DATE: February 25, 2020
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director
Department of Public Health
SUBJECT: Retroactive Revenue Agreement with Manifest MedEx
RECOMMENDED ACTION(S):
TITLE
1. Approve and Authorize Chairman to execute a Retroactive Revenue Agreement with Manifest MedEx for implementation of the +EMS Program portion of the Health Information Exchange, effective December 31, 2019 to September 30, 2021 ($219,900); and
2. Adopt Budget Resolution increasing the Fiscal Year 2019-20 appropriations and estimated revenues for the Department of Public Health Org 5620 in the amount of $109,950 (4/5 vote).
REPORT
Approval of the first recommended action will provide for the implementation of health information exchange between participating emergency ambulance providers and hospitals by allowing immediate and secure access and sharing of patients’ vital medical information electronically, with no increase in Net County Cost. The State Emergency Medical Services Authority (EMSA) awarded Manifest MedEx a total of $4.9 Million for the +EMS grant program to implement “SAFR” project with EMS Agencies, EMS participants, and Hospitals. Each of the participating agencies, including the County’s Department of Public Health, have a specific scope of work to complete. The proposed Agreement outlines the scope of work and allocates funding for reimbursement when specific milestones are achieved. Approval of the second recommended will increase the Department’s appropriations and estimated revenues for FY 2019-20. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended actions, immediate access and sharing of patient health information between participating emergency ambulance providers and hospitals would not be implemented in Fresno County resulting in less efficient and less comprehensive methods continuing.
RETROACTIVE AGREEMENT:
The recommended agreement was received from Manifest MedEx on November 20, 2019 and is retroactive to December 31, 2019. The Department could not present to your Board sooner due to the time required to review and process the recommended agreement.
FISCAL IMPACT:
There is no Net County Cost associated with the recommended actions. Funding to Manifest MedEx is being made through the California Department of Public Health as part of Centers for Medicare / Medicaid Services (CMS) 90/10 Funding and CARESTAR Foundation matching funds. The State Emergency Medical Services Authority (EMSA) awarded Manifest MedEx a total of $4.9 Million for the +EMS grant program to implement “SAFR” project with EMS Agencies, EMS participants, and Hospitals.
The proposed Agreement allocates $219,900 over the next two years to the County of Fresno, which will be distributed to participating agencies. Fresno County will receive a total of $97,650 and the remaining $122,250 will be distributed by the County to the participating ambulance providers and the electronic patient care reporting system vendor when specific milestones are achieved. Approval of the second recommended action will increase the FY 2019-20 appropriations and estimated revenues in the amount of $109,950 in the Department’s Org 5620. The remaining funds ($109,950) will be included in the FY 2020-21 Requested budget.
DISCUSSION:
On January 28, 2019, EMSA issued the Federal +EMS Local Assistance Grant Funding Opportunity announcement seeking proposals from Regional Health Information Organizations (RHIO) with the support of a local EMS agency (LEMSA). Manifest MedEx was awarded a grant that includes the participation of six LEMSAs including the Central California EMS Agency, which is a Division of the Fresno County Department of Public Health. Fresno County is a partner of the Central Valley Health Information Exchange (CVHIE), which is a non-profit local affiliate of Manifest MedEx. The Department has worked extensively with Manifest MedEx on development of our local HIE.
The +EMS project will integrate the pre-hospital systems and EMS into the HIE and allow caregivers to immediately access ambulance records of a specific patient, when needed, and also allow pre-hospital care personnel in the field to appropriately access and securely share a patient’s vital medical information electronically. The objective is to provide access to information that will result in better medical care for the patient.
By entering into the agreement with Manifest MedEx, Fresno County agrees to implement and onboard interoperate health information exchange between participating emergency ambulance service providers (American Ambulance and American Ambulance of Visalia) and hospitals (Community Regional Medical Center) through use of electronic health records. The goal of the +EMS HIE grant is to integrate pre-hospital electronic health records (EHRs) into the HIE allowing SEARCH, ALERT, FILE and RECONCILE (SAFR) functionality.
American Ambulance, American Ambulance of Visalia and Community Regional Medical Center are covered entities and have electronic patient health information. The transmission of treatment, payment, and operation information between covered entities, about a specific patient, is allowed under the Health Information and Portability and Accountability Act (HIPPA) and California Health and Safety Code.
REFERENCE MATERIAL:
BAI # 54 - January 29, 2019
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with Manifest MedEx
On file with Clerk - Resolution (Org 5620)
CAO ANALYST:
Raul Guerra