Developmental Services - Case Management Manual

Referral and Intake

I.   Introduction

Intake is a process by which a person with mental retardation/autism/or pervasive developmental disorder and Developmental Services establish a formal relationship.

People referred to the Department are considered to be in intake status until eligibility is determined. Eligibility is defined in the Developmental Services policy entitled Eligibility for Developmental Services. (34B MRSA Section 5465) People are eligible for Developmental Services for adults at the age of 18.

Foreign language and/or sign language interpreters must be utilized whenever there is a communication barrier to comply with Federal and State Laws concerning equal access to service.

II.   Referral

A. The referral/intake process begins when a request for Developmental Services is made by a person with mental retardation/autism or PDD or by any person or agency acting on behalf of the person who is not currently or has not in the past received services from Developmental Services.  The consumer and/or guardian must consent to the referral unless it is an Adult Protective Referral. This consent can be given by the person or guardian over the phone. Persons acting on behalf of the individual must provide a sign release prior to information being accepted by DHHS.

B. Each district office has established a procedure whereby a referral can be accepted at any time so that a person making a referral is not required to re-contact the district office. The staff person accepting the initial referral is responsible for completing the referral information used by a district office.  While completing this form, the staff person should attempt to determine the applicant's circumstances and need for services, how the applicant may be contacted, the possible need for emergency intervention, as well as the identifying information indicated on the form. The staff person accepting the referral should be sufficiently aware of Developmental Services to answer general questions regarding services.

III.  Intake

  1. The referral information is forwarded to the district supervisor who assigns responsibility for completion of the intake process to the appropriate staff person.  This person will be referred to as the intake worker.   Eligibility may be determined at any point during the referral/intake process once enough information is available to ascertain the eligibility of the individual.
  2. The intake worker assigned will proceed promptly with all prescribed intake activities. The initial contact will take place within 10 working days of the initial referral. For Adult Protective referrals, action should be taken as soon as possible. Specific actions to be taken in this situation are outlined in the cooperative agreement between Developmental Services and Adult Protective Services. Copies of this are available in each district office.

     The intake worker shall contact the applicant, or other informant, in order to obtain Permission for Service. The Permission for Service form establishes the basis for an ongoing relationship between the applicant and Developmental Services. The form permits Developmental Services to act on behalf of the person with mental retardation.

    The competent adult with mental retardation/ autism/PDD should sign the permission for himself or herself. The term "competence" used here implies the ability of the person to understand the nature of the services to be provided, and the appropriateness of such services for himself or herself. In some cases, incompetence may have already been determined by the court and therefore, the person will have a court appointed guardian.  The working assumption is that if legal incompetence has not been established by the court the applicant is, therefore, competent. Competence may later be clarified by court action. A competent person with intellectual disabilities or his legal guardian may decline Developmental Services.

    The date of the signed permission shall be considered the date that the intake process has begun. At this time the intake worker will determine whether a visit is necessary at this time or at a later date. If the individual is already receiving case management from Children's Services, as an example, it may not be necessary to do a visit if all relevant information is available for intake.
  3. f available information from the source of referral indicates that pre-arrangement of the visit is not advisable, this fact should be noted and documented. The goals of a visit are: the functional assessment of the applicant, the compilation of historical and biographical information regarding the applicant, and the completion of various forms related to the intake.

    The selection of the site of the visit should be in an environment familiar and comfortable for the applicant in order to gain the greatest insight regarding the applicant's behavior, needs, and abilities; the need for emergency intervention; or the availability of an informant. Based upon what is known about the applicant and his or her circumstances, consideration of the above factors may indicate that one setting is more expedient, or that one setting may yield the most relevant information.
  4. It is not intended that the intake worker will make a diagnosis of mental retardation/autism or pervasive developmental disabilities (PDD). The primary purpose of the intake is to gather information in order to determine eligibility. In addition, information is collected to assist in preliminary service planning. To these ends, the intake worker shall:
    1. Collect pertinent demographic data
    2. Determine the nature and type of services already provided to the person
    3. Identify service needs
    4. Collect information regarding developmental history and current living arrangements
    5. Determine what information will be needed to establish eligibility
    6. Provide the referral source an opportunity to receive an explanation of  Developmental Services
    7. Provide services or referral for singular immediate needs particularly regarding health and safety. 
    8. Begin to gather information for a service plan.

IV.  Intake Documentation

  1. The intake worker is responsible for the completion of various required documents.

    The forms to be completed include:
    1. The information sheet on EIS
    2. The Permission for Service;
    3. The Release of Information, (to);
    4. The Release of Information, (from), as required; and
    5. Intake assessment.
    In addition, the intake worker will arrange for a psychological evaluation unless current copies can be obtained from another source.
  2. Information Sheet

    The information sheet (EIS) is completed at the intake. The form serves as a source of information regarding the applicant. Upon acceptance of the applicant for services, the form will become the face sheet for the case record.
  3. Release of Information (to)

    This form gives permission for Developmental Services to release specific information to a designated person or agency. A separate release is required each time information is disclosed. The original signed release stays in the case record.

    Only records or information which are generated by  Developmental Services and which will not be harmful to the consumer may be authorized for release. All such information shall be stamped “Privileged and Confidential Information, Not to be Used Against Client’s Best Interest”.
  5. Release of Information (from)

    This form authorizes the release of information generated by the primary source to Developmental Services. The release is specific to the agency noted in the release and the information requested. A separate release should be completed for each agency from which information will be requested. It should be understood that the release form authorizes the one-time release of information from the primary source, and that the authorization is specific to the information specified on the form. When requesting additional information from a particular agency, a new Release of Information form should be completed. The intake worker should insure that the "to" section on the release is filled in prior to asking an applicant or legal guardian to sign.  The original signed form will be sent to the agency from which information is requested.

  6. Intake Assessment

    This document provides the structure to the assessment phase of the intake process.  It provides a basis for a psychosocial evaluation of the prospective person.

V.     Establishing the Need for Evaluation

  1. An updated psychological evaluation may be requested at the discretion of the District Supervisor in order to determine a diagnosis of mental retardation/autism. This may be particularly necessary in the referral of children transitioning to adult services considering the potential for growth and achievement. A licensed Ph.D., psychologist or a licensed psychological examiner, must conduct the evaluation. Additional professional assessments may include physical examination, psychiatric evaluation, physical therapy evaluation, occupational therapy evaluation, speech and hearing evaluation, etc.  Foreign language and/or sign language interpreters must be utilized whenever there is a communication barrier to comply with Federal and State Laws concerning equal access to service.

  3. The intake worker, through observation and interview, may determine areas where further evaluation may be useful. Certain professional evaluations may be indicated solely on the basis of the timeliness of the available information. Other needs for evaluation may become obvious during the intake process. Evaluations requested that are not directly related to determination of eligibility should not delay a decision being made within the accepted time frame.
  4. The intake process should be completed within 90 days. The end date for completion is date of a letter of eligibility. If the process can not be completed within 60 days a letter will be provided to the applicant explaining that eligibility has not been determined and providing specific information as to why with a projected completion date. The Disability Rights Center will be notified. If at the projected date the eligibility cannot be determined the applicant will be contacted again in writing explaining the reason for a decision not being made with another projected date. The Disability Rights Center will again be notified.

VI.    Disposition of a Referral

  1. Once the intake worker has completed the intake assessment and other necessary forms, and has obtained a current psychological evaluation, the intake worker will meet with the district supervisor to discuss all of the relevant information obtained by the intake process.
  2. Denial of Services
    1. If the District Supervisor determines that the applicant does not meet the established criteria, (See Eligibility for Developmental Services ) in Case Management Manual) the person will be denied Developmental Services. To the greatest extent possible, the intake worker and the District Supervisor will attempt to suggest to the applicant or to the referral source, alternative services.
    2. The applicant and/or the individual acting on behalf of the applicant shall be informed of the denial in writing and when necessary via other appropriate means, and given notice of their right to appeal that decision and of the availability of the Disability Rights Center to provide assistance. (See Eligibility for Developmental Services in Case Management Manual)
  3. Acceptance for Services
    1. If the District Supervisor determines that the applicant meets the eligibility criteria, he or she will be accepted for Developmental Services. The District Supervisor and intake worker will determine the case management status   based on the criteria in the case status procedures.
      (See case management status procedures active, inactive, closed in case management manual.) The person will be informed in writing of their eligibility and will be provided with:
      1. A statement of rights, information about the grievance process and the availability of the Disability Rights Center;
      2. Information about the case status to which the person has been assigned;
      3. If assigned to Active status, the name of the CM and contact information. For all other statuses, the name and title of a person to contact.
    2. A psychosocial will be written by the intake worker for transfer to case management or to the person covering the inactive case status.
    3. The intake worker for transfer to case management or inactive case status will write an initial service plan. (If an applicant had not met with a representative of the department until acceptance, a meeting will occur at this time to review needs and develop a service plan.)