Title
Authorize the Interim Chief Executive Officer for Natividad Medical Center (NMC) or a designee to execute Renewal and Amendment No. 5 to the Agreement (A-16532) with Triage LLC (formerly RTG MSP Medical, LLC dba RTG Medical) for the provision of staff procurement management services, extending the Agreement for an additional one year period (August 1, 2026 through July 31, 2027) for a revised full Agreement term of August 1, 2023 through July 31, 2027, and adding $4,000,000 for a revised total Agreement amount not to exceed $22,200,000.
Report
RECOMMENDATION:
It is recommended the Board of Supervisors:
Authorize the Interim Chief Executive Officer for Natividad Medical Center (NMC) or a designee to execute Renewal and Amendment No. 5 to the Agreement (A-16532) with Triage LLC (formerly RTG MSP Medical, LLC dba RTG Medical) for the provision of staff procurement management services, extending the Agreement for an additional one year period (August 1, 2026 through July 31, 2027) for a revised full Agreement term of August 1, 2023 through July 31, 2027, and adding $4,000,000 for a revised total Agreement amount not to exceed $22,200,000.
SUMMARY:
Approval of Renewal and Amendment No. 5 will ensure NMC maintains access to qualified supplemental clinical personnel needed to support ongoing workforce challenges and operational demands. The renewal and amendment extends the agreement for one year, increases the maximum compensation amount, and updates the approved rate schedule to reflect current market conditions. Continued availability of registry staffing is critical to maintaining safe staffing levels, supporting uninterrupted operations, and ensuring the delivery of high-quality patient care.
DISCUSSION:
Triage LLC provides supplemental clinical personnel through a network of more than thirty specialized healthcare staffing agencies. These services support critical, high-demand patient care areas, including the Emergency Department, Intensive Care Unit, Intermediate Care Unit, Labor and Delivery, Surgery, Neonatal Intensive Care Unit, Mother-Baby Unit, Psychiatric Services, and Rehabilitation Services, as well as ancillary departments such as Physical Therapy, Speech Therapy, Occupational Therapy, Diagnostic Imaging, Interventional Radiology, Clinical Laboratory Services, Dietetics, and Pharmacy.
Like healthcare organizations nationwide, NMC continues to experience workforce shortages and increased competition for qualified healthcare professionals. Vacancies, employee resignations, leaves of absences, and recruitment challenges have increased reliance on supplemental personnel to maintain safe staffing levels, support uninterrupted operations, and ensure the continued delivery of high-quality patient care.
The amendment also revises the approved registry rate schedule to better reflect current market conditions and provide NMC with the flexibility to respond to fluctuations in staffing supply and demand. This flexibility is essential to securing qualified temporary personnel for critical positions throughout the organization.
The Labor and Delivery department continues to be one of the most challenging areas to recruit and retain qualified nurses. Thus, the need to maintain core staffing levels has created an urgent need for additional registry support. The revised rate ranges will enhance NMC's ability to attract qualified registry nurses and other clinical personnel, maintain safe staffing levels, meet operational requirements, and ensure continued access to high-quality maternal and newborn care.
OTHER AGENCY INVOLVEMENT:
The Office of County Counsel has reviewed and approved this Renewal and Amendment No. 5 as to form, and the Auditor-Controller has reviewed and approved as to payment provisions. Renewal and Amendment No. 5 has also been reviewed and approved by NMC’s Finance Committee and by its Board of Trustees on July 10, 2026.
FINANCING:
The cost for this Renewal and Amendment No. 5 is $4,000,000, which is included in the FY 2026-27 Adopted Budget. There is no impact on the General Fund with this action.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
This Agreement significantly enhances NMC's ability to respond to critical staffing needs in a timely and effective manner. Renewal and Amendment No. 5 ensures continued access to qualified nurses and other clinical personnel when needed, helping NMC maintain appropriate staffing levels and meet patient care demands. Additionally, by ensuring a stable and skilled clinical workforce, this Agreement supports the County of Monterey's strategic priority of workforce engagement and organizational excellence. By supporting the delivery of high-quality healthcare services, this Agreement contributes to improved health outcomes and an enhanced quality of life for patients and their families.
__ Economic Development
__ Administration
X Health and Human Services
__ Infrastructure
__ Public Safety
Prepared by: Janine Bouyea, Chief People Operations Officer, 831-783-2701
Approved by: Nancy Buscher, Interim Chief Executive Officer, 783-2560
Attachments:
Board Report
Triage LLC Renewal and Amendment No. 5
Triage LLC Amendment No. 4
Triage LLC Amendment No. 3
Triage LLC Amendment No. 2
RTG Medical MSP, LLC. dba RTG Medical Amendment No. 1
RTG Medical MSP, LLC. dba RTG Medical Agreement
Attachments on file with the Clerk of the Board