Youth must meet all five of the criteria which include:
1. Youth has a covered SED DSM-IV-TR diagnosis as the primary diagnosis.
2. As a result of the youth’s SED diagnosis, and for a period of at least six months, or for a predictable period over six months the youth consistently and persistently demonstrates behavioral abnormality in two or more following spheres, to a significant degree, well outside normative developmental expectations, that cannot be attributed to intellectual, sensory, or health factors:
For Youth 6 through 17th Year or 19th Year if Still in Secondary School
a) Has failed to establish or maintain developmentally and culturally appropriate relationships with adult care givers or authority figures; b) Has failed to demonstrate or maintain developmentally and culturally appropriate peer relationships; c) Has failed to demonstrate a developmentally appropriate range and expression of emotion or mood; d) Has displayed disruptive behavior sufficient to lead to isolation in or from school, home, therapeutic, or recreation settings; e) Has displayed behavior that is seriously detrimental to the youth’s growth, development, safety, or welfare, or to the safety or welfare of others; or f) Has displayed behavior resulting in substantial documented disruption to the family including, but not limited to, adverse impact on the ability of family members to secure or maintain gainful employment.
For Youth Under Age 6
SED with respect to a youth under six years of age means the youth exhibits a severe behavioral abnormality that cannot be attributed to intellectual, sensory, or health factors and that results in substantial impairment in functioning for a period of at least six months and obviously predictable to continue for a period of at least six months, as manifested by one or more of the following:
a) Atypical, disruptive, or dangerous behavior which is aggressive or self-injurious; b) Atypical emotional responses which interfere with the child’s functioning, such as an inability to communicate emotional needs and to tolerate normal frustrations; c) Atypical thinking patterns which, considering age and developmental expectations, are bizarre, violent, or hypersexual; d) Lack of positive interests in adults and peers or a failure to initiate or respond to most social interaction; e) Indiscriminate sociability (e.g., excessive familiarity with strangers) that results in a risk of personal safety of the child; or f) Inappropriate and extreme fearfulness or other distress which does not respond to comfort by care givers.
3. Outpatient interventions have been attempted and have been documented to be insufficient to meet the youth’s needs and safety concerns;
4. There is a comprehensive and viable discharge plan with an estimated length of stay.
5. Additional criteria: youth must meet at least (3) of the following (4) criteria:
a) Symptoms of the youth’s emotional disturbance or mental illness are of a severe or persistent nature requiring more intensive treatment and clinical supervision than can be provided by outpatient mental health service; b) The youth exhibits behaviors related to the covered diagnosis that result in significant risk for psychiatric hospitalization or placement in a more restrictive environment if therapeutic family care is not provided, or the youth is currently being treated or maintained in a more restrictive environment and requires a structured treatment environment in order to be successfully treated in a less restrictive setting; c) As a result of the serious emotional disturbance, the youth exhibits an inability to perform daily living activities in a developmentally appropriate manner; d) The youth is transitioning from an out of home placement to a community setting and there is clinical evidence that less-intensive treatment will not be sufficient to prevent clinical deterioration, to stabilize the disorder, to support effective rehabilitation or to avert the need to initiate or continue a more intensive level of care due to current risk to the youth or others.
Additionally, child is under the custody of the Child and Family Services, Tribal Social Services, or may be a private placement by a family but funding must be available for the child’s care.
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