Title
Health and Human Services Agency (HHSA) recommending the Board:
1) Make findings pursuant to Section 3.13.030 (C) of the El Dorado County Ordinance Chapter 13, Contracting Out, that the provision of as-needed behavioral health staffing services provided by Amergis Healthcare Staffing, Inc. (Amergis) is in the public’s best interest due to the limited timeframes, temporary or occasional nature, or schedule for the project or scope of work to be performed is not sufficient to warrant addition of permanent staff;
2) Waive formal bid requirements in accordance with Procurement Policy C-17 Section 3.4.(4) Exemptions from Competitive Bidding, due to a competitively bid Cooperative Agreement with a government agency being available for as-needed behavioral health staffing services;
3) Authorize the use of competitively bid Cooperative Agreement 061324 between Sourcewell and Amergis, for the provision of behavioral health staffing services, for an initial term of August 25, 2026, through October 24, 2028, with the option to extend the Agreement for up to three additional one-year terms for a term not to exceed October 24, 2031, with a maximum obligation of $2,600,000 for the initial term, with each optional one-year extension to not exceed $1,000,000 per year, for a total maximum obligation not to exceed $5,600,000 if all extensions are granted;
4) Approve and authorize the Chair to sign the Sourcewell Statement of Work addendum to the Cooperative Agreement (Fenix 10386);
5) Designate the HHSA Behavioral Health Deputy Director as the Authorized Representative to complete and sign Customer Assignment Confirmation forms (Attachment A of the Cooperative Agreement), to provide Amergis with the details for as-needed personnel assignments/staffing needs for the Behavioral Health Division (BHD); and
6) Authorize the Purchase Agent to execute amendments related to this Cooperative Agreement, as applicable, that do not increase the term or maximum obligation, contingent upon approval by County Counsel and Risk Management, as applicable.
FUNDING: 50% State and Federal, 40% Behavioral Health Services Act (BHSA) and 10% Behavioral Health Realignment.
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DISCUSSION / BACKGROUND
HHSA’s BHD has been facing significant staffing shortages, impacting both temporary and permanent positions, including critical vacancies in the role of Mental Health Clinicians and Psychiatric Technicians. Notably, the Mental Health Clinician position has sustained a 40% vacancy rate for over a year, and HHSA has worked with County Human Resources to run a continuous recruitment for the Psychiatric Technician position for two years, in which no qualified applicants have been received. These staffing shortages intensifies the strain on the BHD's ability to deliver essential services.
On December 5, 2023, the Board authorized the Chair to execute Agreement 7954 with Maxim Healthcare Staffing Services, now known as Amergis, to address HHSA’s Public Health Division's critical nursing staffing needs (Legistar file 23-1757). On September 24, 2024, the Board approved the First Amendment to Agreement 7954 with Amergis to add the BHD to the agreement in order to address significant behavioral health staffing shortages, which enabled BHD to utilize as needed behavioral health positions (Legistar file 24-1324). This Agreement expires August 24, 2026. It is important to note that this Amergis agreement did not include mental health Licensed Social Workers (LSWs) or psychiatric staffing services, which BHD continues to experience shortages.
To address these shortages, HHSA recommends the Board approve the Cooperative Agreement with Sourcewell/Amergis presented in this agenda item, which will allow BHD to continue to utilize Amergis’ provision of temporary behavioral health staffing, to include Mental Health Clinicians and Counselors, inclusive of LSWs, and Licensed Marriage and Family Therapists (LMFT), along with Licensed Psychiatrists. On an as-needed basis, BHD will utilize this agreement to assign temporary staff to key areas within the County’s BHD system of care for adult beneficiaries, ensuring continuity and quality of care. As the Medi-Cal Mental Health Plan (MHP) in the County, BHD is mandated to provide specialty mental health services (SMHS) to Medi-Cal beneficiaries in accordance with Title 9, California Code of Regulations, Section 1810.100. This responsibility underscores the importance of addressing BHD’s existing staffing needs to meet regulatory obligations and deliver comprehensive mental health care to the community. HHSA recommends that the Board approve this agenda item to enable BHD to address its staffing shortages and better meet County resident’s behavioral health related needs.
In accordance with Board Procurement Policy C-17, Section 3.4.(4) allows for the exemption from competitive bidding when a cooperative contract is available and the service is procured from a vendor that has a contract with another public agency, Joint Powers Association, or cooperative purchasing agreement. Sourcewell is a State of Minnesota local government unit and service cooperative that offers cooperative procurement solutions to local, federal and state government entities. In 2024, Sourcewell issued Request for Proposal 061324 for Staffing Services and Solutions, in which Amergis was selected as the most successful bidder, resulting in the Cooperative Agreement 061324 presented in this agenda item.
ALTERNATIVES
Should the Board decline to approve this recommendation, hard-to-fill HHSA BHD clinical positions are likely to continue remaining vacant for extended periods of time. These vacancies greatly impact the County's ability to provide quality of care, reduce staffing shortage, and remain compliance with California Regulation.
PRIOR BOARD ACTION
12/05/2023 Legistar file 23-1757, HHSA Maxim Healthcare Staffing Services, 7954
09/24/2024 Legistar file 24-1324, HHSA Amergis Staffing Services (Maxim), 7954 A1
OTHER DEPARTMENT / AGENCY INVOLVEMENT
County Counsel and Risk Management.
CAO RECOMMENDATION
Approve as recommended.
FINANCIAL IMPACT
There is no Net County Cost associated with this agenda item. Sufficient appropriations were included in the Fiscal Year 2026-27 budget and will be included in future budgets for the term of the Agreement.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Clerk of the Board to obtain signature of Chair on the original Sourcewell Statement of Work addendum to the Cooperative Agreement (Fenix 10386).
STRATEGIC PLAN COMPONENT
N/A
CONTACT
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency