Title
Approve and authorize the Director of Health, or Assistant Director of Health, to execute Amendment No. 3 to Agreement with Medical Doctor Associates, d.b.a Cross Country Locums (Cross Country), addressing changes in laws applicable to staffing agencies, and increasing the contract amount by $570,000 for a revised contract amount not to exceed $1,720,000 for locum tenens healthcare provider referrals, effective upon execution by both parties through June 30, 2022.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
Approve and authorize the Director of Health, or Assistant Director of Health, to execute Amendment No. 3 to Agreement with Medical Doctor Associates, d.b.a Cross Country Locums (Cross Country), addressing changes in laws applicable to staffing agencies, and increasing the contract amount by $570,000 for a revised contract amount not to exceed $1,720,000 for locum tenens healthcare provider referrals, effective upon execution by both parties through June 30, 2022.
SUMMARY/DISCUSSION:
The Health Department Clinic Services Bureau (Clinic Services) operates ten community clinic sites designated as Federally Qualified Health Centers (FQHCs) which provide preventive, primary, and specialty medical care services.
Clinic Services engages in Locum Tenens services in times of critical medical need when sufficient permanent staffing is not available in clinic due to circumstances such as resignations, extended leaves and increases in demand for services. The Board of Supervisors approved Agreement No. A-12773 on June 23, 2015 with Medical Doctor Associates (MDA) for the provision of temporary physician, nurse practitioner, and physician assistant health care placement services to Clinic Services. Amendment No. 1 was executed on July 1, 2018 to extend services for an additional two years. Since then, MDA has changed its name to Cross Country Locums, while maintaining seamless and uninterrupted service availability to Clinic Services. The Board of Supervisors approved Amendment No. 2 on June 16, 2020 for an additional two (2) years and increasing the contract to $1,150,000.
Clinic Services has been utilizing Locum Tenens Internist Physicians to provide full-time services at the Laurel Internal Medicine Clinic since April 2020 until the vacancy can be filled, and multiple Locum Tenens Nurse Practitioners and Physician Assistants (Advanced Practitioners) have been utilized for coverage since March 2020 to ensure Clinic Services has adequate staffing to support emergency response and recovery from the COVID-19 pandemic.
In December 2020, Cross Country notified Clinic Services that Assembly Bill 5, the California bill that clarifies the criteria for classifying individuals as independent contractors in California. As a result, locum advanced practitioners (i.e. Nurse Practitioners and Physician Assistants) working on behalf of Cross Country are now classified as employees as of January 1, 2021. This Amendment includes the new requirements imposing 720-hour per fiscal year work-hour limitations for the advanced practitioners in the same way they apply to temporary workers. This change does not affect locum tenens Physicians.
Approval of this Amendment will allow the additional funding required for Cross Country to continue providing locums tenens and temporary worker coverage needed to meet primary care and COVID-19 response and recovery support during ongoing provider absences and/or shortages.
This work supports the Monterey County Health Department 2018 - 2022 Strategic Plan initiative(s): Ensure access to culturally and linguistically appropriate customer-friendly, quality health services. It also supports one or more of the ten essential public health services, specifically: 7) Link people to needed personal health services and assure the provision of health care when otherwise unavailable; and 8) Assure competent public and personal health care workforce.
OTHER AGENCY INVOLVEMENT:
The Office of County Counsel has approved this Amendment No. 3 as to form.
FINANCING:
Sufficient funds are available in the FY 2021-2022 Proposed Budget for Clinic Services Bureau, Health Department (4000-HEA007). There is no financial impact to the General Fund resulting from approval of this Amendment No. 3.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Check the related Board of Supervisors Strategic Initiatives:
☐Economic Development:
• Through collaboration, strengthen economic development to ensure a diversified and healthy economy.
☐Administration:
• Promote an organization that practices efficient and effective resource management and is recognized for responsiveness, strong customer orientation, accountability and transparency.
☒Health & Human Services:
• Improve health and quality of life through County supported policies, programs, and services; promoting access to equitable opportunities for healthy choices and healthy environments in collaboration with communities.
☐Infrastructure:
• Plan and develop a sustainable, physical infrastructure that improves the quality of life for County residents and supports economic development results.
☐Public Safety:
• Create a safe environment for people to achieve their potential, leading businesses and communities to thrive and grow by reducing violent crimes as well as crimes in general.
Prepared by: Prisca Segovia, Management Analyst II, 755-4939
Approved by:
______________________________Date: _________
Elsa Mendoza Jimenez, Director of Health, 755-4526
Attachments:
Amendment No. 3
Amendment No. 2
Amendment No. 1
Agreement