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Click ‘Get Form’ to open the iicaps referral form in the editor.
Begin by entering the 'Date of Referral' at the top of the form. This is crucial for tracking purposes.
Fill in the 'Child's Name', 'D.O.B.', and 'Age'. Ensure accuracy as this information is vital for identification.
Provide details regarding insurance, including 'Insurance #' and 'Referral Source'. This helps streamline processing.
Complete sections on family information, including names, ages, and relationships. Highlight any special education needs if applicable.
In the 'Reason for Referral' section, elaborate on behaviors of concern and domains affecting the child. Use clear language to describe specific issues.
Lastly, review all entries for completeness and accuracy before submitting. Utilize our platform’s features to save your progress or share with others as needed.
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IICAPS Program Description: IICAPS provides home-based treatment to children, youth and families in their homes and communities. Services are provided by a clinical team which includes a Masters-level clinician and a Bachelors-level mental health counselor.
What is icaps for kids?
Intensive In-Home Child and Adolescent Psychiatric Services (IICAPS) Our IICAPS program is designed to keep your child (aged 3-18) who is at risk of psychiatric hospitalization or who may need additional clinical support, in the community.
What is the voluntary remediation program in CT?
This Voluntary Remediation Program (VRP) is an elective program in which an Environmental Condition Assessment Form (ECAF) and fee are filed with DEEP so that any party can expedite the investigation and remediation of any contaminated property.
What is the basic needs program in CT?
The Basic Needs Program (BNP) is a program administered by the CT Department of Mental Health and Addiction Services designed to provide assistance with basic daily life needs if you are eligible. This program is for SAGA/GA clients in mental health or addiction treatment who are not receiving cash.
What is a patient referral form?
A patient referral form is a document that is used by medical professionals in order to refer a patient to another doctor. This document can be used for any type of medical practitioner to refer patients to another specialist or doctor. Just customize the questions to match how you want to manage patient referrals.
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What is IICAPSIICAPS CTIICAPS middletown CTIICAPS Wheeler ClinicIICAPS Bridgeport CTIICAPS YaleCHR IICAPSIICAPS Hartford CT
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Transitional Medical Assistance (TMA) is a program offered through the Connecticut Department of Social Services (DSS). This program provides 12 months of extended medical benefits to certain individuals who lost their HUSKY A coverage due to earnings.
Related links
IICAPS Quality Assurance/Quality Improvement Group
This program primarily serves children experiencing severe emotional disturbance, offering an alternative to psychiatric hospitalization for young people withRead more
Referrals to IICAPS are typically made by the DCF Area Offices, System-of-Care Collaboratives, inpatient psychiatric hospitals, and community providers. IICAPSRead more
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