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County staff raise concerns about mental-health access and Solvista contract for discharge coordination
Summary
Health and human services and public health staff told commissioners they lack reliable local mental-health providers who take Medicaid and raised questions about Solvista's role in hospital discharge coordination; staff said they will bring a contract with Solvista to the board for review.
Health and human services and public-health staff told the Board of County Commissioners that limited local mental-health capacity and uncertain discharge coordination from region hospitals are creating gaps in care and uncompensated responsibilities for the county.
Staff said elevated community health (previously Community Care Clinic) is increasing local clinic hours but the county lacks a mental-health provider who accepts Medicaid and can treat children locally. As a result, staff said they are paying for assessments out-of-pocket or arranging transports to regional facilities. "We do not have a mental health provider in our area that takes Medicaid and works with kids," a presenter said.
Hospital discharge planning and Solvista contract Public health staff described recent changes in which Solvista would limit services for Saint Vincent's hospital discharge planning to evaluations rather than full care coordination. Staff said the county receives roughly $30,000 to $37,000 a year for adult protective services and is currently using DHS dollars for higher-level care coordination in complex cases, including nursing-home placements in Denver when those are medically necessary. The presenter said she will bring a contract with Solvista before the board and expressed concern that Solvista "is not actually doing the things that they're supposed to do."
Why it matters: Staff said discharge gaps and spotty local mental-health capacity shift uncompensated workload to the county (DHS and public health) and can leave medically vulnerable residents without appropriate placements. Commissioners and staff discussed using upcoming contract review as leverage to specify expectations.
Other actions and next steps - Staff said they will request a round-table with hospital partners to clarify pathways for discharge and to avoid ad hoc solutions that rely on county emergency funds. - A Solvista contract will be presented to the board for review and discussion, and staff indicated they may use the contract process to demand clearer service commitments.
Ending: Staff asked the board to support conversations with regional health providers and to attach specific performance and coordination expectations to any Solvista contract the county is asked to sign.
