REPORT TO SHASTA COUNTY BOARD OF SUPERVISORS

BOARD MEETING DATE:  June  12, 2018
CATEGORY:  Consent - Health and Human Services-6.

SUBJECT:

Agreement with Aurora Behavioral Healthcare-Santa Rosa, LLC. for Inpatient Psychiatric Hospitalization 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 renewal agreement with Aurora Behavioral Healthcare – Santa Rosa, LLC in amount not to exceed $250,000 per fiscal year to provide inpatient psychiatric hospitalization services for the period July 1, 2018 through June 30, 2021.

SUMMARY

The proposed renewal will allow Shasta County to continue to purchase acute psychiatric inpatient services on a fee-for-service basis at Aurora Behavioral Healthcare – Santa Rosa, LLC. (Aurora) located in Santa Rosa, California, for Shasta County patients evaluated and referred by Shasta County clinical staff or designee. All services provided under the terms of the agreement must be preauthorized by Shasta County, or designee, and may be for either voluntary or involuntary placements.

DISCUSSION

In addition to hospital room and board, the specific services purchased from Aurora include all medications, psychiatrist time, and laboratory work.  Aurora bills the patient’s insurance, when applicable, and applies any payments to offset Shasta County costs.  The services provided on a fee-for-service basis, means Shasta County is only obligated to pay for beds when a Shasta County resident utilizes the inpatient services at Aurora.  Additionally, Aurora bills Medi-Cal for services provided to Medi-Cal beneficiaries.

In addition to the provision of acute psychiatric inpatient hospitalization services for voluntary patients, Aurora is designated as a facility authorized to provide 72- hour involuntary treatment and evaluation under section 5150 of the Welfare and Institutions Code (WIC), as well as 14-day involuntary intensive treatment under WIC Section 5250.

Additionally, this agreement authorizes the Health and Human Services Agency (HHSA) Director (Director), or any HHSA Branch Director designated by 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 in any single rate set on the effective date of signing of this agreement shall not exceed 15 percent during the entire term of this agreement and provided further that any rate increase shall not increase the total compensation payable under this agreement.

ALTERNATIVES

The Board could choose not to approve the agreement, or to approve the agreement at a lesser amount.  Neither of these options is recommended, as facilities such as Aurora 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 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 the agreement with Aurora is $750,000 during the entire term of the agreement. The agreement is fee-for-service and funds are only expended upon a Shasta County resident utilizing inpatient services at Aurora. Funds for this agreement will be included in the Fiscal Year 2018-19 Requested Budget.  There is no additional General Fund impact with the recommended action.