DATE: August 9, 2016
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director, Department of Public Health
SUBJECT: Amendment to Agreement with Health Monitoring Systems, Inc.
RECOMMENDED ACTION:
TITLE
Approve and authorize the Chairman to execute Amendment II to Agreement No. 11-006 with Health Monitoring Systems, Inc., a two-year extension and an increase of $20,500, for participation in a real-time public health surveillance system, effective August 18, 2016 through August 17, 2018 ($77,200).
REPORT
Approval of the recommended action will enable the Department of Public Health to continue monitoring potential disease outbreaks in the Community Medical Centers, St. Agnes, Adventist Medical Centers and Fresno Kaiser Permanente Hospital network of emergency rooms (Healthcare Systems) through the Health Monitoring Systems, Inc. (HMS) EpiCenter bio-surveillance system. The proposed Amendment will allow County epidemiologists to continue syndromic surveillance pursuant to the Patient Protection and Affordable Care Act (PPACA), Public Law 111-148, Section 3003. The two-year extension, funded with Public Health Emergency Preparedness funds, will also allow continued use of the EpiCenter bio-surveillance system while a new no cost syndromic surveillance system is tested and evaluated. This new system will result in no increase in Net County Cost.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended action, the County epidemiologists would not have access to important emergency room data which currently allows them to target certain disease syndromes that are of interest to public health, including neurological, flu-like and rash-like symptoms. The surveillance allows epidemiologists to combine emergency room data with data retrieved through other sources in the detection of new disease syndromes and their potential impact to County residents. Additionally, without the recommended Amendment, the County would not be compliant with the Federal mandate for syndromic surveillance. Non-approval may also result in the participating healthcare systems incurring additional staff training costs and/or creating another interface, which would be necessary if the County were to switch vendors prior to the implementation of the new system.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum FY 2016-17 cost of the Agreement is $10,250; $77,200 for the term. The Amendment will be financed with Public Health Emergency Preparedness funds. The Department could exercise the 60-day notice clause with HMS when the new system is fully functional and meeting all Federal requirements and any remaining costs due to the notice of termination will be prorated based on the annual fee amount of $10,250. Sufficient appropriations and estimated revenues are included in the Department Org 5620 FY 2016-17 Adopted Budget and will be included in the FY 2017-18 budget request.
DISCUSSION:
On August 28, 2007, your Board approved sole source Agreement No. 07-365 with Health Monitoring Systems, Inc. for participation in a real-time public health surveillance system for a term of three years (August 28, 2007 through August 27, 2010) at a maximum cost of $20,700. On January 11, 2011, your Board approved sole source Agreement No. 11-006 with for the same service for a term of four years (August 18, 2010 through August 17, 2014) at a maximum cost of $37,800. On July 29, 2014, your Board approved Amendment I to Agreement No. 11-006 with Health Monitoring Systems, Inc. extending the term to August 17, 2016 increasing the maximum cost to $56,700.
The recommended Amendment will extend the existing Agreement an additional two years allowing the Department to remain in compliance with the PPACA to provide syndromic surveillance under the same terms and conditions.
In December of 2015, the County contracted with the Association of State and Territorial Health Officials (ASTHO), following the County Purchasing Suspension of Competition process for their syndromic surveillance system, BioSense. The agreement with ASTHO is at no cost to the County and is anticipated to meet the Department’s needs based on the County’s epidemiologist’s familiarity with the system. The system will allow real-time monitoring of chronic, acute, and other public health conditions of interest, de-identified patient recording to third party systems, and works seamlessly with a variety of electronic health record systems. The BioSense system is not currently operational, but once fully operational and implemented; it is expected to replace the HMS system.
The recommended Amendment will provide an ongoing system to continue monitoring potential disease outbreaks in the healthcare systems until the new system is fully operational, implemented and evaluated by the Department. The two syndromic surveillance systems will run concurrently during the two-year term as the Department slowly transitions from the current to new system. The recommended Amendment will prevent the participating healthcare systems from incurring additional staff training costs and/or creating another interface.
Throughout the proposed Amendment term, the participating healthcare systems will continue to interface their computer data network with HMS through a Business Associate Agreement and share data with the Department.
The proposed Amendment may be canceled or terminated, without cause, by either party, by giving 60 calendar days advance written notice to the other party. The Department could exercise the 60-day notice clause with HMS when the new BioSense system is fully functional and meeting all Federal requirements and any remaining costs due to the notice of termination will be prorated based on the annual fee amount of $10,250.
REFERENCE MATERIAL:
BAI #34, July 29, 2014 - Amendment I to Agreement No. 11-006
BAI #35, January 11, 2011 - Agreement No. 11-006
BAI #23, August 28, 2007 - Agreement No. 07-365
Attachments Included and/or on file:
On file with Clerk - Amendment II to Agreement No. 11-006 with Health Monitoring Systems, Inc.
CAO ANALYST:
Sonia De La Rosa