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Approve a first contract amendment with UHC Solutions for $350,000 for a total contract amount of $400,000 to provide recruitment services for oral health and primary care providers for the current period through December 8, 2025, and a fourth contract amendment with Barton and Associates, Inc. for $600,000 for a total contract amount of $1,200,000 to provide locum tenens primary care providers for the current period through June 30, 2024 to the Health and Social Services, Family Health Services clinics; Delegate authority to the County Administrator to execute the two contract amendments and any subsequent amendments, with County Counsel concurrence, up to an aggregate of $74,999 for each contract; and Approve a $660,000 Appropriations Transfer Request to recognize unanticipated revenue to fund the contracts (4/5 vote required)
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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 first contract amendment with UHC Solutions for $350,000 for a total contract amount of $400,000 to provide recruitment services for oral health and primary care providers for the current period through December 8, 2025, and a fourth contract amendment with Barton and Associates, Inc. for $600,000 for a total contract amount of $1,200,000 to provide locum tenens primary care providers for the current period through June 30, 2024 to the Health and Social Services, Family Health Services clinics; delegate authority to the County Administrator to execute the two contract amendments and any subsequent amendments, with County Counsel concurrence, up to an aggregate of $74,999 for each contract; and approve a $660,000 Appropriations Transfer Request to recognize unanticipated revenue to fund the contracts (4/5 vote required).
SUMMARY:
UHC Solutions provides recruitment of permanent primary care medical providers for the Health and Social Services, Family Health Services (FHS) clinics upon national sourcing, screening, and recruiting. Barton and Associates, Inc. provides locum tenens primary care medical providers to FHS upon request and availability. Circumstances arising from ongoing vacancies in medical provider staffing in the FHS clinics have resulted in the need for the requested amendments to these contracts. The services provided by Barton and Associates, Inc. will help to fill primary care coverage gaps where sufficient permanent staff is not currently available and allow the FHS program to maintain continuity of care and optimize patient flow in the FHS clinics. UHC Solutions assists in securing permanent primary care providers to staff the FHS clinics. Traditional recruiting methodologies have failed to bring permanent staffing and appropriate ratios of primary care physicians to the FHS.
FINANCIAL IMPACT:
Funding for the contract amendments will be Federally Qualified Health Center billing revenue and 1991 Public Health Realignment with no additional impact to the County General Fund. The Appropriations Transfer Request of $660,000 will increase appropriations for the contract amendments and increase the associated revenues.
The costs associated with preparing this agenda item are nominal and are absorbed by the Department’s FY2023/24 Working Budget.
DISCUSSION:
As a “safety-net” healthcare provider, Health and Social Services, (H&SS) Family Health Services (FHS) functions as a vital partner to the community. FHS 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.
UHC Solutions has had a successful track record of helping Federally Qualified Health Centers (FQHC) recruit permanent healthcare professionals who are mission-driven and have a passion for serving populations that are underserved and marginalized. UHC Solutions is very active within the National Association of Community Health Centers network, which serves over 30 million patients a year nationally. With UHC Solutions’ assistance and current success with recruitments, FHS is building capacity within FHS while improving the health of the communities served.
Barton and Associates, Inc. is a locum tenens agency that provides healthcare provider placement services. The contract amendment with Barton and Associates will be used to engage locum tenens physicians, nurse practitioners and physician assistants to provide professional healthcare services in the FHS clinics during periods of staffing shortages. Locum tenens are licensed physicians and healthcare professionals who are Board Certified or Board Eligible. The locum providers recruited from this agency are contracted for longer periods (six to twelve months), allowing more familiarity with utilizing the electronic health records and clinic flow, and providing services and resources to Solano County patients.
On May 23, 2023, FHS contracted with UHC Solutions for $50,000 to conduct a recruitment for one permanent healthcare professional. UHC Solutions has been successful with recruitment activities for the FHS clinics and H&SS requests Board approval of a first amendment to increase the contract by $350,00 for a new total contract amount of $400,000 and to extend the term to December 8, 2025 for the continuation of recruitment services for oral health and primary care providers.
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 anticipated fee ranges for the primary care providers and updated certain contract conditions but did not increase the total contract amount. The fourth amendment to increase the contract by $600,000 is needed to provide adequate medical coverage in the FHS clinics.
ALTERNATIVES:
The Board may choose not to approve these contract amendments with Barton and Associates, Inc. to provide placement for primary care staffing and UHC Solutions to provide recruitment services for permanent placement for primary care staffing. However, this is not recommended as it would reduce H&SS, FHS’ ability to provide adequate healthcare coverage in areas of critical medical need.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved the contracts for legal sufficiency.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION