Crisis Community stabilization (Project 3.a.ii)
What do we hope to accomplish?
- Connect psychiatric patients who frequently utilize emergency room services to comprehensive, coordinated and ongoing safety net services that diminish the incentive to seek non-emergent care in an emergency room setting
Who is our target population?
- Adults and children who present for behavioral health services with complex needs and challenges of access to ongoing care and a full spectrum of services
How will we do it?
- Embed psychiatric services within the emergency department to identify non-emergent, emergent and chronic users and to provide them with enhanced discharge planning, expedited care planning and follow-up in real-time
- Utilize a Critical Time Intervention Team (CTI) model and cross-disciplinary psychiatric teams to target patients in potentially destabilizing periods of transition
- Link patients to services underpinning unmet needs, including but not limited to:
- Substance abuse services
- Primary care services
- Appointments management assistance
- Prescription adherence support
- Housing providers
- Health insurance assistance
- Navigation, Peer Services and community-based assistance and treatment
- Build and maintain strong relationships with community organizations
NY State Requirements
- Implement a crisis intervention program that, at a minimum, includes outreach, mobile crisis, and intensive crisis services.
- Establish clear linkages with Health Homes, ER and hospital services to develop and implement protocols for diversion of patients from emergency room and inpatient services.
- Establish agreements with the Medicaid Managed Care organizations serving the affected population to provide coverage for the service array under this project.
- Develop written treatment protocols with consensus from participating providers and facilities.
- Include at least one hospital with specialty psychiatric services and crisis-oriented psychiatric services; expansion of access to specialty psychiatric and crisis-oriented services.
- Expand access to observation unit within hospital outpatient or at an off campus crisis residence for stabilization monitoring services (up to 48 hours).
- Deploy mobile crisis team(s) to provide crisis stabilization services using evidence-based protocols developed by medical staff.
- Ensure that all PPS safety net providers are actively connected EHR systems with local health information exchange/RHIO/SHIN-NY and share health information among clinical partners, including direct exchange (secure messaging), alerts and patient record look up by the end of Demonstration Year (DY) 3.
- Establish central triage service with agreements among participating psychiatrists, mental health, behavioral health, and substance abuse providers.
- Ensure quality committee is established for oversight and surveillance of compliance with protocols and quality of care.
- Use EHRs or other technical platforms to track all patients engaged in this project.
Scale and Speed
Metric: The total number of participating patients receiving crisis stabilization services from participating sites, as determined in the project requirements. A count of crisis stabilization includes all activities for that one patient to help them back on their feet after an episode. A readmission/relapse counts as another instance for that patient.
Commitment: At the completion of Year 3, BH Crisis Stabilization will provide stabilization services to 1,300 patients annually.