REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 27, 2023
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Contract Physicians Contract Template
End
RECOMMENDATION(S)
Recommendation
1. Approve contract template for contract physicians to provide ongoing psychiatric and/or other physician services, in the total not to exceed amount of $34,223,532, for the period of July 1, 2023 through June 30, 2028.
2. Authorize the Assistant Executive Officer or Director of the Department of Behavioral Health to execute the contract template with the individual contract physicians, effective upon the date of execution through June 30, 2028, on behalf of the County, subject to County Counsel review.
(Presenter: Georgina Yoshioka, Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Create, Maintain and Grow Jobs and Economic Value in the County.
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). The total amount for services will not exceed $34,223,532 and will be funded by Federal Financial Participation Drug and Mental Health Medi-Cal, Mental Health Services Act, and 1991 and 2011 Realignment funds. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2023-24 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
As the Mental Health Plan and Drug Medi-Cal Organized Delivery System for San Bernardino County (County), DBH is required to provide a qualified network of psychiatric providers to ensure timely access to mental health services. DBH is mandated by the California Department of Health Care Services to maintain a panel of qualified psychiatrists to provide medication support services, as specified in California Code of Regulations, Title 9, Sections 1810.225 and 623.
DBH has utilized a Board of Supervisors (Board) approved contract template for the required contract physician services since 2007, with the most recent approved on May 21, 2019 (Item No. 41). The recommended contract physicians contract template will allow psychiatric and/or other physician services to continue through June 30, 2028. Contracts may be terminated with or without cause upon 14 days’ written notice by either party.
DBH utilizes a mixture of regular positions and contracted services of specialized medical personnel, including psychiatrists and other physicians, for the treatment of adults and children with a mental illness and/or substance use disorder. Due to the current and projected severe shortage of qualified physicians and psychiatrists available to provide these services, recruiting and retaining physicians is extremely competitive.
In collaboration with Human Resources, DBH has developed a recruitment and retention strategy to assist with improving recruitment outcomes for regular positions. This includes succession planning comprised of mentoring, support, County-offered trainings and internal DBH trainings through the department’s Workforce, Education and Training group.
Therefore, to support hiring strategies, the previously approved physicians contract template was updated to properly align salary and benefits with the regular classification to prevent equity concerns and to support contract staff in transitioning into regular positions should they elect to move to a fulltime assignment.
The executed contract for each individual may differ by classification, salary range, and the number of hours worked. The amount of actual psychiatric services used is based upon budgeted clinic physician hours. Compensation for psychiatric and physician services varies dependent upon the position classification and scope of work. The following salary grade designation, aligned with the County’s Professional Unit Memorandum of Understanding, outlines the compensation for individual contract physicians:
|
Contracted Position Classification |
Maximum Rate |
|
Physician with Postgraduate Training License |
Salary Range P1/Step 4 |
|
Psychiatrist I |
Salary Range P1 |
|
Psychiatrist II/Behavioral Health Physician II |
Salary Range P2 |
|
Child Psychiatrist |
Salary Range CP |
|
Senior Psychiatrist/Behavioral Health Physician |
Salary Range P3 |
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Ellayna Hoatson, Administrative Supervisor, 388-0858) on June 1, 2023; County Counsel (Cynthia O’Neill, Principal Assistant County Counsel, 387-5455) on June 5, 2023; Human Resources (Gina King, Assistant Director, 388-0821) on June 22, 2023; Finance (Christopher Lange, Administrative Analyst, 386-8392) on June 2, 2023; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on June 8, 2023.