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Agenda Item
ASR
Control 21-000252 |
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MEETING DATE: |
08/24/21 |
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legal entity taking action: |
Board of Supervisors |
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board of supervisors
district(s): |
All Districts |
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SUBMITTING
Agency/Department: |
Health Care Agency
(Approved) |
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Department contact
person(s): |
Anna Peters (714) 834-5150 |
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Clayton Chau (714) 834-2830 |
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Subject: Master Agreement for
Professional Services
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ceo CONCUR |
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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: Yes |
Current Year Cost:
$4,722,964 |
Annual Cost:
FY 2021-22 $1,574,321 |
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Staffing Impact: |
No |
# of Positions:
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Sole Source:
No |
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Current Fiscal Year Revenue: N/A
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Prior Board Action: 08/25/2020
#6, 09/10/2019 #15, 04/09/2019 #11 |
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RECOMMENDED ACTION(S):
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1. |
Approve the Master Agreement with various licensed clinical providers for provision of Professional Services, for the term of September 29, 2021, through September 28, 2022, for an amount not to exceed $6,297,285. |
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2. |
Authorize the County Procurement Office or authorized Deputy to execute the individual contracts under the Master Agreement with various licensed clinical providers as referenced in the Recommended Action above. |
SUMMARY:
Approval of the Master Agreement with various licensed clinical providers for provision of Professional Services will provide a mechanism to flexibly adjust vital medical staffing in various locations, including jails and clinics, and adapt to changing caseload requirements.
BACKGROUND INFORMATION:
Prior Board of Supervisors (Board) Actions:
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Board Date |
Contract |
Action |
Term |
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April 9, 2019 |
Master Agreement Approved |
Board-approved addition/modification of Contract Psychiatrist - Institutional Classification and Rate Chart |
September
29, 2018, through |
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September 10, 2019 |
Master Agreement Approved |
Board-approved Master Agreement |
September 29, 2019, through September 28, 2020 |
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August 25, 2020 |
Master Agreement Approved |
Board-approved Master Agreement |
September 29, 2020, through September 28, 2021 |
The Health Care Agency (HCA) provides essential medical, dental, behavioral and other support services through its Public Health, Behavioral Health, Medical Health and Correctional Health Services programs. HCA has historically contracted with health care professionals to augment essential services provided to clients. The availability of contracting for these services provides the flexibility needed to maintain levels of services required by state and other mandates, as well as conditions of eligibility for state and federal funding. It provides a mechanism to flexibly adjust vital medical staffing in various locations, including the jails and clinics, and to adapt to changing caseload requirements. These Professional Services Contractors (PSC) help to fill gaps in assignments, such as weekend schedules and unexpected vacancies, augment base staffing levels in times of increased demand and meet caseloads for court-ordered clients. In addition, many of these PSCs are actively working in the Orange County medical community assisting HCA in meeting community standards for health care.
The current individual contracts under the Master Agreement expire on September 28, 2021. Maintaining competitive rates is critical in order to recruit and retain licensed medical staff, particularly for the Correctional Health Services programs. HCA is proposing to increase PSC rates to adjust for salary impacts approved by your Honorable Board on April 9, 2019. The current PSC rates approved by your Board on August 25, 2020, and proposed rates for all PSC classifications are listed below.
The contracted hourly rates in the current Master
Agreement for FY 2020-21, as well as the proposed contract hourly rates in the
new Master Agreement for FY 2021-22, by category, are as follows and noted in
Attachment D, PSC Rate Chart:
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PROFESSIONAL
SERVICES CONTRACTOR |
CURRENT RATE |
PROPOSED RATE |
PROPOSED %
INCREASE |
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CLINICAL PSYCHOLOGIST - INTERN |
$53.04 |
$54.37 |
2.5% |
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CLINICAL PSYCHOLOGIST |
$55.98 |
$57.38 |
2.5% |
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REGISTERED NURSE |
$54.04 |
$55.40 |
2.5% |
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REGISTERED NURSE - CORRECTIONAL |
$64.13 |
$65.74 |
2.5% |
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NURSE PRACTITIONER |
$71.51 |
$73.30 |
2.5% |
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NURSE PRACTITIONER - CORRECTIONAL |
$84.14 |
$86.24 |
2.5% |
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DENTIST |
$88.81 |
$91.04 |
2.5% |
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PHARMACIST |
$75.48 |
$77.37 |
2.5% |
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PHYSICIAN I |
$101.73 |
$104.27 |
2.5% |
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PHYSICIAN I - BOARD ELIGIBLE SPECIALIST |
$99.97 |
$113.14 |
13.2% |
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PHYSICIAN I - BOARD CERTIFIED SPECIALIST |
$116.52 |
$119.44 |
2.5% |
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PHYSICIAN I - CORRECTIONAL |
$116.52 |
$119.44 |
2.5% |
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PHYSICIAN I - BOARD ELIGIBLE SPECIALIST - CORRECTIONAL |
$126.38 |
$129.54 |
2.5% |
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PHYSICIAN I - BOARD CERTIFIED SPECIALIST - CORRECTIONAL |
$133.44 |
$136.77 |
2.5% |
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PSYCHIATRIST |
$150.00 |
$150.00 |
0.0% |
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PSYCHIATRIST - CORRECTIONAL |
$225.00 |
$225.00 |
0.0% |
HCA appropriations for PSC services for FY 2021-22 will increase by approximately $81,000 from FY 2020-21 as a result of these proposed rate increases and will be absorbed within HCA's appropriations. This increase is necessary to ensure compliance with mandated health services and enhance patient care delivery.
These positions provide direct clinical patient care and, because there is a wide variety of classifications involved (Medical Doctor, Registered Nurse, Pharmacist, etc.), there are varying expectations for each classification based upon their specific professional licensure. Qualitative internal monitoring of clinical performance is ongoing, as each PSC is assigned to a supervisor/manager, and clinical performance issues are addressed and documented per County guidelines. Annually, each individual contracted provider’s performance is reviewed by the program service area in order to determine whether individual contract renewal or termination is warranted.
Approving the Master Agreement and authorizing the execution of individual contracts with contracting providers will allow for the continuity of services to vulnerable client populations. The list of anticipated professional services providers for FY 2021-22 is noted in Attachment E. HCA may execute contracts with additional licensed clinical providers to meet service needs.
The contractors’ performances have been confirmed as satisfactory. HCA has verified there are no concerns that must be addressed with respect to contractors’ ownerships/names, litigation status or conflicts with County interests.
The Master Agreement does not currently include subcontractors or pass through to other providers. See Attachment B for Contract Summary Form.
The County has historically indemnified these health care professionals from any and all claims resulting from acts or omissions while acting on HCA's behalf, pursuant to the terms of the Master Agreement. County Executive Office/Office of Risk Management has approved the indemnification provision and determined the risk to be acceptable for these services. See Attachment F for a Risk Assessment Form.
HCA requests that the Board approve the Master Agreement for provision of Professional Services as referenced in the Recommended Actions.
FINANCIAL IMPACT:
Appropriations for this Master Agreement are included in Budget Control 042 FY 2021-22 Budget and will be included in the budgeting process for future years. This Master Agreement does not have individual maximum obligations, as the Professional Services Contract individuals are paid through the County's payroll system, rather than by invoice.
The Professional Services Contract has provisions that allow for immediate termination of the contract by either party without cause.
Funding Sources
GF: 50%
State: 43%
Federal: 3%
Fees/Other: 4%
The funding percentages are aggregate of funding sources within multiple programs anticipated to utilize this agreement.
STAFFING IMPACT:
N/A
ATTACHMENT(S):
Attachment A - Master Agreement MA-042-20011926 Provision
of Professional Services
Attachment B - Contract Summary Form
Attachment C - Redline Version to Attachment A
Attachment D - PSC Rate Chart
Attachment E - List of Anticipated Contracting Providers
Attachment F - Risk Assessment Form