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Adopt a resolution to designate Kaiser Permanente’s crisis stabilization unit located in Fairfield, California, as a California Welfare and Institutions Code §§5150 et seq. involuntary detention facility for evaluation and treatment of Kaiser-insured persons who are experiencing acute psychiatric symptoms
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Published Notice Required? Yes _____ No __X__
Public Hearing Required? Yes _____ No __X__
DEPARTMENTAL RECOMMENDATION:
The Department of Health and Social Services (H&SS) recommends that the Board adopt a resolution to designate Kaiser Permanente’s crisis stabilization unit located in Fairfield, California, as a California Welfare and Institutions Code §§5150 et seq. involuntary detention facility for evaluation and treatment of Kaiser-insured persons who are experiencing acute psychiatric symptoms.
SUMMARY:
In order to provide evaluation and treatment services to involuntary psychiatric patients pursuant to §§5150 et seq. of the California Welfare and Institutions Code, (WIC) a facility must be granted Lanterman-Petris-Short (LPS) designation by the County Board of Supervisors and approved by the State Department of Health Care Services.
Kaiser Permanente operates private healthcare facilities and outpatient physical and behavioral health-managed healthcare services in multiple Bay Area and Solano County locations. The new Kaiser Permanente crisis stabilization unit is scheduled to open in July 2025, pending LPS designation approval from the Department of Health Care Services (DHCS). The six-bed facility will provide urgent care 24-hours per day and 7-days a week for Kaiser-insured individuals experiencing acute psychiatric symptoms.
FINANCIAL IMPACT:
There is no cost to designating Kaiser Permanente’s crisis stabilization unit as a WIC §§ 5150 et seq. facility. Kaiser Permanente plans to operate the crisis stabilization unit with private Kaiser Permanente funding and is not requesting certification as a Medi-Cal billable facility. Solano County Behavioral Health may be responsible for reimbursement for the cost of treatment services rendered to County Medi-Cal clients.
DISCUSSION:
Under the Lanterman-Petris-Short Act (LPS Act), when a person, as a result of a mental health disorder, is a danger to themselves or others or gravely disabled, as defined, the person may, upon probable cause, be taken into custody for a period of up to 72 hours for assessment, evaluation, and crisis intervention, to include placement in a crisis stabilization unit (CSU) facility designated by the county of assessment and treatment and approved by the DHCS.
Clients presenting to the CSU will receive a thorough assessment and, if appropriate, will be admitted to the facility for crisis stabilization services. Additionally, clients placed on a Welfare and Institutions Code (WIC) §5150 hold by area law enforcement or other designated agents will be evaluated at the CSU, and a determination will be made whether the §5150 hold is appropriate and what further treatment is necessary.
According to the DHCS Licensing and Certification Section, to designate a facility as WIC §5150, specific requirements are essential:
1) The County Behavioral Health Director needs to request approval for such a designation from the DHCS on behalf of the Board of Supervisors; and
2) The request must be accompanied by a formal Board of Supervisors’ adopted resolution indicating approval of the WIC §5150 designation and authorizing the facility as a designated 23-hour and 59-minute evaluation and treatment facility for persons who are experiencing acute psychiatric symptoms; and
3) Attestation that indicates the program will meet or has capacity to meet the requirements of Title 9, California Code of Regulations 663, "Minimum Staffing Requirements," and 821, "Approval of Facilities."
Solano County operates a CSU with 16 beds, primarily for Medi-Cal recipients. The County does not currently have beds for privately insured individuals, who often end up in emergency departments waiting long hours to receive care.
As a valuable healthcare partner in our community, Kaiser Permanente serves thousands of Solano County residents' physical and mild to moderate mental health needs. Kaiser is requesting to operate a CSU for its insured members after internally evaluating the impact on its emergency departments and determining the need to assess and treat members experiencing a mental health emergency in a county-designated mental health crisis setting.
The H&SS Behavioral Health Division has worked closely with Kaiser Permanente personnel to meet the requirements for a WIC §§5150 designation. It supports Kaiser Permanente in its effort to enhance its care delivery system. Solano County H&SS deems the resources needed to evaluate the Kaiser facility for LPS designation and any future re-designations as available and appropriate use of such resources.
The Solano County Behavioral Health Quality Assurance team has completed the requisite evaluation and is recommending that the Board of Supervisors adopt a resolution to designate Kaiser Permanent CSU as a WIC §§5150 facility. The Board’s adopted resolution will be submitted to the California DHCS along with the QA team’s site and policy review of the facility prior to DHCS officially designating the facility.
ALTERNATIVES:
The Board of Supervisors may choose not to approve the resolution. This is not recommended because Kaiser’s ability to evaluate and treat its health plan members in an LPS-designated CSU allows them to free up resources in emergency departments, support mobile crisis triage, and provide emergency psychiatric care in a more appropriate setting.
OTHER AGENCY INVOLVEMENT:
Kaiser Permanente worked with the Solano County H&SS Behavioral Health Quality Assurance team to complete the Involuntary Detention Facilities designation site and policy review.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION