REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
December 17, 2024
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Amendments to Contracts for Professional Clinical Informatics Staffing and Consulting Services
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 2 to the following contracts for clinical informatics staffing and consulting services, increasing the not-to-exceed aggregate amount by $6,311,828, from $18,000,000 to $24,311,828, with no change to the term of December 1, 2022 through November 30, 2027:
a. Optimum Healthcare IT LLC, Contract No. 22-1098
b. 314e Corporation, Contract No. 22-1099
c. Eight Eleven Group, LLC dba Medasource, Contract No. 22-1100
d. Tegria Services Group - US, Inc., Contract No. 22-1101
e. Nordic Consulting Partners, Inc., Contract No. 22-1102
2. Authorize the ARMC Chief Executive Officer to approve and sign Statements of Work and amendments to Statements of Work for the above contracts,
subject to review by County Counsel.
3. Authorize the Auditor-Controller/Treasurer/Tax Collector to post the necessary budget adjustments to the Arrowhead Regional Medical Center 2024-25 budget to reallocate funds as detailed in the Financial Impact section (Four votes required).
(Presenter: Andrew Goldfrach, ARMC Chief Executive Officer, 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). The cost of $6,311,828 will be funded by the additional revenue from the AB85 Rate Range Revenue. The recommended budget adjustments, as reflected in the table below, are needed to provide Arrowhead Regional Medical Center (ARMC) with sufficient appropriation authority in fiscal year 2024-25 to fund increased costs in professional fees.
|
Funds Center |
Commitment Item |
Description |
Action |
Amount |
|
9184834200 |
52002900 |
Other Professional Fees |
Increase |
$6,311,828 |
|
9110004200 |
40449685 |
ARMC - AB85 Rate Range Revenue |
Increase |
$6,311,828 |
BACKGROUND INFORMATION
Approval of the Amendments will allow ARMC to fund increased costs and additional support through the use of consultants to assist the hospital with the Epic electronic health record system implementation and training while permanent recruitment is underway. This will be provided through the use of five consulting firms selected from the Request for Proposal (RFP) process. The agreements allow ARMC to consult with multiple firms that have the expertise and experience providing technical and clinical consultation for all aspects of the implementation and training of the Epic electronic health record system. The consultants will provide support and training to the department and support a smooth transition/hand-off once permanent positions are filled.
The additional cost was a result of vacancies and the need to extend the statements of work for the consultants. ARMC was unable to hire 23 full-time employees that completed the Epic Credentialing and Training Modules. The consultants have provided support and training to the department and will support a smooth transition/hand-off once permanent positions are filled. The additional funds will expand the Value-Based Program (VBP) to include expansion of ARMC's VBP workforce, maintain performance momentum, and transition to self-sustainability.
Current consultants include physicians, pharmacists, credentialed trainers, and Epic analysts with specialized technical skills specific to Epic application development, support, training, and onboarding new staff hired at ARMC. These consultants have both clinical and technical skills specific to the patient delivery system in a large hospital setting with a robust electronic health record system.
Consultant staffing will facilitate ARMC’s progression toward process improvement, implementation of new best practices, and use of industry-leading technology. With value-based services becoming the new norm in healthcare, ARMC continues to align itself with a structure that will allow quality services at appropriate costs. ARMC will leverage the expertise of these consultants to enhance the current experience of county citizens through the analysis of current structures and the implementation of best demonstrated practices.
On November 15, 2022 (Item No. 10), as the result of solicitation No. ARMC123-ARMC-4683, the Board of Supervisors (Board) approved the contracts listed in the Recommendation on an as-needed, fee-for-service basis for clinical informatics staffing and consulting services in the not-to-exceed aggregate amount of $10,000,000 for the five-year period of December 1, 2022 through November 30, 2027.
On August 22, 2023 (Item No. 13), the Board approved Amendment No. 1 to the contracts for clinical informatics staffing and consulting services, increasing the not-to-exceed aggregate amount by $8,000,000 from $10,000,000 to $18,000,000, with no change to the term of December 1, 2022 through November 20, 2027.
ARMC recommends approval of Amendment No. 2 to the contracts, as they will provide the technical expertise and experience to ARMC in application development and maintenance services, program management, clinical application development and support, analysis, programming, programming, architecture, data management, reporting, quality assurance, optimization services, workflow design and optimization, and project management.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Supervising Deputy County Counsel, 387-5455) on November 18, 2024; Purchasing (Veronica Pedace, Buyer III, 387-2464) on November 18, 2024; Human Resources (Gina King, Assistant Director, 387-5571) on November 22, 2024; Auditor-Controller/Treasurer/Tax Collector (Charlene Huang, General Accounting Manager, 382-7022) on, November 27, 2024; ARMC Finance (Chen Wu, Finance Budget Officer, 580-3165) on November 21, 2024; Finance (Jenny Yang, Administrative Analyst, 387-4884) on November 27, 2024; and County Finance and Administration (Valerie Clay, Deputy Executive Officer, 387-5423) on December 2, 2024.