Title
Authorize the Purchasing Manager for Natividad Medical Center (NMC) to execute Amendment No. 2 to the Amended and Restated Agreement (A-09333/MYA456) with RehabCare Group Management Services Inc. for Rehabilitation Program Management Services at NMC, extending the Agreement to June 30, 2015 and adding $2,199,695 for a revised total Agreement amount not to exceed $10,146,430 in the aggregate. (ADDED VIA ADDENDUM)
Report
RECOMMENDATION:
It is recommended the Board of Supervisors authorize the Purchasing Manager for Natividad Medical Center (NMC) to execute Amendment No. 2 to the Amended and Restated Agreement (A-09333/MYA456) with RehabCare Group Management Services Inc. for Rehabilitation Program Management Services at NMC, extending the Agreement to June 30, 2015 and adding $2,199,695 for a revised total Agreement amount not to exceed $10,146,430 in the aggregate.
SUMMARY/DISCUSSION:
The County of Monterey, on behalf of NMC, has an agreement with RehabCare Group Management Services, Inc, a premier provider of rehabilitation services and post acute care services at 2,200 locations in 47 states. Prior to the agreement with RehabCare, NMC operated a Long Term Care facility. The service line was not profitable and therefore NMC pursued the implementation of an Acute Rehabilitation Unit in its place. At that time, Natividad went through a rigorous process of establishing criteria for a Request for Proposals (RFP) based on the County, State and Federal guidelines for providing this level of service. RehabCare was selected as a result of RFP #9678 in February of 2003.
RehabCare manages NMC's Acute Rehab Unit under the direction of the NMC Medical Director providing rehabilitation services for NMC patients. For the last eleven years, pursuant to the parties' agreement, RehabCare provides management and therapy services for NMC's Acute Rehabilitation Unit ("ARU"), a specialized clinical unit that serves patients with a multitude of diagnoses including stroke, orthopedic conditions, arthritis and traumatic brain injuries. Over the past two years the ARU at NMC has demonstrated 20% growth in admissions. This trend is expected to continue as NMC achieves trauma certification in 2015.
The following is the annual spend per fiscal year beginning in fiscal year 2010/2011, and the total spent to date (as of 2/28/2014) for fiscal year 2013/2014:
FY 10-11: $2,047,833
FY 11-12: $2,040,691
FY 12-13 $1,803,619
FY 13-14 $1,791,405.64 under an encumbered Purchase Order of $2,156,462
Amendment #2 to the 2012 Amended and Restated Agreement also clarifies the shared staffing relationship between NMC and RehabCare group to allow for an increase to the hourly rate for Speech Language Pathologists and provide an overtime rate. NMC ultimately desires to bring Speech Therapy services in house, but as an interim step will work with RehabCare group to provide these services. NMC has historically contracted Speech Therapy services out to a contractor since 2006. This relationship will discontinue June 30, 2014. The services that RehabCare group will provide includes assessment and treatment for both adult and pediatric patients and treatment for inpatient Neonatal Intensive Care Unit (NICU) patients and outpatient children with suspected feeding, swallowing or cognitive deficits and/or language disabilities. The adult patient services include inpatient and outpatient evaluation of dysphasia, aphasia post stroke, traumatic brain injury and treatment for deficits from surgery, Alzheimer's, Parkinson's disease and trauma.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved this Amendment No. 2 as to legal form and risk provisions. Auditor-Controller has reviewed and approved this Amendment No. 2 as to fiscal provisions. 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. The Amendment has also been reviewed and approved by Natividad Medical Center's Finance Committee 5.29.14 and Board of Trustees 6.6.2014.
FINANCING:
The cost for this Amendment No. 2 is $2,199,695 for a revised total Agreement amount not to exceed $10,146,430. $2,199,695 is included in the Fiscal Year 2014/2015 Recommended 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: Nancy Buscher, Interim Chief Nursing Officer, 783-2560
Approved by: Harry Weis, Chief Executive Officer, 783-2553
Attachments: Amendment No. 2, Amended and Restated Agreement, Amendment No. 1, Spend Sheet.
Attachments on file with the Clerk to the Boards Office