DATE: December 3, 2024
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Amendment IV to Master Agreement for Locum Tenens
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute Amendment IV to Master Agreement for Locum Tenens to revise service reimbursement rates for contractor Jackson & Coker LocumTenens, LLC, with no change to the term of May 7, 2019 through June 30, 2025, or compensation maximum of $51,500,000.
REPORT
There is no Net County Cost associated with the recommended action, which will revise service reimbursement rates for Jackson & Coker LocumTenens, LLC on the Master Agreement for Locum Tenens. This would allow the Department of Behavioral Health (Department) to competitively recruit and retain qualified and experienced psychiatrists and psychiatric nurse practitioners through the contractors. This item is countywide.
ALTERNATIVE ACTION(S):
If your Board were not to approve the recommended action, the Department would continue to struggle to meet essential needs for psychiatric services for severely mentally ill adults and seriously emotionally disturbed children and adolescents.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum cost of the Master Agreement for Locum Tenens is $51,500,000 and will be financed with mental Health Realignment and Short/Doyle Medi-Cal revenue. Maximum compensation for each fiscal year is $7,000,000. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2024-25 Adopted Budget. Actual cost will be determined by actual services provided.
DISCUSSION:
On May 1, 2018, your Board approved agreement 18-234 with Central California Faculty Medical Group (CCFMG), for psychiatric services by licensed psychiatrists serving Department of Behavioral Health clients for CCFMG to recruit and fill full-time on-site psychiatrist positions; however, the continued shortage of psychiatrists in the Central Valley and in the state of California resulted in major challenges in recruitment. Your Board approved the following agreements with Inspire Health:
• January 18, 2022: agreement 22-023 (amendment I to agreement 18-234) to revise employment incentives and approve a salary resolution to improve the Department’s ability to meet the needs for psychiatry services in Fresno County.
• June 20, 2023: agreement 23-298 (amendment II to agreement 18-234) to extend for two additional 12-month terms through June 30, 2025.
While CCFMG continues to recruit full-time psychiatrists and psychiatric nurse practitioners, the Department continues to utilize Locum Tenens psychiatrists to provide onsite psychiatry services. Your Board approved the following agreements for Locum Tenens onsite psychiatry services:
• May 7, 2019: original agreement 19-200 for onsite psychiatry services.
• February 28, 2023: agreement 23-081 (amendment I to agreement 19-200) to add contractors and revise rates.
• June 20, 2023: agreement 23-305 (amendment II to agreement 19-200) to add contractors, revise rates, and extend the overall contract term for two additional 12-month terms through June 30, 2025.
• November 7, 2023: agreement 23-591 (amendment III to agreement 19-200) to add contractors.
This amendment would revise service reimbursement rates for Jackson & Coker LocumTenens, LLC to the master agreement for Locum Tenens by increasing the telehealth psychiatrist hourly rate from $270 to $276, and by establishing the telehealth psychiatric nurse practitioner hourly rate of $208. This contractor currently has several long-standing and good quality providers working for the County through the contract. Should this contractor terminate their agreement with the County, the County will have an inadequate number of providers for these services. There are no changes to any other contractor on this master agreement, the maximum compensation, or the contract term.
REFERENCE MATERIAL:
BAI #45, November 7, 2023
BAI #46, June 20, 2023
BAI #35, February 28, 2023
BAI #48, May 7, 2019
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment IV to Master Agreement for Locum Tenens
CAO ANALYST:
Ronald Alexander