REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
January 23, 2024
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
Appropriation Adjustment to Contract with Joint Commission Resources, Inc. for Quality Improvement and Compliance Consulting Services
End
RECOMMENDATION(S)
Recommendation
1. Approve an increase in funding allocation to Contract No. 21-727 with Joint Commission Resources, Inc. in the amount of $400,000 for quality improvement and compliance consulting services, increasing the total contract amount from $400,000 to $800,000, with no change to the contract term of October 5, 2021 through October 4, 2026.
2. Designate the Director of Arrowhead Regional Medical Center as the authorized official to approve and sign Statements of Work and amendments to Statements of Work under the terms of Contract No. 21-727, subject to review by County Counsel, so long as the aggregate costs do not exceed $800,000 and do not exceed the contract term.
(Presenter: William L. Gilbert, Director, 580-6150)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Operate in a Fiscally-Responsible and Business-Like Manner.
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost). The cost of $400,000 is funded by State Medi-Cal, Federal Medicare, private insurance, and other departmental revenue. Funding sources may change in the future pending any legislative activity related to the repeal and/or replacement of the Affordable Care Act. Adequate appropriation and revenue have been included in the Arrowhead Regional Medical Center (ARMC) 2023-24 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
The increase in appropriation will allow ARMC to continue to advance quality improvement and patient safety efforts as established in Contract No. 21-727 with Joint Commission Resources, Inc (JCR). JCR is owned by The Joint Commission, the national accrediting body for ARMC. The Joint Commission accredits and certifies more than 22,000 health care organizations and programs in the United States and is the nation’s oldest and largest accrediting body in health care. JCR offers educational and consultation services, publications, and software to complement The Joint Commission’s accreditation experience.
ARMC is expanding the utilization of JCR’s services beyond assistance with Nursing and Infection Control Consultative services to include Behavior Health Services, Life Safety, and Environment of Care, all of which have surveyable challenges. The utilization of JCR’s services will support ARMC’s efforts to maintain its acute care license and remain in good standing with the California Department of Public Health and the Centers for Medicare and Medicaid Services. The specific scope of work will be determined by Statements of Work which will detail the services to be provided, the deliverables, and specific fees to be paid, all subject to the terms and conditions of Contract No. 21-727. The original contract did not include a total not-to-exceed amount as payment is based on each individual Statement of Work (SOW) as services are utilized. ARMC budgeted an anticipated $400,000 for the initial term of the contract. Because the utilization of JCR’s services is being expanded, ARMC is requesting additional allocation of funding for the expanded services.
Approval of Recommendation No. 2 will authorize the Director of ARMC to approve and execute the Statements of Work and any amendments, subject to review by County Counsel, so long as they, collectively, do not exceed the contract amount of $800,000, and do not exceed the term of the contract.
The Purchasing Department executed an agreement between JCR and ARMC for consulting services on July 20, 2018. Since July 2018, JCR has provided consulting services to ARMC with the latest best practices and education that have led to the hospital’s continued accreditation with The Joint Commission and the Centers for Medicare and Medicaid Services. JCR provides consultants with expertise in a variety of healthcare areas including: acute care, nursing, behavioral health and ambulatory clinics. Additionally, ARMC’s leadership receives training, education, and routinely conducts mock surveys with JCR to prepare for accreditation surveys. Lastly, products can be purchased from JCR to advance ARMC’s quality improvement efforts and patient safety activities.
On October 5, 2021 (item No. 7), the Board of Supervisors (Board) approved Master Services and Subscription Agreement No. 21-727 with JCR to provide quality improvement and compliance consulting services in the not-to-exceed contract amount of $400,000, from October 5, 2021 through October 4, 2026. The Board also designated the ARMC Director to approve and sign Statements of Work.
ARMC recommends approval of this increase in appropriation as it will enable the hospital to maintain and improve operations throughout the facility to ensure safe and quality care is delivered to all patients.
PROCUREMENT
Purchasing supports the non-competitive procurement of services with JCR as the services that will be delineated in future Statements of Work require specialized credentials/expertise/training that only JCR has as a wholly owned subsidiary of the regulatory agency, The Joint Commission.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Deputy County Counsel, 387- 5455) on December 8, 2023; Purchasing (Veronica Pedace, Buyer III, 387-2198) on December 8, 2023; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on December 22, 2023; Finance (Jenny Yang, Administrative Analyst, 387-4884) on December 28, 2023; and County Finance and Administration (Valerie Clay, Deputy Executive Officer, 387- 5423) on December 28, 2023.