To: Board of Supervisors
From: DHHS: Behavioral Health
Agenda Section: Consent
Vote Requirement: Majority
SUBJECT:title
Fifth Amendment to the Professional Services Agreement with Nightingale Nurses, LLC Regarding the Provision of Supplemental Staffing Services at Various Department of Health and Human Services - Behavioral Health Facilities in an Amount of $11,828,000 for the Period of July 1, 2023 through June 30, 2027end
RECOMMENDATION(S):Recommendation
That the Board of Supervisors:
1. Approve, and Authorize the Department of Health and Human Services - Behavioral Health Director, or a designee thereof, to execute the attached fifth amendment to the Professional Services Agreement with Nightingale Nurses, LLC dated May 10, 2023 regarding the provision of supplemental staffing services at various Department of Health and Human Services - Behavioral Health facilities in an amount not to exceed Eleven Million Eight Hundred Twenty-Eight Thousand Dollars ($11,828,000.00) for the period of July 1, 2023 through June 30, 2027; and
2. Authorize the Department of Health and Human Services - Behavioral Health Director, or a designee thereof, to execute any and all subsequent amendments to the professional services agreement dated May 10, 2023 with Nightingale Nurses, LLC, after review and approval by County Counsel, Risk Management, and the County Administrative Office; and
3. Authorize the Department of Health and Human Services - Behavioral Health Director, or a designee thereof, to execute professional services agreements that are substantially similar to the professional services agreement with Nightingale Nurses, LLC dated May 10, 2023, and any amendments thereto, after review and approval by County Counsel, Risk Management, and the County Administrative Office; and
4. Direct the Clerk of the Board to electronically provide the Department of Health and Human Services - Contract Unit with one (1) fully executed certified copy of the Board order related to this item.
Body
STRATEGIC PLAN:
The recommended actions support the following areas of the Board of Supervisors’ Strategic Plan:
Area of Focus: Safe & Healthy Communities
Strategic Plan Category: 1001 -Support and sustain partnerships between public safety and partner agencies to enhance public safety in our communities
DISCUSSION:
The Humboldt County Department of Health and Human Services - Behavioral Health (“DHHS - Behavioral Health”) is responsible for providing behavioral health treatment services to eligible individuals being served at DHHS - Behavioral Health’s psychiatric health facility, crisis stabilization unit and medication support clinics and other County of Humboldt facilities including the Humboldt County Juvenile Hall. In order to meet such obligations, DHHS - Behavioral Health has contracted with qualified professional staffing firms, including, without limitation, Nightingale Nurses, LLC who have historically provided supplemental registered nursing personnel due to the difficulties associated with recruiting and retaining qualified psychiatric licensed nurses in Humboldt County.
On May 10, 2023, the County of Humboldt entered into a professional services agreement with Nightingale Nurses, LLC regarding the provision of supplemental registered nursing personnel to fill various positions at DHHS - Behavioral Health facilities for the period of July 1, 2023 through July 30, 2024. DHHS - Behavioral Health subsequently amended the professional services agreement with Nightingale Nurses, LLC dated May 10, 2023, four (4) times in order to extend the term thereof, increase the maximum amount payable thereunder and modify the budgetary requirements set forth therein. The attached fifth amendment to the professional services agreement with Nightingale Nurses, LLC dated May 10, 2023 will further increase the maximum amount payable thereunder and modify the insurance and budgetary requirements set forth therein.
Accordingly, DHHS - Behavioral Health recommends the Board approve, and authorize the DHHS - Behavioral Health Director, or a designee thereof, to execute the attached fifth amendment to the professional services agreement with Nightingale Nurses, LLC dated May 10, 2023 regarding the provision of supplemental staffing services at various DHHS - Behavioral Health facilities for the period of July 1, 2023 through June 30, 2027. It is also recommended that the Board authorize the DHHS - Behavioral Health Director, or a designee thereof, to execute any and all subsequent amendments, and additional professional services agreements that are substantially similar, to the professional services agreement with Nightingale Nurses, LLC dated May 10, 2023, after review and approval by County Counsel, Risk Management and the County Administrative Office, in order to avoid potential delays in the provision of needed supplemental staffing services.
SOURCE OF FUNDING:
Behavioral Health Fund (1170-424)
FINANCIAL IMPACT:
|
Expenditures (1170-424) |
FY 25-26 |
FY 26-27 Projected* |
|
Budgeted Expenses |
$3,168,000.00 |
$3,020,000.00 |
|
Total Expenditures |
$3,168,000.00 |
$3,020,000.00 |
|
Funding Sources (1170-424) |
FY 25-26 |
FY 26-27 Projected* |
|
State/Federal Funds |
$3,168,000.00 |
$3,020,000.00 |
|
Total Funding Sources |
$3,168,000.00 |
$3,020,000.00 |
*Projected amounts are estimates and are subject to change.
The attached fifth amendment to the professional services agreement with Nightingale Nurses, LLC dated May 10, 2023 will increase the maximum amount payable thereunder from Eleven Million Six Hundred Eighty Thousand Dollars ($11,680,000.00) to Eleven Million Eight-Hundred Twenty-Eight Thousand Dollars ($11,828,000.00) for the period of July 1, 2023 through June 30, 2027. In no event shall the maximum amount paid under the professional services agreement with Nightingale Nurses, LLC dated May 10, 2023 exceed Two Million Six Hundred Twenty Thousand Dollars ($2,620,000.00) for fiscal year 2023-2024, Three Million Twenty Thousand Dollars ($3,020,000.00) for fiscal years 2024-2025, Three Million One Hundred Sixty-Eight Thousand Dollars ($3,168,000.00) for fiscal year 2025-2026 and Three Million Twenty Thousand Dollars ($3,020,000.00) for fiscal year 2026-2027. However, if local, state or federal funding is reduced or eliminated, the County of Humboldt may reduce the above-referenced maximum amount payable or terminate the professional services agreement with Nightingale Nurses, LLC dated May 10, 2023 in its entirety.
Expenditure appropriations related to the attached fifth amendment to the professional services agreement with Nightingale Nurses, LLC dated May 10, 2023 have been included in the approved fiscal year 2025-2026 budget for DHHS - Behavioral Health budget unit 1170-424. Funding for the attached fifth amendment to the professional services agreement with Nightingale Nurses, LLC dated May 10, 2023 is available through 47% federal Medi-Cal financial participation, 35% state realignment and 18% Behavioral Health Services Act revenues received by DHHS - Behavioral Health.
STAFFING IMPACT:
Approval of the attached fifth amendment to the professional services agreement with Nightingale Nurses, LLC dated May 10, 2023 will not impact current staffing levels.
OTHER AGENCY INVOLVEMENT:
None
ALTERNATIVES TO STAFF RECOMMENDATIONS:
The Board may choose not to approve the attached fifth amendment to the professional services agreement with Nightingale Nurses, LLC dated May 10, 2023 regarding the provision of supplemental services at various DHHS - Behavioral Health facilities. However, this alternative is not recommended since it may delay the provision of required professional psychiatric services to eligible individuals being served at DHHS - Behavioral Health facilities.
ATTACHMENTS:
1. Fifth Amendment to the Professional Services Agreement with Nightingale Nurses, LLC Dated May 10, 2023, Regarding the Provision of Supplemental Staffing Services at Various Department of Health and Human Services - Behavioral Health Facilities
2. Fourth Amendment to the Professional Services Agreement with Nightingale Nurses, LLC Dated May 10, 2023, Regarding the Provision of Supplemental Staffing Services at Various Department of Health and Human Services - Behavioral Health Facilities
3. Third Amendment to the Professional Services Agreement with Nightingale Nurses, LLC Dated May 10, 2023, Regarding the Provision of Supplemental Staffing Services at Various Department of Health and Human Services - Behavioral Health Facilities
4. Second Amendment to the Professional Services Agreement with Nightingale Nurses, LLC Dated May 10, 2023, Regarding the Provision of Supplemental Staffing Services at Various Department of Health and Human Services - Behavioral Health Facilities
5. First Amendment to the Professional Services Agreement with Nightingale Nurses, LLC Dated May 10, 2023, Regarding the Provision of Supplemental Staffing Services at Various Department of Health and Human Services - Behavioral Health Facilities
6. Professional Services Agreement with Nightingale Nurses, LLC Dated May 10, 2023, Regarding the Provision of Supplemental Staffing Services at Various Department of Health and Human Services - Behavioral Health Facilities
PREVIOUS ACTION/REFERRAL:
Meeting of: 6/25/2019
File No.: 19-937