UM Guidelines

Clinical Indications for Admission to Residential Care

• Admission to Respite Care for Children and Adolescents[A](1)(2) is judged appropriate as indicated by ALL of the following:
  • Individual is between the ages of 5-18, however special consideration will be given for children under age 5.
  • Patient must meet ALL of the following:
    • Child/youth demonstrates an incapacitating or debilitating disturbance in mood, thought and/or behavior that interferes with functioning in any domain to the extent that immediate stabilization is required
    • Child/youth demonstrates significant risk of danger to self or others (but is not imminently dangerous)
    • Child/youth has no available supports to provide continuous monitoring
    • Symptoms can be expected to respond to intensive, short-term structured intervention such that all safety issues will be resolved
  • Absence of ALL the following exclusions:
    • Manifests behavioral and/or psychiatric symptoms that require a more intensive level of care
    • Child/youth can be safely maintained and effectively treated at a less intensive level of care
    • The symptoms are a result of a medical condition that warrants a medical setting for treatment
    • Child/youth and /or parent/guardian/custodian do not voluntarily consent to treatment and there is no court order requiring such treatment
    • Child/youth has a sole presenting diagnosis of Substance Abuse

References

1. Edgar, M.Uhl, M. National Respite Guidelines: Guiding principles for respite models and services. ARCH National Resource Center 2011.
2. Dougherty, S. Respite for caregivers of children with serious emotional disturbance. The Technical Assistance Center for Life Respite June 2012; fact sheet number 34:1-16. ARCH National Respite Network and Resource Center. retrieved from http://archrespite.org/productspublications/arch-fact-sheets#SEDChildren

Footnotes

[A] Program Definition: This level of care is a short-term crisis stabilization response that provides stabilization and safety in a licensed facility or licensed home for children/youth for a three day initial authorization and up to five days total. Respite Care provides the child/youth with an opportunity to stabilize problematic and escalating behaviors. The respite enables the child/youth and family to work intensely with the community providers so that the child/youth and family will be unified within three to five calendar days. The parent/guardian/custodian must agree to take the child/youth back when the crisis behavior is stabilized. If the child/youth is unable to return home within five days, the child/youth will be referred to a clinically-determined level of care or to an alternative living situation. This intervention provides a safe, controlled environment with a high degree of supervision and structure in which the child/youth receives therapeutic intervention and specialized programming. The purpose is to stabilize the child/youth within the five-day period and prepare him/her for reintegration back into the living environment from which he/she came.