DATE: May 21, 2024
TO: Board of Supervisors
SUBMITTED BY: Edward Hill, Chief Operating Officer/Interim Director of Internal Services/Chief Information Officer
David Luchini, RN, PHN, Director, Department of Public Health
SUBJECT: Agreement with Netsmart Technologies, Inc.
RECOMMENDED ACTION(S):
TITLE
1. Make a finding that it is in the best interest of the County to suspend the competitive bidding process consistent with Administrative Policy No. 34 for unusual or extraordinary circumstances, as Netsmart Technologies, Inc.’s myAvatar software system is the only electronic health record system used by the Department of Public Health for client registration, referrals, client service tracking, quality assurance, scheduling, billing, and reporting; and
2. Approve and authorize the Chairman to execute an Agreement with Netsmart Technologies, Inc., for continued support and maintenance of myAvatar, the Clinical Workstation and Mobile Licenses, and consulting services, in support of the Department of Public Health’s nursing case management modules, and Laboratory Information Management System, effective upon execution, not to exceed five consecutive years, which includes a three-year base contract and two optional one-year extensions, total not to exceed $1,423,218.
REPORT
There is no additional Net County Cost associated with the approval of the recommended actions, which would allow the Department of Public Health (DPH) to continue maintenance and support of myAvatar, the Clinical Workstation and Mobile Licenses, which are used across all programs in the DPH Nursing Division, and the Laboratory Information Management System (LIMS). This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended actions, DPH would not have the right to continue using the software license, maintenance, and support of the myAvatar software application and LIMS, affecting over 150,000 unique clients in myAvatar.
SUSPENSION OF COMPETITION/SOLE SOURCE CONTRACT:
DPH’s request to suspend the competitive bidding process is consistent with Administrative Policy No. 34 under the “unusual or extraordinary circumstances” exception, as Netsmart Technologies, Inc. (Netsmart) is the only provider of maintenance and support for myAvatar, the Clinical Workstation and Mobile Licenses, and LIMS. DPH has used the electronic health record system since 2002. The Internal Services Department - Purchasing Division concurs with DPH’s request to suspend the competitive bid process.
RETROACTIVE AGREEMENT:
The recommended agreement is retroactive to March 25, 2024, due to delays in negotiations between the County and Netsmart.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. Cost associated with the recommended agreement will not exceed $1,423,218 for the total possible five-year term. The funds will cover usage of the electronic medical record components and laboratory information management system, offset with Health Realignment fees, and grant funding. Sufficient appropriations and estimated revenues are included in the DPH’s Org 5620 FY 2023-24 Adopted Budget and will be included in subsequent budget requests.
DISCUSSION:
DPH has been using myAvatar, a computer-based information system, since 2002 for client registration, referral, client service tracking, quality assurance, scheduling, billing, and reporting. DPH staff uses the system’s client logs to manage program wait lists for accuracy, for perinatal outreach services, to assist with supervision in the determination of staff caseload for assignment of referrals, and to ensure caseload accuracy.
On March 25, 2014, your Board approved Agreement No. 14-111 with Netsmart for continued maintenance and support for myAvatar, as well as for the addition of Netsmart’s Clinicians Workstation and Mobile Module, a public health nursing case management system that interfaces with myAvatar, allows for utilization on mobile devices, and streamlines data requirements from multiple grants and funders.
On March 20, 2018, your Board approved the First Amendment to Agreement No. 14-111 for the purchase of Netsmart’s Orchard Laboratory Information Management System (LIMS), a laboratory information module that integrates with existing electronic medical and clinic records and billing modules to achieve timely billing and recording of lab results by reducing dual data entry. However, implementation of the Orchard LIMS was delayed due to a flood at the Brix-Mercer building in October 2018, which impacted the DPH’s laboratory, rendering it inoperable. Since the flood, a new location for DPH’s laboratory was established.
On April 9, 2019, your Board approved a new agreement with Netsmart to allow for continued maintenance and support of myAvatar, the Clinicians Workstation, the Mobile Module, and LIMS implementation. Including optional extensions, this agreement was effective for a five-year term from March 25, 2019 through March 24, 2024.
The recommended agreement with Netsmart deviates from the County’s standard as it incorporates a limitation of liability, limiting each party’s total liability to the amount of fees paid by the County to the Contractor in the 24 months immediately preceding the date the damaged party notifies the other of a claim. Except for a breach of the license restrictions, the County and Netsmart shall not be responsible for indirect, consequential, incidental, punitive, or exemplary damages. The Human Resources Department-Risk Management Division has reviewed the provisions and recommends the agreement not include this limitation of liability language; however, ISD-IT and DPH believe that the risks associated with these changes are an acceptable business risk, given the County’s longtime relationship with Netsmart and the value of its services to County operations. The prior agreement with Netsmart included a similar limitation of liability, limiting the liability of the contractor to County for damages to two (2) times the agreement maximum.
The recommended agreement with Netsmart allows for continued maintenance and support of myAvatar, the Clinicians Workstation, the Mobile Module, and LIMS.
REFERENCE MATERIAL:
BAI #40, April 9, 2019
BAI #43, March 20, 2018
BAI #52, March 25, 2014
ATTACHMENTS INCLUDED AND/OR ON FILE:
Suspension of Competition Acquisition Request
On file with Clerk - Agreement with Netsmart Technologies, Inc.
CAO ANALYST:
Ahla Yang