REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
March 12, 2024
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
Appropriation Adjustment to Agreement with Prolacta Bioscience, Inc. for Products Derived from Human Breast Milk
End
RECOMMENDATION(S)
Recommendation
Authorize the Purchasing Agent to increase appropriation to the Purchase and Discount Agreement with Prolacta Bioscience, Inc., in the amount of $1,500,000, for human breast milk-based feeding fortifier, increasing the contract amount from $488,000 to a total not-too-exceed amount of $1,988,000, and automatically extending the contract term by two years, for a total term of February 11, 2021 through February 10, 2026.
(Presenter: William L. Gilbert, Director, 580-6150)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
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) as the cost of $1,500,000 is funded by State Medi-Cal, Federal Medicare, private insurances, 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
On February 11, 2021, the Purchasing Department (Purchasing) executed a Purchase and Discount Agreement (Agreement) with Prolacta Bioscience, Inc. (Prolacta), with an initial term of three years, for the purchase of human breast milk-based feeding fortifier that is used for premature newborns. Under the Agreement, approved by Purchasing, the term is automatically extended for two additional one-year terms for a total term of five years.
Purchasing originally approved the Agreement in an amount not to exceed $225,000 based on estimated usage at the time due to its restricted use of the fortifier for only the lowest birthweight infants. Since the effective date of that Agreement, studies have shown the fortifier to be beneficial to a wider group of premature infants. The additional $1,500,000 will allow the purchase of this fortifier for all infants meeting the criteria of 12-16 weeks prematurity for the remaining two years of this Agreement. This has resulted in a significant increase in usage of the fortifier beyond the estimated amounts. ARMC anticipates a continued increase in use over the next two years as the high-risk population of premature infants has also increased at the hospital.
On December 22, 2022, the Purchasing Agent approved an increase to the Agreement in the amount of $263,000, from $225,000 to $488,000, based on continuing emergency needs, with no change to original term of the Agreement. Because the total amount expected to be expended from April 28, 2022 to April 7, 2023, was $234,014, exceeding Purchasing’s general authority, the Purchasing Agent utilized its emergency authority under County Policy No. 11-04 to approve the increase, which was subsequently ratified by the Board of Supervisors on July 11, 2023 (Item No. 16).
Approval of the Recommendation will allow ARMC to continue to purchase human breast milk-based feeding fortifier. Providing Prolacta’s feeding fortifier helps prevent a potentially fatal condition called Necrotizing Enercolitis and promotes optimal growth and development of premature vital organs, tissue and brain. The use of Prolacta’s feeding fortifier in the first few weeks of life can improve overall health of premature infants, decrease Neonatal Intensive Care Unit stay, transfers to other area facilities, and reduce morbidity and death.
PROCUREMENT
Purchasing continues to support this non-competitive procurement, as Prolacta is the only manufacturer which produces pasteurized human milk and human milk-based fortifier.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Deputy County Counsel, 387-5455) on February 14, 2024; Purchasing (Veronica Pedace, Buyer III, 387-2198) on February 15, 2024; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on February 16, 2024; Finance (Jenny Yang, Administrative Analyst, 387-4884) on February 20, 2024; and County Finance and Administration (Valerie Clay, Deputy Executive Officer, 387-5423) on February 23, 2024.