DATE: August 18, 2020
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
SUBJECT: Retroactive Agreement with Regents of the University of California on Behalf of the University of California, San Francisco - Fresno, Medical Education Program for Psychiatric Resident Services
RECOMMENDED ACTION(S):
TITLE
1. Make a finding that it is in the best interest of the County to waive the competitive bidding process consistent with Administrative Policy No. 34 for unusual or extraordinary circumstances as the Regents of the University of California on behalf of the University of California, San Francisco - Fresno, Medical Education Program is the only accredited University in Fresno County eligible to provide psychiatric residents.
2. Approve and authorize the Chairman to execute a retroactive Agreement with the Regents of the University of California on behalf of the University of California, San Francisco - Fresno, Medical Education Program for psychiatric resident services provided at the Department of Behavioral Health facilities effective July 1, 2020, not to exceed five consecutive years, which includes a three-year base contract and two optional one-year extensions, total not to exceed $2,113,768.
REPORT
Approval of the recommended actions will allow for the continued assignment of psychiatric residents from the University of California San Francisco - Fresno (UCSF - Fresno) to participate in clinical rotations at the Department of Behavioral Health (DBH) mental health programs, with no increase in Net County Cost. This item is countywide.
ALTERNATIVE ACTION:
There are no viable alternative actions. If the recommended actions are not approved, there will be a reduction in psychiatric services for Department clients who are un-served and underserved within Fresno County. The demand for psychiatric services will continue and may result in a higher cost to the County if timely and appropriate services are not maintained. Additionally, the County will not benefit from the opportunity to introduce the psychiatric residents to the County and engage those that may return as future employees.
SUSPENSION OF COMPETITION/SOLE SOURCE CONTRACT:
The Department’s request to waive the competitive bidding process is consistent with Administrative Policy No. 34 as UCSF is the only accredited University in Fresno County that is eligible to provide psychiatric residents to the Department. The ISD - Purchasing concurs with the Department’s request to waive the competitive bidding process.
RETROACTIVE AGREEMENT:
The recommended Agreement is retroactive to July 1, 2020. Circumstances resulting from the COVID-19 pandemic led to delays in completion of contract negotiations and review of the recommended Agreement.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The maximum compensation ($2,113,768) will be offset with Mental Health Services Act - Workforce Education and Training (WET) allocations and Short-Doyle Medi-Cal Federal Financial Participation funds. Actual costs will be based upon the documented psychiatric residents’ timecards approved by the Department. Sufficient appropriations and estimated revenues are included in the Behavioral Health Org 5630 FY 2020-21 Recommended Budget and will be included in all subsequent budgets for the remainder of the contract term. There is one pending invoice for FY 2019-20 in the amount of $6,528.78.
DISCUSSION:
On June 2, 2015, your Board approved County Agreement No. A-15-213 for psychiatric residents. Psychiatric residents can assist with providing direct patient care and maintain appropriate caseloads for all psychiatric personnel. Prior to rendering services to clients, all psychiatric residents will be credentialed through the Department’s Managed Care Division and be required to participate in the Department’s Compliance and Documentation & Billing trainings. Services provided by the residents are billed to third party payers by the County, with the corresponding revenues retained by the County. In addition to psychiatric services, the goal of the Department is to recruit and retain these psychiatric residents for client services within Fresno County.
The recommended Agreement provides funding for psychiatric residents, mainly on a three days per week rotation, although the number of residents may vary during the school year due to an increase/decrease in the number of students in the residency program, attrition within the resident classes, changes in accreditation requirements, and/or other curricula changes. Residency schedules are the responsibility of UCSF-Fresno in consultation with the Department. Resident salaries, benefits and related costs, including professional liability insurance, are the responsibility of UCSF-Fresno.
The recommended Agreement provides for a three-year base contract which may be extended for two additional twelve-month periods upon the same terms and conditions, unless written notice for non-renewal is given by Regents of the University of California, UCSF, the County, or the Department’s Director, or designee, no later than sixty days prior to the next renewal date (July 1). The recommended Agreement may be terminated by either the County or Regents of the University of California without cause upon giving a ninety-day advance written notice.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was informed of the recommended agreement at its June 17, 2020 meeting.
REFERENCE MATERIAL:
BAI #30, June 2, 2015
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with Regents of the University of California
E-PD-048 -- Suspension of Competition Acquisition Request
CAO ANALYST:
Ronald Alexander