A statewide initiative to address emergency department boarding of patients needing inpatient psychiatric care went into effect on Thursday, February 1. ED boarding of behavioral health patients has been a long-standing problem., but under the leadership of EOHHS Secretary Marylou Sudders, the Department of Mental Health (DMH) developed an escalation process to secure appropriate placement for individuals boarding in EDs who require inpatient psychiatric hospital level of care. The system was designed in consultation with MassHealth, the Department of Public Health, the Division of Insurance (DOI), and several stakeholder groups, including MHA.
For escalating cases where placement has not been achieved in a reasonable period of time, the new policy establishes clear steps and responsibility for senior clinical leadership at insurance carriers, inpatient psychiatric units, and ultimately at DMH, with the goal of identifying and resolving barriers to admission. As part of revised DMH regulations expected in the next few weeks, inpatient psychiatric facilities will follow new licensing requirements to ensure they have the range of inpatient resources necessary to address the clinical needs of patients. DOI has instructed insurance carriers that they are expected to facilitate admission of difficult cases seven days a week, to provide authorization for specific needs as soon as the need is known, and to maintain adequate networks of inpatient psychiatric facilities.
As this policy is rolled out, MHA is holding bi-weekly implementation calls through April to hear from members about what is and is not working.
Detailed information on the policy can be found both on
Patient CareLink and on
DMH’s website.