From Autism Transition Handbook
Wrap Around Services, or Behavioral Health Rehabilitation Services (BHRS), are designed to support or "wrap around" the child and his or her family. Services focus on behavioral interventions, and are not intended for educational purposes. Trained clinical staff work to transfer skills to primary caregivers (at home, school and in the community) and allow for the child/adolescent to function within his or her environment using their natural supports. The child's family is expected to fully participate in Wrap Around services by helping to consistently carry out treatment plans, give feedback on progress, and eventually independently implement the interventions. A caregiver is present for all levels of service at all times. In Pennsylvania, children ages 2-21 can qualify for Wrap Around if they meet "medical necessity criteria", which will be determined by a licensed psychologist during an intake evaluation.
Wrap Around services begin with a psychological evaluation, recommending the services in the format of a specific prescription for each individual child/adolescent. Depending on several variables, the prescription can include all or some the following components:
BHRS Case Manager: Bachelor level staff responsible for maintaining and coordinating the child/adolescents' services. Role includes scheduling psychological evaluations, team meetings, accessing community resources and ensuring quality of services.
Behavioral Specialist Consultant (BSC): Doctoral or (most likely) Master level clinician responsibile for collaborating with the individual, family and other treatment team members (school, community members) and designing and implementing an individual behavior support plan. BSC's provide assessment, program design and monitoring of treatment interventions as a consultant to the team rather than direct therapy.
Mobile Therapist (MT): Doctoral or (most likely) Masters level clinician who provides individual and/or family therapy to the child in the home. Identifies the strengths and needs of the child/family, determines the need for family support services, develops a crisis plan with the family and team.
Therapeutic Staff Support (TSS): Bachelor level staff responsibile for carrying out the specific interventions one on one that are identified in the behavior support plan. Implements and models interventions to family, school and community members and eventually transfers skills to the natural supports.
- Since the inception of Act 62 (Autism Insurance Act), accessing Wrap Around Services has changed. If a child is covered under the family's commercial insurance (and that insurance has an Autism Benefit), the family can call an in-network Wrap Around Provider directly and ask for an intake evaluation to see if Wrap Around services are appropriate. It is recommended that the family checks with their commercial insurance plans to see if the autism benefit applies to them, and if it does, they should ask for a list of providers eligible to service the child.
- If a child does not have commercial insurance, or has commercial insurance without an autism benefit, the child must follow their county's process. The child must have current Medical Assistance (MA) eligibility. Many counties direct families to their Base Service Units for what is called an "Extended Assessment". The Extended Assessment process serves as the intake, to determine what services are most appropriate for the child and his or her family. For direction and guidance on each county's process, the family is encouraged to contact their local county office of MH/IDD.
See Pennsylvania's DPW webpage for frequently asked questions on BHRS: "A Guide to Behavioral Health Rehabilitative Services (BHRS) in Pennsylvania"
Delaware Wrap-around services are available in Delaware through the Division of Prevention and Behavioral Health Services (DPBHS). These services are available for anyone who could benefit from the services who are under the age of 18, do not have health insurance coverage, or who need more coverage then the 30 hours of outpatient coverage provided by Medicaid. There are three ways to obtain services: through outpatient treatment, through crisis intervention, and through central intake. For more information, call 302-892-4515 or see Information for Families.