Behavioral Health Rehabilitation Services (BHRS)

A Guide to Behavioral Health Rehabilitative Services (BHRS) in Pennsylvania Note: Information included on this web page covers BHRS as a whole and is NOT Autism specific.

The Office of Mental Health and Substance Abuse Services (OMHSAS) in the Department of Public Welfare (DPW) administers mental health services, including Behavioral Health Rehabilitation Services (BHRS). Individuals who have medical assistance (MA) are eligible to receive medically necessary BHRS services until the day before their 21st birthday.

BHRS is a rehabilitative, MA-funded program providing trained professional support for youth to reduce or replace challenging behavior with positive, socially appropriate behavior. BHRS are family and child-centered and can take place in a variety of settings, including the home and community. Services are defined by the Behavior Treatment Plan, or Behavior Care Plan. Progress is monitored with data, updated regularly and reevaluated every four to twelve months.

To determine whether an individual is eligible for Medical Assistance, and subsequently eligible for BHRS, contact the County Assistance Office in the county you reside. If an individual is already receiving Medical Assistance or has been determined eligible for Medical Assistance, you can request BHRS by contacting the behavioral health managed care organization in your county or by calling the County MH/MR or Department of Human Services (DHS) office. Go to www.hcsis.state.pa.us and click "Services and Support Directory" then "County Contacts" or check the government pages of your phone book to locate your county offices.

BHRS - Frequently Asked Questions

What are BHRS services?

How are services decided?

An evaluation is done by a psychologist or a physician who recommends appropriate services. A Treatment Plan is developed by an interagency team representing several support agencies, including the county Mental Health/Mental Retardation (MH/MR) program representative. This team includes parents, any lead teacher, a Behavior Specialist Consultant (BSC), any services coordinator, any therapist or counselor, and any person(s) the family wishes, including an advocate. If appropriate, your child is included. The plan includes goals, objectives, and treatments. Goals may target safety, functional, communication, social and classroom behavior and each member of the team is assigned responsibility to help meet the goals. Goals are individual to the needs of your child and family, and are updated as often as needed.

Who provides services?

When and where do services occur?

The evaluation includes the prescription for "level of care," or the treatment hours assigned each week to TSS, MT and BSC, and in which setting. Settings often include school, community (camp, scouts, or other various community-based activities), and/or home.

What do services look like?

TSS and TSSA provide one-on-one service. For instance, your child’s therapist may instruct a child on how to take turns using cards, a worksheet, games, checklists, scripts and other strategies. The TSS and TSSA may then prompt the child to practice that skill in natural settings such as circle-time, recess or during a play date. This instruction may occur at your home and be practiced there, and at some point with other children. The TSS or TSSA take data and record treatment notes to measure the client’s progress toward independent use of the skill. The BSC regularly reviews these notes to adjust treatment and goals as needed.

How can my child get services?

To determine whether your child is eligible for Medical Assistance, and subsequently eligible for BHRS, contact the County Assistance Office in the county you reside. If your child is already receiving Medical Assistance or has been determined eligible for Medical Assistance, you can request BHRS by contacting the behavioral health managed care organization in your county or by calling the County MH/MR or Department of Human Services (DHS) office. Go to www.hcsis.state.pa.us and click "Services and Support Directory" then "County Contacts" or check the government pages of your phone book to locate your county offices. Families should contact BHRS provider agencies to determine which may have the best experience and staff for their child’s needs.

What BHRS is not

BHRS is not a substitute or supplement for speech and language, occupational or physical therapies.

BHRS is not a substitute for academic instruction by a teacher.

BHRS is not a Big Brother/Big Sister-type program.

BHRS is not a babysitting service.

For details, visit our glossary for the definitions of acronyms and words used in this section. In addition, your behavior health managed care organization (BHMCO) likely has printed materials and a web site designed to help you understand their services and complaint process.

Why does my child need BHRS when I already have education services?

There are similarities between BHRS and education services. However there are important differences because the long-term goals of these two systems are different. School services are designed to meet the goals of IDEA, a federal education law that focuses on functional and academic skills that prepare a student for independent living, a job or further education. BHRS focus on community integration and skill development to increase the independence of individuals and their families.

BHRS serve behavioral health needs exclusively, with the purpose of helping the child learn skills to become independent in their daily environments as they develop. Services to teach independence can occur anywhere a child needs them, including play-dates, community outings, and recreation. This may include school activities, whether public or otherwise.

BHRS staff are hired and trained for the sole purpose of supporting the needs of the child and their family arising from the child’s disability. Staff hired must have state-mandated minimum levels of education and experience. Therapeutic Support Staff (TSS) who provide direct support must have a two-year college degree or 60 credit hours toward a degree, but often have a four-year college degree, if not advanced health training. They teach and support the learning of specific positive behaviors, such as safety skills and social interactions, like dealing with conflict and maintaining conversations.

Long-term goals are addressed with short-term objectives in a Treatment Plan. Parents are encouraged to be actively involved in creating, carrying out and following through on the Treatment Plan.

In contrast, education services historically focus on the school setting. School staff are historically trained to serve the needs of children without disabilities, but may receive additional training about children with disabilities. In addition, school staff aides may be hired without a college degree or advance training. Training usually relates to typical activities of a public school. School services for children with disabilities are designed to meet a legal obligation to provide the child access to the general education curriculum and provide individualized services and support that enable them to benefit from a public education. Issues such as school related concerns, special education regulations, or procedural safeguards would be directed to the PA Department of Education, Bureau of Special Education’s Special Education Consultline at 1-800-879-2301.

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For a printable version of this information click the link below.

A Guide to Behavioral Health Rehabilitative Services (BHRS) in Pennsylvania

If you have questions or concerns regarding BHRS services, please contact the Bureau of Children’s Behavioral Health Services at 717-705-8289. For questions regarding all other behavioral health services, please contact the Office of Mental Health and Substance Abuse Services at 717-787-6443.

If you cannot find the information you need, please Contact DPW.