County Boosts Tele-Psychiatry Services

Written by Estero Bay News

May 4, 2022

San Luis Obispo County has signed a contract with a telehealth group for phone-in psychiatric services in its further attempts at dealing with mental health issues and a lack of staffing.

Back in March, County Supervisors approved a 16-month contract with Thomas Milam MD, Inc. (dba Iris Telehealth Medical Group), part of a total of $2.04 million allocated by the County, according to a report from the County Health Agency.

The contract covers the time period from March-June 2022 and all of the 2022-2023 fiscal year. The contract also has a 1-year option that would extend it through the end of 2023-2024, at the discretion of the Health Agency Director.

The report said Telehealth Medical would provide, “telepsychiatry via the use of licensed psychiatrists and psychiatric/mental health nurse practitioners. Iris Telehealth operates similarly to locum tenens staffing agencies, utilizing a nationwide pool of participating psychiatrists, psychiatric/mental health nurse practitioners, and specialized licensed therapists, but in a virtual setting to provide telehealth to their clients’ consumers.”

The company will step in when the County can’t. “The use of telepsychiatry will help assure proper mandated coverage and medical supervision at multiple clinic sites when permanent staff or contracted staff are not available,” the report said.

The Health Department explained that there is a shortage nationwide of “psychiatrists, psychiatric/mental health nurse practitioners, and specialized licensed therapists. A number of demographic and other factors continue to make this shortage especially prevalent in San Luis Obispo County where demands for services exceed available resources. Recruitment and retention of this limited pool of licensed medical staff is impacted by competition from Atascadero State Hospital [ASH and California Men’s Colony [CMC].” 

Because the State’s pay and benefits exceed the County’s, they are losing potential new hires to the State facilities. “Behavioral Health,” the County said, “currently has 1.25 full-time equivalent [FTE] Staff Psychiatrists [0.75 FTE and 0.50 part time] working for the County. With a shortage of psychiatrists, wait times increase for clients to receive assessments and medication support. The contract with Iris Telehealth will help to fill the gaps for mandated coverage throughout the clinics and help ensure the provision of timely client care.”

The company is one of several the County has under contracts approved last August by Supervisors. Those were with: Ascend Medical Staffing LLC; LLC; CA Locums, PC; ExMed, Inc.; PE Healthcare Staffing; Medical Doctors Associates, LLC, DBA Cross County Locums; and Jackson & Coker LocumTenens, LLC. Iris Telehealth Medical Group was added to that list.

Why so many contracts? “It is important to maintain a wide pool of agencies,” the County report said, “to assure that when the Health Agency has a need for a psychiatrist, psychiatric/mental health nurse practitioner, or specialized licensed therapist, the appropriate one can be placed in a timely manner.” It will also allow the County to pick and choose docs with certain specialties for different clients.

The contract pays for 8,635 hours of “psychiatric professional placement services (approximately 4.20 FTE psychiatrists) at a total budgeted cost of $2,040,420 for the pooled providers.”

The contracts apparently are open ended. “The contracts for these types of contractors have no limit,” the County said, “as they are only paid for actual services rendered as needed by the County, which varies based on other staffing vacancies. Psychiatrists will provide services to clients within the Mental Health, Drug & Alcohol, and Justice Services divisions of Behavioral Health.”

The $2 million comes out of a trio of sources — Medi-Cal Revenues for 2021-22 at $1.2M; some $482,000 is out of “Realignment Revenue;” and $339,000 is coming out of County funds.

Psychiatric services are an integral part of the County’s mental health efforts. “Psychiatrists, psychiatric/mental health nurse practitioners and specialized licensed therapists provide psychiatric assessments and medication support services to clients who are severely and persistently mentally ill or seriously emotionally disturbed. Psychiatric professionals are required to review and approve clinical documentation in order to be compliant with availability and accessibility State mandates.”

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