Program B: Patient Care
Program Authorization: Executive Reorganization Act; R.S. 38:259C; Mental Health Law; and R.S. 28:1 et. seq.
PROGRAM DESCRIPTION
The mission of the Patient Care Program is to provide safe, individualized rehabilitative care for mental health patients in the least restrictive setting, in the collaboration with the community.
The goals of the Patient Care Program are:
1. Continually improve the quality and availability of clinical service in the hospital and the community.
2. Continually upgrade and expand clinical support services to meet ongoing clinical needs.
The Patient Care Program provides medically directed inpatient and outpatient services to persons five years of age and above with psychiatric diagnoses and who are not moderately, severely or profoundly mentally retarded. Since there is no infirmary, individuals who are bedridden and who require active care for medical problems are not admitted. The majority of the inpatient beds are for acutely ill psychiatric patients who are provided surroundings of physical protection and sustenance with close supervision for those patients who may be psychotic, suicidal, homicidal or so disabled by mental disorder as to be unable to care for their basic needs. The community-based programs are designed to prevent and/or reduce the need for hospitalization or reduce the length of stay if hospitalization is warranted.
Major activities of this program are Children’s Services, Adolescent Services, Developmental Neuropsychiatric Program, Adult Services, and Acute Psychiatric Inpatient Unit.
OBJECTIVES AND PERFORMANCE INDICATORS
Unless otherwise indicated, all objectives are to be accomplished during or by the end of FY 1999-2000. Performance indictors are made up of two parts: name and value. The indicator name describes what is being measured. The indicator value is the numeric value or level achieved within a given measurement period. For budgeting purposes, performance indicator values are shown for the prior fiscal year, the current fiscal year, and alternative funding scenarios (continuation budget level and Executive Budget recommendation level) for the ensuing fiscal year (the fiscal year of the budget document).
RESOURCE ALLOCATION FOR THE PROGRAM
SOURCE OF FUNDING
The Patient Care Program is funded with General Fund, Interagency Transfers, Fees and Self-generated Revenue and Federal Funds. Interagency Transfers include Title XIX reimbursement for services provided to Medicaid eligible patients, and reimbursement from the State Department of Education for eligible meals provided under the School Lunch Program, reimbursements from the Office of Substance Abuse and Vocational Rehabilitation for space occupied and services received, and reimbursement for operation of the Washington-St. Tammany Regional Medical Center inpatient acute psychiatric unit. Self-generated Revenue represents reimbursement for ineligible patients with insurance or personal payments based on a sliding fee scale and meals served to employees and visitors. Federal Funds are Title XVIII reimbursement for services provided to Medicare eligible patients.
ANALYSIS OF RECOMMENDATION
|
GENERAL FUND |
TOTAL |
T.O. |
|
DESCRIPTION |
|
|
|
|
|
|
|
$500,000 |
$22,497,581 |
549 |
|
ACT 19 FISCAL YEAR 1998-1999 |
|
|
|
|
|
|
|
|
|
|
|
BA-7 TRANSACTIONS: |
|
$0 |
$0 |
0 |
|
None |
|
|
|
|
|
|
|
$500,000 |
$22,497,581 |
549 |
|
EXISTING OPERATING BUDGET – November 20, 1998 |
|
|
|
|
|
|
|
$0 |
$313,046 |
0 |
|
Annualization of FY 1998 -1999 Classified State Employees Merit Increase |
|
$0 |
$319,307 |
0 |
|
Classified State Employees Merit Increases for FY 1999 -2000 |
|
$0 |
$149,987 |
0 |
|
Acquisitions and Major Repairs |
|
$0 |
($110,528) |
0 |
|
Nonrecurring Acquisitions and Major Repairs |
|
$0 |
($350,594) |
0 |
|
Salary Base Adjustment |
|
$0 |
($330,095) |
0 |
|
Attrition Adjustment |
|
$0 |
($248,050) |
(8) |
|
Personnel Reductions |
|
|
|
|
|
|
|
$500,000 |
$22,240,654 |
541 |
|
TOTAL RECOMMENDED |
| |
|
|
|
|
|
$0 |
($256,927) |
(8) |
|
DIFFERENCE (TOTAL RECOMMENDED AND EXISTING OPERATING BUDGET) |
The total means of financing for this program is recommended at 98.9% of the existing operating budget. It represents 95.1% of the total request ($23,388,268) for this program. The major changes reflected in this analysis include a decrease of $296,386 to fully fund salaries in other programs and personnel reductions. The changes should have no significant impact on the delivery of services.
PROFESSIONAL SERVICES
|
$7,410 |
|
Payments to the East St. Tammany Mental Health Association (d/b/a Sunshine House) to provide members of the Sunshine House with part-time employment through participation in a transitional employment program at SELH |
|
$39,200 |
|
Contract to assist patients in their transition from hospitalization to community living by having patients participate on a part-time basis in a continuity of care program |
|
$17,352 |
|
Part-time dentist required to assess and treat the dental care needs of patients, provide emergency services and equipment if not available in dental clinic and coordinate services if specialist is required |
|
$66,500 |
|
Contract provides speech and hearing evaluations and therapy for children and adolescents as required by hospital standards and surveyors |
|
$27,508 |
|
Clinical dietitian to assist in assuring the provision of optimal nutritional care and documentation of appropriate dietetic information for patients including dietary assessments, diet instructions/counseling, nutrition classes, food and drug interaction instruction/counseling and writing/calculating special diets for patients |
|
$93,750 |
|
Part-time pharmacists to dispense medications and maintain controls of medication per standards, review the medication records of patients and participate in staff development and drug abuse education programs |
|
$4,100 |
|
Developmental psychologist to work with staff on youth services for management of point system, counselor in-service, problem solving of children behaviors and assessment coordinates |
|
$12,480 |
|
Psychology students who provide testing and group therapy services in the children’s unit |
|
$25,010 |
|
Serves as psychologist post-doctoral fellow and renders psychological services (assessments, individual, group and family) for children’s unit |
|
$20,000 |
|
Contractor to provide psychological evaluations on all patients at Washington-St. Tammany Acute Psychiatric Unit |
|
$16,640 |
|
Psychologist to provide specialized neuropsychological testing for the Developmental Neuropsychiatric Program unit and for consultative testing on the other adolescent units |
|
$42,000 |
|
Licensed, clinical psychologist to participate in staffing of new patients on adult wards, assists in researching diagnosis and treatment llans as well as participates in case reviews, responsible for reports of group psychological testing, administers individual psychological testing and provides results, and available for consultation concerning patient with psychiatrist and social worker |
|
$11,400 |
|
Contract to provide on site consultation to achieve on going compliance with standards, promote commission survey readiness and educate staff regarding performance improvement and follow up each visit with a written report |
|
$140,400 |
|
Provides occupational therapy to patients at Southeast, including screening and evaluation to determine level of functioning in areas of perceptual motor, activities and daily living, cognitive and psychological skills as well as treatment planning and implementation to remediate deficits in the diagnosed areas |
|
$58,500 |
|
Provides occupational therapy to patients at Washington-St. Tammany Regional Medical Center including screening and evaluation to determine level of functioning |
|
$53,500 |
|
Provides interpreters for hearing impaired patients |
|
$53,375 |
|
Physicians to provide histories and physicals on all patients admitted to Washington-St. Tammany Regional Medical Center Acute Unit within 24 hours of admission |
|
$46,800 |
|
Provide relief coverage for the medicine clinic at Southeast which shall consist of histories and physicals on all new patients with 24 hours of admission, medical consults for ward patients, histories and physicals on new employees |
|
$23,000 |
|
Radiology technician to perform all radiology procedures ordered by staff doctors |
|
$23,660 |
|
Contractor to provide psychiatric/medical coverage for Southeast on weeknights |
|
$50,048 |
|
Contract provides services for the hearing impaired which are essential for their adequate assessment and treatment |
|
$91,300 |
|
Contractor serves as psychiatrist responsible for admission, evaluation, diagnosis and treatment of patients, conducts staffing, case reviews and team reviews, conducts mental status exam, interview patients, establishes short and long term care goals, develops treatment plans, and discharge planning |
|
|
$9,000 |
|
Cardiologist services required to interpret electrocardiograms |
|
$18,000 |
|
Certified neurologist to render neurological consultations to staff and interpret electroencephalogram tracings |
|
$36,000 |
|
Contract to provide psychopharmacology consultation |
|
$17,160 |
|
Psychiatric resident provides a full array of psychiatric services for the brief stay adolescent unit |
|
$50,000 |
|
Medical researcher for the Washington-St. Tammany Regional Medical Acute Unit |
|
$15,000 |
|
Clinical pastoral consultants |
|
$30,000 |
|
Professional travel for above contracts |
|
|
|
|
|
$1,099,093 |
|
TOTAL PROFESSIONAL SERVICES |
OTHER CHARGES
|
$60,000 |
|
Funding of the patient recreation fund |
|
|
|
|
|
$60,000 |
|
TOTAL OTHER CHARGES |
|
|
|
|
|
|
|
Interagency Transfers |
|
$141,075 |
|
Payments to LSU Medical Center for resident physicians weekend and holiday coverage |
|
$14,400 |
|
Payments to LSU Medical Center for a consulting radiologist |
|
$28,543 |
|
Payments to LSU for employee drug testing |
|
|
|
|
|
$184,018 |
|
TOTAL INTERAGENCY TRANSFERS |
ACQUISITIONS AND MAJOR REPAIRS
|
$149,987 |
|
Recommended level of funding for the replacement and repairs of obsolete, inoperable or damaged equipment and buildings |
|
|
|
|
|
$149,987 |
|
TOTAL ACQUISITIONS AND MAJOR REPAIRS |
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