REPORT TO SHASTA COUNTY BOARD OF SUPERVISORS

BOARD MEETING DATE:  September  13, 2022
CATEGORY:  Consent - Health and Human Services-11.

SUBJECT:

Approve a retroactive agreement with Aloha Psychiatry for telepsychiatry services in an amount not to exceed $1,475,000.

Supervisorial District No. :  All

DEPARTMENT CONTACT:  Miguel Rodriguez, Interim Branch Director, HHSA Adult Services, (530) 225-5900

STAFF REPORT APPROVED BY:  Laura Burch, Acting Director, Health and Human Services Agency

RECOMMENDATION

Approve a retroactive agreement, effective September 1, 2022, with Aloha Psychiatry in an amount not to exceed $1,475,000 to provide telepsychiatry services for the period September 1, 2022, through June 30, 2025.

DISCUSSION

This is a new contract to provide medically necessary mental health services to Shasta County clients.  Aloha Psychiatry is a contractor that is familiar with Shasta County clients. That knowledge increases efficiency and lowers costs given their familiarity with Shasta County’s practices and Electronic Health Record (EHR). The proposed agreement will allow Shasta County to have continued access to a psychiatrist through a new vendor, Aloha Psychiatry (Aloha), as needed during periods of psychiatrist staffing shortages in both Adult and Children’s Services.

The proposed agreement would authorize Aloha to provide psychiatry services for our target population.  Providing medically necessary psychiatric treatment is a County obligation for Medi-Cal clients receiving specialty mental health services pursuant to the agreement between the State Department of Health Care Services and Shasta County.   There can be significant health disparities for adults living with serious mental illness (SMI) or co-occurring disorders (SMI/SUD), and children with Serious Emotional Disturbance (SED).  Several studies state that people living with serious mental illness die an average of 25 years earlier than those without SMI.  Some of the increase in morbidity and mortality can be attributed to behavioral risk factors such as, smoking, obesity, physical inactivity, or poor medication adherence, as well as difficulties in navigating systems and accessing care.

While the Health and Human Services Agency (HHSA) continues to actively recruit for an additional full-time psychiatrist, additional psychiatric services continue to be needed throughout the year and continue to be challenging to obtain. Without adequate psychiatric resources, Shasta County is less able to address the most devastating symptoms of serious mental illness that require prescription medication(s).

This agreement is retroactive due to negotiations with a new contractor for complex services with very specific County, state, and federal requirements. The contractor has been providing services to the County via the California Locum Tenens agreement; therefore, transitioning from that agreement to a new agreement was a bit more complex than usual and required negotiations with both parties.

ALTERNATIVES

The Board could choose not to approve the recommendation, defer consideration to a future date, or provide alternate direction to staff.

OTHER AGENCY INVOLVEMENT

County Counsel has approved the agreement as to form.  Risk Management and County Information Technology have approved the agreement. This recommendation has been reviewed by the County Administrative Office.

FISCAL IMPACT

The total cost of this agreement for Fiscal Years (FY) 2022-25 is $1,475,000.  Costs incurred through this contract are funded through Mental Health (BU 410).  Adult Services’ and Children’s FY 2022-23 Adopted Budget includes sufficient appropriation authority for the activities described in this agreement and will be included in future budget submittals.  Revenue to offset approximately 50 percent of the cost of psychiatric services is reimbursed from Medi-Cal, with the local share of cost met largely though Realignment. There is no additional General Fund impact.