REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
December 5, 2023
FROM
TRACY REECE, Chief Probation Officer, Probation Department
SHANNON D. DICUS, Sheriff/Coroner/Public Administrator
SUBJECT
Title
Amendment to Contract with NaphCare, Inc. for TechCare Electronic Health Records Services
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 3 to Contract No. 15-886 with NaphCare, Inc. for use of TechCare Electronic Health Records services in detention facilities operated by the Probation Department and the Sheriff/Coroner/Public Administrator, increasing the contract amount by $1,407,080, from $5,014,500 to a new total amount not to exceed $6,421,580, and extending the contract term by two years, for a new contract period of December 16, 2015 through December 15, 2025.
2. Authorize the Chief Probation Officer or Assistant Chief Probation Officer, on behalf of the Probation Department, and the Sheriff/Coroner/Public Administrator or Undersheriff, on behalf of the Sheriff/Coroner/Public Administrator, to execute change orders to Contract No. 15-886, subject to review by County Counsel, in an amount not to exceed $100,000 per change order, so long as the total aggregate amount does not exceed $449,511 or amend the contract term.
3. Direct the Chief Probation Officer, Assistant Chief Probation Officer, Sheriff/Coroner/Public Administrator, or Undersheriff to transmit all contract change orders to the Clerk of the Board of Supervisors within 30 days of execution.
(Presenter: Tracy Reece, Chief Probation Officer, 387-5692)
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 additional Discretionary General Funding (Net County Cost). Extending the contract with NaphCare, Inc. (NaphCare) will provide the County with continued access to the system infrastructure necessary to operate the TechCare Electronic Health Records (EHR) system.
The annual cost for the Probation Department (Probation) EHR maintenance and hosting services during the two year extension will be funded by Public Safety Realignment Revenue (Assembly Bill [AB] 109). Total increased cost for EHR services are as follows:
|
Product/Service |
2024 |
2025 |
|
TechCare EHR Contract Renewal - Juvenile Facilities Only, Unlimited License |
$150,000 |
$150,000 |
|
TechCare Hosted Infrastructure - Juvenile Facilities Only, Unlimited License, Dedicated Connection |
$42,500 |
$42,500 |
|
SureScripts Medication Reconciliation: Annual Maintenance Fee |
$9,000 |
$9,000 |
|
eRX & EPCS: 4 Provider Access License |
$7,040 |
$7,040 |
|
300 Additional Billable Hours @ $150/hour |
$45,000 |
- |
|
Total |
$253,540 |
$208,540 |
Sufficient appropriation is included in Probation’s 2023-24 budget and will be included in future recommended budgets.
The annual cost for the Sheriff/Coroner/Public Administer (Sheriff) for EHR maintenance and hosting services for the two year extension will be funded primarily by Public Safety Realignment Revenue (AB 109) in the amount of $300,000 (4424301000), and the remaining from other Sheriff sources (4420001000). Total increased costs for EHR services are as follows:
|
Product/Service |
2024 |
2025 |
|
TechCare EHR Contract Renewal - Adult Facilities Only, Unlimited License |
$400,000 |
$400,000 |
|
TechCare Hosted Infrastructure - Adult Facilities Only, Unlimited License, Dedicated Connection |
$50,000 |
$50,000 |
|
300 Additional Billable Hours @ $150/hour |
$45,000 |
- |
|
Total |
$495,000 |
$450,000 |
Sufficient appropriation is included in the Sheriff’s 2023-24 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
After relying on a paper-based medical records system, Sheriff and Probation implemented an EHR system in 2015. The EHR facilitates and improves information sharing by automating the process of collecting and maintaining records for medical, mental, dental, vision and wellness services for individuals housed at County detention facilities. Further, the EHR provides improved continuity of care during and after release, including services from other County programs upon release, thereby promoting healthier communities and reducing recidivism.
On December 15, 2015 (Item No. 74), the Board of Supervisors (Board) approved Contract No. 15-886 with NaphCare to implement an EHR system for use by Sheriff and Probation for adult and juvenile detention facilities, respectively, for the period of December 16, 2015 through December 15, 2020, with the option to extend the contract by one three-year period, followed by two one-year periods.
On March 24, 2020 (Item No. 52), the Board approved Amendment No. 1 to Contract No. 15-886 with NaphCare to provide an additional 900 hours of proprietary software development for the EHR, increasing the contract amount by $135,000, for a new total amount not-to-exceed $3,135,000, with no change to the contract term of December 16, 2015 through December 15, 2020.
On December 8, 2020 (Item No. 43), the Board approved Amendment No. 2 to Contract No. 15-886 with NaphCare to add the NaphPro hosting platform to the EHR services, increasing the contract amount by $1,879,500, for a new total amount not to exceed $5,014,500, and exercising the first option to extend the contract by three years, for a new total contract term of December 16, 2015 through December 16, 2023.
Approval of this item will allow for the continuation of EHR services utilizing the NaphPro hosting platform at Sheriff and Probation detention centers, amending the contract term to combine the two one-year extensions to one two-year extension, and exercising the updated option to extend the contract term by two years for a new contract period of December 16, 2015 through December 15, 2025.
PROCUREMENT
In September 2020, NaphCare presented the Sheriff and Probation with an optional NaphCare hosted EHR agreement, NaphPro, to attempt to alleviate the system’s current demand on the County’s hosted technology infrastructure. As the EHR system continues to grow and support a larger user and patient population base, newer technology and increasing data demands, a greater need exists for increased performance, storage, and processing power.
Approval of this item will allow for the continuation of EHR services utilizing the NaphPro hosting platform at Sheriff and Probation detention centers and exercising the final option to extend the contract term by two years for a new contract period of December 16, 2015 through December 15, 2025. The contract may be terminated by either party upon a 30 day advance written notice of termination for all, or part, of the services described therein.
REVIEW BY OTHERS
This item has been reviewed by Sheriff/Coroner/Public Administrator (Jose Torres, Administrative Manager, 387-3465) on November 2, 2023, County Counsel (Maria Insixiengmay, Deputy County Counsel, 387-5455) on November 6, 2023, Purchasing Department (Jessica Barajas, Supervising Buyer, 387-2065) on November 7, 2023, Finance (Kathleen Gonzalez, Administrative Analyst 387-5412) on November 14, 2023, and County Finance and Administration (Robert Saldana, Deputy Executive Officer, 387-5423) on November 16, 2023.