Memorandum
Date: January 25, 2022
To: The Honorable Lake County Board of Supervisors
From: Todd Metcalf, MPA, Director Behavioral Health Services
Subject: Approve Agreement between County of Lake and Adventist Health St. Helena and Vallejo for Acute Inpatient Psychiatric Hospital Services and Professional Services Associated with Acute Inpatient Psychiatric Hospitalizations for Fiscal Years 2021-22 and 2022-23 for a maximum compensation of $300,000 and authorize the Chair to sign
Executive Summary:
Acute psychiatric inpatient hospitalization is a highly structured level of care designed to meet the needs of individuals who have emotional and behavioral manifestations that put them at risk of harm to self or others, or otherwise render them unable to care for themselves. Inpatient Psychiatric Acute Hospitalization services are an entitlement for Medi-Cal beneficiaries. And, regardless of insurance status, Mental Health Plans are financially responsible for County residents admitted to an Acute Psychiatric Hospital or Institute of Mental Disease (IMD) facility per California Code of Regulations § 1810.350: <https://govt.westlaw.com/calregs/Document/IA4DA4B20E2E211DF8104A9E3DFB5B3E7?contextData=%28sc.Default%29&bhcp=1&transitionType=Default>
The Crisis Team at LCBHS works diligently to place clients as quickly as possible and uses the most up-to-date hospital list from the Department of Health Care Services. It is important to note that the number of beds available in California is markedly limited, and finding a bed can be a challenge. Attached to this item is the most recent list of licensed Institutions for Mental Disease from the Department of Health Care Services, for reference. From 1995 to 2017, California saw a 27% reduction in the number of acute psychiatric hospital beds while the population increased by about 25%, see the most recent annual report from the California Hospital Association: <https://calmatters.org/wp-content/uploads/2019/04/CHA-Psych-Bed-Data-Report-Sept.-2018.pdf>
Acute Psychiatric Hospitals and IMDs have up to one year to submit an invoice for a client. This contract represents invoices dating back to August 2021. We have been working with the contractor to generate this contract since October and it went through editing with both the County and Adventist’s legal team, which delayed the process. In years’ past, we have had a separate contract for both Adventist facilities and engaged in single-year Agreements. The Agreement now before the Board includes both Adventist facilities with whom we place clients and spans two fiscal years, decreasing the administrative burden for the County and Department.
If not budgeted, fill in the blanks below only:
Estimated Cost: _$300,000_ Amount Budgeted: _$300,000_ Additional Requested: __N/A__ Future Annual Cost: _ N/A__
Consistency with Vision 2028 (check all that apply): ☐ Not applicable
☒ Well-being of Residents ☐ Public Safety ☐ Disaster Prevention, Preparedness, Recovery
☐ Economic Development ☐ Infrastructure ☐ County Workforce
☐ Community Collaboration ☐ Business Process Efficiency ☐ Clear Lake
Recommended Action: Approve Agreement between County of Lake and Adventist Health St. Helena and Vallejo for Acute Inpatient Psychiatric Hospital Services and Professional Services Associated with Acute Inpatient Psychiatric Hospitalizations for Fiscal Years 2021-22 and 2022-23 for a maximum compensation of $300,000 and authorize the Chair to sign.