It is important to challenge the common—but incorrect—assumption that individuals with bleeding disorders are inherently “medically complex” and therefore inappropriate for admission to behavioral health facilities.

According to the National Bleeding Disorders Foundation’s Medical and Scientific Advisory Council (MASAC), this assumption does not align with current medical standards. MASAC Document #289, approved in October 2024, states:

“If a person with a bleeding disorder is stable and has an established treatment protocol from a hematologist, the daily, ongoing treatment of the condition is straightforward and not complex.”

Facilities may label individuals with bleeding disorders as medically complex due to unfamiliarity with the condition. However, stable individuals typically manage their treatment independently in community settings without the need for hospitalization, continuous monitoring, or intensive medical oversight.

The presence of a bleeding disorder should not be used as a reason to deny or delay behavioral health treatment

• “Our country’s national experts in bleeding disorders have issued formal guidance clarifying that if a person with a bleeding disorder is stable and has an individualized treatment protocol from a hematologist, the daily, ongoing management of their condition is straightforward and not complex. This is a critical distinction that helps prevent inappropriate exclusion from behavioral health treatment.”

  “Bleeding disorders are rare, genetic, chronic conditions with which many mental health and substance use disorder providers may not be familiar. That unfamiliarity can understandably lead to the assumption that managing the condition requires intensive medical support. However, national guidance clarifies that this is not the case for stable individuals.”

  My patient is medically stable, and as long as they are permitted to continue their prescribed bleeding disorder medication during admission, they are not medically complex. Their bleeding disorder alone should not be a reason for exclusion from care.”

  “According to the National Bleeding Disorders Foundation’s Medical and Scientific Advisory Council (MASAC), Document #289 (approved October 2024):
  ‘Stable persons with bleeding disorders typically manage their condition independently in accordance with their established treatment protocol in the community. They do not require hospitalization, frequent medical visits, remote monitoring, or medical supervision.’”

  “So long as [insert patient name] is permitted to continue their prescribed medication while in your care, they are not medically complex and should not be excluded from treatment.”

  “MASAC also states that:
  ‘The presence of an underlying bleeding disorder alone does not make a patient medically unfit or medically unstable and should not preclude them from admission to a mental health or substance use disorder treatment facility.’”

  “If the person with a bleeding disorder experiences a medical event unrelated to their bleeding disorder during treatment, the facility should follow the usual standard of care—just as you would with any other patient.”

  “I’m happy to send you the full MASAC recommendation and walk through any questions you may have.”

• MASAC Document 289