Upon approval, this action has an annual cost of approximately $27,729, which is fully funded by Mental Health Realignment funds.  

Karen Ramirez retired from County Service on April 4, 2019 after nearly 19 years of service as a Psychiatric Technician in the County's Mental Health Division.  
  
Beginning in February 2018, the California Department of Health Care Services required the County Mental Health Plan (MHP) to comply with Federal Network Adequacy Standards quarterly reporting, imposed by the Center for Medicare and Medicaid Services. The MHP Plan is mandated to complete quarterly GeoMapping of zip codes where mental health consumers live and the service location of providers for both county-operated programs and contracted community-based organizations. This regulation is required to ensure the County has adequate staffing capacity to meet the service needs of its mental health consumers.   
  
Recruitment of psychiatrists in the Bay Area is challenging, even more so in the eastern part of the County. In order improve access and meet the Federal Network Adequacy Standards, the MHP recently hired a psychiatrist to perform Telepsychiatry Services for East County mental health consumers. This service delivery model requires a medical staff to be physically present locally with the consumer, and perform a wide range of services before, during and after the Telepsychiatry visit. Ms. Ramirez is a licensed psychiatric technician (LPT) who has the required training and qualifications to perform all nursing-related duties of Telepsychiatry Services under the direction of the psychiatrist. Hiring Ms. Ramirez in a temporary capacity is necessary in order to support the Telepsychiatry Services for mental health consumers in East County and stay in compliance with the Federal Network Adequacy Standards.   
  
The recruitment for this classification is open continuous but applications are few and far in between. During the last hiring interview, there were only two (2) names on the eligible list and both candidates declined the interview. The Department is impacted by psychiatric technician staffing shortages across the region and will focus on additional outreach to increase the candidate pool.

If this action is not approved, the Health Services Department will not have adequate staff which negatively impacts the patient services for mental health consumers in East Contra Costa County.