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Health and Human Services Agency recommending the Board approve and authorize the Director of Health and Human Services Agency to sign the attached letter opposing California Assembly Bill 451 as it is currently proposed. (Est. Time: 10 Min.)
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DISCUSSION / BACKGROUND:
On February 11, 2019, California Assembly Members Arambula and Santiago introduced Assembly Bill (AB) 451 to amend Section 1317 of the Health and Safety Code, relating to health facilities, essentially requiring a psychiatric unit within a general acute care hospital, a psychiatric health facility (such as the El Dorado County Psychiatric Health Facility or PHF), or an acute psychiatric hospital that has accepted a person for the purpose of determining the existence of a psychiatric medical emergency condition, to provide emergency services and care to treat that person, regardless of whether the facility operates an emergency department.
In accordance with the Social Security Act Section 1905 (a)(B), there are criteria which exclude some institutions for mental disease, also known as “IMD”s (including a hospital, nursing facility or other institution of more than 16 beds) from federal reimbursement. However, the El Dorado County (EDC) PHF meets the criteria to receive federal reimbursement via Medicaid and Medicare, as it has only sixteen beds (this is known as the IMD exemption). As such, the EDC PHF primarily serves clients who are Medi-Cal beneficiaries or are indigent, in accordance with the County’s agreement with the State which establishes EDC as the Mental Health Plan to serve Medi-Cal clients. Adoption of AB 451 in its current form, requiring the EDC PHF to essentially function as an Emergency Department would require the EDC PHF to accept individuals with other types of insurance, potentially displacing Medi-Cal beneficiaries to other non-exempt facilities, thereby requiring EDC to pay higher cost for services in facilities which cannot receive Medicaid o...
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