IHBT Rules

The Ohio Department of Mental Health and Addiction Services (OhioMHAS) and the Ohio Department of Medicaid (ODM) have included Intensive Home Based Treatment (IHBT) in the Medicaid Behavioral Health State Plan Services as one ofthe specialized services.

The Ohio Medicaid Behavioral Health Redesign Initiative is an integral component of Ohio’s comprehensive strategy to rebuild community behavioral health system capacity. The Initiative is based on key Medicaid behavioral health reforms implemented in four steps.

IHBT and Behavioral Health Redesign Entails:
– Developing new services for people with high intensity needs
– Ensuring IHBT is included in Behavioral Health Redesign menu of services
– Possible inclusion of additional eligibility requirements (more than OMHAS IHBT rule)
– Requiring ODM IHBT fidelity thresholds
– Requiring OMHAS Certification

Implications of Behavioral Health Redesign for IHBT can include:
– Treatment delivered per model fidelity not per agency productivity standard
– Increased access and availability of intensive home and community-based treatments
– Focus on training and supervision
– Need for workforce development at the pre-service level
– IHBT as a level of care/treatment episode
– Fidelity and outcomes emphasized

Rationale for IHBT Intensive Home-based Treatment
– Least restrictive, most normative
– Supportive framework for effective treatment
– Cost effective
– High engagement: Access, flexibility, and responsiveness
– Treatment is focused on whole family
– Alternative to custody relinquishment
– Benefits other child-serving systems
– Avoids negative consequences related to placement
– Targets high users of services & resources

IHBT is proving a pivotal service, in that youth and families benefit when families have options in a comprehensive system of care. Furthermore, IHBT expands the continuum of care, making less restrictive service options available for youth at risk of placement due to behavioral health issues. And finally, IHBT is a viable alternative to out-of-home treatment options, i.e. incarceration and/or hospitalization.

Below are the different areas to help keep you informed of current rules as implemented in January 2018.