DATE: May 17, 2022
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health
SUBJECT: Agreement with Care Coordination Systems
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 an integrated data sharing platform system as Care Coordination Systems, LLC is the only provisionally certified vendor for the Pathways Community Hub model; and
2. Approve and authorize the Chairman to execute an Agreement and related documents with Care Coordination Systems, LLC for an integrated data sharing platform, effective upon execution, for a five-year term, total not to exceed $845,750.
REPORT
There is no additional Net County Cost associated with the recommended actions. Approval of the recommended actions would allow Care Coordination Systems, LLC (CCS) to provide the County with a database sharing platform to implement the County’s Community Health Worker (CHW) network. Traditionally, CHWs have operated in silos, and referrals they make are dependent on their individual knowledge. To be more consistent, the County has elected to adopt a centralized model where data and information can be shared amongst CHWs and healthcare organizations. The Pathways Community Hub (PCH) model is an evidence based framework adopted across the nation which standardizes how CHWs are trained, with consistent documentation, and a payment for outcome structure. Fresno Community Health Improvement Partnership (FCHIP) is contracted with the County to administer and implement the Hub model. The services are funded through Department of Public Health grant funds and other public health resources. This item is countywide.
ALTERNATIVE ACTION(S):
If the Board does not approve the recommended actions, the County will not be able to quickly implement a CHW network, which will cause delays in a coordinated approach to address the social determinants of health that are impacting our community. Further delay may result in not fulfilling the grant requirements before the funding period ends, risking non-compliance.
SUSPENSION OF COMPETITION/SOLE SOURCE CONTRACT:
The Department requests to waive the competitive bidding process consistent with Administrative Policy No. 34. CCS is uniquely qualified as they are the only vendor that is provisionally certified through PCH. CCS also has extensive experience with PCH and has completed integrated data systems for over 65 Pathways Community Hubs nationwide. The ISD - Purchasing concurs with the Department’s request to suspend the competitive bidding process.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The recommended agreement is fully funded through federal noncompetitive grant funding to address health disparities as well as other funding which addresses data integration for Fresno County. The total cost of the recommended 5-year agreement with CCS is $314,750 in year one and $132,750 for subsequent years; $845,750 for the term. Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2021-22 Adopted Budget and will be included in subsequent budget requests.
DISCUSSION:
On December 14, 2021, your board approved agreement No. 21-539 which allowed the County to partner with Fresno Metro Ministries to allow them to act as the fiscal sponsor for FCHIP. This agreement also allowed FCHIP to contract with community-based organizations to continue critical COVID response activities as well as develop a CHW Network Hub to convert the reimbursement process into a payment for outcome structure consistent with a national evidence based CHW Hub Pathways Model. Through the Pathways Hub, CHWs will be able to coordinate with healthcare providers and other CHWs for resources and referrals. The Hub also allows providers and CHWs to track client progress and measure client success through various programs. FCHIP is the only organization in the Central Valley that is recognized by the Pathways Hub organization for utilization of their evidence-based model.
The PCH Hub builds off the groundwork laid by the COVID Equity Project and continues the shared initiative of FCHIP and the Department to establish an evidence based CHW network that can be significantly funded from various funding resources through year 2023. The CCS platform is a key component in creating a successful CHW network through their integrated capabilities with PCH. CCS is a PCH preferred vendor, and the only vendor provisionally certified for the Pathways model. The CCS payment for outcome invoicing function allows clients to be tracked through the lifetime of a referral and determines the most appropriate blended funding sources to be billed based on services provided as well as client success through the Pathway model. Through the Hub model, multisector partners throughout Fresno County will be able to take a coordinated approach to address the social determinants of health that have contributed to high rates of preterm, infant mortality, obesity, diabetes, cardiovascular disease, as well as other health issues faced by our residents. The CCS platform creates a safe and seamless electronic data sharing and referral network for partners. This includes the usage of this platform by other CHW efforts led by Fresno County Department of Public Health, such as Advancing Health Literacy, Fresno County’s Initiative to Address COVID-19 Related Health Disparities, and Rural Mobile Health Program. The CHW network in conjunction with the PCH Hub and CCS platform will allow for residents to receive access to a closed loop referral network unique to their individual needs. The Hub will address health disparities impacted by COVID-19 and address longstanding inequities that vulnerable populations of Fresno County have experienced long before COVID-19. This model will be sustained beyond the Health Disparities grant by FCHIP and community-based organizations who, after the initial purchase, will continue to utilize this software through Hub model funding to create a sustainable network of care in Fresno County.
Internal Services Department and County Counsel have reviewed the contract and have found it to be acceptable. County Counsel would like the following deviations from the standard contract noted:
• The agreement requires arbitration in Ohio.
• A limitation of liability section has been accepted at the discretion of the Department.
• CCS’s cyber liability limits will begin at $1,000,000 at execution and be upgraded to $2,000,000 at the time of their policy renewal on October 9, 2022 through the remainder of the term.
REFERENCE MATERIAL:
BAI #68, December 14, 2021
ATTACHMENTS INCLUDED AND/OR ON FILE:
Suspension of Competition Acquisition Request
On file with Clerk - Agreement with Care Coordinated Systems, LLC
CAO ANALYST:
Ron Alexander