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Approve a first amendment with Jackson & Coker Locum Tenens, LLC for $230,000 for a total contract amount of $630,000 to provide physician staffing support to the Department of Health and Social Services, Behavioral Health Division, through June 30, 2026; and Delegate authority to the County Administrator to execute the amendment
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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 the Board of Supervisors:
1. Approve a first amendment with Jackson & Coker Locum Tenens, LLC for $230,000 for a total contract amount of $630,000 to provide physician staffing support to the Department of Health and Social Services, Behavioral Health Division, through June 30, 2026; and
2. Delegate authority to the County Administrator to execute the amendment
SUMMARY/DISCUSSION:
Jackson & Coker Locum Tenens, LLC provides physician staffing support to the Department of Health and Social Services (H&SS), Behavioral Health Division, to manage increased specialty mental health caseload resulting from a California Department of Health Care Services (DHCS) mandate to transfer clients from Kaiser Permanente to the County's mental health plan. Due to service demand exceeding initial projections, H&SS requests approval of a contract amendment to increase the total contract amount to ensure service continuity through June 30, 2026.
As a county Mental Health Plan (MHP), the Behavioral Health Division is required under federal Medicaid regulations (42 CFR Sections 438.206 and 438.68) and DHCS annual network adequacy certification requirements to maintain sufficient psychiatric provider capacity to ensure timely access to Specialty Mental Health Services (SMHS) for Medi-Cal beneficiaries. DHCS expressly recognizes locum tenens physician contracts as a mechanism for county MHPs to satisfy psychiatry network adequacy requirements. Failure to meet these standards may result in DHCS withholding Medicaid payments, imposing civil monetary sanctions, or terminating the County's MHP contract.
Beginning July 1, 2024, DHCS required the County to absorb an estimated 600 Medi-Cal SMHS clients previously served under a longstanding arrangement in which the State paid Kaiser Permanente directly for Solano County's Medi-Cal behavioral health members. This State mandated client transfer increased the Behavioral Health Division's SMHS caseload by approximately 46 percent. Ongoing recruitment and retention challenges for permanent psychiatrist positions have required continued reliance on locum tenens staffing to maintain network adequacy compliance and ensure continued access to care for SMHS clients.
This contract was originally approved by the Board of Supervisors on June 25, 2024, for $400,000, effective July 1, 2024.
FINANCIAL IMPACT:
The amendment will be funded with Federal and State Medi-Cal revenues, 2011 Realignment, and County General Fund. Appropriations are available in the FY2025/26 Working Budget. No additional County General Fund is needed.
ALTERNATIVES:
The Board could choose not to approve this amendment. This is not recommended, as the county mandates Medi-Cal Specialty Mental Health Services.
OTHER AGENCY INVOLVEMENT:
None.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION