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DHS Continues Push to Increase Access to High-Quality Services, Announces Telephonic Psychiatric Contracts

07/22/2016

Harrisburg, PA - The Department of Human Services today announced the statewide selection by the HealthChoices managed care organizations (MCOs) of awards for Pennsylvania’s Telephonic Psychiatric Consultation Service Program (TiPS). TiPS is a new HealthChoices program designed to increase the availability of peer-to-peer child psychiatry consultation teams to primary care providers (PCPs), medical specialists, and other prescribers of psychotropic medications for children insured by Pennsylvania’s Medical Assistance programs.

“It is critical that all children, regardless of where they live, have access to quality health care services,” said DHS Secretary Ted Dallas. “Access to child psychiatry has been a significant problem nationwide for years. Today’s announcement means that more of our kids will have the services they need, and not just another prescription.”

The program provides real time provider-to-provider or peer-to-peer resources to the PCPs and other providers who desire immediate consultative advice for children with behavioral health concerns, covered by Medical Assistance, up to age 21. Phone inquiries are usually patient-specific, but can also be about any general question related to child psychiatry, behavioral health, or community resources.

There was one vendor selected by the physical health MCOs for each of the five HealthChoices zones. The following teams will ensure access to quality services in the appropriate setting based on the child’s needs and will help mitigate the lack of available child psychiatry resources: 

   · Children's Community Pediatrics – Southwest and Northwest zones

   · Penn State Children’s Hospital – Northeast and Lehigh/Capital zones         

   · The Children’s Hospital of Philadelphia – Southeast zone

In June 2015, DHS, in partnership with PolicyLab at CHOP, released new data on psychotropic medication use among Medicaid-enrolled Pennsylvania children in foster care, as well as the state’s action plan to address the findings.

“In the year following the release of this report, the department and our MCOs have been diligently working to improve the safety of Medicaid-enrolled foster children and the efficacy of the psychotropic medications prescribed to them,” said Dallas. “The TiPS program provides an alternative to unacceptable prescribing and is the latest step in addressing this issue.”

The TiPS teams are comprised of child psychiatrists, licensed therapists, care coordinators, and administrative support. They are available to assist any PCP who sees children or adolescents covered by HealthChoices and the Fee-for-Service program. They also support behavioral health clinicians who may be involved with complex cases and need additional supports.

TiPS core services include:

   · Telephone and face-to-face consultation

   · Care coordination

   · Training and education

“The department is committed to increasing access to high-quality services statewide. The rising prevalence of child behavioral health issues coupled with a stagnant workforce has only intensified current access challenges,” said Dallas. “Children's PCPs end up meeting the current unmet need even though they may not feel completely equipped to do so. In partnership with the TiPS teams, pediatricians and family physicians can effectively work together to serve youth with common mental health conditions such as ADHD and mild depression.”

TiPS team members respond to a request for consultation within 30 minutes, and often immediately. The consultation would usually result in one of the following outcomes, depending on the needs of the child and family:

   · An answer to the PCP's question

   · Referral to the team care coordinator to assist the family in accessing local behavioral health services such as therapy, specialty psychiatry, or neuro-psychological assessment

   · Referral to the team therapist to provide transitional, face-to-face care or telephonic support to the child and family until the family can access local behavioral health resources

   · Referral to the team or local child psychiatrist for a face-to-face acute psychopharmacological or diagnostic consultation

Some youth may need specialty psychiatric care and have medication needs that are not appropriately managed in the primary care setting. TiPS teams will help to connect people to the appropriate care, as TiPS psychiatrists do not prescribe medications. This model is now being used in more than 30 other states throughout the country.

TiPS care coordinators, working with the county mental health administration and the behavioral health MCO, will identify and maintain up-to-date behavioral health resources in the community. They will work with families to identify appropriate options, and follow-up to ensure connections are made. Care coordinators keep the PCPs and other providers informed of the referrals and the outcome of the follow-up efforts so the referring provider can ensure their patients are receiving the care they need.

For more information, visit www.dhs.pa.gov.  

MEDIA CONTACT: Kait Gillis - 717-425-7606

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