The county this week abruptly expanded its contract with a thus-far untested traveling nursing agency from $100,000 to $1 million.
Earlier this year, as part of the preparations for the 2016-17 county budget, the county’s chief purchasing agent, Laurie Rozko, authorized the issuance of a non-competitive master blanket purchase order to Fastaff in the amount of $100,000 for the period of July 20, 2016, through July 19, 2017.
Fastaff is a rapid response nurse staffing company based in Greenwood Village, Colorado. The nurses on hire from Fastaff were intended to cover assignments in the operating, emergency and maternity rooms at Arrowhead Regional Medical Center, the primary campus of the San Bernardino County’s county hospital.
Rozko had the authority to make such a commitment under County Policy 11-04.
From the initiation of the current fiscal year on July 1 through earlier this week, of the $100,000 authorized for hiring Fastaff nurses, none of that money had been expended.
At the recommendation of William L. Gilbert, the director of Arrowhead Regional Medical Center, the county board of supervisors this week, agreed to increase the $100,000 master blanket purchase order with Fastaff by an additional $900,000 for nursing staffing services.
According to Gilbert, “Experienced operating room (OR) staff is vital to patient care in the ARMC OR, as well as other critical care areas such as the labor and delivery (L&D) department and emergency department (ED), which all require additional staffing at this time. Each of these areas requires special skills and experience. The ARMC OR staffing is currently at a critical level due to increased patient volume, recent departure of staff in difficult to recruit positions, and staff on short or long term leave. These staffing issues will negatively impact the ability to operate the minimum number of operating rooms to meet patient needs for elective and trauma surgeries. ARMC has researched staffing vendors currently providing registry services to supplement the ARMC nursing staff to cover absences and ensure that ARMC maintains nurse-to-patient ratios required by Assembly Bill 394; however, these vendors were unable to provide any staff with OR experience.”
Gilbert continued, “Registry nurses perform services under per diem contracts. Traveler nurses specialize in providing rapid response nursing services in urgent or crucial situations. Traveler nurses are placed on temporary longer term assignments under four to 13 week contracts, will travel outside of their local area to assignments, and are compensated at a higher rate to do so than registry nurses. Some of the current registry vendors contracted with ARMC provide both registry and traveler nurses. ARMC has been able to tentatively obtain contracts with four traveler nurses through Fastaff for the OR with a projected cost of $450,000.”
Gilbert said that “In order to reduce reliance on traveler nurses, ARMC has initiated a new nurse training program to complement the number of experienced OR nurses. The program provides training to six nurses per session, trained over a six-month period to prepare them to work in the OR. Each nurse is being offered a 13-week contract to staff the OR, providing for the safety, health, and social service needs of county residents by ensuring patient care continues while the hiring process for permanent staff is completed by the county. ARMC anticipates a list of candidates to begin interviewing shortly. However, none of the applicants have the necessary OR experience, so will be part of the new six-month nurse training program. Fastaff will also provide staff to fill additional vacancies in the critical care areas of L&D and ED. The availability of registry nurses to augment the staffing needs of the ED has decreased over the past three to four months, as many registry nurses have taken permanent positions with other local hospitals and health care organizations.”
Gilbert justified the county’s use of Fastaff as a sole-source vendor thusly, “This is a non-competitive procurement based on specialized credentials, as Fastaff is able to provide ARMC with traveler nursing staff with the required experience in OR, L&D, and ED. In an effort to procure these specific staffing services, the ARMC Materiel Management Department contacted each of the current vendors contracted with ARMC to provide registry nursing services. Of the vendors that responded, none were able to provide ARMC with nursing staff with the required experience. Two of these vendors, Medical
Staffing Network and Healthcare Pros, responded that they are currently recruiting for nurses with this experience. As none of the current registry vendors are able to provide these services to ARMC, an additional vendor was found to provide ARMC with traveler nurses for the OR, L&D, and ED.”
Deputy county counsel Frank Salazar signed off on the arrangement prior to the board of supervisors vote on the matter.