Title
a. Authorize the Purchasing Manager for Natividad Medical Center (NMC) to extend the Master Agreements between the County of Monterey ("County"), on behalf of NMC, and Per Diem Staffing formerly known as Agostini Nurse Staffing; American Traveler Staffing Professionals, LLC; C&A formerly known as Aureus Nursing; Randstad North America, LP, formerly Spherion Staffing LLC; Cross Country Staffing, Inc. formerly known as Travel Staff, LLC, Local Staff, LLC., and Assignment America, LLC doing business as Medical Staffing Network; Tempus LLC formerly known as Emerald Health Services; Healthcare Pros; Rise Medical Staffing LLC formerly known as Healthcare One Staffing; HRN Services Inc.; PPR (Professional Placement Resources) Healthcare Staffing; SHC Services Inc. doing business as Supplemental Health Care; Aya Healthcare Inc. formerly known as TG Health Care Services; Premier Healthcare Professionals Inc.; Integrated Healthcare Staffing Inc.;, and; Cirrus Holdings USA (collectively these businesses are known as, "Nurse Registry Agencies currently providing services at NMC") for an additional one year term from July 1, 2015 through June 30, 2016, pursuant to the terms and conditions of RFP #10093; and
b. Authorize a total aggregate amount to $7,000,000 for Fiscal Year 2015-16 for all contracts issued pursuant to RFP #10093, with authority to open purchase orders and distribute these funds for Fiscal Year 2015-16 among all contractors under the Master Agreements in any manner of allocation determined to be appropriate by NMC and County; and
c. Authorize the Purchasing Manager for NMC to enter into Amendment No. 4 to the Master Agreement (RFP #10093), utilizing the template presented, with each of the Nurse Registry Agencies currently providing services at NMC, extending each Master Agreement to June 30, 2016 and appending as an exhibit, as relevant, any revised rate sheet for Fiscal Year 2015-16 that may be negotiated between the County and the Nurse Registry Agency, subject to further review and approval by County Counsel and County Auditor-Controller.
d. Authorize the Deputy Purchasing Agent for NMC to execute future Amendments to the Agreement which do not significantly alter the scope of work and do not cause an increase to the total Agreement amount.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Authorize the Purchasing Manager for Natividad Medical Center (NMC) to extend the Master Agreements between the County of Monterey ("County"), on behalf of NMC, and Per Diem Staffing formerly known as Agostini Nurse Staffing; American Traveler Staffing Professionals, LLC; C&A formerly known as Aureus Nursing; Randstad North America, LP, formerly Spherion Staffing LLC; Cross Country Staffing, Inc. formerly known as Travel Staff, LLC., Local Staff, LLC., and Assignment America , LLC doing business as Medical Staffing Network; Tempus LLC formerly known as Emerald Health Services; Healthcare Pros; Rise Medical Staffing LLC formerly known as Healthcare One Staffing; HRN Services Inc.; PPR (Professional Placement Resources) Healthcare Staffing; SHC Services Inc. doing business as Supplemental Health Care; Aya Healthcare Inc. formerly known as TG Health Care Services; Premier Healthcare Professionals Inc.; Integrated Healthcare Staffing Inc.;, and; Cirrus Holdings USA (collectively these businesses are known as, "Nurse Registry Agencies currently providing services at NMC") for an additional one year term from July 1, 2015 through June 30, 2016, pursuant to the terms and conditions of RFP #10093; and
b. Authorize a total aggregate amount to $7,000,000 for Fiscal Year 2015-16 for all contracts issued pursuant to RFP #10093, with authority to open purchase orders and distribute these funds for Fiscal Year 2015-16 among all contractors under the Master Agreements in any manner of allocation determined to be appropriate by NMC and County; and
c. Authorize the Purchasing Manager for NMC to enter into Amendment No. 4 to the Master Agreement (RFP #10093), utilizing the template presented, with each of the Nurse Registry Agencies currently providing services at NMC, extending each Master Agreement to June 30, 2016 and appending as an exhibit, as relevant, any revised rate sheet for Fiscal Year 2015-16 that may be negotiated between the County and the Nurse Registry Agency, subject to further review and approval by County Counsel and County Auditor-Controller.
d. Authorize the Deputy Purchasing Agent for NMC to execute future Amendments to the Agreement which do not significantly alter the scope of work and do not cause an increase to the total Agreement amount.
DISCUSSION/SUMMARY:
California has state mandated minimum nurse-to-patient ratios for every unit in general acute care hospitals such as NMC. These nurse-to-patient ratios were phased in, beginning 2004, and require: One licensed nurse for every two patients in the intensive care, critical care, and neonatal intensive care units, in post-anesthesia recovery, labor and delivery, and when patients in the emergency room require intensive care. One licensed nurse for every three patients in step-down units. One licensed nurse for every four patients in ante-partum (not active labor), postpartum (1:4 mother-baby couplets) pediatric care, and in the emergency room, telemetry, and other specialty care units. One licensed nurse for every five patients in medical-surgical units. One licensed nurse for every six patients in psychiatric units. In addition, under Emergency Medical Treatment and Labor Act (EMTALA) regulations, NMC cannot refuse to provide treatment to patients who arrive at the hospital with an emergency medical condition or are in active labor.
NMC must predict how many nurses will be needed during multiple shifts of the day and staff accordingly. Nurse staffing needs cannot always be met by regular NMC staff. NMC utilizes the services of nineteen (19) Nurse Registry Companies. NMC continuously assesses staffing needs based on volume. Research was conducted into using a GPO (Group Purchasing Order) for these services, but learned better quality of nurses would be found by continuing to use the nurse registries. In order to continue receiving these state mandated staffing levels, NMC would like to continue the master agreement and all current nurse registry services for the July 2015 to June 2016 fiscal year and add $7,000,000 to cover the services for that year due to higher than expected use of the services. NMC intends to go out for a new RFP for Nurse Registries and Ancillary Services during the next year.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved this Amendment No. 4 as to legal form and risk provisions, and the Auditor-Controller has reviewed and approved as to payment provisions. The Amendment No. 4 has also been reviewed and approved by NMC's Finance Committee on 4/23/15 and by its Board of Trustees on 5/1/15.
FINANCING:
The total cost for Amendment No. 4 is $7,000,000 of which $7,000,000 was included in the NMC Fiscal Year 2015-16 Recommended Budget. The total aggregate amounts for all contracts issued pursuant to RFP #10093 for the full term 11/3/08 through 6/30/16 would be $21,171,279. There is no impact to the General Fund.
Prepared by: Janine Ray-Bouyea, 783-2701
Approved by: Gary R. Gray, DO, Chief Executive Officer, 783-2504
Attachments:
Amendment No.4 with each contracted vendor
One Sample of the Original Agreement and One Sample of Amendment Nos. 1-3
Historical Board Orders
Cross Country Staffing Inc.'s Assignment and Assumption Agreement by and between Travel Staff, LLC, Local Staff, LLC, and Assignment America, LLC DBA Medical Staffing Network ("Assignor") to Cross Country Staffing, Inc. ("Assignee")