Description of the Intense Plus Service Level
Definition of Intense Plus:
Intense Plus Services consist of a high degree of structure to support the child in his or her environment while intervening as necessary to protect the child. The caregivers have specialized training specific to the characteristics of the child, and the therapists on staff have professional licensure or graduate level education to provide therapeutic services and intense therapeutic supports and interventions, including:
- 24-hour supervision to ensure the child’s safety and sense of security, which includes constant one-to-one monitoring during waking hours by an employee who is trained on the child’s therapeutic interventions and is able to provide immediate on site response.
- Participation in individual and/or group therapy sessions that are research-supported, reimbursable by Medicaid, and readily available in the community, including but not limited to specialized therapies such as Eye Movement Desensitization and Reprocessing Therapy, Applied Behavior Analysis (certified); and Treatment for Anorexia/Bulimia/Eating Disorders, and others as appropriate;
- Use therapeutic programs that are documented as either well supported, supported, promising practice or evidence based and are appropriate to the child’s age and development to promote the child’s well-being. Therapy must address trauma and the behaviors resulting in the need for intense plus level of care.
- Contact with siblings, family members, and other persons significant to the child in order to maintain a sense of identity and culture;
- Provision of services to help the child learn or improve skills and functioning for daily living;
- Medical intervention and therapy that is structured daily and professionally designed and supervised to help the child attain functioning more appropriate to the child’s age and development addressing the behaviors resulting in the need for intense plus services;
- Consistent and constant direction, intervention, and structured support to help the child attain stabilization and connect appropriately with the child’s environment.
- A child with intellectual or developmental disabilities will receive professionally directed, designed, and monitored interventions to enhance mobility, communication, sensory, motor, cognitive development, behavioral and self-help skills.
Characteristics of Youth Who Need Intense Plus services:
A child needing intense plus services has severe problems in two or more areas of functioning that present an extreme, imminent and critical danger of harm to self or others. The youth needing intense plus services may include a child whose characteristics include more than one of the following:
- Extreme and reoccurring episodes of physical aggression that causes harm;
- Extreme and reoccurring episodes of sexually aggressive behaviors;
- Assaultive, homicidal, suicidal, recurring major self-injurious actions;
- Chronic runaway behaviors;
- Severely impaired reality testing, communication skills, and cognition;
- A child who abuses alcohol, drugs, or other conscious-altering substances whose characteristics include a primary diagnosis of substance dependency or abuse in addition to being extremely aggressive or self-destructive to the point of causing harm;
- A child who is Lesbian, Bisexual, Gay, Transgendered or Questioning
- A child with eating disorders causing concerns for health and well-being;
- A child with intellectual or developmental disabilities whose characteristics include; impairments so extreme in conceptual, social, and practical adaptive skills that the child’s ability to actively participate in the program is limited and requires constant one-to-one supervision for the safety of self or others; and a consistent inability or unwillingness to cooperate in self-care while requiring, constant one-to-one supervision for the safety of self or others.
- A child who is actively psychotic and has acted out on the psychosis;
- A child who is a survivor of human or sex trafficking;
- A child with chronic criminal behaviors that result in current or recent involvement with the justice system; and/or
- A child who has displayed animal cruelty in the last 90 days.
Intense Plus Requirements:
- Offer placement for individual youth.
- Provision of individual and/or group therapy. The therapies must be research-supported, reimbursable by Medicaid, and readily available in the community, including but not limited to specialized therapies such as Eye Movement Desensitization and Reprocessing Therapy, Applied Behavior Analysis (certified); and Treatment for Anorexia/Bulimia/Eating Disorders, Sex Offender Treatment, and others as appropriate.
- Continued care for a child following psychiatric or medical hospitalization.
- Provision of discharge planning, including recommendations for care and intervention strategies and availability for ongoing phone calls with the caregiver for three months to begin during placement transition. Intense Plus Service Level will be reviewed every 90 days by YFT.
- Initial determination for Intense Plus will be determined by YFT and not through a service level waiver.