The Indiana Resource Center for Autism (IRCA) staff always believe serving children/students in the least restrictive environment in their school and home setting is the most appropriate and beneficial. However, at times, IRCA staff receive phone calls from desperate family members or professionals looking for emergency placement for students/children whose behavior have put themselves or others in danger. Here are some resources to consider when pursuing a more restrictive placement for your son/daughter or a student.
To Get Started
Before calling an alternative placement, gather information that will help build a cohesive profile of the student. The potential placement will ask about:
1. Student’s Disability: Share if the student has a specific syndrome.
2. Intellectual disability/IQ (72 and above or below). IQ matters because programs have specific licensing/criteria related to intellectual disability.
3. Co-occurring psychiatric diagnoses or symptomology.
4. Intensity of the student’s behavior. Describe the student’s behavior of concern and intensity. Having documentation/data confirming these behaviors is important.
5. Age of student; 18 being an adult.
6. Know all previous community services wrapped around the student and the family.
7. Know the payer source: Will placement occur via the school corporation through excess cost dollars, by parents seeking placement through insurance, via Medicaid funding, or through the Department of Child Services.
• Every place accepts different funds and/or has different options depending on the funding source. Will have to ask each individual facility.
• Know if the student has a BDDS Medicaid waiver or other financial support.
Connect with County Resources
Exhaust all services within the community first. Many counties have System of Care and all counties have access to Community Mental Health Centers (CMHCs).
• Family and Social Service Administration (FSSA) maintains information about Systems of Care: https://www.in.gov/fssa/dmha/youthservices/.
• Division of Mental Health and Addictions (DMHA) maintains a list of providers for children: https://www.in.gov/fssa/dmha/apply-for-services/mental-health- services/providers-for-children/. Some of these agencies do not provide services to those who are diagnosed with an intellectual disability or ASD and mental health.
Residential Placement Options
An excellent resource for options for day treatment, acute care, and/or residential placement is through Indiana Association of Resources and Child Advocacy (IARCA) https://www.iarca.org/. On the website is a Resource Directory of Services for Children and Families, https://www.iarca.org/uploads/IARCA_Member_Resource_Directory_October_2021.pdf (updated October 2021).
Other resources include:
• List of Licensed Private Secure Facilities (State regulations differ from state to state). The list for Indiana was updated in 2015, https://www.in.gov/dcs/files/LicensedPrivateSecureFacilities.pdf. Information includes the name, address, and contact information for facility by county; plus, gender and age of students accepted and total number of beds. Calling each place is the only way to gather information about vacancies.
• If the student is sent to their local Emergency Room (ER) during a crisis:
o The hospital may help the student be placed for a short-term stay.
o If placement in a facility is deemed necessary and one is available, often
the facility will pick up the student from the ER. This helps families who do not have resources for transportation.
• A student/child can be placed in a residential placement for 30 days for a Diagnostic and Evaluation (D&E). This option can be used to review and adjust medication, and to develop behavioral approaches that can be transferred to the community/home/school. Having accurate information about the student’s diagnosis and medication/medical history is critical. This option is used if the student has been in and out of programming, in foster homes, in living arrangements other than with immediate family members, or is experiencing drastic changes due to extenuating circumstances.
• The NeuroDiagnostic Institute (NDI) on the campus of Community East Hospital in Indianapolis has a short-term specialized autism treatment program https://www.in.gov/fssa/dmha/state-psychiatric-hospitals/neurodiagnostic-institute/.
The program is:
o 4–6-week program that is run by DAMAR.
o Referral criteria: ages 12-17.5, IQ 45-90, willingness to have family involvement in treatment (home to discharge for parent training), resident of Indiana, current or suspected diagnosis of ASD as primary disability.
o Need a referral from the child’s psychiatrist with a reason for inpatient psychiatric treatment (letter and application) sent to email@example.com.
Highest Level of Care
When behaviors become extreme and all other options have been unsuccessful, the most restrictive options may be pursued. These should only be considered in extreme cases. Community Mental Health Centers (CMHC) act as a “gatekeeper” by facilitating an individual’s transition into the hospital, and from the hospital back to the community or other appropriate setting. The CMHC decides if the student needs a certain level of care. The referral is then sent to Department of Mental Health and Addiction (DMHA) for review before a placement would occur. The gatekeeper from Wabash Valley Alliance in Lafayette, Candice Tetzloss (765-490-0935) is a helpful resource for everyone. She will answer your questions and share facts to guide you anywhere in the state.
State Psychiatric Hospital Placement: The Division of Mental Health and Addiction: Indiana Family and Social Service Administration maintains information (https://www.in.gov/fssa/dmha/4325.htm) and a listing of State Psychiatric Hospitals and Community Mental Health Centers by counties: https://www.in.gov/fssa/dmha/files/DMHA_SOFs_and_CMHCs.pdf.
• Admission for individuals to be admitted to a state hospital only occurs after a screening by a Community Mental Health Center (CMHC) responsible for providing case management to the individual in both the hospital and community. Click on this link to find the Community Mental Health provider in your area: https://www.in.gov/fssa/dmha/files/CMHC_Outpatient_Mental_Health_Service_Locations.pdf.
• In Indiana, there are two options for State Psychiatric hospitals for students/children https://www.in.gov/fssa/dmha/state-psychiatric-hospitals/. These options are:
o Evansville Psychiatric Children’s Center (https://www.in.gov/fssa/dmha/state- psychiatric-hospitals/evansville-psychiatric-childrens-center/) is for students/children ages 2-13. Must be extreme cases (e.g., multiple residential placements, multiple DCS incidents, cannot be a case where residential was successful but parents didn’t follow through on recommendations, multiple foster homes, been in jail).
o NeuroDiagnostic Institute and Advanced Treatment Center (NDI) on the campus of Community East Hospital in Indianapolis. https://www.in.gov/fssa/dmha/state-psychiatric-hospitals/neurodiagnostic-institute/. Only takes students/children ages 12 and older, with an IQ above 70 and must have a psychiatric diagnosis.
Pratt, C. (2022). Guide for looking for residential, day school, or emergency placement. Retrieved from https://www.iidc.indiana.edu/irca/articles/alternative-placements.