Inter-Departmental Correspondence

Health Services Agency



November 29, 2004


December 14, 2004



Honorable Board of Supervisors



Charlene A. Silva, Director of Health Services

Gale Bataille, Director of Mental Health Services



Agreements with Psychiatrists Only and J&C Nationwide



Adopt a resolution:


A) Authorizing the President of the Board to execute agreements with Psychiatrists Only and J&C Nationwide for the provision of locum tenens services; and


B) Authorizing the Director of the Health Services Agency to execute subsequent amendments and minor modifications not to exceed an aggregate of $25,000 and to make minor changes in the type of services and activities provided under the Agreement.



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, and subsequently contracted with Psychiatrists Only and J&C Nationwide for FY 2003-04 to provide locum tenens psychiatrists for either adults or children as requested by the Medical Director.


Both agencies were to have been offered the opportunity to provide locum tenens services, if needed, however Mental Health Services did not require the use of these services in FY 2003-04.



Mental Health Services is renewing the Agreements with Psychiatrists Only and J&C Nationwide for FY 2004-05. Having these Agreements in place serves as a backup while we continue recruitment efforts for permanent psychiatry staff.


The maximum for the two Agreements 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 $131.25, respectively. Payment to these agencies is on a fee-for-services basis. Locum tenens psychiatrists usually serve for a minimum of a two-month period.


Performance Measures

2003-04 Objective

2003-04 Actual

2004-05 Objective

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





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, 2004, through June 30, 2005.


The total obligation under these Agreements is $120,000, with funding coming from the following sources: $43,200 from federal and State Medi-Cal; $2,400 from insurance - including Healthy Families and Healthy Kids; $27,600 from the State allocation for AB3632; $1,200 from SAMHSA grant funds; and $1,200 from the System of Care match from the Human Service Agency. These funds have been included in the Mental Health budget for FY 2004-05. The remaining $44,400 is the net county cost.