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Louisa County weighs paying detox stays after state funding cut
Summary
County supervisors discussed a request from a regional provider to cover medically monitored detox stays after the state ended reimbursement July 1. The provider said two uninsured Louisa County residents sought services since the change; supervisors asked staff to draft a contract with a $5,500 maximum and place it on the next agenda.
Louisa County supervisors on Oct. 7 discussed a provider request for county funding to cover short-term, medically monitored detox stays after the state ended reimbursement for that level of care July 1.
Kayla, a representative of the regional behavioral-health provider, said the change has left uninsured people without a payer source for “level 3.7, medically monitored inpatient” detox services. "Since July 1, we have been tracking how many people we have had to turn away," Kayla said. She told the board two callers who identified themselves as Louisa County residents were accepted into the program but could not pay the daily rate.
The provider said the program—harges $550 per day and that typical lengths of stay run three to five days. "This is a short, maybe 3 to 5 day stay typically for people that are withdrawing from alcohol, opioids, benzodiazepines," Kayla said, adding the facility provides medication management and arranges follow-up substance-use treatment or residential placement when appropriate.
Supervisors discussed two contracting approaches: a fee-for-service arrangement where the county would pay for individual uninsured patients, or a contract with a capped maximum that the county could draw down. A county official noted the board has an opioid-settlement fund balance the board said was about $76,000 and suggested piloting a maximum drawdown. One supervisor proposed a $5,500 cap as a starting point for the county to cover two uninsured stays at the provider's rates.
County staff and the provider said courts committals are accepted by the facility, but voluntary walk-ins who lack insurance have been turned away. Kayla said providers also assist patients in applying for Medicaid after admission when appropriate, and the provider would refund private pay if coverage later backdated to include the stay.
The board directed staff to insert a $5,500 maximum into the provider contract template and to place the draft contract on the next meeting agenda for formal approval. No final appropriation or contract was signed at the Oct. 7 meeting.
The board id not set a long-term policy in the meeting; supervisors said they would review the contract and its use after a budgeted drawdown or at a midpoint review if the contract proceeds.
