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Psychiatric Care Capacity Response

Initial Situation Summary: On October 6, 2018, the Alaska Psychiatric Institute (API) notified external partners that it was at capacity and could not accept psychiatric patients at that time due to high patient acuity, workforce shortage and increased staff injury rates. In response to API capacity issues, hospital emergency rooms holding psychiatric patients, and public safety concerns, DHSS Commissioner Davidson activated the DHSS Emergency Operations Center (EOC) on October 13, 2018. Governor Bill Walker and staff were briefed on October 14, 2018 by DHSS Commissioner Davidson, Dr. Jay Butler, and the Incident Management Team. Incident Management Team contacted and briefed stakeholders on EOC activation.

This page will be updated biweekly. If you would like to provide feedback or have questions about this response effort, please email dhsseoc@alaska.gov
 

October 23, 2018 Update


Updated Situation Summary: The Incident Commander and Operations met the week of October 15th to address response actions and tactics.
 
The following Tactics Groups were created to develop and implement strategies, tactics, and plans to address high patient acuity across the system, API workforce shortages, and a recent increase in API staff injury rates:
 
Alaska Psychiatric Institute (API) Staffing: Recruit and train 102 additional positions to operate 80 beds. This will help take the pressure off the hospital emergency departments, improve staff safety, and ensure patients needing psychiatric care receive the most appropriate level of evaluation, therapy and rehabilitation. Group is in the process of identifying additional recruitment resources to attract more applicants to API.
 
Media Communications Plan: Provide timely updates to state and local media, state government agencies, stakeholders and the public about the psychiatric care capacity response. Group is in the process of identifying additional ways to educate the public about the challenges related to Alaska’s behavioral health system and steps the state is taking to address these challenges.
 
Crisis Stabilization Center: Contract with a vendor to stand up and manage a Crisis Stabilization Center in Anchorage, which would serve as a pre-triage location allowing individuals to receive immediate attention and be quickly referred to the appropriate level of care. This would help reduce the pressure on hospital emergency departments and allow time for individuals to be evaluated and determine the best resources needed to support them.
 
North Star Behavioral Health System: Explore North Star’s proposal to help alleviate emergency department overflow issues attributed to the waitlist at API. The group is in the process of reviewing information from North Star to determine the best path forward.
 
Access to Patient Care Plans in Emergency Departments: Determine how to share limited API patient care plans with hospital emergency departments to best support the psychiatric patients and reduce redundant services. Group is in the process of identifying available resources and IT requirements to make this happen.
 
Substance Use Disorder (SUD) Services Expansion Proposal: Expedite review of the Substance Use Disorder grant RFP proposals. The deadline for proposals was Friday, October 19. Evaluation is underway and DHSS plans to award the grants in early November.
 
Medicaid Emergency Room Boarding Coverage: Resolve coding issues to allow hospitals to bill Medicaid for eligible patients after 23 hours of care in the emergency room. As of October 20, this issue has been resolved.
 
Disproportionate Share Hospitals (DSH) Funds Distribution: Distribute funding to hospitals that qualify under federal and state regulations. Analyze other options to distribute funding to impacted hospitals. Group is in the process of identifying legal parameters for DSH funds in order to determine a path forward that best meets the needs of impacted hospitals.
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