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The following are links to best practices resources and articles.

Task force members are welcome to submit additional resources for inclusion in this section.
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Integrating behavioral health into Medicaid managed care: Design and implementation lessons from state innovators. 
Center for Health Care Strategies. April, 2016
Medicaid enrollees with behavioral health needs have a high prevalence of chronic conditions and are often frequent users of physical and behavioral health services.  This brief provides insights from Medicaid officials and health plan representatives in five states - Arizona, Florida, Kansas, New York and Texas - that are pursuing innovative approaches to integrate BH services within a comprehensive managed care arrangements.  This brief explores key lessons to guide state integration efforts to improve outcomes and reduce costs.

bh-integration-brief_041316.pdf
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Triple aim strategies to improve behavioral health care. 
American Hospital Association. February, 2016
A guide which outlines strategies, action steps, and examples for hospitals, health systems and community stakeholders to work together to develop well-coordinated, accessible, affordable, and accountable systems for delivering behavioral health care.

triple_aim_and_behavioral_health_02_26_16_final.pdf
File Size: 437 kb
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New trends in emergency psychiatry: Strategies to treat psychiatric crises and improve ED input. 
Barton Associates. 2012
Provides description of Comprehensive Psychiatric Emergency Programs (CEPSs) as cost-effective solutions to help individuals experiencing psychiatric crisis.    There are currently 200 CPEPs operating in the U.S.  The article also covers other options for those who cannot easily access a CPEP such as mobile crisis units and telepsychiatry.

barton-associates-new-trends-in-emergency-psychiatry.pdf
File Size: 171 kb
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The PES - Crisis stabilization and evaluation for all: Regional Dedicated Psychiatric Emergency Services (PES) - Dedicated psychiatric/substance use disorder emergency department.
California Hospital Association.  August 18, 2014.
An overview of a Psychiatric Emergency Services (PES) unit as a model for people in crisis.  PES programs are designed to provide accessible, professional, cost-effective services to individuals in psychiatric and/or substance abuse crisis, and strive to stabilize consumers on site an avoid psychiatric hospitalization whenever possible.  Outlines "Zeller's 6 Goals of Emergency Psychiatric Care."
psychiatric_emergency_services_concept.pdf
File Size: 398 kb
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Psychiatric ER proposed for Portland would provide new link in mental health crisis treatment.
Bernstein, M.  December 4, 2014. The Oregonian.
Portland, OR opened a designated psychiatric ER in Northeast Portland to provide short-term care for people experiencing a mental health crisis.   This is based on Zeller's model which is operating in Alameda County, CA. The model includes dedicated psychiatric hospital that either accepts patients who are either transferred there from regular ERs, taken there by ambulance or who walk in.
portlander.pdf
File Size: 182 kb
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A Literature Review:  Psychiatric Boarding.
U.S. Department of Health and Human Services. 2008.
A comprehensive literature review of information related to psychiatric boarding.  The review includes a definition of boarding, scope of the issue, reasons behind the issue and potential short and long term solutions.
uddhhs_literaturereviewrepsychiatricboarding.pdf
File Size: 1772 kb
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New strategies to reduce psychiatric patient boarding in ERs.
Scott Zeller, MD. Psychiatry Advisor. October 6, 2014.
Explains that boarding can lead to worsening of psychiatric symptoms.   Outlines solutions from within the ED and from outpatient programs external to the ED. 

pschadvisor_zeller_2014.pdf
File Size: 316 kb
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Psychiatric Boarding: Averting long waits in emergency rooms.
Scott Zeller, MD. Psychiatric Times. September 16, 2013.
Review of the Zeller's "Alameda Model" including process and outcomes.  Touches on costs of model and potential coding changes from U.S. Medicare and Medicaid.

psychiatric_times_-_psychiatric_boarding_averting_long_waits_in_emergency_rooms_-_2014-03-31.pdf
File Size: 1125 kb
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Psychiatrist improved ER treatment of mentally ill.
Scott Zeller, MD.  San Francisco Times.  July 27, 2012 
Brief overview of Scott Zeller's quest to improve emergency services for those experiencing psychiatric crisis.
san_francisco_news_zeller_article.pdf
File Size: 359 kb
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The Banner Psychiatric Center: A model for providing psychiatric crisis care to the community while easing behavior health holds in emergency departments.
The Permanente Journal, 17(1), 45-49. Winter, 2013.
Journal article with detailed description of how Banner Health developed a process to in its Phoenix, AZ market, to provide individuals in behavioral health crisis and alternative to presenting in the ER. The document includes a review of the collaborative 6-step process to develop the new care model.  The solution includes development of an emergency psychiatric center open 24/7, improved centralized transfer services, education outreach for professionals in EDs, use of telemedicine services, and addressing the needs of behavioral health patients with comorbidity. 

psychiatriccare.pdf
File Size: 348 kb
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Crisis stabilization claims analysis: Technical Report.
Mental Health Crisis Alliance: Wilder Research, 2013.
The Mental Health Crisis Alliance is a coalition of mental health leaders and providers working to transform the crisis service systems for adults in the eastern metropolitan are of Minneapolis-Saint Paul, MN.  The group commissioned a study on the impact of community-based stabilization services on healthcare utilization.  The full report is attached.  Key findings found that proper crisis stabilization processes resulted in decreased use of ER and impatient services, and an increased use of outpatient mental health services.  The report shares a formula to measure the ROI of mental health crisis programs. 
crisis_stabilization_claims_analysis_-_technical_report.pdf
File Size: 692 kb
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In need of help? Crisis and suicide prevention just a phone call away.
Marjorie Cortez  Desert News. January 17, 2014. 
Business newspaper article about crisis services in Salt Lake City, UT.  The article highlights the Crisis Line operated by the University Neuropsychiatric Institute and the successful use of Mobile Crisis Outreach Teams as alternatives to ERs.  It provides information about UNI's Wellness Recovery Center as an alternative to hospitalization.  The Center is a short-terms residential program for Salt Lake City County residents experiencing acute mental health crisis.
desertnews_article.pdf
File Size: 368 kb
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Its mental health treatment system saves San Antonio millions.
Jenny Gold.  National Public Radio.
August 20, 2014.
Transcript from radio segment on National Public Radio highlighting San Antonio's mental health system model, which has saved the city and county more than $50 million over the past five years.  Based on a collaborative effort of the police, courts, prisons, hospitals, providers  and local government, they developed a Restoration Center.  They pulled their resources to create the Center which integrates services for mental health, substance abuse, and homeless services.
npr_san_antonio__aug_2014.pdf
File Size: 225 kb
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Medicaid considering IMD-exclusion alternatives.
Behavioral Healthcare. August 15, 2014
Article about ACA and possible payment models for psychiatric treatment in the U.S.  It covers issue of access, CMS grants, and policy options for the IMD exclusion.
medicaid_considering_imd-exclusion_alternatives.pdf
File Size: 285 kb
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Hospital strategies for addressing psychiatric boarding.
Monica Oss.  openminds.com. October 29, 2014.
Blog post about 4 alternative solutions to ease psychiatric boarding issues; 1) collaboration among competitors, 2) regional psychiatric emergency services, 3) telepsychiatry on demand, and 4) behavioral emergency response teams. 
hospital_strategies_for_addressing_psychiatric_boarding_moncia_oss.pdf
File Size: 214 kb
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Another perspective on psychiatric boarding.
Monica Oss.  openminds.com. October 27, 2014.
Blog post about psychiatric boarding and why 'more beds' is not the only solution.

another_perspective_on_psychiatric_boarding_monica_oss.pdf
File Size: 305 kb
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Best practices themes
March 9, 2015
Presentation made to the PCES task force on March 9, 2015.  Highlights themes in best practices research. 

pces_best_practices_overview.pptx
File Size: 1076 kb
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