“With the shrinking of inpatient psych care, we don't have enough inpatient psych beds, so more and more psych patients are ending up in emergency rooms,” says Mark Covall, president and CEO of the National Association of Psychiatric Health Systems in Washington. “They are remaining in (emergency departments) are for hours, days, sometimes weeks because there is no availability of a bed,” he said. He adds that some patients have to travel hours to reach a general hospital to receive care. “It's very important to provide access for this population.”
According to the CMS, the demonstration defines psychiatric emergencies as expressions of suicidal or homicidal thoughts or gestures that result in an evaluation that the patient is dangerous to himself or others. The demo will allow for federal reimbursement to treat psychiatric emergencies in IMD settings. And it covers a key patient population, as Covall explains that the 22-64 age group does not receive coverage in a freestanding hospital, which requires them to seek care in general acute-care settings.
States have 60 days—until Oct. 14—to apply for the funding, and the CMS review process is likely to last throughout November and December, according to Covall. While he says there is no official start date, he expects the demo to begin in early 2012.
Covall says in addition to providing better care for mental health patients and helping to lighten the load of the nation's emergency rooms, he hopes the demo will also produce longer-term results.
“And finally, that these patients would have better outcomes because they're getting more timely inpatient care,” he says of his hopes for the program. “And, hopefully, as part of discharge planning, getting the services they need—so a more coordinated system of care.”
You can follow Jessica Zigmond on Twitter @MHJzigmond.