Agenda Item   

AGENDA STAFF REPORT

 

                                                                                                                        ASR Control  25-000675

 

MEETING DATE:

02/24/26

legal entity taking action:

Board of Supervisors

board of supervisors district(s):

2

SUBMITTING Agency/Department:

Health Care Agency   (Approved)

Department contact person(s):

Veronica Kelley (714) 834-7024 

 

 

Ian Kemmer (714) 834-2160

 

 

Subject:  Renewal Amendment to Contract for Physician Services

 

      ceo CONCUR

County Counsel Review

Clerk of the Board

          Concur

Approved Agreement to Form

Discussion

 

 

3 Votes Board Majority

 

 

 

    Budgeted: N/A

Current Year Cost:   N/A

Annual Cost: FY 2026-27 $605,000
FY 2027-28 $605,000

 

 

 

    Staffing Impact:

No

# of Positions:            

Sole Source:   Yes

    Current Fiscal Year Revenue: N/A

   Funding Source:     State: 100% (Behavioral Health Services Act, Realignment)

County Audit in last 3 years: No

   Levine Act Review Completed: Yes

 

    Prior Board Action:         5/9/2023 #15

 

RECOMMENDED ACTION(S):

 

 

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.

 

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).

 

Adult and Older Adult

Total Number of Clients Served

Number of Full Time Equivalent (FTE) Resident Psychiatrists

Number of Clients Served per FTE

FY 2023-24

469

1.8

260.6

FY 2024-25

367

1.4

262.1

FY 2025-26 (through 11/30/25)

183

1.5

122.0

 

Children Youth

Number of Clients Served

Number of FTE Child Fellows

Number of Clients Served per FTE

FY 2023-24

129

0.8

129

FY 2024-25

192

0.8

192

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