IMHPAC: Adult Inpatient Subcommittee Minutes 03/14/2022

Date: March 14, 2022

Subj: Adult Inpatient Meeting

Present: Dr. Sid Weisman; Dr. Dennis Hopkins

The topic of this meeting revolves around the establishment of the 988 Crisis Program. What is there in terms of significance to make this program work. First and foremost is a referral system to the needs of the people being served. To make this referral system effective, knowledge of bed availability and services provided by specific hospitals and call centers so that the evaluator can send someone directly to an open mental health bed on a 24-hour, 7 day a week basis. No other issues can be heard right now until this persistent problem is rectified. For instance, a person with untreated manic disorder may become totally problematic if a psychiatric bed is not immediately found. Finding an ER bed close by may only exacerbate the problem for the client and hospital alike. All that uncontrolled energy exhibited by the client will be highly disruptive to any ER setting, especially one that has no psychiatric unit on campus. The other issue is defining a "safe way" to transport the patient.

Without question, having a system available that enables evaluators to be able to direct clients to an effective hospital setting is crucial. Knowing which hospitals have the ER staff to handle the client is imperative. State psychiatric hospitals (i.e., Chicago Read and Madden) are often poorly staffed and thus unable to handle admissions during the evening and weekend hours. This can be the only logical reason to explain the difficulty in admitting psychiatric patients during non-regular business hours at state hospitals. But admitting someone to a psychiatric bed in a non-state hospital setting can be problematic if the first question asked is what type of insurance the client has. Even though the client may have a relatively quality insurance plan, the issue of client portion pay is paramount. It does no good for the client to have quality insurance, but the client is not able to meet their deductible. And this deductible is often in the thousands of dollars. Insurance policies with high deductibles are often selected by clients because the monthly payments are affordable. Clarification on the funding issues is necessary. What direction is needed to be given hospitals by DHS to allow for psychiatric admissions to become a reality? Answering this question may be pivotal in the success of the 988 Program.