2009 California Welfare and Institutions Code - Section 5902-5903.5 :: Article 2. Interim Contracting Mechanism

5902.  (a) In the 1991-92 fiscal year, funding sufficient to cover
the cost of the basic level of care in institutions for mental
disease at the rate established by the State Department of Health
Services shall be made available to the department for skilled
nursing facilities, plus the rate established for special treatment
programs. The department may authorize a county to administer
institutions for mental disease services if the county with the
consent of the affected providers makes a request to administer
services and an allocation is made to the county for these services.
The department shall continue to contract with these providers for
the services necessary for the operation of the institutions for
mental disease.
   (b) In the 1992-93 fiscal year, the department shall consider
county-specific requests to continue to provide administrative
services relative to institutions for mental disease facilities when
no viable alternatives are found to exist.
   (c) (1) By October 1, 1991, the department, in consultation with
the California Conference of Local Mental Health Directors and the
California Association of Health Facilities, shall develop and
publish a county-specific allocation of institutions for mental
disease funds which will take effect on July 1, 1992.
   (2) By November 1, 1991, counties shall notify the providers of
any intended change in service levels to be effective on July 1,
1992.
   (3) By April 1, 1992, counties and providers shall have entered
into contracts for basic institutions for mental disease services at
the rate described in subdivision (e) for the 1992-93 fiscal year at
the level expressed on or before November 1, 1991, except that a
county shall be permitted additional time, until June 1, 1992, to
complete the processing of the contract, when any of the following
conditions are met:
   (A) The county and the affected provider have agreed on all
substantive institutions for mental disease contract issues by April
1, 1992.
   (B) Negotiations are in process with the county on April 1, 1992,
and the affected provider has agreed in writing to the extension.
   (C) The service level committed to on November 1, 1991, exceeds
the affected provider's bed capacity.
   (D) The county can document that the affected provider has refused
to enter into negotiations by April 1, 1992, or has substantially
delayed negotiations.
   (4) If a county and a provider are unable to reach agreement on
substantive contract issues by June 1, 1992, the department may, upon
request of either the affected county or the provider, mediate the
disputed issues.
   (5) Where contracts for service at the level committed to on
November 1, 1991, have not been completed by April 1, 1992, and
additional time is not permitted pursuant to the exceptions specified
in paragraph (3) the funds allocated to those counties shall revert
for reallocation in a manner that shall promote equity of funding
among counties. With respect to counties with exceptions permitted
pursuant to paragraph (3), funds shall not revert unless contracts
are not completed by June 1, 1992. In no event shall funds revert
under this section if there is no harm to the provider as a result of
the county contract not being completed. During the 1992-93 fiscal
year, funds reverted under this paragraph shall be used to purchase
institution for mental disease/skilled nursing/special treatment
program services in existing facilities.
   (6) Nothing in this section shall apply to negotiations regarding
supplemental payments beyond the rate specified in subdivision (e).
   (d) On or before April 1, 1992, counties may complete contracts
with facilities for the direct purchase of services in the 1992-93
fiscal year. Those counties for which facility contracts have not
been completed by that date shall be deemed to continue to accept
financial responsibility for those patients during the subsequent
fiscal year at the rate specified in subdivision (a).
   (e) As long as contracts with institutions for mental disease
providers require the facilities to maintain skilled nursing facility
licensure and certification, reimbursement for basic services shall
be at the rate established by the State Department of Health
Services. Except as provided in this section, reimbursement rates for
services in institutions for mental diseases shall be the same as
the rates in effect on July 31, 2004. Effective July 1, 2005, through
June 30, 2008, the reimbursement rate for institutions for mental
disease shall increase by 6.5 percent annually. Effective July 1,
2008, the reimbursement rate for institutions for mental disease
shall increase by 4.7 percent annually.
   (f) (1) Providers that agree to contract with the county for
services under an alternative mental health program pursuant to
Section 5768 that does not require skilled nursing facility licensure
shall retain return rights to licensure as skilled nursing
facilities.
   (2) Providers participating in an alternative program that elect
to return to skilled nursing facility licensure shall only be
required to meet those requirements under which they previously
operated as a skilled nursing facility.
   (g) In the 1993-94 fiscal year and thereafter, the department
shall consider requests to continue administrative services related
to institutions for mental disease facilities from counties with a
population of 150,000 or less based on the most recent available
estimates of population data as determined by the Population Research
Unit of the Department of Finance.

5903.  (a) For the purposes of this section, the following
definitions shall apply:
   (1) "Client" means an individual who is all of the following:
   (A) Mentally disabled.
   (B) Medi-Cal eligible.
   (C) Under the age of 65 years.
   (D) Certified for placement in an institution for mental disease
by a county.
   (E) Eligible for Supplemental Security Income/State Supplementary
Program for the Aged, Blind, and Disabled (SSI/SSP) benefits.
   (2) "Client's payee" means an authorized representative who may
receive revenue resources, including SSI/SSP benefits, on behalf of a
client.
   (3) "SSI/SSP benefits" means revenue resources paid to an eligible
client, or the client's payee, by the federal Social Security
Administration pursuant to Subchapter 16 (commencing with Section
1381) of Chapter 7 of Title 42 of the United States Code, and Chapter
3 (commencing with Section 12000) of Part 3 of Division 9.
   (b) (1) Between August 1, 1991, and June 30, 1992, institution for
mental disease providers shall make reasonable efforts to collect
SSI/SSP benefits from a client or a client's payee. The provider
shall invoice the client or the client's payee for the SSI/SSP
benefits, minus the personal and incidental allowance amount as
established by the Social Security Administration, and remit all
SSI/SSP funds collected to the department pursuant to procedures
established by the department.
   (2) Commencing July 1, 1992, and to the extent permitted by
federal law, institution for mental disease providers may collect
SSI/SSP benefits from a client or a client's payee. The amount to be
invoiced shall be the amount of the client's SSI/SSP benefits, minus
the personal and incidental allowance amount as established by the
Social Security Administration. The administrative mechanism for
collection of SSI/SSP benefits, including designation of the party
responsible for collection, shall be determined by negotiation
between the counties and the providers.
   (c) In collecting SSI/SSP benefits from the client or the client's
payee, the provider shall not be deemed to be the authorized
representative, as defined in Section 72015 of Title 22 of the
California Code of Regulations, for purposes of handling the client's
moneys or valuables.
   (d) Providers shall make all reasonable efforts, as specified in
procedures developed by the department in consultation with
providers, to collect SSI/SSP benefits from the client or the client'
s payee. Providers shall establish an accounting procedure, approved
by the department, for the actual collection and remittance of these
funds.
   (e) Providers shall prorate the client's SSI/SSP benefits by the
number of days spent in the facility.
   (f) After June 30, 1992, and not later than January 1, 1993, the
department shall make data available to the Legislature, upon
request, regarding the SSI/SSP collections made by institution for
mental disease providers pursuant to this section.

5903.5.  Notwithstanding any other provision of law, the department
may liquidate accounts receivable from individual clients or payees
of clients from institution for mental disease funds appropriated by
the Legislature, when they have been determined by the department to
be uncollectible, including accounts receivable in existence prior to
the effective date of this section. Liquidation shall occur no
sooner than 12 months after the original date of the accounts
receivable debt.