Starting the process of looking into residential treatment can be overwhelming. We sat down with Nexus-Gerard's Admissions Supervisor Loren Nerison and discussed some common questions families have when starting the residential treatment process.
How does a family reach out to a treatment site? Do they need a referral?
Parents can absolutely initiate the referral process or reach out with any questions. The most important part of the referral process is gathering the necessary documentation. It is not important who sends the documentation, whether it is a referring agent or the parent.
Residential treatment sites may have differing needs in terms of the proper documentation. At Nexus-Gerard, a youth needs the following:
- Diagnostic Assessment
- Psychological Evaluation
- Psychiatric Evaluation
- Developmental/Social History
- Discharge summaries from previous placements
- Progress reports from current placements
- County placement agreement (if applicable)
- CASII
- Individual Educational Plan (IEP)
- Most recent school evaluations
Does insurance always cover treatment? If not, what options does a family have?
In many instances, insurance does cover residential treatment, but not in all cases. It depends on the insurance company and, more specifically, the individual plan. Our admissions department will take care of checking into benefits and the authorization process. Nexus-Gerard cannot bill Medical Assistance policies for residential treatment. However, Medical Assistance benefits can come into play if there is county involvement.
What is a standard wait time from first contact to the child moving to a site?
There isn’t a standard wait time, but depends on our wait list and the needs of each case. Over the past couple of years, two months has been a close to average wait time.
What criteria does a child have to meet to be eligible for treatment?
The admission criteria is a complicated question to answer, other than to say that there needs to be documentation in the form of a current (past 6 months) Diagnostic Assessment that supports the need for residential treatment. Some of the things that would automatically rule someone out for Nexus-Gerard would be having an IQ under 70, having a primary diagnosis of chemical dependency, or having primary issues that require sex-specific treatment. There are many other factors that go into determining whether or not a referral is a fit for the program.
The most important thing to know is that anyone, in any capacity, should not hesitate to call the admissions department with questions. It can seem very intimidating to start a referral, but we are happy to answer all questions and simplify the process in a step-by-step manner.
Contact any Nexus agency location for more information on our services. Visit our Residential Treatment services page to find an agency closest to you.
