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Approve a third contract amendment with LocumTenens.com for $610,000 for a total contract amount of $2,297,450; and a second contract Jackson & Coker for $90,000 for a total contract amount of $986,442 to provide psychiatric medical services; Approve a first contract amendment with First Choice in Psychiatric Recruitment for $14,000 for a contract total of $62,000 for professional staff recruitment from the current period through June 30, 2018; and Authorize the County Administrator to execute the amendments
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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 contract amendment with LocumTenens.com for $610,000 for a total contract amount of $2,297,450; and Jackson & Coker for $90,000 for a total contract amount of $986,442 to provide psychiatric medical services from the current period through June 30, 2018; Approve a contract amendment with First Choice in Psychiatric Recruitment for $14,000 for a contract total of $62,000 for professional staff recruitment; and Authorize the County Administrator to execute the amendments.
SUMMARY:
LocumTenens.com and Jackson & Coker are full-service physician and advanced practice recruitment locum agencies working in the high-demand medical specialties. Under the existing agreements, LocumTenens.com and Jackson & Coker provide Health & Social Services, Mental Health Services with temporary professional staffing such as Psychiatrists and/or mental health experienced Nurse Practitioner/Physician Assistants in the Mental Health Integrated Care Clinics. First Choice in Psychiatric Recruitment (FCS) provides professional level employment recruitment services for connecting qualified psychiatric (professional and mid-level) candidates to the County for interview and potential hire.
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. The professional staffing (Psychiatrists) provide medical oversight, medication support, psychiatric assessments and diagnoses, and clinical leadership in serving people who have severe and persistent mental illness.
The ongoing vacancies and quantity of patients in care have resulted in the need for the requested amendments.
FINANCIAL IMPACT:
Funding for the amendments will come from Short Doyle Medi-Cal, Intergovernmental Transfer (IGT) monies, and County General Fund. Appropriation is available in the Department’s FY2017/18 Adopted Budget. There is no additional financial impact to the County General Fund.
DISCUSSION:
On July 1, 2016, contracts with First Choice in Psychiatric Recruitment, LocumTenens.com, and Jackson & Coker were established. Respectively, these agreements provide Health & Social Services with employment recruitment activities and the ability to continue offering at or near service demand needs with temporary placements of Psychiatrists and or Nurse Practitioner/Physician Assistants.
First Choice in Psychiatric Recruitment successfully placed two candidates with Health & Social Services in 2017, a 1.0 FTE Psychiatrist and a 1.0 FTE Nurse Practitioner/Physician Assistant, as well as recently directing another candidate interested in a vacant 1.0 Full Time Equivalent Psychiatrist position. The requested contract increase will provide the funds necessary to cover the recruitment fee associated with this third anticipated employment placement.
Agreements with LocumTenens.com and Jackson & Coker to provide the temporary staffing solution for Health & Social Services were built on the premise each would see a decline in utilization as successful employment recruitment activities continue. While these new recruitment efforts have gained County improved employment attention its life cycle has not been long enough or quick enough to overcome the vacancy deficit to mitigate the heavy reliance on temporary staffing. The continued severe provider shortage has resulted in the significant lack of client care appointments the County is mandated to provide. Thus usage of the LocumTenen.com and Jackson & Coker contracts will be relied upon to meet the service requirements until more vacancies are filled. Both LocumTenens.com and Jackson & Coker are each contacted when a need arises as it is difficult to determine when and from which contractor a successful temporary placement will arrive.
These amendments are necessary to provide the continuation of intensive services for mental health clients and represents ongoing employment recruitment services through June 2018. The amendments with LocumTenens.com and Jackson & Coker allows for the purchase of approximately 2,400 aggregate psychiatry hours, whereas the amendment with First Choice in Psychiatric Recruitment provides the necessary recruitment and finders fees for one mid-level professional.
On August 22, 2017, the first contract amendment for LocumTenens.com was approved by the Board. On October 24, 2017, the Board approved the second contract amendment for LocumTenens.com and the first amendment to Jackson & Coker.
This is the first contract amendment for First Choice in Psychiatric Recruitment.
ALTERNATIVES:
The Board may choose not to approve the contract amendment for LocumTenens.com, Jackson & Coker, and/or FCS. 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 contracts for legal sufficiency.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION