RCSU – Psychiatric Assessment (Page 55, 3rd Bullet)

• Requiring review by psychiatric provider within 4 hours is unnecessary burden that does not add value in itself and a full psych evaluation completed within 24hrs. Individual likely already admitted and services and nursing engaged. All CSUs have and appropriately use 24/7 psychiatric and medical coverage around the clock, which includes daily psychiatric services.
• Fails to recognize the significant investment programs have made already dedicating psychiatric services and coverage and now attempting to expand bandwidth to meet system’s critical needs.
•  Does not recognize the need to be good steward of already critical system-wide shortage of psychiatric providers. Additionally, another requirement not accounted for in the Mercer Rate Study years ago.
• Leads to potential of serious unintended consequences to access and sustainability in the system.

I concur that the allowance to use a psychiatric evaluation completed within the last 24 hours is helpful for those referred by psychiatric providers. However, it appears appropriate that consideration for a window to extend this period to 72hrs. with documented review at admission.