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American Innovative Healthcare Solutions  LLC Psychiatric Care Service Expansion Proposal
Presentation Overview ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Values ,[object Object],[object Object],[object Object],[object Object]
Principles of our Philosophy ,[object Object],[object Object],[object Object],[object Object],[object Object]
Cost Effectiveness comes from: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Developing a Continuum of Care
Targeted Populations Adults   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Who We Are and Are Not Adults ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What We Learned/Where We Are Going ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Advantages for Members ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Advantages for Community Provider ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Psychiatric Levels of Care Problems   and Services Problems GAF Appropriate Services Inpatient Severe uncontrolled delusions, hallucinations, suicidal plans or attempts. 1 0-30 Medication management, crisis stabilization, referral to outpatient resources, including housing and 24 X 7 supervision. Partial Hospitalization Moderate-Severe delusions, hallucinations, suicidal  thoughts without plans. 25-40 Medication optimization, group Therapy, Psychological education, Med. Ed., Individual therapy and  referrals to outpatient resources made. Intensive Outpatient Mild-moderate, Delusions, hallucinations, decreasing suicidal  thoughts without plans. 41-60 Group Therapy, psychological education, Individual therapy has begun with an individual therapist and psychiatrist. Linkage to outpatient resources completed. Outpatient  Medically Necessary Care Reasonable Probability to Benefit. Mild-moderate, Delusions, hallucinations, decreasing suicidal  thoughts without plans. 35-70 Group Therapy. Individual therapy has begun with an individual therapist and psychiatrist. Evaluation and Management. Medication management. Psychosocial Rehabilitation  No medical necessity for group or individual therapy. Moderate-Severe delusions, hallucinations, without suicidal  plans. 10-50 Assistance with most activities of daily living, group social, recreational activity. Medication compliance, teaching social interaction skills, Med. Ed.,
Psychiatric and Addictions Levels of Care Levels of Care Behaviors Global Assessment of Functioning  (GAF) Axis V Hours per week What is  Medically Necessary & Reasonable?  Appropriate Services Inpatient Hallucinations, delusions, suicidal GAF 10-30 24 X 7 care Emergency management, Stabilization. Medication changes Individual, family, group tx, medication Ed., OT Partial Hospitalization Impairment in reality testing and communication GAF 25-40 16-20 hours per week Increase family support, teach coping skills, optimize meds. Individual, family, group tx, psychological education, medication Ed., OT Intensive Outpatient (Not recognized by Medicare) Moderate symptoms, and difficulty in working  and social functioning GAF 50-70 10-20 hours per week Expand support system, demonstrate effective coping skills,  return to work or school. Psych Assessment, psychological education, Group, individual and family therapy. Outpatient Mild-severe symptoms. 35-70 1-10 hours per week Talk therapy, medical management, reassessment every 30-90 days. Psych Assessment, Group, individual and family therapy Psychosocial Rehabilitation Low probability to improve Reached their baseline of functioning Activities Daily Living,  recreation, social  activity, med. compliance Support, counseling, employment to maintain baseline.
LCPC LCSW Behavioral Health Assistants M.D. Senior Leadership Professional Disciplines Psychiatrists
Licensed Clinicians Functions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Psychological Services under the Incident-to Provision  WPS PSYCH-013-014   ~   ~
List of “Qualified Individuals” Illinois ,[object Object],[object Object],[object Object],~   ~
Professional Credentialing ,[object Object],[object Object],~   ~
Professional Credentialing  ,[object Object],~   ~
Coding Guidelines for Incident-to ,[object Object],[object Object],~   ~
Shared Case Work Functions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Next Steps ,[object Object],[object Object],[object Object],[object Object],[object Object]
Contact Information ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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American Innovative Healthcare Solutions Psychiatric Care Expansion Proposal

  • 1. American Innovative Healthcare Solutions LLC Psychiatric Care Service Expansion Proposal
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  • 12. Psychiatric Levels of Care Problems and Services Problems GAF Appropriate Services Inpatient Severe uncontrolled delusions, hallucinations, suicidal plans or attempts. 1 0-30 Medication management, crisis stabilization, referral to outpatient resources, including housing and 24 X 7 supervision. Partial Hospitalization Moderate-Severe delusions, hallucinations, suicidal thoughts without plans. 25-40 Medication optimization, group Therapy, Psychological education, Med. Ed., Individual therapy and referrals to outpatient resources made. Intensive Outpatient Mild-moderate, Delusions, hallucinations, decreasing suicidal thoughts without plans. 41-60 Group Therapy, psychological education, Individual therapy has begun with an individual therapist and psychiatrist. Linkage to outpatient resources completed. Outpatient Medically Necessary Care Reasonable Probability to Benefit. Mild-moderate, Delusions, hallucinations, decreasing suicidal thoughts without plans. 35-70 Group Therapy. Individual therapy has begun with an individual therapist and psychiatrist. Evaluation and Management. Medication management. Psychosocial Rehabilitation No medical necessity for group or individual therapy. Moderate-Severe delusions, hallucinations, without suicidal plans. 10-50 Assistance with most activities of daily living, group social, recreational activity. Medication compliance, teaching social interaction skills, Med. Ed.,
  • 13. Psychiatric and Addictions Levels of Care Levels of Care Behaviors Global Assessment of Functioning (GAF) Axis V Hours per week What is Medically Necessary & Reasonable? Appropriate Services Inpatient Hallucinations, delusions, suicidal GAF 10-30 24 X 7 care Emergency management, Stabilization. Medication changes Individual, family, group tx, medication Ed., OT Partial Hospitalization Impairment in reality testing and communication GAF 25-40 16-20 hours per week Increase family support, teach coping skills, optimize meds. Individual, family, group tx, psychological education, medication Ed., OT Intensive Outpatient (Not recognized by Medicare) Moderate symptoms, and difficulty in working and social functioning GAF 50-70 10-20 hours per week Expand support system, demonstrate effective coping skills, return to work or school. Psych Assessment, psychological education, Group, individual and family therapy. Outpatient Mild-severe symptoms. 35-70 1-10 hours per week Talk therapy, medical management, reassessment every 30-90 days. Psych Assessment, Group, individual and family therapy Psychosocial Rehabilitation Low probability to improve Reached their baseline of functioning Activities Daily Living, recreation, social activity, med. compliance Support, counseling, employment to maintain baseline.
  • 14. LCPC LCSW Behavioral Health Assistants M.D. Senior Leadership Professional Disciplines Psychiatrists
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  • 16. Psychological Services under the Incident-to Provision WPS PSYCH-013-014 ~ ~
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Editor's Notes

  1. New expensive meds. SNFs lose money on every patient. Unfunded Trauma patients.