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Approve a contract with Amergis Healthcare Staffing, Inc. for $728,000 to provide behavioral health staffing services for the period of May 1, 2025 through April 30, 2026; and Delegate authority to the County Administrator to execute the contract and any subsequent amendments, with County Counsel concurrence, up to an aggregate of $74,999
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Published Notice Required? Yes ___ No _X _
Public Hearing Required? Yes ___ No _X _
DEPARTMENTAL RECOMMENDATION:
The Department of Health and Social Services recommends that the Board of Supervisors approve a contract with Amergis Healthcare Staffing, Inc. for $728,000 to provide behavioral health staffing services for the period of May 1, 2025 through April 30, 2026; and delegate authority to the County Administrator to execute the contract and any subsequent amendments, with County Counsel concurrence, up to an aggregate of $74,999.
SUMMARY:
Amergis Healthcare Staffing is a locum tenens staffing agency specializing in recruiting and placing licensed behavioral health clinicians, nurses, and psychologists. Solano County Behavioral Health has an obligation to provide behavioral health services to clients. Due to statewide and local mental health workforce shortages, Solano County Behavioral Health needs to ensure adequate client care is provided and to ensure provision of medically necessary services, which are entitlement benefits per the California Department of Health Care Services (DHCS) Behavioral Health Performance contract.
FINANCIAL IMPACT:
This contract is funded by the 2011 Realignment offset with Federal Financial Participation generated through Medi-Cal claiming. Appropriations are available in the FY2024/25 Working Budget. There is no additional financial impact on the County General Fund.
DISCUSSION:
In 2016, the Centers for Medicare and Medicaid Services (CMS) issued the final Medicaid mental health parity rule which includes service level requirements. These requirements are specific to time, distance, and timely access to services, which includes ensuring that a client has a first treatment appointment within ten business days of request. Solano County Behavioral Health is experiencing staffing shortages, including critical shortages in the roles of licensed behavioral health clinicians, nurses and psychologists, which has been straining Behavioral Health’s ability to deliver services. Recruitment and retention of mental health professionals, particularly those who are trained to support the acuity level of those requiring specialty mental health services (i.e. higher needs clients), is particularly challenging. Mandated services cannot be met when there are not enough staff to provide the required services. To address the staffing shortages, Amergis staff will be strategically assigned to key areas within the County’s Behavioral Health system of care for limited time periods, while recruitments continue, ensuring continuity and quality of care for Behavioral Health beneficiaries.
Additionally, new State initiatives and mental health (Proposition 1) legislation has overwhelmed county behavioral heath systems. Since 2022, just over 50 new initiatives, programs, or compliance mandates from new laws have been added to Mental Health Plan requirements without increased funding. This workload has become a crisis for county behavioral health systems to manage concurrent and constant changes, update policies and practices, while experiencing workforce shortages. Some of the new initiatives include Community Assistance, Recovery, and Empowerment (CARE) Act, Justice-Involved Reentry Initiative, Behavioral Health Services Act (BHSA), and Lanterman-Petris-Short (LPS) Act Reform. Also, there is the Kaiser Carve In, which increased the number of individuals being served in Behavioral Health for specialty mental health services.
ALTERNATIVES:
The Board of Supervisors may choose not to approve this contract; however, this is not recommended as the County is mandated to provide specialty mental health services per the California Department of Health Care Services (DHCS) Behavioral Health Performance contract. This contract will ensure that clients have a smooth transition in their psychiatric care and medication regimen, which, if not approved, would result in poor client outcomes and higher costs to the County and the community.
OTHER AGENCY INVOLVEMENT:
None.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION