DATE: August 21, 2018
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director, Department of Public Health
SUBJECT: Retroactive Agreement with Health Monitoring Systems, 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 for the solicitation of a real-time public health surveillance system for the Department of Public Health; and
2. Approve and authorize the Chairman to execute a retroactive Agreement with Health Monitoring Systems, Inc. for use of its real-time public health surveillance system, effective August 18, 2018, not to exceed five consecutive years, which includes a three-year base contract and two optional one-year extensions, total not to exceed $125,625.
REPORT
Approval of the recommended actions would allow Health Monitoring Systems, Inc. (HMS) to provide a real-time public health surveillance system. HMS has provided syndromic surveillance for the Department since 2007, and as required by Code of Federal Regulations Titles 45 and 42 since 2010. HMS has since established connections to six local hospital emergency departments, investing time and training staff to access the system. The recommended agreement includes the opportunity to expand to other medical facilities. The system will be funded with Public Health Emergency Preparedness (PHEP) Grant funds, with no increase in Net County Cost. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended actions, the Department’s access to the HMS public health surveillance system would end, causing the County to be out of compliance with Federal mandate; therefore, unable to engage in effective syndromic surveillance until access to another real-time surveillance system can be acquired. In addition, non-approval would require the emergency department staff at six engaged local hospitals to access and retrain in a new surveillance system.
SUSPENSION OF COMPETITION/SOLE SOURCE CONTRACT:
The Department’s request to suspend the competitive bidding process is consistent with Administrative Policy No. 34 as HMS has been the surveillance system provider for the Department since 2007. The system allows the Department access to real time data from emergency departments at six hospitals located in the County. Connection began with Community Regional Medical Center in 2007, with additional hospitals added in subsequent years. The Department’s epidemiologists are able analyze the data to target disease systems that are of interest to public health. If the County were to discontinue use of HMS to supply this data, the connected hospitals would be required to acquire access and train staff in the use of a different surveillance system provider, resulting in additional time and cost to the hospitals. The Internal Services Department - Purchasing Division concurs with the Department’s request to waive the competitive bidding process.
RETROACTIVE AGREEMENT:
The recommended agreement is retroactive to August 18, 2018. Due to delays in negotiations, the agreement was not finalized by HMS until July 18, 2018.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The maximum compensation for the five-year term is $125,625. The annual compensation may fluctuate due to the optional services that may be accessed. The agreement will be fully funded with PHEP Grant funds. Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2018-19 Recommended Budget and will be included in future budget requests for the term’s duration.
DISCUSSION:
Pursuant to meaningful use requirements contained in 45 Code of Federal Regulation (CFR) and 42 CFR, public health departments are required to be able to receive medical information via electronic health records (EHR) from applicable medical providers. To fulfill this mandate, the Department has contracted with HMS to receive EHR since 2007, and as required by Federal regulations since 2010. The recommended agreement will allow the Department to continue to fulfill the mandate and utilize the real-time EHR data from local hospital emergency departments, where significant public health threats are most likely to be identified in patients, through HMS’ EpiCenter surveillance system.
EpiCenter is a secure health data center that links hospitals and public health departments by receiving, analyzing, and displaying real-time data, thereby allowing epidemiological surveillance monitoring of chronic, acute, and other public health conditions of interest enabling the Department’s epidemiologists to target specific disease symptoms. These may include neurological, flu-like, and rash-like symptoms, among others. Further, EpiCenter allows epidemiologists to combine data from emergency departments with data retrieved through other sources in the detection of new disease syndromes and to identify the potential impact to County residents. EpiCenter allows alerts to be set if certain conditions are presented at area emergency departments at a greater than expected frequency. If conditions exceed alert parameters, Department staff receive notifications indicating a public health threat may be present, which may prompt further investigation.
In addition, the recommended agreement would allow HMS to provide optional services, enabling the Department to tailor requests to obtain more specific data sets not included in EpiCenter’s standard services. The services would allow users to research other areas of public health interest. The agreement includes a provision for additional area hospitals or other facilities to connect to HMS, gaining surveillance data from newly connected facilities.
In December 2015, the Department entered into a no cost contract with the Association of State and Territorial Health Officials (ASTHO) for access to its surveillance system, BioSense, for the purpose of thoroughly evaluating BioSense alongside HMS’ EpiCenter system and determining whether BioSense could serve as a no-cost alternative to the HMS’ system. After thorough evaluation, the Department determined that it would not be cost effective to switch from HMS’ EpiCenter to BioSense. BioSense delivers raw data and would have required an additional half-time to full-time staff member to make the data usable, whereas EpiCenter delivers data that has already been filtered and aggregated for surveillance. The added cost for a position utilizing BioSense would be significantly more than the average annual cost of the proposed HMS agreement ($25,125).
With your Board’s approval, the agreement with HMS will allow the County to continue access to real time data from emergency department’s at six local hospitals with the opportunity to expand to additional medical facilities.
REFERENCE MATERIAL:
BAI #50, August 9, 2016 - Amendment II to Agreement No. 11-006
Purchasing Agreement, P-16-102-P, December 22, 2015
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 - Agreement with Health Monitoring Systems, Inc.
Suspension of Competition Acquisition Request
CAO ANALYST:
Sonia M. De La Rosa