REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE COUNTY OF SAN BERNARDINO
AND RECORD OF ACTION
October 8, 2019
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
Approval of the purchase of unbudgeted fixed assets
End
RECOMMENDATION(S)
Recommendation
1. Approve the purchase of five Edwards EV-1000 monitor, as unbudgeted fixed assets at an aggregate amount of $140,000 and associated cable and services at $20,000 from Edwards Lifesciences, LLC.
2. Approve budget adjustment of $160,000 to fund the purchase of five Edwards EV-1000 monitors and associated cable and services necessary and authorize the Auditor-Controller/Treasurer/Tax Collector to post the necessary budget adjustments, as detailed in the Financial Impact Section. (Four votes required).
(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). The total cost of $160,000 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. This item authorizes the Auditor-Controller/Treasurer/Tax Collector to post the following adjustments to the 2019-20 budgets:
Fund Center |
WBSE |
Commitment Item |
Description |
Action |
Amount |
9110004200 |
NA |
54404040 |
Equipment |
Increase |
$140,000 |
9110004200 |
NA |
52006200 |
Equip Maint Svcs |
Increase |
$20,000 |
9110004200 |
NA |
40449685 |
ARMC- AB85 Rate Range Revenue |
Increase |
$20,000 |
9110004200 |
NA |
40909995 |
Residual Equity Transfer In |
Increase |
$140,000 |
BACKGROUND INFORMATION
Approval of this item will allow Arrowhead Regional Medical Center (ARMC) to purchase five Edwards EV-1000 monitors, as unbudgeted fixed assets, along with the associated cable and services, to replace the current fleet of Vigileo monitors which were phased out by the manufacturer. At the time ARMC had 10 working monitors. Currently, ARMC is down to one working monitor and the Centers for Medicare and Medicaid Services (CMS) and the Joint Commission (TJC) require appropriate levels of monitoring for patients receiving IV vasopressors and fluid management for our most critically ill patients in the Intensive Care Unit (ICU) in order to provide the clinician with clinically relevant information to guide medication drip titration and appropriate selection of therapy or interventions.
These monitors will help the clinician with management of patients in shock, heart failure, and fluid management that allows ARMC to deliver safe and efficient patient care that will improve the chances of survival. These monitors have been used by ARMC for years and have demonstrated accuracy and reliability in presenting pertinent hemodynamic data that’s essential to properly manage our critically ill patients.
ARMC recommends the purchase of these unbudgeted fixed assets because the current fleet of monitors have been discontinued by the manufacturer. ARMC is the major trauma center in the area and receive some of the sickest patients that need this technology. County Policy No. 11-04 requires approval from the Board of Supervisors for unbudgeted fixed assets with a unit value of $10,000 or more.
PROCUREMENT
This is a non-competitive procurement as Edwards Lifesciences, LLC is a sole source provider of the EV1000 “ClearSight Platform” which allows for the continuous monitoring of essential hemodynamic information, providing rapid insight on a minimally invasive, and non-invasive easy-to-use platform. The EV-1000 monitors are proprietary to Edwards Lifesciences, LLC. Edwards Lifesciences, LLC is the only company that supplies the flotrac transducer sensor capable of analyzing pulse contour waveforms to produce advanced hemodynamic measurement.
Purchasing concurs with the sole source justification.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Scott Runyan, County Counsel, 387-5455) on August 27, 2019; Purchasing Department (Ricardo Salazar, Supervising Buyer, 387-2060) on August 30, 2019; Auditor-Controller (Lisa Lazzar, Accounting Manager, 382-3196) on September 24, 2019; Finance (Amanda Trussell, Principal Administrative Analyst, 580-3165) on September 26, 2019; and County Finance and Administration (Katrina Turturro, Deputy Executive Officer, 387-5423) on September 26, 2019.