Wyoming MDT Triptych

Multidisciplinary team (MDT) psychiatric evaluations are funded by the state of Wyoming and are available to children involved in Wyoming’s Department of Family Services (DFS). Child and adolescent psychiatrists affiliated with the University of Washington School of Medicine and Seattle Children's Hospital perform MDT evaluations via video teleconference.

What are MDT psychiatric evaluations?

A one-time evaluation performed at the request of a child’s MDT for the purpose of aiding mental/behavioral health assessment and/or treatment planning.

This MDT psychiatric evaluation can be used as the tool to inform the team of a broad range of treatment planning issues, including level of care, diagnosis, medication strategies and appropriate psychosocial supports. It also can serve as the physician order for admission to a psychiatric residential treatment facility (PRTF).

MDT Psychiatric Evaluation and Instructions

All forms are PDFs.

  1. Complete the MDT referral form.
  2. Complete and sign the MDT consent form.
  3. Complete and sign the authorization to obtain/release patient health information form.
  4. Complete and sign the ambulatory consent for care form.
  5. Complete and sign the consent to participate in telemedicine consultation form.
  6. Gather required records based on evaluation type (see below for specific requirements).

Medication evaluation requirements

  • Current medication list (within last six months)
  • Past medication trials (within last six months)

Diagnosis evaluation requirements

  • Current medication list (within last six months)
  • Past psychological evaluation (within last six months)
  • Past psychiatric evaluation (within last six months)
  • Testing reports (within last six months)

Placement evaluation requirements

  • Current medication list (within last six months)
  • Admission assessment (within last six months)
  • DFS placement and/or social history (within last six months)

Fax the completed referral packet and records to 206-985-3195 or email to us as an attachment. Once all necessary paperwork and appropriate documentation have been received, the MDT administrative team will contact you to schedule the appointment.

Appointments are performed using secure, dedicated telemedicine equipment. We are available Monday through Friday, 9 a.m. to 6 p.m. Mountain time, to answer questions about our services and to schedule appointments.

Frequently Asked Questions

  • Who can request an MDT?

    MDT evaluations may be requested by a guardian ad litem; the Care Management Entity (CME) Magellan; Wyoming Department of Family Services (DFS); and Xerox Care and Quality Solutions (CQS).
    back to top
  • How long will it take to schedule my MDT request?

    The MDT appointment can be scheduled after we receive the referral application and all the required documentation. Depending on availability and currently scheduled MDT evaluations, we usually can schedule within two weeks.
    back to top
  • How will the MDT evaluation proceed?

    The psychiatrist will start by gathering the history of the child. The child may or may not need to be present during this initial phase. If you think sitting through a description of the history would be unnecessarily distressing to the child, then the psychiatrist would encourage the child to come in to the appointment later (estimated 30 minutes). Older children will have much to contribute themselves in describing their history. Next, the psychiatrist needs to meet the child – either to observe them during the appointment (if very young, typically less than 5), to interview them with caregiver present (typically for elementary school–age children) and/or to interview them without caregiver present (typically for middle- to high-school–age children).The visit will end with our psychiatrist providing some general feedback to those present during the evaluation, in which they will describe the recommendations they are planning to make in the report.
    back to top
  • Is the child required to be present for the MDT evaluation?

    Yes, the child needs be present for at least part of the videoconference meeting. Our psychiatrists need to interact with the patient to get a better sense of their needs. If the child is not available, the psychiatrist will miss vital information, and the meeting will need to be rescheduled until he or she can attend.
    back to top
  • Who performs the MDT evaluation?

    The evaluation is performed by a University of Washington/Seattle Children’s Hospital child and adolescent psychiatrist under a contract with the Wyoming Department of Health.
    back to top
  • Can an MDT evaluation be done if the requester is not present at the time of the telemedicine visit?

    Yes, as long as our psychiatrist has had the opportunity to discuss the case with the requester in advance. Also, there needs to be someone at your facility who can turn on the equipment, usher the child and caregiver into the room and help “close” the visit by ushering the child and caregiver back out at the end.
    back to top
  • Why should the requester speak to the psychiatrist by phone apart from the patient and caregivers?

    We are most helpful when we know the evaluation question you would like us to answer and can hear from you first about the child’s circumstances. Our psychiatrist would like to know if there is anything important to share that cannot be shared openly during the appointment itself and to discuss what is hoped to be accomplished by the appointment. This generally will take 30 minutes, followed by the telemedicine evaluation to meet the patient and caregiver.
    back to top
  • How much time should be planned for the MDT appointment?

    Allow for a maximum of two hours.
    back to top
  • Can an MDT evaluation be done using Skype or a PC connection?

    No – due to security concerns, we will not do appointments with Skype or standard PC connections.
    back to top
  • Should current treating providers submit statements?

    Input from current providers is very helpful. Written statements from these individuals are encouraged. Please fax or email them to us along with an authorization to obtain/release patient health information form for each treating provider that is sending a statement.
    back to top
  • What required records should I send with the MDT referral form?

    Depending on the evaluation selected, these are the minimum required records:

    • Medication evaluation requirements
      • Current medication list
      • Past medication trials
    • Diagnosis evaluation requirements
      • Current medication list
      • Past psychological evaluation
      • Past psychiatric evaluation
      • Testing reports
    • Placement evaluation requirements
      • Current medication list
      • Admission assessment
      • DFS placement and/or social history
    back to top
  • When will the final report on the MDT evaluation be ready?

    Generally, the report will be ready within five business days. If there are special circumstances that require a faster turnaround, please let our schedulers know in advance of scheduling the appointment.
    back to top
  • Where do you provide telemedicine appointments?

    • Afton Department of Family Services
    • Buffalo Department of Family Services
    • Casper Department of Family Services
    • Casper Juvenile Detention Center
    • Catholic Charities of Wyoming
    • Cheyenne Department of Family Services (East Pershing)
    • Cody Department of Family Services
    • Patton Place Counseling
    • Douglas Department of Family Services
    • Dubois K-12 School
    • Evanston Department of Family Services
    • Gillette Department of Family Services
    • Jackson Department of Family Services
    • Lander Department of Family Services
    • Laramie Department of Family Services
    • Park County Detention Center
    • Rawlins Department of Family Services
    • Riverton Department of Family Services
    • Rock Springs Department of Family Services
    • Sweetwater County Detention Center
    • Sheridan Department of Family Services
    • Specialty Counseling and Consulting
    • Thermopolis Department of Family Services
    • Wheatland Department of Family Services
    • Worland Department of Family Services
    • Wyoming Behavioral Institute
    • Wyoming Boys' School
    • Wyoming Girls' School
    back to top