LIPOS stands for Local Inpatient Purchase of Service. The State disperses funds to each Region for the CSB’s to purchase private psychiatric hospital beds for individuals with no healthcare benefits when admission to a state psychiatric hospital is not possible. Region 2 includes five Community Services Boards: Alexandria, Arlington, Fairfax-Falls Church, Loudoun, and Prince William.

Individuals with no healthcare benefits (i.e., commercial insurance, Medicaid, Medicare) who are evaluated by CSB staff to require inpatient hospitalization, and no state bed is available. Individuals must meet state psychiatric hospital inpatient admission criteria and must not have a primary SA diagnosis. Further, no lesser restrictive alternative is available.

Individuals who present to a hospital emergency department who were not referred by the CSB, and who consent to voluntary psychiatric admission, referrals from inpatient psychiatric units, and referrals from hospital medical units. Further, individuals with healthcare benefits are not eligible for LIPOS funding.

Hospitals have a contract with Fairfax County that is monitored by the Region 2 Office. The contract describes the complete list of requirements. Overall, hospitals are expected to:

• Accept individuals identified by the referring Region 2 CSB and provide high quality inpatient psychiatric services;
• Respond to a CSB request for services within 30 minutes of request by authorized CSB staff;
• Accept referrals from all five CSBs in Region 2;
• Receive CSB authorization for LIPOS funding prior to the hospital admission for services;
• Incorporate principles of the Recovery Model into the treatment model as appropriate;
• Complete an interview and assessment in accordance with JCAHO standards upon admission;
• Begin working with the CSB Discharge Planner to begin discharge planning upon admission, and continue this collaboration throughout stay;
• Complete a History and Physical and a full psychiatric evaluation within 24 hours of admission;
• Complete a psychosocial within five days of stay, or by the time of discharge (whichever comes first);
• Provide copies of individual’s record to referring CSB upon discharge;
• If CSB discharge planner and hospital staff determine that a state facility is required, work with CSB discharge planner to fax required paperwork to the state facility; provide active treatment while waiting for the transfer
• For a transfer to a state facility, payment to a facility stops when a bed at the state facility becomes available;
• Notify referring CSB immediately if consumer signs out AMA;
• Provide individual with a two week supply of medication upon discharge;
• Provide transportation services at the time of discharge as clinically appropriate for the needs of the individual.

CSB Emergency staff will:

• Complete the LIPOS Private Bed Purchase Admission form and authorize 1-5 days of LIPOS funding;
• Fax completed forms and the copy of completed Prescreening to the accepting hospital and to the Regional Projects Office;
• Notify appropriate CSB Discharge Planner of the admission;
• If across jurisdictions, notify Emergency Services staff in home CSB, who will notify appropriate discharge planner.

CSB Discharge Planner will:

• Contact LIPOS admitting hospital within one business day of admission;
• Complete the appropriate forms (extension authorization or receiving forms) and fax to the Regional office;
• Work collaboratively with private hospital to provide appropriate discharge planning for individual and/or coordinate transfer to a state facility for further stabilization.