Transcript River Valley Detention Center Mental Health Team

JJC HOSPITALIZATION
Dr. John Cosma, JJC Psychologist
JJC Hospitalization Process
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JJC recognizes that from time to time residents admitted may
experience emotional deregulation, a psychotic break, and/or
traumatic experiences that may be out of their control.
JJC is very sensitive to these experiences and once the resources are
exhausted, residents may need to be hospitalized in order to
become more stable, be placed on appropriate medication, and/or
for their safety until the crisis is under their control.
Residents may be hospitalized for several reasons such as, psychotic
behaviors (delusions, hallucinations, thought disorder, basically losing
touch with reality), acting out behaviors (defecating and spreading
feces), suicide and serious self harm attempts.
Once the residents are experiencing these behaviors, the JJC
psychologist will assess them and if they are not able to be redirected and their behavior persist, the JJC psychologist will pursue
hospitalization.
Hospitalization Process
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There are mainly two modalities that residents can be hospitalized
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Through Medicaid
Through Insurance
Medicaid
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Obtain the medicaid information
Screening, Assessment, and Support Services (SASS)
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Caseworker comes and assesses the resident in crisis
Determine hospitalization
If resident meets hospitalization criteria, the caseworker makes arrangements with
local hospitals and arranges transportation to the hospital
DCFS Wards are being serviced by at least two types of HMO insurance
Advocate HMO
Harmony HMO
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Insurance
Obtain information from the insurance company on hospitals
within the network by calling the insurance card information
 Obtain a precertification letter
 Call hospitals for bed availability
 Describe to intake worker the residents symptoms and why
hospitalization in needed
 Transport resident to hospital
 The process can take anywhere from two to several hours to
get a resident hospitalized
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Hospitalization difficulties/challenges
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Certain insurances have contracts with certain hospitals
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We need to take the resident to those hospitals only
The bed availability may be full. We may need to call several hospitals
before we obtain a bed.
Once we inform the hospital the resident is from the Juvenile Justice
Center…almost immediately we are informed that there is no bed
availability.
Certain insurances do not have contract with local hospitals. As such, we
may need to transport residents into Chicago or surrounding suburbs of
Chicago. Example: DCFS Wards
Advocate HMO Insurance – APSonly hospital servicing this insurance is in Kankakee and Chicago (St.
Elizabeth Hospital).
Harmony HMO-Streamwood Hospital,
Scott Nolan Center, St. Joe’s Hospital
Parent may have specialized type of insurance for psychiatric services.
Example; BCBS-HMO
Advocate Plan (for medical and psychiatric
services) APS Plan (for Psychiatric Hospitalizations). Once again, these
plans have contract with certain treatment facilities for services.
JJC Involvement
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We follow up with the admitting hospital on status of
the resident
We are involved in staffing of the resident while they
are in the hospital
We are in close communication with the court, out of
county probation, and SASS regarding the resident’s
status
We transport resident back to JJC from the hospital
upon discharge
Residents are seen and monitored by the Psychiatrist
and JJC Psychologist upon resident’s return from the
hospital for the duration of their admission
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Hospitalizations and Diagnoses
2008
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Total Admissions:
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Number of Residents Admitted with a Diagnosis: 369 (36%)
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Top Diagnoses:
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1017
Depression
ADHD
Bipolar Disorder
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Number of Residents Admitted with Medication:
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Hospitalizations:
187 (18%)
7
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2009
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Total Admissions:
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Number of Residents Admitted with a Diagnosis:
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Top Diagnoses:
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686
308 (44%)
ADHD
Depression
Bipolar Disorder
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Number of Residents Admitted with Medication:
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Hospitalizations:
165 (24%)
3
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2010
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Total Admissions:
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Number of Residents Admitted with a Diagnosis:
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Top Diagnoses:
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836
144 (17 %)
Bipolar Disorder
ADHD
Adolescent Antisocial Behavior
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Number of Residents Admitted with Medication:
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Hospitalizations:
172 (20%)
4
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2011
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Total Admissions:
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Number of Residents Admitted with a Diagnosis:
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Top Diagnoses:
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780
120 (15 %)
Bipolar Disorder
ADHD
Mood Disorder
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Number of Residents Admitted with Medication:
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Hospitalizations:
196 (25%)
7
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2012 – August
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Total Admissions:
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Number of Residents Admitted with a Diagnosis: 280 (33%)
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Top Diagnoses:
854
ADHD
Bipolar Disorder
Anxiety Disorders
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Number of Residents Admitted with Medication: 242 (28%)
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Hospitalizations:
6
Yearly Summary
400
350
300
250
200
150
100
50
0
Diagnoses
Medications
Hospitalizations
2008
369
187
7
2009
308
165
3
2010
144
172
4
2011
120
196
7
2012
280
242
8
Questions/Comments?