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Health and Human Services Agency (HHSA) recommending the Board:
1) Make findings pursuant to Section 3.13.030 (B) of the El Dorado County Ordinance Chapter 3.13, Contracting Out, that licensed software as a service provided by Netsmart Technologies, Inc. (Netsmart) requires specialty skills and qualifications not expressly identified in County classifications are involved in the performance of the work;
2) Approve and authorize the Chair to sign Amendment I to Agreement for Services 8522 with Netsmart to add implementation fees, additional user licenses and clinician accounts, increasing the contract value by $268,617.42 for a new not-to-exceed amount of $1,945,076.27 with no change to the term expiring May 31, 2029, which is exempt from competitive procurement as outlined in Procurement Policy C-17 Section 3.5;
3) Authorize the Purchasing Agent to execute amendments relating to Agreement 8522, contingent upon approval by County Counsel and Risk Management, which do not increase the maximum dollar amount or term of the Agreement; and
4) Authorize the HHSA Director, or the Chief Assistant Director, to execute programmatic, administrative, and fiscal documents relating to Agreement 8522.
FUNDING: 20% State of California funded Department of Health Care Services Crisis Care Mobile Unit Program Grant, 80% Mental Health Services Act.
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DISCUSSION / BACKGROUND:
Netsmart specializes in healthcare technology solutions, particularly for behavioral health, social services, and substance use treatment. Netsmart’s electronic health record (EHR) systems and software enhance care delivery, streamline administrative processes, and improve communication among providers.
Since 2005, HHSA has contracted with Netsmart for the Avatar EHR system and billing software. This partnership has facilitated effective electronic billing, enabling HHSA to secure ongoing Medi-Cal funding for Behavioral Health Division (BHD) services. On May 21, 2024, the Board approved HHSA Agreement for Services 8522 with Netsmart for a five-year term (Legistar file 24-0784).
DHCS developed the CCMU Program Grant to utilize $150 million in funding received from the Behavioral Health Continuum Infrastructure Program (BHCIP), and $55 million received from the Substance Abuse and Mental Health Services Administration through the Coronavirus Response and Relief Supplemental Appropriations Act (CRRSAA) to support and expand behavioral health mobile crisis and non-crisis services. Allowable expenditures under the CCMU funding include, but are not limited to, staffing, consultant services, equipment, supplies, and software.
CCMU's aim to assist individuals in behavioral health crises through de-escalation and stabilization techniques, reducing immediate risks. Providers must document mobile crisis service encounters that describe all service components delivered to the beneficiary.
Netsmart maintains the current version of the Licensed Software in compliance with applicable State and Federal laws including data capture, reporting, and claiming. This proposed Amendment will accommodate the expansion of the CCMU's by adding various expenditures including additional Avatar Plexus Cloud SaaS - Named Users, Implementation Fees and CarePOV Clinician accounts. These resources will enhance documentation of treatment goals and outcomes, promote efficiency, and ensure person-centered care while maintaining quality and program integrity. Board Procurement Policy C-17 finds that proprietary software has a specific exemption from competitive procurement. Netsmart’s Avatar EHR system and billing software is a proprietary software which has been used by HHSA since 2005.
HHSA recommends approval of this agenda item to ensure the continuity of Netsmart’s latest EHR system and billing software.
ALTERNATIVES:
Should the Board decline to approve this recommendation, HHSA will experience a gap in availability of an EHR system which will hinder HHSA BHD’s ability to accommodate the State mandated CCMU services.
PRIOR BOARD ACTION:
05/21/24, 24-0784, HHSA Netsmart Agreement 8522
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
County Counsel, Human Resources, and Risk Management. The Auditor Controller has been notified per Policy B-12.
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
There is no Net County Cost associated with this agenda item as year one of the agreement is funded 100% through the DHCS CCMU Program Grant and additional years are 100% funded through MHSA funds. Sufficient appropriations have been included in HHSA’s Fiscal Year 2024-25 Budget and will be included in future budgets for the term of the Agreement.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Clerk of the Board to obtain signature of Chair on one original Amendment I to Agreement 8522.
STRATEGIC PLAN COMPONENT:
N/A
CONTACT
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency