Community-Based Alternative to Psychiatric Residential Treatment Facilities: Early Evidence of Mississippi's MYPAC Program Effect

The New Freedom Commission on Mental Health recommended that the Centers for Medicare & Medicaid Services (CMS) conduct a demonstration evaluating the effectiveness of community placements for children and youths with serious emotional disturbances (SED) in Psychiatric Residential Treatment Facilities (PRTF). As a result, CMS awarded demonstration grants to Mississippi and eight other states to implement alternative community programs for children and youth with SED. The State began operating Mississippi Youth Programs Around the Clock (MYPAC) in November 2007. MYPAC provides an array of services to children and youth diverted or transited from PRTF, including case management and respite care and wraparound services.

Congress mandated local and national evaluations to test whether the program maintains or improves children's level of functional and is cost neutral. As a control group, Mississippi selected children in PRTF meeting the same level of care as those in MYPAC. Baseline, 6-month follow-up and discharge data were collected for all participants. An early pre-post comparison of 19 youths in MYPAC 6 months and longer suggests that since they joined MYPAC: 1) their school absence and substance abuse severity has been either maintained or reduced; 2) most had fewer arrests; 3) fewer had problems with law enforcement; however 4) more youths have been involved with Child Protective Services. These preliminary findings suggest that a community setting may improve children's functional outcomes. However, more data collection and analyses will be performed to gauge the program effect and help identity policy options for community health planning.