To: Board of Supervisors
From: Dr. Ori Tzvieli, Interim Health Services Director
Report Title: Payments for Services Provided by FirstLocum Inc. (dba DirectShifts)
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Auditor-Controller, or designee, to pay an amount not to exceed $702,585 to FirstLocum Inc. (dba DirectShifts), a corporation, for additional temporary Physician staffing services provided at Contra Costa Regional Medical Center (CCRMC) and Contra Costa Health Centers during the period February 1, 2025 through April 30, 2025, as recommended by the Interim Health Services Director.
FISCAL IMPACT:
Approval of this payment will result in a one-time expenditure of up to $702,585 and will be funded 100% by Hospital Enterprise Fund I.
BACKGROUND:
CCRMC and Contra Costa Health Centers have an obligation to provide medical Physician staffing services to patients. Therefore, the County contracts with temporary help firms to ensure patient care is provided during peak loads, temporary absences, vacations and emergency situations where additional staffing is required. The County has been using the Contractor’s temporary Physician staffing services since July 1, 2019. This Contract is entered into under and subject to the following legal authorities: California Government Code §§ 26227 and 31000. CCRMC’s Health Services Personnel approved this Contract to ensure no conflicts with labor relations. Quality Management, Utilization Management and Contract Monitor Staff meet on a regular basis to ensure monitoring and performance measures in the contract are upheld. Per Administrative Bulletin 600.3 Physician services are exempt from solicitation requirements.
On May 9, 2023, the Board of Supervisors approved Contract #76-662-8 with FirstLocum Inc. (dba DirectShifts), in an amount not to exceed $3,800,000, for the provision of temporary Physician staffing services to ensure patient care is provided during peak loads, temporary absences, vacations and emergency situations, and for the provision of recruitment services for the period May 1, 2023 through April 30, 2025.
On March 5, 2024, the Board of Supervisors approved Contract Amendment #76-662-9 with FirstLocum Inc. (dba Directshifts), effective January 1, 2024, to increase the payment limit by $7,600,000 to a new payment limit of $11,200,000 for additional temporary Physician staffing services with no changes in the term.
On March 25, 2025, the Board of Supervisors approved Contract Amendment #76-662-11 with FirstLocum Inc. (dba Directshifts), effective March 1, 2025, to increase the payment limit by $2,000,000 to a new payment limit of $13,200,000 for additional temporary Physician staffing services with no change in the term.
Due to the unanticipated increase in need for Physician staffing, services were requested by County and provided by Contractor in good faith. This Contract includes services provided by represented classifications and the County has met its obligations with the respective labor partner(s).
The Contractor is entitled to payment for the reasonable value of its services under the equitable relief theory of quantum meruit. That theory provides that where a Contractor has been asked to provide services without a valid contract, and the Contractor does so to the benefit of the County, the Contractor is entitled to recover the reasonable value of those services. The Contractor has provided services at the request of the County after the original Contract payment limit had been reached. The Department cannot pay Contractor for services rendered that exceed the Contract limits. As such, the Department recommends that the Board authorize the Auditor-Controller to issue a one-time payment not to exceed $702,585 to FirstLocum Inc. (dba DirectShifts).
CONSEQUENCE OF NEGATIVE ACTION:
If this Contract is not approved, CCRMC and Contra Costa Health Centers will not have access to Contractor’s temporary Physician staffing services.