Partial Hospitalization / Inpatient Hospitalization
Gratiot Integrated Health Network
Partial Hospitalization / Inpatient Hospitalization
Service Codes: 0100, 0124, 0134, 0913
Program Philosophy: Gratiot Integrated Health Network provides services to build resilience, and to support the recovery or well-being of individuals and the integration of individuals served into the community. Through service provision, symptoms or needs will be reduced and individuals will experience an improvement in level of functioning in their environment. The program strives to continually improve service provision in order that individuals served experience an enhanced quality of life.
Program Goals: Both Partial and Inpatient Hospitalization services are used to treat a person who has mental illness and requires intensive, highly coordinated, multi-modal ambulatory care with active psychiatric supervision. The goal of Inpatient treatment is to provide a protective environment for medical stabilization, support, treatment for psychiatric and addictive disorders (when applicable), and medical supervision. However, Partial Hospitalization services are utilized with the goal of preventing an inpatient psychiatric hospitalization and stabilizing acute, emergent symptoms of mental illness.
Services/Scope of Services:
Partial Hospitalization: Partial Hospitalization services may be used to treat a person with mental illness who requires intensive, highly coordinated, ambulatory care with active psychiatric supervision. Services include close and continuous skilled medical observation and supervision necessary to make significant changes to, and/or monitor psychotropic medications. Intensive group and individual therapy is provided, along with psycho-education, nursing services, and continuous monitoring for safety. Patients are linked to additional treatment resources as needed.
Populations served include individuals with signs and symptoms of a serious psychiatric disorder, demonstrating significant functional impairments in self-care, daily living skills, interpersonal/social and/or educational/vocational domains, and is exhibiting some evidence of clinical instability. The severity of the illness and impairment must not require treatment at a higher level of care.
Partial Hospitalization services are provided for six or more hours per day, five days a week at the Gratiot Medical Center in Alma Monday through Friday, 9:00 am to 3:00 pm.
Inpatient Hospitalization: Services associated with an Inpatient Hospitalization include a physical examination, orders for appropriate tests, face-to-face consultation with a physician, close and continuous skilled medical observation and supervision necessary to make significant changes to, and/or monitor psychotropic medications. Intensive group and individual therapy is provided, along with psycho-education, nursing services, and continuous monitoring for safety. Patients are linked to additional treatment resources as needed.
Populations served include individuals with signs and symptoms of a serious psychiatric disorder, and/or demonstrating significant functional impairments in self-care and independent functioning, and/or harm to self and/or others, and/or experiencing drug/medication complications, or co-existing general medical conditions requiring care.
The Inpatient Hospitalization program assesses for hospitalization in locations that meet the needs of the person served and ensure optimal safety. The majority of assessments for hospitalization occur at the Hospital ER. Hospitals providing inpatient psychiatric care include all facilities meeting Medicaid Standards of Care. Services are accessible seven days per week, 24 hours per day.
Inpatient and Partial Hospitalization services are initiated at the request of the individual, parent or legal guardian. Information from referral sources will be accepted after proper consent for release of information is obtained. Services will not be denied based on an individual’s inability to pay for services.
Admission/Re-Admission Criteria: Priority for Partial Hospitalization services is given to individuals with acute exacerbation of psychiatric illness, functional impairment, and need for continuous skilled medical observation. Individuals must be able to contract for safety and demonstrate an ability to benefit from Partial Hospitalization Program services such that they are not in need of treatment at a higher level of care.
Any individual meeting medical necessity as outlined above may utilize Inpatient Hospitalization services. Individuals meeting medical necessity will receive an initial authorization of up to 2days if admitted Monday – Thursday, and up to 3 days if admitted over the weekend. Lead crisis staff are responsible for conducting Continued Stay reviews and will authorize 1-3 additional days per review, based on evidence of medical necessity.
It is the policy of Gratiot Integrated Health Network to provide services to all eligible consumers in a manner that is sensitive to the cultural and socio-economic needs of the individual in a nondiscriminatory and/or non-threatening manner. Services are provided to eligible individuals without regard to race, religion, color, national origin, age, sex, marital status, sexual preference, handicap, juvenile justice status or any other protected status as required by law. The agency endeavors to accommodate individuals with special needs, or refers to providers equipped to meet their needs.
When individuals are found to be ineligible for services, they are given the reason(s) and are directed to alternative or more appropriate services. In addition, when applicable, the family/support system and/or the referral source are informed as to the reason for ineligibility. Assistance in contacting alternative services is available upon request.
Partial Hospitalization: Patients will be transitioned to a higher level of care when needs exceed the Partial Hospitalization’s scope of service. Examples include imminent risk of harm to self or others, increased severity of psychiatric symptoms and impairment requiring 24-hour supervision.
An individual may be discharged from the Partial Hospitalization Program when psychiatric signs and symptoms subside, and/or no longer require close and continuous skilled medical observation, and when less restrictive options are appropriate and available. Individuals may also be discharged when requested or if the individual fails to participate and drops out.
Inpatient Hospitalization: Patients will be transitioned to a lower level of care when: progress is made toward treatment goals as evidenced by a measurable reduction in signs/symptoms, impairments, or harm inclinations; biologic/medication complications have improved; or there is no longer an imminent risk of harm to self/others or increased severity of psychiatric symptoms and impairment requiring 24-hour supervision.
An individual may be discharged from the Inpatient Hospitalization Program when there is no longer an imminent risk of harm to self or others, and there is decreased severity of psychiatric symptoms and impairment no longer requiring 24-hour supervision.
When an individual is discharged or removed from these programs for aggressive and/or assaultive behavior, follow-up will occur within 72 hours to insure linkage to appropriate care.
Regardless of discharge status, any individual may reapply for services by contacting GIHN.