|
Back to Calendar
Return
|
| |
Consent-Health & Human Services # 19.
|
| Board of Supervisors |
Administration |
|
|
|
| Subject |
| Approve the delegation of signing authority for medical provider agreements to the Health & Human Services Agency Director for up to $350,000 per provider, per fiscal year, and to the County Administrator for up to $500,000 per provider, per fiscal year. (No general fund impact) (Larsen) |
| Recommended Action |
Approve the delegation of signing authority for medical provider agreements to the Health and Human Services Agency Director for up to $350,000 per provider, per fiscal year, and to the County Administrator for up to $500,000 per provider, per fiscal year.
|
| Strategic Plan Goal(s) |
Operational Excellence
Thriving Residents
Safe Communities |
| Reason for Recommended Action/Background |
On March 10, 2015, the Board of Supervisors approved the delegation of signing authority for medical provider agreements to the Health Services Director for up to $350,000 per provider, per fiscal year and to the County Administrator for up to $500,000 per provider, per fiscal year for the provision of residential (24/7) care to children, youth and adults living with serious emotional disturbance, serious mental illness and/or substance use disorders.
At the time of this approval, the Health and Human Services Agency (HHSA) was not a fully integrated agency. During this time, the Alcohol, Drug and Mental Health (ADMH) and Health departments were integrated, known as Health Services.
HHSA is now a fully integrated agency, which includes ADMH, Health and Employment & Social Services. HHSA wishes to expand this delegation of signing authority for its entire agency.
HHSA is responsible for the provision of residential (24/7) care to children, youth and adults living with serious emotional disturbance, serious mental illness and/or substance use disorders. The nature of these illnesses necessitates placements at a wide variety of facilities. Therefore, HHSA engages numerous contracts every year with residential facilities to meet the varied needs of these clients. Accordingly, numerous contracts are required to manage the individual needs. Further, frequent amendments are necessary due to shifting locations of placement, differing complexity of the medical needs of patients and the availability of willing and licensed service providers.
Rather than using a competitive bid process resulting in a singular provider to the exclusion of all others, these residential service agreements are secured using an “any willing provider” process where any licensed/qualified/appropriate and willing provider of such services can each be engaged with a contract for service. Adequate delivery of this level of care involves the entire community of licensed service providers, and significant shortfalls in availability persist.
In order to improve the quality of care delivered to clients, maintain positive vendor relations and increase the speed at which providers can be paid for services delivered to clients, HHSA is requesting this higher signing authority be expanded to all of HHSA for those contracts that pertain to the provision of residential (24/7) care to children, youth and adults living with serious emotional disturbance, serious mental illness and/or substance use disorders. This will allow HHSA to engage service providers, pay claims more quickly and have greater flexibility in matching clients with the most appropriate and cost effective provider. This will also help in addressing challenges presented by the current space/bed availability at the provider level and the complexity of the medical/psychiatric care required for clients. All services delivered to clients will continue to be reviewed and authorized in advance for medical necessity by county staff and/or by court ordered placements. |
| Collaborations (including Board advisory groups and external partner agencies) |
County Counsel, County Administrator, Department of Financial Services
|
|
| Fiscal Impact |
|
|
| Source of Funds for this Expenditure |
|
|
Explanation (Expenditure and/or Revenue) |
| Further explanation as needed: |
There is no direct fiscal impact associated with this request for delegation of signing authority. Payments will be made to medical service providers based on services delivered to clients which have been authorized by HHSA staff based on medical necessity and/or by court ordered placements.
|
|
|
|
|
|