SECTIONS 4330-4335 - California Statutes

WELFARE AND INSTITUTIONS CODE

SECTION 4330-4335

4330. The State Department of Mental Health shall be reimbursed for
use of state hospital beds by counties pursuant to Part 1
(commencing with Section 5000) of Division 5 as follows:
(a) (1) For the 1991-92 fiscal year, the department shall receive
reimbursement in accordance with subdivision (b) of Section 17601.
This total may be adjusted to reflect any and all amounts previously
unallocated or held in reserve for use by small counties and any
adjustments made pursuant to Chapter 1341 of the Statutes of 1990.
(2) It is the intent of the Legislature to encourage and allow
greater flexibility with respect to resources during the first
transitional year, and, to this end, the Director of Mental Health
may implement proposals for purchase in or purchase out of, state
hospital beds which were proposed in accordance with Chapter 1341 of
the Statutes of 1990.
(3) Funds and bed days historically allocated to small counties
shall be allocated to counties with no allocation.
(b) Commencing with the 1992-93 fiscal year and each fiscal year
thereafter, the department shall be reimbursed in accordance with the
contracts entered into pursuant to Section 4331.
(c) The rate of reimbursement which shall apply each fiscal year
shall be determined by the department and shall include all actual
costs determined by hospital and by type of service provided. Any
costs resulting from overexpenditure in the previous year shall be
clearly separated from actual costs projected for the contract year
and identified as a part of the rate negotiation. Costs shall not
include costs incurred for capital outlay relating to existing
facilities or capacity, which shall remain the responsibility of the
state. Costs for capital outlay related to future expansions or
construction of new facilities requested by any county or cost
related to innovative arrangements under Section 4355 shall be a cost
to the county unless the expansion, construction or innovative
arrangements are determined to be of statewide benefit. Pursuant to
Section 11343 of the Government Code, the rate of reimbursement shall
not be subject to Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code.
(d) After final determination of state hospital costs for patients
covered under Part 1 (commencing with Section 5000) of Division 5,
funds that remain unencumbered at the close of the fiscal year shall
be made available to counties that used fewer state hospital beds
than their contracted number, proportional to the contracted amount
not used, but this amount shall not exceed the value of the unused
contracted amount. These funds shall be used for mental health
purposes.

4331. (a) No later than July 1, 1992, and in each subsequent year,
each county acting singly or in combination with other counties shall
contract with the department for the number and types of state
hospital beds that the department will make available to the county
or counties during the fiscal year. Each county contract shall be
subject to the provisions of this chapter, as well as other
applicable provisions of law, but shall not be subject to Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2
of the Government Code, the State Administrative Manual, or the
Public Contract Code and shall not be subject to review and approval
by the Department of General Services.
(b) (1) No later than January 1, 1992, each county acting singly
or in combination with other counties, shall notify the department in
writing as to the number and type of state hospital beds the county
or counties will contract for with the state in the 1992-93 fiscal
year.
(2) No later than July 1, 1992, and no later than July 1 of each
subsequent year, each county acting singly or in combination with
other counties shall give the department preliminary written
notification of the number and types of state hospital beds that the
county or counties will contract for with the state during the
subsequent fiscal year. Counties may include in their notification a
request for additional beds beyond their previous year's contract.
(3) No later than January 1, 1993, and no later than January 1 of
each subsequent year, each county acting singly or in combination
with other counties shall give the department final written
notifications of the number and types of state hospital beds that the
county or counties will contract for with the state during the
subsequent fiscal year. These notifications shall not preclude
subsequent changes agreed to by both the state and the county in the
contract negotiation process.
(4) The department shall provide counties with preliminary cost
and utilization information based on the best data possible, 60 days
in advance of the preliminary notification deadline, and a proposed
final cost estimate, based on the best data possible, 60 days in
advance of the final deadline. Final rates shall be subject to
contract agreement.
(c) There shall be no increase in the number of beds provided to a
county or group of counties during a fiscal year unless the contract
between the department and that county or group of counties is
amended by mutual agreement. Any significant change in services
requested by a county shall require amendment of the contract.
(d) If a county or group of counties has not contracted with the
department by July 1 of any given year, the number of beds to be
provided that fiscal year shall be the same as the number provided
the previous fiscal year, unless the department and a county have
formally agreed otherwise, and the rate of reimbursement that shall
be paid to the department shall be at the amount set by the
department for the fiscal year commencing July 1 of that year. The
department shall provide a mechanism for formal agreement of bed
levels no later than June 15 of each year. However, after July 1 the
department and a county or group of counties may enter into a
contract pursuant to this chapter and the contract shall govern the
number of state hospital beds and rates of reimbursement for the
fiscal year commencing July 1 of that year.

4332. (a) Contracts entered into pursuant to Section 4331 shall do
all of the following:
(1) Specify the number of beds to be provided.
(2) Specify the rate or rates of reimbursement.
(3) Set forth the specific type of services requested by the
county, in detail.
(4) Specify procedures for admission and discharge.
(5) Include any other pertinent terms as agreed to by the
department and the county.
(b) The department shall consult, in advance, with the counties
regarding any changes in state hospital facilities or operations
which would significantly impact access to care or quality of care,
or significantly increase costs.
(c) Beginning with the 1992-93 fiscal year and annually
thereafter, the department shall make available to counties upon
request the basis upon which its rates have been set, including any
indirect cost allocation formulas.

4333. (a) In the event a county or counties elect to reduce their
state hospital resources, beginning July 1, 1992, systemwide state
hospital net bed reduction in any one year may not exceed 10 percent
of the total for patients under Part 1 (commencing with Section 5000)
of Division 5 in the prior year without the specific approval of the
Director of Mental Health.
(b) Net bed reductions at any one hospital may not exceed 10
percent of its contracted beds without specific approval of the
Director of Mental Health.
(c) If the proposed reduction in any year exceeds the maximum
permitted amount, the department, with the assistance of counties,
shall make every effort to contract for beds with other purchasers.
(d) If total county requests for bed reduction in any one year or
at any one facility still exceed the amount of reduction allowed,
each county's share of the reduction shall be determined by taking
the ratio of its contracted beds to the total contracted and
multiplying this by the total beds permitted to be reduced.
(e) (1) Small counties shall be exempted from the limitations of
this section and shall have the amount of their reduction determined
by the Director of Mental Health.
(2) For purposes of this chapter, "small counties" means counties
with a population of 125,000 or less based on the most recent
available estimates of population data determined by the Population
Research Unit of the Department of Finance.
(f) It is the intent of the Legislature that counties have maximum
flexibility in planning the use of these resources, which includes
making full use of existing facilities and that the Director of
Mental Health enforce his or her exemption authority in a manner
consistent with this intent. Because freed-up beds may be purchased
by other counties or may be used for other purposes, it is
anticipated that individual county flexibility will be substantially
greater than the 10-percent figure described in subdivisions (a) and
(b).
(g) Counties may annually contract for state hospital beds as
single entities or in combination with other counties. For purposes
of this section, small counties, as defined in subdivision (e):
(1) Are encouraged to establish regional authorities to pool their
resources to assure their ability to provide the necessary array of
services to their mentally ill populations not otherwise available to
them on an individual basis.
(2) May receive loans from the General Fund when emergency state
hospital beds are needed, not to exceed one year in duration, with
interest payable at the same rate as that earned through the Pooled
Money Investment Fund. Any interest due may be waived based upon a
finding of emergency by the Secretary of Health and Welfare and the
Director of Finance.

4333.5. (a) The department shall encourage the counties to use
state hospital facilities, in addition to utilizing state hospital
beds pursuant to contract, for additional treatment programs through
contracts, on either an individual county or regional basis.
(b) For purposes of contracts entered into through encouragement
provided by the department pursuant to subdivision (a), costs shall
be based on the actual costs to the state, and shall be prorated on
an annual lease basis.

4334. By July 1, 1992, the State Department of Mental Health, in
collaboration with counties, shall do all of the following:
(a) Prepare and publish a catalogue of available state hospital
services. The catalogue shall be updated annually.
(b) Develop a process by which a county or group of counties
constituting the primary user of a particular hospital may, upon
their request individually, or through selected representatives,
participate in long-range planning and program development to ensure
the provision of appropriate services.
(c) Ensure direct county involvement in admission to, and
discharge from, beds contracted for patients under Part 1 (commencing
with Section 5000) of Division 5.

4335. Nothing in this chapter is intended to prevent the department
from entering into innovative arrangements with counties for
delivery of state hospital services. The Director of Mental Health
may contract with a county, or group of counties, for excess state
hospital space for purposes of staffing and operating their own
program.