Intensive Home and Community-Based Services

Intensive Home and Community Based Services Option

  • The Vermont Agency of Human Services (AHS) would make administrative policy changes to Vermont’s Medicaid mental health services.   

    Almost all Intensive Home and Community Based Services (IHCBS) would be delivered as rehabilitation services instead of as home and community-based services. This is a technical change, not a change to services.

    • These changes would allow Designated Agencies and Specialized Services Agencies (DA/SSAs) to continue providing mental health case management (service coordination) and still provide most IHCBS services to children and families eligible for IHCBS. 
    • To avoid conflict of interest, a small subset of IHCBS home and community-based services, such as respite, would need to be delivered by other direct service providers (not DA/SSAs).
    • This option would minimize change for people receiving IHCBS services and the IHCBS providers.  It would support continuity of existing therapeutic relationships.
  • ProsCons
    • Maintains DA/SSA structure with minimal disruption of IHCBS services for individuals and families.
    • Maintains close coordination/integration of HCBS case management and direct services within same agency.
    • Will need to develop additional separate HCBS provider capacity for the mental health HCBS service (such as respite) that cannot be defined as Medicaid Rehabilitation Services.
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