COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

October 20, 2005

BOARD MEETING DATE:

November 8, 2005

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director, Health Department

Gale Bataille, Director of Mental Health Services

SUBJECT:

Agreements with JC Nationwide and Psychiatrists Only

RECOMMENDATION:

Adopt a resolution:

A) Authorizing the President of the Board to execute agreements with JC Nationwide and Psychiatrists Only for the provision of locum tenens services for the term of July 1, 2005 through June 30, 2006, for a shared maximum obligation of $120,000; and

B) Authorizing the Director of the Health Department 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.

VISION ALIGNMENT:

Commitment: To ensure basic health and safety for all.

Goal 8: Help vulnerable people – the aged, disabled, mentally ill, at risk youth, and others – achieve a better quality of life.

These agreements contribute to this commitment and goal by providing psychiatrists to provide professional services for Mental Health clients.

Performance Measure(s):

Measure

FY 2004-05
Actual

FY 2005-06
Projected

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

N/A*

80%

* Contractors did not provide services in FY2004 – 2005.

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 needed 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 for the period FY 2003-06. Subsequently, your Board approved contracts with J&C Nationwide, Inc. and Psychiatrists Only for FY 2003-04 and for FY 2004-05 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. Mental Health Services did not require the use of these services in either FY 2003-04 or FY 2004-05. In November of 2004 J & C Nationwide, Inc. changed its name to JC Nationwide.

DISCUSSION:

Mental Health Services is renewing the agreements with JC Nationwide and Psychiatrists Only for FY 2005-06. 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 JC Nationwide and Psychiatrists Only, based upon the usage of either agency 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 JC Nationwide and Psychiatrist Only are $131.25 and $150.00, respectively. Payment to these agencies will be made on a fee-for-services basis. Locum tenens psychiatrists usually serve for a minimum of a two-month period.

FISCAL IMPACT:

The term for both agreements is July 1, 2005 through June 30, 2006.

The total combined 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. The remaining $44,400 is the net county cost. These funds have been included in the Mental Health budget for FY 2005-06.