REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 11, 2024
FROM
JOSHUA DUGAS, Director, Department of Public Health
SUBJECT
Title
Amendment to Contract with California University of Science and Medicine for Primary Care Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 3 to Contract No. 19-398 with California University of Science and Medicine to continue providing primary care services, psychiatry services, and the Refugee Health Assessment Program, update contract language, increase the contract amount by $4,807,824, from $14,665,887 to $19,473,711, and extend the contract for one additional year for the total contract period of July 1, 2019 through June 30, 2025.
(Presenter: Joshua Dugas, Director, 387-9146)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
This item will not impact Discretionary General Funding (Net County Cost). The not to exceed cost of $19,473,711 for the continuation of primary care and psychiatry services are funded by fee-for-service, Medi-Cal, Managed Care Medi-Cal, private insurance, private pay clients, and 1991 Realignment funds. Services provided under the Refugee Health Assessment Program (RHAP) include health assessments and referrals for identified health conditions and are reimbursed by the State. Adequate appropriation and revenue will be included in the Department of Public Health’s (DPH) 2024-25 Recommended Budget.
BACKGROUND INFORMATION
DPH currently operates four Federally Qualified Health Centers (FQHCs) in the cities of Adelanto, Hesperia, Ontario, and San Bernardino. Services provided at the FQHCs, include primary care, maternal health, pediatric care, HIV care and treatment, reproductive health services, dental and nutrition services, and diagnostic radiology.
Under the terms of the recommended Amendment No.3 to Contract No. 19-398 (Contract), California University of Science and Medicine (CUSM) will continue to provide comprehensive primary care, RHAP, and psychiatry services through licensed physicians and mid-level practitioner support at the FQHCs, Monday through Friday. In 2023, primary care services were provided to 10,519 unique patients, not inclusive of any return or follow-up visits. CUSM will continue to act as the lead agency and subcontract services through an agreement with CEP-America AUC, dba Vituity, Inc. (Vituity). Vituity provides licensed physicians and mid-level practitioners for the delivery of the contracted services.
Lastly, the recommended amendment will allow for the addition of a physician to provide additional support to the Hesperia Health Center.
The recommended Amendment No. 3 to the Contract with CUSM will allow the County to continue providing comprehensive health care services through licensed physicians and mid-level practitioner support at the department’s FQHCs, without disruption of services, while the County enacts a formal procurement.
CUSM’s performance is monitored by review of monthly reports to ensure compliance with the administrative, program, and fiscal terms and conditions of the contract. CUSM will continue to cooperate with the County in the implementation, monitoring, and evaluation of this contract and continue to comply with all reporting requirements established by the contract.
On June 11, 2019 (Item No. 42), as a result of Request for Proposals (RFP) No. DPHE19-CO-3153, the Board of Supervisors (Board) approved the Contract with CUSM to provide primary care services, in the amount of $7,667,464, for the period of July 1, 2019 through June 30, 2022, with the option to extend the Contract two additional one-year periods.
On June 14, 2022 (Item No. 55), the Board approved Amendment No. 1 to the Contract to continue to provide primary care services, expand services to include RHAP and psychiatric services, exercise the first option to extend for one year, and increase the contract amount by $3,368,343, from $7,667,464 to $11,035,807, for the total contract period of July 1, 2019 through June 30, 2023.
On May 23, 2023 (Item No. 61), the Board approved Amendment No. 2 to the Contract to continue to provide primary care services, psychiatry services and RHAP services, update contract language, exercise the second option to extend for one additional year, and increase the contract amount by $3,630,080, from $11,035,807 to $14,665,887, for the total contract period of July 1, 2019 through June 30, 2024.
The Purchasing Department supports this recommended amendment to increase the Contract amount by $4,755,123 and extend the term by an additional year for a total term of July 1, 2019 through June 30, 2025, to allow DPH time to complete another formal procurement, and avoid any disruption of services. The current recommended increase is higher than past years to account for growing physician and staffing costs, as well as the addition of two more physicians.
PROCUREMENT
The Purchasing Department continues to support this competitive procurement based on the RFP above. DPH will use the extension to avoid disruption of services while completing another formal procurement for primary care, psychiatry, and RHAP services within the FQHCs.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Adam Ebright, Deputy County Counsel, 387-4229) on May 16, 2024; Purchasing (Ariel Gill, Supervising Buyer, 387-2070) on May 17, 2024; Finance (Carl Lofton, Administrative Analyst, 387-5404) on May 22, 2024; and County Finance and Administration (Robert Saldana, Deputy Executive Officer, 387-4342) on May 22, 2024.