HomeMy WebLinkAboutConfidential Health Info yep 11 20082: 13PM BEHAVIORAL HEAt TH OCCC 5337188 P. 1
Butte County Department of Behavioral Health
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OROVI LLF,C AT 1
Sep 11,2000-P- 18PM BFHAVIORAL HFMTH OCCC 5337188 p. 2
MEDICAL STAFFS ACTION PLAN TO SOLVE
BEHAVIOR HEALTH'S FISCAL CRISIS
Thank you for -L-ie opportunity to describe --he 3 major components cf the Medic-D'
Staff's action plan which when iffrpla-rented will bring the departir-erlt out
of
its current financial crisis.
A. increase clinical oroductivity in a responsible Tnznner.
The overall Droduc-tivity in the outpatient clinics is a0CLIt
that is, foreverytwo hours of work the average clinician Provides
�
level one hour of direct patient
50%
ft treatirent or care. -Level results
essentially from the efforts of 2/3rd's of the clinical staff. The
productivity of the remaining 1/3rd is only 16t. This Icw figure is
due in part to the -fact that clinical administrators, program managers
and clinical supervisors typ_-'ca_11Y see t0w, if any, patients. if this
group accaunting for 1-/3rd of the staff would increase -productivity to an
average of only 40%, revenues would increase by an ezitiffo':-_ed $3.5 willic:'
The Crisis Service consisting of 32 total staff operates at only 18%
productivity compared to the overall average of clinicians of about 500.
If these 32 staff increased heir r average productivity to only 30%.
the additional revenues would amount to an estimated $1.15 million.
_"
.1r. Walker has been unable or unwilling to begin these re ,,Drms in spite
of the strong recommendations of the medical staff. To accomplish these
reforms will. require a director who understands the seriousness of the
problem, is capable of motivating underproduc-*ng staff to make the necessary
changes, has the trust and respect of the staff -and has the clinical know-how
to make sure the changes are acccnTlished.
B. Contract with Welfare for an eligibility worker to facilitate shifting
CMSP patients to MediCal so as to increase revenue by an estimated
$750,000. These patients may be on cur inpatient facility or in our
out-patient clinics. These individuals are often our most seriously ill.
patients and certainly should never be denied needed treatTrr-nt.
C. Develop a range of residential facilities under contract to provide a
cost-effective alternative to expensive out-of-county hospitalization and
placeirents. The first step is the contract fcr a residential facility
in Chico which should be able to divert about 50 youth and children a year
from expensive and often ineffective out-cf-county hospitalization. Not
only will dollars stay n our county but the children will be treated by
i I
cur own psychiatrists and their familiies will be able to actively
participate in their treatnv--nt.
Additional local residential facilities are needed to reduce out-of-county
7no d
hospitalizations for adults and longer-term placerL_r S t for both adult an youth.
These six bed facilities should all be developed through contracts and if funded
through MFSA should result ir substantia-', saving in realignment dollars:
T.
1. An adult crisis facility to provide an alternative to the P 7
for voluntary patients.
2. A six bed adult and a six bed youth transitional facility to assist
patients to move from institutional and group home settings to more
independent living arrangements.
3. A six bed youth and a six bed adult facility for those needing
longer-term stays as alternatives to distant placement facilities.
Sep 11 2008 2: 18PM BEHAVIORAL HEALTH OCCC 5337188 p. 3
CRITICAL NON-DISCLOSURE AND IMPROPER ACCOUNTING
IN BH 08-09 BUDGET PROPOSAL
did not tel you `hat it is veryf ,'I
ii'-elv that thosc C;7ir-:c-
-ylaid of bring �r -ore Te,,enue� t-an Lthem =-2
nave hcen or a_-c beij- I sts in --igur�nq the tot�l)
henGf-'.ts. Instead, Mr., ;,;ajKer ae;,de,�, in his overhead or- - - abi
c, - clinician. fir. wa'kerr not only did not make cuir�,- E
ost ci. a c. couid not even tell
reduction-- i
-n nis overhead, 2u-�: �,&�en he was asked, he
you what was in it.
Na— 7.pact. on patients
you of t�-ie negative i.
-r
er also did not f, y j--Zo-M
which results -ot.c-n treatment cu,.d counseiinc ic, cj-isr-�pted when_ their
cojj�.,se!Lor or therapist is e-ther laid cff or transferred t-c fil-I a vacant
pcsition. in his budget, Mr. walker recomer edJ dropping 35 vacant c-inical
positions and
terminating Ling 23 clinical staff. The loss of these 58 s-,Iff WOU11-4
rcsi.AL in 53,360 therapy ho=s cvery year no lotiger teing a-vai-'abic to the
residents of our county. In I C yea-s, t,
is s will r t-- over a half million
lost hours off --herapy.
2. Mr. F;alker told vcu that transfcrrinq the. Paradise adult outpaieit clinic
to a contract provider would save the county 1$205,000. The truth is
gnat
tie clillic brines in $38,00C *core Enn-n ;'-- costs. P�!-. walkar arrived
at hip $205,00C figure by violatinc the accepted principles of accounting.
ire used the total eNpenses at-; of 6/30/08 - including any not yet
but used only those revenues which had been received as of June 30th.
L-i other words, he used the acoria' method in reporting 'n,-s expenses certified tlic tu-t-
-Pu
the c=sn method in reporting revenues. Accordinc tc a c
ccuantant with ;Wncm we consulted, L--ds is not only contrary to g0cd
practices but "if accountants did tlh4=, they wcuJc` lose their licenses.
3. viacn you approved the $1.� iaLllion Ycuti-, for c-'-ange contract v--u were told
by Mr. walker that "it wouldn't cost the county a penny." You since have
been informed by your Medical. Staff that the County must pay iC% or $190,CCO
up `rent of which is returned as revenue
and tLat there are tr addition
costs of v--ricus department staff who are assigned to -ronit,'Dr aF-7 dc--ini ter
the ccntract- which costs Pix. Walker also (fi-d not disclose.
4. WEen N-r. Welker rec=mended -Layincj off proc,active clini(--i-ans in order tz> save
ra--ney, no did not -inform you that the '.;--roles cE Car-2 ,.'ant as ;3f 5/31/08
had $i,225,357.4d of urigircnt funds. On the 15th of tais =uC7llt J 11 clin-1--cal
staff .-epertsdiv wi.1-1- rc=`ve notices that they will he ta rm. inated efff.---tive
Se-ztamber 25L-�. '14-ie $1.2 i-ru-111ion of unsz:,,ent fLL:.d!s: amore ust s-itt-JiLzic in
the �.-rarit, doing no one any good, and EhCL-1d be spent to restore the-se
11 '
9'a-"f and preserve s=ices to pane: is and families. A!- that is
recuire<: to cualify for t lose funds would he to organ`zc the staff i:i+--c
CUT--Urrallv coope-tent teams.
Tf those 1-1 clinical staff are in(3ecd tarTinatcd,, the result wi-' to 'C!71&t
10,120 �rierapy hours every Veaz wi-I no long=. '-e available r-cr our rx,ients.