator who works with you and your child to create an Individualized Care Plan which serves as a framework for the other members of the care team.

In-Home Therapy (IHT) 

This involves intensive home-based child therapy designed to work with your family to address problematic patterns and create healthier routines. This component requires direct involvement from the child’s family members or caregivers.

Family Support and Training (FS&T, or “Family Partner”) 

These are other parents who have been through this process with their own child and can offer their support and guidance from a caregiver perspective.

In-Home Behavioral Services (IHBS) 

In-home services are provided by a therapist; this person works closely with the child and family to improve behavior and overall family functioning.

Therapeutic Mentoring (TM) 

A therapeutic mentor who works as a peer support system for the child.

Mobile Crisis Intervention (MCI) 

(MCI) is a mobile crisis team that is available 24 hours a day, 7days a week and can evaluate your child at home or by the phone to assess for safety.

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What if my child doesn’t have Mass Health and they are struggling with mental health symptoms too?

If your child has commercial insurance there is a similar, parallel state initiative which also aims to support children and their families called Behavioral Health for Children and Adolescents (BHCA). With BHCA it’s important to note that your coverage depends upon the type of commercial plan that you have. If you have insurance through your employer, ask Human Resources whether your policy is “fully- funded” or “self-funded”. If you have a fully funded plan from Massachusetts, your plan likely includes coverage. Another important difference between BHCA and CBHI is that these commercially covered home-based services can only be available to children up until the age of 19.

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Who can refer my child for BHCA services?

Your PCP or child’s counselor can make a referral for an evaluation to determine their eligibility. Again, there will be an assessment to determine if your child qualifies for these services. If they do meet medical necessity, they may be eligible to receive some of the same type of home-based services mentioned above with secondary MassHealth coverage.  To learn more about applying for secondary MassHealth, visit here.

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Resources for additional information:

Children's Behavioral Health Initiative

CBHI Brochures for Parents/Caregivers

Top 10 Things You Should Know About In-Home Therapy

Behavioral Health Services for Children and Adolescents (BHCA)