Agenda Item   

AGENDA STAFF REPORT

 

                                                                                                                        ASR Control  25-000535

 

MEETING DATE:

09/23/25

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 

 

 

Joanne Lim (714) 647-6048

 

 

Subject:  Renewal for On-Site Psychiatry and Telepsychiatry Services

 

     ceo CONCUR

County Counsel Review

Clerk of the Board

          Concur

Approved Agreement to Form

Discussion

 

 

3 Votes Board Majority

 

 

 

    Budgeted: Yes

Current Year Cost:  $3,800,000

Annual Cost: FY 2026-27 $8,925,915

 

 

 

    Staffing Impact:

No

# of Positions:           

Sole Source:   No

    Current Fiscal Year Revenue: N/A

   Funding Source:    GF: 67%, State: 33% (Realignment)

County Audit in last 3 years: No

   Levine Act Review Completed: Yes

 

    Prior Board Action:         8/27/2024 #13, 3/14/2023 #26

 

RECOMMENDED ACTION(S):

 

 

1.

Approve Amendment No. 4 to renew the Master Contract with various providers for the provision of On-Site Psychiatry and Telepsychiatry Services for the term April 1, 2026, through March 31, 2027, renewable for one additional one-year term, and to increase the contract’s aggregate amount not to exceed by $12,725,915, for a revised amount not to exceed $36,229,575, effective October 1, 2025, through March 31, 2027.

 

 

2.

Authorize County Procurement Officer or Deputized designee to execute Master and individual amendments with Bridge Telehealth, Lavaca Street Ventures, LLC, and Orbit Health, as referenced in the Recommended Action above.

 

 

 

 

SUMMARY:

 

Approval of Amendment No. 4 to the Master Contract with various providers for the provision of On-Site Psychiatry and Telepsychiatry Services will allow for continued on-site and telehealth mental health services for patients under the care of Behavioral and Correctional Health Services in custody in the County of Orange detention facilities.

 

 

 

 

BACKGROUND INFORMATION:

 

The County of Orange (County) is mandated to provide medical care to persons in the County's custody pursuant to State of California Penal Code Sections 4011 and 4015 and Government Code Section 29602. The Health Care Agency's (HCA) Correctional Health Services (CHS) division is the designated provider of health care to adult persons in custody on behalf of the Orange County Sheriff's Department. Over the past decade, the number of mental health cases within the jail system has risen significantly. This upward trend has continued in recent years, with a 10 percent increase from 2023 to 2024, and an additional 24 percent increase from 2024 to the present. The average jail daily population is 3,941 individuals. CHS provides mental health care to approximately 58 percent of this population. These services include, but are not limited to, psychiatric evaluation, development of treatment plans, medication management and crisis intervention and management. Historically recruitment for psychiatrists and mental health nurse practitioners has proven to be difficult due to the competitive market, work environment, nature of the work location and the extensive background process. As such a renewal for these services is needed to provide the required medical care.   

The Orange County Preference Policy is not applicable to these Contracts.

 

The actions below have been executed pursuant to appropriate authorities:

 

Board Date

Contract/Amendment

Action

Term

March 14, 2023

Contract

Board Approved Contract

April 1, 2023-March 31, 2026

N/A

 

Amendment No. 1

Deputy Purchasing Agent (DPA), Delegated Authority, Administrative Revision

April 1, 2023-March 31, 2026

August 27, 2024

Amendment No. 2

Board Approved Increase

April 1, 2023-March 31, 2026

N/A

 

Amendment No. 3

DPA, Delegated Authority, Administrative Revision

April 1, 2023-March 31, 2026

 

Scope of Services

The contract outcomes call for psychiatric evaluations for each custody patient that meet the referral criteria for further evaluation after an extensive intake screening. Psychiatric evaluations include a review of each Custody Patient’s medical and psychiatric history, diagnosis, and treatment plan. This criteria is met for the 58 percent of the population receiving mental health care.

 

As of June 2025, CHS provided care to 2,290 mental health patients on a daily basis. Staffing levels are revised to reflect the current service demands and ensure continued compliance to care standards. This Master Contract is established to provide both telepsychiatry and on-site psychiatric contract personnel for patient care services within Adult CHS. These services include, but are not limited to, psychiatric evaluation, development of treatment plans, medication management and crisis intervention and management for this patient population. As this is a contract for contracted personnel for patient care services for inmates, traditional performance measures are not required; however, HCA does review the following: time needed to fill requests, retention rates, quality of hires, candidates experience, and background screenings to ensure the contracted personnel meet required care standards. 

 

The Contracts with Bridge Telehealth, Lavaca Street Ventures, LLC, and Orbit Health, do not currently include subcontractors or pass throughs to other providers. The Contractors’ performance has been confirmed as satisfactory. HCA has verified there are no concerns that must be addressed with respect to Contractor’s ownership/name, litigation status or conflicts with County interests. See Attachment E for Contract Summary Forms.

 

 

 

 

FINANCIAL IMPACT:

 

Appropriations for this Contract are included in Budget Control 042 FY 2025-26 Budget and will be included in the budgeting process for future years.

 

The Contracts include provisions allowing HCA to terminate the Contracts, reduce the level of services, and/or renegotiate the levels of services provided, as necessary. This includes a notice that allows HCA adequate time to transition or terminate services to clients, if necessary.

 

 

 

STAFFING IMPACT:

 

N/A

 

 

 

ATTACHMENT(S):

 

Attachment A – Amendment No. 4 to Master Contract MA-042-23010987 for On-Site Psychiatry and Telepsychiatry Services
Attachment B – Amendment No. 4 to Contract MA-042-23010987 with Bridge Telehealth
Attachment C – Amendment No. 4 Contract MA-042-23010987 with Lavaca Street Ventures, LLC Attachment D – Amendment No. 4 to Contract MA-042-23010987 with Orbit Health
Attachment E – Contract Summary Form
Attachment F – State and Government Codes