DATE: November 7, 2023
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Amendment III to Master Agreement for Locum Tenens Services
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute Amendment III to Master Agreement for Locum Tenens Services to add Lavaca Street Ventures, LLC and Orbit Health, A Professional Corporation and their rates as contractors, with no change to term of May 7, 2019 through June 30, 2025, or compensation maximum of $51,500,000.
2. Approve and authorize the Chairman to execute Amendment III to Master Agreement for Telemedicine Services to add Lavaca Street Ventures, LLC and Orbit Health, A Professional Corporation and their rates as contractors, with no change to term of January 7, 2020 through June 30, 2025, or compensation maximum of $40,863,680.
REPORT
Approval of the recommended actions will add contractors Lavaca Street Ventures, LLC and Orbit Health, A Professional Corporation to the master agreements for Locum Tenens and Telemedicine. These actions will allow the Department of Behavioral Health (Department) to competitively recruit through the contractors and retain qualified and experienced onsite psychiatrists and psychiatric nurse practitioners. This item is countywide.
ALTERNATIVE ACTION(S):
If your Board were not to approve the recommended actions, 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 actions.
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 2023-24 Adopted Budget and will be included in subsequent budget requests for the duration of the recommended master agreement. Actual cost will be determined by actual services provided.
The maximum cost of the master agreement for Telemedicine is $40,863,680 and will be financed with Mental Health Realignment and Short/Doyle Medi-Cal revenue. Maximum compensation for each fiscal year is $7,762,560. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2023-24 Adopted Budget and will be included in subsequent budget requests for the duration of the recommended master agreement. 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 CCFMG:
• 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 an additional two 12-month terms through June 30, 2025.
While CCFMG recruits 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 master agreements for Locum Tenens Psychiatry for onsite services:
• May 7, 2019: agreement 19-200.
• 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 12-month terms through June 30, 2025.
Your Board also approved the following master agreements for Telemedicine Psychiatry services for remote service provision:
• January 7, 2020: agreement 20-015.
• February 28, 2023: agreement 23-082 (amendment II to agreement 20-015) to add contractors and revise rates.
• June 20, 2023: agreement 23-306 (amendment III to agreement 20-015) to add contractors, revise rates, and extend the overall contract term for one 12-month term through June 30, 2025.
This amendment would add contractors Lavaca Street Ventures, LLC and Orbit Health, A Professional Corporation and their respective rates to the Locum Tenens master agreement and the Telemedicine master agreement.
REFERENCE MATERIAL:
BAI #46, June 20, 2023
BAI #35, February 28. 2023
BAI #17, January 18, 2022
BAI #23, January 7, 2020
BAI #48, May 7, 2019
BAI #13, May 1, 2018
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment III to Master Agreement for Locum Tenens
On file with Clerk - Amendment III to Master Agreement for Telemedicine
CAO ANALYST:
Ronald Alexander