Family Behavioral Resources
BHRS Consumer Handbook
[FBR OFFICE LOCATION]
[Street Address]
[City, PA Zip Code]
[Phone: xxx-xxx-xxxx]
[Fax: xxx-xxx-xxxx]
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Family Behavioral Resources:
BHRS Consumer Handbook
Table of Contents
Page
1. Welcome!
3
2. The “Philosophy” of Wraparound
4
3. The “Flow” of Wraparound
5
4. Meet Your Clinical Office Team
6
5. Overview of Families’ Rights
7
6. Overview of Client’s Rights
8
7. Quality Improvement Program, and
Nondiscrimination in Services/Employment
9
8. Privacy Practices
10
9. Expectations of Families and Staff
11
10. Program Guidelines
12
11. Do’s and Don’ts
13
12. Cancelled Sessions, Consent for Phone Messages,
PCP involvement & Child Protective Services Law
14
13. Description of Reason Codes
15
14. Explanation of the BSC, MT and TSS Roles
16
15. Role of BSC, TSS, and MT
17
16. Frequently Asked Questions
18
17. How to File a Grievance
19
18. Discharge (Life after Wraparound)
20
19. Review of Intake Paperwork
21
20. Consumer Safety Handout
22
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Welcome, and thank you for choosing Family
Behavioral Resources as your Wraparound Provider.
 Communication is fundamentally important to better serve you as our client, and
to provide competent BHR services to meet your family and child’s needs. We
will work together as a team to establish and maintain ongoing communication
among the therapist(s) on your team, our office staff including the management
team, and your family.
 Initially and throughout your time with BHRS, you will be required to read and
understand many forms that can seem overwhelming or confusing. Our office
staff, as well as the members assigned to your team, are trained to help you
understand these forms, and to explain them in terms that are easy to understand.
We encourage you to have all of your questions answered before signing. Your
signature indicates to us that you have read, understand, and agree with the
information provided on each form. It is therefore important to ask questions right
away.
Here at Family Behavioral Resources, we foster collaboration
through offering parent training.
 Clients of Family Behavioral Resources are permitted and encouraged to attend
agency trainings which provide thorough, detailed information on the FBR
policies, services provided, and treatment modalities. If you would like more
information regarding training topics, your FBR staff can provide you with a list
of trainings offered and a corresponding schedule. If you wish to attend a
training, please notify your FBR office to reserve your attendance.
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The “Philosophy” of Wraparound
The focus of the Wraparound Services of Family Behavioral Resources shall remain
consistent with FBR’s overall commitment to act in the best interest of all children,
adolescents and families whom we serve, to provide high quality, clinically appropriate,
innovative services to our clients which are both efficient and effective, and which are
respectful to each family’s strengths, needs, and values; and to maintain standards of
integrity in the provision of state-of-the-art services and interventions.
We are committed to the essential philosophy of wraparound, the principles of the Youth
and Family Institute (formerly known as CASSP), and the value of ongoing
improvements in the level of quality with which we serve our clients. Treatment planning
is based upon the strengths of each child and family. Families are viewed as partners in
the treatment team, with expertise in the knowledge of their needs. It is also recognized
that in order for treatment to be successful, it is necessary to encourage the family’s
involvement, participation and investment in the ongoing treatment planning process.
Arrays of services must be developed within a spectrum of care, in which levels of care
are integrated in order to work toward the elimination of service gaps. Networking and
collaborating with outside agencies to provide an integrated and balanced system is seen
as critical to effective treatment.
Taken from the Pennsylvania Youth and family Institute (formerly known as CASSP):
 The wraparound model is based on individualized, needs-driven planning and
services. It is not a program or type of service. It is a value base and unconditional
commitment to create services on a one-of-a-kind basis to support normalized and
inclusive options for youth with complex needs and their families.
 An individualized plan is developed by a Child and Family Team, the people who
know the child best.
 This plan is needs-driven rather than service-driven. Services are not based on a
categorical model.
 This plan is family-centered rather than child-centered. The parent is an integral
part of the team and has ownership of the plan.
 The plan is strengths-based. Human services have traditionally relied on the
deficit model, focusing on pathology. Positive reframing to assets and skills is a
key element in all wraparound planning.
 The plan is focused on normalization. Normalized needs are those basic needs
that all persons (of all ages, gender, culture) have.
 The team makes a commitment to unconditional care. Services are changed to
meet the needs of the family.
 Services are created to meet the unique needs of the child and family. Though
many wraparound plans rely on blending and reshaping categorical services,
teams have the capacity to create individualized services.
 Services are community-based. Restrictive care is assessed only for brief periods
of stabilization.
 Services are culturally competent.
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 Planning and services are comprehensive, addressing needs in three or more life
domain areas. These life domains are: family, living situation,
educational/vocational, social/recreational, psychological/emotional, medical, and
crisis.
 The plan is functionally supported by flexible use of existing categorical dollars
or through a flexible fund.
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The “Flow” of Wraparound
 Your first step in getting help for your child is to arrange for a psychological
evaluation from a licensed psychologist, who will evaluate your child with a Best
Practices Evaluation, to determine what types of services your child may need.
 After the evaluation, a meeting will be held to discuss the psychologist’s
recommendations. This is called the Interagency Service Planning Team Meeting
(ISPT). Participants in this meeting may include:
- you as the parents,
- the psychologist,
- a representative from your BHRS provider (such as FBR),
- a representative from your Managed Care Organization (or MCO; here in
Allegheny County, your MCO is the Community Care Behavioral Health
Organization, or CCBHO),
- your child’s teacher or other representative from the school district, and
- anyone else you wish to attend.
At this meeting, the whole team discusses the needs of your child and family. If
wraparound services (such as BSC, TSS, or MT) are recommended, you will
discuss the psychologist’s recommendation for hours as well as concerns and
priorities of treatment.
 After your meeting, FBR will submit your packet for approval to the insurance
company, and after we receive approval, services will begin for your child in a
timely manner.
 If you choose Family Behavioral Resources as your provider, the Lead Clinician
assigned to your case (BSC or MT) will come to your home and complete the
intake process.
 After services begin, your child will need to receive another psychological
evaluation in four months. (Evaluations are typically good for a 4 month period,
except for extended authorizations). When the time is coming for your child’s reevaluation, you will receive a reminder via letter from your FBR office staff, to
schedule the evaluation. After the re-evaluation has taken place, another
interagency team meeting will occur to discuss progress in the previous treatment
quarter, as well as continued needs to be worked on in the upcoming quarter. The
team will decide which services should continue, and to what extent.
 Please note that interagency meetings can be held at any time during the treatment
quarter to discuss your child’s progress through treatment.
 Wraparound services will continue as long as the psychologist finds that the
services are medically necessary and the team agrees to the recommendations.
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Meet Your Clinical Office Team
[Family Behavioral Resources- office]
[Street Address]
[City, PA Zip Code]
[Phone: xxx-xxx-xxxx]
[Fax: xxx-xxx-xxxx]
NAME & credentials, Clinical Director
NAME & credentials, Clinical Supervisor
NAME & credentials, Autism Director
NAME & credentials, Office Manager
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Overview of Families’ Rights at Family Behavioral Resources
 Basic treatment involves the child and family sharing factual and often very
personal information. Essential to this process is FBR’s recognition that
families have the right to confidentiality, privacy, and informed consent.
 Confidentiality refers to the explicit, agency-wide constraints placed upon
the use of, access to, and protection of information obtained in the course of
the client’s relationship with the agency.
 Privacy refers to the rights of the individual to determine who will have
access to information about him/her, to decide when and under what
circumstances that access will occur, and to be made aware of the ultimate
use that will be made of that information. Although a child has the right to
know his/her treatment program, the revealing of the contents of the record
is something that must be done thoughtfully and requires team deliberation.
The decision to share all or part of the written record must be made
judiciously.
 Informed consent indicates that the release of information is restricted by
guidelines and attested to by client signatures. Informed consent requires
that the client know the nature of the request and whether or not s/he is
legally required to comply. Under these guidelines, the clients are aware of
the nature of their records, know with whom the data is to be shared and the
time frames with which it is to be handled, know what is to be revealed, and
are aware of the implications of providing this information insofar as this is
predictable.
 If the referring agency has temporary custody of a child, some of the
parental rights are limited and shared with the referring agency.
Family Behavioral Resources is committed to working with
families in a cooperative way. Any problems you may have regarding
your rights should be brought to the attention of your Lead Clinician,
Clinical Director, or Autism Director.
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Overview of Client’s Rights
All individuals receiving service shall have any rights provided to them under the law,
including but not limited to the following:
1. The right to be treated with consideration and respect for personal dignity,
autonomy and privacy.
2. The right to receive services in a humane setting which is the least restrictive
setting feasible as defined by the treatment plan.
3. The right to be informed of one’s own condition, of proposed or current services,
treatment or therapies, and of the alternatives, as well as the risks and benefits of
those treatments.
4. The right to consent to or refuse any service, treatment or therapy upon full
explanation of the expected consequences of such consent or refusal. A parent or
legal guardian may consent to or refuse any service, treatment, or therapy on
behalf of a client who is a minor.
5. The right to a current, written, individualized treatment plan that addresses one’s
own mental health, physical health, social and economical needs and that
specifies the provision of appropriate and adequate services, as available, either
directly or by referral.
6. The right to active and informed participation in the establishment, periodic
review and assessment of the treatment plan.
7. The right to freedom from unnecessary or excessive medication.
8. The right to freedom from unnecessary restraint or time-out.
9. The right to participate in any appropriate and available agency service, regardless
of refusal of one or more other services, unless there is a valid and specific
necessity which preludes and/or requires the client’s participation in other
services. This necessity shall be explained to the client and written in the client’s
current treatment plan.
10. The right to be informed of and refuse any unusual and hazardous treatment
procedures.
11. The right to be advised of and refuse any observation by techniques such as oneway vision mirrors, tape recorders, televisions, movies or photographs.
12. The right to have the opportunity to consult with independent treatment specialists
or legal counsel, at one’s own expense. A listing of advocates is available as a
resource to all clients.
13. The right to have an independent person who is not a member of the treatment
team resolve a problem raised by the client.
14. The right to confidentiality of communications and of all personally identifying
information within the limitations and requirements for disclosure of various
funding and/or certifying sources, state or federal statutes, unless release of
information is specifically authorized by the client, parents, or legal guardian of a
minor client or court-appointed guardian of an adult client in accordance with
State and Federal Regulations. This also includes the right to be informed of the
nature of information to be released to other parties.
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15. The right to have access to one’s own psychiatric, medical, or other treatment
records, if 14 years of age or older. The agency may withhold information from a
child which it has good reason to believe will be harmful to that child. The basis
for withholding information from a child shall be recorded in the child’s case
record. It is required that the placing agency concur with thus withholding prior to
the information being withheld from a child who requests information from
his/her record.
16. The right to be informed in advance of the reason(s) for discontinuation of service
provision and to be involved in planning for consequences of that event.
17. The right to receive an explanation for the denial of services.
18. The right not to be discriminated against in the provision of service on the basis of
religion, race, color, creed, sex, national origin, age, lifestyle, physical or mental
handicap, developmental disability or inability to pay.
19. The right to know the cost of services.
20. The right to follow and practice your own religion or abstain from practice of
religion.
21. The right to be discharged as soon as care and treatment are no longer necessary.
22. The right to be fully informed of all rights and responsibilities as well as the
program’s rules and regulations.
23. The right to exercise any and all rights without reprisal in any form including
continued and uncompromised access to service.
24. The right to file a grievance or offer suggestions to the program director or his/her
designee.
25. The right to oral and written instructions for filing a grievance.
26. All other rights which are required under law.
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Quality Improvement Program
 Our Quality Improvement Team (QI) is constantly striving to provide and ensure
the highest quality of care. You may receive a letter or phone call from a
representative from the QI Team, conducting a client satisfaction survey. All
results of this survey are confidential, and results are calculated in percentages.
Personal information, such as names and telephone numbers, is never disclosed.
These QI calls are necessary to continue to evaluate and improve the quality of
services. It is not mandatory that you participate in these surveys; however, they
are a vital tool in the evaluation of services at FBR, and we encourage your
cooperation.
 In addition, our QI team is here to help you. If you feel in any way that your
service has been less than satisfactory, please do not hesitate to call our Quality
Improvement Hotline at the following number: 1-866-302-6837.
The sooner you voice your concerns, the sooner we can work to fix them.
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Nondiscrimination in Services/Employment
 Admissions, the provisions of services, and referrals of clients shall be made
without regard to race, color, religious creed, disability, ancestry, national origin
(including limited English proficiency), age or sex, perceived sexual orientation,
actual or perceived gender identity, and/or actual or perceived gender expression
 Program services shall be made accessible to eligible persons with disabilities
through the most practical and economically feasible methods available. These
methods include, but are not limited to, equipment redesign, the provision of
aides, and the use of alternative service delivery locations. Structural
modifications shall me considered only as a last resort among available methods.
 Any individual/client/and or their guardian, who believe they have been
discriminated against, may file a complaint of discrimination with:
Family Behavioral Resources
PO Box 879
150 S. Independence Mall West
Greensburg, PA 15601
PA Human Relations Commission
Department of Public Welfare
301 Fifth Avenue Place
Bureau of Equal Opportunity
Suite 390, Piatt Place
Room 223, Health and Welfare Building
Pittsburgh, PA 15222
P.O. Box 2675
Harrisburg, PA 17105
Bureau of Equal Opportunity
Department of Public Welfare
U.S. Department of Health and Human
Western Field Office
Services
301 Fifth Avenue
Office of Civil Rights
Suite 410, Piatt Place
Suite 372, Public Ledger Building
Pittsburgh, PA 15222
Philadelphia, PA 19106-9111
Bureau of Equal Opportunity
Department of Public Welfare
PA Human Relations Commission
Western Field Office
Eleventh Floor
Rm. 702, Pittsburgh State Office Building
Pittsburgh State Office Building
300 Liberty Avenue
300 Liberty Avenue
Pittsburgh, PA 15222
Pittsburgh, PA 15222
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 We receive information from
Privacy Practices
 Family Behavioral Resources is
committed to protecting its clients’
privacy. This notice describes our
policies and practices for collecting,
handling, and protecting personal
information about our clients. This
notice is being provided to all of our
current clients and will be given to each
new client and/or the client’s
parent/guardian. This policy, in the
same manner as all our policies, will be
continually reviewed for clarity and
effectiveness. Consequently, it may be
necessary for us to revise our privacy
policy in the future. If we make
revisions, you will be notified about
these in writing.
 To be able to better administer our
behavioral health program, we must
collect, use, and disclose non-public
personal information. Non-public
personal information is information
related to an individual client and/or the
client’s parent/guardian. This
information could include the client’s
name, name of the client’s
parent/guardian, other identifying
information, insurance plan information
used in billing for services, and
information relating to the client’s
service program that would reside in the
client’s chart. Non-public personal
information does not include publicly
available information or statistical
information that does not identify
individual persons.
Information that we collect and maintain: Nonpublic personal information about our clients
and/or client’s parent/guardian is collected
from the following sources:
BHRS Consumer Handbook

our clients and/or clients’
parents/guardians, from
psychological evaluations
performed by psychologists or
psychiatrists, clients’ insurance
companies, county agencies,
schools, and other organizations
who have involvement in our
clients’ services. This
information may be submitted to
us in person, in writing, by
telephone, fax, or electronically.
We collect and use this
information in developing
treatment plans, providing
ongoing services, performing
reviews, providing for billing,
handling any appeals or
grievances, and any other client
service-related activity. This
information might include a
diagnosis code, personal
histories, previous treatment
information, identifying
information, progress notes, and
other information related to
clients’ cases according to the
need.
Information that we may disclose and the
purpose: We use and disclose the personal
information we collect (described above) only
as necessary for us to deliver behavioral health
services. This use and disclosure includes:
 Development of treatment plans for
each client, including goals and
treatment interventions.
 Monitoring progress of treatment
interventions in achieving the goals
identified in treatment plans.
 Monitoring the quality of our services
as part of our ongoing Quality
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




Assurance Program during which
written and telephone surveys are made
to supplement other case information.
Providing personal information to your
insurance company so that we can
effectively provide services, and to our
billing department in order to receive
payment for those services. Our
contracts require these organizations to
protect the confidentiality of any
information that is used or shared.
Disclosing information under order of a
court of law in connection with a legal
proceeding.
Disclosing information in accordance
with federal or state laws such as the
Pennsylvania Child Protective Services
Act of 1975.
Disclosing information to government
agencies or credentialing organizations
that monitor our compliance with
applicable laws and standards.
Disclosing information under a
subpoena or summons to government
agencies that investigate possible
violations of law.
 Please direct questions about the
Privacy Notice to:
Office: Corporate Privacy
Department
Telephone: 724-850-8118
Fax: 724-850-9500
Address: P.O. Box 879
Greensburg, PA 15601
How we protect information: We restrict access
to our clients’ non-personal public information
to those employees, agents, consultants, or
other persons working in our organization who
need to know the information to allow us to
provide behavioral health services. We obtain
signed clearances from clients’
parents/guardians in instances where there is a
need to transfer information to other
organizations such as another service provider.
We maintain physical and procedural
safeguards that comply with state and federal
regulations to guard non-public personal
information from unauthorized access, use and
disclosure.
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Expectations of Families and
Staff
A family who is new to BHRS often does not
know what to expect from their team members,
or what is expected of them as participants in
the wraparound program. Here is a general
overview of the expectations of both roles:
other caregivers, schools, etc. (all staff,
but primarily BSCs)
 Respect the wishes of the family while
providing therapeutic services
 Provide therapeutic services according
to the treatment plan, with the highest
clinical integrity
The family is expected to:
 Have their child evaluated quarterly by
an psychologist, psychiatrist, the CDU,
or other approved evaluator
 Actively participate in the quarterly
Interagency Service Planning Team
Meetings, also known as ISPTs
 Actively participate in treatment
planning
 Actively participate as much as possible
in their child’s therapy sessions
 Be available for therapy sessions
according to the child’s schedule, and
give ample notice when possible if a
shift must be cancelled
 Form a positive, collaborative, yet
professional relationship with team
members
Your team members (wraparound staff) are
expected to:
 Form a positive, collaborative, and
professional relationship with the
family (all staff)
 Arrive in a timely manner to the child’s
therapy sessions (all staff)
 Attend ISPT meetings, psychological
evaluations, and sometimes IEP
meetings (BSC’s)
 Collaborate with other entities such as
case management, occupational or
speech therapists, daycare providers or
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Program Guidelines
~ This is an important part of this
handbook, please be sure to review and
ask questions ~
 We understand the consistency of care
is vital for continued and successful
therapy for your child. Sometimes the
occasion may arise during your child’s
therapy where the therapist may not be
able to provide services as scheduled
due to illness, emergency situations, etc.
If this happens, we will contact you as
soon as possible to alert you of this
change.
 If you are expecting a therapist for a
session and the therapist does not arrive,
please phone the office immediately to
inform us. If your child, the client, is
not home when the therapist arrives for
a scheduled session, the therapist will
wait for 15 minutes for your arrival.
After 15 minutes if your child has not
arrived, the therapist is permitted to
leave.
 In the event that you or your child is ill
and will not be available for a scheduled
therapy session, please notify the office
at the number indicated on the enclosed
business card.
prohibits includes, but is not limited to,
the following:
 Lending, borrowing, purchasing
or selling any form of personal
property;
 Allowing or requiring clients to
perform services of a personal
nature for the benefit of any
staff member;
 Giving keys, telephone numbers
to be used for personal contact,
address or other inappropriate
property and information to
clients and their families;
 Personal, sexual, or romantic
involvement with clients;
 Initiating contact with current or
former clients and failing to
report coincidental contact;
 Certain activities which present
a conflict of interest including
the acceptance of gifts from
families;
 Any contact with families which
is not directly related to the
treatment of the client;
 Any other contact, behavior or
attitudes which FBR deems
harmful to the best interest of its
clients and program operation
(taken from FBR Corporate
Policy 300-003, Client
Relationships).
 FBR is committed to the proper,
professional, and responsible care and
treatment of clients and to safeguarding
the integrity of staff/client relationships
at all times. Employee/client behavior
and conduct which FBR considers
inappropriate, unacceptable and strictly
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when collaborating and
working with your team
members.
Do’s and Don’ts
Still not sure what is expected of the family, or
what is “allowed and not allowed?” Refer to
the table below to learn more of the “do’s and
don’ts” when receiving wraparound services.
DO
DON’T
Be present for your
child’s therapy sessions,
or arrange for another
caregiver to be present.
Leave your child with the
therapist. Wraparound staff
provides therapeutic clinical
interventions, and are not
permitted to give respite
care or babysitting services
to the family.
Expect the TSS or other
staff to transport the child.
This is not a billable
therapeutic function, and
also creates a liability for
the staff.
Provide transportation for
your child to sessions
held in the community –
summer camp,
community outings, other
related therapy services,
etc.
Have your staff provide
goals, therapeutic
behavioral supports and
positive behavioral
modifications during
toilet training.
Alert your staff to
medication changes.
Ask the staff to change a
diaper or clothing. The
TSS, however, should
provide supports that help a
child generalize skills and
create opportunities for
independence.
Ask a staff to directly feed a
child. The TSS, however,
should provide supports that
help a child generalize
skills and create
opportunities for
independence.
Ask the BSC to create
sensory-based interventions
for the child, or for the TSS
to engage the child in
sensory-based activities on
their own. It is our policy to
provide these supports only
in collaboration with the
child’s OT.
Ask your staff to give the
child their medicine.
Remain professional
Cross boundaries by
Have your staff provide
goals, therapeutic
behavioral supports and
positive behavioral
modifications during
feeding therapy.
Have your staff model
interventions and provide
carryover supports from
an occupational therapist
(such as a “sensory diet”,
brushing, etc.).
BHRS Consumer Handbook
Expect your staff to wait
15 minutes if you are
arriving late for a session.
*Cancel a shift with as
much notice as possible
by calling your home
office. They will notify
the staff.
Actively participate in
your
child’s
therapy
sessions as much as
possible.
Cancel your session if
your child is sick with any
of the following within 24
hours of the session: fever
over
100
degrees,
vomiting, diarrhea, or
other
communicable
disease including pinkeye,
or severe productive
cough or sneeze.
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creating opportunities for
personal interaction –
inviting the TSS on
vacation, asking the TSS to
babysit, inviting staff to
family functions, sharing
too much personal
information that has no
bearing on the child’s
therapy, asking for too
much personal information
about the staff (i.e. asking
about their marriage or
children, etc.)
Expect them to wait for a
longer time period. Families
expect that their staff arrive
in a timely manner, so the
same courtesy is expected.
*Wait until the last minute
to cancel a session (though,
sometimes emergencies do
happen!).
Use TSS as a respite
service. Families should
learn from the TSS and
model what they are doing
with a child. There are
exceptions to the rule,
however, when a child is
using the parent as an
“escape”
or
seeking
negative attention. In these
cases, the parents may be
asked to leave the room for
a short time while the child
completes a task or activity.
Expect or ask staff to
provide service when your
child is sick. This will not
be therapeutic for your
child, and may pass germs
to the staff which they then
take to other clients.
Page #17
 Please indicate whether you release Family
A Note about Cancelled
Sessions…
 We understand that illness and
emergencies do come up, and we expect
that you understand they come up for
our staff as well. In addition, our staff is
required to attend certain trainings and
meetings, which further their clinical
knowledge and skill when working with
your child. As such, the occasion may
arise where staff has to cancel a session
due to a training or other company
requirement. We will do our best to
minimize the impact of such an
occasion on your child by rescheduling
or providing a substitute when possible.
 Please know that repeated cancellations
on your part, for reasons other than
illness or emergencies, may affect your
future service. If you are finding that
the therapy schedule is inconvenient for
your family, talk to your Lead Clinician
and your office staff about changing the
schedule. We want to optimize the use
of your child’s prescription and will
work collaboratively to find the most
convenient schedule possible.
Consent for Phone Messages:
 In order to protect your privacy under
HIPAA guidelines, Family Behavioral
Resources needs written permission in
regards to leaving messages/voicemails
regarding your care or the care of your
child. If an FBR representative needs to
contact you and you are unavailable, it
may be necessary for staff to leave a
message for you to return our call.
BHRS Consumer Handbook
Updated 4/25/11
Behavioral Resources from liability for leaving
a message on your home, work or cellular
phones by circling yes or no next to each
contact number on the Emergency Information
Sheet.
Primary Care Physicians (PCP):
 In order to ensure your child receives
comprehensive care across service
providers and across life domains, we
offer collaboration with your child’s
PCP. You can choose to have the PCP
involved in your child’s meetings; we
can offer him/her an invitation to
participate in meetings. You can
indicate your choice regarding the
PCP’s involvement on the Emergency
Information Sheet.
Child Protective Services Law
(mandated reporters)

All employees of Family Behavioral
Resources follow the Child Protective
Services Law (CPSL) that mandates the
reporting of suspected child
maltreatment. The staff who work in
your home (BSC, MT, TSS) as well as
any staff you collaborate with (Clinical
Director, Autism Director, psychologist,
Administrative Supervisors, outpatient
therapists, office staff, etc) are all
named as mandated reporters under this
law. FBR has a committee (Child
Abuse Prevention Committee) to
provide education, consultation and
training regarding child abuse to
employees and families. The mission of
all FBR staff is to ensure that our
consumers, their siblings and other
family members are afforded a safe and
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secure environment in which they can
learn, grow, and reach their potential.
BHRS Consumer Handbook
Updated 4/25/11
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Page #19
Description of Reason Codes
BHRS DESCRIPTION OF REASON
CODES
CODE AUTHORIZED SERVICES
PROVIDED
0
All services provided as
authorized
AUTHORIZED SERVICES NOT
PROVIDED DUE TO:
1
Family does not want the level
of service authorized
2
Family or child sick,
unavailable, or provider
unable to establish contact
with family
3
Family offered services as
authorized but requests
another staff/provider for
reasons not included in the
prescription
4
Staff resigns or becomes
unavailable. Family chooses to
wait without service for new
staff/provider. Services to
begin within two weeks.
5
Family terminates service
against medical advice.
6
Child moved out of the county
or is no longer MA eligible.
7
Therapist/prescriber
recommends reduction in
service.
8
Staff cannot provide service or
reasons of security (unrelated
to the child’s diagnosis) or
infectious disease in the home.
9
Staff temporarily unavailable
due to reasons such as
sickness and vacation.
10
Staff resigns or becomes
BHRS Consumer Handbook
11
12
13
14
unavailable. Family wishes to
wait without BHRS for new
staff/provider. Delay in service
will exceed two weeks.
Sufficient staff unavailable.
Alternative services are being
provided.
Sufficient staff unavailable.
Family declines alternative
services.
Sufficient staff unavailable.
Other BHR service providers
or alternative services not
available.
other
In the above chart you will find an explanation
of the reason codes that we use to describe
missed hours on the weekly encounter form.
Please review the codes and the explanation;
your signature on the Verification of
information and parent handbook
acknowledgment form confirms that you have
been presented with the documentation of
reason codes, and an explanation of those
codes.
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 Therapeutic Staff Support – TSS are
Bachelor’s level (Associate’s level in
cases where the individual has three
years of direct experience with children)
clinicians who carry out the
interventions recommended in the
treatment plan written by the BSC.
They work one-on-one with the child in
either the family home, community, or
school. Parents should observe TSS
sessions to ensure consistency of
interventions (behavior modification,
etc.). A typical prescription for TSS is
anywhere from 10-30 hours (can be
more or less). Young children may be
recommended for a smaller number of
hours, and slowly work up to a “full”
prescription.
Explanation of the BSC, MT and TSS
Roles
There are three levels of services offered within
a wraparound agency. This page gives a brief
overview of each. (See the next three pages for
an in-depth description of each role.)
Your child’s psychological evaluation will
recommend a number of hours per week for
one or more of the following:
 Behavioral Specialist Consultant – A
Master’s level clinician who works with
a family to develop a treatment plans
for the child. The plan will recommend
any number of interventions that are
based on intensive behavioral
modification, acquiring age-appropriate
skills, developing positive relationships
through social skill development, and
more. The BSC consults with parents,
and does not work one-on-one with the
child. They visit the home, as well as
observe classrooms, daycares, or
community settings, attend
psychological evaluations and the
quarterly team meetings. A typical
prescription is anywhere from 1-6
hours.
 Mobile Therapist –A Mobile Therapist
is also a Master’s level clinician. MTs
counsel family members as well as the
affected child in the home. They are
usually assigned to higher-functioning
children, since the child is an active
participant in this therapy. In some
cases, the MT may write a treatment
plan (if the child is not recommended
for BSC). A typical prescription is 2-4
hours.
BHRS Consumer Handbook
To simplify: In most cases, the BSC
writes the treatment plan, while the TSS
(and sometimes MT) carry it out in the
home, community, or school. It is the
BSC’s job to ensure that the plan is being
followed, and to continue to collaborate
with everyone involved on your child’s
team.
Other important notes:
FBR follows the guidelines and regulations provided by
the state in terms of requirements for BHRS positions.
Clinicians should have a background in a human service
field such as Psychology, Sociology, Counseling, Social
Work, Criminal Justice, or (Special) Education. The
DPW also requires TSS to complete 24 hours of initial
training within the first six months of hire, and an
additional 20 hours per year. FBR is committed to
recruiting employees who share our commitment to
providing services with integrity, professionalism and
passion.
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What is the Role of a BSC?
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What is the Role of a TSS?
Design and oversee all aspects of treatment to clients
assigned to caseload. Planning must be childcentered and family focused and must include the
active participation of the entire treatment team.
Ensure, on an ongoing basis, that treatment goals are
addressing the client’s current needs and adjust plan
as needed. Remain aware of and always incorporate
CASSP principles and guidelines in the treatment.
Work with all members of the treatment team to
ensure that they fully understand the needs and goals
for the client and family.
Collaborate with other members of the treatment
team, other professionals involved with the family,
other service systems, and FBR supervisors and
administrators.
Prepare and/or provide clinical team with
supplemental materials to aid in assessment,
treatment, and data collection.
Participate, with necessary documentation completed
in advance, in Interagency Team Meetings,
psychological evaluations, medication checks, IEPs,
etc. and serve as an advocate for the most appropriate
treatment.
Completion of all required paperwork and
documentation, including treatment plans, monthly
reviews, clinical progress notes, encounter forms, etc.
Provide ongoing clinical supervision to TSS assigned
to cases to ensure that treatment plan interventions
are being executed correctly and to provide feedback
to TSS regarding implementation of treatment plan.
Participate in supervision and internal trainings as
required.
Provide the prescribed number of hours to each client
each week.
Seek additional trainings that would promote
professional growth and more effective treatment.
Support and facilitate the success of clients and their
families.
As directed by the treatment plan:
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provide specific interventions to assist the child in
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developing age-appropriate daily living skills and
social and cultural interaction skills with his or her
peer group, family, and other social groups or
settings.
provide support to parents and other responsible
adults in their efforts to provide direct supervision
of the child.
provide assistance to the parent or other
responsible adult in providing therapeutic structure
and limits for the child.
provide assistance in implementing a behavioral
intervention plan for the child.
provide assistance in implementing alternative
activities to redirect challenging behaviors.
provide assistance in providing individualized,
supervised recreational and cultural opportunities.
maintain a planned schedule that guides the use of
authorized time with the child.
always remember that the goal of mental health
services is to offer new alternatives to the child
and family on a time limited basis, with the goal of
promoting family problem solving skills and self
sufficiency rather than inappropriate dependency
on the worker and/or services.
collaborate with other members of the treatment
team and other professionals working in the home
or other community settings and will be present
and participate in any meetings, supervision and
trainings as required, including weekly supervision
requirements and annual training requirements as
set by the state in order to remain as field staff.
What is the Role of an MT?
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Provision of child-centered, family focused, individual and family therapy as agreed upon by the therapist and family.
Participation, as required and/or requested, in team meetings, evaluations, etc. regarding the client’s progress in treatment.
Completion of all required paperwork and documentation, including treatment plans, monthly reviews, clinical progress
notes, encounter forms, etc. Documentation and paperwork must be completed in a timely manner.
Provide ongoing assessment, with the active participation of the child and family, of strengths and progress of treatment.
Collaborate with other members of the treatment team, other professionals involved with the family, other service systems,
and FBR supervisors and administrators.
Participate in supervision and internal trainings as required.
Provide the prescribed number of hours to each client each week
Seek additional trainings in therapeutic modalities that would promote professional growth and more effective treatment.
Support and facilitate the success of clients and their families.
Be aware of and operate within all CASSP principles when providing treatment to the child and family.
Work within all policies and procedures set forth by Family Behavioral Resources .
BHRS Consumer Handbook
Updated 4/25/11
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Frequently Asked Questions
 Can a TSS/BSC/MT be left alone with my child?
There must be a responsible adult with staff on the premises. We are there to support you
with your child’s behaviors, not to provide child care.
 Can a TSS/BSC/MT feed my child?
Staff cannot prepare or serve meals. However, they can assist with increasing
independent feeding skills if specified in the treatment plan.
 Can a TSS/BSC/MT change my child’s diaper?
Staff cannot change diapers. They can only assist and support behavioral interventions
which may occur during the caregiver’s responsibility.
 Can a TSS/BSC/MT give my child medicine?
Staff cannot administer prescribed or over-the-counter medicine, including supplements.
 Can a TSS/BSC/MT babysit for my family?
Staff are not to be involved with your family except on a professional basis. Babysitting
could lead to professional boundaries being crossed.
 Can a TSS/BSC/MT work with other siblings?
Staff can work with siblings as long as the identified child (client) is present with the
sibling, and there are specific treatment plan goals which involve siblings.
 Can a TSS/BSC/MT go on vacation or overnight visits with my family?
Staff are not permitted to go on vacation or stay overnight with the family.
 Can a TSS/BSC/MT help with homework?
Staff can assist with behaviors surrounding this issue, but cannot help with academic
teaching.
 I am having justifiable problems with my TSS/BSC/MT. Who do I contact?
Please call the office managers, including the Clinical Director/Autism Director/ or
Administrative Supervisor.
Any other questions: please call the office and speak to one of the managers. We will be happy to
assist you.
How to File a Grievance
BHRS Consumer Handbook
Updated 4/25/11
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Page #23
As a family-focused organization, FBR strives to deliver the highest clinical quality of service to our
clients at all times. However, if you should ever feel that the service provided to your family has
been less than satisfactory, please follow the procedure outlined below for filing a complaint or
grievance:
 First, address the grievance with your Lead Clinician (either BSC or MT). If the grievance is
with your Lead Clinician, you may address his/her immediate supervisor, either the Clinical
Director or Autism Director in your FBR office.
 If you feel the grievance has not been satisfactorily resolved with your Lead Clinician, please
contact the Clinical Director or Autism Director at your FBR office to report your grievance.
 If you are still not satisfied with the response, please contact our Corporate Quality Improvement
Hotline at 1-866-302-6837. At this point, you will also be informed of your right to obtain
advocacy assistance via outside agencies.
Remember, our staff is committed to delivering high quality service to your family.
If we do not know what is wrong, we cannot work to change it…
so do not hesitate to speak up as soon as you become concerned.
BHRS Consumer Handbook
Updated 4/25/11
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Discharge- aka, “Life after Wraparound”
One of the first things you may notice at your initial team meeting is the topic of “fading and discharge.”
You may be wondering why, at the onset of services, we would already discuss fading the services, and
ultimately, discharge. Here at FBR, we advocate active discharge planning, which is explained below.
 At each ISPT meeting (usually every few months), the team will discuss discharge. The purpose
is not to make you feel we are trying to “rush” you out of wraparound; we will certainly continue
to provide service as long as it is medically necessary up to the age of 21. However, we discuss
discharge to help you begin to think about what life will be like after wraparound, as we want
your child and family to be as independent as possible.
 Discharge is typically begun with a systematic decrease in your child’s hours, called a “fade
plan.” This plan will begin when your child has achieved the goals in the treatment plan, is
stable, and services are no longer effective or an alternative type of service may be more
effective. Fading may also occur if a child has become dependent on the service in such a way
that it interferes with the child’s ability to make independent progress. Services may also be
terminated if a child over the age of 14 requests the termination of services, and no longer wants
to continue in the service program.
 The team will discuss natural community supports that your child can “step down” to after
wraparound, such as summer camps, YMCA/YWCA, Boy Scouts/Girl Scouts, Big Brother/Sister
programs, outpatient therapy, and more. These ideas may change over the course of treatment,
but active discharge planning involves the entire team speaking about what will help your child
continue to grow and succeed, after wraparound is no longer necessary.
 Each treatment plan will outline criteria the team has discussed. When your child meets these
criteria, the team will begin to discuss discharge.
Teamwork is the key to effective discharge planning. You as the family, the psychologist, and your
team members from FBR will work together to decide when your child is ready for discharge. Our
team will then help you find
community supports to continue with after discharge from BHRS.
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Updated 4/25/11
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Page #25
Review of Intake Paperwork
At your initial meeting, an FBR Representative will review and ask you to complete several papers, as
listed below. Please ask questions during this process, as your signature on any form serves as
acknowledgement of both your receipt of the form as well as your understanding of what it contains.
Intake Paperwork:
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Consent for Treatment
Emergency Contact Information
Service Coordination Choice (if needed)
Client Schedule and Substitution Request
Releases of information
Consent or Declination for the FBA (Functional Behavioral Assessment)
Consumer Safety Handout
Acknowledgement of receipt of this Parent Handbook
BHRS Consumer Handbook
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FBR CONSUMER SAFETY HANDOUT
Fire safety
* Keep matches and lighters out of children’s reach.
*Talk to children regularly about the
dangers of fire.
*Turn off portable heaters when you leave
the room or go to sleep.
*Keep items that can catch on fire at least
three feet away from anything that emits heat or flame
* Never smoke in bed.
*Unplug appliances when not in use.
Cooking Safety
*Do not leave the home while simmering,
baking, roasting or boiling food. Use a timer to remind
you that food is cooking. Never leave the kitchen area
while frying, grilling or broiling foods.
*Keep all flammable items away from the stove.
*Keep all animals off cooking surfaces and
countertops to prevent them from
knocking things onto the burner.
Smoke/Carbon Monoxide Alarms
*Install alarms on every level of
your home, either inside bedrooms or close to
sleeping areas.
*Educate all household members what alarms sound
like and what they need to do if they hear one.
*Replace batteries in alarms twice a year.
*A good reminder is to change them when the clocks
change for daylight savings time.
Fire Escape Planning
*Develop two escape routes, educate all members of the
family, and practice the escape routes from each room
of the house at least every six months.
*If the home is filled with smoke, crawl, do not walk out
of the home, and smoke rises.
****************************************************************
IMPORTANT PHONE NUMBERS
*In the event of an emergency or disaster, important
numbers should be readily available.
*This list should be kept in a wallet and or in with your
Emergency Readiness Kits
*The list should have the following phone numbers
listed:
Police and Fire Departments, Electric, and or Gas
Service providers, MD’s for each family member, and
cell phone numbers in the case your cell phone is
damaged.
BHRS Consumer Handbook
*Develop a gathering point so everyone knows where to
meet once outside the house.
*Educate each family member the universal help number
is 911.
*Do not call 911 from inside house; wait until you are
outside and out of harm’s way.
*Once outside DO NOT RETURN TO THE HOME for
any reason.
*Should anyone’s clothing catch fire, STOP, DROP and
ROLL!
*Before opening doors, feel them first, if hot, do not
open, use another means of exit.
*If all exit routes are impassable, or hot to touch, remain
in the room with doors closed. If possible, wet and roll a
towel under the door, open windows and either yell, use
a flashlight or article of clothing to alert emergency crews
to your location.
Fire Extinguisher Cautions:
*Only if you have been trained by
the fire department and if the following
conditions exist should you attempt to extinguish a fire:
*The fire is confined to a small area,
and is not growing.
*The room is not filled with smoke.
*Everyone has exited the building.
*The fire department has been called.
*Use the PASS technique.
*Pull the pin and hold the extinguisher with the
nozzle pointing away from you.
*Aim low. Point the extinguisher at the base of
the fire.
*Squeeze the lever slowly and evenly.
*Sweep the nozzle from side to side.
*Never turn your back to a fire and if the fire is not
contained, evacuate the area immediately
*Additional numbers for National emergency agencies
include: American Red Cross: 1-800-REDCROSS,
Federal Emergency Management Agency 1-800-621FEMA,TTY 1-800-462-7585, Centers for Disease
Control and Prevention, 1-800-CDC-INFO, TTY 1-888232-6348, and Environmental Protection Agency 1-800424-9346, TDD 1-800-553-7672
Updated 4/25/11
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Emergency Readiness Kits
Each family should have an Emergency Kit that should
last for at least 3 days in the case of any emergency.
The items for the emergency kit need to be in airtight
containers and stored in a cool dry place. Check the kit
contents at least twice a year and replace any expired
items.
At the minimal, the items needed include:
*Water-stored in sealed containers, calculate 1 gallon /
water/day /person
*Light Source-battery operated flashlight, lanterns and
batteries
*Canned foods-with a manual can opener
Storms
Thunderstorm
*If outside seek shelter if possible, buildings, or cars.
*If no shelter head for low ground and crouch down.
*If in or on the water, get out immediately and seek shelter
*If indoors, avoid windows, glass doors etc.
*Avoid using electrical equipment, use battery operated only.
*Do not bath or shower during storm.
*If driving, remain in vehicle with windows up and flashers on.
Tornados
*If outside, seek shelter immediately. If none immediately
available get into a vehicle, fasten seatbelt, and proceed to
closest shelter.
*Do not stay in a mobile home, immediately evacuate! If you
own a vehicle, get into vehicle, buckle seat beat and proceed
to nearest shelter.
*If tornado is in area and you are in a vehicle, and debris is in
air, pull over and park. Then either, stay in car with seat belt
on, cover head with blanket and lie on the floor, below the
windows, or if you can quickly access a level lower than your
car, lie down in that area, covering your head with your hands
and a blanket.
*The safest place is underground in a room without windows,
or doors.
*If underground shelter, is not available, proceed to lowest
level of building/home staying in the middle of the room, get
under sturdy furniture.
Winter Storms
*Layer clothing; wear a hat that covers ears and mittens for
hands.
*Wear waterproof boots and a few pair of socks.
*Keep alert to weather condition changes and alerts by tuning
into radio or TV stations.
*Bring pets indoors.
*If water line freezing is a possibility, run (trickle) water in sinks
*Avoid driving and strenuous activity.
*Keep vehicles winterized, ensuring windshield fluid is full and
keep at least ½ tank of gas to prevent fuel line freezing.
*If using chimneys, have them inspected and cleaned yearly
BHRS Consumer Handbook
Updated 4/25/11
*First Aid Kit
*Medications
*Blankets
*A record or log of your belongings and a small amount of cash
*Baby supplies, if applicable
*Pet supplies, if applicable
Know the meaning of the terms
ADVISORY-Conditions possible in the next 2-5 days
WATCH-Conditions are possible within the next 36-48 hours
WARNING-Severe conditions either have begun or are
expected within the next 24 hours.
General Safety Tips for Natural Disasters
*Never use unvented fuel-burning equipment, i.e. generators or
grills inside your home, garage, or any partially enclosed
areas.
Floods
*If on high ground, tune into TV /radio for specific instructions
*If not, move to higher ground away from rivers, streams,
creeks, and storm drains.
*Do not drive around barricades; they are there for your
safety.
*If your car stalls in rapidly rising waters, abandon it
immediately and climb to higher ground.
*If evacuation is required, turn off all utilities, unplug all
appliances, and evacuate to designated shelter
*Take only essential items with you.
*Put pets/animals in a safe area; do not take them with you to
shelters.
*DO NOT drive through flowing water, reroute if necessary and
watch for down power lines.
*For states of emergency, remain at home until cleared by the
authorities.
Environmental Contaminates
*Close and lock all windows and exterior doors.
*Turn off all heating, air conditioners and fans.
*Protect yourself in an UPSTAIRS room that has no doors and
windows if possible.
*Secure this upstairs room as your home shelter remembering
to bring your emergency kit into the room with you also.
*If you are told there is danger of explosion, close the window
shades, blinds, or curtains.
*Use a heavy tape and plastic to seal all doors and window
cracks, and vents, and a wet towel under the doors.
*Bring your pets with you, and be sure to bring additional food
and water supplies for them.
*If driving at the time, proceed to closest shelter.
*If you are not near a shelter, pull off the road; turn off engine
and close air vents.
*Keep listening to your radio or television until you are told all
is safe to either return to the road, or come out of your home
shelter.
www.familybehavioralresources.com
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