Facing the loss of psychiatric services staff in the county’s Mental Health Branch, the Board of Supervisors has approved a one-year contract with a firm that recruits and hires psychiatrists.
The $3.5 million contract with the Traditions Behavioral Health firm was unanimously approved at the March 17 supervisors meeting. Traditions will recruit and hire 5.6 full-time equivalent psychiatrists who will work for the county and live here.
A sudden departure of psychiatrists from the Mental Health Branch has been attributed by those who have resigned to poor management and failure to maintain staffing levels. But Department of Health and Human Services Director Phil Crandall said many rural counties are dealing with staff shortages.
Crandall told supervisors that a “surge” of county Medi-Cal recipients has challenged staffing capacity.
He added that with other avenues of opportunity opening up in prisons and in the Veterans Administration, psychiatric specialists have left county work at a pace recruitment efforts can’t keep up with.
“We have been working very hard over the past several years with the Department of Human Resources and we just have not been able to recruit and retain our psychiatric services at the rate that we’re losing them, so it’s not for lack of trying,” Crandall said.
Contracting with Traditions will not increase staffing costs and brings the branch to 6.4 full-time equivalent psychiatrists, he continued. Asked about the long-term approach to Mental Health staffing, Crandall said the Affordable Care Act and managed care are the “new models” in an evolving health care environment.
“For the next one to three years, if the contract relationship is good, we would retain that and then we would see a migration to another form of mental health provision that would be in partnership with the health care systems and managed care entities,” he continued.
Supervisors at times alluded to the emergency situation the contract proposal emerged from. “I’m sorry we got this far along before we realized we’re in crisis stage,” said Supervisor Rex Bohn.
Board Chair Estelle Fennell said she’s “absolutely appalled” that the board wasn’t apprised of the staffing challenges sooner.
But the idea of contracting with Traditions was met with optimism and supervisors were pleased to hear that its doctors will live in Humboldt and not be what was termed as “rent-a-docs.”
Asked how long it will take to stabilize the staffing situation, Dr. Gary Hayes, Tradition’s owner and founder, said the early stage will be the most challenging but his firm has dealt with other difficult situations.
He said Traditions contracted with the San Leandro-based John George Psychiatric Pavilion facility a year after a physician had been murdered there.
“It was considered to be catastrophically difficult and we were told we wouldn’t be able to get it done and we got it done — we gravitate toward the more challenging situations,” Hayes continued.
He said that when his firm starts its county contract on April 10, “We will probably be rocky to start out with” due to short notice. But he added that by this time next year, “It will be stable … you’ll forget all about us, most likely.”
During public comments, board members of the county’s National Alliance on Mental Illness chapter said they’re relieved the staffing situation has been dealt with quickly. They highlighted staff safety as a concern and recommended that the county implement a means of evaluating safety risks.
Traditions contracted with the county once before, in 1999, but was phased out after two years. Supervisors and staff credited the firm for its willingness to start work quickly and Fennell summarized the reaction to the contract by saying, “I’m optimistic about what it can do for us.”
Interesting that the DHHS Director, Crandall, announced his ‘retirement’ a few days ago. Given what he knew and did not reveal to the Board of Supervisors he should be fired now not allowed to drift through his final year. Incompetent and paranoid come to mind with that person.