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Board Agenda Item 35
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DATE: February 28, 2023
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Amendment I to Master Agreement for Locum Tenens Services
RECOMMENDED ACTION(S):
Approve and authorize the Chairman to execute Amendment I to Master Agreement for Locum
Tenens to revise service reimbursement rates for contractor Jackson &Coker LocumTenens,
LLC, and add Curative Talent, LLC and Cross Country Staffing, Inc. as contractors, with no change
to term of May 7, 2019 through June 30, 2023 and no change to the contract maximum of
$37,500,000.
Approval of the recommended action will revise service reimbursement rates for Jackson & Coker Locum
Tenens, LLC as well as add two additional contractors, Curative Talent, LLC and Cross Country Staffing,
Inc. to the master agreement. These actions will allow the Department of Behavioral Health (Department)to
competitively recruit through the contractors and retain qualified and experienced onsite psychiatrists and
psychiatric nurse practitioners. This item is countywide.
ALTERNATIVE ACTION(S):
If your Board were not to approve the recommended actions, the Department would continue to struggle to
meet essential needs for psychiatric services for severely mentally ill adults and seriously emotionally
disturbed children and adolescents.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The maximum cost of
the master agreement is $37,500,000 and will be financed with Mental Health Realignment and Short
Doyle/Medi-Cal revenue. Maximum compensation for each fiscal year is$7,000,000. Sufficient
appropriations and estimated revenues are included in the Department's Org 5630 FY 2022-23 Adopted
Budget and will be included in subsequent budget requests for the duration of the recommended master
agreement. Actual cost will be determined by actual services provided.
DISCUSSION:
On May 1, 2018, your Board approved agreement 18-234 with Central California Faculty Medical Group
(CCFMG)for psychiatric services by licensed psychiatrists serving Department of Behavioral Health clients.
CCFMG would recruit and fill full-time on-site psychiatrist positions; however, the continued shortage of
psychiatrists in the Central Valley and in the state of California resulted in major challenges in recruitment.
On January 18, 2022, your Board approved agreement 22-023 and Amendment I to agreement 18-234, to
revise employment incentives and approve a salary resolution to improve the Department's ability to meet
the needs for psychiatry services in Fresno County.
County of Fresno Page I File Number.23-0095
File Number:23-0095
While CCFMG recruits full-time psychiatrists and psychiatric nurse practitioners, the Department continues
to utilize locum tenens psychiatrists to provide onsite psychiatry services. On January 7, 2020 your Board
approved master agreement 20-015 for psychiatry services via telemedicine. On May 7, 2019, your Board
approved master agreement 19-200 for locum tenens psychiatry services serving Department of Behavioral
Health clients.
Due to the highly competitive environment for psychiatry services, it is increasingly difficult to attract and
retain qualified and experienced locum tenens psychiatry providers. As a result, it is necessary to, on
occasion, review and moderately revise existing reimbursement rates to be competitive enough to attract
quality providers while not inflating the market unnecessarily.
Although the original agreement authorizes the Department's Director or designee to modify the agreement
and add or delete contractors, your Board has assumed the sole authorization to approve any changes to
the agreement, including additions and deletions of contractors. This Amendment would revise the
telehealth rate range for Jackson & Coker LocumTenens, Inc from $220-$249 per hour to $230-$270 per
hour for psychiatrists to be more competitive in the current market and add new contractors Curative Talent,
LLC and Cross Country Staffing, Inc.
REFERENCE MATERIAL:
BAI #17, January 18, 2022
BAI #23, January 7, 2020
BAI #48, May 7, 2019
BAI #13, May 1, 2018
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk-Amendment I to Master Agreement
CAO ANALYST:
Ron Alexander
County of Fresno page 2 File Number.23-0095