County Supervisors have revised a contract with a private bus company to have it transport people for medical appointments and things like court hearings.
Supervisors recently approved a new contract with United Cerebral Palsy of SLO County, which operates Ride On Transportation, increasing the contract by some $827,000 for a new total contract amount of $1.31 million a year.
The contract would have Ride On “provide transportation for clients to various facilities for medically necessary treatment and other activities that may include Court hearings and treatment sessions,” reads the report from County Behavioral Health, and County Administration. The new contract would run through the end of the 2024/25 fiscal year.
The change is driven by an increase in demand experienced by Behavioral Health, especially as the Coronavirus Pandemic was raging.
“Throughout Fiscal Year 2021-22,” the report said, “Behavioral Health saw an increased need for transportation of clients for a variety of reasons. Several of these factors remain true for FY 2022-23 and continue to increase the volume of client transports.” These include:
• An increase in requests for transportation for inpatient services outside of the County, primarily for adults who have Medicare or private insurance, or for minors. The need for return trips home to San Luis Obispo County have also continued to increase, and receiving hospitals require an assurance that the patient will be transported at discharge to an appropriate location.
• The PHF staff is no longer providing transportation for Public Guardian clients who need to return to the County for court hearings or back to the clients’ out-of-county residential placements. These trips are now provided by vendors.
• CenCal still has not developed additional resources for medically necessary transport to out-of-county facilities; vendors or the County continue to provide transportation, when necessary, which is not always reimbursed by CenCal, to ensure timely placement of Medi-Cal beneficiaries in appropriate levels of care.
• Payment for transportation of private insurance or Medicare clients by third party carriers continues to be inconsistent.
• Minors may not be admitted to the Psychiatric Health Facility (PHF) and are directly transferred to other facilities that can provide care more appropriate to their needs. The change to exclude minors from PHF admission began due an increase in numbers of inmates from the jail to the PHF several years ago.
• Local emergency departments are not equipped or staffed to care for individuals in acute psychiatric need for long periods of time. Due to the lack of inpatient beds in the County, individuals must be transported as expeditiously as possible to out-of-county facilities once a bed is procured by contract staff.
• During COVID-19 outbreaks, the PHF is forced to temporarily limit admissions, which results in an increase in transports needed as patients are diverted to out of county hospitals. There were approximately 57 days through the second quarter when the PHF was closed to admissions, or patients were diverted to out-of-county psychiatric hospitals.
This latest contract amendment is the last of four the County had to change with its four transportation vendors that provide these transportation services. The other three were amended back in February.
The contracts have clauses that allow for two, 1-year extensions past the original terms and the County Health Director can amend the contracts with regards to services, service levels or rates, because Supervisors in approving the amendments gave that authority to the Health Agency director.
The contracts are an example of the lengths and expenses SLO County must go to with regards to its mental health programs because there are no in-patient mental health facilities located within SLO County.