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

  1. Implement a crisis intervention program that, at a minimum, includes outreach, mobile crisis, and intensive crisis services.
  2. 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.
  3. Establish agreements with the Medicaid Managed Care organizations serving the affected population to provide coverage for the service array under this project.
  4. Develop written treatment protocols with consensus from participating providers and facilities.
  5. Include at least one hospital with specialty psychiatric services and crisis-oriented psychiatric services; expansion of access to specialty psychiatric and crisis-oriented services.
  6. Expand access to observation unit within hospital outpatient or at an off campus crisis residence for stabilization monitoring services (up to 48 hours).
  7. Deploy mobile crisis team(s) to provide crisis stabilization services using evidence-based protocols developed by medical staff.
  8. 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.
  9. Establish central triage service with agreements among participating psychiatrists, mental health, behavioral health, and substance abuse providers.
  10. Ensure quality committee is established for oversight and surveillance of compliance with protocols and quality of care.
  11. 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.