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Agenda Item
ASR
Control 25-000675 |
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MEETING
DATE: |
02/24/26 |
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legal entity taking action: |
Board
of Supervisors |
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board of supervisors district(s): |
2 |
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SUBMITTING Agency/Department: |
Health
Care Agency (Approved) |
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Department contact person(s): |
Veronica
Kelley (714) 834-7024 |
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Ian
Kemmer (714) 834-2160 |
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Subject: Renewal Amendment to Contract for
Physician Services
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ceo CONCUR |
County Counsel Review |
Clerk of the Board |
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Concur |
Approved
Agreement to Form |
Discussion |
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3
Votes Board Majority |
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Budgeted: N/A |
Current Year
Cost: N/A |
Annual Cost: FY 2026-27 $605,000 |
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Staffing Impact: |
No |
# of Positions: |
Sole Source: Yes |
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Current Fiscal Year Revenue: N/A
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Prior Board Action: 5/9/2023 #15 |
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RECOMMENDED
ACTION(S):
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1. |
Approve Amendment No. 2 to renew the
Contract with The Regents of The University of California, as described in
Article IX, Section 9 of the California Constitution, on Behalf of UC Irvine
School of Medicine, Department of Psychiatry for provision of Physician
Services, for the term of July 1, 2026, through June 30, 2028 for an amount
not to exceed $1,210,000 for a revised cumulative amount not to exceed of
$3,025,000. |
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2. |
Authorize the County Procurement Officer
or Deputized designee to execute Amendment No. 2 to Contract with The Regents
of The University of California, as described in Article IX, Section 9 of the
California Constitution, on Behalf of UC Irvine School of Medicine,
Department of Psychiatry, as referenced in the Recommended Action above. |
SUMMARY:
Approval of Amendment No. 2 to
renew the Contract with The Regents of The University of California, as
described in Article IX, Section 9 of the California Constitution, on Behalf of
UC Irvine School of Medicine, Department of Psychiatry, for the provision of
Physician Services will allow continued provision of highly specialized
psychiatric services for both adults and children.
BACKGROUND
INFORMATION:
On May 9, 2023, your Honorable
Board of Supervisors (Board) approved the Sole Source Contract with The Regents
of The University of California, as described in Article IX, Section 9 of the
California Constitution, on Behalf of UC Irvine School of Medicine, Department
of Psychiatry (UCI), for the provision of Physician Services, for the term of
July 1, 2023, through June 30, 2026, for an amount not to exceed of $1,815,000.
Administrative revisions were completed via Amendment No. 1 effective August
30, 2023, through the delegated authority of the Deputy Purchasing Agent.
The proposed Amendment No. 2 will
allow for Fellow and Resident Physician Services to continue for the term of
July 1, 2026, through June 30, 2028, with UCI. The Orange County Preference
Policy is not applicable to this Contract.
The proposed Amendment No. 2 to the
Contract with UCI is sole source because UCI is the only institution in Orange
County (County) that operates an accredited psychiatry residency and fellowship
program, providing highly specialized clinical training essential for meeting
the County’s behavioral health needs.
Neighboring counties also have University/Medical Center Psychiatry
Training Programs; however, their training programs work with their county
clinics and county hospitals. UCI services offer HCA the ability to partner
with a public university/training facility that teaches cutting edge
psychiatry. In addition, having the UCI Resident and Fellow Psychiatrists in
the County clinics has been an excellent source of recruiting and has led to
successful employment of psychiatrists providing services to the residents of
Orange County. The presence of these residents also enables the County clinics
to meet State-mandated timeliness standards for psychiatric care. This
partnership promotes continuity of care, supports workforce development, and
strengthens collaboration between academic training programs and community
mental health systems, thereby improving access to and quality of psychiatric
services for the County’s population.
Scope
of Services
Resident
Psychiatrists from the UCI medical program provide highly specialized
psychiatric services to adults living with serious mental illnesses and/or
substance use disorders who are enrolled in HCA's Behavioral Health Services
(BHS) outpatient clinics. The outpatient mental health and substance use
disorder clinics are located in Anaheim, Aliso Viejo, Santa Ana and
Westminster. Services include assessment, diagnosis and medication management.
Resident Psychiatrists will provide psychiatric care under the clinical
supervision of HCA psychiatrists.
In addition to the
above services, Amendment No. 2 allows UCI Child Fellows in Psychiatry to
provide highly specialized psychiatric services to seriously emotionally
disturbed children and youth. Services will be targeted to system-involved
youth enrolled in HCA BHS programs and youth in County-operated regional
outpatient clinics. Psychiatric services are tailored to meet the needs of
these often significantly traumatized populations with increased incidents of
co-occurring disorders. Services for clients will be provided at Youth
Reporting Centers, Juvenile Hall, Youth Guidance Center, Youth Leadership
Academy, Orangewood Children and Family Center, and East Regional Outpatient
Clinic. Services include assessment, diagnosis and medication management. This
Contract also allows medical school faculty hours needed for clinical
supervision of Child Fellows.
Performance
Outcomes
The table below demonstrates the number of
clients served by the Resident Psychiatrists and Child Fellows during the last
three Fiscal Years (FY).
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Adult
and Older Adult |
Total Number of Clients Served |
Number of Full Time Equivalent (FTE) Resident
Psychiatrists |
Number of Clients Served per FTE |
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FY
2023-24 |
469 |
1.8 |
260.6 |
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FY
2024-25 |
367 |
1.4 |
262.1 |
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FY
2025-26 (through 11/30/25) |
183 |
1.5 |
122.0 |
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Children
Youth |
Number of Clients Served |
Number of FTE Child Fellows |
Number of Clients Served per FTE |
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FY
2023-24 |
129 |
0.8 |
129 |
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FY
2024-25 |
192 |
0.8 |
192 |
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FY
2025-26 (through 11/30/25) |
31 |
0.6 |
*31 |
*FY 2025-26 has a
lower number served thus far due to a Fellow leaving the program and a lower
volume in one of the clinics the Fellows are assigned to.
The Contractor’s performance has
been confirmed as satisfactory. HCA has verified there are no concerns that
must be addressed with respect to UCI’s ownership/name, litigation status or
conflicts with County interests.
Prior to the expiration of this
Contract, the Health Care Agency plans to issue a solicitation to continue
services.
An analysis was completed to verify
the contract provides the County with persons specially trained, experienced,
expert and competent to perform the special services in accordance with the
law.
This proposed Amendment No. 2 does not
include subcontractors or pass through to other providers. See Attachment B for
the Contract Summary Form.
Hiring additional psychiatrists alone is
not a viable solution due to the significant statewide and nationwide shortage
of psychiatrists, particularly in public mental health settings. Recruitment
for these highly specialized positions is extremely competitive, and the County
has historically experienced challenges in attracting and retaining qualified
candidates. Partnering with UCI provides access to an established pipeline of
psychiatrists and child psychiatrists through its accredited residency and fellowship
programs, which not only addresses immediate service needs but also serves as a
proven strategy for long-term workforce development. This partnership ensures
continuity of care, compliance with state timeliness standards, and
cost-effective staffing solutions that cannot be achieved through direct hiring
alone.
HCA requests that the Board approve
Amendment No. 2 to renew the Contract with UCI for the provision of Physician
Services, as referenced in the Recommended Action.
FINANCIAL
IMPACT:
Appropriations for this Contract
will be included in Budget Control 042 FY 2026-27 budget and will be included
in the budgeting process for future years.
This Contract contains language allowing
HCA to terminate the contract, reduce the level of services and/or renegotiate
the levels of services to be provided should funding become unavailable.
Funding is based on known sources currently and may change if other funding
becomes available.
STAFFING
IMPACT:
N/A
ATTACHMENT(S):
Attachment
A – Amendment No. 2 to Contract MA-042-24010172 with UCI
Attachment B – Contract Summary Form