Consultation

Need:

  • Baby boomers are turning 65 at a rate of 10,000/day
  • Over 2 million Americans live in long-term care facilities, and the number of residents is steadily rising
  • More than 60% of residents in long-term care have psychiatric and behavioral symptoms.
  • Fewer than 1500 geriatric psychiatrists practice in the US with dwindling membership, limiting the ability of specialists to care for residents individually.
  • New models are needed for quality behavioral health management in long-term care, particularly in response to emerging bundled payment mechanisms.

Solutions for long-term care communities

Psychopharmacology oversight

Regular psychopharmacology review is a requirement by law of all nursing homes and increasingly, assisted living facilities. Behavioral health issues and prescribing misadventures are also a driving force in hospital admissions and readmissions, thus an important target in the emerging accountable care landscape.

Services provided include:

  • Direct supervision (in person or virtual) of psychopharmacology review committee
    • Efficient, actionable guidance to meet regulatory requirements
  • Oversight of safe psychotropic medication reduction
  • Gradual dose reduction tracking
  • Formalized partnerships with consultant pharmacists

Organizational behavioral health review and interdisciplinary consultation

Appropriate prescribing and behavioral health management depend on the cultural readiness of the organization and staff engagement. Additionally, many facilities have limited or no access to outpatient psychiatry making their jobs even harder. Simple strategies to align expectations and goals of behavioral health can improve retention, staff morale and resident quality outcomes.

Services provided include:

  • Behavioral health preparedness plan: provides the structure for a facility (or owner/group of facilities) to discern or design appropriate behavioral health referral and hospitalization criteria and to identify local resources specific to their location and population.
  • Interdisciplinary roundtables for culture change: engages all relevant stakeholders to validate real and perceived barriers to achieving a culture of appropriate medication use, and creates a measurable plan of action.

Solutions for primary care practices

Population Health and Behavioral Health Integration (BHI)

Primary care of vulnerable older adults is often provided by practices dedicated to geriatrics, but most practices do not have formal relationships with behavioral health partners. Collaborative care models embedded in primary care are proven to improve not only behavioral health, but also global health outcomes and reduce unscheduled health utilization. New Medicare billing codes now support this integrated approach, which can be accomplished with native staff and registry based solutions when overseen by a trained psychiatrist.

Services provided include:

  • BHI readiness review and action plan
  • Psychiatry oversight of PCP’s allowing use of behavioral health codes