Speeding up the De Novo Process Healthcare is becoming an all time high these days for a lot of people to afford

. A lot of people dont have any insurance at all. In a time when government funde d healthcare is under close watch, and the issue of the cost of healthcare is fo refront in our minds, the often abused De Novo process were streamlined and more e ffective the state could save a lot of money. A lot of money could be saved when it comes to Central State Hospital where they treat people with psychiatric nee ds, rehab, and nursing care services. People with or without insurance can be ta ken to the hospital to get care. Theres a term called De Novo which means a proce dure when an involuntary patient refuses to participate in treatment plan like t aking their medicine to get better then the De Novo order is put in process and the patient cant refuse treatment. The first step is when the review committee determines that the patient needs to be De Novoed. The second step put in place where the patient is tarced meaning a ll the medicines that the patient takes is reviewed.(Putnam 2011) The review commi ttee gets the medication that the patient is taking and reviews the side effects and determines whats good for the treatment of the patient. (Kentucky Mental Heal th Hospitalization Act 1982) Then the committee has a hearing whether its a mental inquest hearing or final hearing for the patient and they tell the judge that t reatment is necessary to protect the patient and others from being harmed statin g that the patient is incapable of giving any constant to treatment and stating the medicines that the patient takes the side effects to the judge who will make the final decision if the patient will benefit from the De Novo.( Kentucky Menta l Health Hospitalization Act 1982) Most times a patient is only De Novoed for me dication where if they refuse to take medication the nurse will insert the medic ine in a needle and inject the medicine in the patients body. Other times not on ly is the patient De Novoed to take medicine but they have to take vitals everyd ay it just depends on the patient and what medication they are court ordered to take. The state of Kentucky could probably save a lot of money if they would make the De Novo process a lot sooner than 30 days to go to court to make a patient take their medicine. The process starts three days after the patient refuses medicin e but the whole process can take up to a month. Sometimes after a De Novo is put in place for an example a patient can be De Novoed and the judge can order 30, 60, 90, 180, or 360 days on the De Novo and if it expires and the patient doesnt show any signs of getting better the hospital has to take a hold out on the pati ent which is a 72 hour hold and then has to go back to court and start the proce ss over again. (Putnam 2011) Central State Hospital is a psychiatric hospital with 192 beds its limited at ti mes because not all rooms are two person rooms and not every person can have a r oommate. (Murphy 2003) There are patients that are not allowed roommates becaus e of having some type of illness, behavior issues, or lie on people saying a pat ient or staff did something to them. Right now there are only four units open at the hospital so space is limited to patients. Three of the units hold any illne ss or disorder that a patient comes in with the other unit is called the Forensi c unit. The Forensic unit which houses the mentally ill people competency to stand trial and provides inpatient treatment for individuals convicted of felony offenses. That unit is limited to space because two years ago the unit had to move into th e main hospital with the rest of the hospital patients because the building was becoming too expensive to keep running. Those patients were housed in the grauha n building which was off to itself surrounded by a high security fence and a bas ketball court. It was a building with everything that was needed to treat the pa tients no one had to leave to go to another building to get anything.

If the state can close down different buildings on the property because it was being too expensive to manage why not save money by getting the patients treatme nt faster so that they can get well sooner and be able to leave and other sick p atients can come in and get treatment instead of taking 30 days to get a patient treatment costing the state $18,000 for a wasted stay without treatment just th ree hots and a cot. Theres always talk of closing the hospital down or even movin g the hospital and no one will really never know until it happens is what is sai d all the time to the employees. With the raising cost of healthcare the state c ould run out of money to fund Central State Hospital one day and have no choice but to close their doors if the hospital continues to run the way it has been an d something isnt done to move more patients along in and out the hospital faster. According to Secretary James Holsinger of the Cabinet for Health and Family Serv ices in 2004 he distributed a concept paper recommending the closing of the hosp ital. (Cabinet for health and family services 2011) There has been talk of trying to close the hospital down in the past and possible relocation. Consolidation at least until more consideration can be given to all associated care issues and t he proposal would cause more consumers of the hospital services to be moved fart her away from their home communities and from their support systems, including t heir families and the proposal to build one large facility is reminiscent of out dated treatment methods of past ages when large facilities were the norm. (Cabine t for health and family services 2011) Public forums considered testimony expressed support for better services for pers ons with mental illness, as well as opposition to the hospital the preferred tre atment protocol requires services to be available in a continuum of care, with h ospital settings utilized as a necessary part of the continuum, closure of the h ospital, relocation would cause disruption strain on the training of mental heal th professionals, and hamper the ability to conduct on-site research resulting i n failure to serve the best needs of the hospitals current and future patients.( Cabinet for health and family services 2011) Moving the hospital from critical tr iage and medical services in Jefferson County would be detrimental to maintainin g the continuum of medical and psychiatric care and closure of the hospital woul d sever the critical relationship established with law enforcement and the judic ial systems, and would create difficulties for handling transfers from the Kentu cky State Reformatory and the Kentucky Correctional Psychiatric Center. (Cabinet for health and family services 2011) Central State Hospital, an 18 year-old facility, should be retained in the Louisv ille community; and the mental health needs, including but not limited to the in patient mental health needs, numerous organizations representing consumers, fami ly members, advocates, and providers have expressed their opposition to the prop osal to close Central State Hospital and build a separate psychiatric hospital i n a different community Central State Hospital should remain in its current comm unity and service individuals needing hospitalization should continue and shoul d be improved. (Cabinet for health and family services 2011) Working at Central State Hospital for almost three years now Ive met a lot of dif ferent people coming in and out of the hospital. People come and go with differe nt problems. The one problem that I see constantly is taking up a lot of money i s people getting a staying at the hospital for a long period of time because the y dont want to take medicine and then they have to be De Novoed by the court. It costs the state $600.00 a day to admit a patient to the hospital the shortest st ay at the hospital is three days to some others that never leave. Why should it take 30 days for the court system to determine a De Novo on a patient because th ey refuse medication? With $600.00 a day the court system should have someone on top of that issue to make sure that the process doesnt take that long to get don e. It is a right to refuse treatment but when a patient is not in their right mi nd the process needs to be speeded up. A patient can refuse medicine for three d ays and then after that a decision will be made by the review committee which is a committee thats appointed by the hospital director whether the patient needs a De Novo to be put in place for their treatment. There may be a lot of sick people that come in and out of the hospital that need treatment and a faster process would save a lot of money for the state and help

a lot of people. When Central State is full its costing the area hospitals even more to keep the patients because they cant release everyone to the streets they may be harm to themselves or others. Not all patients are taken to Central Stat e some are released if they can be stabilized at area hospitals. Some patients a re released from area hospitals later to return to the hospital sometimes the ne xt day or commit crimes that maybe could have been prevented dangering the lives of the people in the state of Kentucky when they are released to the streets. A rea hospitals are more expensive to stay a day where if they were transferred to Central State hospital and a De Novo was put in process within a few days of st ay patients could get on their medicine a lot sooner and get well a lot faster. Sometimes not being able to get a De novo fast some of the patients that are see n at Central State can be very dangerous because they havent had medicine in a lo ng while they can sometimes hurt other patients or the hospitals employees.