Observation Services for Children & Adolescents (OSCA)

What is the Observation Services for Children and Adolescents (OSCA) Program? 

St. Luke’s Behavioral Health Center’s OSCA Program offers outpatient observation services (up to 23 hours) for children and adolescents (5-17) who may be suffering from a mental or behavioral health crisis. The program’s purpose is to help de-escalate a crisis by allowing an assessment or further monitoring to occur in hopes that the patient can be safely returned to his/her parent or guardian.

Who is allowed to come to the OSCA program? 

Any youth (5-17) who have a consenting legal guardian. 

Assessment for Admissions: What to Expect When You Arrive 

After some routine paperwork is complete, the patient will be assessed by our Intake Department Staff. The parent/guardian will be present during this process and is encouraged to participate.

The assessment includes:

• Meeting with an Intake Therapist to complete a psycho-social evaluation, where the patient and guardian will be asked questions regarding the child’s background and what has lead to the current behavioral health crisis. This information will help our staff determine the most appropriate level of care for the child.
• Meeting with an Intake Nurse, who will collect information regarding the child’s medical history and any prescribed medication. 

To ensure each patient the greatest success, we strongly encourage that siblings and other individuals are not present during the evaluation. We make this request to protect the integrity of the assessment.

Note: If the patient arrives to St. Luke’s with any medical condition that requires immediate attention, the patient will be referred to an appropriate level of care for stabilization prior to being evaluated for admission to OSCA.

Qualifying Admissions Criteria

Based on the information collected during the assessment, the OSCA Provider will determine whether or not the patient meets the admissions criteria for observation. This observation period cannot exceed 23 hours.

• If the patient meets admissions criteria: The parent/guardian will be given a Family Crisis Debriefing (FCD) time & Discharge Return Time and advised to return to the OSCA program. Only the "LEGAL GUARDIAN" can sign a patient in/out of the program and he or she must return at the specified time for the FCD/Discharge Return.
• The parent/guardian will also be given a Questionnaire prior to leaving the unit and are strongly encouraged to complete it and bring it back to St. Luke's Behavioral Health Center for review during the FCD.
• If the patient does not meet admissions criteria: The patient will be released back to the guardian and additional outpatient support will be established.

What Happens During the Observation Period?

The following is a list of activities the patient and parent/guardian can expect to happen during the 23-hour observation period:

• The patient will participate in groups, exercise activities and written assignments that focus on allowing the patient to process through their particular crisis.  These activities are lead by qualified OSCA Nurses and Behavioral Health Technicians who monitor and engage with the patients throughout their stay.
• The OSCA Provider will review the patient’s medication regimen and make adjustments if necessary.
• Lab draws and urine-testing will be completed as needed.
• The OSCA Provider will perform a 1:1 assessment of the patient to determine the crisis status and next level of care.  Communication with outpatient agencies will begin once a patient is admitted to the program so that discharge planning can begin in a timely manner.

Discharge and Aftercare
Upon completion of the observation period, the patient and parent/guardian will attend the FCD with the OSCA Nurse. Based on evaluation of the patient during their stay on the unit, the OSCA Provider will then make a recommendation on whether or not the patient is ready for discharge, or if they require inpatient care.

IF DISCHARGE is the recommendation, the St. Luke’s team will work with the patient's assigned Managed Care plan (if applicable) to develop an appropriate plan of care.

IF INPATIENT CARE is the recommendation, OSCA staff will coordinate with the SLBHC Intake Department to get authorization from the Managed Care plan for admission, and the patient will be admitted to an appropriate psychiatric inpatient facility.