- Report Published -
|Annual Report on Community Services Board Contracts for Private Inpatient Psychiatric Treatment Services July 1, 2007 - June 30, 2008|
|Department of Mental Health, Mental Retardation and Substance Abuse Services|
|Appropriation Act - Item 315 K. (Regular Session, 2008)|
|Item 315.K of the 2008 Appropriation Act requires the Department to submit a report annually to the Chairmen of the House Appropriations and Senate Finance Committees regarding community services board (CSB) contracts with private providers for local inpatient psychiatric treatment services. CSBs contract with private providers of local inpatient psychiatric treatment services in two ways. Historically, a few CSBs have contracted individually with some private providers for local inpatient psychiatric services. Based on survey results, CSBs paid $125,828 to eight private providers for 455 bed days of inpatient psychiatric treatment for 129 individuals in FY 2008. However, CSBs contract with private providers of local inpatient psychiatric services primarily on a regional basis through the Local Inpatient Purchase of Services (LIPOS) mechanism. In FY 2008, CSBs paid $14,761,454 of LIPOS funds to 32 private providers for 22,731 bed days of inpatient psychiatric treatment for 4,241 individuals. Thus, in FY 2008, CSBs reported that they paid a total of$14,887,282 to 32 private providers for 23,186 bed days of inpatient psychiatric treatment for 4,370 individuals.|
The purchase of these services by CSBs and the diversion of individuals receiving those services from admission to state hospitals had a significant impact on potential state hospital expenditures, utilization, and operations. Any savings realized by community-based inpatient psychiatric treatment services would be reflected in avoidance of increased state hospital expenditures and in decreased demand for state hospital beds. Of the 4,370 individuals served in FY 2008 through these contracts, only 459 individuals, or 10.5 percent of the total number, were transferred to a state hospital upon their discharge from private providers. These individuals needed longer term extended rehabilitation services offered by state hospitals. As a result of these contracts, 3,911 individuals were diverted from possible admission to state hospitals. In FY 2008, 3,270 individuals were served in state hospital admission units. If all 3,911 diverted individuals had been admitted, this would have increased the number of individuals admitted to state hospital admission units by 119.6 percent in FY 2008.
In conclusion, CSB contracts for local private inpatient psychiatric treatment services served more individuals than state hospital admission units in FY 2008, 4,370 versus 3,270 individuals. Those contracts obtained services for these individuals at far less cost than they could have been served in state hospitals, $14,887,282 in the community versus up to as much as $107,705,029 in state hospitals, depending on assumptions made about average lengths of stay in state hospital admission units and the proportion of those individuals who might have been admitted to state hospitals. Therefore, it is vitally important that funding for the purchase of local inpatient psychiatric treatment services delivered through contracts with private providers be maintained and even increased as Virginia moves to transform its public mental health, mental retardation, and substance abuse services system to serve individuals with serious mental illnesses most appropriately and effectively, increasing the availability of services in the community.