Rights in a Statewide Inpatient Psychiatric Program (SIPP) for Children under 18

Services for Individuals under 18 Years Old

Statewide Inpatient Psychiatric Program (SIPP) services are provided in an intensive residential setting and include: crisis intervention; bio-social and or psychiatric evaluation; close monitoring by staff; medication management; individual, family, and group therapy; and connection to community based services. These services are expected to be relatively short termed (less than six-months). Youth must have a Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) diagnosis other than substance abuse, developmental disability, or autism. The youth must be expected to benefit from residential treatment and a less restrictive setting is not available. All referrals must be approved by the Circuit Substance Abuse and Mental Health (SAMH) Program Office. SIPP is a Medicaid Waiver program.

Florida’s Circuits

There are six-circuits in Florida serving 67 counties and 15 Statewide Inpatient Psychiatric Programs (SIPPs) serving the needs of Florida’s youth:

Southern

  • Citrus (RITS)
  • Jackson Memorial Hospital

Southeast

  • Alternate Family Care
  • Citrus (CATS)
  • Sandy Pines

Sun Coast

  • BayCare Behavioral
  • Manatee Palms Youth Services

Central

  • Central Florida Behavioral Hospital
  • Devereux
  • University Behavioral Center
  • The Vines

Northeast

  • River Point Behavioral
  • Daniel Memorial

Northwest

  • Meridian/Lakeview
  • Devereux

SIPP Process

A designated staff person in the local Department of Children and Families (DCF) District Substance Abuse and Mental Health (SAMH) office completes referrals to the Statewide Inpatient Psychiatric Program (SIPP). The parent, guardian, or family member will be told the availability of treatment programs in their area. The youth and the youth’s responsible party will be able to tour the facility and receive an assessment from the provider to determine if all parties involved agree that this is an acceptable course of action. Once the SAMH staff, the youth, responsible party, and the provider determine that admission is appropriate, the SIPP provider will contact the state utilization management contractor for prior authorization of the admission. Then scheduled admission is discussed.

Each provider will supply:

  • A brochure in English and other lanuages
  • Admission criteria

The youth will be given the choice of enrolled providers in his/her area and will be encouraged to select the closest one to his/her residence. Special needs populations will be accommodated. 

Services Provided

The Statewide Inpatient Psychiatric Programs (SIPPs) offer the following services:

  • Inpatient psychiatric services for youth under the age of 18 years of age.
  • A clearly defined treatment philosophy and approach that includes:
    • Review or completion of assessments and evaluations including medical, psychiatric, neurological, psychological , social, educational and substance abuse;
    • Treatment planning developed by a team comprised of the child, child psychiatrist, parents, legal guardian or child welfare counselor, primary clinician, direct child care staff, recreational staff, school personnel, and other persons involved in the care.
    • Psychiatric and medical services including medication management and routine care services;
    • Clinical therapy services, including behavioral programming by a certified behavior analyst;
    • Therapeutic home visits with approval of a clinician and treatment team with clinical on-call support staff;
    • Parent educational and parenting classes;
    • Peer and group interaction activities;
    • Overall coordination of a child’s care while participating in the SIPP Program;
    • Detailed discharge planning;
    • Provision of outpatient aftercare;
    • Transportation;
    • Vocational Rehabilitation services; and
    • Toll free help lines for aftercare, 7 days a week/24 hours a day.

Denial of Services

Whenever the Department denies a request for service, the youth has the right to exercise a formal appeal process mandated under federal law.  The process commences with a file review but can go as far as a formal hearing known as a “fair hearing”. 

How to Request Reconsideration of the Denial

The youth, legal guardian, attending physician or provider has the right to request a formal reconsideration of any denial of services. The formal reconsideration must be made in writing to the Agency for Healthcare Administration’s (AHCA’s) utilization management contractor within forty (40) calendar days of the date of the notice of initial determination. The date of notice is the date of the letter plus five additional days for mailing. The medical records must be submitted with the request for reconsideration.

The Process for Reviewing the Reconsideration

Upon receipt of the request, a board-certified psychiatrist, not involved in the initial determination, will review all submitted documentation and render a determination within thirty days of receipt. If the second psychiatrist agrees with the original determination, the decision is upheld and the reconsideration process is completed.  If the second psychiatrist reverses the original adverse determination, the case is overturned and the reconsideration process is complete.

The Utilization Manager contractor will approve written notification of the reconsideration determination within thirty (30) working days of the dated receipt.

The written request for reconsideration must be sent to Florida’s current Utilization Manager First Health Services of Florida, Inc. at:

Florida Division
Reconsideration Unit
First Health Services of Florida, Inc.
4300 Cox Road
Glen Allen, VA 23060

How to Request a Fair Hearing

After the reconsideration process, a youth can exercise his/her right to appeal the determination further by submitting a request for a fair hearing.  A fair hearing is a formal process that allows each party a forum to present witnesses and evidence in support of their positions on provision of services that are at issue.  A request for a Fair hearing must be sent to the:

Department of Children and Families
Office of Public Assistance Appeal Hearings
1317 Winewood Boulevard, Building 1, Room 309
Tallahassee, Florida 32399-0700

Access to Care

The youth’s access to quality medical services must, at a minimum, not be adversely affected by a 1915 (b) (4) waiver program. A waiver must ensure an adequate amount of services during reasonable time periods and within reasonable geographic distance from the residence of the individual enrolled under the waiver. Furthermore, access to emergency services and family planning services must not be restricted.