State Hospital Reimbursement Programs Overview
State legislatures in 2023 passed SB 228 and HB 2184 directing KDADS to reimburse counties, healthcare providers, law enforcement, and other entities for costs related to holding individuals in custody, observation, and transportation. SB 228 focuses on competency examination and treatment for defendants, while HB 2184 addresses unpaid costs of patient observation and transportation. KDADS processes reimbursement requests based on specific criteria, with set rates and amounts allocated for each program. Eligible entities must be registered in the SMART system to receive reimbursements.
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County Reimbursement for State Hospital Wait Times August 2, 2023 Scott Brunner, Deputy Secretary Department for Aging and Disability Services 1
2023 Legislature SB 228 Directs KDADS to reimburse counties for costs related to holding a person in custody while awaiting examination, evaluation, or treatment to restore competency to stand trial. The rate is $100 per day. KDADS is directed to develop a process to pay on a quarterly basis. Counties can be compensated for each day a person is in custody and confined. For defendants waiting for examination or evaluation, compensation is for days from the date the request for examination or evaluation is made until the date the person is taken from confinement in the county jail for such examination or evaluation or the examination or evaluation is completed at the county jail. For defendants awaiting competency restoration treatment, compensation is for days from the date of return to confinement in the county jail from examination or evaluation or the examination or evaluation is completed at the county jail until the date the person is taken from confinement in the county jail for such treatment or treatment is completed at the county jail.
Key points to the process KDADS is paying counties. Counties must be registered in SMART (State Accounting System). The only types of competency examination, evaluation or treatment eligible for reimbursement are under K.S.A.: 22-3219 22-3302 22-3303 22-3429 22-3428 22-3430 Reimbursements are based on requests from counties for defendants in custody and confined based on criminal charges or court orders. Defendants on bond or on an Outpatient Treatment Order are excluded. KDADS can verify against information maintained at Larned State Hospital (LSH) State Security Program about defendants ordered for evaluation or treatment.
2023 Legislature HB 2184 HB 2184 directs KDADS to reimburse healthcare providers, law enforcement, and other county entities for unpaid costs of patient observation and transportation. (x) During the fiscal year ending June 30, 2024, in addition to the other purposes for which expenditures may be made by the above agency from moneys appropriated from the state general fund or any special revenue fund or funds for fiscal year 2024 as authorized by this or any other appropriation act of the 2023 regular session of the legislature, expenditures shall be made by the above agency from such moneys in an amount not to exceed $5,000,000 for the purpose of reimbursing healthcare providers, law enforcement and other county entities for unpaid costs of patient observation and transportation.
Key points to the process KDADS is authorized to healthcare providers, law enforcement, and other county entities. Any organization that is requesting payment must be registered in SMART (State Accounting System). HB 2184 directs reimbursement for unpaid costs. The proposed KDADS process collects reimbursement requests from the designated types of providers. The reimbursement is for costs within the State fiscal year July 1, 2023 through June 30, 2024. There s no rate established in the Appropriations bill for observation costs or transportation. $5 million is appropriated to KDADS for this purpose. Proposing to reimburse for patients waiting for admission to Larned State Hospital, Osawatomie State Hospital, or a State Institution Alternative provider. KDADS can verify reimbursement requests against patients ordered for involuntary commitment under the Care and Treatment Act.
Provider Payment and Contact Information Requesting Organization is the name of the County, Law Enforcement Organization, or healthcare provider. This should be the hospital making the request for payment SMART Supplier ID is a 5-digit number assigned by the state Division of Accounts and Reports. Short supplier name is assigned in SMART. This could help match up a county with Vendor ID if there is a discrepancy. The Supplier ID and Supplier Name are critical to matching a payment to the right county or provider and processing the payment.
Time Frame for the Reimbursement The selection should be the timeframe when services were provided, and reimbursement is requested. The possible years are 2023 and 2024 for the correct state fiscal years.
Information about the Defendants Name and Case Number should match the person on the waiting list. Defendant s Current Location is the county housing the defendant. If another jail is housing a defendant on behalf of the responsible county, this can help KDADS and Larned State Hospital verify the defendant on the wait list. The reimbursement should go to the County where the criminal charges were filed. A single defendant could appear multiple times if there are additional charges or if the defendant moves between competency evaluation and restoration.
Information about Dates and Payment Court order date is the date stamped on the order. July 1, 2022 should be entered for any orders for a defendant in custody before July 1, 2022. The service start date/Admission or Mobile Completion date is when : a defendant is transported and admitted to LSH or OSH Mobile competency is completed and the transmittal letter with the Forensic Evaluation Report is send to the court. Number of days is calculated by subtracting the two dates. That is carried up to billable days and for all defendants on the spreadsheet. If the reimbursement is for a defendant still in custody at the end of the quarter, the Start Date is the last day of the quarter.
Information about the Service K.S.A. Authority is a drop-down field to select the legal order from the court for a defendant. Options are: 22-3219 22-3302 22-3303 22-3302/22-3219 22-3428 22-3429 22-3430 Service provided by: LSH Inpatient OSH Inpatient Mobile LSH This would be through a contractor or LSH staff member Waiting for services CMHC Future option where a CMHC is conducting competency as ordered by District Court
Reimbursement for past expenses We d like to make a single payment to each county that held defendants waiting between July 1, 2022 and June 30, 2023. Fill in defendants' names and case numbers for every one that was in custody in that time period. If the legal authority changed during the year, create a new line for that defendant with the corresponding dates. If a defendant is in custody after June 30, 2023, counties could choose to wait until the defendant is admitted or enter June 30, 2023 in the completion date field to close out the retroactive reimbursement. If a defendant was in custody before July 1, 2022, KDADS can not pay for days before July 1, 2022. KDADS can verify information with the wait list and admission records at LSH and OSH.
Information about patientsInvoluntary Commitment Name should match the person on the waiting list. Admitted from is the location the patient is being admitted to a state hospital from. This could be the hospital, a Law Enforcement Organization, or Community Mental Health Center. There should be a connection to the organization requesting reimbursement. Admitted to is a drop down box. Select the appropriate state hospital or SIA. Court order is a yes/no selection if the provider or organization is submitting a copy of the court order directing involuntary commitment.
Information about Dates and Payment Date and Time of Commitment/Admission Decision is the start time for reimbursement. This should be the date and time a patient is accepted for admission. Admission date and time is when the patient is delivered to the state hospital or SIA facility. The reimbursement amount is calculated by subtracting the two dates to generate the number of hours. Proposing $40 per hour to capture the inclusive costs for patient observation. Created an option to seek a monthly payment if a patient carries over from month to month.
Information about Transportation Costs Built a second tab on the spreadsheet to capture transportation costs. Built to reimburse the round trip mileage at the state rate of $ 0.585 per mile or a lump sum amount. Providers could send the bill from secure transport service, ambulance, or other provider. Any costs related to staff observation during the transport would be included in the hourly reimbursement amount.
Law Enforcement and Emergency Commitment Law Enforcement can be engaged with a patient when there is a risk to self or others. Patients are taken into protective custody while there is a medical assessment. For Law Enforcement, the start time would be when the health care provider has determined the patient is a risk to self or others and the State Hospital is notified of that determination. This would not wait for the civil commitment process to be complete. There could be some coordination between Law Enforcement and the health care provider over which organization is incurring costs and when, or who pays the transportation costs.
Reimbursement Process Submit reimbursement forms to KDADS.reimburse@ks.gov with any supporting documentation. If a provider is not enrolled in SMART as a vendor, submit the DA-130 form to register and a W-9 (forms will be provided and available on the KDADS website) Upon submission of a claim form, KDADS will verify the entity submitting the report as a vendor in SMART, verify the patients with patient lists from LSH and OSH. KDADS will verify the patient has a court ordered Care and Treatment case, the admission status at the state hospital or SIA, and relevant dates of the order and admission. KDADS will validate the requested payment amount, create an invoice for one payment to the facility for the month, and send to KDADS accounting for payment to the registered vendor. Expect processing to payment within 30 days of submission.
Contact information KDADS.ks.gov/state-hospitals-and-institutions
Contact Information KDADS.reimburse@ks.gov Submission of forms Additional documentation Questions about the process or status Suggestions for improvement Scott Brunner Scott.Brunner@ks.gov 785-296-0237
