DATE: December 3, 2024
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health
SUBJECT: Master Agreement with Qualified Providers for Temporary Staffing Services
RECOMMENDED ACTION(S):
TITLE
1. Under Administrative Policy No. 34, for competitive bids or requests for proposals (AP 34), determine that an exception to the competitive bidding requirement under AP 34 is satisfied and a suspension of competition is warranted due to unusual or extraordinary circumstances, and that the best interests of the County would be served by entering into a Master Agreement with qualified providers given the non-competitive nature of the Master Agreement; and
2. Approve and authorize the Chairman to execute a Master Agreement with qualified providers for temporary staffing services, effective upon execution through June 30, 2026, which includes a base contract and one optional one-year extension, total not to exceed $390,000 (4/5 vote).
REPORT
There is no additional Net County Cost associated with the recommended actions. Approval of the recommended actions will allow the Department of Public Health to utilize temporary staffing vendors to provide Licensed Vocational Nurses for the Department’s Community Health Division. Licensed Vocational Nurse positions have been difficult to fill because of competition from local hospitals and skilled nursing facilities. Temporary staffing services will provide time-limited assistance to ensure continuation of critical services to vulnerable and high-risk populations, while ongoing County recruitment and retention efforts continue. The recommended Agreement will be funded with State and Federal awards, and Health Realignment, with no Net County Cost. This item is countywide.
ALTERNATIVE ACTION(S):
If the Board does not approve the recommended actions, the Department of Public Health (Department) would continue to be understaffed in its Community Health Division, causing delayed patient care for vulnerable and high-risk populations, and increasing risk to the community.
SUSPENSION OF COMPETITION/SOLE SOURCE CONTRACT:
It is requested that the County find under AP 34 that an exception to the competitive bidding requirement is satisfied, and a suspension of competition is warranted due to unusual or extraordinary circumstances, because of the non-competitive nature of the Master Agreement. All qualified and interested vendors may be added to the Master Agreement, subject to Board approval, to meet the Department’s placement needs and in accordance with all terms and conditions specified in the contract. The Internal Services Department - Purchasing Division, concurs with the Department’s assessment that this satisfies the exception to the competitive bidding process required by AP 34.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The maximum compensation for the full term of the recommended agreement is $390,000, funded by a mix of State and Federal awards. The Department will cover any unreimbursed costs that may arise with Health Realignment. Actual costs will be dependent on services provided. Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2024-25 Adopted Budget and will be included in subsequent budget requests for the duration of the term.
DISCUSSION:
The Department has insufficient clinical staffing levels to meet service needs in its Community Health Division, the most critical need being in the Tuberculosis (TB) Control Program. The TB Control Program aims to prevent, control, and ultimately eliminate TB among residents of the County by initiating prompt treatment and ensuring completion of effective therapy to cure disease and reduce further transmission through timely case finding and contact follow-up. In order to achieve these goals, the program requires clinical staffing that can meet the needs of the community and provide services in accordance with Health and Safety Code Sections 121350 through 121555 and that reflect current standards of care and public health practice.
The County continues to struggle filling LVN vacancies with increased competition from hospitals and skilled nursing facilities offering higher salaries. Additionally, the turnover rate for LVNs exceeds what the County recruitment process can keep up with to maintain safe and effective services to the community. The current LVN vacancy rate in Public Health is approximately 83%. If the recommended agreement is not approved, Public Health will continue to be understaffed, resulting in delayed patient care for this vulnerable and high-risk population and increasing risk to the community.
If approved, the recommended agreement will become effective upon execution through June 30, 2025 with one optional one-year extension and may be terminated by the Department or the contractor(s) upon providing a 30-day advanced written notice. The services provided are contingent upon the Department’s need and can be reduced or terminated at any time during the contract period.
The recommended agreement deviates from the County’s standard agreement language in that it contains a shorter agreement term and includes a provision for modification to object levels in the budget that do not exceed 10% of the maximum compensation, with written approval of the Department Head, or designee. Maximum compensation payable to the contractors, services and scope of work shall remain unchanged.
The County’s Human Resources Department concurs with the recommendation. Bargaining Unit 12 was noticed, and the County completed the Meet and Confer process on October 22, 2024.
ATTACHMENTS INCLUDED AND/OR ON FILE:
Suspension of Competition Acquisition Request
On file with Clerk - Master Agreement
CAO ANALYST:
Ronald Alexander