Therapeutic Behavioral Service (TBS) Medi-Cal Services

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What are Therapeutic Behavioral Services (TBS)?

TBS is a type of mental health service available to you if you have serious emotional problems that put your placement at risk. You must be under 21 and have full-scope Medi-Cal to get TBS.

  • If you are living at home, the TBS staff person can work one-to-one with you to reduce severe behavior problems to try to keep you from needing to go to a higher level of care, such as a group home for children and young people with very serious emotional problems.
  • If you are living in a group home for children and young people with very serious emotional problems, a TBS staff person can work with you so you may be able to move to a lower level of care, such as a foster home or back home.

TBS will help you and your family, caregiver or guardian learn new ways of controlling problem behavior and ways of increasing the kinds of behavior that will allow you to be successful. You, the TBS staff person, and your family, caregiver or guardian will work together very intensively for a short period of time, until you no longer need TBS. You will have a TBS Plan that will say what you, your family, caregiver or guardian, and the TBS staff person will do during TBS, and when and where TBS will occur. The TBS staff person can work with you in most places where you are likely to need help with your problem behavior. This includes your home, foster home, group home, school, day treatment program and other areas in the community.

Who can get TBS?

You may be able to get TBS if you have full scope Medi-Cal, are under 21 years old AND

  • Have serious emotional problems AND
  • Live in a group home for children and young people with very serious emotional problems. [These group homes are sometimes called Rate Classification Level (RCL) 12,13 or 14 group homes]; OR
  • Live in a state mental health hospital, a nursing facility that specializes in mental health treatment or Mental Health Rehabilitation Center (these places are also called institutions for mental diseases or IMDs); OR
  • Are at risk of having to live in a group home (RCL 12,13 or 14), a mental health hospital or IMD; OR
  • Have been hospitalized, within the last 2 years, for emergency mental health problems; OR
  • Have previously received TBS

Are there other things that must happen for me to get TBS?

Yes. You must be getting other mental health services. TBS adds to other mental health services. It doesn't take the place of them. Since TBS is short term, other mental health services may be needed to keep problems from coming back or getting worse after TBS has ended.
TBS is not provided if the reason it is needed is:

  • Only to help you follow a court order about probation.
  • Only to protect your physical safety or the safety of other people.
  • Only to make things easier for your family, caregiver, guardian or teachers.
  • Only to help with behaviors that are not part of your mental health problems.

You cannot get TBS while you are in a mental health hospital, an IMD, or locked juvenile justice setting, such as a juvenile hall. If you are in a mental health hospital or an IMD, though, you may be able to leave the mental hospital or IMD sooner, because TBS can be added to other mental health services to help you stay in a lower level of care (home, a foster home or a group home).

How do l get TBS?

If you think you may need TBS, ask your Fresno County Mental Health Provider, if you already have one, to contact the county mental health department and request services. A family member, caregiver, guardian, doctor, psychologist, counselor or social worker may call and ask for information about TBS or other mental health services for you. You may also call the MHP at 1-800-654-3937 for more information about TBS. Who decides whether or not I need TBS and where and when I can get it?

The county mental health department decides if you need mental health services, including TBS. Usually your Mental Health Provider will send a TBS referral to the Mental Health Plan TBS advisors. The referral will be reviewed for TBS class criteria and, if appropriate, will be forwarded to our TBS Provider. A meeting will then be scheduled with the caregiver and the initial TBS Plan will be developed utilizing both the input from the information provided by the referring clinician and the caregiver.

What is in my TBS Plan?

Your TBS Plan will spell out the problem behaviors that need to change and what the TBS staff person, you and sometimes your family, caregiver or guardian will do when TBS happens. The TBS Plan will say how many hours a day and the number of days a week the TBS staff person will work with you and your family, caregiver or guardian. The hours in the TBS Plan may be during the day, early morning, evening or night. The days in the TBS Plan may be on weekends as well as weekdays. The TBS plan will say how long you will receive TBS. The TBS Plan will be reviewed regularly. TBS may go on for a longer period of time, if the review shows you are making progress but need more time.

What if the county mental health department doesn't approve TBS, but you, your family or caregivers disagree?

You can file a grievance with the county mental health department if the county mental health department doesn't approve TBS, but you, your family, caregiver or guardian disagree. Call the MHP at 1-800-654-3937 for information and help. You may also call the county patient's rights advocate at (559) 492-1652 or the State Mental Health Ombudsman Office at I –800-896-4042 or TTY 1-800-896-2512.

You and your family or caregivers can ask for a State Hearing instead of filing a grievance or at the same time you file a grievance with the county mental health department. Call 1-800-952-5253, send a fax to 916-2294110, or write to the State Department of Social Services/State Hearings Division, P.O. Box 944243, Mail Station 19-37, Sacramento CA 94244-2430. You must ask for a State Hearing within 90 days after you learn that your request to the county mental health department for TBS was denied. Protection & Advocacy, Inc. is also available to assist with grievances and appeals at 1-800-776-5746 or http://www.pai-ca.org.

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