We recently received an updated set of criteria for IC3 (Intensive Customized Care Coordination) from DBHDD (Department of Behavioral Health and Developmental Disabilities) , which required us to make some changes to the Pre-Referral Questionnaire for ages 6-21. This new set of criteria not only decreased the complexity of qualification, but it also increased the number of ways a child/youth may qualify for CME services.
It is important that referring parties use the newest form, which can be found at https://goo.gl/VXiLQ9, to prevent youth who do meet criteria from being screened out prematurely and decrease chances a referral will be delayed/denied due to being incomplete. If you have this form saved as a favorite in your browser, please delete the old form and save the new one.