REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
May 23, 2023
FROM
JOSHUA DUGAS, Director, Department of Public Health
SUBJECT
Title
Amendment to Contract with California University of Science and Medicine for Primary Care Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 2 to Contract No. 19-398 with California University of Science and Medicine to continue providing primary care services, psychiatry services and the Refugee Health Assessment Program, updating contract language, exercising the second option to extend for one additional year, and increasing the contract amount by $3,630,080, from $11,035,807 to $14,665,887, for the total contract period of July 1, 2019 through June 30, 2024.
(Presenter: Joshua Dugas, Director, 387-9146)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
This item will not impact Discretionary General Funding (Net County Cost). The not to exceed cost of $3,630,080 for the continuation of primary care is funded by fee-for-service, Medi-Cal, Managed Care Medi-Cal, private insurance, private pay clients, and 1991 Realignment funds. Adequate appropriation and revenue will be included in the Department of Public Health’s (DPH) 2023-24 recommended budget.
BACKGROUND INFORMATION
DPH currently operates Federally Qualified Health Centers (FQHCs) in the cities of Adelanto, Hesperia, Ontario, and San Bernardino. Section 330 of the Public Health Services Act requires that FQHCs serve an underserved area or population, provide comprehensive primary care services and coverage for medical emergencies during and after business hours, ensure continuity of care and hospital admitting privileges, and have an ongoing quality assurance program. FQHCs qualify for enhanced reimbursement from Medicare and Medicaid under the Prospective Payment System (PPS) rate, which is a special cost-related structure for FQHCs that helps cover costs related to the uninsured patient population.
Under the terms of the recommended amendment, California University of Science and Medicine (CUSM) will continue to provide comprehensive primary care services through licensed physicians and mid-level practitioner support at the designated FQHCs, Monday through Friday. In 2022, primary care services were provided to 10,164 unique patients, not inclusive of any return or follow-up visits. The cost for services varies as it is based on the type of visit, specialty service, and/or procedure/treatment given based on the patient’s need. CUSM will continue to act as the lead agency and subcontract a portion of the services through an agreement with CEP-America AUC, dba Vituity, Inc. (Vituity). Vituity will provide licensed physicians and/or mid-level practitioners for the primary care services.
In addition to primary care services, the recommended amendment allows continuation of provider hours to enhance the existing Refugee Health Assessment Program (RHAP). These program services are funded by the State of California and provide newly arrived refugees, asylees, victims of trafficking, and other eligible entrants with culturally and linguistically appropriate comprehensive health assessments, including follow-up and referrals for health conditions identified in the assessment process. This amendment will also allow the continuation of the provision of psychiatry services.
CUSM’s performance is monitored by review of monthly reports to ensure compliance with the administrative, program, and fiscal terms and conditions of the contract. CUSM will cooperate with the County in the implementation, monitoring, and evaluation of this contract and will comply with all reporting requirements established by the contract. CUSM’s charges must be for services provided to eligible beneficiaries under applicable Federal, State, and locally funded programs. DPH Budget and Administrative Services will review invoices and attachments remitted by CUSM prior to payment. The County reserves the right to request additional program and/or fiscal reports to facilitate this monthly review.
PROCUREMENT
On June 11, 2019 (Item No. 42), as a result of a formal procurement, the Board of Supervisors (Board) approved Contract No. 19-398 with CUSM to provide primary care services, in the amount of $7,667,464, for the period of July 1, 2019 through June 30, 2022, with the option to extend the Contract two additional one-year periods.
On June 14, 2022 (Item No. 55), the Board approved Amendment No. 1 to Contract No. 19-398 with CUSM, including non-standard terms, to continue to provide primary care services, expand services to include RHAP and psychiatric services, exercising the first option to extend for one year, and increasing the contract amount by $3,368,343, from $7,667,464 to $11,035,807, for the total contract period of July 1, 2019 through June 30, 2023.
REVIEW BY OTHERS
This item has been reviewed by Human Services Contracts (Patty Steven, Contracts Manager, 388-0241) on April 21, 2023; County Counsel (Adam Ebright, Deputy County Counsel, 387-5455) on May 2, 2023; Finance (Paul Garcia, Administrative Analyst, 386-8392) on May 3, 2023; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on May 8, 2023.