North Carolina medical journal
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An unprecedented number of North Carolinians are coming to hospital emergency departments with behavioral health needs. There are significant delays after emergency treatment as the patient awaits placement in an inpatient facility often requirig the patient to be "boarded" in the hospital. Any viable solution to this "crisis" crisis will require significant community collaboration.
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Community Care of North Carolina initiated efforts to improve care transitions for North Carolina Medicaid recipients in 2008. The transitions program is now statewide, serving more than 4,000 patients every month, virtually every North Carolina hospital, and more than 1,400 primary care practices. This commentary describes program components, early outcomes, and future challenges.
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This commentary explores transitions in care for people who have severe and persistent mental illnesses and reside in long-term care communities. Challenges and historical approaches as well as barriers to successful transitions are examined. Recent policy changes in North Carolina are discussed and contextualized in emerging evidence-based practices that emphasize intentional collaborative efforts.