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Health and Human Services Agency, recommending the Board:
1) Approve and authorize the Chair to sign Amendment II to Agreement for Services 162-S1511 with LocumTenens.com, LLC, for the provision of medical practitioners for behavioral health services, increasing the maximum contractual obligation by $250,000 for a combined total maximum contractual obligation of $1,120,000, and extending the term of the Agreement to August 31, 2018; and
2) Authorize the Purchasing Agent, or designee, to execute further documents relating to Agreement for Services 162-S1511, including amendments which do not increase the maximum dollar amount or term of the Agreement, and contingent upon approval by County Counsel and Risk Management.
FUNDING: State (including Mental Health Services Act) and Federal Funding.
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DEPARTMENT RECOMMENDATION:
Health and Human Services Agency (HHSA) recommending the Board approve and authorize Amendment II to Agreement for Services 162-S1511 with LocumTenens.com, LLC to provide medical practitioners for mental health services to ensure ongoing availability of mental health professionals for the duration of the Agreement. These services are consistent with those outlined in the Mental Health Services Act (MHSA) Plan and Three-year Plan-Updates. Despite long-term and continuous recruitment for permanent part- or full-time psychiatrists, the County continues to experience shortage in medical practitioners to provide services to the Behavioral Health Division clients. LocumTenens.com, LLC provides access to medical practitioners on an “as requested” basis to provide supplemental psychiatric services.
DISCUSSION / BACKGROUND:
Welfare and Institutions (W&I) Code Section 5897 directs the State to implement the mental health services defined in the W&I Code Section 5800 (Adult and Older Adult Mental Health System of Care Act), Section 5840 (Prevention and Early Intervention Programs), and Section 5850 (The Children’s Mental Health Services Act) through contracts with county mental health programs or with counties acting jointly. HHSA, on behalf of the County, contracts with the State to serve as the Mental Health Plan (MHP) for the County. As the MHP, the County is required to ensure various mental health services, including availability of psychiatrist services for treatment and medication.
In 2004, California voters passed Proposition 63, the MHSA. The MHSA imposes a one (1) percent tax on personal income in excess of $1,000,000. The funds from the tax are distributed to California counties and are intended to transform the Mental Health System into one that is consumer and family driven, is recovery-oriented, accessible and culturally competent, and offers services appropriate for the population that is served.
On August 26, 2014, the Board approved the MHSA Three-Year Plan, which covers Fiscal Years (FY) 2014-15, 2015-16, and 2016-17 (File 14-0806, Item 35). With each MHSA Three-Year Plan, there are Annual Updates. On August 25, 2015 and June 13, 2016, the Board approved Annual Updates (File 15-0964, Item 19 and File 15-0964, Item 2). It is anticipated that HHSA will present the next Three-Year Plan in 2017, which will cover FY 2017-18, FY 2018-19, and FY 2019-20.
Under the Capital Facilities and Technological Needs (CFTN) component of the MHSA Plan is the “Telehealth Program.” Telemedicine allows psychiatrists to provide psychiatric services using video conferencing technology, allowing clients and psychiatrists to see and hear one another through a secure network. This program provides clients who are unable to travel to the psychiatrist’s office or who live in areas not staffed by a psychiatrists to obtain needed psychiatric service.
The County has been unsuccessful in recruiting permanent part or full-time psychiatrists, despite long-term and continuous recruitment processes. LocumTenens.com has successfully provided supplemental psychiatrist staffing on an “as requested” basis since 2010.
HHSA continues to experience difficulty locating and hiring permanent psychiatrists.
Although no substantive changes are anticipated, should the approved MHSA Three-Year Plan for FY 2017-18 through 2019-20 differ materially from the current draft, impacting this Agreement, HHSA will amend this Agreement or rely on language which provides for cancellation, if appropriate.
ALTERNATIVES:
Disapproval of Amendment II to Agreement for Services 162-S1511 will result in continued psychiatrist staffing challenges, potential diminished capacity to provide psychiatrist services for clients and potential for not meeting HHSA’s contractual obligation as the MHP for the County.
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
County Counsel, Human Resources, and Risk Management.
CAO RECOMMENDATION:
It is recommended that the Board approve this item.
FINANCIAL IMPACT:
There is no Net County Cost associated with this Agenda item. Sufficient appropriations were included in the fiscal year 2017/18 budget, and will be included in future budgets for the term of the Agreement
CLERK OF THE BOARD FOLLOW UP ACTIONS
1) Clerk of the Board to obtain signature of Chair on two (2) original Amendment II to Agreements for Services 162-S1511.
2) Clerk of the Board to return one (1) fully executed Agreement to the HHSA Contracts Unit at 3057 Briw Road.
STRATEGIC PLAN COMPONENT:
N/A
CONTACT
Patricia Charles-Heathers, Ph.D., Director