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Pre-Admission Counseling

Pre-admission counseling helps to make sure that the person seeking admission to an ICF where nine or more people live, is fully aware of the service and support options available to meet their needs while living outside of an ICF.

 The purpose of pre-admission counseling is to ensure the person seeking admission has had the opportunity to explore all available options for services and support. The process focuses on supporting informed choice, and is not intended to deter someone from living in an ICF if they choose to.

Pre-admission Counseling is required when an Ohio resident is seeking new admission to an ICF with nine or more beds who does not have previous history of admission to an ICF.

Pre-Admission Counseling is not required when

  • a person is seeking admission to an ICF with eight beds or fewer,

  • out-of-state residents seek admission to an ICF,

  • a person is transferring from one ICF to another, including transfers between a state-operated developmental center and another ICF,

  • a person who has left an ICF for a Nursing Facility returns to the ICF, 

  • a person is already on a waiver and seeking a short-term admission to an ICF, or 

  • a person who used to live in an ICF is seeking re-admission.

Emergency Admission

Pre-Admission Counseling is required for an emergency admission, however it should not prevent the admission from occurring.  On the day of an emergency admission, the ICF will send the referral for Pre-Admission Counseling to the county board of developmental disabilities. The county board must conduct the interview and complete the form within 5 days.  The form must be submitted to DODD the day after the interview is held.  If a Level of Care assessment is complete, it will be approved when the Pre-Admission Counseling form is received.

Pre-Admission Counseling Process

Process Initiation


Complete the Referral

Submit the Referral

An ICF with nine or more beds has a current vacancy or vacancy within the next six months and plans for a new admission are in place.

The ICF submits a Pre-admission counseling referral form to the county board of developmental disabilities in the person's county of residence. 

The county board receives referral form and has five days to interview the person, complete the form, and submit it to DODD for review.


The county board identifies the person's current needs, and the supports required to meet those needs.

The board works to identify any new supports needed and new or additional resources that can be used.

 County board staff attach the completed referral form emailing it to ICFdoc@dodd.ohio.gov. A pre-admission counseling form remains valid for up to six months.

DODD will review the form and notify the county board and the ICF of the outcome by e-mail within two business days of receipt.                                                                                                                                                                


Click each tab for more details about each step of the process. 

Process Initiation

The pre-admission counseling process is initiated when an ICF with nine or more beds has a current vacancy or anticipates a vacancy within the next six months. If the ICF agrees to accept the person for admission, and the person agrees to accept the next opportunity for admission, a referral must be submitted to the county board of developmental disabilities in the person’s county of residence.

The county of residence is the county in which the person presently resides or, for minors in the custody of Child Protective Services, the county where legal custody is maintained.

For each vacancy, the ICF may refer up to three people at a time to the county board. All referrals must be made using the form developed by the DODD. The cover page must be completed in its entirety, including required signatures from the person and a representative from the ICF. Incomplete referrals may not be accepted by the county board. 

When more than one person is referred, the ICF must prioritize the referrals in the order in which they are to be considered for admission. The county board will schedule face-to-face interviews in the order in which the referrals are prioritized. The person with first priority will be interviewed prior to anyone else who has been referred.


Upon receipt of a complete referral from an ICF, the county board has five business days to complete the pre- admission counseling form and submit it to DODD for review. The county board will include the person, legal guardian, if applicable, and anyone else chosen by the person to participate in the pre-admission counseling interview. The names of all those participating must be included on the pre-admission counseling form.

The county board representative must carefully explain the purpose of the session and clarify that the person maintains the right to seek admission to the ICF. The Pre-Admission & Options Counseling Informational Pamphlet developed by DODD must be presented to the person during this process. The pamphlet explains the general differences between home and community-based and ICF services.

Using a conversational, person-centered approach, the representative will assess the person’s preferences in the areas listed on the pre-admission interview form. The areas in which the person currently requires support will also be identified.

  • If no assistance is required in an area, “not applicable” must be selected on the form.
  • For all areas in which supports are currently required, the county board representative will identify the resource primarily used to meet that need at this time.
  • The representative will select “yes” or “no” to indicate if an area of support is new or if additional support is needed.

The representative must also explore the strengths, resources, and barriers that may contribute to or inhibit the person’s success in a community-based setting. During this discussion, the representative is required to explain how available resources may be utilized to support the person in a community-based setting and to overcome historic barriers.

Complete the Referral

Upon reviewing all available options with the person, the county board representative must ask the person if he or she chooses to proceed with admission to the ICF or if a community-based option is preferred.

Once the person’s choice of service has been identified and the pre-admission interview form is complete, the county board representative must email the form to DODD for review.

  • The form must be sent to ICFdoc@dodd.ohio.gov.
  • The subject line of the email should indicate the county and name of the ICF to which the person is seeking admission, e.g., Brown - Fake Provider, Inc.
  • The county board representative must also notify the ICF contact person listed on the pre-admission referral form of the person’s choice of service setting.

Within two days of receiving the form, DODD will review completed pre-admission forms to ensure the appropriate process was followed. DODD will keep a record of the names of people who participated in the counseling process, the facilities in which they are seeking admission, and the settings they chose.



A pre-admission counseling form remains valid for up to six months. A person who has completed the process within the last six months and is now being selected for admission to an ICF does not need to complete another interview prior to admission.

If it has been between six and 12 months since a person selected for admission to an ICF participated in pre-admission counseling, the county of residence must contact the person to see if anything has changed since the last interview.

If not, the person may proceed with admission to the ICF.

If there have been changes, the county board may update the form gathering information by phone, face-to-face, or other electronic means. All updated forms must be submitted to DODD for review by emailing the attached form to ICFdoc@dodd.ohio.gov.

DODD will notify the CBDD and the ICF of the Pre-Admission Counseling review outcome via email within 2 business days of receipt.