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Health and Human Services Agency (HHSA) recommending the Board:
1) Make findings that the provision of Electronic Patient Health Record and Medical Billing software services provided by Patagonia Health, Inc. are in the public's best interest and that there are specialty skills, qualifications, and equipment not expressly identified in County classifications involved in the performance of the work in accordance with El Dorado County Ordinance Code, Chapter 3.13.030(B), El Dorado County Charter, Section 210(b)(6), and/or Government Code Section 31000;
2) Approve and authorize the Chair to sign Amendment III to Agreement for Services 407 (209-S1711) with Patagonia Health, Inc., increasing the not-to-exceed amount by $275,000, for a new maximum contractual obligation of $1,027,071, with no change to the term of the Agreement; and
3) Authorize the HHSA Director, or Public Health Director, to execute further documents relating to Agreement 407 (209-S1711), contingent upon approval by County Counsel and Risk Management, including amendments which do not increase compensation or extend the term of the Agreement.
FUNDING: 100% Federal and State funding.
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DISCUSSION / BACKGROUND:
Electronic Medical Records Systems (EMRs) electronically house notes and information on clients seen by Public Health nursing staff. EMRs also allows the department to run reports to evaluate services and target interventions. On December 13, 2016 (File 16-1192), the Board of Supervisors authorized HHSA to enter into an Agreement with Patagonia Health, Inc., for the purchase of software licenses, support, and implementation of Electronic Patient Health Record (EHR) and Medical Billing software, for Public Health Nursing, for a five (5) year term of December 13, 2016, through December 12, 2021, with a maximum contractual obligation of $315,475.
Amendment I to Agreement 407 (209-S1711), approved and executed on September 21, 2021, provided for additional on-site system gap analysis performed in December 2021, by Patagonia Health Practice to ensure the department was using the system at its fullest capacity. This amendment increased the maximum contractual obligation by $150,000, for a new total of $465,475.
Amendment II to Agreement for Services 407 (209-S1711), approved and executed on November 16, 2021, increased the maximum contractual obligation by $286,595, for a new total of $752,071. The sole purpose of this amendment was to extend the term of the software licenses and support for an additional five years through December 31, 2026.
HHSA is requesting Amendment III to Agreement for Services 407 (209-S1711), to increase the maximum contractual obligation by $275,000, for a new total of $1,027,071, providing for additional add-on services to fill the gaps identified in the on-site system analysis from December 2021, which includes but is not limited to on-site and/or virtual training, consulting, software development and enhancements, and the purchase of additional software modules. Other changes to the agreement include the addition of Section 15 “Electronic Signature”. These changes will be critically helpful in supporting the Public Health Department to meet its services mandates, which the State has added to this Fiscal Year 2022-23. Further mandate adjustments are expected in upcoming fiscal years and the additional software modules would position Public Health to meet those requirements as they are communicated.
In accordance with Board of Supervisors Procurement Policy C-17, Section 7.11, the contractor selection process for service contracts in excess of $100,000 must include a review of the scope of services and contractor’s professional qualifications by a group of individuals (including at least one representative from outside the department requesting the services) qualified to judge the contractor’s ability to perform the services. HHSA has documentation on file that such a review was performed.
ALTERNATIVES:
Should the Board decline to approve this Amendment, HHSA would be limited in the full utilization of the Patagonia Electronic Medical Records System, possibly needing to search for comparable system, obtain quote, purchase, and implement a new health record system or return to the use of an antiquated health record systems, including a manual billing process. This would impact the ability for Public Health to efficiently meet its services mandates.
PRIOR BOARD ACTION:
1) 11/16/21, 21-0946 HHSA 407-A2 Patagonia Health Inc.
2) 09/21/21, 21-1159 HHSA Patagonia Health Agreement 407 AMD I
3) 12/13/16, 16-1192 HHSA Patagonia Agreement
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
Approved by County Counsel, Human Resources, and Risk Management.
The Auditor-Controller has been notified per Policy B-12.
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
The Agreement is funded with federal and state funds. There is no Net County Cost associated with this Agenda item. Sufficient appropriations were included in the Fiscal Year 2022-23 Budget and will be included in future budgets for the term of the Agreement.
CLERK OF THE BOARD FOLLOW UP ACTIONS:
1) Obtain signature of Chair on one (1) original Amendment III to Agreement for Services 407 (209-S1711).
STRATEGIC PLAN COMPONENT:
Healthy Communities: Improved health, well-being and self-sufficiency of El Dorado County communities, residents, and visitors
CONTACT
Daniel Del Monte, Interim Director, Health and Human Services Agency