Intensive In-Home Services (IIS) are intensive in nature, provided in the home setting and designed to prevent the unnecessary out-of-home placement of children. These services are provided only to families authorized by the state agency where the following conditions exist:

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  • There is a child abuse or neglect situation or a child who has committed a status offense. (Some projects also accept referrals on delinquent children and children with severe emotional disturbances);
  • One or more child(ren) will be placed in out-of-home care within 48 hours unless the family crisis can be resolved; and
  • The family will accept Intensive In-Home Services and the safety of the child(ren) and In-Home Specialist is reasonably assured.

The model represents a psycho-educational crisis intervention approach which emphasizes teaching and skill building during periods when the family is in crisis and most susceptible to change. As the current crisis is resolved, the family is taught alternate responses to minimize future problems.

There are no waiting lists for the provision of services. Families referred for these services are accepted for assessment on a first-come, first-serve basis.  The contractor accepts all referrals for assessment unless the caseload of the specialist will not allow for the provision of immediate services.  If available to provide services, the specialist must see the family within 24 hours of the initial referral.  Upon determination that the family is appropriate for IIS, the specialist completes a family assessment that evaluates the safety of the children and of all family members.  A treatment plan is developed with the family that sets achievable and measurable goals.

Specialists are available to the family 24 hours per day, seven (7) days per week. Depending upon the needs of the family, the IIS specialist delivers a wide variety of educational and counseling services.  Specialists must also, if necessary, transport clients, complete household chores, and obtain additional community services for families.

A crisis intervention fund is maintained for dispensing funds as authorized by CD to provide concrete services to meet the basic or emergency needs of families receiving IIS. When no other resources exist, this fund is used to pay reasonable immediate expenses for families to assist them in resolving the crisis that might otherwise result in removal of a child.  Funds are dispensed upon the approval of the Division.  The types of expenses covered may include, but are not limited to, rent, clothing, utilities, auto repair, gasoline, pest control, laundry cost, food, etc.

If the assessment determines a family is not appropriate for IIS, the contractor is reimbursed for their time spent screening the family for services.

The essential elements of the IIS Program Include:

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  • One or more children in the family must be at imminent risk of out-of-home placement;
  • No waiting list for services;
  • Specialists’ availability within 24 hours of referral;
  • Home-based service orientation;
  • Focus on the entire family as the service recipient;
  • Intensive intervention, up to 20 hours per family (or more, if needed), per week;
  • Specialists’ availability to family 24-hours per day, seven days per week;
  • Specialists’ delivery of both concrete and counseling services;
  • Regular staffing conducted between the specialist, supervisor, referral agent, follow-up provider and other pertinent individuals;
  • Crisis intervention fund available for family emergency needs and treatment enhancement;
  • Time limited (six week maximum) service period;
  • Specialists’ caseloads limited to two families;
  • Coordination of IIS follow-up services;
  • Specialists possess specific educational and training requirements; and,
  • Intensive In-Home Services are available statewide for the benefit of all Missouri families.

Related Practice Points and Memos:

1-10-20 – CD20-05 – Children’s Treatment Services

9-22-20 = CD20-45- Medical Record Fees