REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 27, 2023
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title
Agreement with InvisAlert Solutions, Inc. for a Patient Observation Compliance Program
End
RECOMMENDATION(S)
Recommendation
Approve License and Services Agreement with InvisAlert Solutions, Inc., for a patient observation compliance program through their ObservSMART software, in the total amount of $285,125, for the term of July 1, 2023 through June 30, 2028.
(Presenter: William L. Gilbert, Director, 580-6150)
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 Discretionary General Funding (Net County Cost). The cost of $285,125 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 have been included in the Arrowhead Regional Medical Center (ARMC) 2023-24 recommended budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
Approval of the Agreement with InvisAlert Solutions, Inc. (InvisAlert) will allow ARMC to establish a patient observation compliance program for behavioral health patients. Through InvisAlert’s system, ObservSMART, ARMC staff will use mini-iPads with proprietary software that is synchronized with waterproof, tamper-resistant wristbands and clasps to complete patient checks. The tamper-resistant wristbands prevent removal of critical patient identifying information to lessen disruptions to care for behavioral health patients. Furthermore, ObservSMART provides proximity-enforced patient monitoring and helps to enhance staff accountability. The ObservSMART patient observation compliance program by InvisAlert will help to ensure ARMC meets requirements of regulatory agencies, The Joint Commission and the Centers for Medicare and Medicaid. The Agreement also includes implementation and program maintenance services for the hospital.
The ObservSMART License and Services Agreement is InvisAlert’s standard commercial contract, which includes terms that differ from the standard County contract and omits certain County standard contract terms. While the parties negotiated certain contract terms to County standard terms, InvisAlert would not agree to all County standard terms. The non-standard and missing term include the following:
1. The County is required to indemnify InvisAlert against third party claims related to: (a) patient safety, care and experience; (b) misuse of ObservSMART or any component thereof; (c) violations of applicable laws; (d) claims by County personnel or any government agency related to the payment of employment taxes and benefits; (e) breach of Section 5.2 of the Agreement; and (e) any grossly negligent acts or omission or intentional misconduct of County or its directors, officers, employees, contractors or agents.
• The County standard contract does not include any indemnification or defense by the County of a contractor.
• Potential Impact: By agreeing to indemnify InvisAlert, the County could be contractually waiving the protection of sovereign immunity. Claims that may otherwise be barred against the County, time limited, or expense limited could be brought against InvisAlert without such limitations and the County would be responsible to defend and reimburse InvisAlert for costs, expenses, and damages, which could exceed the total Agreement amount.
ARMC recommends approval of the Agreement, including the non-standard term, to support the County goal of providing for the safety and health of County residents through proper patient monitoring services.
PROCUREMENT
The Purchasing Department supports the non-competitive procurement of ObservSMART based on the proprietary nature of the system that provides 1:1 proximity-enforced patient monitoring, staff accountability tools, and waterproof tamper-resistant beacons, wristbands and clasps. Additionally, InvisAlert retains the United States patent for the waterproof, tamper resistant wristbands for the hospital setting that are used solely with the ObservSMART software. The software and wristbands were designed to be used together as a solution for validating patient observations for non-compliant patients.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Bonnie Uphold, Supervising Deputy County Counsel, 387-5455) on May 15, 2023; Purchasing (Ariel Gill, Buyer III, 777-0722) on May 23, 2023; Risk Management (Victor Tordesillas, Director, 386-8623) on May 23, 2023; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on June 2, 2023; Finance (Jenny Yang, Administrative Analyst, 387-4884) on June 7, 2023; and County Finance and Administration (Valerie Clay, Deputy Executive Officer, 387-5423) on June 8, 2023.