Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Icaps Level Of Care topic
No spam. Unsubscribe anytime.
ICAPS leaders urge Connecticut to drop lower age limit for intensive in‑home psychiatric care
Summary
Victoria Staub, clinical director of the ICAPS model, urged state partners to remove the lower age restriction from Connecticut’s ICAPS level‑of‑care guidelines so preschool children with severe relational or psychiatric disturbance can access intensive in‑home services; state officials said guideline changes must go through committee review and cited fiscal implications for Medicaid.
Victoria Staub, clinical director for the ICAPS model development and operations, told the Child Analysis and Quality Subcommittee on April 26 that the network is recommending an update to Connecticut’s ICAPS level‑of‑care guidelines to remove the program’s lower age restriction and “clarify that chronological age alone is not a basis for admission or exclusion from ICAPS.”
Staub — who said ICAPS is an intensive in‑home child and adolescent psychiatric service delivered by a two‑person team — told the panel the network saw a substantial post‑pandemic drop in capacity, with service volume falling from more than 2,000 children annually before COVID‑19 to roughly 700 during the pandemic. She credited recent Medicaid rate increases and supplemental grants from DCF with helping stabilize the network but said staffing gaps remain, with about 30 open positions statewide and regional variation in coverage.
The ICAPS team presented outcome data they say support broader eligibility. In a Q1 2026 snapshot Staub reported nearly 77% treatment completion among recent cases, an approximately 65% decrease in inpatient admissions, about an 80% decrease in psychiatric inpatient days and a roughly 51% reduction in emergency department visits when comparing pre‑ICAPS periods to care during ICAPS. Staub also said approximately 67% of children in their sample reported one or more complex trauma experiences and that treatment gains for completers have been seen up to six months after discharge.
Paul Correa, medical director for Caraval — identified in the meeting as the behavioral health administrative services organization for the Connecticut Behavioral Health Partnership — told the committee the level‑of‑care guidelines are publicly posted and, as currently written, leave little room for local interpretation on age eligibility. “The level of care guidelines is very clear when it comes to the age range,” he said, describing the standard registration process used when a child falls within the written range and the review process that can be triggered when a child falls outside it.
Committee members pressed ICAPS on program access and engagement. A member identified as Bernetta asked whether declines in service use during the pandemic were associated with more emergency department visits or justice‑system referrals; Staub said the decline primarily reflected staff unwillingness to do in‑home work during COVID and masking and safety concerns, and that survey procedures for family satisfaction vary by site but leadership receives direct contacts when families are unhappy.
On capacity, Staub said the network’s current unduplicated wait list is about 548 families, with typical waits of two to three months and some areas reaching four months. She said agencies have increased wages, bonuses and training, and that DCF supplemental funding and Medicaid rate increases have helped reduce turnover and rebuild teams, though rural “quiet corner” catchments still have limited coverage.
Staub also outlined research plans: a retrospective target trial emulation using administrative data (covering roughly 2023–2026) to strengthen the evidence base and pursue federal recognition of ICAPS effectiveness; separate replication work is under way in Rhode Island to support psychiatric hospital and residential diversion.
Committee leaders and state partners emphasized process and fiscal constraints. Members noted any change to the level‑of‑care guidelines would need to proceed through the Partnership’s committee review and approval process and that expanding a Medicaid‑reimbursable service carries budget implications. The meeting concluded with state staff and ICAPS agreeing to meet offline — Stephanie and the state agencies will follow up with Yale/ICAPS and report back in a month or two — and with ICAPS offering to connect providers working with commercial payers and to share presentation slides.
No formal motion or vote was taken at the meeting; the committee recorded the recommendation and established follow‑up steps.
