Mental Health

Adult

Children

Substance Use

Developmental

1.800.928.8000

Redetermination/Appeal Process

Open Requesting a Redetermination of a Level from CRP configuration options

To obtain the most accurate level of care, it is important to submit all relevant information at the time of initial level assignment, as well as for routine level reviews.

When new information becomes available about a child which may impact a level assignment or a DCBS worker or a PCC disagrees with the LOC assigned to a child because they consider the LOC to be too high or too low, they may seek to have the LOC redetermined (922 KAR 1:360).


Requesting a Redetermination of a Level from CRP

When submitting a request for Redetermination, include the following:

  • The most recent level of care assignment form (CRP-2, CRP-4, CRP-5, or CRP-6) with the redetermination section completed. Please print or write legibly.
  • A letter/narrative that identifies new evidence (since the last level of care assignment) supporting a higher or lower level of care, or an explanation of why the writer believes the previous level does not meet regulatory criteria.
  • Supporting documentation such as incident reports detailing the behavioral issues may be included when further clarification is warranted. Most of the time a well written letter/narrative will suffice.
  • Further guidance can be found here: CRP Redetermination Guidance

 

It is not necessary to submit a new ALP (CRP-7) report, 886A, or a new tool (i.e., Screener/CANS Assessment Report ) with the request for a redetermination.

The redetermination letter/narrative and any supporting documentation can be sent to the Children’s Review Program via fax (859) 225-3565 or emailed via secure email to one of the following email addresses:

PCC/PCP ONLY: [email protected]

DCBS ONLY: [email protected]

Appeal to the Gatekeeper: If the redetermination is denied, the requester may appeal to the CRP director’s office for review. To do this, send a cover letter indicating the request for appeal and providing the basis for the appeal. Because this is an appeal, only the information submitted with the original Request for Redetermination will be considered. The appropriate time to submit new evidence is with the Request for Redetermination. Information for the appeal should be directed to: Roni Giberson, Children’s Review Program Director, and faxed or emailed as indicated above.

A written response will be provided within 10 working days of the receipt of the request.

Seek an Informal Dispute Resolution from CHFS: If the appeal to CRP is denied, the requester may appeal to CHFS by filing an informal dispute resolution as outlined in Section 14 of 922 KAR 1:360. This informal dispute resolution request will be reviewed by DCBS and DCBS will render the decision. Please remember when making an informal dispute resolution to include the same documentation that was provided to CRP so that the review team can determine whether or not a level change is justified. The informal dispute resolution will be based on information previously submitted for the redetermination of level. If new information is available, please seek a redetermination of level.

Requests for an informal dispute resolution can be sent to:
David Gutierrez, LCSW
Branch Manager, Family Violence Prevention Branch
Department for Community Based Services
275 East Main Street 3E-A
Frankfort, KY 40621
Fax: 502-564-4653
email: [email protected]

Request an Administrative Hearing: If an agency is still not satisfied with the decision after receiving a response from their informal dispute resolution request, then the agency may request an administrative hearing as outlined in 922 KAR 1:360.

FEATURED VIDEO

RELATED SERVICES

LATEST HEADLINES

FIND A LOCATION

110 Roach Street, Georgetown, KY 40324
Phone: 502.863.4734
Fax: 502.863.4735

Open Access is available 8:00 a.m.-5:00 p.m. Monday-Friday
Contact the 24-Hour Help Line to make arrangements 1.800.928.8000

438 Washington Street, Stanton, KY 40380
Phone: 606.663.2274
Fax: 606.663.2210

Open Access is available 8:00 a.m.-5:00 p.m. Monday-Friday
Contact the 24-Hour Help Line to make arrangements 1.800.928.8000

403 Gibson Lane, Richmond KY 40475
Phone: 859.661.4530

Monday – Friday: Morning 8:00 – 12:00 Afternoon 1:00 – 4:00

415 Gibson Lane, Richmond, KY 40475
Phone: 859.661.4526
Fax: 859.623.9160

411 Gibson Lane, Richmond, KY 40475
Phone: 859.626.5030
Fax: 859.626.8020

Open Access is available 8:00 a.m.-5:00 p.m. Monday-Friday
Contact the 24-Hour Help Line to make arrangements 1.800.928.8000

322 Frontier Boulevard, Stanford, KY 40484
Phone: 606.365.2197
Fax: 606.365.8310

Open Access is available 8:00 a.m.-5:00 p.m. Monday-Friday
Contact the 24-Hour Help Line to make arrangements 1.800.928.8000

324 Southview Drive, Nicholasville, KY 40356
Phone: 859.885.6315
Fax: 859.887.1886

Open Access is available 8:00 a.m.-5:00 p.m. Monday-Friday
Contact the 24-Hour Help Line to make arrangements 1.800.928.8000

257 Parkland Heights, Cynthiana, KY 41031
Phone: 859.234.6940
Fax: 859.234.5772

Open Access is available 8:00 a.m.-5:00 p.m. Monday-Friday
Contact the 24-Hour Help Line to make arrangements 1.800.928.8000

First Steps – Birth to Age 3 Developmental Delays
2935 Dolphin Drive, Suite 204, Elizabethtown, KY 42701
Phone: 270.737.5921 or 1.800.678.1879
Fax: 270.982.0829

191 Doctors Drive, Frankfort, KY 40601
Phone: 502.223.2182
Fax: 502.223.3338

Open Access is available 8:00 a.m.-5:00 p.m. Monday-Friday
Contact the 24-Hour Help Line to make arrangements 1.800.928.8000

149 Richmond Road, Irvine, KY 40336
Phone: 606.723.5128
Fax: 606.723.3288

Open Access is available 8:00 a.m.-5:00 p.m. Monday-Friday
For support, questions and to make an appointment contact the 24-Hour Helpline 1.800.928.8000

325 Professional Avenue, Winchester, KY 40391
Phone: 859.744.2562
Fax: 859.745.0020

Open Access is available 8:00 a.m.-5:00 p.m. Monday-Friday. For support, questions and to make an appointment contact the 24-Hour Helpline 1.800.928.8000

650 High Street, Danville, KY 40422
Phone: 859.236.2726
Fax: 859.236.0373

Open Access is available 8:00 a.m.-5:00 p.m. Monday-Friday
Contact the 24-Hour Help Line to make arrangements 1.800.928.8000

4223 Lexington Road, Suite D, Paris, KY 40361
Phone: 859.987.6127
Fax: 859.987.7728

Open Access is available 8:00 a.m.-5:00 p.m. Monday-Friday
Contact the 24-Hour Help Line to make arrangements 1.800.928.8000

1060 Glensboro Road, Lawrenceburg KY 40342
Phone: 502.839.7203
Fax: 502.839.0041

Open Access is available 8:00 a.m.-5:00 p.m. Monday-Friday
Contact the 24-Hour Help Line to make arrangements 1.800.928.8000

201 Mechanic Street, Second Floor, Lexington, KY 40507
Phone: 859.721.8505
Fax: 859.253.1177

Monday – Friday | Morning 8:00 – 12:00 Afternoon 1:00 – 4:00

201 Mechanic, Street, Lexington, KY 40507
Phone: 859.721.8501
Fax: 859.253.1177

3479 Buckhorn Drive, Suite 106, Lexington, KY 40515
Phone: 859.246.7282
Fax: 859.246.7675

Open Access is available 8:00 a.m.-5:00 p.m. Monday-Friday
Contact the 24-Hour Help Line to make arrangements 1.800.928.8000

1351 Newtown Pike Building 3, Lexington, KY 40511
Phone: 859.225.3296
Fax: 859.254.2412

201 Mechanic Street, Lexington, KY 40507
Phone: 859.425.1210
Fax: 859.425.1213

Open Access is available 8:00 a.m.-5:00 p.m. Monday-Friday
Contact the 24-Hour Help Line to make arrangements 1.800.928.8000

1351 Newtown Pike, Building 5, Lexington, KY 40511
Phone: 859.233.0444
Fax: 859.225.6027

201 Mechanic Street, Lexington, KY 40507
Phone: 859.977.6080
Fax: 859.977.4502

1351 Newtown Pike, Building 5, Lexington, KY 40511
Phone: 859.271.9448 or 1.800.454.2764
Fax: 859.272.6893

600 Old Frankfort Circle, Lexington, KY 40510
Phone: 859.425.2746
Fax: 859.425.2623

1351 Newtown Pike, Building 1, Lexington, KY 40511 View Map
Phone: 859.253.1686
Fax: 859.255.4866

201 Mechanic Street, Lexington, KY 40507
Phone: 859.977.6080
Fax: 859.977.4502

1351 Newtown Pike, Building 5, Lexington, KY 40511
Phone: 859.233.0444
Fax: 859.268.8888

1351 Newtown Pike, Building 5, Lexington, KY 40511
Phone: 859.272.7483
Fax: 859.233.0144

New Vista Newsletter

Sign up to receive updates from New Vista.