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Alternatives to Residential Services

Georgetown’s National Technical Assistance Center for Children’s Mental Health (TA Center) has been providing technical assistance to states who are implementing community-based alternatives to residential treatment, as well as offering resources to others including webinars, web-based video resources, and access to insights from the Community- Based Alternatives to Psychiatric Residential Treatment Facilities (PRTF) Waiver Demonstration (FY2007 through FY2011).


Serving children, youth, and young adults in the community that may otherwise be served in a residential setting requires comprehensive strategies to ensure the individuals’ and families’ complex needs are met. The 9 states participating in the PRTF Waiver Demonstration program funded by the Centers for Medicare and Medicaid Services have learned many lessons in this program that was designed to test whether children could successfully and cost-effectively be served in the community. These 9 states demonstrated that the children and youth served in the community maintained or improved their functional status at an average cost of less than a third of the cost of a PRTF. The goal of these 9 states, as well as other states across the county, is to prevent or shorten stays in residential treatment settings while improving outcomes for children and youth with serious mental health challenges in areas such as:

  • Education
  • Family relationships
  • Mental health
  • Decreasing contacts with the child welfare and juvenile justice system

Target Audience

The audience is states and communities who want to develop strategies for providing effective home and community-based services for children and youth with serious mental health challenges who otherwise may be served in a residential setting.


In a partnership, the Georgetown TA Center and JBS International, Inc. analyzed interviews from 134 youth, families, service providers, local administrators, state representatives, and policy makers involved in the demonstration to obtain insights from the field. Interviewees were asked to comment on their experiences with the Demonstration. Of all the interviews, individuals overwhelmingly talked about strengths of the waiver, success stories, and concerns for what happens if the demonstration is not made permanent.
Theservices that are provided by this program enabled us to become a family again.” —parent

“My vision is to see that the collaborative effort continues among agencies and entities, as well as to see that we do breakdown the silos that have caused problems for us in the past, that have not seen the whole picture of what the family needs and what the youth need.” —local administrator

“I think the greatest success of the waiver has been that we’ve been really able to serve these children in the community. But for the waiver, these children would likely be in an institution. And I think everybody needs to always remember that.” —service provider

Click here for more information on insights from the field and conclusions from ongoing qualitative and quantitative secondary data analysis.

Contact Information

For further information or additional questions, please contact:
Sherry Peters, M.S.W., A.C.S.W.
Senior Policy Associate
National Technical Assistance Center for Children’s Mental Health
Center for Child and Human Development, Georgetown University