COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

 

DATE:

June 2, 2003

BOARD MEETING DATE:

June 10, 2003

 

TO:

Honorable Board of Supervisors

   

FROM:

Margaret Taylor, Director of Health Services

 

Gale Bataille, Director, Mental Health Services

   

SUBJECT:

Agreements with Psychiatrists Only and J&C Nationwide

 

Recommendation

Adopt a resolution:

1.

authorizing the President of the Board to execute agreements with Psychiatrists Only and J&C Nationwide for the provision of locum tenens services, and

2.

authorizing the Director of Health Services to execute amendments and minor modifications up to an aggregate of $25,000 for the term of the agreements.

 

Background

 

The Mental Health Services Division has had difficulty recruiting psychiatrists due to the high cost of living in the Bay Area. The most acute shortage is for child psychiatrists, as there are national work force shortages for this profession. Mental Health Services has been unsuccessful in its efforts to recruit child psychiatrists. Recruitment efforts have included development and distribution of specialized promotional materials, visiting local professional job fairs and listing job announcements on websites and in state and national professional publications.

 

In November 2002, the Mental Health Services Division issued a Request for Proposals (RFP) for locum tenens psychiatry services. The RFP was for an initial one-year agreement with the option to renew for two additional years. Two agencies responded to the RFP, Psychiatrists Only and J & C Nationwide. Both locum tenens agencies have been offered an opportunity to provide these services because of their experience in the field and the difficulty in finding appropriate psychiatrists. Rates for the two agencies are comparable. Payments to these agencies are made only for services provided by psychiatrists who they refer for placement.

 

Discussion

 

Psychiatrists Only has been in existence since January 1998 and specializes in the provision of locum tenens and permanent psychiatrists. This company has a history of strong relationships with the Veteran's Administration, as well as state and county agencies. J&C Nationwide is the nation's oldest and second largest physician staffing firm, and has been in business for 25 years. Although they provide referrals for over 40 medical specialties, psychiatry placements comprise over 10% of their total business.

 

Up to this point Mental Health Services has not had to use locums tenens services. Having these contracts in place serves as a backup while we continue recruitment efforts for permanent child psychiatry staff.

 

Performance Measures

2003-04 Objective

Psychiatrist referrals or status reports will be provided within 3 days of request.

80%

Locum tenens physician(s) will have a performance rating of at least 90%.

100%

 

Vision Alignment

 

The agreements with Psychiatrists Only and J&C Nationwide keep the commitment to Ensure Basic Health and Safety for All and goal number 8: Help vulnerable people - the aged, disabled, mentally ill, at risk youth, and others - achieve a better quality of life. The agreements contribute to this commitment and goal by providing psychiatrists to provide professional services for mental health clients.

 

Fiscal Impact

 

The term of the agreements is July 1, 2003, through June 30, 2004. The budget of $120,000 for FY 2003-04 will be shared between Psychiatrists Only and J & C Nationwide, based upon the respective success of either firm in placing psychiatrists. The current rate that Mental Health pays for a contracted child psychiatrist is $105.58 per hour. The hourly child psychiatrist rates for Psychiatrists Only and J & C Nationwide are $150 and $128.13, respectively.

 

Funding will come from Medi-Cal (30.5%), SB 90 (26%), SAMHSA (19%), and state managed care allocation (4.5%). The remaining 20% ($24,000) is the net county cost, which is included in the proposed Mental Health budget for FY 2003-04. The cost of locum tenens placements will be covered through savings from vacant staff or contracted psychiatry positions.

 

It is requested that the Director of Health Services be given signing authority to execute minor amendments and modifications up to an aggregate of $25,000 for the term of the agreement.