Title
a. Ratify Amendment No. 2 to the Agreement with eCare Manage, Inc. which extended the Agreement term to March 31, 2014 (a no cost extension); and
b. Authorize the Purchasing Manager for NMC to execute Renewal and Amendment No. 3 to the Agreement with eCare Manage, Inc., retroactive to April 1, 2014, to extend the Agreement term through and including December 31, 2014 and increase the total amount of the Agreement by an additional $1,547,500 for a revised total Agreement amount not to exceed $4,037,500.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Ratify Amendment No. 2 to the Agreement with eCare Manage, Inc. which extended the Agreement term to March 31, 2014 (a no cost extension); and
b. Authorize the Purchasing Manager for NMC to execute Renewal and Amendment No. 3 to the Agreement with eCare Manage, Inc., retroactive to April 1, 2014, to extend the Agreement term through and including December 31, 2014 and increase the total amount of the Agreement by an additional $1,547,500 for a revised total Agreement amount not to exceed $4,037,500.
SUMMARY/DISCUSSION:
Natividad Medical Center (NMC) is working to complete several Information Technology initiatives to meet regulatory requirements, Meaningful Use and DSRIP goals, and to ensure the facility meets all the necessary upgrades and changes to our various medical systems to maintain the quality of care our patients expect.
In an effort to meet the ongoing needs of our patients it is important that NMC continues to have a resource available to provide strategic direction to the NMC Information Systems Department. Over the next year NMC needs to continue progress toward implementing a fully electronic health record, a patient and physician portal, and a regional Health Information Exchange. Approval of the Renewal and Amendment No. 3 to the Agreement with eCare Manage Inc. will allow NMC to maintain five consulting resources to help NMC move forward with this Vision.
NMC will be seeking Board Approval to recruit and hire six budgeted positions in an effort to fully or partially reduce its dependence on eCare in the future. It is anticipated that the recruitments for these positions will begin in June of 2014 and be filled by December 31, 2014. NMC will reduce eCare consulting hours as internal fully competent staff are hired as replacements.
NMC entered into its original agreement with eCare Manage Inc. in 2011 and received approval for an Agreement of $450,000 for Chief Information Officer services. NMC entered into a new board approved Agreement (A-12169) with eCare Manage Inc. for modified and expanded services to include strategic direction and add additional Information Technology services for a total amount not to exceed $1,350,000 and a one year term from January 1, 2012 to December 31, 2012.The total of these two Agreements led to an aggregate total of $1,800,000. Board approval was granted for Renewal and Amendment No. 1 to the Agreement (A-12169) which extended the term for an additional one year period with an associated cost increase of $1,140,000 for a new total not to exceed amount of $2,490,000 and a new aggregate total of $2,940,000.
Amendment No. 2 to the Agreement (A-12169) was then executed by the NMC Purchasing Manager which extended the Agreement for three additional months at no increased cost, but due to an oversight Amendment No. 2 was never approved by the Board of Supervisors. Therefore, NMC is now requesting that the Board of Supervisors ratify Amendment No. 2 to the eCare Manage Inc. Agreement (A-12169).
NMC is also requesting the Board approve Renewal and Amendment No.3 to the Agreement (A-12169) to extend the Agreement term to December 31, 2014 and to increase the Agreement by an additional $1,547,500 due to the term extension, for a revised total Agreement amount not to exceed $4,037,500 and a new aggregate total for eCare Manage Inc. services of $4,487,500.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved both Amendment No. 2 and the Renewal and Amendment No. 3 as to legal form and risk provisions. Auditor-Controller has reviewed and approved both Amendment No. 2 and the Renewal and Amendment No. 3 as to fiscal provisions. Although the Renewal and Amendment No. 3 was reviewed by NMC's Finance Committee and its Board of Trustees, it was submitted to them labeled incorrectly as "Renewal and Amendment No. 2" when it should have been submitted as "Renewal and Amendment No. 3. Approval was obtained by both the NMC Finance Committee and the NMC Board of Trustees, however, after those approvals were granted on April 4, 2014, NMC has since renegotiated a shorter term end date with eCare Manage Inc. and the Agreement end date is now on December 31, 2014 instead of June 30, 2015. The CAO-Budget and Analysis Division has advised to inform the BOS the spending authority (appropriations) associated with NMC's FY 2014 Adopted Budget has been exceeded and approval and authorization for modification of NMC's appropriation budget should be presented to the BOS. Since NMC is an Enterprise Fund, this does not prevent continued expenditures, but it is considered good public policy, transparency and fiscal management.
FINANCING:
The cost for the Renewal and Amendment No. 3 is $1,547,500 for a revised total Agreement amount not to exceed $4,487,500 is included in the Fiscal Year 2013/2014 Adopted Budget and is included in the NMC FY 2014/2015 proposed budget. NMC's FY 2013-2014 appropriation obligations exceeded its budget for the period July 2013 through December 2013 (six months). NMC has received additional Disproportionate Share funding from the State and is forecasted to be back on budget. NMC is confirming its appropriations position and if its spending authority has been exceeded will return to the Board.
There is no impact to the General Fund.
Prepared by: Janine Bouyea, HR Administrator, 783-2701
Approved by: Harry Weis, Chief Executive Officer, 783-2553
Attachments:
1. eCare Manage Inc. original Agreement plus Renewal and Amendment No. 1
2. eCare Manage Inc. Amendment No. 2
3. eCare Manage Inc. Renewal and Amendment No. 3
4. ecare Manage Inc. Spend Sheet
Attachments on file with the Clerk to the Boards Office