The unnecessary change in the language of the description of IIH services will ultimately limit what the In-Home worker is able to do, and will continue to burden an already overrun CSB. In-Home services are imperative to giving at-risk children the opportunity to thrive and succeed in their own home and school environment, and the change in semantics would further restrict how the In-Home counselor can assist the child and his/her family. Being that the work that QMHP-Cs do includes care givers and other family members in the child’s treatment and is in the child’s home environment, In-Home Counselors have the unique opportunity to develop a healthy and strong therapeutic bond with the child and form a relationship of mutual trust with family members. Requiring these families to seek case management services from the CSB rather than their in-home worker may fracture the bond that takes significant time to develop, and ultimately hinder the child’s treatment. Furthermore, the work that In-Home counselors do render them the most knowledgeable in regards to the child’s needs and best interest, at a level that a CSB case worker cannot match because of the high volume caseloads that they carry. Many clients receiving in-home services have limited financial capacity and chaotic home environments, which complicates their ability to schedule and attend outside appointments. Please consider that many of the parents that In-Home counselors work with have more than one child, work full-time or multiple jobs, and often have limited transportation options. Requiring CSBs to provide case management services adds not only another burden for the child’s caregiver, but also adds another worker involved with the child’s care that is ultimately wasteful and unnecessary, as the In-Home worker is able, and often more suited to provide the family with case management services. It is imperative that the Department consider the long-term effects that a change like this would have on the psychiatric treatment of children, and if our ultimate goal is to allow this children to live fulfilling and successful lives, we must give them the opportunity to work with one In-Home counselor with whom they have developed a therapeutic bond and deep level of trust, who is able to not only meet their behavioral and psychiatric needs, but can also meet their needs regarding case management services.