Tag: ED

Addressing Hurdles for Behavioral Health Patients Seeking Care in the ED

MiCare Champion Cast

The MHA released a new episode of the MiCare Champion Cast exploring the need to expand the pre-admission screening assessment for behavioral health providers.

Lauren LaPine, senior director of legislative & public policy, MHA, joined to provide insight on how Michigan continues to experience issues with timely access to behavioral health services. More specifically, LaPine shared how and why Medicaid patients experiencing a behavioral health crisis are often stuck in emergency departments (EDs) longer than those who are commercially insured.

Infographic illustrating the differing processes that commercially insured patients go through to be assessed for a behavioral health need compared to a Medicaid beneficiary.
Infographic illustrating the differing processes that a Medicaid beneficiary goes through to be assessed for a behavioral health need compared to a commercially insured patient.

Under the current guidelines, LaPine explained, there are a series of arduous steps needed in order to get patients with Medicaid coverage inpatient behavioral healthcare. One of the biggest hurdles is that following an assessment by ED clinicians, a patient with Medicaid must receive a secondary pre-admission screening from a community mental health (CMH) agency.

This process can take hours – if not days – to complete. Meanwhile, a patient needing the same level of care who is commercially insured is not required to have the pre-admission screening by a CMH.

Last year, there were more than 1.2 million emergency room visits where behavioral health was one of the reasons for care. LaPine noted that pediatric and geriatric patients board for the longest periods of time.

One proposed solution to alleviate the process is to expand the three-hour assessment responsibility to allow clinically qualified staff to conduct pre-admission screenings in order to improve the delivery of care for behavioral health patients in Michigan hospital EDs.

“Emergency departments across the state are well-equipped to complete the pre-admission screening to determine if someone needs inpatient psychiatric care,” said LaPine. “Implementing this change will really help us to expand the number of available healthcare personnel that are able and available to conduct that pre-admission screening…it also allows Medicaid patients to be assessed in a similar manner as patients that have commercial insurance.”

According to recent survey data, there are more than 155 patients waiting in a hospital emergency department for access to behavioral health services; Whether that is an assessment through a CMH agency, an inpatient bed or a transfer to a short-term, residential setting.

The episode is available to stream on Apple Podcasts, Spotify, SoundCloud and YouTube.

Michigan Legislature Introduces Behavioral Health Bills

Member News
capitol building

capitol buildingThe Michigan Legislature introduced several bills recently related to behavioral health. The bills are a result of MHA advocacy activity that supports the behavioral health section of the MHA Strategic Action Plan.

Each of the bills proposes specific policies that would address some of the challenges hospitals experience when behavioral health patients seek care in the emergency department (ED).

A summary of each bill is provided below:

  • Senate Bill (SB) 802 introduced by Sen. Wojno (D-Warren): Requires sharing of the availability of community based mental health and substance use disorder services and integrates that information with the Michigan Crisis and Access Line.
  • SB 806 introduced by Sen. Hauck (R-Mount Pleasant): Expands the three-hour assessment responsibility by allowing clinically qualified staff to conduct pre-admission screenings for a patient presenting in an ED.
  • SB 811 introduced by Sen. Huizenga (R-Walker): Expands hospital swing bed eligibility to include inpatient behavioral health patients, beyond existing acute care or skilled nursing care patients.
  • SB 833 introduced by Sen. Geiss (D-Taylor): Prohibits arbitrary limitations placed by commercial insurers on the duration of inpatient psychiatric admissions that are not consistent with care for physical health admissions.

Advocating in favor of these bills is a large focus for MHA advocacy and policy staff for the remainder of the session. The MHA is also working closely with other lawmakers for introduction of additional legislation specific to this issue. An infographic on the problems hospitals experience caring for behavioral health patients in the ED and proposed solutions will be shared with lawmakers. The resource includes data points from the MHA’s weekly behavioral health ED boarding survey.

Members with questions on these bills should contact Lauren LaPine at the MHA.