Anchorage Emergency Service Pathways

 

 

 

 

 

Updated 12-02

Referral Pathway

 

 

Go to Providence PSYCH ER ?

 

 

 

Go to API Without Treatment at the Providence PSYCH ER?

 

Go to CTC or EDU Without Treatment at Providence PSYCH  ER?

 

 

 

Transportation Directions

 

POA or Ex Parte to API from outside of Anchorage

 

 

No

 

Yes

 

N/A

 

 

Go to directly to API -   AST or D-Tec provides the transportation

 

 

POA from Anchorage Police (APD) or AST,  from within the Anchorage Bowl

 

 

Yes

 

No

 

No

 

Go directly to the  PSYCH ER – Typically APD  transport

Ex Parte’ or screening order from Anchorage Bowl

No

 

Yes

 If API assesses there is a medical concern, the patient is transported from API to the PAMC ER for medical clearance

 

No

Typically AST transport

 

POA  or Ex Parte from Elmendorf, ANMC, Northstar,  Providence Hospital (other than PSYCH ER) or AK Regional Hospital

 

No

 

Yes

No phone coordination with  PSYCH ER:  the API On-Call MD screens case and accepts/denies the person  following a MD/ANP to API MD phone contact

 

 

N/A

 

Go to directly to API - Typically these consumers will be transported via

ambulance, per EMTALA. However, if  law enforcement is used, they must be told to go directly to API or APD/AST may automatically take to PSYCH ER

 

 

Telephone request to API for admission

 

 

Told to call  PSYCH ER directly; or told to go to the PSYCH ER

 

No

 

No

 

Transport privately arranged to PSYCH ER

 

A person walks in to API seeking  a voluntary  admission

 

 

N/A

 

 

API assesses and can:

1) admit to API;

2) directly refer the client to  PSYCH ER for an evaluation; or

3) request that the PSYCH ER Mobile Crisis Team come to API to assess for transfer to PSYCH ER

 

 

No

 

If Transfer to the  PSYCH ER is accepted, either

1) the Mobil Team will transport; or

2) an Ambulance will be called by API to transfer the person to the PSYCH ER

 

A local mental health professional (Outpatient Provider) seeks to voluntarily admit one of their clients to API (either  telephonic or walk-in

admission request)

 

Yes, If client does NOT have a demonstrated history of API admissions

(as always, the main effort is to consider utilization of the PSYCH ER first)

 

Yes:

1) If client is well- known to API and the  outpatient provider;

2) Both API and the outpatient provider agree that an API admission is best plan; and 

3) There is no need for medical clearance at  PSYCH ER

 

 

No

 

Outpatient MH provider expected to provide or fund the transportation to API or the PSYCH ER if the provider, or a family member or friend cannot provide transportation

 

(Updated 12-5-02)

 

 

Type of Admission

 

 

Go to Providence PSYCH ER?

 

 

 

Go to API Without Treatment at PSYCH ER?

 

Go to CTC or EDU Without Treatment at PSYCH ER?

 

 

 

Transportation Directions

 

API M.D. POA’s a

consumer to API and there is little medical risk concern

 

N/A

 

Yes

 

N/A

 

Police told to take person directly to API

 

PSYCH ER Mobile Team  in community

assesses a consumer and determines an API admit is needed (no noted medical risks)

 

 

N/A

 

Yes - API On-Call M.D. screens case with Mobile Crisis Team staff person.

 

N/A

 

Police told to take person to API if involuntary (POA); If not on a POA, PSYCH ER expected to provide or fund the transportation, (including use of mobile team), if not family or friend

 

PSYCH ER Mobile team in community assesses consumer and

determines CTC or EDU is needed (no noted medical risks)

 

[Please note:  person would first be taken to the PSYCH ER if medical risk(s) were noted]

 

N/A

 

Yes – After referral is discussed with CTC or EDU and person is accepted for admission

 

Mobile Crisis Team,

Detec, Taxi, Family or friend, or possibly police or ambulance will transport;  PSYCH ER Expected to provide or fund the transportation, if not by family or friend, or law enforcement

 

PSYCH ER Mobile Team in community assesses consumer and determines possible medical risk(s) exist or  needs more observation to make an assessment

 

Yes, consumer is taken to the PSYCH ER

 

N/A

 

N/A

 

Ambulance or possibly police will transport, if mobile crisis is unable to transport to PSYCH ER

 

 

 

 

SCCC refers own client to CTC

 

            OR

 

Clitheroe refers own client to EDU

 

 

 

 

N/A

 

N/A

 

Yes. Option exists to use Mobile Crisis Team to directly assess the person if further assessment is needed.

 

SCCC Or Clitheroe is to provide or fund transportation to their own facility if ambulance is not needed and family or friend is not able to drive them.

 

CTC, EDU or Dual Diagnosis Residential refers a destabilizing client directly to API

 

 

Referral to PSYCH ER should be made if initial stabilization will enable return to EDU, CTC, or Dual Diagnosis Residential.

 

Yes – CTC, EDU, or Dual Diagnosis Residential staff call API ASO and inform API of the client’s impending transfer to API; if the client will not return to API voluntarily, then CTC, EDU or Dual Diagnosis staff will POA or Ex Parte the client directly to API.

 

 

N/A

If the CTC client , will go to API voluntarily, CTC staff will walk  or drive the CTC client over to API; if the client will not return to API  voluntarily, or if CTC staff are not comfortable transferring the client to API, then APD will transport to API.

EDU and Dual Diagnosis Residential will transport a voluntary client to API or request APD on volatile or POA cases.

 

 

(Updated 12-5-02)

 

 

Type of Admission

 

 

Go to Providence PSYCH ER?

 

 

 

Go to API Without Treatment at PSYCH ER?

 

Go to CTC or EDU Without Treatment at PSYCH ER?

 

 

 

Transportation Directions

 

API refers a client to CTC or EDU

 

N/A

 

N/A

 

Yes. API presents case directly to CTC or EDU

 

 

API expected to provide or fund the transportation to the CTC or EDU

 

A SCCC team refers a person directly to the EDU

 

N/A

 

N/A

 

Yes. SCCC staff presents case directly to EDU

 

 

SCCC expected to provide or fund the transportation to the EDU

 

Clitheroe refers directly to CTC

 

Clitheroe must call the PSYCH ER’s Mobile Crisis Team to come to Clitheroe to assess the referred person between 8 a.m. and  9:30 p.m. weekdays and 11a.m. to 9:30 p.m. weekends. If the referral occurs when the Mobile Team is not available, Clitheroe  should refer either directly to the PSYCH ERor to API, as appropriate

 

N/A

 

Yes & No - Between 8 a.m. and  9:30 p.m. weekdays and 11a.m. to 9:30 p.m. weekends, the PSYCH ER Mobile Crisis Team will assess the Clitheroe client and determine the most  appropriate referral facility, possibly including a referral to CTC

 

Mobile Crisis will transport to CTC between  8 a.m. and  9:30 p.m. weekdays and 11a.m. to 9:30 p.m. weekends; Detec will transfer at any time to either API or CTC

 

ANMC, Elmendorf, Providence (when not a PSYCH ER case), Northstar, and AK Regional assesses a client and  refers to EDU

 

N/A

 

N/A

 

Yes.

If necessary, PSYCH ER will dispatch Mobile Team to assess on site at the hospital seeking an EDU bed

 

 

Referring hospital expected to provide or fund the transportation if the client, friend or family is not able to provide transport

 

ANMC, Elmendorf, Providence (when not a PSYCH ER Case), Northstar, and AK Regional assesses a client and refers to  CTC .

[Please note:  this is a temporary require-ment until CTC can train these hospitals on referral guidelines to CTC]

 

 

Call Mobile Crisis Team to assess between 8 a.m. and  9:30 p.m. weekdays and 11a.m. to 9:30 p.m. weekends. If after 9:30 p.m.,  Refer the client to the PSYCH ER or API

 

N/A

 

Yes.

PSYCH ER will dispatch the Mobile Team to assess at the hospital seeking a CTC bed

 

Mobile Crisis or

Detec to provide transportation between  8 a.m. to  9:30 p.m. weekdays and 11a.m. to 9:30 p.m. weekends.

 

 

PSYCH ER Referral Grid