PRTF APPLICATION AND ADMISSION ASSESSMENT FORM
• Admissions Checklist
New Way of Southwest Louisiana, LLC PRTF is invested in providing the highest quality of
services to our clients. Our residential program includes the following services: New Way shall not refuse admission of any client on the grounds of race, nationality, origin, ethnicity or disability. New Way PRTF shall only accept residents for placement from parent(s), legal
guardian(s), custodial agency, or a court of competent jurisdiction. Residents, parents, legal
guardian, and others, as appropriate will be given reasonable opportunity to participate in the admission panel and decision. When appropriate, potential residents/families may have a pre-admission on-site visit to New Way PRTF. Potential residents will note that screening tools used are uniformly administered and staff are trained on tools prior to administration. Proper consent will be obtained before admission. New Way will minimize time between first contract to screening within 24 hours and timing between screening to admission or referrals (72 hours) when possible, time establishes by New Way.
Services Provided in the Scope of Treatment:
New Way of Southwest Louisiana’s treatment staff is committed to the holistic transformation of each resident. Our staff will use a volume of techniques to cultivate and rebuild the well-being of each resident. We will use a variety of techniques including but not limited to pastoral counseling, cognitive behavioral therapy, family systems therapy, medication management, medical care, and psychosocial skills training. Specific means of engaging in such interventions may possibly include individual, group, and family counseling and psychosocial skills training, occupational therapy, recreational therapy, case management, anger management, grief therapy, preparation for educational and job opportunities, and assistance in activities of daily living (ADL’s). New Way will only admit those residents whose needs, pursuant to the certification of need and comprehensive plan of care can be fully meet by New Way PRTF. Resources include but are not limited to: adequate grounds and facility books, food, washing areas, medical equipment, and office equipment. Any urgent or critical needs of the potential resident will be documented. A potential resident who has or whose parent/guardian has uncertainties when appropriate may have a pre-admission on-site visit to the New Way PRTF along with his parent/guardian. Technicians will assist in tour.
Checklist
PRTF Application
Psychological Evaluation
Child’s Immunization Record
Heal Records
Clinical Assessments/Hospital Records
Educational Records (IEP or 504 Plan is applicable), Drop Form
Discharge Summaries from previous treatment programs
Insurance Card
Birth Certificate
Social Security Card
Please bring with you:
• Current medication
• School uniforms
• 3 changes of clothing
Admission Criteria
To be admitted into New Way of Southwest Louisiana PRTF, the individual shall have received certification of need from the department or the department’s designee that recommends admission into the PRTF. The certification shall specify that:
1. Ambulatory care resources available in the community do not meet the treatment needs of the recipient
2. Proper treatment of the recipient’s psychiatric condition requires services on an inpatient basis under the direction of a physician.
3. The services can reasonable be expected to improve the resident’s condition or prevent further regression so that the services will no longer be needed.
Exclusionary Criteria include but may not be limited to:
• Severe psychiatric disorders or psychosis requiring hospitalization,
• Actively suicidal or homicidal,
• Chemical dependency requiring detoxification or substance abuse treatment,
• Physical or medical conditions which require skilled nursing services,
• Significant impairments resulting from organic brain disorders or traumatic brain injury which prohibit full participation in a residential program,
• Chronic violence (including sexually aggressive behaviors) which are incompatible with a group living environment,
• Intellectual challenges as indicated by psychological testing and/or clinical judgement.
Referrals
Applications for New Way of Southwest Louisiana PRTF are received from family members, clergy, medical personnel and facilities, law enforcement agencies, the juvenile justice system, insurance companies, managed care organization, wraparound agencies, the Louisiana Office or Juvenile Justice, and the Louisiana Department of Children and Family Services.
If prior authorization for placement into care is required by a child’s insurance or managed care company, the corporate office of New Way will work with the third-party payer to assist with authorization processes.
If screening or authorization is not performed or required by the referring agency or payer, admissions applications for residential services are screened in an initial telephone review or personnel visit. An application packer is sent to the inquirer, which must be completed before placement. This includes the application for admission, a release of information form, and a financial statement. In addition, before placement occurs, the following must also be made available to the corporate office manager of designee; a social summary, school transcripts and records, psychological and psychiatric information, proof of custody, copy of birth certificates, and medical and immunization records.