Agenda

Return

D.4

To:	Board of Supervisors
From:	William Walker, M.D., Health Services Director
Date:	March 7, 2017

Contra

Costa

County

Subject:

Amendment #26-577-14 with All Health Services Corporation

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 03/07/2017

APPROVED AS RECOMMENDED

OTHER

Clerks Notes:

VOTE OF SUPERVISORS

AYE:

John Gioia, District I Supervisor
Candace Andersen, District II Supervisor
Diane Burgis, District III Supervisor
Karen Mitchoff, District IV Supervisor
Federal D. Glover, District V Supervisor

Contact:	Anna Roth, (925) 370-5101
cc:	Kathleen Cyr Marcy Wilhelm

I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown.
ATTESTED: March 7, 2017
David Twa,

BY:	, Deputy

RECOMMENDATION(S):

Approve and authorize the Health Services Director, or his designee, to execute, on behalf of the County, Contract Amendment Agreement #26-577-14 with All Health Services Corporation, effective February 1, 2017, to amend Contract #26-577-12 (as amended by Amendment Agreement #26-577-13), as follows: (1) to increase the payment limit by $600,000, from $3,842,000 to a new maximum payment limit of $4,442,000, and 2) change the termination date from September 30, 2017 to April 30, 2017; or

Approve and authorize the Auditor-Controller, or his designee, to pay an amount not to exceed $150,000 to All Health Services for services rendered to the Contra Costa Regional Medical Center, clinics, and detention facilities through March 7, 2017.

RECOMMENDATION(S): (CONT'D)

FISCAL IMPACT:

Upon approval of either the first or second recommendation above, payments of a maximum of $600,000 will be covered by Hospital Enterprise Fund I. No rate increase will be included in either contract amendment.

BACKGROUND:

On October 20, 2015, the Board of Supervisors approved Contract #26-577-12 (as amended by Amendment Agreement #26-577-13) with All Health Services Corporation, for the provision of temporary medical staffing services at the Contra Costa Regional Medical Center and Health Centers (CCRMC) and Detention facilities, including registered nurses, licensed vocational nurses (LVN), and certified medical assistants (CMA), through September 30, 2017.

On November 1, 2016 the Board rescheduled the department’s request to increase the payment limit of this contract by $2,389,412 to a new payment limit of $4,356,412 through September 30, 2017, to a future meeting date to address the concerns brought to their attention by Teamsters Local 856. This union represents LVN and CMA classifications in Contra Costa.

After five (5) meet and confers with Teamsters, the department re-submitted to the Board, at their December 6, 2016 meeting, a request to increase the payment limit of this contract by $1,875,000 for a new payment limit of $3,842,000, effective July 1, 2016, through September 30, 2017. This amendment, which included a significant decrease in scope, was agreeable to both Teamsters and the County at that time.

Since December 6, 2016, despite significant efforts to permanently fill vacant positions, the County continues to face a shortage of permanent personnel and per diems to cover necessary shifts. The County engaged in three (3) additional meet and confers (February 6, 10, and 16, 2017) with Teamsters Local 856 to discuss this contract and the need to continue providing services to our patients while the County works to fill its vacant LVN and CMA positions. The union does not agree to amend or renew this contract; however, it is not feasible for the Health Services Department to provide the necessary medical services without maintaining contracts for the services offered by this contract.

The County has implemented various efforts to minimize the utilization of this contract, which includes prioritizing LVN and CMA hiring. As of February 27, 2017, the County has made 31 permanent LVN and 10 CMA job offers. Additionally, the County is actively working through various hiring processes for the remaining 19 LVN and 10 CMA vacancies, which are all either currently open for bid or have interviews scheduled. This contract is critical to ensuring that services throughout the health clinics and detention health are not interrupted while the County works through the entire hiring process. Even with all of these positions filled, there will be an ongoing need for these services to prevent disruption of clinical patient care at detention and health clinic facilities.

In order to ensure continuity of patient care while the County is conducting interviews and working with selected candidates through the background, physical and other pre-employment requirements, the department is requesting an additional $600,000 for this contract to cover staffing needs through April 30, 2017. This will result in a contract payment limit of $4,442,000 and shorten the term from September 30, 2017 to April 30, 2017. Approval of this amendment will allow the County to continue to provide patient care services through April 30, 2017 while the County continues to meet with the union, recruit permanent staff and pursue a new contract beginning May 1, 2017 with significantly reduced services at CCRMC, clinics, and detention facilities.

CONSEQUENCE OF NEGATIVE ACTION:

If this amendment is not approved through April 30, 2017, the County will not be able to provide necessary services to patients at CCRMC, clinics, detention facilities and the Contractor will not be paid for services rendered.