Psychiatric Residential Treatment Facility Referral



Similar documents
AmeriHealth Caritas District of Columbia Psychiatric Residential Treatment Facility Referral

PSYCHIATRIC INFORMATION: Currently in treatment? Yes No If no, what is barrier to treatment: Clinical Treatment Agency:

Admission Application

Psychiatric Residential Treatment Facility (PRTF): Aligning Care Efficiencies with Effective Treatment. BHM Healthcare Solutions

CRITERIA CHECKLIST. Serious Mental Illness (SMI)

I. Each evaluator will have experience in diagnosing and treating the disease of chemical dependence.

SPOUSE / PARTNER ONE TO COMPLETE THIS SECTION SEPARATELY. Name: (Last) (First) (Middle Initial)

Background: Previous Research

How To Know If You Can Get Help For An Addiction

ADVANCED BEHAVIORAL HEALTH, INC. Clinical Level of Care Guidelines

Wake Forest Mind and Health, PLLC 501 North Main Street Wake Forest, NC 27587

Children s Community Health Plan INTENSIVE IN-HOME MENTAL HEALTH / SUBSTANCE ABUSE SERVICES ASSESSMENT AND RECOVERY / TREATMENT PLAN ATTACHMENT

Adult Information Form Page 1

Medical Necessity Criteria

Provider Attestation (Expedited Requests Only) Clinical justification for expedited review:

Inpatient Behavioral Health and Inpatient Substance Abuse Treatment: Aligning Care Efficiencies with Effective Treatment

PARTNERS IN PEDIATRIC CARE. Intake and History for Mental Health Referral

Appendix D. Behavioral Health Partnership. Adolescent/Adult Substance Abuse Guidelines

Durham SOC Care Review LEVELS OF RESIDENTIAL CARE

Maryland Medicaid HealthChoice Substance Use Disorder Form Instructions

WORKERS COMPENSATION PROTOCOLS WHEN PRIMARY INJURY IS PSYCHIATRIC/PSYCHOLOGICAL

Facility information- Please provide accurate contact information for the facility and the contact person should DDM have additional questions.

Psychiatric Residential Treatment Facility (PRTF) Prior Authorization Request

Program criteria. A social detoxi cation program must provide:

Mental Health Fact Sheet

REFERRAL FORM FOR ADMISSION TO HOMEWOOD HEALTH CENTRE

Washington State Regional Support Network (RSN)

Admission Application

Instructions for Funding Authorization/Reauthorization Process. Residential Alcohol and Other Drug Treatment Programs

ASAM 101: How to complete the ASAM Placement Form

RESIDENTIAL TREATMENT CENTER (RTC)

Application for Residential Treatment Center Placement (Must be completed by family)

SUBSTANCE USE DISORDER SOCIAL DETOXIFICATION SERVICES [ASAM LEVEL III.2-D]

Suicide Screening Tool for School Counselors

Easy Does It, Inc. Transitional Housing Application

How To Know If You Should Be Treated

Rekindling House Dual Diagnosis Specialist

Community, Schools, Cyberspace and Peers. Community Mental Health Centers (Managing Risks and Challenges) (Initial Identification)

Managed Health Care Administration Initial Assessment Child/Adolescent Program Parent Questionnaire Page 1

Overview of the ASAM Patient Placement Criteria, Second Edition Revised (ASAM PPC-2R)

Optum By United Behavioral Health Florida Medicaid Managed Medical Assistance (MMA) Level of Care Guidelines

INSTRUCTIONS FOR FORM PCF05: PSYCHIATRIC/SUBSTANCE ABUSE EXTENSION OR RECONSIDERATION. NOTE: Fields 1 6 MUST be filled in

OK to leave Messages?

Behavioral Health Consulting Services, LLC

Maryland Medicaid HealthChoice Use Form Instructions

Procedure/ Revenue Code. Billing NPI Required. Rendering NPI Required. Service/Revenue Code Description. Yes No No

Dr. John Carosso, Psy.D Psychologist Autism Center of Pittsburgh

Brantford Native Housing Residential Support/ Addiction Treatment Program

LEVEL III.5 SA: SHORT TERM RESIDENTIAL - Adult (DUAL DIAGNOSIS CAPABLE)

American Society of Addiction Medicine

D. Clinical indicators for psychiatric evaluation are established by one or more of the following criteria. The consumer is:

Phoenix House. Outpatient Treatment Services for Adults in Los Angeles and Orange Counties

McLean Ambulatory Treatment Center Adult Partial Hospital and Residential Program for Alcohol and Drug Abuse 115 Mill Street Belmont, MA

Kanawha Valley Fellowship Home

Conceptual Models of Substance Use

RULES OF THE TENNESSEE DEPARTMENT OF MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES

Arrive 15 minutes before your scheduled appointment time.

North Bay Regional Health Centre

Smoky Mountain Center LME-MCO Care Coordination

LEVEL II.1 SA: INTENSIVE OUTPATIENT - Adult

1. The youth is between the ages of 12 and 17.

PATIENT TREATMENT AGREEMENT

Intensive Customized Care Coordination Transaction

REFERRAL INFORMATION CHILD, YOUTH AND FAMILY PROGRAM

The purpose of this policy is to describe the criteria used by BHP in medical necessity determinations for inpatient CH treatment services.

UNDERSTANDING CO-OCCURRING DISORDERS. Frances A. Campbell MSN, PMH CNS-BC, CARN Michael Beatty, LCSW, NCGC-1 Bridge To Hope November 18, 2015

LEVEL I SA: OUTPATIENT INDIVIDUAL THERAPY - Adult

Traumatic Stress. and Substance Use Problems

Ranch Ehrlo Society. referral information. Does this referral meet the TFCP criteria? Child s Name:

MAIL: Recovery Center Missoula FAX: Wyoming St. OR ATTN: Admissions Missoula, MT ATTN: Admissions

5. The average alcoholic dies years earlier than he or she would otherwise. 6. It is said that alcoholic patients have two sides. What are they?

Debbie Papps, LCSW, LLC 333 Lincoln St, Saco, ME 04072

THE OFFICE OF SUBSTANCE ABUSE SERVICES REQUIREMENTS FOR THE PROVISION OF RESIDENTIAL DETOXIFICATION SERVICES BY PROVIDERS FUNDED WITH DBHDS RESOURCES

Alcohol and Drug Abuse Treatment Centers

JACKSON RECOVERY CENTERS Initial Substance Abuse Assessment Form. Substance used: Method: Age started: Last used: Frequency/progression of use:

Chapter B WAC CHEMICAL DEPENDENCY SERVICES. Section One--Chemical Dependency--Detoxification Services

Comprehensive Behavioral Care, Inc. Level of Care Guidelines Substance Abuse Children/Adolescents

Mental Health Needs Assessment Personality Disorder Prevalence and models of care

Concurrent Disorder Comprehensive Assessment: Every Interaction is an Intervention

Level of Care Criteria Psychiatric Criteria

Clinical Treatment Protocol For The Integrated Treatment of Pathological Gamblers. Presented by: Harlan H. Vogel, MS, NCGC,CCGC, LPC

BOARD OF PHARMACY SPECIALITIES 2215 Constitution Avenue, NW Washington, DC FAX

Welcome Letter - School Based Health Center

opiates alcohol 27 opiates and alcohol 30 April 2016 drug addiction signs 42 Ranked #1 123 Drug Rehab Centers in New Jersey 100 Top

[Provider or Facility Name]

Preadmission Screening. Who Is Subject to PASRR Screens. Who can Complete the ACH PASRR Level I Screen. Getting Help

Behavioral Health Medical Necessity Criteria

UTAH DIVISION OF SUBSTANCE ABUSE AND MENTAL HEALTH SUBSTANCE USE DISORDER SERVICES MONITORING CHECKLIST (FY 2014) GENERAL PROGRAM REQUIREMENTS

Instructions for SPA Paper Application

MONROE COUNTY OFFICE OF MENTAL HEALTH, DEPARTMENT OF HUMAN SERVICES RECOVERY CONNECTION PROJECT PROGRAM EVALUATION DECEMBER 2010

Department of Social and Health Services Division of Alcohol and Substance Abuse. WAC Revision Recommendations Patient Placement Criteria

Megan Ogle, PsyD Clinical Psychologist 1215 SW 18 th Avenue, Portland, OR

Mental Health and Substance Abuse Reporting Requirements Section 425 of P.A. 154 of 2005

Transcription:

Psychiatric Residential Treatment Facility Referral Date of referral: Psychiatric Residential Treatment Facility (PRTF) Referral Information Referral contact: Phone number: Referring facility/agency: Fax number: PRTF Referrals Made Has the member been accepted at a PRTF? Yes No If yes, please list actual facilities in the table below. If no, please list the potential facilities that the referring agency has identified as possible placements. PRFT NAME Accepted Not Accepted Awaiting Decision Is this facility recognized by Louisiana DHH? Date of Admission/Potential admission to PRTF: _ Demographic Information (Please print) Child's name: Male Female Date of birth: I Age: Ethnicity: Current placement: Admission Date: SSN: I Primary language: Medicaid ID number: Address: City: I State: ZIP Code: Home phone number:

Emergency Contact (Other than Primary Caregiver): Phone: _ Name: Relationship to child: Languages: Address: Home/Cell phone: Work phone: Legal Guardian (if other than listed above): Relationship to child: I Home phone: I Work phone: DCFS Involvement (if applicable) DCFS supervisor: DCFS program supervisor: DCFS social worker area office: Phone: Phone: Phone: Reason and level of DCFS involvement: Client DCFS Status: Child is in Custody Investigation other: Is the member in OJJ custody? Yes/No Arrest History: Criminal Charge When Where Disposition Last version 11/10/15

Current Family Situation Living situation (name/legal/relationship to member): Family history, family psychiatric and substance abuse history, domestic violence, current family stressors that may be affecting patient: Family's role in treatment: Family's strengths: Child's strengths: Religious I cultural background: Restrictions I special needs based on religious I cultural background or physical needs (if any): Last version 11/10/15

Name of secondary insurance carrier: Secondary Insurance Information (if any) Insurance number: Subscriber: Plan code number: DOB: Subscriber's employer: Relationship to insured: Insurance verified: 0 Yes 0 No Psychiatric Clinical Information What is the main clinical need or focal problem that leads you to request admission to a PRTF? What are the contributing factors to the main clinical need/focal problem? Please consider factors from multiple life domains, including the individual, family, peer, school and community: What are the goals for the PRTF stay and the recommended interventions corresponding to the contributing factors stated above?

Current Diagnosis: DSM-5 Diagnoses (include mental health, substance abuse & medical): Current Psych Medications and Dosages: Name of Drug/Symptoms Behaviors Dose Schedule Prescribing MD Target Were any medications discontinued due to adverse reactions? If so, which?

Has the child experienced any of the following? (Please check one response) Symptom/Behavior/Diagnosis Aggressive behavior Anxiety I panic attacks Attention deficit disorder Depression Dissociative features Eating patterns I concerns Fire setting Hallucinations- Auditory Hallucinations- Visual History of cruelty to animals Homicidal threats Impulsive behavior Juvenile court involvement Oppositional behavior Runaway Substance Use Self-injurious behavior Sexualized behavior School problems Sleep problems Suicidal ideation Trauma history/abuse: Yes No Unknown If yes, please explain when and by whom and if member has received any treatment to address:

Medical Information Primary care physician: Allergies? Phone: Check all that apply: Asthma Birth Complications Cardiac Diabetes GI Disease HIV /AIDS Head Trauma Seizures Thyroid Disease Medical issues- significant medical history, hospitalizations, surgeries: Recent Test Date Abnormalities Y/N? EKG EEG CT Scan MRI Other Explain Identify any potential risk factors that may interact with medications:

Current Medical Medications: Name of drug Dose Schedule Prescribing MD Target symptoms/behaviors Any medical conditions that might impact use of restraint? Educational Information Child's current grade level: Current school: Special education classification? D Yes D No Testing date: scores: Current IEP date: Academic, behavioral and social functioning in school. Note any suspensions:

Treatment History and Plan Has child ever received any of the following services? Where? Psychiatric hospitalization: Substance abuse treatment: CPST Services: CSoC Waiver: Outpatient treatment: Partial hospitalization: Residential treatment center: Psych-sexual evaluation: Psychological testing: Neuro-psych testing: Other Waiver Services: Other: Other: Other: Other: What is the long term disposition plan for this child? _ Therapeutic Foster care Group Home _ Other: What is the child's future vision for the long term disposition plan? Other: Home Therapeutic Foster Care Residential Treatment Group Home

Current Service Providers Contact Name Agency Phone Services Provided Dates of Participation Does the child require a single room? If yes, state reason: Previous experience with roommates: Substance Use Disorder ASAM Dimensions Dimension Rating (0-4) Dimension 1: Acute Intoxication and/or Withdrawal Potential Rating: Substances Used (pattern, route, last used): Current ASAM Dimensions are Required Tox Screen Completed? History of withdrawal Symptoms: Yes No If Yes, Results: Current Withdrawal Symptoms: Dimension 2: Biomedical Conditions & Complications Rating: Vital Signs: Is member under doctor care? Yes No Current medical conditions: History of seizures? Yes No Dimension 3: Emotional, Behavioral or Cognitive Conditions & Complications Rating: MH Diagnosis: Cognitive Limits? Yes No Psych Medications and Dosages: Current Risk Factors (SI, HI, Psychotic Symptoms, Etc ): Dimension 4: Readiness to Change Rating: Awareness/commitment to change: Internal or External Motivation: Stage of change, if known: Legal problems/probation officer: Dimension 5: Relapse, Continued Use or Continued Problem Potential Rating: Relapse Prevention Skills: Current assessed relapse risk level: High Moderate Low Longest period of sobriety: Dimension 6: Recovery/Living Environment Rating: Living Situation: Sober Support System: Attendance at support group: Issues that impede recovery:

Criteria Section Is the child/adolescent expected to: (Circle one) 1. Potential for improvement in symptoms/ 2. Treatment expected to maintain symptoms/behavior Behavior with treatment without further deterioration Over the last week has the child/adolescent had any of the following behaviors? (Circle all that apply) A. Fire Setting F. Angry outburst/aggression unmanageable B. Self mutilation G. Positive psychotic symptoms unmanageable C. Runaway for more than 24 hours H. Hypomanic symptoms/increasing unmanageable D. Daredevil/impulsive behavior I. Arrest/confirmed /illegal activity E. Sexually inappropriate/aggressive/abusive J. Persistent violation of court order Has the child/adolescent's behaviors been present at least 6 months? Yes No Are the child/adolescent's behaviors expected to persist longer than 1 year without treatment? Yes No Has child/adolescent had any of the following unsuccessful treatments within the past year? (Circle all that apply) A. Treatment foster care D. At l east 3 psych1atnc partial hosp1ta l admissions B. Residential treatment center I Therapeutic group home E At least 4 psychiatric admissions to inpatient I partial C At least 3 psych1atric inpatient admissions hospital /Inpatient /outpatient in any combination Are the child/adolescent's behaviors unable to be managed safely in a lesser level of care? Yes No Is the child/adolescent's support system: (Circle any of the following): A. Unavailable D. Abusive B. Unable to ensure safety E. Intentional sabotage of treatment C High-risk environment F. Unable to manage intens1ty of symptoms Does the child/adolescent have any of the following functioning problems: (Circle all that apply) A. Unable I Unwilling to follow instructions I Negotiate needs B. Socially withdrawn C Unable I unwilling to perform ADLs D. Behavioral control for more than 48 hours and Improvement IS not expected within next 2 weeks Signature and Title of Referring Person: Date:

Supporting documentation required with packet: o Court order for placement (if one exists) o Most recent psychiatric evaluation recommending PRTF placement in order to complete the Certification of Need (CON) o Most recent clinical update, including diagnosis and medications o Most recent IEP o Clinical justification: if the member has not had extensive OP services, please get clinical justification as to why the member needs to be placed in a PRTF as opposed to starting more intensive OP services Facilities may require additional documentation/information prior to approval/decision. 12