Program B: Patient Care

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Program B: Patient Care

Program Authorization: Act 253 of 1972; Act 519 of 1978; and Act 1 of First Extraordinary Session of 1988

PROGRAM DESCRIPTION

The mission of the Patient Care Program is to provide safe, individualized rehabilitative care for the mental health patients in the least restrictive setting, in collaboration with the community.

The goal of the Patient Care program is to provide evaluation, diagnosis and treatment services to children, adolescent and adults in inpatient, residential and partial hospitalization settings in order to return the patient to the community as a healthy and productive individual.

The Patient Care Services Program is responsible for the provision of therapeutic treatment to acute inpatient psychiatric patients and residential and partial hospitalization clients, in accordance with licensing, Health Care Financing Administration (HCFA), and Joint Care Commission on Accreditation of Healthcare Organizations (JACHO) certification and accreditation standards. The general population served is children and adolescent patients.

The three distinct units of the hospital are Adult Acute Psychiatric Service Unit (44 bed unit), the Partial Hospitalization Program (40-60 bed unit), and the Adolescent Female Residential Treatment Unit (16 bed unit).

Adult Acute Psychiatric Service is a short-term, acute program providing crisis intervention and/or stabilization to patients with a psychiatric history and presenting problems consistent with rapid treatment response, with subsequent discharge to community care. This unit is approved by HCFA and JCAHO.

Partial Hospitalization Program is a day treatment program for children and adolescents who are experiencing emotional and behavioral problems. The program serves as an alternative to inpatient treatment but also facilitates the transition from inpatient to outpatient care. This unit is approved by JCAHO.

Adolescent Female Residential Treatment Unit is a residential program for adolescent girls in the custody of the Office of Community Services. The target population is girls aged 13 to 17 from all parts of the state, who have not adapted well to other settings including relatives, foster homes, and other residential programs. The intent of this program is to provide a consistent and secure environment that contains and redirects the maladaptive behaviors of the girls, so they can learn from their experiences, and have the benefit of uninterrupted schooling and adult guidance. This unit is approved by JCAHO.

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 and Interagency Transfers. Interagency Transfers include Title XIX reimbursement for services provided to Medicaid eligible patients, reimbursement from Office of Community Services for the Spring House, IAT from the Health Care Services Division - Earl K. Long Medical Center for the inpatient psychiatric acute unit and reimbursement from Vocational Rehabilitation.

ANALYSIS OF RECOMMENDATION

GENERAL FUND	TOTAL	T.O.	DESCRIPTION

$653,634	$6,121,240	145	ACT 19 FISCAL YEAR 1998-1999

			BA-7 TRANSACTIONS:
$0	$336	0	Carry Forward
$0	$131,785	2	BA-7 #4 Transfer from OADA
$0	$0	1	Transfer from OADA

$653,634	$6,253,361	148	EXISTING OPERATING BUDGET – November 20, 1998

$0	$63,672	0	Annualization of FY 1998 -1999 Classified State Employees Merit Increase
$0	$64,946	0	Classified State Employees Merit Increases for FY 1999 -2000
$0	$58,670	0	Acquisitions and Major Repairs
$0	($19,000)	0	Nonrecurring Acquisitions and Major Repairs
$0	($336)	0	Nonrecurring Carry Forwards
$0	$347,931	0	Salary Base Adjustment
$0	($87,859)	0	Attrition Adjustment
$0	$21,123	1	Other Adjustments – Addition of new T.O. for existing position
$0	($148,620)	0	Other Adjustments – Adjustment for IAT MOF (decrease revenue from DSS)
$1,241,883	$0	0	Means of Financing Substitutions – Replace IAT with SGF based on IAT projections for FY 1999

$1,895,517	$6,553,888	149	TOTAL RECOMMENDED

$1,241,883	$300,527	1	DIFFERENCE (TOTAL RECOMMENDED AND EXISTING OPERATING BUDGET)

The total means of financing for this program is recommended at 105% of the existing operating budget. It represents 91.9% of the total request ($7,133,375) for this program. The major changes reflected in this analysis include an increase of $39,670 for acquisitions and major repairs; an increase of $388,690 to fully fund salaries; and the addition of a new position as mandated by the Department of Civil Service. The changes should have no significant impact on the delivery of these services.

PROFESSIONAL SERVICES

$10,600		Serves as radiologist for GSH; provides daily interpretations of X-rays taken by GSH's radiology technician. Contractor to provide overall supervision on a consultant basis for operation of radiological services at GSH.
$51,959		Contractor to provide psychiatric/medical evaluation and care
$40,687		Part-time pharmacist to dispense medication and maintain necessary controls of medications, give consultation to clinical staff as needed and review medication records of patients.

$28,000		Clinical dietician to assure provision of optimal nutritional care and documentation of appropriate dietetic information for patients of the adult psychiatric service. Services include dietary assessments, diet instruction/counseling, nutrition classes, food and drug interaction instruction/counseling, and writing/calculating special diets.

$8,400		Contractor to serve as minister
$1,200		Provision of therapeutic services to hearing impaired
$13,500		Provision of radiological technician services. Responsible for picture taking and development of X-rays for clients and maintenance of required yearly tests on staff as required by JCAHO.
$6,000		Contractor to serve as librarian for professional library. Contractor will organize and maintain the library collection, develop an unattended system to check out and return library materials, receive, catalog, and shelve new journals and books and remove torn and outdated material from the collection.
$15,960		Contractor will assist hospital physicians in maintaining timely patient record.
$16,200		Contractor to organize, manage, and operate a volunteer service which shall be directed toward enhancements of services to meet clients' social, recreational, and interactional needs.
$120,000		Contractor who shall be responsible for directing and coordinating all activities relating to the care and treatment of patients in the adult psychiatric units
$45,000		Contractor to serve as clinical director of GSH
$105,280		Contractor to provide physician coverage for weekends and holidays

$462,786		TOTAL PROFESSIONAL SERVICES

OTHER CHARGES

		Interagency Transfers:
$13,080		Payments to LSU to serve as neurologist
$46,302		Payments to LSU to provide psychological assessment services and therapy
$9,093		Payments to LSU to provide drug testing services

$68,475		TOTAL INTERAGENCY TRANSFERS

ACQUISITIONS AND MAJOR REPAIRS

$58,670		Recommended level of funding for the replacement and repairs of obsolete, inoperable or damaged equipment and buildings

$58,670		TOTAL ACQUISITIONS AND MAJOR REPAIRS

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