REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 13, 2023
FROM
VICTOR TORDESILLAS, Director, Department of Risk Management
SUBJECT
Title
Contracts for Nurse Case Management Services to Support the County’s Self-Insured Workers’ Compensation Program
End
RECOMMENDATION(S)
Recommendation
Approve fee-for-service contracts with the following companies to provide workers’ compensation nurse case management services for an estimated aggregate cost not-to-exceed $2,250,000, for the period of June 14, 2023, through June 13, 2028:
1. EK Health Services, Inc of San Jose, CA
2. Encompass Health Solutions, Inc of Folsom, CA
3. Genex Services, LLC of Wayne, PA
4. IW Care Connection, Inc of Sherman Oaks, CA
5. Pinnacle Case Management Solutions, LLC of Riverside, CA
(Presenter: Victor Tordesillas, Director 386-8621)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Operate in a Fiscally-Responsible and Business-Like Manner.
FINANCIAL IMPACT
Approval of this item will not result in the use of additional Discretionary General Funding (Net County Cost). The five-year estimated aggregate cost not-to-exceed $2,250,000 for workers’ compensation nurse case management services will be paid from the Department of Risk Management (DRM) countywide and Special Districts workers’ compensation insurance funds. These services will be paid on a fee-for-service basis in accordance with the contracted rate schedule (Attachment A) of each contract. Sufficient appropriation will be included in the DRM 2023-24 recommended budget and in future recommended budgets.
BACKGROUND INFORMATION
DRM manages the County’s self-insured workers’ compensation program and aims to reduce financial loss to the County through an integrated Managed Medical Care Program. As part of this program, DRM utilizes workers’ compensation Nurse Case Management Services to maximize savings while ensuring County, Special Districts, Flood Control and Fire Protection employees receive high-quality workers’ compensation medical care.
Nurse Case Management Services facilitate effective communication between treating physicians, pharmacies, and other service providers, including Utilization Review doctors and Independent Medical Review doctors. These services prevent disruptions in care and provide personalized assistance to injured workers. Additionally, nurse case management services help ensure that all necessary paperwork for the workers’ compensation system is accurately processed in a timely manner to minimize delays in providing care.
PROCUREMENT
On October 10, 2022, DRM released Request for Proposal (RFP) No. RMG123-RMADM-4695, soliciting proposals for workers’ compensation nurse case management services. The RFP was posted on San Bernardino County’s Electronic Procurement Network (ePro), and the following companies submitted proposals:
|
Vendor Name |
Location |
|
EK Health Services, Inc. |
San Jose, CA |
|
Encompass Health Solutions, Inc. |
Folsom, CA |
|
Genex Services, LLC |
Wayne, PA |
|
IW Care Connection, Inc. |
Sherman Oaks, CA |
|
Pinnacle Case Management Solutions, LLC |
Riverside, CA |
A subject matter expert reviewed the proposals for responsiveness, and all proposers proceeded to the evaluation stage. An evaluation committee consisting of DRM staff evaluated the proposals based on qualifications, experience, and relevant expertise necessary to serve the County. Reference checks and a cost analysis were also performed. The evaluation committee recommends awarding contracts to all proposers. No protests were received.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Laura Crane, Principal Assistant County Counsel, 387-5455) on April 18, 2023; Purchasing (Bruce Cole, Supervising Buyer, 387-2148) on May 1, 2023; Human Resources (Diane Rundles, Assistant Executive Officer, 387-5572) on May 18, 2023; Finance (Ivan Ramirez, Administrative Analyst, 387-4020) on May 23, 2023; and County Finance and Administration (Paloma Hernandez-Barker, Deputy Executive Officer, 387-5423) on May 30, 2023.