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Approve a fifth contract amendment with Barton and Associates, Inc. for $535,000 for a total contract amount of $1,735,000 to provide additional locum tenens primary care providers to the County’s Family Health Services’ clinics for the current period through June 30, 2024; Delegate authority to the County Administrator to execute the amendment and any subsequent amendments, with County Counsel concurrence, up to an aggregate of $74,999; and Approve an Appropriation Transfer Request of $535,000 from salaries and benefits to contracted services
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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 (H&SS) recommends that the Board of Supervisors approve a fifth contract amendment with Barton and Associates, Inc. for $535,000 for a total contract amount of $1,735,000 to provide additional locum tenens primary care providers to the County’s Family Health Services’ clinics for the current period through June 30, 2024; delegate authority to the County Administrator to execute the amendment and any subsequent amendments, with County Counsel concurrence, up to an aggregate of $74,999; and approve an Appropriation Transfer Request of $535,000 from salaries and benefits to contracted services.
SUMMARY:
Barton and Associates, Inc. is a locum tenens agency that provides healthcare provider placement services. Circumstances arising from ongoing vacancies in medical professional staffing in the County’s Family Health Services’ clinics have resulted in the need for this fifth contract amendment. The services provided by Barton and Associates help fill primary care coverage gaps where sufficient permanent staff is not currently available and allow H&SS to maintain continuity of care and optimize patient flow in the Family Health Services’ clinics.
Family Health Services (FHS) functions as a vital partner to the community and is currently recruiting for several provider positions, but this process has been extremely challenging with higher demand nationally for providers and a shortage of applicants. This contract amendment will allow FHS to bridge the capacity gap to meet patient needs until the appropriate number of providers can be hired.
FINANCIAL IMPACT:
The department has sufficient appropriation within its operating budget to cover the increased contract cost; however, an ATR is needed to adjust appropriations. The costs associated with preparing this agenda item are nominal and are absorbed by the department’s FY2023/24 Working Budget.
DISCUSSION:
On September 14, 2021, the Board approved a three-year contract with Barton and Associates, Inc. for $600,000 to provide locum tenens primary care providers to the FHS’ clinics through June 30, 2024. The first, second and third amendments (effective December 14, 2022, February 22, 2023 and September 1, 2023, respectively) updated the fee ranges for the primary care providers and updated certain contract conditions but did not increase the total contract amount. On January 23, 2024, the Board approved a fourth amendment to increase the contract by $600,000 for a total contract amount of $1,200,000 to provide additional and adequate medical coverage in the clinics. This fifth contract amendment is needed due to ongoing vacancies and increased utilization of locum tenens services. This amendment will allow Family Health Services to continue to fill the primary care coverage gaps and continue to provide adequate coverage while recruitments for current vacancies continue.
ALTERNATIVES:
The Board may not approve this contract amendment with Barton and Associates, Inc. to provide placement for primary care staffing. However, this is not recommended as it would reduce Family Health Services’ ability to provide adequate healthcare coverage in areas of critical medical need.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved the contract as to form.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION