Children's Review Program
A program of bluegrass.org
Funded in Whole from Federal and Cabinet for Health and Family Services Funds

Utilization Review

Purpose

The purpose of a Utilization Review (UR) is to insure that children's current needs are accurately reflected in their assigned levels of care (LOCs) and to periodically review children's progress in care. For children in a PCC placement, it is the PCC provider's responsibility to send in the necessary reports for the LOC assignment in order to continue the appropriate LOC funding for the placement.

Schedule

  • Foster care placements require that the LOC be reviewed every six months. The Foster Care Application for Level of Care Payment (ALP) must be submitted for each review.
  • PCC residential placements require that the LOC be reviewed after the first six months and every three months thereafter. The Residential Application for Level of Care Payment (ALP) must be submitted every three months.
  • ALPs must be received by CRP on or before the UR due date. If the UR due date falls on a weekend or holiday and the ALP is mailed, the ALP, including the CBCL if due, must be received no later than the last business day prior to the weekend or holiday in order to be considered "on time". UR dates are provided on-line through the Youth Information List and also on the Monthly Census Report. For information on accessing this information on line or to register as a user, contact Tye Reece by e-mail or by phone (859-455-7452 ext. 228).
  • For PCC funding, the effective dates for LOCs that have been changed as a result of a UR vary according to 922 KAR 1:360 and are summarized in PCC Payment Dates.

Protocol

  • Foster Care (DCBS & PCC) placements will submit:
    • The Application for LOC Payment (ALP) (CRP-7).
    • Additional documentation as necessary to provide an accurate assessment of children's current needs.
    • CBCL for children with IQ of 70 or above or the Reiss (every 12 months) for children with an IQ below 70.
  • PCC Residential placements will submit:
    • The Application for LOC Payment (ALP) (CRP-7)
    • Additional documentation as necessary to provide an accurate assessment of children's current needs.
    • CBCL for children with IQ of 70 or above or the Reiss (every 12 months) for children with an IQ below 70.

Results of URs are communicated by fax to the DCBS worker and/or PCC on the "Notice of Level Assignment" form.

Please remember that each ALP must include information about the child that is new and different from the previous ALP.

  • If CRP receives an ALP that is a duplicate or a near duplicate of an ALP previously received, CRP will assign a level but will notify the agency that the information received had limited new information and if another similar ALP is received in the future, it will not be accepted.
  • If a second similar ALP is received, CRP will not accept the ALP and will notify the sender and a designated supervisor within the agency. The ALP will not count as being received until an updated ALP with new information has been submitted. If a different level is assigned, this may impact the level effective date.

On-Line Training for Completing the Application for LOC Payment (ALP) (CRP-7)

A 1.25 credit hour on-line training for how to complete an Application for Level of Care Payment (ALP) form is now available through Eastern Kentucky University’s TRIS Web-based Training site.