Right Care in Right Setting: New Psych ED Opens

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Doors opened today for the Seton Psychiatric Emergency Department, the first Central Texas medical facility specifically designed to treat adults from throughout the community who suffer from psychiatric crises. See more photos from the event.

This project is one of several under way to fill a yawning gap in local mental health services. After emergency treatment, psychiatric patient outcomes depend on outpatient and inpatient services that are available over the longer term. Currently, there are not enough of these follow-on services available. Seton Healthcare Family andCentral Health, Travis County’s health care district, are working with community partners to develop and manage these much needed, additional services.

“As with the rest of Texas and the U.S., Travis County does not have enough properly equipped facilities to meet psychiatric patient needs, but this new facility is a good and much-needed step forward,” saidJesús Garza, Seton Healthcare Family president and chief executive officer. “The psychiatric ER is the most visible evidence so far that the Community Care Collaborative will improve health care across Travis County, whether patients have health insurance or not.”

The Community Care Collaborative (CCC) is a new not-for-profit created and managed by Central Heath and Seton. The CCC is a physician-led coalition of health care and service providers working to close gaps in the continuum of care. In addition to emergency psychiatric care, the CCC is providing additional obstetric, reproductive health, child obesity and chronic condition management services.

Doors at the new psychiatric facility opened today at 3 p.m. following a morning dedication event featuring Texas Health and Human Services Executive Commissioner Dr. Kyle Janek and Texas State Sen. Kirk WatsonConstruction began in late December 2013.

Watson and Janek unveiled a small monument that will adorn the psychiatric emergency facility’s patio area, inscribed with the words of St. Vincent de Paul: “Extend mercy toward others, so that there can be no one in need whom you meet without helping.”

“One of the goals of our Medicaid transformation waiver is to fund projects that expand care available outside of the traditional emergency room setting.” Janek said. “This new psychiatric facility is a great example of how we’re making it possible for communities to do that.”

The new psychiatric facility also will eliminate bottlenecks in regular emergency rooms throughout Travis County. Until today, patients experiencing psychosis or other psychiatric crises could only go to regularly ERs and often require a lot of attention from doctors and nurses while patients who are physically ill or injured must wait for medical help.

The medical unit’s entrance is on the north side of University Medical Center Brackenridge, at 601 E. 15thSt. It will be staffed by psychiatrists; psychiatric family medicine and advanced practice nurses; social workers; clinical assistants; and other professionals.

Seventeen rooms will be divided into two sections: seven for ambulatory “treat and release” patients and 10 for more acute patients who need to be transferred to a higher level of care or are held involuntarily. The section for more acute patients includes space to walk around, an enclosed patio and a common room.

No one under 18 years of age can be treated in this new unit. Regulations require that adult and pediatric psychiatric patients be treated in separate facilities. Younger patients will continue to be diagnosed and treated at Dell Children’s Medical Center of Central Texas, also operated by Seton, and at other local hospitals.

“Fortunately, Austin is ahead of many other Texas communities – in terms of collaboration among key leaders and groups – in improving health care quality and access,” said Dr. Kari Wolf, Seton vice president of medical affairs for the new facility and director of the Seton Mind Institute. “However, as a community, we have a long way to go in addressing overall psychiatric needs. Our hope is that this psychiatric emergency room will be a catalyst for developing the additional services and facilities that are needed.”

Behavioral health patients who also need emergency medical care will be treated first in the emergency rooms at UMC Brackenridge and other hospitals. They will be transferred to the psychiatric facility for evaluation after they are stabilized.

The Seton Psychiatric Emergency Department is expected to handle 2,500 patient visits through the end of the federal fiscal year 2014, which ends Sept. 30. The numbers are expected to increase to 5,500 during federal fiscal year 2015 and 10,500 during federal fiscal year 2016.

“This psychiatric emergency department is much needed and will become the first of its kind in our community’s psychiatric care and support system,” Watson said. “Improved psychiatric services and facilities are one of the ‘10 Goals in 10 Years’ I laid out in late 2011 for our community to strive toward. I’m beyond pleased that the Community Care Collaborative has made this investment possible less than three years later.”

Funding for a psychiatric emergency department is driven by a transformation project through the Medicaid 1115 Waiver – Texas Health Care Transformation and Quality Improvement Program. It is one of the 33 such transformation projects for which Central Health serves as funder, via intergovernmental transfer. Through the 1115 Waiver, these projects receive federal matching dollars at a rate of approximately $1.40 for every $1 raised locally.

This project was also the result of years of community needs assessment and planning. One of the primary reasons Central Health was created was to address the lack of psychiatric services in Travis County. In 2006, Central Health convened a community based Psychiatric Stakeholders Group, which prioritized the creation of a psychiatric emergency department to relieve pressure on local medical emergency departments.

About Central Health and its Roles in the 1115 Waiver
Central Health serves as the anchor entity for a six-county region (Regional Healthcare Partnership 7) in which 78 Delivery System Reform Incentive Payment (DSRIP) Projects are underway through 10 Performing Providers.  Central Health also provides the intergovernmental transfer funds for 33 projects inside Travis County. Of those 33 projects, the Community Care Collaborative (CCC) performs 15. The CCC, a nonprofit public-private partnership between Central Health and the Seton Healthcare Family, is the nexus of delivery system transformation in Travis County, and the 1115 Waiver is creating the foundation for that transformation.




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