NJHA, NJ-ACEP Applaud Lawmaker for Putting Patients First

Healthcare organizations today applauded N.J. Assemblyman Joe Cryan (D-Union) for sponsoring legislation that will improve access to behavioral health services and ease excessively long waits for these vulnerable patients.

Surveys have shown that N.J. patients have waited up to a week in hospital emergency departments awaiting transfer to an appropriate behavioral health program. (see below.)

Cryan’s package of three bills is scheduled for a vote today in the state Assembly. The package has received strong support from the New Jersey Hospital Association and the New Jersey chapter of the American College of Emergency Physicians.

“Behavioral health patients all too often end up in hospital Emergency Departments, victims of a disjointed system and inadequate specialty services for their unique needs,” said Dr. Bruce Bonanno, president of NJ-ACEP. “With all due respect to the dedicated professionals in our Emergency Departments, this is no place for this fragile population. These patients deserve prompt access to specialized inpatient programs and state facilities to give them the right care in the right setting.”

NJHA President and CEO Betsy Ryan joined Dr. Bonanno in supporting the bills. She cited the results of an NJHA survey of emergency departments across the state, which revealed exceedingly long waits for patients awaiting transfer to a behavioral health program.

“The results of our survey were astounding and disturbing,” said Ryan. “We routinely saw patients waiting days at a time – sometimes nearly a week – awaiting a transfer. We must find remedies to keep these patients from becoming virtual boarders in our state’s emergency departments.”

Survey Reveals Long Waits for Patients

NJHA’s survey, conducted in August and September 2008, asked hospitals to document each interval in which a behavioral health patient waited 12 hours in the ED. In total, 36 hospitals reported more than 1,400 episodes in which patients waited at least 12 hours for the behavioral health services they needed. Detailed findings revealed:

• About 700 of the documented occurrences were patients waiting between 12 and 24 hours.
  
• About one third – 470 cases – were waits of 24 to 48 hours.
  
• Close to 70 patients waited 48 to 60 hours.
  
• Nearly 100 patients waited from 60 to 108 hours.
  
• And 10 patients spent 108 to 156 hours in the emergency department waiting for the specialized care they needed.

Snapshot checks of hospitals since the initial survey have revealed continued gridlock for behavioral health patients awaiting transfer.

Assemblyman Cryan’s package includes three measures to address the crisis: A-3582 would require the state Division of Mental Health Services to develop procedures to enable hospitals to promptly transfer emergency department patients with mental illness to an appropriate treatment setting. A-3583 would require the Department of Human Services to establish standardized admission protocols and medical clearance criteria for admission to state or county psychiatric hospitals or short-term care facilities. And A-3584 would require DMHS to identify available mental health services and perform a statewide needs assessment.

“Assemblyman Cryan has taken the lead in finding relief for these vulnerable patients and for all New Jerseyans who count on the state’s increasingly busy emergency departments,” said Ryan.

On behalf of the state’s emergency physicians, Dr. Bonnano added his appreciation for the Assemblyman’s efforts.

“We deal with urgent cases, and our goal is to provide the best possible care to our patients,” said Dr. Bonnano. “Unfortunately, the current system is not an optimal one for our behavioral health patients, and we applaud Assemblyman Cryan for taking steps to address a growing human problem.”