SUBJECT
Title
AUTHORIZE COMPETITIVE SOLICITATION AND AN INTERIM CONTRACT WITH TRADITIONS BEHAVIORAL HEALTH FOR MEDICAL SERVICES GROUP SERVICES (DISTRICTS: ALL)
Body
OVERVIEW
The San Diego County Board of Supervisors (Board) has demonstrated an ongoing commitment to ensuring a robust continuum of services to meet the needs of individuals with behavioral health conditions in San Diego County. The San Diego County Psychiatric Hospital (SDCPH) is a critical setting within the local behavioral health continuum of care, providing services for some of the region’s most vulnerable residents. Care and support for operations at SDCPH is largely provided by County of San Diego (County) staff, including nursing, social work, environmental services, recreational therapy, quality assurance, and other staffing categories. Certain services at the hospital, such as physician staffing and other temporary staffing, are provided via contracted providers.
Today’s action requests the Board authorize a competitive solicitation for comprehensive physician staffing services via a medical services group and to authorize an interim contract with Traditions Behavioral Health. Through this interim contract, the medical services group would provide physician staffing, including coverage of clinical and administrative physician functions, during the procurement period. Other categories of staffing would not be impacted.
This item supports the County vision of a just, sustainable, and resilient future for all, specifically those communities and populations in San Diego County that have been historically left behind, as well as our ongoing commitment to the regional Live Well San Diego vision of healthy, safe, and thriving communities. This will be accomplished by ensuring the critical behavioral health workforce that supports the provision of quality care for underrepresented communities.
RECOMMENDATION(S)
CHIEF ADMINISTRATIVE OFFICER
1. In accordance with Board Policy A-87, Competitive Procurement, and Section 401, Article XXIII of the County Administrative Code, approve and authorize the Director, Department of Purchasing and Contracting, to issue a competitive solicitation for physician staffing services via a medical services group and upon successful negotiations and determination of a fair and reasonable price, award contracts for an Initial Term of up to one year, with four 1-year Options, and up to an additional six months, if needed; and to amend the contracts to reflect changes in program, funding or service requirements, subject to the availability of funds and the approval of the Agency Director, Health and Human Services Agency.
2. Waive Board Policy A-87, Competitive Procurement, and in accordance with Administrative Code Section 401, authorize the Director, Department of Purchasing and Contracting, subject to successful negotiations and a determination of a fair and reasonable price, to award a contract to Traditions Behavioral Health for medical services group services, for an initial term of up to one year, with one 1-year option, and up to an additional six months if needed, subject to the availability of funds; and amend the contract as required in order to reflect changes to services and funding allocations, subject to the approval of the Agency Director, Health and Human Services Agency.
EQUITY IMPACT STATEMENT
The vision of the County of San Diego (County) Health and Human Services Agency, Behavioral Health Services is to build a behavioral health services delivery system in which mental health and substance use services are regionally distributed and accessible to all individuals and families who are in need, particularly those vulnerable and traditionally underserved populations. To accomplish this, the County needs a robust and skilled behavioral health workforce. However, there is currently a nationwide, statewide, and local behavioral health worker shortage.
According to the 2022 San Diego Workforce Partnership workforce report, there are approximately 17,000 behavioral health professionals working in San Diego County - 8,000 less than the number needed to meet current and future needs. To meet the behavioral health workforce needs in San Diego County, it is crucial that the County prioritizes actions that both maintain and grow the local behavioral health workforce. Utilizing a medical services group for physician staffing services will ensure the San Diego County Psychiatric Hospital can continue the provision of behavioral health care to the most vulnerable adults with behavioral health needs across San Diego County, including individuals who are at risk of or experiencing homelessness, to reduce local health disparities.
SUSTAINABILITY IMPACT STATEMENT
Today’s proposed action supports the County of San Diego (County) Sustainability Goal #2 to provide just and equitable access to County services and appropriate resource allocation with investments focused on chronically underserved communities and Sustainability Goal #4 to protect the health and well-being of everyone in the region. This will be accomplished by ensuring the San Diego County Psychiatric Hospital can continue providing critical behavioral health care to individuals with chronic behavioral health conditions, who are historically underserved, and ensure the psychological health and well-being of clients.
FISCAL IMPACT
Funds for this request are included in the Fiscal Year (FY) 2024-26 Operational Plan in the Health and Human Services Agency. If approved, this request will result in estimated costs of and revenue of $10.5 million in FY 2024-25 and $10.9 million in FY 2025-26. The funding source will be existing Realignment and Federal Financial Participation. It is anticipated that reduced utilization of other contracts for staffing services will provide sufficient revenue to cover the costs of this new contract. If further appropriations are determined to be necessary in order to cover projected costs, staff would return to the Board as needed. There will be no change in net General Fund cost and no additional staff years.
BUSINESS IMPACT STATEMENT
N/A
Details
ADVISORY BOARD STATEMENT
Information on this item will be shared with the Behavioral Health Advisory Board at their regular meeting on September 5, 2024.
BACKGROUND
The San Diego County Board of Supervisors (Board) has demonstrated an ongoing commitment to ensuring a robust continuum of services is available to meet the needs of individuals with behavioral health conditions in San Diego County. The San Diego County Psychiatric Hospital (SDCPH) is a key part of the local behavioral health continuum of care. SDCPH provides 24/7 acute inpatient psychiatric care and emergency psychiatric services, including psychiatric evaluation and crisis intervention treatment, to adults experiencing a mental health crisis to stabilize them and connect them to ongoing care. This level of care requires staff who are highly skilled in providing clinical and administrative activities. This includes psychiatrists, critical members of the behavioral health workforce who are particularly difficult to recruit and retain.
Today’s action seeks authority to issue a competitive solicitation for physician staffing at the SDCPH through a medical services group and subject to successful negotiations, enter into a contract for such services for an initial term of one year and up to four additional option years, with an additional six months if needed. The medical services group includes both medical leadership and psychiatric physicians.
In order to ensure critical physician functions at SDCPH are fulfilled, authority is also requested to establish an interim contract with Traditions Behavioral Health while the competitive solicitation for physician staffing at the SDCPH through a medical services group is completed. Authority for the interim contract is requested for a term of one year with up to one option year and an additional six months as needed to ensure a successful competitive solicitation for comprehensive staffing services via a medical services group can be completed. Other categories of staffing would not be impacted.
Through extensive research, Traditions Behavioral Health was identified as a common provider of medical services group services with other California counties that provide oversight of psychiatric facilities similar to SDCPH. While there may be other providers able to provide these services, it was determined that Traditions Behavioral Health was uniquely positioned to enter into an interim contract due to their existing contracts providing medical service group services to counties throughout the state and their ability to meet the immediate needs for physician staffing support. During the time period of this interim contract, County staff will continue to provide patient care and support operations as they have across SDCPH. Existing contracts for locum tenens temporary physician staffing support will remain in place to be used on an as-needed basis.
Today’s action requests the Board authorize a competitive solicitation for comprehensive physician staffing via a medical services group and authorize an interim contract with Traditions Behavioral Health. Through this contract, the medical services group would provide physician staffing, including coverage of clinical and administrative physician functions.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
Today’s proposed action supports the County of San Diego 2024-2029 Strategic Plan initiatives of Equity (Health) and Community (Quality of Life) as well as the regional Live Well San Diego vision of healthy, safe, and thriving communities. This will be accomplished by ensuring the critical behavioral health workforce that supports the provision of quality care for underrepresented communities.
Respectfully submitted,
ebony n. shelton
Chief Administrative Officer
ATTACHMENT(S)
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