REPORT TO SHASTA COUNTY BOARD OF SUPERVISORS

BOARD MEETING DATE:  March  20, 2018
CATEGORY:  Consent - Health and Human Services-2.

SUBJECT:

Renewal Agreement with BHC Sierra Vista Hospital, Inc. for Inpatient Hospital Services

Supervisorial District No. :  All

DEPARTMENT CONTACT:  Dean True, Branch Director, HHSA Adult Services, (530) 225-5900

STAFF REPORT APPROVED BY:  Dean True, Branch Director, HHSA Adult Services

RECOMMENDATION

Approve and authorize the Chairman to sign a retroactive renewal agreement with BHC Sierra Vista Hospital, Inc. in an amount not to exceed $450,000 to provide inpatient psychiatric hospitalization services for the period July 1, 2017 through June 30, 2020.

SUMMARY

This renewal agreement will allow BHC Sierra Vista Hospital, Inc., (Sierra Vista) to continue to provide acute psychiatric inpatient services to Shasta County residents on a fee-for-service basis.

DISCUSSION

The proposed renewal agreement will allow Shasta County to continue to purchase acute psychiatric inpatient services at Sierra Vista for Shasta County patients evaluated and referred by Shasta County clinical staff or designee.  Based upon current experience, this contractor has performed satisfactorily in the past. Under the terms of the agreement, Shasta County clinical staff, or designee, will evaluate patients to determine if there is a need for acute psychiatric inpatient care.  If acute care is deemed appropriate, clinical staff, or designee, will coordinate the transfer and admission to Sierra Vista. All services provided under the terms of this agreement must be preauthorized by Shasta County, or designee, and may be for either voluntary or involuntary placements.

In addition to hospital room and board, the specific services purchased from Sierra Vista will include all medications, psychiatrist time, and laboratory work.   Sierra Vista will also coordinate with Shasta County clinical staff, or designee, prior to a patient’s discharge, to insure an appropriate discharge plan is in effect, including transportation if necessary.  Sierra Vista will bill the patient’s insurance, when applicable, and apply any payments to offset the Shasta County cost.  Additionally, Sierra Vista has the ability to bill Medi-Cal for services provided to Medi-Cal beneficiaries.

This agreement also authorizes the Health and Human Services Agency (HHSA) Director or HHSA Branch Director designated by the Director to approve rate changes made by Provider, in writing and in advance, and rate changes made by the state, both retroactive and prospective, provided that the increase shall not exceed 15 percent during the entire term of this agreement provided further that any rate increase shall not increase the total compensation payable under this agreement.

The retroactivity of this agreement is due to having recently received confirmation of rates from Sierra Vista.

ALTERNATIVES

The Board could choose not to approve the agreement, or to approve the agreement at lesser amounts.  Neither of these options is recommended, as facilities such as Sierra Vista are scarce.  While every attempt is made to minimize use of inpatient hospitalization, it is, at times, the most appropriate treatment option and must be available to use when necessary.  Without access to Sierra Vista beds, Shasta County may be unable to provide the level of treatment required for Shasta County residents requiring acute psychiatric inpatient hospitalization.

OTHER AGENCY INVOLVEMENT

County Counsel has approved the agreement as to form. Risk Management has approved the agreement.  The County Administrative Office has reviewed the agreement.

FINANCING

The maximum amount of compensation for Sierra Vista is $450,000 during the entire term of the agreement. The agreement is fee-for-service based and funds are only expended upon a Shasta County resident utilizing inpatient services at Sierra Vista.  Sufficient appropriations were included in the Fiscal Year 2017-18 Adopted Budget. There is no additional General Fund impact with the recommended actions.