Approve and authorize the Chairman to sign a retroactive renewal agreement with Okechukwu Nwangburuka, MD, in the amount of $249,600 per fiscal year for the provision of psychiatry services for the period July 1, 2016 through June 30, 2019.

This renewal agreement will allow Dr. Nwangburuka to continue to provide ongoing psychiatry services.  Services include conducting initial assessments and follow-up psychiatric medical visits via video teleconference.  The proposed renewal agreement will allow (HHSA) Children’s Services Branch to maintain a consistent, timely source of psychiatry, and continue to provide a high level of expertise for the treatment.

Dr. Nwangburuka is licensed as a physician by the Medical Board of California, is a Diplomate in Psychiatry certified by the American Board of Psychiatry and Neurology, and is Board Certified in Child and Adolescent Psychiatry, General Adult Psychiatry and Psychosomatic Medicine by the same organization.

Under the proposed retroactive renewal agreement Dr. Nwangburuka will continue to conduct initial psychiatric assessments, prescribe appropriate medications, and explain possible medication side effects to the family or other caregivers.  Additionally, he will continue to provide follow-up medication monitoring visits, re-order medications as needed, monitor lab results and consult with HHSA Children’s Services Branch nursing and other clinical staff.  Under the terms of the agreement, Dr. Nwangburuka will provide psychiatric medical services via video teleconference from his medical office in Sacramento.  

This proposed renewal agreement reflects Shasta County’s continuing efforts to ensure sufficient quality psychiatric services are available to clients. Dr. Nwangburuka provides flexibility in working clients  into his schedule that are in need of immediate care, and that he has been consistently available by phone to consult and direct staff throughout the work week.  The contract with Dr. Nwangburuka provides a consistent, reliable and high quality resource for psychiatric care.

The agreement has a proposed hourly rate of $220 per hour for physician time, and $40 per hour for support staff time, if needed.  These rates are within the amount reimbursable by Medi-Cal for psychiatric treatment.  The contract maximum remains the same as in prior years. By comparison, rates paid to contracted locum tenens psychiatrists are somewhat lower (currently $185 - $190 per hour), however, locum tenens agencies have been unsuccessful in placing Board Certified child psychiatrists specializing in young children’s services with Shasta County. Additionally locum tenens placements are typically short term. Current contracts with organizational providers who serve children in out of county placements include reimbursement rates of up to $289 per hour for Psychiatry, based on the Medi-Cal cost reimbursement system.  This is reflective of the scarcity of and high demand for child psychiatrists across the state.   Children’s Services continues to seek psychiatry resources to ensure adequate coverage for our clients is consistently available.

This agreement is retroactive due to unexpected delays in the time necessary to refine contract language and finalize the agreement.

The Board could choose to not approve the agreement, defer consideration to a future date, or provide direction to staff to negotiate changes to the agreement. 

County Counsel has reviewed the agreement and approved it as to form.  Risk Management has reviewed and approved the agreement.  The recommendation has been reviewed by the County Administrative Office.