Alabama Administrative Code › Title 660 - ALABAMA DEPARTMENT OF HUMAN RESOURCES › Chapter 660-5-52 - REFERRAL, ADMISSION, AND DISCHARGE PROCEDURES FOR INPATIENT PSYCHIATRIC SERVICES › Section 660-5-52-.03 - Referral And Admission

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The
			 ISP team shall be fully involved when assessing the need for, and
			 appropriateness of, inpatient services even though child welfare staff and
			 supervisors have primary responsibility for completing the referral and
			 admission process. The referral and admission process includes assessing a
			 child's need for inpatient services; confirming the need with a qualified
			 professional; and obtaining SDHR consultation and approval for service
			 delivery.
(2) A qualified
			 professional must be a physician licensed under Alabama law to practice
			 medicine; or a master's level psychologist or a psychological technician
			 licensed under Alabama law; or a master's level professional counselor licensed
			 under Alabama law; or a master's level social worker (non-DHR employee)
			 licensed under Alabama law or who has specialized training in psychiatric care;
			 or a registered nurse who has completed a master's degree in psychiatric
			 nursing.
(3) Assessing The Needs
			 For Inpatient Services - Inpatient services shall
only
be considered when a child cannot be safely evaluated and/or treated on an
			 outpatient basis or in a less restrictive setting. The provision of supportive
			 services shall always be considered prior to inpatient referral. ISP team
			 members shall assess information gathered about behavioral indicators and prior
			 services and treatment interventions.
(4) Confirming The Need For Inpatient
			 Services - Once the ISP team has determined that the child is unable to be
			 served in a less restrictive setting and that
inpatient
services appear to be needed, that need must
			 be confirmed by a qualified professional
prior to
			 contact
with SDHR for placement approval. The qualified
			 professional shall not be on staff at the hospital setting where inpatient
			 services will be sought. The qualified professional shall personally assess the
			 child, and as appropriate, the child's family members and other caregivers. The
			 qualified professional shall obtain and document information regarding specific
			 needs related to exhibited behaviors; risk of harm to self or others;
			 diagnosis; clear evidence that the child's needs can not be met on an
			 outpatient basis or in a less restrictive setting with supportive services
			 being provided; and whether services require an inpatient setting, and, if so,
			 the anticipated length of the hospital stay. Confirmation by the qualified
			 professional may be provided in an ISP meeting, a case staffing with the
			 professional and other appropriate child and family planning team members in
			 attendance, or it may be provided to the child and family planning team in
			 writing.
(5) If a service provider
			 recommends inpatient services and the ISP team is not in agreement, a second
			 opinion may be sought. If deemed necessary, the second opinion shall be
			 provided by a qualified professional
not on staff
at
			 the hospital where services will be sought. The child welfare staff are
			 responsible for contacting that professional to obtain confirmation that
			 inpatient services are necessary.
(6) State DHR Consultation And Approval -
			 Inpatient psychiatric services require State Office approval prior to the
			 child's admission. The SDHR consultant having responsibility for providing
			 consultation and approval for child welfare services shall be contacted during
			 the assessment process to assist the ISP team in determining both the need for,
			 and appropriateness of, inpatient services. When a qualified professional has
			 confirmed the need for inpatient services, the consultant shall be contacted
			 for placement approval. If it is necessary to hospitalize a child for inpatient
			 psychiatric services on the weekend or after office hours, the supervisor must
			 notify the SDHR consultant of the child's hospitalization on the next working
			 day.
(a) Extensions - When inpatient services
			 are needed beyond 14 days, extensions are considered on a case-by-case basis.
			 Information required for extensions includes child's current status; a
			 description of the progress made during hospitalization; barriers which are
			 impeding progress toward discharge; supportive services offered and delivered
			 to address the barriers; a description of efforts made to develop supportive
			 services which will facilitate the child's safe placement in a less restrictive
			 setting; and documentation supporting the need for an extension (i.e., treating
			 physician or therapist's statement), estimated length of the extension, and if
			 a second (2nd) opinion is considered necessary. Prior approvals for extensions
			 also require the SDHR consultant's approval.
Author:
Jerome Webb