Purpose: To ensure that CABHS only accepts youth whose behavioral, emotional, psychiatric, medical, and supervision needs can be safely and appropriately managed within our non-locked, community-based residential treatment setting.
CABHS provides 24-hour supervision, therapeutic services, behavioral support, and structured programming. CABHS does not utilize physical restraints, seclusion, or locked confinement.
Youth Who May Not Be Appropriate for Admission
1. Severe Physical Aggression
- Youth with a persistent pattern of serious physical assaults against staff or peers.
- Youth with recent incidents involving weapons or attempts to cause serious bodily harm.
- Youth requiring frequent physical restraints to maintain safety.
2. Chronic AWOL / Elopement Behaviors
- Youth with repeated runaway episodes that create significant safety risks.
- Youth who consistently leave placements without permission and cannot be safely supervised in a non-locked environment.
- Youth with a documented history of dangerous behavior while AWOL.
3. Severe Property Destruction
- Youth with repeated incidents of significant property damage.
- Youth who intentionally destroy windows, doors, vehicles, or other property in ways that endanger others.
- Youth with a history of fire-setting or arson-related behaviors that present an ongoing safety concern.
4. High-Risk Sexual Behaviors
- Youth with recent or ongoing sexually aggressive or coercive behavior toward others.
- Youth requiring specialized supervision or treatment for sexual behaviors beyond CABHS's capabilities.
- Youth who present a substantiated, significant risk of sexual harm to other residents.
5. Acute Suicidal or Self-Harming Behaviors
- Youth experiencing active suicidal intent with a plan requiring immediate psychiatric stabilization.
- Youth with severe, ongoing self-injury requiring continuous one-to-one observation or a higher level of care.
- Youth requiring a secure psychiatric setting for immediate safety.
6. Significant Medical Needs
- Youth with uncontrolled seizures or complex epilepsy requiring emergency medical interventions beyond staff capabilities.
- Youth requiring continuous skilled nursing care or advanced medical monitoring.
- Youth with medically unstable conditions that cannot be safely managed in the residential setting.
7. Intensive Developmental or Functional Support Needs
- Youth requiring extensive assistance with daily living activities beyond available staffing and training.
- Youth requiring specialized communication, behavioral, or developmental services that CABHS cannot provide.
- Youth whose needs require continuous individualized supervision unavailable within the program.
8. Severe Psychiatric Instability
- Youth experiencing acute psychosis or psychiatric symptoms requiring inpatient hospitalization.
- Youth requiring a secure or locked treatment environment.
- Youth whose symptoms cannot be safely managed through CABHS's therapeutic and behavioral interventions.
9. Severe Substance Use Concerns
- Youth requiring medical detoxification.
- Youth with active substance use creating an immediate and significant safety risk.
- Youth requiring specialized inpatient substance use treatment beyond CABHS's capabilities.
10. Extensive Supervision or Safety Requirements
- Youth requiring continuous one-to-one staffing that CABHS cannot provide.
- Youth whose safety plans depend on physical restraints, seclusion, or locked confinement.
- Youth whose documented behaviors pose an immediate and substantial risk to other residents or staff that cannot be adequately mitigated.
Additional Admission Considerations
The following concerns require further clinical review but do not automatically disqualify a youth:
- History of suicidal ideation without current acute risk.
- Diagnoses such as ADHD, ODD, DMDD, PTSD, bipolar disorder, or autism spectrum disorder.
- Previous psychiatric hospitalizations.
- History of school refusal or noncompliance.
- Occasional verbal aggression or emotional outbursts.
- Prior placement disruptions.
- Past substance use.
- Previous AWOL incidents without ongoing serious safety concerns.
Required Pre-Admission Screening
CABHS will review the youth's:
- Psychiatric diagnoses, medications, and treatment history.
- History of physical aggression and property destruction.
- Suicidal ideation, attempts, and self-injurious behaviors.
- AWOL and elopement history.
- Sexual behavior concerns and safety risks.
- Number of residential placements within the previous 24 months and reasons for discharge.
- History of physical restraints or seclusion.
- Medical conditions and emergency intervention requirements.
- Current supervision needs and behavioral support plan.
Admission Determination
CABHS reserves the right to decline referrals when a youth's assessed needs exceed the program's licensed services, staffing capabilities, clinical resources, or ability to maintain a safe therapeutic environment.
All admission decisions must be individualized, based on documented clinical and safety needs, and consistent with applicable Ohio QRTP requirements, nondiscrimination laws, and reasonable accommodation obligations. A diagnosis, disability, or history of behavior alone does not automatically exclude a youth.
Final admission approval: CABHS Administration and Clinical Leadership.