Mental Retardation Screening Form Instructions

Rational:

    AMHD is required to:

    ; Screen

    ; Track

    ; Report

    Our sub-population of co-occuring mental illness and mental retardation.

The importance of is for the following reasons:

    ; Improved treatment for the special needs of this sub-population

    ; Planning (examples: contracting, training, fiscal, stragetic plans)

    ; Budgeting

    ; Inter-Divisional Collaboration (AMHD, DDD, DHS)

    ; Compliance with the court ordered Plan for Community Services

    ; Gaining access to appropriate services and resources

    Definition of Mental Retardation: IQ score of 70 or below, verified by psychological testing, documented before age 18 (paraphrased from the DSM IV TR).

    To accomplish the task of screening, tracking and reporting the Mental Retardation Screening Form has been developed. These are a few points regarding the use/administration of the form:

    ; Implementation for the MR Screening form will start no later than Jan. 1, 2005.

    ; The form is to be completed at admission or 6 month treatment review.

    ; Once completed, it need not be repeated unless information is later discovered which will

    change the outcome of this tool. (Example: The consumer was suspected to qualify for

    MR but there was no supporting documentation. A year later, the family located

    psychological testing done while the consumer was under 18 substantiating the

    diagnoisis. The form can then be re-done and the change is status should be noted on

    the Utilization Authorization form)

    ; Discovery/Detection of MR should result in collaboration with the Developmental

    Disabilities Division for coordination of care or linkage for intake/assessment with DDD.

    ; A lack of information to accurately answer the questions should be followed by planned

    action to ascertain the answers to Questions 1-4. (Examples of appropriate actions

    would be, 1) get release to speak with significant others to get information, 2) obtain a

    release to speak with Developmental Disabilities Division to verify service connection,

    etc.)

    ; If subsequent information gathering changes the outcome of the screening form then new

    status should be reported on the U.M. form.

For further information/feedback contact Eva Kishimoto

    ekkishim@amhd.health.state.hi.us

For further information/feedback contact Eva Kishimoto

ekkishim@amhd.health.state.hi.us