Catawba Regional Partnership 

LOCAL INPATIENT PURCHASE OF SERVICES

The purpose of Local Inpatient Purchase of Service Project (LIPOS) is to serve indigent individuals from the CSB catchment areas who require inpatient hospitalization for a serious mental illness as an alternative to Catawba Hospital admission.  LIPOS funds are used to purchase acute stabilization psychiatric services from Acute Care Providers. 

The Regional Management Group has designated the Census Management Team (CMT) as the primary utilization management structure for the regional LIPOS Project.  CMT is comprised of representatives from BRBH, Catawba Hospital, LewisGale Medical Center, Carilion Clinic, the Local Inpatient Discharge Planner (LIDP), and the Catawba Regional Partnership (CRP) Project Manager. The CRP Project Manager reports back to the Regional Management Group on LIPOS utilization, trends, deviations from expected utilization, and any other issues relevant to the Project.

The Census Management Team meets monthly to review utilization data and recommend any necessary actions.  Additionally, this group monitors utilization and trend indicators, as well as evaluates any deviations from expected utilization. 

The CRP Project Manager maintains data on each individual authorized for LIPOS funding to include name, date of birth, age, CSB of origin, admitting hospital, diagnosis, TDO status, admission, commitment, and discharge dates, discharge recommendations, compliance with recommended follow-up services, and number of times LIPOS has previously been authorized. 

 

Eligibility for LIPOS:

In order to be eligible for LIPOS, a patient must meet the following criteria:

  • Patient must be indigent, without benefits or other resources to pay for care
  • Patient must reside in the CSB catchment areas for Blue Ridge Behavioral Healthcare.
  • Patient must require inpatient psychiatric treatment
  • Patient must have an Axis I serious mental health diagnosis. A diagnosis of substance abuse or mental retardation must be secondary to a serious mental health diagnosis.

LIPOS is authorized for a maximum of four days per hospital admission when meeting the above criteria.  LIPOS is not authorized for any readmission within 30 days of hospital discharge. 

The LIDP consults with the private providers on admissions that meet the authorization criteria outlined above.  The LIDP monitors the mental status and treatment of any patient receiving treatment paid for by LIPOS funding and attends and/or provides input to meetings of the treatment team serving the LIPOS patients.  

In addition to authorizing individuals from CSBs for LIPOS funding, the LIDP utilizes evidence based practices as much as possible to connect individuals with outpatient services following hospital discharge.  The LIDP makes efforts to connect individuals from both CSBs to needed services.  These efforts are not solely focused on individuals authorized for LIPOS, but may extend to any individual who has been readmitted within the last 45 days and is not connected with recommended follow-up services.

Authorization for LIPOS funding includes the benefit of eligibility for State Pharmacy medication rates.  The LIDP assists those authorized for LIPOS in accessing psychotropic medications. 

In addition to keeping a database on all LIPOS authorizations, the CRP Project Manager processes all LIPOS billing, maintains data on fund usage and availability for each CSB, and provides coordination toward the overall goal of reducing hospital readmission rates. 

The CRP Project Manager coordinates the establishment of yearly LIPOS bed day rates with Acute Care Providers based on an average of current Medicaid bed day rates. 

Regional LIPOS Needs:

Need for acute psychiatric beds has risen each year far above yearly LIPOS allocations.