Expanded Community Services     

The SMH Expanded Community Services (ECS) Program was designed to help overcome barriers to discharge for long-term hospitalized patients, mostly elderly people with dementia. Utilizing resources provided by DSHS in association with state hospital bed closures, ECS program goals include providing these patients with community-based services, including comprehensive diagnostic assessment, psychopharmacology consultation, education and training in behavior management for skilled-nursing and residential care facility staff, collaborative crisis management, and coordination of services with other community care providers. These services are available to identified ECS patients on a twenty-four hour, seven day a week basis. To be identified as an ECS patient, eligibility criteria must be met including an established diagnosis of Alzheimer's disease or another type of dementia, cognitive disorder, or severe and persistent mental illness. Other ECS criteria include the existence of complex medical and pharmacological problems, behavioral management issues, and previous residential placement challenges. The SMH ECS team consists of a psychiatrist, and three RN consultants, all with specialized training and expertise in complex geriatric mental health and medical issues. They have participated in program planning and case review meetings at state and community hospitals, skilled-nursing and residential care facilities, emergency rooms, and mental health centers in a coordinated effort to integrate services for ECS patients and their families. The ECS team has endeavored to work with all involved stakeholders to facilitate the discharge and community residential placement process.