Mom is in AL and her previous psychiatrist refuses to continue care if she is not living with family. Who can refill psych medications?

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Tajann Asked August 2023

Mom is in AL and her previous psychiatrist refuses to continue care if she is not living with family. Who can refill psych medications?

Mom is staying in a private pay AL temporarily until she is eligible to go into a Medicaid waiver facility. Mom's psychiatrist states he can no longer refill prescriptions since she is in an assisted living facility and no longer staying with family. Mom's primary care doctor does not feel comfortable refilling medications until we can find another psychiatrist. Mom doesn't want current assisted living Dr. to take over her care because she will be moving again. She wants to keep her primary care physician, but she will not refill needed meds. What other options does she have if we can't find a psychiatrist to see her before her medications run out?

Medication Management Medications Mental Health Senior Health

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score 1 · Answer 1

Like suggest, maybe Doctor does not take Medicaid. And he is under the impression she is on it now. Once someone is on Medicaid they must use doctors who take Medicaid. My nephew was going to a Neurologist and his insurance was covering it at the time. When he went on Medicaid the doctor did not take it. I asked if he could pay out of pocket no, it was against the law for a doctor not under a Medicaid contract to take money from a Medicaid recipient. Thats the reason they had Medicaid, they had no money. I couldn't even pay.

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Mom has Medicare and a PPO supplement. She does not have Medicaid as her insurance. The Medicaid waiver is only for housing assistance.

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score 0 · Answer 2

The AL administrator may have a psychiatric practice working with the AL she is living in now.

She will keep her original PCP and add the psychiatric practice recommended through her current facility.

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As soon as we get her to an assisted living who accepts Medicaid waiver, I will ask if they have a psychiatrist on staff to continue medication management.

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score 0 · Answer 3

Assisted Living residences are not all the same, however, that level of care does not usually come with the administration of medications, or the supervision of meds.

While staff at an AL could not legally 'administer' the meds, family could.

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What??? All the ALs I've been associated with have medication administration programs available and most residents use it! RNs dole out narcotics, opioids, but QMAPs dole out the rest. For residents not on the medication administration program and handling their own RXs, they have to remain in a locked drawer in their apartment at all times.

OP, I think BarbBrooklyn nailed it in her response to you.

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score 1 · Answer 4

There must be something about the AL that you have her in, that her psychiatrist is wary of. Maybe the AL has contracted with a doctor's clinic to be their exclusive provider (it works in the AL's favor because it will be easier to get the paperwork/process from just one clinic.) or... or...

I can understand your Mom's PCP not wanting to be liable for psych meds. It isn't her specialty. However, she doesn't seem to have an issue with the AL.

So it sounds like you will have to use the AL's doctor, or move her to wherever she will end up, prior to the meds running out. Any AL would prefer private pay over Medicaid.

Icky, icky.

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score 1 · Answer 5

She can probably still see him. He just isn’t going to write her prescriptions.

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score 2 · Answer 6

Maybe the psychiatrist does not accept Medicaid.

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score 4 · Answer 7

Even if the AL has a doctor, does not mean u have to use him. A
psychiatrist is a specialist. In an AL you can go to whomever you want. I would ask the psychiatrist why does being in AL have anything to do with him being her doctor. She is a resident not a patient. This seems weird to me.

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score 5 · Answer 8

I suspect mom's psychiatrist does not want to step on the professional toes of the doc at AL.

That is who should be prescribing for your mom.

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Mom is in AL and her previous psychiatrist refuses to continue care if she is not living with family. Who can refill psych medications?

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