NonSub Change - IME Behavioral and Mental Health Concerns categories

NonSub Change Request_0466.docx

Initial Medical Exam Form and Dental Exam Form

NonSub Change - IME Behavioral and Mental Health Concerns categories

OMB: 0970-0466

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To: Jordan Cohen

Office of Information and Regulatory Affairs (OIRA)

Office of Management and Budget (OMB)


From: Kirsten Buckley

Office of Refugee Resettlement

Administration for Children and Families (ACF)


Date: May 9, 2022


Subject: NonSubstantive Change Request – Initial Medical Exam Form and Dental Exam Form (OMB #0970-0466)



This memo requests approval of nonsubstantive changes to the approved information collection, Initial Medical Exam Form and Dental Exam Form (OMB #0970-0466)


Background

On December 10, 2020, the Office of Refugee Resettlement (ORR) within the Administration for Children and Families received approval to collect information on a standardized Initial Medical Exam performed on all unaccompanied children within 2 business days of admission into ORR custody. The Initial Medical Exam is performed by a mid-level medical professional or higher and includes a psychosocial risk evaluation that is used to identify potential mental health concerns or symptoms. To capture these concerns and symptoms, disorder-based mental health diagnosis options were listed in the Behavioral and Mental Health Concerns category within the Diagnosis section of the current Initial Medical Exam Form. However, since the date of approval, an ORR Behavioral and Mental Health Team comprised of licensed mental health professionals was created and after careful consideration, the Team believes the current format may cause a child to be prematurely and inappropriately labeled with a mental health disorder. Per ORR guidelines, a child identified with a symptom-based diagnosis at the Initial Medical Exam would be referred to a specialist for evaluation and a disorder-based diagnosis which would be captured in the Health Assessment form (OMB #0970-0509). Therefore, ORR feels that it is in the best interest of the child to provide symptom-based mental health diagnoses in lieu of disorder-based diagnoses on the Initial Medical Exam Form.


Overview of Requested Changes

ORR is requesting to replace all disorder-based mental health diagnoses with symptom-based diagnoses in the Behavioral and Mental Health Concerns category within the Diagnosis section of the current Initial Medical Exam Form. An overview of the requested changes is provided in the following table and we have provided an updated form with this submission.


Behavioral and Mental Health Concerns Category

Proposed Update

Hallucinations

No Change

Nonconsensual sexual activity

No Change

Other (with specify field)

No Change

Separation Anxiety Disorder

Change to "Anxiety symptoms (e.g., panic attacks, excessive worry/fear)"

Self-injury/cutting

Change to "Urge for/current self-harm"

Behavioral concerns (e.g., aggression, trouble following rules)

Add

Delusions

Add

Depressive symptoms

Add

Manic symptoms (e.g., elated mood, pressured speech)

Add

Social/Emotional delay

Add

Trauma symptoms (e.g., nightmares, flashbacks)

Add

Urge for/current harm to others

Add

History of psychiatric diagnoses or treatment

Add, to include a free text "Specify" field

ADHD/ADD

Remove from IME form

Adjustment disorder

Remove from IME form

Autism

Remove from IME form

Bipolar disorder

Remove from IME form

Borderline personality disorder

Remove from IME form

Conduct disorder

Remove from IME form

Depressive disorder

Remove from IME form

Eating disorder

Remove from IME form

Generalized anxiety disorder

Remove from IME form

Obsessive-Compulsive Disorder

Remove from IME form

Oppositional Defiant Disorder

Remove from IME form

Panic disorder

Remove from IME form

PTSD

Remove from IME form

Schizophrenia

Remove from IME form

Suicide ideation/attempt

Remove from IME form



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorJones, Molly (ACF)
File Modified0000-00-00
File Created2022-05-10

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