Overview of Psychiatric Services

Psych Workgroup – June 24, 2015

Definitions

• “Adult” means any individual aged 18 years or older.• "Child/adolescent" means any individual less than 18 years of

age.• "Flex bed" means an existing adult psychiatric bed converted

to a child/adolescent psychiatric bed in an existing child/adolescent psychiatric service to accommodate during peak periods and meet patient demand.

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Psychiatric Beds and Occupancy - 2013 Data

Source – 2013 CON Annual Survey Data

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Acute Care Hospital-Based

Freestanding Hospital

Statewide

Number of Facilities 50 10 60

Number of Adult Beds 1409 609 2018

Number of Child Beds 67 174 241

Number of Flex Beds* 0 28 28

Occupancy Rate(Adult & Child Combined)

66.98% 80.00% 71.45%

*Approved but not yet operational in 2013.

Psychiatric Services Compliance

• Based on 2012 CON Annual Survey data• Group-1:

Requires 60% occupancy for adult & 40% for child beds19 hospitals of which 7 hospitals have child beds1 facility not meeting occupancy for adult beds

• Group-2: Requires 85% occupancy for adult & 75% for child beds8 hospitals of which 1 hospital has child beds8 facilities not meeting occupancy for adult beds1 facility not meeting occupancy for child beds

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Psychiatric Services Compliance

• Group-3: Requires 85% occupancy for adult & 85% for child beds4 hospitals 3 facilities not meeting occupancy for adult beds

• Group-4: State Health Plan; no occupancy requirements11 hospitals of which 1 hospital has child beds

• Group-5: Grandfathered (prior to CON)17 hospitals of which 1 hospital has child beds

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Psychiatric Services Compliance Findings

• Acute shortage of psychiatrists in the State (e.g., high cost of hiring temporary contract employees)

• Retention of the current staff in the inpatient psychiatric setting• Physical design of the psychiatric units

Private, semi-private rooms vs. 3 or 4-bed wards Lack of appropriately set up bed (e.g., male/female patient) Lack of capital for physical plant enhancements Lack of secured/isolated units for high-acuity patients

• Internal operational procedures for certain Community Mental Health (CMH) and terms of contracts with psychiatric providers

• Different types of patient population and their treatment plans Geriatric patients Developmentally disabled, mentally impaired, autistic Patients with acute medical conditions High acuity (extreme violent behavior), one-to-one patient

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Psychiatric Flex Beds• Three freestanding psych hospitals approved for flex beds

Pine Rest Christian Mental Health – 12 beds Forest View Psychiatric – 8 Beds (Operational 04/2014) Henry Ford Kingswood – 10 Beds (Operational 05/2014)

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Facility 1 Facility 2

Number of Beds in the Flex Bed Unit 8 10

Days the Flex Bed Unit Treated Child/Adolescent Patients 98 127

Patient Days of Care for Child/Adolescents Treated in Flex Beds

417 605

Discharges for Child/Adolescents Treated in Flex Beds 42 83

Occupancy Rate for Flex Beds for Child/Adolescent Days 53.2% 47.6%

Average Daily Census for Flex Beds for Child/Adolescent Days

4.3 4.8

Questions or Comments

Tulika Bhattacharya, ManagerPhone: 517-241-3344

E-mail: bhattacharyat@michigan.gov

Joette Laseur, Reviewer/Specialist: 517-241-3342laseurl@michigan.gov

Andrea Moore, Compliance Analyst: 517-241-3345moorea20@michigan.gov

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