Title
a. Authorize the Chief Executive Officer for Natividad Medical Center (NMC) or a designee to execute a Nonstandard Participation agreement with Manifest Medex, a California nonprofit public benefit corporation for Electronic Health Information Exchange services at NMC for a maximum County obligation of $150,000 with a not exceed obligation of $30,000 per fiscal year, commencing upon execution and shall remain in effect until terminated as set forth in the Agreement.
b. Approve the NMC’s Chief Executive Officer’s recommendation to accept non-standard agreement in its entirety.
Report
RECOMMENDATION:
It is recommended the Board of Supervisors:
a Authorize the Chief Executive Officer for Natividad Medical Center (NMC) or a designee to execute a Nonstandard Participation agreement with Manifest Medex, a California nonprofit public benefit corporation for Electronic Health Information Exchange services at NMC for a maximum County obligation of $150,000 with a not exceed obligation of $30,000 per fiscal year, commencing upon execution and shall remain in effect until terminated as set forth in the Agreement.
b. Approve the NMC’s Chief Executive Officer’s recommendation to accept non-standard agreement in its entirety.
SUMMARY:
Natividad Medical Center has an ongoing need to maintain and enhance its electronic health record system’s health information exchange capabilities. Previously, the Board approved an agreement with Serving Communities Health Information Organization (SCHIO) to provide these services. However, SCHIO terminated their contracted services on December 31, 2025-only a few months after Natividad Medical Center had gone live on their platform-as SCHIO will no longer provide independent health information exchange services. To ensure uninterrupted data exchange and regulatory compliance, Natividad Medical Center is requesting approval to enter into a new agreement with Manifest MedEx, a national health information exchange. Natividad Medical Center will closely monitor the implementation phases with Manifest MedEx to ensure all milestones for data integration and exchange are met in a timely manner to replace the lost functionality.
DISCUSSION
Transitioning to Manifest MedEx is highly beneficial and essential for Natividad Medical Center for three primary reasons:
1) Regulatory Compliance: It ensures continued compliance with the State of California’s legislative mandate (AB133), which requires all hospitals in the state to securely exchange patient information via a Qualified Health Information Exchange.
2) Patient Care: It maintains a vital health information exchange platform to facilitate seamless transitions of care for our patients between Natividad Medical Center, the Monterey County Health Department, and area hospitals.
3) Financial Incentives: Most importantly, participation in this specific national health information exchange is required to meet the data exchange requirements of our local health plan, the Central California Alliance for Health (CCAH). Utilizing Manifest MedEx is required for Natividad Medical Center to qualify for and receive enhanced Medi-Cal and Cal-Aim incentive payments from CCAH.
This new agreement directly addresses the gap in service caused by SCHIO's decision to cease providing independent health information exchange services on December 31, 2025. Partnering with Manifest MedEx ensures Natividad Medical Center does not experience a prolonged lapse in mandated data exchange capabilities and secures our ability to receive critical incentive funds.
OTHER AGENCY INVOLVEMENT:
The Office of County Counsel has reviewed and approved this participation agreement as to form, and the Auditor-Controller has reviewed and approved as to payment provisions. The participation agreement has also been reviewed and approved by NMC’s Finance Committee and by its Board of Trustees on April 10, 2026.
FINANCING:
The cost for this participation agreement is $150,000 of which $ 30,000 is included in the FY 2026-27 Recommended Budget. Amounts for remaining years of the agreement will be included in those budgets as appropriate. There is no impact on the General Fund with this action.
BOARD OF SUPERVISORS STRATEGIC PLAN GOALS SECTION:
This agreement supports the goal of Safe and Resilient Communities by ensuring that Natividad Medical Center maintains a robust and secure health information exchange infrastructure. By facilitating the seamless transfer of patient data between healthcare providers, this partnership enhances the coordination of care and improves health outcomes for Monterey County residents. Furthermore, securing the Central California Alliance for Health (CCAH) incentive funds ensures the continued financial resilience of the hospital’s health information technology systems.
__ Well-Being and Quality of Life
__ Sustainable Infrastructure for Present and Future
X Safe and Resilient Communities
__Diverse and Thriving Economy
__ Administrative
Prepared by: Ari Entin, Hospital Chief Information Officer, 783-2564
Approved by: Charles R. Harris, Chief Executive Officer, 783-2553
Attachment(s):
Board Report
Manifest Medex Participation Agreement
Attachments on file with the Clerk of the Board