HASC members and County of Orange Behavioral Health representatives met recently to discuss how they could continue their work to establish a Psychiatric Emergency Services (PES) patient care site in Orange County.

These individuals had previously collaborated to prepare an SB 82 grant application seeking state funding for two PES facilities in Orange County. The grant was not funded.

Interest in the PES model of care has been fueled by success in other communities with expedited treatment in a dedicated, PES setting, for behavioral health patients experiencing psychiatric emergencies. Additionally, a Joint Commission report recently substantiated concerns over the boarding of these patients in hospital emergency rooms, noting that patients boarded in emergency rooms awaiting treatment are at risk for harming themselves or others.

Goals for the collaborative discussions between hospitals and the county were adopted at the end of 2013:

• Expedite crisis intervention, stabilization and treatment for patients experiencing psychiatric emergencies in more appropriate care settings, bypassing hospital emergency departments when not needed.
• Reduce the need for involuntary inpatient treatment.
• Expedite crisis intervention, stabilization and treatment for children and youth (including youth under age 12) experiencing psychiatric emergencies in more appropriate care settings such as residential beds, instead of hospital emergency departments.

It was agreed that establishment of a PES in Orange County will:

• Expedite the commencement of treatment of the psychiatric emergency within two hours, in the most appropriate care setting.
• Stabilize patients more quickly, reducing exposure to physical harm for hospital emergency room personnel.
• Expand capacity in the county for addressing psychiatric emergencies.
• Significantly alleviate emergency room crowding, benefitting the health care delivery system as a whole by freeing up emergency rooms for patients with acute medical needs.
• Save thousands of taxpayer dollars by triaging and providing crisis intervention for behavioral patients in the least costly and most appropriate level of care setting.
• Provide uniform triage and treatment services for all behavioral patients regardless of their insurance plan.

Field screenings would identify individuals in psychiatric crisis who can be transported directly to the PES facility rather than to a hospital emergency room so that the above-noted benefits can be realized.

Next steps will be concurrent efforts of four workgroups to identify actions toward implementation.

Contact: Julie Puentes

(714) 663-0294, jpuentes@hasc.org