DATE: May 21, 2024
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health
Susan L. Holt, LMFT, Director of Behavioral Health
SUBJECT: Amendment I to Agreement with Manifest MedEx
RECOMMENDED ACTION(S):
TITLE
1. Approve and Authorize the Chairman to execute Amendment I to Agreement with Manifest MedEx to remove Central Valley Health Information Exchange and update agreement scope of work, effective upon execution with no change in term of January 4, 2022 to June 30, 2027, and increasing the maximum by $415,000 to a total not to exceed $503,130; and
2. Approve and authorize the Director of the Department of Public Health, or designee, as signatory to approve changes and additions of Statement of Work documents, expenditure forms and reports, and to add new Statement of Work as needed by program which do not result in any change to the maximum compensation amount.
REPORT
There is no additional Net County Cost associated with the recommended actions, which will remove Central Valley Health Information Exchange and update agreement scope of work to allow the Department of Public Health and the Department of Behavioral Health continued access to exchange patient data with healthcare facilities and providers, and monitor, track, and improve patient care coordination utilizing the health information technology infrastructure maintained by Manifest MedEx. The increase in the maximum compensation will be funded with American Rescue Plan Act - State Local Fiscal Recovery Funds (ARPA-SLFRF), as it relates to the County’s Integrated Data System project. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended actions, the Departments will not be able to continue to utilize Manifest MedEx’s (MX) technology infrastructure to access and exchange patient data with healthcare facilities and providers, requiring staff to continue to utilize existing manual, less efficient, and less comprehensive methods of obtaining patient data.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The recommended amendment increases the maximum compensation by $415,000 to a total of $503,130, which will be fully funded with ARPA-SLFRF. Sufficient appropriations and estimated revenues are included in DPH Org 5620 FY 2023-24 Adopted Budgets and will be included in future budget requests for the duration of the term.
DISCUSSION:
On January 4, 2022, the Board approved Agreement No. 22-011 with Central Valley Health Information Exchange (CVHIE) and MX for the provision of a health information exchange system for patient data transmission for the Department of Public Health and Behavioral Health.
In August 2023, CVHIE was dissolved, due to completion of the implementation of the Health Information Exchange (HIE) and in turn every participant had direct agreements with MX.
The proposed recommended actions will support the projects for the County Integrated Data System for Youth Suicide Prevention and Home Visitation/Care coordination focus. Immediately, the goal for Youth Suicide Prevention is when a child presents in a hospital emergency room with suicidal ideations there is an email sent to the child’s school nurse or school counselor of the visit. Security and legal protocols will be followed with the County infrastructure, MX, and the receiving schools.
MX will develop a policy framework to support ongoing data exchange between providers, public health, county behavioral health, and school districts/schools for patients who are minors, providing recommendations for both MX and the County of Fresno best practices and potential policies. These findings, along with independent review and analysis by the County of Fresno legal counsel, will inform the parameters for data exchange for Youth Suicide Prevention.
MX will work with the County of Fresno and Its stakeholders to further define existing and novel data flows for Youth Suicide Prevention, including how and where relevant data is captured, triggers for data transmission, user permissions, and user technology needs, including infrastructure and user interfaces. This collaborative analysis will also identify any additional or ancillary technology beyond MX’s current technology that is required to enable the Youth Suicide Prevention use case.
MX will implement a notification service (“MX Notify”) that alerts the County of Fresno when a Patient of the County of Fresno is seen in the emergency department or is admitted to or discharged from the hospital. Notifications will be based on the patient panels submitted by the County of Fresno.
The recommended amendment I to the agreement amends the scope of services to expand as the County Integrated Data System continues to be built. Funding is available in the proposed amendment to assist County departments with tailoring the system to address suicide prevention or home visitation/care coordination requirements. Additionally, the Department may evaluate the capacity with Manifest MedEx to assess patients receiving rural mobile health services if we experienced a reduction of emergency room utilization from that patient population.
REFERENCE MATERIAL:
BAI #27 - January 4, 2022
BAI #54 - January 29, 2019
BAI #33 - October 11, 2016
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment to Agreement with Manifest MedEx
CAO ANALYST:
Ron Alexander