REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
May 24, 2022
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
Amendments to Agreements with Santa Rosa Consulting, Inc., Santa Rosa Staffing, Inc., and Optimum Healthcare IT, LLC for Electronic Health Record Clinical and Technical Consulting Services
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 1 to Contract No. 19-541, which is an Assignment and Consent to Assignment of the Contract from Santa Rosa Consulting, Inc. to Santa Rosa Staffing, Inc., retroactively effective as of February 19, 2021.
2. Approve Amendments to contracts with the following vendors on an as-needed, fee-for-service basis for implementation services related to the new Electronic Health Record system at Arrowhead Regional Medical Center, increasing the total aggregate amount by $8,000,000, from $10,000,000 to a total aggregate amount of $18,000,000, and to extend the contract period as set forth below:
a. Amendment No. 2 to Contract No. 19-541 with Santa Rosa Staffing, Inc. extending the contract period from August 5, 2022 to December 1, 2022, for a total contract period of August 6, 2019 through December 1, 2022.
b. Amendment No. 1 to Contract No. 21-219 with Optimum Healthcare IT, LLC extending the contract period from July 8, 2022 to December 1, 2022, for a total contract period of March 24, 2021 through December 1, 2022.
3. Authorize the Director of Arrowhead Regional Medical Center to execute Statements of Work and changes to the Statements of Work under Contract Nos. 19-541 and 21-219 for implementation services within the aggregate not-to-exceed amount of $18,000,000 and so long as the Statements of Work do not change the term of the contracts, subject to review by County Counsel.
(Presenter: William L. Gilbert, Director, 580-6150)
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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 additional not-to-exceed aggregate cost of $8,000,000 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. Adequate appropriation and revenue are included in the Arrowhead Regional Medical Center’s (ARMC) 2021-22 budget and will be included in the 2022-23 recommended budget.
The additional $8,000,000 will be used to continue fee-for-service for specialized staff to address temporary clinical informatics and technical needs associated with support of the new Electronic Health Record (EHR) across the organization, which includes quarterly updates to the new EHR, also known as Epic. The fee-for-service support will also assist in specialized areas requiring Epic certified staff to accomplish time sensitive projects, as needed.
BACKGROUND INFORMATION
On January 1, 2021, MedMatica Consulting Associates, Inc. (MedMatica) acquired certain assets of Santa Rosa Consulting, Inc. As a part of this acquisition, MedMatica and Santa Rosa Consulting, Inc. merged to form a new company called Santa Rosa Staffing, Inc. Approval of Recommendation No. 1 will result in the County consenting to assignment of Contract No. 19-541 from Santa Rosa Consulting, Inc. to Santa Rosa Staffing, Inc. (Santa Rosa). As a result of this assignment, Santa Rosa Staffing, Inc. will perform all of the obligations that were contractually required to be performed by Santa Rosa Consulting, Inc. There are no anticipated changes to the leadership or team of consultants providing service to the County as a result of this assignment.
Approval of Recommendation No. 2 will increase the total aggregate contract amounts for Santa Rosa and Optimum Healthcare IT, LLC (Optimum), and extend the term of those contracts through December 1, 2022. The increase to these contracts will allow ARMC to use fee-for-service consultants with the required skills and certification to assist with support and maintenance of the Epic system, ensuring proper functionality throughout ARMC. Qualified consultants with required certifications will provide specialized support to ARMC Clinical Information (CI) teams, as well as provide specialized training to current and new staff. ARMC requires the use of consultants within the CI department with health information technology experience and required Epic certification to meet project deadlines and deliverables, assist in handling increased workloads, and install required updates.
Specialized certification is required to complete specific work in the clinical informatics and technical portions of the Epic system. Based on the required knowledge and certification need within the CI team to work with the Epic system, ARMC and Human Resources are working in conjunction on the recruitment and identification of qualified candidates, which will continue until staffing reaches capacity to maintain the system. In order to address the lack of Epic-credentialed applicants, ARMC and Human Resources have initiated the process to recruit Epic trainee level positions to develop staff internally to potentially eliminate the need of temporary consultant support.
The extensions to these contracts will allow ARMC time to conduct a Request for Proposal (RFP) process, which will establish new contracts for staffing support, if and when needed in the future.
Delegation of authority to the Director of ARMC to execute Statements of Work and changes to the Statements of Work is requested because as Epic system projects progress, revisions may be necessary to address new circumstances and updates essential to the system functionality. So long as the changes do not exceed the total project funding or change the term of the contracts, authorizing the Director to approve these changes in consultation with ARMC Project Managers and subject to review by County Counsel will allow timely revisions to address immediate needs and ensure patient safety.
On August 6, 2019 (Item No. 10), the Board of Supervisors (Board) approved Contract No. 19-541 with Santa Rosa Consulting, Inc. and Contract No. 19-540 with Impact Advisors, LLC to provide services in the total aggregate amount of $10,000,000 for the period of August 6, 2019 through August 5, 2022.
On March 13, 2020, the County exercised its right to terminate Contract No. 19-540 with Impact Advisors, LLC for implementation services. ARMC entered into negotiations with the next highest rated proposer from the Request for Proposal process, Huron Consulting Group (Huron). After a good faith effort, the County determined that Huron was unable to provide consultant services as required. The County terminated negotiations with Huron and began negotiations with the next highest rated Proposer, Optimum.
On March 23, 2021 (Item No. 16), the Board approved Contract No. 21-219 with Optimum to provide information technology staff and consulting services related to the implementation of a new EHR, in a not-to-exceed amount of $5,000,000 for the period March 24, 2021 through August 5, 2022. The end date of August 5, 2022, reflected on the contract cover sheet and previously approved by the Board was incorrect. Upon further review of the contract, the actual term is March 24, 2021 through July 8, 2022, as indicated in Recommendation No. 2.b.
PROCUREMENT
The Purchasing Department supports the recommended contract amendments as a continuation of a competitive procurement based on RFP ARMC119-ARMC-3191.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Deputy County Counsel, 387-5455) on May 20, 2022; Purchasing Department (Ariel Gill, Buyer III, 777-0722) on April 19, 2022; Human Resources (Gina King, Deputy Director, 387-5571) on May 4, 2022; ARMC Finance (Chen Wu, Finance Budget Officer, 580-3165) on April 20, 2022; and County Finance and Administration (Diane Atkeson, Deputy Executive Officer, 387-5423) on April 20, 2022.