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Health and Human Services Agency recommending the Board:
1) Approve the attached template Agreement that allows other counties to contract with the County of El Dorado for the provision of acute inpatient mental health services for clients they refer to the County Psychiatric Health Facility; and
2) Adopt and authorize the Chair to sign Resolution 181185-2020 authorizing the Director of the Health and Human Services Agency to execute said agreements on behalf of the County with other local agencies for the provision of acute inpatient psychiatric treatment for clients referred by those agencies, for a term no longer than three years, and an amount not-to-exceed $250,000, contingent upon approval by County Counsel and Risk Management.
FUNDING: Fee-for-service revenue from other local agencies.
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DISCUSSION / BACKGROUND:
The Health and Human Services Agency (HHSA) has contracted with other counties for many years to provide access to the County’s Psychiatric Health Facility (PHF) for the provision of services for their clients who require acute inpatient mental health services. Services provided by the County PHF, operated by Telecare Corporation, Inc. (Telecare) per Agreement #4330 (File ID: 19-1397, Item No. 19) include psychiatry, medication, clinical treatment, nursing, and the required documentation and maintenance of health information in accordance with prevailing federal and state laws and regulations.
Telecare staff manage the daily census, and, in conjunction with the Behavioral Health Division, accepts or declines referrals from other counties based on specified requirements including availability of beds in the facility. Accepting clients from other counties helps HHSA to maximize revenues and offset fixed operational costs of the PHF, while assisting other counties with their mandated services. To ensure availability of PHF beds for County Clients, the County retains the exclusive right of refusal for referrals from other counties.
The new PHF template Agreement updates the current template Agreement language (approved by the Board in Resolution 029-2015, Filed ID: 15-0187, Item #32), to comply with new state requirements. Should any modifications to the PHF template Agreement be necessary (e.g. to accommodate issues such as updates to the rate exhibit, changes in code references, or changes suggested by Counsel, etc), those revisions must be reviewed and approved by County Counsel and Risk Management.
It should be noted that the current published rates for counties to contract with the PHF are under review. HHSA will be conducting a fee study in the next few months to review several fees, including the fees for the PHF in order to cover the costs of the PHF while remaining at a competitive industry standard. This contract template allows for the published rate to be changed at any time during the term of the agreement with 15 days notice to admitting counties. HHSA plans to prioritize the fee review and recommendation of the PHF as part of the fee study and change the published rate schedule attached to the contract template as soon as revised fees are available.
ALTERNATIVES:
Should the Board decline to approve this recommendation, the process of executing Use of PHF Agreements with other local agencies will take longer, possibly decreasing needed revenue that offsets the cost of PHF operations.
PRIOR BOARD ACTION:
1) 15-0187, 02/24/15, HHSA Use of County PHF Template/Resolution
2) 19-1394, 12/17/19, HHSA PHF Telecare Agreements 4330 and 4332
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
Approved by County Counsel and Risk Management.
CAO RECOMMENDATION:
Approve as recommended with the additional recommendation that HHSA provide a memo to the Board within 120 days or after the completion of the fee study (whichever is sooner) providing an update of the PHF rates.
FINANCIAL IMPACT:
There is no Net County Cost associated with the revenue generating template Agreement. While the current fees do not recover all costs, HHSA is reviewing the fee amounts to recover PHF expenses as much as possible while remaining competitive within an industry standard. A review of the rates will be prioritized as part of the HHSA fee study to be conducted in Fiscal Year 2020-21 and revised rates will be attached to the contract and utilized by admitting counties as soon as they are available.
CLERK OF THE BOARD FOLLOW UP ACTIONS
1) Clerk of the Board to obtain signature of Chair on two (2) original Resolutions.
2) Clerk of the Board to return one (1) certified Resolution and one (1) Certified Minute Order to HHSA Contracts Unit at 3057 Briw Road.
STRATEGIC PLAN COMPONENT:
N/A
CONTACT
Don Semon, Director