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File #: 20-1097    Version: 1
Type: Agenda Item Status: Approved
File created: 8/13/2020 In control: Board of Supervisors
On agenda: 12/15/2020 Final action: 12/15/2020
Title: Health and Human Services Agency recommending the Board: 1) Approve and authorize the Chair to sign Amendment 4 to Agreement for Services 844 (447-S1711) with Netsmart Technologies for the provision of the Netsmart Avatar electronic health record and billing system, which adds a Telehealthâ„¢ subscription to the agreement, and removes the CareManager subscription from the agreement; increasing the total amount of the Agreement by $1,700, for a new total not to exceed amount of $926,200; with no change to the term of the Agreement; and 2) Authorize the Purchasing Agent, or designee, to execute further documents relating to Agreement for Services 844 (447-S1711) including amendments which do not increase the maximum dollar amount or term of the Agreement, and contingent upon approval by County Counsel and Risk Management. FUNDING: Federal and State Funding: 50% Medi-Cal, 24% Mental Health Realignment, and 26% Mental Health Services Act.
Attachments: 1. A - Approved CRS, Netsmart 844 A4, 2. B - Netsmart 844 A4, 3. C - Netsmart 844, A1, A2, A3 + Approved CRSs, 4. Executed Agreement 844
Related files: 17-0321, 19-0384, 19-1716, 21-1487

Title

Health and Human Services Agency recommending the Board:

1) Approve and authorize the Chair to sign Amendment 4 to Agreement for Services 844 (447-S1711) with Netsmart Technologies for the provision of the Netsmart Avatar electronic health record and billing system, which adds a Telehealth™ subscription to the agreement, and removes the CareManager subscription from the agreement; increasing the total amount of the Agreement by $1,700, for a new total not to exceed amount of $926,200; with no change to the term of the Agreement; and

2) Authorize the Purchasing Agent, or designee, to execute further documents relating to Agreement for Services 844 (447-S1711) including amendments which do not increase the maximum dollar amount or term of the Agreement, and contingent upon approval by County Counsel and Risk Management.

 

FUNDING:   Federal and State Funding:  50% Medi-Cal, 24% Mental Health Realignment, and 26% Mental Health Services Act.

 

Body

DISCUSSION / BACKGROUND:

In 2005, the Board approved a Mental Health Agreement to contract with the California Regional Mental Health Systems Coalition Joint Powers Authority (JPA) to develop an integrated information systems infrastructure.  The JPA members researched available software systems suitable for Mental Health records and billing that satisfied the requirements of the California Medi-Cal system.  As a result, the JPA selected and implemented the Avatar system, a product of the Netsmart Technologies Corporation, to achieve this goal and meet the State requirements.

 

Despite the quality and success of the product, the Application Service Provider (ASP) billing configuration proved to be problematic and the JPA system was dissolved by June 30, 2013.  HHSA desired to continue using Avatar due to the financial and staff time investment in developing and using the software, the multitude of records contained in the software platform, and to ensure continuity of record keeping for those clients whose records already reside in the system.

 

Netsmart has proven to be a consistent partner, providing support and customizing as requested.  Electronic billing processes result in Medi-Cal funding to support Behavioral Health services.

 

Amendment 1 (A1), signed within the authority of the Purchasing Agent, was necessary to execute a Mutual Non-Disclosure Agreement regarding access to Avatar hosting files.

 

Amendment 2 (A2) was necessary to add three new software subscriptions, including the CareManager subscription. (File ID:  19-0384, Item No. 11)

 

Amendment 3 (A3) added a training service titled Enterprise Training at a one time cost of $7,000.

 

In addition, the original Agreement included a Master Agreement Expenditures (MAE) chart identifying software, support, and travel expenditures.  When Amendment 2 was processed, the MAE chart was not updated.  The Board item also incorrectly reflected a maximum obligation of $951,262 (File ID:  19-0384, Item# 11) because the annual software subscription reflected two years instead of one.  Therefore, A3 updated the MAE chart, adding the Enterprise Training, and reducing the annual software subscription by the erroneous one extra year to result in a maximum obligation of $924,500.

 

Amendment 4 (A4)  adds a Telehealth™ subscription through the end of the Agreement in the amount of $27,200; and removes the CareManager subscription (added in A2) in the amount of $25,500, resulting in a net increase to the agreement of $1,700 for a new total maximum obligation of $926,200.

 

In accordance with Resolution 142-2001, software (proprietary) is exempt from competitive bidding.

 

ALTERNATIVES:

Disapproval of Amendment 4 to Agreement for Services #844 (447-S1711) will limit HHSA’s ability to provide services to its Behavioral Health clients via electronic or telecommunication technologies, a crucial component during the current COVID-19 public health emergency.

 

PRIOR BOARD ACTION:

1) 04/18/17, 17-0321, Approved Agreement for Services 447-S1711 (FENIX #844)

2) 05/21/19, 19-0384, HHSA Netsmart Agreement 844 Amendment 2

3) 03/17/20, 19-1796, HHSA Netsmart Technologies, 844 A3 (447-S1711)

 

OTHER DEPARTMENT / AGENCY INVOLVEMENT:

Approved by County Counsel, Information Technologies, and Risk Management.

 

CAO RECOMMENDATION:

Approve as recommended.

 

FINANCIAL IMPACT:

There is no use of General Fund for this Agreement.  The increase of $1,700 will be paid from Medi-Cal, Mental Health Realignment, and Mental Health Services Act.  Sufficient appropriations were included in the Fiscal Year 2020-21 budget, and will be included in future budgets for the term of the Agreement.

 

CLERK OF THE BOARD FOLLOW UP ACTIONS

1) Clerk of the Board to obtain signature of Chair on two (2) originals of Amendment 4 to Agreement for Services 844; and

2) Clerk of the Board to return one (1) fully executed Amendment 4 to the HHSA Contracts Unit at 3057 Briw Road, Suite B.

 

STRATEGIC PLAN COMPONENT:

Health and Human Services Agency Strategic Plan Objective 4.1.7: Identify cost effective emerging technologies to improve service delivery and drive efficiency for HHSA employees.

 

CONTACT

Don Semon, Director