To: Board of Supervisors
From: Anna Roth, Health Services Director
Report Title: Amendment #76-662-9 with Firstlocum, Inc. (dba Directshifts)
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee

RECOMMENDATIONS:
APPROVE and AUTHORIZE the Health Services Director, or designee, to execute on behalf of the County Contract Amendment Agreement #76-662-9 with Firstlocum, Inc. (dba Directshifts), a corporation, effective January 1, 2024, to amend Contract #76-662-8, to increase the payment limit by $7,400,000, from $3,800,000 to a new payment limit of $11,200,000 for additional temporary physician staffing services with no change in the original term of May 1, 2023 through April 30, 2025.
FISCAL IMPACT:
Approval of this amendment will result in additional annual expenditures of up to $7,600,000 and will be funded as budgeted by the department by 100% Hospital Enterprise Fund I. (No rate increase)
BACKGROUND:
Contra Costa Regional Medical Center (CCRMC) and Contra Costa Health Centers have an obligation to provide medical 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 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 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 CCRMC 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.
Approval of Contract Amendment Agreement #76-662-9 will allow the contractor to provide additional temporary specialty physicians at CCRMC and Contra Costa Health Centers through April 30, 2025. This amendment is late due to ongoing negotiations between the contractor and CCRMC. There was an unanticipated increase in utilization for various specialties. This contract includes services provided by represented classifications and the county has met its obligations with the respective labor partner(s).
CONSEQUENCE OF NEGATIVE ACTION:
If this amendment is not approved, County will not have access to contractor’s temporary physician staffing services.