Title
Authorize and direct the Purchasing Manager for Natividad Medical Center (NMC) to execute Amendment No. 4 to the Agreement (A-12028) with Health Care Interpreter Network (HCIN) for Shared Interpreter Services at NMC, extending the Agreement to June 30, 2015 and adding $55,000 for a revised amount not to exceed $300,000 in the aggregate (for the period May 1, 2010 to June 30, 2015).
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
Authorize and direct the Purchasing Manager for Natividad Medical Center (NMC) to execute Amendment No. 4 to the Agreement (A-12028) with Health Care Interpreter Network (HCIN) for Shared Interpreter Services at NMC, extending the Agreement to June 30, 2015 and adding $55,000 for a revised amount not to exceed $300,000 in the aggregate (for the period May 1, 2010 to June 30, 2015).
SUMMARY/DISCUSSION:
Approximately 52% of the patient population at NMC identify themselves as limited English proficient (LEP). The Joint Commission, the agency that accredits NMC, has standards which require effective communication for LEP patients through the use of competent qualified interpreters. The California and Federal laws that regulate equal access to all patients, including Title VI of the Civil Right Act of 1964, prohibit discrimination on the basis of race, color or national origin and require that healthcare be delivered with effective communication for non-English speakers. The provision of interpretation services helps NMC reduce liability for medical errors due to a breakdown in communication and improves the quality of healthcare.
NMC utilizes a three-pronged approach to meet the language needs of patients: in-person interpreting by NMC Medical Interpreters, NMC dual-role bilingual staff, and independent contractors; video interpreting; and over-the-phone interpreting. The Health Care Interpreter Network (HCIN) is a cooperative of California hospitals and health care providers sharing trained healthcare interpreters through an automated video/voice call center system. Videoconferencing devices and all forms of telephones throughout each hospital connect within seconds to an interpreter on the HCIN system, either at their own hospital or one of their colleague hospitals.
NMC has an Agreement with HCIN to provide access to a system of shared interpreter services. NMC was allowed to establish a connection to the HCIN secure broadband network and utilize the services of its Video/Voice over IP Call Center. This allows NMC to provide 24/7 interpreting services to our patients in 170 languages including American Sign Language (ASL). A valuable aspect of this service is that our staff interpreters can log onto the system and offset the cost by providing interpreter services to the hospitals on the network on their slow or down time, making them more productive. Without these services NMC would lose their capacity to provide a qualified interpreter to a large group of patients and would not be in compliance with the Joint Commission standards, California and Federal laws that regulate equal access to all patients.
NMC wishes to amend the Agreement in order to continue to provide interpretation without interruption through June 30, 2015. The additional $55,000 is for the estimated amount of services to be provided during the extended term of the Agreement. The actual cost is contingent upon patient volume, the needs of individual patients, and the number of bilingual staff hired into positions which require bilingual skills, which is unpredictable by nature.
Business Automobile Insurance Exemption: Business Automobile Liability Insurance requirements are waived for this vendor under this Agreement. There is no risk or exposure regarding vehicles. Contractor does not travel onto County property with vehicles.
Worker's Compensation Insurance Exemption: Contractor is the sole provider of services with no permanent or temporary workers. Accordingly, Worker's Compensation Insurance is not required.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved this Amendment as to legal form and risk provisions. Auditor-Controller has reviewed and approved this Amendment 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 present 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 on April 24, 2014 and Board of Trustees on May 2, 2014.
FINANCING:
The total cost for this Agreement is $300,000. $34,248 was disbursed in Fiscal Year 2010/2011; $52,176 in Fiscal Year 2011/2012; $54,047 in Fiscal Year 2012/2013; and $55,000 is included in the Fiscal Year 2013/2014 Adopted Budget, of which $34,102 has been disbursed year to date. $55,000 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: Victor Sosa, Language Access Coordinator, 796-1612
Approved by: Harry Weis, Chief Executive Officer, 783-2124
Attachments: Agreement; Amendments 1-4
Attachments on file with the Clerk to the Boards Office