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Health and Human Services Agency recommending the Board:
1) Make findings pursuant to Section 3.13.030 (C) of the El Dorado County Ordinance Chapter 3.13, Contracting Out, that the provision of as-needed public health nursing and 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) Make findings in accordance with Procurement Policy C-17 Section 3.4(2f) exempting the competitive bidding process, with Purchasing Agent concurrence, because “the procurement is for goods where the continuity of providers will provide efficiency or critical knowledge, and other providers of the goods cannot provide similar efficiencies or critical knowledge”;
3) Approve and authorize the Chair to sign Amendment I to Agreement for Services 7954 with Amergis, formerly known as Maxim Healthcare Staffing Services, increasing compensation from $200,000 to $600,000, due to the expanded scope of work to include behavioral health staffing services, with no change to the term of December 3, 2023, through December 31, 2025; and
4) Authorize the Purchasing Agent to execute amendments relating to Agreement 7954 which do not increase the maximum dollar amount or extend the term of the agreement beyond three years, contingent upon approval by County Counsel and Risk Management.
FUNDING: 25% State California Department of Public Health Immunization Funding, 50% Mental Health Services Act, and 25% Federal Medi-Cal.
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DISCUSSION / BACKGROUND:
On December 5, 2023, the Board authorized the Chair to execute Agreement 7954 with Maxim Healthcare Staffing Services, now known as Amergis, for the term of December 5, 2023, through December 31, 2025, with a maximum obligation of $200,000, to address HHSA Public Health Division’s (PHD) critical nursing staffing needs (Legistar file 23-1757). Following this agreement's execution, HHSA’s Behavioral Health Division (BHD) staff were informed that Amergis also provides behavioral health staffing services. Subsequently, BHD staff initiated conversations with Amergis to discuss if this contractor could expand its scope in the agreement to include the provision of qualified Behavioral Health staffing to address critical staffing shortages.
HHSA BHD has been facing significant staffing shortages, impacting both temporary and permanent positions, including critical vacancies in the role of Mental Health Clinicians. Notably, this position has sustained a 40% vacancy rate for over a year, intensifying the strain on the BHD's ability to deliver essential services. To address these shortages, Amergis staff will be strategically assigned 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, HHSA 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 Amendment I to Agreement 7954 with Amergis to enable BHD to utilize this provider’s staffing services, to address its staffing shortages and better meet County resident’s behavioral health related service needs. Amendment I includes an increase in rates for Licensed Marriage and Family Therapists and Licensed Clinical Social Workers to $110 per hour and adds rates for telehealth services and behavioral health specific classifications.
In accordance with Board of Supervisors Procurement Policy C-17, the contractor is exempt from competitive bidding, with Purchasing Agent concurrence, per Section 3.4 (2)(f), as the procurement is for services where the continuity of providers will provide efficiency or critical knowledge, and other providers of the services cannot provide similar efficiencies or critical knowledge. An approved Non-Competitive Bid Justification form is attached.
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, impacting the County’s ability to provide quality care to clients and reduce staffing shortages.
PRIOR BOARD ACTION:
1) 08/25/2020, 20-1024, HHSA Maxim Healthcare Staffing Services, 5061
2) 01/26/2021, 21-0031, HHSA Maxim Healthcare Staffing Services, 5061 A2
3) 11/16/2021, 21-1008, HHSA #5061-A3 Maxim Healthcare Staffing Services, Inc.
4) 12/05/2023, 23-1757, HHSA Maxim Healthcare Staffing Services, 7954
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
Approved by County Counsel, Human Resources, and Risk Management. The Auditor Controller has been notified per Policy B-12.
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 2024-25 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 one original Amendment I to Agreement for Services 7954.
STRATEGIC PLAN COMPONENT:
N/A
CONTACT
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency