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Iowa DHS scolds hospitals for neglecting mental health bed tracker
Erin Jordan
Oct. 9, 2015 4:11 pm
IOWA CITY - The Iowa Department of Human Services sent a letter this week to hospitals in the state with psychiatric units scolding officials for not updating a bed database intended to speed care for mentally-ill Iowans.
CareMatch, a $147,000 state database launched Aug. 1, is designed to allow hospitals with inpatient psychiatric units to regularly update bed availability so smaller hospitals will know where they can transfer patients having mental health crises.
DHS wants Iowa's 29 hospitals with psych units to update the database three times a day but that isn't happening, DHS reports.
'In some cases, hospitals are not updating CareMatch data for several days at a time, especially over the weekends,” Rick Shults, administrator of DHS's Mental Health and Disability Services, said in an Oct. 5 letter sent to the hospitals. 'During that lapse in reporting a hospital could have admitted or discharged several patients affecting the hospital's actual bed availability.
'Failing to report timely diminishes the usefulness of the system and leads to delayed treatment for patients,” Shults wrote.
Most of Iowa's rural hospitals don't have psychiatrists, so they are required to find inpatient beds elsewhere. Hospital staff call dozens of psychiatric hospitals around the state as the patient - sometimes suicidal or violent - waits in the ER for a transfer. Sheriff's deputies often drive patients up to six hours to find an available bed.
Iowa's 700 mental health beds are clustered in 27 hospitals and two mental health institutes across the state. Nearly one-quarter of those beds are located at hospitals in the Corridor.
the University of Iowa Hospitals and Clinics, in Iowa City, has 73 psychiatric beds - 58 for adults and 15 for children. Staff members update the CareMatch database twice a day, at 10 a.m. and 5 p.m., Spokesman Tom Moore said.
UnityPoint Health - St. Luke's Hospital, in Cedar Rapids, has 72 inpatient beds and updates the bed tracker three times a day, said Kent Jackson, the hospital's behavioral health director.
'We feel the database has potential but it needs to be updated in real time to be most effective,” Jackson said in an email. 'We are unable to constantly update the database because our top priority has to be on our patients who need immediate care.”
Mercy Medical Center, in Cedar Rapids, tries to update the CareMatch database once every shift, but at least twice a day, said Amanda Jilovec, who oversees access nurses. The hospital has a 20-bed psychiatric unit.
'It has been a resource because it tells you what services each hospital provides,” Jilovec said about the database. But Mercy staff still make many phone calls because the software doesn't list specific restrictions for each bed, such as severity of the mental health disorder.
Jilovec said she hoped the state would start requiring hospitals to update the database regularly.
But that's not going to happen unless the Legislature demands it.
'DHS does not have the authority to make the system mandatory and it is not required in hospital licensing or reporting requirements,” said Amy McCoy, an agency spokeswoman. 'Making the system mandatory would require legislative action.”
But Shults's Oct. 5 letter issued a pointed reminder of who values the database:
'This effort has been a high priority for the governor, the Legislature and the department to more quickly match individuals needing acute psychiatric inpatient services with the hospitals that can serve them and to better understand what the statewide need is for inpatient psychiatric hospital beds.”
Branstad closed two state mental health institutes last summer - a move Democrats and union leaders are fighting in court.