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 cooperation with community.
The goal of the Patient Care Program is to provide medically directed inpatient services to persons five years of age and above with psychiatric diagnoses that warrant hospitalization, and who are not moderately, severely, or profoundly mentally retarded.
The Patient Care Program provides medically directed inpatient services to persons five years of age and above with psychiatric diagnoses that warrant hospitalization and who are not moderately, severely, or profoundly mentally retarded. Since there is no infirmary, 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 a mental disorder as to be unable to care for their basic needs.
OBJECTIVES AND PERFORMANCE INDICATORS
1. In FY 1998-99, the Patient Care Program will establish and maintain a comprehensive, integrated, community based system of mental health services to meet the needs of adults with serious mental illness and children with serious emotional disturbances, thereby reducing the need for long term inpatient treatment placement.
2. In FY 1998-99, the Patient Care Program, through its Children's Service activity, will establish and maintain a comprehensive, integrated, community-based system of mental health services to meet the needs of adults with serious mental illness and children with serious emotional disturbances, thereby reducing the need for long term inpatient treatment placement.
3. In FY 1998-99, Patient Care Program, through its Adolescent Services activity, will establish and maintain a comprehensive, integrated, community based system of mental health services to meet the needs of adults with serious mental illness and children with serious emotional disturbances, thereby reducing the need for long term inpatient treatment placement.
4. In FY 1998-99, Patient Care Program, through its Adolescent Service (Brief Stay) activity, will establish and maintain a comprehensive, integrated, community based system of mental health services to meet the needs of adults with serious mental illness and children with serious emotional disturbances, thereby reducing the need for long term inpatient treatment placement.
5. In FY 1998-99, Patient Care Program, through its Developmental Neuropsychiatric Program activity, will establish and maintain a comprehensive, integrated, community-based system of mental health services to meet the needs of adults with serious mental illness and children with serious emotional disturbances, thereby reducing the need for long term inpatient treatment placement.
6. In FY 1998-99, Patient Care Program, through its Adult Services activity, will establish and maintain a comprehensive, integrated, community based system of mental health services to meet the needs of adults with serious mental illness and children with serious emotional disturbances, thereby reducing the need for long term inpatient treatment placement.
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
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GENERAL FUND
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TOTAL
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T.O.
|
|
DESCRIPTION
|
|
|
|
|
|
|
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$500,000
|
$20,995,987
|
571
|
|
ACT 18 FISCAL YEAR 1997-1998
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|
|
|
|
|
|
|
|
|
|
|
BA-7 TRANSACTIONS:
|
|
$0
|
$0
|
0
|
|
None
|
|
|
|
|
|
|
|
$500,000
|
$20,995,987
|
571
|
|
EXISTING OPERATING BUDGET - December 10, 1997
|
|
|
|
|
|
|
|
$0
|
($29,162)
|
0
|
|
Equipment/Major Repairs Adjustment(s)
|
|
$0
|
$251,382
|
0
|
|
Annualization of 1997 -'98 Merit Pay Adjustment(s)
|
|
$0
|
$343,909
|
0
|
|
1998 -'99 Merit Pay Adjustment(s)
|
|
$0
|
($514,194)
|
(22)
|
|
Personnel Reduction(s)
|
|
$0
|
$1,518,130
|
0
|
|
Attrition Adjustment(s)
|
|
$0
|
($56,432)
|
0
|
|
Reductions in various Expenditure Categories; Including reductions to fully fund Salaries
|
|
$0
|
($12,039)
|
0
|
|
Retirement Rate Adjustment(s)
|
|
|
|
|
|
|
|
$500,000
|
$22,497,581
|
549
|
|
TOTAL RECOMMENDED
|
|
|
|
|
|
|
|
$0
|
$1,504,594
|
(22)
|
|
DIFFERENCE (TOTAL RECOMMENDED AND EXISTING OPERATING BUDGET)
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The total means of financing for this program is recommended at 107.1% of the existing operating budget. It represents 93.6% of the total request ($24,013,196) for this program. The major changes reflected in this analysis include: reduce (22) vacant positions for personnel reductions, increase interagency transfer means of financing by $595,291 for merit pay adjustments, an attrition adjustment, and a means of financing substitution of federal funds for interagency transfers to reflect a projected increase in Medicare collections. The changes should have no significant impact on the delivery of services.
PROFESSIONAL SERVICES
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$2,400
|
|
Pathologist to provide consultation and supervision to the clinical laboratory services in order to provide quality laboratory techniques for reliable test results
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$18,684
|
|
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
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$67,040
|
|
Speech Therapist to provide assessment of speech and language, provide counseling, treatment, rehabilitation and conduct audiometric screening as required by regulatory bodies
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$14,400
|
|
Contractor to provide services of radiologist on a consulting basis, interprets and renders timely reports on all radiological procedures
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$116,244
|
|
Contract to provide weekend resident physicians for all duties and/or calls for admission of new patients, emergency coverage for the entire hospital and restraint/seclusion assessments
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$7,500
|
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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
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$5,700
|
|
Cardiologist services required to interpret electrocardiograms and render a written report in a timely manner or by telephone if an emergency
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$7,241
|
|
Payments to the St. Tammany Mental Health Association (d/b/a Sunshine House) to fulfill a community need as a psychosocial rehabilitation club house providing socialization and support services to Southeast patients.
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$100,000
|
|
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 educational programs
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|
|
|
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$18,000
|
|
Contract to provide certified neurologist to render neurological consultations to staff and serve as interpreter of electroencephalograms tracings performed at Southeast
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$16,640
|
|
Psychologist to provide specialized neuropsychological testing for the 20 bed Developmental Neuropsychiatric Program (DNP) unit and for consultative testing on the other adolescent units.
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|
$17,160
|
|
Psychiatric resident provide a full array of psychiatric services of the brief stay adolescent unit (new Hope) which is a specialized unit providing intensive cognitive based therapy
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$41,600
|
|
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
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$27,450
|
|
Physicians to provide histories and physicals on all patients admitted to Washington-St. Tammany Regional Medical Center within 24 hours of admission
|
|
$100,000
|
|
Part-time psychiatrist responsible for admission, evaluation, diagnosis and treatment, conduct staffing, case reviews and team reviews, conduct mental status exams and interviews
|
|
$102,688
|
|
Provide occupational therapy to patients at Southeast, including screening and evaluation to determine level of functioning in areas of perceptual motor, activities of daily living, cognitive and psychological skills as well as treatment planning and implementation to remediate deficits in the diagnosed areas
|
|
$46,800
|
|
Provides occupational therapy to patients at Washington-St. Tammany Regional Medical Center including screening and evaluation to determine level of functioning in areas of perceptual motor, activities of daily living, cognitive and psychological skills as well as treatment planning and implementation to remediate deficits in the areas
|
|
|
|
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$38,700
|
|
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
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|
$30,000
|
|
Provides interpreters for hearing impaired patients
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|
$38,400
|
|
Contract provides services for the hearing impaired which are essential for their adequate assessment and treatment
|
|
$23,000
|
|
Radiology technician to perform all radiology procedures ordered by staff doctors
|
|
$42,000
|
|
Licensed clinical psychologist to participate in staffing of new patients on adult wards, assists in researching diagnosis and treatment plans 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
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|
|
|
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$43,519
|
|
Part-time contractors to provide psychiatric/medical coverage at Southeast; provide evaluates, diagnoses, admissions or referrals, and is responsible for psychiatric care of all patients; and to evaluate, treat or refer all physically ill patients
|
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$79,556
|
|
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
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|
$24,960
|
|
Contract to provide psychological evaluations including written reports on all patients at Washington-St. Tammany Regional Medical Center acute psychiatric unit
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|
$25,010
|
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Serves as psychologist post-doctoral fellow and renders psychological services (assessments, individual, group and family) for children's unit
|
|
$36,000
|
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Contract to provide psychopharmacology consultation
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$11,400
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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
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|
|
|
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$29,550
|
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Provide relief coverage for the medicine clinic at Southeast which shall consist of histories and physicals on all new patients within 24 hours of admission, medical consults for ward patients, histories and physicals on new employees
|
|
$26,000
|
|
Contract to provide coverage to the acute psychiatric unit at Washington-St. Tammany consisting of telephone consultations with staff, routine admit orders for new patients, restraint and seclusion orders which involve seeing the patient and writing the order within one hour of going into restraints
|
|
$15,000
|
|
Clinical pastoral consultants
|
|
$17,010
|
|
Professional Travel services for above contracts
|
|
|
|
|
|
$1,189,652
|
|
TOTAL PROFESSIONAL SERVICES
|
OTHER CHARGES
|
$60,000
|
|
Funding of the Patient Recreation Fund to be used: 1) on the children's unit as a therapeutic tool to intervene in and change problematic behavior; 2) on the adolescent unit as an integral component of the therapeutic milieu; 3) to provide indigent patients with a weekly allowance; 4) for social and recreational activities; and 5) to provide a way for patients to participate in the Special Olympics.
|
|
|
|
|
|
$60,000
|
|
TOTAL OTHER CHARGES
|
|
|
|
|
|
|
|
Interagency Transfers
|
|
$10,008
|
|
Payments to LSU to provide services for the hearing impaired which are essential for adequate assessment and treatment
|
|
$10,985
|
|
Payments to LSU Medical Center to the hearing impaired which are essential for their adequate assessment and treatment
|
|
$6,266
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Payment to LSU for Professional Travel services for above contracts
|
|
$31,200
|
|
Payment of the University of New Orleans for Psychology students to provide testing and group therapy services in children's unit
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|
$35,000
|
|
Payments to LSU Medical Center for Employee drug testing program
|
|
|
|
|
|
$93,459
|
|
TOTAL INTERAGENCY TRANSFERS
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ACQUISITIONS AND MAJOR REPAIRS
|
$110,528
|
|
Recommended level of funding for the replacement and repairs of obsolete, inoperable or damaged equipment and buildings
|
|
|
|
|
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$110,528
|
|
TOTAL ACQUISITIONS AND MAJOR REPAIRS
|
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