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September 2021

New method of obtaining emergency crisis assessment for psychiatric issues, treatment coming

Starting Oct. 1, 2021, Blue Cross Blue Shield of Michigan and Blue Care Network will begin covering mobile crisis and crisis stabilization services. Both urgent care and crisis residential services are already covered. 

Note: Medicare Plus Blue℠ members won’t be included in this new program at this time.

Mobile crisis services include:

  • Professional mental health teams in the community who can evaluate the members wherever they are located
  • Evaluations face to face or over the phone to determine appropriate placement for the member

The mobile crisis team may stay involved for two to four weeks after the initial encounter to ensure members are connected to the right level of care for mental health or substance use disorder treatment and to provide treatment, as necessary.

Crisis stabilization services (formerly psychiatric observation) include:

  • Behavioral health evaluation to initiate appropriate treatment (similar to medical observation services)
  • Physical site‑based services that are necessary to support the mobile crisis team
    • Services include intake assessment, psychiatric evaluation, crisis intervention, psychotherapy, medication administration, therapeutic injection, observation and peer support
  • Initiate linkages and “warm handoffs” to the appropriate level of care and community resources

“The goal of such services is to make sure our members get treated at the right place at the right time,” said Dr. William Beecroft, medical director of behavioral health.

Facilities to be used for physical site-based services would be open 24/7 and use the services of a multidisciplinary staff, including physicians, registered nurses, licensed master social workers, psychologists, clinical supervisors and additional support staff. Members may be referred to a facility from a mobile crisis team, law enforcement or other community-based services, or they may walk in on their own.

Blue Care Network recently conducted a pilot program with two providers in Southeast Michigan — Hegira Health's COPE** and Common Ground Resource and Crisis Center.** COPE, which stands for Community Outreach for Psychiatric Emergencies, is a program created by Hegira Health, Inc.

As the State of Michigan further develops the certification process for crisis stabilization units in freestanding and hospital‑affiliated locations across the state, Blue Cross and BCN will expand their efforts to include additional providers within the state.

Here’s some additional information about the Common Ground and COPE centers:

Common Ground Resource and Crisis Center
Hours: Open 24 hours
Phone: 248‑451‑2600
Services: Mobile, walk‑in, crisis stabilization (observation), residential

Hegira Health’s COPE
Hours: Open 24 hours
Phone: 734‑721‑0200
Services: Mobile, walk‑in, crisis stabilization (observation), residential

BCN has had two years of experience working with these two centers, with positive results. Some of the benefits for members receiving treatment at one of these two locations include:

  • A speedy assessment of their immediate needs. Members can be seen by a behavioral health specialist promptly.
  • A multidisciplinary evaluation, which leads to a plan of care and placement in the appropriate level of care.
  • A positive, less stigmatizing experience than with some other systems of care.
  • Rapid access to behavioral interventions, including medication, nursing care, psychotherapy and psychoeducation.
  • Alleviation of a sense of crisis, encouraging feelings of hope.

As part of the evaluation and treatment process at these centers, some members may still need psychiatric hospitalization.

Beecroft pointed out that the Substance Abuse and Mental Health Services Administration, or SAMHSA, published a paper suggesting that a significant number of individuals presenting for crisis services don’t require hospital admission and can be treated in another, more appropriate care setting. “Centers that offer mobile crisis and crisis stabilization services make it more likely that people will get treated quickly and at the right level of care,” he said.

We’ll be publishing additional details about our coverage of crisis services as they become available and let you know of additional providers that join us in this transformative program of care. We’ll also be including program criteria in our provider manuals. Watch for further updates and information on how you can become involved on web-DENIS and in The Record and BCN Provider News.
                                                                                                                                                                                   
**Blue Cross Blue Shield of Michigan and Blue Care Network don’t own or control this website.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2020 American Medical Association. All rights reserved.