DATE: December 4, 2018
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
SUBJECT: Retroactive Master Agreement for Temporary Staffing
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a retroactive Master Agreement with various Temporary Staffing Agencies effective November 1, 2018 through June 30, 2023, which includes a two-year and eight-month base contract and two optional one-year extensions, total not to exceed $12,133,333.
2. Authorize the Director of the Department of Behavioral Health, or designee, to add and/or delete vendors to the Master Agreement, as necessary, with oversight and approval from Internal Services Department - Purchasing Division, and to renegotiate and approve rates based upon the prevailing market.
REPORT
Approval of the first recommended action will allow the Department of Behavioral Health (DBH) to utilize Temporary Staffing Agencies to provide staffing qualified to deliver services to adults with severe mental illness and youth with serious emotional disturbances when gaps in qualified County staff coverage is identified, including Licensed Marriage and Family Therapists (LMFT), Licensed Clinical Social Workers (LCSW), Licensed Professional Clinical Counselors (LPCC), Licensed Vocational Nurses (LVN), Registered Nurses (RN), and Nurse Practitioners (NP) through a Master Agreement.
Approval of the second recommended action will allow the DBH Director, or designee, to modify, add and/or delete Temporary Staffing Agencies to the recommended agreement, as needed, and/or to renegotiate their rates based upon the prevailing market.
ALTERNATIVE ACTION(S):
There is no viable alternative action. Should your Board not approve the recommended actions, individuals receiving mental health services will be subject to the negative consequences of inadequate staffing. Optimal staffing is critical for DBH operations and ongoing services to clients. Given the current vacancies, it is crucial that appropriate staffing levels are maintained. The requested classifications in need of recruitment are essential in the operation of DBH to continue to provide services to seriously mentally ill clients, which helps deter decompensation of the individuals and also aids in preventing costly hospitalization. Periods of inadequate staffing may cause gaps in services received which may pose a danger to clients. Additionally, the State of California mandated staffing ratios must be maintained at all times.
RETROACTIVE AGREEMENT:
The recommended agreement is retroactive to November 1, 2018 due to time required to review multiple competitive bid responses and the resulting contract negotiations. In order avoid gaps in coverage, the agreement will be retroactive to provide a mechanism for the Department to reimburse the contracted providers for services they may have delivered after November 1, 2018.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The annual contract maximum is $1,733,333 for FY 2018-19 and $2,600,000 for FY 2019-20 and subsequent years for all providers combined; $12,133,333 for the entire contract term. The costs will be fully funded by Medi-Cal Federal Financial Participation, Mental Health Realignment funds, and funds available due to salary savings from the vacant positions, which will be filled by this staffing agreement. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2018-19 Adopted Budget and will be included in future Requested Budgets.
DISCUSSION:
In 2018, DBH solicited the services of temporary staffing agencies via a competitive bid process, Request for Statement of Qualifications (RFSQ #18-053) specializing in the recruitment of the following licensed positions: Licensed Marriage and Family Therapist (LMFT), Licensed Clinical Social Worker (LCSW), Licensed Professional Clinical Counselor (LPCC), Licensed Vocational Nurse (LVN), Registered Nurse (RN), and Nurse Practitioner (NP) to provide services to the individuals with serious mental illness in the County of Fresno. Respondents were to identify and recruit qualified candidates who satisfy the criteria as established by DBH pertaining to each respective staff classification.
There continues to be a shortage of qualified applicants for LMFT, LCSW, LPCC, LVN, RN and NP recruitments. As a result, DBH continues to struggle with filling these positions through the County of Fresno recruitment process.
Upon your Board’s approval, the proposed agreement would be retroactive to November 1, 2018 to avoid gaps in staffing coverage. Additionally, the temporary staffing agencies will provide worker’s compensation, general and professional liability insurance coverage for all temporary staff. The recommended agreement allows the County, the individual contractor(s) or DBH Director, or designee, to provide written notice of non-renewal no later than 60 days prior to the close of the initial base contract period and for termination without cause upon 30-days advance written notice of the intention to terminate.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board has been informed of this item at their October 17, 2018 meeting.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Master Agreement
CAO ANALYST:
Ronald Alexander