PRP Intakes

For CHILDREN/ADOLESCENTS we need to assess for ONE of the following criteria:

Children need to be assessed for an emotional disturbance or a behavioral issue that is affecting their home/school life.

1. A clear, current threat to the youth's ability to be maintained in their customary setting?

2. An emerging risk to the safety of the youth or others?

3. Significant psychological or social impairments causing serious problems with peer relationships and/or family members?

For ADULTS we need to assess for the following criteria:

1. Does the participant have marked inability to establish or maintain competitive employment?

   • Describe the symptoms of this Priority Population diagnosis that affect the participant's functioning*

   • Describe how, specifically, these symptoms impair the participant's functioning.

   • Provide specific concrete examples of THIS participant's impaired function.

2. Does the participant have marked inability to perform instrumental activities of daily living (e.g. shopping, meal preparation, laundry, basic housekeeping, medication management, transportation, and money management)?

   • Describe the symptoms of this Priority Population diagnosis that affect the participant's functioning*

   • Describe how, specifically, these symptoms impair the participant's functioning.

   • Provide specific concrete examples of THIS participant's impaired function.

3. Does participant have deficiencies of concentration/persistence/pace leading to failure to complete tasks?

   • Describe the symptoms of this Priority Population diagnosis that affect the participant's functioning*

   • Describe how, specifically, these symptoms impair the participant's functioning.

   • Provide specific concrete examples of THIS participant's impaired function.

4. Does the participant have marked inability to establish/maintain a personal support system?

   • Describe the symptoms of this Priority Population diagnosis that affect the participant's functioning*

   • Describe how, specifically, these symptoms impair the participant's functioning.

   • Provide specific concrete examples of THIS participant's impaired function.

5. Is the participant unable to perform self-care (hygiene, grooming, nutrition, medical care, safety)?

   • Describe the symptoms of this Priority Population diagnosis that affect the participant's functioning*

   • Describe how, specifically, these symptoms impair the participant's functioning.

   • Provide specific concrete examples of THIS participant's impaired function.

6. Does the participant have marked deficiencies in self-direction, shown by inability to plan, initiate, organize, and carry out goal directed activities?

   • Describe the symptoms of this Priority Population diagnosis that affect the participant's functioning*

   • Describe how, specifically, these symptoms impair the participant's functioning.

   • Provide specific concrete examples of THIS participant's impaired function.

7. Does the participant have marked inability to procure financial assistance to support community living?

   • Describe the symptoms of this Priority Population diagnosis that affect the participant's functioning*

   • Describe how, specifically, these symptoms impair the participant's functioning.

   • Provide specific concrete examples of THIS participant's impaired function.