YOUTH CONSULTATION SERVICE
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Site Specific Policy & Procedure Manual
DOCUMENT #: A-10 Procedure Date: 10.7.10
Rev.: 2.11.14
TITLE: Program Description
To be completed by each individual site, with final review and
approval by both the Regional Clinical Assistant Vice President and Medical Director- Revise items in red.
I. PURPOSE: To identify the services, and prospective individuals that would benefit from services, at a particular YCS service site. To identify when it would be appropriate for an individual to transition to another site or exit the agency.
II. INTRODUCTION: This policy identifies the procedure for being admitted to a YCS
residential program.
III. PROCEDURES / IV STAFF RESPONSIBLEV REPORTING AND DOCUMENTATION
Pre-admission: General
Youth Consultation Service (YCS) does not discriminate, or deny admission, on the grounds of race, sex, color, national origin, religion, age, physical or mental disability, ancestry, sexual preference / affiliation, including AIDS or HIV infection, atypical cellular hereditary blood traits or any other legally protected status.
The ______Program is funded by state, Federal and grant monies, and therefore, does not charge a client fee for service(s) except where cost of care guidelines will be considered (as needed and approved). / Regional Administration:
Main Number: ______
· Vice President
· Assistant Vice President
· Assistant Clinical Vice President
Medical Director: ______
Site Administrator: _____
Pre-admission: Services:
The ______Program provides supervised residential housing for the [developmentally disabled, behaviorally challenged, emotionally disturbed, medically fragile] consumer. (See Below).
As part of the residential service, consumers are provided with necessary transportation, day program activities, recreational, behavioral support, medical and dental care coordination, and other services consistent with, and as indicated by, a consumer’s [Treatment Plan/ Individual Habilitation Plan (IHP)]. In addition, YCS provides an integrated approach of behavioral and physical health care. / YCS services are provided through:
Regional Administration:
Main Number: ______
· Vice President
· Assistant Vice President
· Assistant Clinical Vice President
Medical Director: ______
Site Administrator: _____
Pre-admission Criteria: General:
Criteria for admission:
Age: Age Range
Gender: Male and/or Female
General Diagnostic: Diagnostic Categories / The general admission criteria to YCS Residential Programs are determined by the YCS Chief Executive Officer, in consultation with the YCS Board of Directors, and the relevant licensing agency.
Pre-admission Criteria: Site Specific: Behavioral
For adult DDD programs:
Assessed Behavioral Level Served: Up to Level 4
Diagnostic: Behavioral: The following conditions, listed below, will be considered for admission to a YCS DDD Group Home when they are not physically or cognitively disabling to the point of requiring frequent and/or prolonged hospitalization or long-term custodial care.
Attention Deficit Disorders and Disruptive Behavior Disorders, Impulse Control Disorders, Schizophrenia and Other Psychotic Disorders, Mood Disorders, Anxiety Disorders, Personality Disorders, Problems Related to Abuse or Neglect, Personality Disorders, and Eating Disorders (being controlled).
Assessed Self-Care Level Served: Up to Level 3 (Level 4 with approval by Regional Vice President)
Level of functioning: Residents should be able to engage in a basic level of communication (with assistance, as necessary), and evidence minimal proficiency with basic daily living skills.
Habilitative Needs: Residents should evidence a past history, of mild to moderate ability, in responding to habilitative interventions (for example, Positive Behavioral Supports), in both daily living skill and behavioral improvements, as identified by goal areas in their IHP.
Conditions Requiring Special Consideration by Intake Team:
Paraphilias (Pedophilia is excluded, see below).
Exclusions: Behavioral:
· Alcohol and/or Drug Disorders, Pedophilia, Fire-setting, and/or Sexual Perpetrator History.
· Residents evidencing a frequent and/or prolonged history of requiring use of Personal Control(s), yet are unable or unwilling to sign consent for its use, and/or special medical conditions prohibiting its use and application.
· Residents who have been convicted of crimes of aggression.
For youth residential programs:
Diagnostic: Behavioral: The following conditions, listed below, will be considered for admission to ______Program when they are not physically or cognitively disabling to the point of requiring frequent and/or prolonged hospitalization or long-term custodial care.
Neurodevelopmental Disorders, Psychotic Disorders, Bipolar and Depressive Disorders, Anxiety Disorders, Obsessive Compulsive Disorders, Trauma/Stressor Disorders, Dissociative Disorders, Somatic Disorders, Feeding/Eating Disorders (being controlled), Elimination Disorders, Sleep-Wake Disorders, Sexual Dysfunctions, Gender Dysphoria, Disruptive/Impulse-control/Conduct Disorders, Personality Disorders, Paraphilic Disorders, Substance-Related/Addictive Disorders (if in early or sustained remission, but not displaying symptoms of withdrawal).
Conditions Requiring Special Consideration by Intake Team:
Neurodevelopmental Disorders, Psychotic Disorders, Obsessive Compulsive Disorders, Trauma/Stressor Disorders, Dissociative Disorders, Feeding/Eating Disorders, Elimination Disorders, Sleep-Wake Disorders, Disruptive/Impulse-control/Conduct Disorders, Personality Disorders, Paraphilic Disorders, Substance-Related/Addictive Disorders.
Exclusions: Behavioral:
Neurodevelopmental Disorders, Psychotic Disorders, Obsessive Compulsive Disorders, Trauma/Stressor Disorders, Dissociative Disorders, Feeding/Eating Disorders, Elimination Disorders, Sleep-Wake Disorders, Disruptive/Impulse-control/Conduct Disorders, Personality Disorders, Paraphilic Disorders, Substance-Related/Addictive Disorders. / Responsibility for Admissions are determined by the
Site Administrator, with Advice and Assistance from Regional Intake Coordinator
All intake recommendations regarding pre-admission and admission are determined by the Intake Team, which consists of the:
· Site Administrator;
· Regional Intake Coordinator; and
· Site-based Nurse
As requested, intake review may include:
· Regional Board Certified Behavioral Assistant (BCBA)
· Regional Vice President and/or Vice President
· Medical Director; and/or
All final decisions for admission must be reviewed and approved by the Regional Assistant Vice President for Clinical Services.
Note: See Medical Approval Below
Pre-admission Criteria: Site Specific: Medical
For adult DDD programs:
Assessed Medical Level Served, either:
· Up to Level 4 – Specialized Medical (requiring on-site day nursing staff) and Ambulation Support Required; or
· Up to Level 6 – Specialized On-site (24 Hour) Nursing and Ambulation Support.
Diagnostic: Medical: Up to Level 4
· Persons may have one or more medical conditions (i.e., high blood pressure, asthma ulcers, etc) but no special medical attention is needed on-site besides that normally provided by day and residential support staff (for example, medication administration); or
Diagnostic: Medical: Levels 5 & 6
· Persons have one or more medical conditions, i.e., respiratory, digestive, cardiovascular, etc. Treatments may include dressing or would care, catheter or colostomy emptying and maintenance; monitoring of oxygen use; insulin administration; turning and positioning, use of Epi Pen; and administration of enemas; or
· Persons have one or more medical conditions, i.e., respiratory, digestive, cardiovascular, etc. Treatments may include oral and/or nasal suctioning; intravenous medications; tube feeding; and catheterization.
Ambulation:-- either:
· Persons able to walk independently with or without corrective devices and/or wheelchairs – needing no assistance transferring or moving from place to place; or
· Persons can walk only with assistance from another person and/or use wheelchairs and need assistance when transferring or moving from place to place
Medical Care:
· Up to level 4, not requiring twenty four (24) hour on-site nursing care, or
· Levels 5 & 6, requiring twenty four (24) hour on-site nursing care.
Exclusions: Medical
· Assisted ventilation (i.e. ventilator, will accept CPAP)
· Intubated
· Tracheostomies
For youth residential programs:
Diagnostic: Medical:
Some typical medical conditions ______Program is equipped to manage include:
· Asthma
· Diabetes
· Food/Environmental Allergies
· GERD/GI Conditions
· Seizure Conditions
· Obesity
· Other
Medical Care:
Exclusions: Medical: / Responsibility for Admissions are determined by the
Site Administrator, with Advice and Assistance from Regional Intake Coordinator
All intake recommendations regarding pre-admission and admission are determined by the Intake Team, which consists of the:
· Site Administrator;
· Regional Intake Coordinator; and
· Site-based Nurse
As requested, intake review may include:
· Regional Board Certified Behavioral Assistant (BCBA)
· Regional Vice President and/or Vice President
· Medical Director; and/or
· Assistant Vice President for Clinical Services.
All medical information must be reviewed and receive final approval from the Medical Director, prior to admission
Admission: Process and Contact
Any individual, parent, or guardian, considering admission to the ______Program, and approved for Residential care by the DDD or DCSOC, should contact the YCS Regional Intake Coordinator, at ______. YCS believes every individual and/or their guardians have a right to visit the potential living site of their residence. Therefore, pre-placement interviews will be conducted, whenever possible, at the program site.
The appropriate DDD Regional Office shall provide the Sawtelle ______Program, prior to admission, with the following:
· Information which addresses eligibility for services;
· Results from a medical examination conducted no more than 90 days prior to admission; and
· A current immunization record, as available and hepatitis B screening results in accordance with N.J.A.C. 10:48-2; 28.
The Sawtelle ______Program will report all admissions in writing to the appropriate licensing agency, as required, within five days. / All referrals for intake are processed through the Regional DDD Offices or DCSOC and Performcare.
As approved for Residential and other services by the Regional DDD Office or DCSOC and Performcare, an individual, parent, or guardian should contact the Regional Intake Coordinator at: ______.
Site Administrator shall ensure admissions are reported to the appropriate agency, as required
Site Compliance with Admission Requirements:
The ______Program will not admit more than ______individuals, which is its licensed capacity.
Each YCS Program will offer the program description for review by the consumer, their guardians and their advocates at or prior to intake. / Site Administrator: ______
Modalities:
Each YCS residential program will employee the Evidence-Based modality/modalities most appropriate to the population served. The ______Program will use ______interventions with individuals and ______interventions with families. / Site Administrator: ______
Lead Clinician: ______
BCBA: ______
AVP for Clinical Services:
______
Transition:
All programs (Adult DD Sawtelle programs only when appropriate) will develop transitional plans for their consumers. The plan will begin upon determination of a discharge date. Transitional plans will address the specific needs of the consumer to help ensure a positive and successful transition. It will provide orientation to the new placement. Family therapy will be provided, should reunification or foster care be the discharge plan.
The criteria for transition to a lower level of care (step down) will be as follows:
- A consumer will be ready for transition when 80% of goals are completed
- A consumer will be ready for transition when it is determined by the treatment team that s/he can function at a lower level of care.
The criteria for transition to a higher level of care (step-up) will be as follows:
- A consumer will be considered appropriate for a higher level of care when it is determined by the treatment team that s/he cannot function at the current level of care.
- A consumer will be considered appropriate for a higher level of care when s/he cannot be safely maintained at the current level of care.
The criteria for a lateral transition will be as follows:
- A consumer will be considered appropriate for a lateral transition when the length of stay as per contract so determines.
- A consumer will be considered appropriate for a lateral transition when the location of the new program is more conducive to meeting the consumer’s needs. (For example, when closer to family, educational/day program or place of employment.) / Site Adminstrator:
Clinician:
BCBA:
New Program Site Administrator
Exit/Discharge
A thorough and comprehensive exit/discharge summary will be completed. This document is suitable to be used as a basis for developing future goals based on the individual consumer’s strengths, problems, continuing needs, and at-risk behaviors. It also takes into consideration preferences and abilities. (See 5.1 Policy and Procedure for Documenting Client Discharge/Transfer.)
VI. ATTACHMENTS (OR DOCUMENTATION)
NONE
VII. REGULATORY REFERENCES: 10:44A-4.1 Pre-admission and admission
CARF D.1.a-d.1.f
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