Introducing Pennsylvania’s Telephonic Psychiatric Consultation Service Program (TiPS)
What is TiPS?
TiPS is a new Pennsylvania HealthChoices program designed to increase the availability of child psychiatry consultation teams regionally and telephonically to Primary Care Providers (PCPs) and other prescribers of psychotropic medications for children insured by Pennsylvania’s Medical Assistance (Medicaid) Program, Health Choices. The program provides real time peer to peer resources to the PCP who desire immediate consultative advice for children (up to the age of 21) with behavioral health concerns.
TiPS provides one team per each HealthChoices zone and ensures both access to quality services in the appropriate setting based on need and mitigates the lack of available child psychiatry resources. TiPS psychiatrists do not prescribe medications.
Access to child psychiatry has been a significant problem nationwide for years, as documented in the Surgeon General’s report of 2000. Increasing prevalence of child behavioral health issues coupled with a stagnant workforce has only exacerbated the situation. Children’s primary care providers end up meeting this need even though they do not feel completely prepared to do so.
In response to the issue, Pennsylvania has adopted a psychiatry consultation program based upon a University of Massachusetts Medical School program. This model is now being used in more than 30 other states throughout the country.
With help from TiPS teams, pediatricians and family physicians can effectively meet the needs of youth with common mental health conditions such as ADHD and mild depression. Of course, some youth need specialty psychiatric care and have medication needs that are not appropriately managed in the primary care setting. TiPS teams can help connect to appropriate care.
Who are TiPS team members?
TiPS teams are comprised of child psychiatrists, licensed therapists, care coordinators, and administrative support. They are available to assist any PCP who sees children or adolescents covered by Health Choices, Pennsylvania’s Medical Assistance (Medicaid) Program. They also support behavioral health clinicians working on-site in primary care practices.
TiPS core services include:
- Telephone and face-to-face consultation
- Care coordination
- Training and education
Practices use TiPS most frequently for a provider to provider (peer to peer) consultation. Phone inquiries are usually patient-specific, but can also be about any general question related to child psychiatry, behavioral health, or community resources.
TiPS team members respond to a request for consultation within 30 minutes, and often immediately. The consultation will result in one of the following outcomes depending on the needs of the child and family:
- An answer to the PCP’s question
- Referral to the team care coordinator to assist the family in accessing local behavioral health services such as therapy, specialty psychiatry, or neuro-psychological assessment
- Referral to the team therapist to provide transitional, face-to-face care or telephonic support to the child and family until the family can access local behavioral health resources
- Referral to the team or local child psychiatrist for a face-to-face acute psychopharmacological or diagnostic consultation
TiPS care coordinators are expert at identifying and maintaining up-to-date behavioral health resources in the community. They work with families to identify appropriate options, provide information on the expected wait times, and follow-up to ensure connections are made. Care coordinators keep the PCP or other practice informed of the referrals and the outcome of the follow-up efforts so the referring provider can ensure their patients are receiving the care they need.
Training and Education
TiPS teams for each zone are available for training and education based on the needs and desires of the practice. These can be brief “brown bag” lunches on specific topics, round table seminars with multiple practices, grand rounds, or case consultations.
Common topics include:
- Education on a particular class of type of psychotropic medication; black box warnings; new prescribing guidelines
- Implementation and use of screening or assessment tools
- Specific diagnostic or symptom education, i.e. self-injury, binging, substance use
- Developing a referral network of community resources
How to enroll in TiPS
There is no fee to enroll; TiPS is funded by the Pennsylvania Department of Human Services (DHS) through the Medicaid Managed Care Organizations (MCOs) and is free for all prescribers of psychotropic medications to use. The team you work with is determined by geography; there is a TiPS team in each Health Choices Zone. Supervision of the program is provided by the MCOs, who are contracted with DHS for the Health Choices program. You can contact your TiPS team at the number below to enroll.
Once your practice enrolls in TiPS, the regional team will come to your office or provide education over the phone for you and your staff. They will explain the program, how to access services, answer questions, and discuss expectations.
Regional TiPS team phone lines:
NE and Lehigh Capital Zones: Penn State Hershey 800-233-4082, then press “4” for kids
SW and NW Zones: Children’s Community Pediatrics (Children’s TiPS) 844-WPA-TiPS (972-8477)
SE Zone: Children’s Hospital of Pennsylvania (CHOP) 267-426-1776