ACUTE INPATIENT TREATMENT

Similar documents
Inpatient Psychiatric Services for Under Age 21 Manual. Acute Inpatient Mental Health (Child/Adolescent)

Inpatient Mental Health

Review of Medical Necessity Criteria

LOUISIANA MEDICAID PROGRAM ISSUED: 04/13/10 REPLACED: 03/01/93 CHAPTER 13: MENTAL HEALTH CLINICS SECTION13.1: SERVICES PAGE(S) 9 SERVICES

PARTIAL CARE. Partial Care (Youth/Young Adult) Service Definition

LEVEL OF CARE CRITERIA FOR ADULTS

Adult Mental Health Services applicable to Members in the State of Connecticut subject to state law SB1160

FAMILY FUNCTIONAL THERAPY (FFT)

California Medical Necessity Criteria. Updated October 2017

CHIPA Medical Necessity Criteria 2016 ( ) Page 1 of 32

ADVANCED BEHAVIORAL HEALTH, INC. Clinical Level of Care Guidelines

SUD Requirements. Proprietary

CALIFORNIA COUNTIES TREATMENT RECORD REQUIREMENTS

Medical Necessity Criteria

Members must meet medical necessity criteria for a particular LOC of care. Medically necessary services are those which are:

Medical Necessity Criteria

CIGNA STANDARDS AND GUIDELINES/MEDICAL NECESSITY CRITERIA. For Treatment of Mental Health and Substance Use Disorders

CIGNA STANDARDS AND GUIDELINES/MEDICAL NECESSITY CRITERIA

MEDICAL POLICY No R8 EATING DISORDERS POLICY/CRITERIA

Members must meet medical necessity criteria for a particular LOC of care. Medically necessary services are those which are:

LINEHAN RISK ASSESSMENT AND MANAGEMENT PROTOCOL (LRAMP)

MULTNOMAH MENTAL HEALTH (MMH) UTILIZATION REVIEW PRACTICE GUIDELINES

Legal 2000 and the Mental Health Crisis in Clark County. Lesley R. Dickson, M.D. Executive Director, Nevada Psychiatric Association

Substance Abuse Level of Care Criteria

This chapter contains information on LOC criteria and service descriptions for inpatient behavioral health (BH) treatment including:

Hospitalization, Psychiatric, Adult

MULTISYSTEMIC THERAPY (MST)

Disclosures 8/28/2014 4:40 AM 1

BRTC IMMINENT SUICIDE RISK AND TREATMENT ACTIONS NOTE

Mental Health Outpatient Treatment Report Form

ADULT Addictions Treatment: Medically Monitored Residential Treatment (3B)

FAMILY FUNCTIONAL THERAPY (FFT) - Youth. Program Description

Residential Treatment (RTC)

ASAM Criteria, Third Edition Matrix for Matching Adult Severity and Level of Function with Type and Intensity of Service

Child and Adolescent Psychiatry Trends. ADAMHS Board - 28 Oct 2014

CHILD Multi Systemic Therapy Problem Sexual Behavior

INTERQUAL BEHAVIORAL HEALTH CRITERIA ADOLESCENT PSYCHIATRY REVIEW PROCESS

MEDICAL MANAGEMENT POLICY

IMMINENT SUICIDE RISK & TREATMENT ACTION PLAN

SUICIDE PREVENTION POLICY

Adult Mental Health Services Applicable to insured members in the State of Connecticut subject to state law SB1160

Clinical UM Guideline

SUBJECT: Suicide Risk Screening and Assessment of Individuals in State Hospitals and State-Operated Crisis Stabilization Programs

Primary Care: Referring to Psychiatry

Civil Commitments. Presented by Magistrate Crystal Burnett

Obsessive-Compulsive Disorder Clinical Practice Guideline Summary for Primary Care

CHILD Summer Therapeutic Activities Program (STAP)

Condensed Clinical Practice Guideline Treatment Of Patients With Schizophrenia

Clinical UM Guideline. This document provides medical necessity criteria for levels of care relating to substance and addictive disorders.

MEDICAL POLICY SUBJECT: APPLIED BEHAVIOR ANALYSIS FOR THE TREATMENT OF AUTISM SPECTRUM DISORDERS

Bock Associates 221 West 2 nd Street, Suite 607 Little Rock, AR 72201

Risk Assessment. Person Demographic Information. Record the date of admission.

Suicide Risk Screening, Assessment and Management

MEDICAL POLICY EFFECTIVE DATE: 04/28/11 REVISED DATE: 04/26/12, 04/25/13, 04/24/14, 06/25/15, 06/22/16, 06/22/17

NorthSTAR. Section II Substance Abuse and Chemical Dependency LEVEL OF CARE CRITERIA

Adult Mental Health Rehabilitation Treatment Request Form

Initial Evaluation Template

INTERQUAL BEHAVIORAL HEALTH CRITERIA GERIATRIC PSYCHIATRY REVIEW PROCESS

Patient Health Questionnaire-2

Long Term Services Division. Supersedes: Policy Governing Behavior Support Service Planning, 1/19/96 and LTSD Behavior Support Policy Revision 6/23/00

INTERIM POLICY FOR THE PROVISION OF BEHAVIORAL HEALTH TREATMENT COVERAGE FOR CHILDREN DIAGNOSED WITH AUTISM SPECTRUM DISORDER

BEHAVIOR ANALYSIS FOR THE TREATMENT OF AUTISM SPECTRUM DISORDERS

Electroconvulsive Therapy Prior Authorization Request

American Board of Psychiatry and Neurology, Inc. Geriatric Psychiatry Core Competencies Outline

No An act relating to health insurance coverage for early childhood developmental disorders, including autism spectrum disorders. (S.

GISD Suicide Prevention Plan

Health Share Level of Care Authorization Form Adult Mental Health Services Initial Treatment Registration Form

Service Review Criteria

ENTITLEMENT ELIGIBILITY GUIDELINE DEPRESSIVE DISORDERS

Health Share of Oregon

Directions: Use your mouse or the arrows on your keyboard to click through this tutorial.

Psychiatric Residential Treatment Facility Referral

Child and Adolescent Major Depressive Disorder Physician Performance Measurement Set

ASAM Level.05 DIMENSIONS Circle all items in each dimension that apply to the client. ADMISSION CRITERIA

Admit date: 1-WM 2-WM 3.2-WM 3.7-WM 4-WM DSM-V diagnoses: Please list all diagnoses (psychiatric, chemical dependency and medical)

Psychotropic Medication

Medical Necessity Criteria Guidelines

Clinical UM Guideline

CHILD Behavioral Health Rehabilitative Services

MEF Disclosures. GKB Disclosures. OCD Criteria: Obsessions. Clinical Conundrum: Tricky Content. OCD Criteria: Compulsions

Department of Public Welfare PSYCHOLOGICAL IMPAIRMENT REPORT

Mental Health Referral Form

Mental Health Series for Perinatal Prescribers. Severe postpartum syndromes

JC Sunnybrook HEALTH SCIENCES CENTRE

ZERO SUICIDE DATA ELEMENTS WORKSHEET

Community Services - Eligibility

Behavioral Health Medical Necessity Criteria Webinar

Florida s Mental Health Act

Patient Management Tools

Behavioral Health Service Request Form Detox and Substance Abuse Rehab

Acute Mental Health Emergencies- from the office to the ED

MEDICAL POLICY SUBJECT: APPLIED BEHAVIOR ANALYSIS FOR THE TREATMENT OF AUTISM SPECTRUM DISORDERS

Suggested Protocol for Resident Verbalizing Suicidal Ideation or Plan

PSYCHOTROPIC MEDICATION UTILIZATION PARAMETERS FOR CHILDREN AND YOUTH IN FOSTER CARE

PSYCHIATRIC CLINIC, LLC 123 Main Street Anywhere, US (O) (F) Nesmith, Kelly.

Dr Carmelo Aquilina Senior Staff Specialist & Service Director Sydney West Area Health Service Clinical Senior Lecturer, University of Sydney

Your patients with mental health problems: Key issues and good practice in the assessment and management of risk.

Psychological & Neuropsychological Test

Transcription:

I. Definition of Service: ACUTE INPATIENT TREATMENT Acute inpatient hospitalization represents the most intensive level of psychiatric care. Multidisciplinary assessments and multimodal interventions are provided in a 24-hour secure and protected, medically staffed and psychiatrically supervised treatment environment. This level of service may be administered on a locked unit. Twenty-four hour skilled psychiatric nursing care, daily medical care, and a structured treatment milieu under the direction of a psychiatrist, or for children/adolescents, a board certified child and adolescent psychiatrist is required. The goal of acute inpatient hospitalization is to stabilize individuals who display acute psychiatric conditions associated with a relatively sudden onset and a short, severe course, or a marked exacerbation of symptoms associated with a more persistent, recurring disorder. Typically, the individual poses a significant danger to self or others, or displays severe psychosocial dysfunction. Special treatment may include physical and mechanical restraint and/or seclusion. Impulsive behavior increases the need for consideration of this level of care. However, 23-hour observation may be used initially. Additional notation on services for members who are eligible for EPSDT services: Medical necessity has an expanded definition under the Early and Periodic Screening, Diagnostic and Treatment Program, a special health care program for children and youth aged 20 and younger. This definition supersedes the usual definition of medical necessity, which applies to non-epsdt eligible members. The term medical necessity means that a covered service shall be deemed a medical necessity or medically necessary if, in a manner consistent with accepted standards of medical practice, it: 1. Is found to be an equally effective treatment among other less conservative or more costly treatment options, and 2. Meets at least one of the following criteria: The service will, or is reasonably expected to prevent or diagnose the onset of an illness, condition, primary disability, or secondary disability. The service will, or is reasonably expected to cure, correct, reduce, or ameliorate the physical, mental, cognitive, or developmental effects of an illness, injury, or disability. The service will, or is reasonably expected to reduce or ameliorate the pain or suffering caused by an illness, injury, or disability. Page 1 of 5 Revised: March 2017

The service will, or is reasonably expected to assist the individual to achieve or maintain maximum functional capacity in performing activities of daily living. Medical necessity may also be a course of treatment that includes observation or no treatment at all. 3. For additional information on EPSDT definitions and requirements, please refer to COS_EC Policy 248L. II. Admission Criteria: The following criteria are necessary for admission: Individual has been evaluated by a licensed clinician and demonstrates symptomatology consistent with a Medicaid covered behavioral health diagnosis that requires, and can reasonably be expected to respond to therapeutic intervention, and the individual presents with at least one of the following (items A through D) : A. At imminent risk for self-injury with an inability to guarantee safety as evidenced by at least one of the following: A recent suicide attempt that is serious by degree of lethality and intentionality or Current suicidal ideation with a plan and means. Recent self-mutilation that is severe and dangerous Recent statements and/or behavior indicating a high risk for severe injury Command hallucinations directing harm to self B. At imminent risk for injury to others as evidenced by any of the following: Active plan, means and lethal intent to seriously injure others Current assaultive threats or behaviors with a clear risk for escalation or future repetition Recent history of self-mutilation, significant risk-taking or loss of impulse control resulting in danger to self or others. Command hallucinations directing harm to others C. Disordered/bizarre behavior, cognitive functioning or psychomotor agitation or retardation that interferes with the activities of daily living to such a degree that the individual cannot function at a less intensive level of care. For example, the individual is gravely disabled by their psychotic symptoms and cannot meet daily living needs. Page 2 of 5 Revised: March 2017

D. Imminent risk for acute medical status deterioration due to the presence of a psychiatric disorder because either: Psychiatric symptoms or behaviors prevent the accurate diagnosis or treatment of a serious medical condition requiring inpatient medical care Providing the needed acute psychiatric intervention will likely result in deterioration of medical condition and/or mental health. E. Assessment of individuals with suicidal or homicidal behaviors should include: III. Continued Stay Criteria: A thorough psychiatric evaluation and inquiry about thoughts, plans and behaviors and estimation of suicidal or homicidal risk. The presence of continued feelings of helplessness and/or hopelessness, severely depressed mood, and/or recent significant losses. Availability of responsible support systems, including recovery based community services. Assessment of the person s strengths, vulnerabilities and needs in relation to risk and development of the treatment plan. All of the following criteria are necessary for continuing treatment at this level of care: A. The individual s condition continues to meet admission criteria for inpatient care and no other less intensive level of care would be adequate. B. Treatment planning is individualized and appropriate to the individual s changing condition with realistic and specific goals and objectives stated. Treatment planning should include active family or other support systems, social, occupational, and interpersonal assessment with involvement when indicated. C. All services and treatment are carefully structured to achieve optimum results in the most time-efficient manner possible consistent with sound clinical practice. D. Progress in relation to specific symptoms or impairments is clearly evident and can be described in objective terms but goals of treatment have not yet been achieved, or adjustments in the treatment plan to address lack of progress and/or psychiatric/medical complications are evident. E. Care is rendered in a clinically appropriate manner and focused on the individual s behavioral and functional outcomes as described in the discharge plan. Page 3 of 5 Revised: March 2017

F. When medically necessary, appropriate psychopharmacological intervention has been prescribed and/or evaluated. G. There is documented active Discharge Planning. H. There is documented active attempt at coordination of care with the Behavioral Health Provider and the PCP (primary care physician), when appropriate. I. The patient is currently involved and cooperating in treatment process or, they are not cooperating/involved, but there are measurable indicators the patient is progressing towards active involvement in treatment. IV. Exclusion Criteria: Any of the following criteria are sufficient for exclusion from this level of care: A. The individual can be safely maintained and effectively treated at a less intensive level of care. B. Symptoms result from a medical condition, which warrants a medical/surgical setting for treatment. C. The individual exhibits serious and persistent mental illness and is not in an acute exacerbation of the illness. D. The primary problem is social, economic (e.g., housing, family conflict, etc.), or one of physical health without a concurrent major psychiatric episode meeting criteria for this level of care or admission is being used as an alternative to incarceration. E. Symptoms result from a substance use disorder, which warrants a medical or detoxification setting for treatment. V. Discharge Criteria: A. No longer meets admission criteria or meets criteria for a less intensive level of care. B. Plan for continuation of services at a lower level of care has been implemented. C. The client decides that he/she wishes to be discharged and is not on a 27-65- 101 hold for this level of care. VI. Frequency of Review: A. Review for medical necessity will occur at least every three days. VII. Clinical Resources: A. Criteria for Short-term Treatment of Acute Psychiatric Illness. American Academy of Child and Adolescent Psychiatry. 1995. Page 4 of 5 Revised: March 2017

B. Assessing and Treating Suicidal Behaviors: A Quick Reference Guide. American Psychiatric Association. 2003. Page 5 of 5 Revised: March 2017