Approve fourth amendment to Agreement No. 4385 with LocumTenens.com to add funding in the amount of $250,000 for FY 2023-24, for a new contract maximum of $1,470,000 for the period of July 1, 2022 through June 30, 2025, for the provision of adult psychiatric staffing services. (No general fund impact) (Sullivan)

Approve fourth amendment to Agreement No. 4385 with LocumTenens.com to add funding in the amount of $250,000 for FY 2023-24, for a new contract maximum of $1,470,000 for the period of July 1, 2022 through June 30, 2025, for the provision of adult psychiatric staffing services.

On or about June 22, 2022, the County entered into Agreement PO No. 4385 (the Agreement) with LocumTenens.com for the provision of adult psychiatric services for eligible Yolo County clients including County residents conserved under the Lanterman-Petris-Short (LPS) Act. County Behavioral Health programs relied on short-term contracted psychiatric providers to augment their county staffing as recruitment and retention of such staff (i.e., psychiatrists and psychiatric nurse practitioners) is very difficult in this field. Contracting with LocumTenens.com provides professional staffing augmentation, recruitment, presentation, and management which is the best option as this is a challenging process for the County.

On or about February 21, 2023, the parties amended the Agreement via the first amendment (amended by this Board via Agreement No. 23-48) to add funding in the amount of $295,000 for 2022-23 to account for the ongoing inability to recruit and retain psychiatry staff who wish to fill a vacant County position.

On or about May 9, 2023, the parties amended the Agreement via the second amendment (amended by this Board via Agreement No. 23-86) to add funding in the amount of $200,000 for 2023-24 and $215,000 for 2024-25 to account for the continued ongoing inability to recruit and retain psychiatry staff who wish to fill a vacant County position.

On or about July 25, 2023 the parties amended the Agreement to add funding to account for the continued ongoing inability to recruit and retain psychiatry staff who wish to fill a vacant County position.  At the time, HHSA has brought up to three locum tenens staff to cover these vacancies and meet the current client need; and increase the maximum hourly rate for Psychiatry/Telepsychiatry effective July 1, 2023.

This fourth amendment adds funding that is needed to cover incoming 2023-24 invoices. LocumTenens.com providers are being used at a higher level than planned due to ongoing prescriber employee vacancies and the recent retirement of a half-time prescriber staff member. 

Performance Measures included in this Agreement are as follows:
Performance Measures are not associated with this Agreement.

County Counsel has approved this Agreement as to form.
Department of General Services, Procurement Division

On April 26, 2022, the then acting Yolo County Procurement Manager or designee approved a sole/single source procurement for these services.

Procurement reviewed HHSA’s request and determined that it was in the best interest of the County to renew the agreement, based on satisfactory service/reasonable prices and to avoid the interruption of County business. Without sole source approval and renewal of the agreement with the vendor, the County would lose the staffing of two psychiatrists and one nurse practitioner, resulting in devastating impacts to the County’s ability to provide mandated psychiatric care for County mental health clients. Factors considered, include but were not limited to:

1) the County’s ongoing difficulty in recruiting psychiatrists and nurse practitioners (prescribers) due to statewide staffing shortages; 2) satisfactory vendor performance– the vendor has been a County vendor for over five years providing competitive rates and documented successful performance in recruiting high quality locum tenens providers; 3) competitive pricing/cost savings; and 4) loss of three locum tenens providers from the vendor, who are actively on the HHSA clinic psychiatric staff contingent, carrying a combined case load of hundreds of County mental health clients. Without renewal of the agreement, these placements would be terminated, leaving the County without outpatient psychiatric care providers for its mental health clients, severely disrupting the quality & continuity of care for these vulnerable clients.