REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE COUNTY OF SAN BERNARDINO
AND RECORD OF ACTION
March 10, 2020
FROM
WILLIAM L. GILBERT, Director, Arrowhead Regional Medical Center
SUBJECT
Title v
Unified Participation Agreement with American Heart Association, Inc.
End
RECOMMENDATION(S)
Recommendation
Approve the Unified Participation Agreement with the American Heart Association, Inc. for the subscription and participation in the Get with the Guidelines- Stroke Registry, for an initial period of one-year, automatically renewing for one-year periods, at a yearly cost of $10,914.
(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 the Agreement with American Heart Association, Inc. (AHA), will not result in the use of Discretionary General Funding (Net County Cost) as the yearly associated cost of $10,914 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. Sufficient appropriation and revenue are included in the Arrowhead Regional Medical Center (ARMC) 2019-20 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
Approval of this Recommendation will allow ARMC to subscribe and participate in the Get with the Guidelines - Stroke Registry (GWTG -Stroke). The GWTG- Stroke is a program for improving the quality of care for patients hospitalized with stroke by promoting consistent adherence to the latest evidence-based clinical practice guidelines. The GWTG- Stroke is also the industry standard for stroke data submission to regulatory agencies nationwide including but not limited to, Healthcare Facilities Accreditation Program (HFAP), The Joint Commission (TJC), and Centers for Medicare and Medicaid Services (CMS). Failure to participate in the GWTG-Stroke would leave ARMC unable to submit data to regulatory agencies and could affect ARMC’s Stroke Certification and Inland Counties Emergency Medical Agency (ICEMA) designation as a Primary Stroke Center. ARMC has had a long-standing agreement with AHA to cover data reporting services to regulatory agencies.
The AHA Unified Participation Agreement is AHA’s standard program participant agreement, which contains terms that differ from the standard County contract. The non-standard terms include the following:
1. County indemnifies and holds harmless AHA, its affiliates, contractors, and licensors against all liabilities to the extent directly caused by County’s (1) breach of the Agreement or BAA, (2) patient care activities, (3) negligence or willful misconduct, (4) failure to obtain required consents to disclose County data under HIPAA regulations and applicable data and security privacy laws, (5) errors or inaccuracies contained in the County data, (6) infringement arising from AHA’s use or disclosure of the County data, and (7) any violation of law applicable to County’s participation in the programs.
• The County standard contract does not include any indemnification or defense by the County of a Contractor.
• Potential Impact: By agreeing to indemnify AHA, 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 AHA without such limitations and the County would be responsible to defend and reimburse AHA for costs, expenses, and damages, which could exceed the total contract amount.
2. AHA will not be liable to the County for any damages other than the indemnification obligations.
• The County standard contract does not include a limitation of liability.
• Potential Impact: Claims could exceed the liability cap and the contract amount leaving the County financially liable for the excess. In addition, the County’s liability under the contract is not similarly limited.
3. AHA provides the software “AS IS” and disclaims all warranties of any kind.
• There is no warranty requirement in the County standard contract.
• Potential Impact: The County’s use of the software is solely at its own risk.
4. The term of the contract is automatically renewing.
• County Policy 11-04 does not permit indefinite term or automatically renewing contracts unless approved by the Board.
• Potential Impact: There is no end term to the contract and the County is indefinitely bound to the terms and conditions of the contract. However, there is termination for convenience upon 60 days prior written notice.
ARMC recommends the approval of this agreement with AHA, including the non-standard terms, as AHA is the sole provider of registries and web-based solutions for measuring, improving, and reporting on stroke date, quality of care, and positive patient outcomes.
PROCUREMENT
Subscription and participation in the GWTG-Stroke is a non-competitive procurement as the access to the specific stroke data and the submission of data to regulatory agencies is propriety to the AHA. Purchasing supports this non-competitive procurement.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Bonnie Uphold, County Counsel, 387-5455) on January 22, 2020; Purchasing Department (Michelle Churchill, Supervising Buyer, 387-2070) on January 31, 2020. Finance (Amanda Trussell, Principal Administrative Analyst, 387-4773) on January 30, 2020; and County Finance and Administration (Matthew Erickson, County Chief Financial Officer, 387-5423) on January 31, 2020.