HomeMy WebLinkAbout2010-03-17 Business Meeting Additional Agendat�v1"E$ C
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Deschutes County Board of Commissioner:,
1300 NW Wall St., Suite 200, Bend, OR 97701-1960
(541) 388-6570 - Fax (541) 385-3202 - www.deschutes.org
AGENDA REQUEST & STAFF REPORT
For Board Business Meeting of Wednesday, March 17, 2010
Please see directions for completing this document on the next page.
DATE: March 2, 2010
FROM: Lori Hill, Adult Treatment Program Manager Phone: 322-7535
Health Services --Behavioral Health Division
TITLE OF AGENDA ITEM:
Consideration of Board Signature of Document #2010-109, Amendment #1 to 2008-380, Cascade
Healthcare Community regarding Psychiatric Care Services.
PUBLIC HEARING ON THIS DATE? No
BACKGROUND AND POLICY IMPLICATIONS:
Secure inpatient acute psychiatric care is provided to indigent residents of Deschutes, Crook a.id
Jefferson counties at Sageview, a facility and program of Cascade Healthcare Community (CHC).
In addition, CHC agrees to provide longer term services when needed to indigent residents of
Central and Eastern Oregon who have been civilly committed and who may be waitlisted or
placement at the state hospital. Under this Contract, two separate payment amounts have be en
designated, one for acute services to Central Oregon residents and one for post -commitment
services for indigent residents of Central and Eastern Oregon counties.
This amendment provides funds for the period between July 1, 2009 through June 30, 2010 for the
not -to -exceed amount of $529,250 for all post -commitment services. The total amount will cover
all Sageview and Psychiatric Emergency Services (PES) to all post -commitment indigent clients
served during those twelve months. In addition, post commitment services have been extendec to
indigent clients who have exhausted their insurance benefits and have no other financial resources.
FISCAL IMPLICATIONS:
Amendment 1 to Contract Number 2008-380 increases funding by $529,250.
RECOMMENDATION & ACTION REQUESTED:
Behavioral Health recommends approval.
ATTENDANCE: Nancy England, Contract Specialist
DISTRIBUTION OF DOCUMENTS:
An executed copy to:
Nancy England, Contract Specialist, Health Services
DESCHUTES COUNTY DOCUMENT SUMMARY
(NOTE: This form is required to be submitted with ALL contracts and other agreements, regardless of whether the document is to be
on a Board agenda or can be signed by the County Administrator or Department Director. If the document is to be on a Board
agenda, the Agenda Request Form Is also required. If this form is not Included with the document, the document will be retumed to
the Department. Please submit documents to the Board Secretary for tracking purposes, and not directly to Legal Counsel, the
County Administrator or the Commissioners. In addition to submitting this form with your documents, please submit this form
electronically to the Board Secretary.)
Date:
Please complete all sections above the Official Review line.
February 2, 2010
Department:
Deschutes County Health Services, Behavioral Health
Contractor/Supplier/Consultant Name:
Cascade Healthcare Community, DBA Sageview
Contractor Contact: f Robin Henderson
Type of Document:
Contractor Phone #:
Amendment to document #2008-380
541-706-2791
Goods and/or Services: Consideration and signature of document #2010-109,
amendment to Cascade Healthcare Community (CHC), DBA Sageview contract number
2008-380.
Background & History: Secure inpatient acute psychiatric care is provided to indigent
residents of Deschutes, Crook and Jefferson counties at Sageview, a facility and
program of Cascade Health Care Community. In addition, CHC agrees to provide longer
term services when needed to indigent residents of Central and Eastern Oregon who
have been civilly committed and who may be waitlisted for placement at the state
hospital. Under this contract, 2 separate payment amounts have been designated -one
for acute services to Central Oregon residents and one for post -commitment services
for indigent residents of Central and Eastern Oregon counties.
This amendment provides funds for the period between July 1, 2009 through June 30,
2010 for the not -to -exceed amount of $529,250 for all post -commitment services. The
total amount will cover all Sageview and Psychiatric Emergency Services (PES) to all
post -commitment indigent clients served during those twelve (12) months. In addition,
post -commitment services have been extended to indigent clients who have exhausted
insurance benefits and have no other financial resources.
Agreement Starting Date: July 01, 2008 j Ending Date:
Annual Value or Total Payment:
$529,250
June 30, 2010
Amendment will increase contract revenue by
® Insurance Certificate Received (check box)
Insurance Expiration Date:
06/01/2010
Check all that apply:
❑ RFP, Solicitation or Bid Process
❑ Informal quotes (<$150K)
2/1/2010
Z Exempt from RFP, Solicitation or Bid Process (specify — see DCC §2.37)
Funding Source: (Included in current budget? ® Yes ❑ No
If No, has budget amendment been submitted? ❑ Yes ❑ No
Is this a Grant Agreement providing revenue to the County? ❑ Yes ® No
Special conditions attached to this grant:
Deadlines for reporting to the grantor:
If a new FTE will be hired with grant funds, confirm that Personnel has been notified that
it is a grant -funded position so that this will be noted in the offer letter: ❑ Yes 0 No
Contact information for the person responsible for grant compliance: Name:
Phone #:
Departmental Contact and Title:
Phone #:
541-322-7516
Department Director Approval:
Nancy England, Contract Specialist
Distribution of Document: Original to Nancy England - Behavioral Health; Original
to Robin Henderson, Cascade Healthcare Community, 2500 NE Neff Rd, Bend, OR
97701.
Official Review:
County Signature Required (check one): BOCC 0 Department Director (if <$25K)
Administrator (if >$25K but <$)150K; if >$150K, BOCC Order No. _ )
Legal Review ) 64-eGL Date 3
f
Document Number: 2010-109
2/1/2010
For Recording Stamp Only
After Recording Return to:
1. One original to Nancy England — Behavioral Health
2. One original to Jim Diegel, Cascade Healthcare Community, Inc., 2500 NE Neff Road, Bend, OR 97701.
DOCUMENT NO. 2010-109
AMENDING DESCHUTES COUNTY CONTRACT NO. 2008-380
THAT CERTAIN AGREEMENT, Deschutes County Contract No. 2008-380 dated July 1, 2008 by and between
DESCHUTES COUNTY, a political subdivision of the State of Oregon ("County") and Cascade Healthcare
Community, Inc., an Oregon non-profit corporation, doing business as Sage View, 2500 NE Neff Road, Bend,
OR 97701, Federal Tax ID# : 93-0602940 (collectively "Hospital"), previously recorded in the Deschutes County
Clerk's Records, is amended, effective upon signing of all parties, as set forth below. All other provisions of the
contract remain the same and in full force.
1. County Contract 2008-380 is amended as follows: [Numbers preceding paragraphs below refer to the
numbers of sections in Contract No. 2008-380. Former language has strikeout, while new language is in bold.]
7. Payment of Agreement.
PAGE 1 OF 7 —
a. Acute Psychiatric Care
County shall provide quarterly payments to Contractor as outlined in Exhibit 2 for rendering the
services listed in this Agreement. Funds may only be used for the delivery of the service or
services set out in this paragraph unless written permission is granted to use the funds for
other services in accordance with this Agreement.
Notwithstanding the foregoing, for the period between and including July 1, 2008
through June 30, 2009, Contractor shall receive $380,165 in four quarterly payments (Exhibit 2)
from County for Acute Psychiatric Care services to all indigent clients served during those
twelve months. This payment arrangement for 2008-09 requires Contractor to comply with the
conditions outlined in Exhibit 1 and 2 for all services described in this Agreement. Reconciliation
based on actual utilization of bed days will be made in accordance with "Annual Payment
Reconciliation" in Exhibit 2.
For the period including July 1, 2009 -June 30, 2010, Contractor shall receive $380,165
in four quarterly payments (Exhibit 2) from County for Acute Psychiatric Care services to all
indigent clients served during those twelve months. The payment arrangement for 2009-10
requires Contractor to comply with the conditions outlined in Exhibit 1 and 2 for all services
described in this Agreement. Reconciliation based on actual utilization of bed days will be made
in accordance with "Annual Payment Reconciliation" in Exhibit 2. County will consider increased
rates for 2009-10 at close of legislative session. Any rate increase will be determined by mutual
agreement of the Directors of Deschutes, Crook and Jefferson Counties and Cascade
Healthcare Community. Any consideration for a rate increase will be based on information on
cost of care at CHC Sage View unit, the general status of acute care resources available within
the region and any funding for COLA designated by the 2009 Oregon Legislature. Any change
to this payment amount for 2009-10 will be indicated by amendment to this agreement.
2010-.
5
b. Post -Commitment Care
County shall provide monthly payments to Contractor as outlined in Exhibit 3 for rendering the
services listed in this Agreement. Funds may only be used for the delivery of the service or
services set out in this paragraph unless written permission is granted to use the funds for
other services in accordance with this Agreement.
Notwithstanding the foregoing, for the period between and including July 1, 2008
through June 30, 2009, Contractor shall receive no more than $529,250 in 12 monthly
payments (Exhibit 3) from County for Post -Commitment services to all indigent clients as
defined in Exhibit 3 served during those twelve months. For the purpose of the post -
commitment portion of this Contract, indigent clients shall also include those individuals
who have exhausted insurance benefits and have no other financial resources. This
payment arrangement for 2008-09 requires Contractor to the conditions outlined in Exhibit 3 for
all services described in this Agreement.
Any extension of services for the period including July 1, 2009 -June 30, 2010 will be by
separate amendment to this contract.
Notwithstanding the foregoing, for the period between and including July 1,
2009through June 30, 2010, Contractor shall receive no more than $529,250 in 12
monthly payments (Exhibit 3) from County for Post -Commitment services to all indigent
clients as defined in Exhibit 3 served during those twelve months. This payment
arrangement for 2009-10 requires Contractor to the conditions outlined in Exhibit 3 for all
services described in this Agreement.
8. Bed Day Rate.
a. Acute Psychiatric Care:
For the purpose of this Agreement for Acute Psychiatric Care and extensions or renewals of
this Agreement, the Contractor and the County have established a Bed Day Rate to assist in
calculating future payments if both parties discontinue the heretofore described method of
calculating compensation payable to Contractor and replace the same with a fee-for-service
payment method. This calculation is based on a 2008-09 bed day rate of $695. This Bed Day
Rate will be utilized to calculate any 'Annual Reconciliation Based on Actual Bed Day Usage'
as outlined in Exhibit 2.
The bed day rate for 2009-10 will be calculated at $695. County will consider increased
bed day rate for 2009-10 at close of legislative session. Any rate increase will be determined
by mutual agreement of the Directors of Deschutes, Crook and Jefferson Counties and
Cascade Healthcare Community. Any consideration for a rate increase will be based on
information on cost of care at CHC Sage View unit, the general status of acute care resources
available within the region and any funding for COLA designated by the 2009 Oregon
Legislature. Any change to this bed day rate will be indicated by amendment to this
agreement.
By mutual agreement between Contractor and County at time of initial contract for Sage
View Acute Psychiatric Care services, an annual bed day rate increase will not exceed 5% in
any calendar year through December 31, 2024 This provision, as well as the provisions of
Section 32, shall survive termination of this Agreement.
b. Post -Commitment Care:
For the purpose of this Agreement for Post -Commitment Care and extensions or renewals of
this Agreement, the Contractor and the County have established a Bed Day Rate to assist in
calculating future payments based on actual usage under this portion of the contract and future
negotiations with the state for continued services. This calculation is based on a 2008-09 bed
PAGE 2 OF 7 —
day rate of $725. This Bed Day Rate will not affect payment or service levels for the 2008-09
service period.
PAGE 3 OF 7 —
EXHIBIT 2
Description of Covered Services & Authorization Process for
Acute Psychiatric Care
Process for Obtaining Authorization for Covered Mental Health Services
Authorization Process:
In order to track bed day utilization and assure optimum usage of resources, it is agreed that Contractor and
County will adhere to an authorization process that is mutually agreed upon between and among Contractor, the
County, BestCare Treatment Services (on behalf of Jefferson County) and Lutheran Community Services
Northwest (on behalf of Crook County).
Contractor will contact the appropriate county when admission is being considered to obtain
authorization on all patients who meet indigent status as outlined by:
1) At the time of admission, patient has no third party insurance and has no ability to pay as
defined by federal guidelines; or
2) At the time of admission, patient has exhausted their Medicare and/or Commercial insurance
benefits for mental health; or
3) During the course of care, patient has exhausted all ability to pay for services under this
Agreement and is receiving involuntary treatment. Contractor agrees to contact appropriate
county with update regarding *fended Patients status and county will authorize dependent upon
continued stay criteria; or
4) During the course of care if Contractor discovers that at the time of admission, the patient had
no third party insurance as reported and there is no other ability to pay for services, Contractor
agrees to contact appropriate county with update regarding *fended Patients status and county
will authorize dependent upon continued stay criteria.
5) Contractor agrees to utilize the same ability to pay criteria as well as make the same efforts to
collect as for any other patient admitted for hospital services.
6) Contractor is responsible for providing to County a monthly *fended Patients and **Posted
Patients list, due on the 15th day of each month. The report will include pended and posted
patients for all 3 counties.
*fended Patients: This status is descriptive of the period of time the Contractor is engaging in due
diligence to determine the patients ability to pay as outlined by Contractor guidelines.
**Posted Patients: Patients that have been approved for indigent care through the County.
PAGE 4 OF 7 —
EXHIBIT 3
Description of Services and Reporting Process for
Post -Commitment Care
Payment for Post -Commitment Care:
Contractor agrees to the payment methodology outlined in this agreement for post -commitment
care at Sage View (SV) or Psychiatric Emergency Services (PES) at St. Charles Medical Center to
all indigent clients residing in Deschutes, Crook or Jefferson counties as well as Eastern Oregon
counties who are civilly committed by a judge. Eastern Oregon Counties are defined as: Wasco,
Sherman, Hood River, Lake, Wheeler, Morrow, Harney, Grant, Malheur, Baker, Gilliam, Union,
Wallowa, and Umatilla. This includes clients who are already admitted to either SV or PES and
return to the facility after civil commitment hearing, as well as clients who are committed elsewhere
in the state and are clinically appropriate for transfer post -commitment, with the only exception of
bed space being unavailable. Central Oregon residents have first priority for admission, followed by
residents of Eastern Oregon counties. This portion of the contract will cover all services as of the
day post -commitment until transfer to long-term care at the state hospital or other discharge from
the facility.
Residents of other Oregon counties may be served under this contract on a case by case basis and
with joint approval of Director of Behavioral Health Services at Cascade Healthcare Community and
Deschutes County Mental Health Director.
The payment will cover all charges associated with the admission of indigent clients for SV or
PES services, including but not limited to room rate, associated staff time and professional fees
(including psychiatrist / MD), psychiatric medications, lab work and medical care. This contract
will include all bed days beginning the first day post -commitment until transfer to long-term care
or other discharge
Contractor shall neither bill nor expect payment for any additional services as part of this
agreement. County shall provide monthly payments to Contractor, for rendering the services listed
in this Agreement. Funds may only be used for the delivery of the service or services set out in this
contract unless written permission is granted to use the funds for other services in accordance with
this Agreement.
For the period between and including July 1, 2008 through June 30, 2009, Contractor shall receive
a maximum compensation of $529,250 for all post -commitment services regardless of whether
admission is at SV or PES unit in twelve (12)) payments as outlined below. This payment is
calculated at a bed day rate of $725 for 730 bed days. The total amount will cover all SV/PES
services to all post -commitment indigent clients served during those 12 months.
July 15, 2008 $44,104.16
August 15, 2008 $44,104.16
September 15, 2008 $44,104,16
October 15, 2008 $44,104,16
November 15, 2008 $44,104.16
December 15, 2008 $44,104.16
PAGE 5 OF 7 —
January 15, 2009 $44,104.16
February 15, 2009 $44,104.16
March 15, 2009 $44,104,16
April 15, 2009 $44,104,16
May 15, 2009 $44,104.16
June 15, 2009 $44,104.16
For the period between and including July 1, 2009 through June 30, 2010, any continued payments
if approved will be added by separate amendment to this contract.
For the period between and including July 1, 2009 through June 30, 2010, Contractor shall
receive a maximum compensation of $529,250 for all post -commitment services regardless
of whether admission is at SV or PES unit in twelve (12)) payments as outlined below. This
payment is calculated at a bed day rate of $725 for 730 bed days. The total amount will cover
all SV/PES services to all post -commitment indigent clients served during those 12 months.
July 15, 2009 $44,104.16 January 15, 2010 $44,104.16
August 15, 2009 $44,104.16 February 15, 2010 $44,104.16
September 15, 2009 $44,104,16 March 15, 2010 $44,104,16
October 15, 2009 $44,104,16 April 15, 2010 $44,104,16
November 15, 2009 $44,104.16 May 15, 2010 $44,104.16
December 15, 2009 $44,104.16 June 15, 2010 $44,104.16
Reporting Requirements:
Contractor shall provide monthly reports to the County for all usage under this portion of the
contract. Monthly reports shall include the following:
Client Name
County of Responsibility/Residence
Date of Commitment
Date Extended Care Management Unit (ECMU) application was approved
Date of Discharge
Discharge location (i.e. state hospital or other)
Total bed days for the month
Cumulative bed days
PAGE 6 OF 7 —
DATED this day of , 2010.
ATTEST:
Recording Secretary
BOARD OF COUNTY COMMISSIONERS
OF DESCHUTES COUNTY, OREGON
DENNIS R. LUKE, Chair
ALAN UNGER, Vice Chair
TAMMY BANEY, Commissioner
ii
DATED this t day of rre----0 i' c4L- gyp—+ , 2010.
CJ
PAGE70F7-
IEGEL, FACHE, President and CEO