Philadelphia Community Services for Children and Adolescents

VI. Residential Treatment Programs

Parents often ask, "What is available if outpatient treatment or a partial hospitalization program is not working and a child cannot live at home for a time?" Residential treatment facilities are places where your child lives away from home in a setting that provides around-the-clock supervision and therapeutic treatment. They are not as restrictive as a psychiatric hospital. The level of treatment available varies; some facilities provide more comprehensive treatment programs for children with emotional disorders than others.

A. Where To Turn For Residential Treatment Programs

Long-term treatment programs in private facilities that also offer specialized education are very expensive and generally are not covered by private medical insurance plans such as Blue Cross/Blue Shield. However, you should check with your insurance carrier to determine if such a facility would be covered by your plan. For information about programs and fees of private treatment facilities, check the public library for Handbook of Private Schools published by Porter Sargent. This publisher also has a Special Education series.

If you cannot afford private residential treatment for your child, you will need to turn to one of the public service systems (mental health or the School District) for help. Typically, most parents secure these services from the mental health system. Occasionally the Philadelphia School District will pay for residential treatment, but only if it is clear that the placement is necessary for the child to benefit from his or her special education program. Requests for placement through the School District are infrequently approved.

B. Securing Residential Services Through The Mental Health System

Residential mental health treatment services are now available through the county mental health system for children and adolescents with emotional disorders. Residential treatment services are used when other forms of treatment, such as outpatient or day treatment services, have not been successful. Education is provided either on-site or in local public schools, specialized day treatment programs or approved private schools.

1. How Do Parents Obtain Residential Services?

Parents can access residential treatment services through their child's therapist in a community mental health center or specialized agency. Some children are referred to residential treatment on the recommendation of the staff of psychiatric units.

Residential treatment is extremely expensive. For virtually all children, residential treatment is paid for through Medical Assistance (MA). For information about MA eligibility and how to apply, see Financial and Health Care Benefits.

Because the State Office of Medical Assistance requires residential treatment programs to reapply for payment for each child every 120 days, your child will be evaluated every 120 days to determine progress and the need for continued services.

Parents and family members can call Community Behavioral Health (CBH) if they need assistance in arranging appointments, evaluations, and/or negotiating the system. Families should also be aware that most residential treatment facilities are located in the counties surrounding Philadelphia.

For information about accessing residential treatment services, contact:

Your local Community Mental Health Center

Community Behavioral Health (CBH)
215-413-3100
1-888-545-2600 (24-hour)

Parents Involved Network
215-751-1800
www.pinofpa.org

2. Questions For Parents To Ask About A Residential Facility

What is the treatment?
How will I be involved in the treatment planning process?
How will I be kept up to date on my child's progress?
What is the education program?
Where will it be provided and by whom?
What are the policies regarding parental visitation, home visits, and phone calls?
How do you handle a child who is acting out?
How is the child's day, evening, and weekend time structured?
How do you plan for discharge?

3. Parental Involvement After Your Child Is In A Residential Program

It is crucial for you to maintain close contact with the staff who is working with your child. Ideally, you should be kept informed of your child's progress and be involved in planning his or her program. However, the degree to which this happens varies.

To establish regular communication:

You should schedule regular meetings and/or phone conferences with your child's therapist and other staff members who are in regular contact with your child.
If distance prevents you from regularly visiting the facility, establish a regular schedule of phone conferences and request weekly or bi-weekly written reports from your child's therapist and teacher.
You can provide pre-addressed envelopes or postcards giving the date you want the reports mailed and the information you wish included.

For additional information or assistance, contact Parents Involved Network 215-751-1800.

4. Education While In Placement

At some residential facilities, children attend school on the grounds, and at others, children go to the local public school. You have the right to be involved in the development of your child's Individual Education Program (IEP). For information on special education and parental rights, see Special Education.

For additional information or assistance, contact Parents Involved Network 215-751-1800 or the Education Law Center, 215-238-6970.

5. When Your Child Comes Home

When your child has been living in a facility and visiting on weekends only, the transition to living at home full-time can be difficult for both your child and family. Your child has been accustomed to living in a highly structured, group environment and your family has adjusted to living without that child in the house. Before your child comes home, you might want to do the following:

Several months before your child is to be discharged, request meetings with staff to discuss and plan for what will need to be in place before your child comes home - for example, Intensive Case Management and Wraparound Services (See Chapter IV).
Plan for your child's school program and make sure that it will be in place.
Visit the school your child will be attending.
Visit the classroom.
Talk to the teachers.
Make sure the school classroom offers an appropriate program for your child.
Request an IEP conference if your child requires a special education program.
Set up a support system for yourself, your child, and other members of the family.
Encourage an open dialogue between your child and the rest of the family about the difficulties in getting used to each other again. Talking things out can help ease some of the tensions.

C. Securing Residential Services Through The School System

Residential placements through the School District are very difficult to obtain. They are approved infrequently and only under certain conditions. The School District is not obliged to provide or fund residential services except:

When the only appropriate education program is at a facility so far away that daily transportation would be impractical or harmful to the child.
When the child needs the intensity and structure of a residential facility in order to make reasonable education progress.

The School District and the Bureau of Special Education in Harrisburg are very strict in their interpretation of demonstrated need. Few placements are approved. If you decide to pursue this and the School District is not in agreement with you, you have the right to a due process hearing. The due process hearing will determine your child's eligibility for the residential placement. For information on due process, see Special Education.

For questions regarding a residential placement through the school system; refer to the list of Educational Rights organizations.