To:                  All Organizational Components

Subject:           Admissions to all SCDMH Acute Care Facilities

I.          Purpose This directive will serve to ensure that active behavioral health treatment in an appropriate environment be provided as soon as possible for persons in need of SCDMH services.

II.         Scope This directive applies to all clinical organizational components of SCDMH including Centers, hospitals and support staff. This directive applies to all patient care being funded by SCDMH in the local communities including care provided by written contract with a local hospital or other healthcare facility.

III.       Admission Guidelines

A.                 Priority for inpatient care is given to individuals  who need active behavioral health treatment. Clinical judgment by collaborative professionals in local hospitals, Centers and SCDMH facilities is the basis for this decision.

B.         If the individual is unable to be stabilized, and is in a facility, e.g., short-term acute hospital, crisis stabilization unit, etc., the designated professional Center staff will be responsible for determining the  need for transfer from the community setting to a SCDMH inpatient facility subject to medical clearance and applicable law.  The designated professional Center staff will screen for a   transfer to a SCDMH inpatient facility at least by day 7. Follow-up screening at least every 7 days for individuals receiving care in a bed purchased by SCDMH will be expected until discharge to the community or transfer to a SCDMH inpatient facility.  

C.        If the individual  meets the clinical and legal criteria for SCDMH inpatient treatment, current admission information and documentation must be completed. The referring Center staff will be responsible for ensuring that admission information and notification is made to the SCDMH hospital admissions office for priority admission.

D.        This Directive is to be interpreted consistent with other applicable SCDMH Directives, Manuals and written policies including: Pre-admission Screening Directive 688-86; Continuity of Care Directive 830-02; Voluntary Admissions  Directive 755-91; and the CMHC Operations Manual.  No SCDMH Directive is to be read as SCDMH assuming, or in conflict with, any obligations of a non- SCDMH hospital or other health care, or other licensed facility, to provide care or treatment required by applicable law.  Applicable law specifically includes: 42 CFR  489.24 (EMTALA emergency department screening, stabilization and appropriate transfer);  42 CFR Part 482 (Conditions of Participation for Hospitals);  42 CFR 412.106 (federal requirements in hospital acceptance of  Disproportionate Share funds); 44-7-260(E) Code of Laws of South Carolina (DHEC license requirements for hospital emergency care regardless of ability to pay or residence);44-17-450 & 460, Code of Laws of South Carolina (Center and Certifying physician screening and consultation prior to DMH psychiatric emergency admission); 44-13-10, Code of Laws of South Carolina (local county responsibility for medical and other care of persons awaiting a DMH emergency or judicial admission).


Date:  October 5, 2004