Skip to Main Content

Office of Mental Health

Home and Community Based Services Waiver
Guidance Document
Intensive In-Home Services Worker Competencies

  1. Information
    Intensive In-Home (IIH) workers demonstrate knowledge in the following areas:
    1. Psychiatric
      • Childhood psychiatric disorders and trauma: recognizes signs, symptoms, etiology, co-morbidity, course
      • Suicidality: recognizes signs and symptoms of suicide ideation
      • Substance Abuse: recognizes signs of active use/abuse of substances
      • Treatment modalities: describes treatment models used for childhood psychiatric disorders, particularly evidence based treatments
      • Addressing treatment resistance
      • Adult psychiatric disorders: recognizes signs, symptoms, course, decompensation
      • Psychiatric medications: identifies medications used in the treatment of childhood disorders, their side effects and counter indications
    2. Developmental Imperatives:
      • Developmental tasks: describes developmental tasks involved in the social and emotional development of children and teenagers associated with specific ages
      • Barriers: recognizes barriers to normal development
      • Strategies: identifies strategies for supporting growth and resiliency
    3. Other
      • Post crisis debriefing
      • Parenting skills
      • Relationship building
      • Managing stress
      • Anger management
    4. Systems/Resources:
      • HCBS Waiver: describes elements, philosophy, goals and guidelines
      • Treatment providers: understands importance of initial and on-going collaboration to support treatment goals and strategies
  2. Cultural Competence
    The IIH worker practices cultural competency as described in the following:
    • Demonstrates sensitivity to cultural and ethnic norms
    • Recognizes strengths in culturally driven parenting patterns and approaches to discipline
    • Values intergenerational and extended family relationships to family support and child rearing
    • Demonstrates a non-judgmental approach to working with families whose background and values differ from their own
    • Acknowledges and addresses culturally driven barriers to engagement
    • May assist children and families in addressing stigmatization and/or discrimination
  3. Tasks And Skills
    The IIH worker demonstrates competency in performing the following tasks:
    1. Safety
      • Evaluates predictors of violence in the home and community
      • Follows ICC agency’s Worker Safety protocols
      • Addresses family stressors and coping strategies
      • Recognizes and addresses signs of escalation
      • Re-enforces Safety Alerts Plans (SAP) with the child and family
    2. Engagement of Child and Family
      • Partners with child and family in supporting treatment and service plan goals
      • Builds on child and family strengths to move towards wellness and independence
      • Involves child and family in problem solving
      • Employs active listening skills
      • Uses therapeutic engagement methods (e.g., reframing, reflecting back)
      • Provides feedback to child and family
      • Maintains professional boundaries
      • Communicates clearly and respectfully
    3. Applies Interventions and Supports Treatment Strategies
      • Maintains close communication with the Individualized Care Coordinator to provide and receive information
      • Models positive behaviors
      • Provides psycho-social education
      • Teaches parenting skills
      • Utilizes strategies to integrate cognitive and behavioral changes and emotional self-regulation into the home environment, as identified in the treatment and service plans
      • Teaches anger management techniques
      • Explores with the child and family dynamics related to a crisis after it has occurred to prevent further occurrences
      • Implements child/family relationship building strategies
      • Assists in assessing child and family progress
    4. Documentation and Reporting
      • Completes and submits IIH Progress Notes for every contact in a timely manner according to Waiver and ICC agency policy
      • Documents flex fund expenditures
      • May make recommendations to ICC for referrals and Service Plan changes
    5. Fulfillment of Requirements
      • Adheres to NYS and agency requirements including: HIPPA, ethical guidelines, confidentiality, child abuse identification and reporting, incident reporting, worker safety protocols
      • Completes all required training (see 300.4 of Waiver Guidance Document)
      • Attends agency and interdisciplinary team meetings as required