Agenda

Return

C. 99

To:	Board of Supervisors
From:	Anna Roth, Health Services Director
Date:	April 18, 2023

Contra

Costa

County

Subject:

Payment for Services Provided by BHC Heritage Oaks Hospital, Inc.

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 04/18/2023

APPROVED AS RECOMMENDED

OTHER

Clerks Notes:

VOTE OF SUPERVISORS

AYE:

Candace Andersen, District II Supervisor
Diane Burgis, District III Supervisor
Ken Carlson, District IV Supervisor
Federal D. Glover, District V Supervisor

ABSENT:

John Gioia, District I Supervisor

Contact:	Suzanne Tavano, Ph.D., 925-957-5169
cc:	E Suisala M Wilhelm

I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown.
ATTESTED: April 18, 2023
Monica Nino, County Administrator

BY:	, Deputy

RECOMMENDATION(S):

APPROVE and AUTHORIZE the Auditor-Controller, or designee, to pay an amount not to exceed $5,319 to BHC Heritage Oaks Hospital, Inc., a corporation, for the provision of inpatient residential treatment services that exceeded the contract payment limit and was provided in good faith during the period May 24, 2022 through June 26, 2022.

FISCAL IMPACT:

If approved this retro payment in the amount of $5,318.58 will be funded 100% by Mental Health Realignment revenues.

BACKGROUND:

The Behavioral Health Services Division (BHSD) has been contracting with BHC Heritage Oaks Hospital, Inc. since November 2006. This contract meets the social needs of the county’s population by providing inpatient psychiatric hospital services to County-referred adults and adolescents.

BACKGROUND: (CONT'D)

In October 2022, the County Administrator approved and the Purchasing Services Manager executed Novation Contract #24-794-6(12) with BHC Heritage Oaks Hospital, Inc., in an amount not to exceed $150,000, for the provision of inpatient residential treatment services for the period from July 1, 2021 through June 30, 2022 including an automatic extension in an amount not to exceed $75,000 through December 31, 2022.

On June 7, 2022, the Board of Supervisors approved Contract Amendment Agreement #24-794-6(13) with BHC Heritage Oaks Hospital, Inc., effective February 1, 2022, to amend Novation Contract #24-794-6(12) to increase the payment limit from $150,000 to a new payment limit of $275,000, with no change in the term of July 1, 2021 through June 30, 2022, and to increase the automatic extension payment limit from $75,000 to a new payment limit of $137,500 through December 31, 2022.

This contract was previously amended near the end of the 2021-22 fiscal year to cover all anticipated admissions; however, in the last month of the contract, a client was admitted and had a protracted stay. This has resulted in the need for BHSD to pay an additional $5,318.58 to cover this unexpected claim in its entirety. Due to the hospital appealing a denial and the timeframes allowed by the Department of Health Care Services to process claims and appeals, the claim was not approved for payment until now.

Therefore, County staff has determined that BHC Heritage Oaks Hospital, Inc. is entitled to payment for the reasonable value of their services under the equitable relief theory of quantum meruit. That theory provides that where a person has been asked to provide services without a valid contract, and the provider does so to the benefit of the recipient, the provider is entitled to recover the reasonable value of those services. The contractor has provided services at the request of the county after the original contract payment limit had been reached. The Department cannot pay contractor for services rendered that exceed the contract limits. As such, the Department recommends that the Board authorize the Auditor-Controller to issue a one-time payment not to exceed $5,318.58 to BHC Heritage Oaks Hospital, Inc.

CONSEQUENCE OF NEGATIVE ACTION:

If this request is not approved, BHC Heritage Oaks Hospital, Inc. will not be paid for services rendered in good faith to a County client outside of the contract payment limit.