DATE: May 25, 2021
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Interim Director, Department of Public Health
SUBJECT: Ratification of Agreement and Amendment with AMI Expeditionary Healthcare, LLC for daily operation and administration of the County COVID-19 alternate care site
RECOMMENDED ACTION(S):
TITLE
Ratify Agreement and First Amendment with AMI Expeditionary Healthcare, LLC to coordinate and staff daily operation and administration of the COVID-19 alternate care site services, previously executed by the County Administrative Officer acting as the Emergency Services Director, effective August 7, 2020 through December 31, 2021, total not to exceed $33,818,696.
REPORT
There is no additional Net County Cost associated with the recommended action. Approval of the recommended action will ratify Agreement and Amendment with AMI Expeditionary Healthcare, LLC to continue as the contracted agency to coordinate services and staffing when an Alternate Care Site is activated under the County coordination. The Agreement provides for a maximum of fifty (50) beds dedicated to low acuity care for County residents at the designated alternate care site to alleviate strain on local hospitals during the COVID-19 pandemic. This contract was crucial in helping address the countywide hospital emergency service surge and staffing issues during the high peak of COVID-19 cases. This item is countywide.
ALTERNATIVE ACTION(S):
Should you Board not approve the recommended action, the Department would lose the ability to quickly respond to a future hospital capacity surge issue.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The Agreement and amendment ($33,818,696) are fully offset with the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The cost will vary depending on the amount of beds used with price points at the 25 bed and 50 bed thresholds and if the Alternate Care Site is utilized in capacity later in time as noted in the cost table below:
|
Period: |
25 Beds |
50 Beds |
|
August 7, 2020 - December 31, 2020 |
$4,648,120.00 |
$4,648,120.00 |
|
January 1, 2021 - June 30, 2021 |
$6,130,614.00 |
$6,130,614.00 |
|
July 1, 2021 - December 31, 2021 |
$6,130,614.00 |
$6,130,614.00 |
|
|
$16,909,348.00 |
$16,909,348.00 |
There are no outstanding invoices pending related to this Agreement. Sufficient appropriations and estimated revenues are included in the Department’s Organization 5620 FY 2020-21 Adopted Budget and will be included in future Department budget requests should the extension options be exercised in the Agreements.
DISCUSSION:
On March 15, 2020, pursuant to California Government Code, Section 8630 and Fresno County Ordinance Code Chapter 2.44, due to the imminent and proximate threat of exposure of the Novel Coronavirus (COVID-19), a Local Emergency was proclaimed by the County Administrative Officer as Emergency Services Director. Your Board adopted a Resolution proclaiming and ratifying the Local Emergency on March 17, 2020.
Since the first trace of COVID-19 in Fresno County, the numbers have been staggering. As of April 5, 2021, over 99,702 residents have been infected and a total of 1,597 deceased. The numbers are expected to continue to rise through community spread until more vaccines become available and residents get vaccinated.
As hospitalizations grew during the first wave of widespread infection from June 2020 to September 2020 and second wave in November 2020 to March 2021, the County activated an alternate care site to treat low-acuity non-COVID-19 patients referred by hospitals impacted by COVID-19 positive patients including staffing shortages.
The County entered into an agreement with AMI Expeditionary Healthcare LLC to provide staff and support and coordination in an Alternate Care Site setting, as necessary. The original agreement was from August 7, 2020 to December 31, 2020. An Amendment was created to extend the term to June 30, 2021 as cases continued to increase with an option to extend to December 31, 2021, as vaccine processes were still pending at that time. Approval of the recommended action will ratify the Agreement and Amendment with AMI Expeditionary Healthcare, LLC and allow the County to continue ongoing efforts to support the County’s hospital infrastructure during the COVID-19 pandemic and provide relief when necessary. Through the Agreement, AMI Expeditionary Healthcare, LLC is compensated only when the alternate care site is activated. When the alternate care site is not activated, the Agreement obligates AMI Expeditionary Healthcare, LLC to be available.
The Agreement contains non-standard language allowing the County to select the option for the number of beds to be staffed as necessary. This language has been reviewed by Risk Management and deemed to be acceptable. The Agreement and Amendment also contain a 146-day term with the two 183-day extensions.
REFERENCE MATERIAL:
BAI #2, March 17, 2020
BAI #3, March 17, 2020
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with the Clerk - Agreement with AMI Expeditionary Healthcare, LLC
On file with the Clerk - First Amendment to Agreement with AMI
CAO ANALYST:
Ron Alexander