UM Guidelines

Applies to BlueCare Only.

Admission Guidelines

• Admission to Specialized Unit for Children and Adolescents with Intellectual and Developmental Disabilities as indicated by ALL of the following:
  • Age 10 to 17
  • Individual must have a confirmed diagnosis of intellectual and developmental disability
  • Meets criteria for non-specialized inpatient mental health level of care
  • Situation and expectations are appropriate for a Child or Adolescent: Inpatient Care Specialized as indicated by BOTH of the following:
    • Crisis assessment required with recommendation of Specialized Unit for Children and Adolescents with Intellectual and Developmental Disabilities based on acuity
    • There is a history of refusal for inpatient providers for acute referrals, or clinical presentation is appropriate and/or has a history of admissions to other specialized units
  • Comorbid/developmental condition including 1 or more of the following:
    • Complex comorbid medical issues requiring skilled medical care (i.e. diabetes, seizure d/o, etc.)
    • Limited in activities of daily living requiring direct physical assistance (feeding, toileting, showering, etc.) BEYOND verbal prompting hygiene tasks
    • Non-verbal or speech and language deficits that impact behavioral presentation AND Complexity of the patient requiring special subsets of treatment as indicated by 1 or more of the following:
  • Severe to extreme self-injury resulting in the need for medical attention (i.e. opening wounds, head banging resulting in contusions, ingesting objects/attempt to ingest foreign objects, etc.) OR
  • Physical aggression resulting in injury to others (resulting in needing medical attention beyond first aid), OR severe aggression /violence with or without an attempt to seriously harm another individual (i.e. physically attacking peers, staff, other individuals, hitting, kicking, biting, strangling) OR
  • Extreme property destruction/vandalism that could result in high risk of harm to self or others (i.e. breaking windows, throwing glass, throwing broken objects) OR
  • Problematic sexual behaviors (i.e. disrobing, excessive masturbation in public area, inappropriate touching of others)