Rosie D.
Reforming the Mental Health System in Massachusetts

The Remedy: The Pathway to Home-Based Services 

“If implemented and successful, the Plan will represent a new day for this population of underserved disabled children. … It holds the potential to be an enormous step forward.”  

Rosie D. v. Patrick

U.S. District Court Judge Michael A. Ponsor

February 22, 2007


The Rosie D. Remedial Plan, adopted by the Court in February 2007 and finalized in July 2007, provides a mandate to restructure the children’s mental health system in Massachusetts by developing a coherent system of care that proceeds along a pathway for accessing home-based services and supports.  A new children's mental heatlh system, designed and developed consistent with the Remedial Plan, begins on July 1, 2009.

The new system will ensure that medically necessary home-based services are available both to assist children with serious emotional disturbance to remain in their home, in school, and in the community, as well as to reduce, to the extent reasonably possible, the likelihood that such children will be removed from their homes and home communities because of their mental health needs.


The new systems provides for screening, mental health evaluations, service coordination, comprehensive assessments, a single treatment team and single treatment plan, and an array of home-based services.  These services must be implemented with the involvement of families, and delivered through an integrated treatment planning process that includes all relevant state and local agency representatives.  


Twelve child-centered, family-driven principles are the cornerstones of the Pathway to Home-Based Services.  Click here for more information about these core principles.


The Pathway to Home-Based Services includes the following steps.  Click any item for more information about each step along the path.


·         Step 1: Screen and Identify Needs

·         Step 2: Evaluation

·         Step 3: Assign Care Management

·         Step 4: Conduct a Comprehensive Assessment

·         Step 5: Convene the Care Team

·    Step 6: Use the Wraparound Planning Process

·         Step 7: Develop the Care Plan          

·         Step 8: Provide Home-Based Services


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