DATE: September 10, 2024
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health
SUBJECT: Agreement with Central California Faculty Medical Group
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute a retroactive Agreement with Central California Faculty Medical Group, Inc. for Physician Consultation and Administrative Services, effective July 1, 2024, not to exceed five consecutive years, which includes a three-year base contract and two optional one-year extensions, total not to exceed $300,000.
REPORT
Approval of the recommended Agreement with Central California Faculty Medical Group, Inc. (CCFMG) will allow continued physician consultation and administrative services to the County for crucial public health issues and events. This item is countywide.
ALTERNATIVE ACTION(S):
There is no viable alternative action. Should your Board not approve the recommended action, the Department of Public Health (DPH) would not have access to essential physician consultation services, which could impact the ability to effectively serve the community with current and future public health issues.
RETROACTIVE AGREEMENT:
CCFMG was previously providing physician consultation and administrative services under Agreement A-21-359, which expired on June 30, 2021. DPH found it would be in the County’s best interest to develop a new agreement rather than extend the previous agreement. Due to the time needed to finalize changes to the scope of services and indemnity language, the recommended Agreement could not be presented to your Board at an earlier date. The finalized recommended Agreement was received from CCFMG on July 30, 2024, and is retroactive to July 1, 2024, to avoid a gap in services to sufficiently carry out several of the County’s important public health programs.
FISCAL IMPACT:
There is no increase in Net Count Cost associated with the recommended action. The recommended Agreement will be fully offset with funding provided by the Epidemiology and Lab Capacity for Infection Disease (ELC) Enhancing Detection through Coronavirus Response and Relief Supplemental Funds. Services beyond available ELC funding will be fully offset with other State and Federal grant revenues depending on the benefitting programs and/or Public Health Realignment. The recommended Agreement provides for physician consultation services to be paid at a set hourly rate ($160.00) plus an additional 15% administration fee for a maximum of $300,000 during the entire term of the recommended Agreement. Sufficient appropriations and estimated revenues are included in the DPH’s Org 5620 FY 2024-25 Recommended Budget and will be included in future DPH budget requests. There are no pending invoices.
DISCUSSION:
On September 7, 2021, your Board retroactively ratified Agreement A-21-359 with CCFMG, providing physician consultation and administrative services to DPH. DPH has utilized the contracted services since May 2021, under Agreement D-20-427. The assigned physician has worked closely alongside DPH’s executive team and senior management assisting in the following: consultation when necessary, overseeing medical protocols, policies and procedures, and evaluating the quality of medical care provided.
Approval of the recommended action will allow DPH to utilize the expertise of CCFMG physicians for the following areas: be the point of contact for consults regarding individual cases of Carbapenemase Producing Organisms (CPO’s), Multidrug Resistant Organisms, and outbreaks of reportable communicable diseases in congregate settings such as Acute Care Hospitals and Skilled Nursing Facilities (SNF); perform on-site assessments in response to outbreaks for mitigation and in support of Healthcare Associated Infection (HAI) preventions; as well as other tasks related to the Maternal, Child, and Adolescent Health (MCAH) program and public health.
In the past, DPH has attempted to recruit permanent Public Health Physicians to fulfill these duties. This has been unsuccessful due to competition from area public and private entities and a physician shortage impacting the Central Valley. Therefore, DPH recommends approval of the recommended Agreement to continue the required services, effective July 1, 2024, through June 30, 2027, with the option to extend for two 12-month periods.
The recommended Agreement deviates from the standard County insurance language and limits. DPH conferred with the County’s Human Resources - Risk Management Division (Risk) on these items and Risk indicated that a low risk is presented to the County. DPH considers the recommended Agreement to be in the County’s best interest and has elected to move forward subject to your Board’s approval.
REFERENCE MATERIAL:
BAI #48, September 7, 2021
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with CCFMG
CAO ANALYST:
Amina Flores-Becker