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Approve a third contract amendment with LocumTenens.com for $2,276,000 for a total contract amount of $5,876,000 to provide psychiatric medical services for the current period through June 30, 2024; and Delegate authority to the County Administrator to execute this contract amendment and any subsequent amendments to this contract, 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 (H&SS) recommends that the Board of Supervisors approve a third contract amendment with LocumTenens.com for $2,276,000 for a total contract amount of $5,876,000 to provide psychiatric medical services for the current period through June 30, 2024; and delegate authority to the County Administrator to execute this contract amendment and any subsequent amendments to this contract, with County Counsel concurrence, up to an aggregate of $74,999.
SUMMARY:
LocumTenens.com provides physicians and advance practice recruitment services in the high-demand medical specialties. Under the existing agreements, LocumTenens.com provides H&SS with temporary professional staffing in the adult and children’s outpatient clinics such as psychiatrists and/or experienced nurse practitioner/physician assistants experienced in mental health. This is an essential aspect of service delivery and using temporary providers is the only way to provide care when there are not enough County psychiatrists to meet the need.
This is the third contract amendment with LocumTenens.com, and it is necessary for continuation of psychiatric services for mental health clients. The original two-year contract, approved by the Board on June 28, 2022, began July 1, 2022. A first amendment was entered on July 19, 2022 and a second amendment was entered on September 15, 2023. These amendments were technical in nature with no fiscal impact and approved by the Director of H&SS as authorized by the Board.
FINANCIAL IMPACT:
Funding for this amendment is from Short Doyle Medi-Cal, 2011 Realignment, County General Fund, and third-party revenues. Appropriations are available in the Department’s FY2023/24 Working Budget. There is no additional financial impact to the County General Fund.
DISCUSSION:
Psychiatrists provide medical oversight, medication support, psychiatric assessments and diagnoses, and clinical leadership in serving people who have severe and persistent mental illness. Psychiatry services are required by the Department of Health Care Services (DHCS) for the licensing and ongoing operations of Health and Social Services’ mental health clinics.
On a national level, recruitment and placement of psychiatric practitioners continues to be a challenge as demand outpaces supply. On average, psychiatric services are being performed by an older population set than that found in most other medical specialties. Because of this, retirements are exceeding the quantity of new graduates entering the practice. To provide the medically necessary services, H&SS renewed a two-year contract with LocumTenens.com on July 1, 2022, to bridge the appointment demand needs by placing temporary providers while continuous County recruitment activities occur.
ALTERNATIVES:
The Board may choose not to approve the contract amendment with LocumTenens.com. This is not recommended as the County is mandated to provide psychiatric services for clients served in the County mental health system. This amendment will ensure continued psychiatric service delivery so that severely mentally ill individuals have no disruption in their psychiatric care and medication regimen, which would result in poor client outcomes and higher costs to the County and the community.
OTHER AGENCY INVOLVEMENT:
None.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION