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Approve a first contract amendment with LocumTenens.com for $547,000 for a total contract amount of $1,315,000 to provide psychiatric medical services from the current period through June 30, 2018; and Authorize 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 & Social Services (H&SS) recommends that the Board approve a first contract amendment with LocumTenens.com for $547,000 for a total contract amount of $1,315,000, to provide psychiatric medical services from the current period through June 30, 2018; and Authorize the County Administrator to execute the amendment.
SUMMARY:
LocumTenens.com (LT.com) is a full-service physician and advanced practice recruitment locum agency working in high-demand medical specialties. Placement of psychiatrists through LocumTenens.com supplement regular and contract employees to address the ongoing high demand for mental health services while recruitment activities to fill long term vacancies continue. These psychiatrists provide medical oversight, medication support, psychiatric assessments and diagnoses, and clinical leadership in serving people who have severe and persistent mental illness. Psychiatry medical services are required by the Department of Health Care Services (DHCS) for the licensing and ongoing operations of Health & Social Services mental health clinics.
FINANCIAL IMPACT:
Funding for this amendment is from Short Doyle Medi-Cal, Intergovernmental Transfer (IGT) funds, and County General Fund. Appropriation is available in the Department’s FY2017/18 Recommended Budget. There is no additional financial impact to the County General Fund.
DISCUSSION:
On July 1, 2016, H&SS approved a contract with LocumTenens.com for continued placement of psychiatrists within County clinics. These placements augment staff to address continued high demand for mental health services while recruitment activities to fill long term vacancies continue. At that time of the original contract, the usage of this contract was projected to be static as newly engaged recruitment activities were being established and were near implementation, intending to enhance the visibility of County employment opportunities and ultimately reduce reliance on temporary staffing. While these efforts have been extensive and ongoing, they have not yet resulted in acquiring additional full-time psychiatrists. The County anticipates positive recruitment results over the next year as interest from potential candidates suggests that this is probable.
Implemented recruitment and retention efforts include working with outside recruitment agencies, working with local schools (such as Touro University), presenting at universities (such as University of California-San Francisco and Columbia University) and using current employees' contacts to reach potential applicants. The County has implemented a retention and hiring bonus for current and newly hired psychiatrists in exchange for a two year work commitment and a moving and relocation expense allowance for newly hired psychiatrists.
The provider gap has resulted in a significant lack of coverage and available client appointments which the County is mandated to provide. Greater usage of the LocumTenen.com contract continues to be relied on to meet the service requirements until vacancies are filled. This first contract amendment in the amount of $547,000 for a total contract of $1,315,000 is necessary for the continuation of intensive services for mental health clients through June 30, 2018. This amendment allows for the purchase of approximately 2,378 psychiatry hours.
ALTERNATIVES:
The Board may choose not to approve the contract amendment for 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:
County Counsel has reviewed and approved the contract for legal sufficiency.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION.