D.17 Managing Missed Mental Health Appointments.pdf

MANAGING MISSED MENTAL HEALTH APPOINTMENTS

11M-027

G.V. (Sonny) Montgomery VAMC Jackson, Mississippi 39216

Signatory Authority:

GVSMVAMC Chief, Mental Health

Responsible Owner:

GVSMVAMC Chief, Mental Health

Service Line(s):

Mental Health

Effective Date:

September 17, 2019

Recertification Date:

September 17, 2024

1. PURPOSE AND AUTHORITY

a. The purpose of this standard operating procedure (SOP) is to establish guidelines for management of “No Show” and “Cancelled by Patient” mental health appointments.

This policy outlines minimal standards for managing missed mental health appointments. In the interests of maximizing patient safety and enhancing Veteran-centered care, it is the policy of the Mental Health Service (MHS) to make at least three phone attempts to contact a Veteran who No Shows or cancels a mental health appointment without explanation. If the Veteran is formally identified as High Risk for Suicide, those calls must be made by a Licensed Independent Practitioner. The clinical judgment of mental health Licensed Independent Practitioners should dictate, on a case-by-case basis, any additional steps that should be taken in the best interests of the Veteran.

2. PROCEDURES

a. When a Veteran who is not considered High Risk for Suicide No Shows a mental health appointment, a staff member (non-clinician or clinician) will make at least three reasonably spaced attempts to reach the Veteran. The attempts and results will be documented in the medical record. If all phone attempts are unsuccessful, the Veteran will be sent a letter. This should also be documented. The purposes of these contacts are to:

1. Verify the well-being of the Veteran

2. Determine the reason for the No Show, and

3. Arrange a replacement appointment.

September 17, 2019 11M-027

b. When a Veteran who is considered High Risk for Suicide No Shows a mental health appointment, an LIP must make the contact attempts and document as outlined in Procedure A above. If these are unsuccessful, the LIP should consult with the Suicide Prevention Coordinator, who will provide guidance on appropriate safety-driven next steps. These steps may range from contacting individuals listed in the Veterans Suicide Safety Plan to initiating VA contact with local law enforcement for a wellness home visit.

c. When a Veteran cancels a mental health appointment, the recipient of the Veteran’s communication will prompt for the reason and document the reason for the cancellation in the medical record. The Mental Health Treatment Coordinator and/or the clinician who would have been seen in the cancelled appointment should be made Additional Signers on the progress note. If the Veteran cancels an appointment and provides no explanation, the procedures outlined in A. and B. above should be followed, depending on whether the Veteran is considered High Risk for Suicide.

d. On at least a quarterly basis MHS Supervisors will determine through review of a reasonable sample of Veteran medical records whether their Reports are in compliance with this Policy. Supervisees will be provided with constructive and encouraging feedback on the results of these medical record chart reviews.

3. ASSIGNMENT OF RESPONSIBILITIES

a. ACOS/MH – Ensures that this policy is in compliance with Veterans Health Administration guidance for missed mental health appointments and MHS clinicians comply with this policy.

b. Team Leaders / Program Managers – Establish well-understood procedures and clear responsibility to ensure compliance with this policy.

c. Supervisors – Determine, via periodic chart reviews, whether their supervisees are in compliance with their responsibilities under this policy.

d. MHS Clinician – Be familiar with the requirements of this policy and to consistently adhere to it in their daily work.

4. DEFINITIONS

a. No Show – An appointment that the Veteran does not attend and has not cancelled.

b. Cancelled By Patient – An appointment that the Veteran has given advance notice he/she will not attend.

c. Cancelled by Clinic – An appointment that is cancelled due to lack of provider availability

d. Licensed Independent Practitioner (LIP) – The following disciplines are considered LIP’s in the VA system: Physicians, Psychologists, Nurse Practitioners, September 17, 2019 11M-027

Physician Assistants, Clinical Psych pharmacologists, Licensed Clinical Social Workers, Licensed Professional Counselors, and Licensed Marriage & Family Therapists

REFERENCES

NONE

5. REVIEW

This SOP will be reviewed, at minimum at recertification, when there are changes to governing document, and any regulatory requirement for more frequent review.

6. RECERTIFICATION

This SOP is scheduled for recertification on or before the last working day of September 2024. In the event of contradiction with national policy, the national policy supersedes and controls.

7. SIGNATORY AUTHORITY

Sharetta Young, LCSW Associate Chief of Staff, Mental Health Date Approved:

NOTE: The signature remains valid until rescinded by an appropriate administrative action.

DISTRIBUTION: SOPs area available at S: Drive: Mental Health-Mental Health Service Polices-Current Policies.