Title
Authorize and direct the Purchasing Manager of Natividad Medical Center (NMC) to execute Amendment No. 2 to the Agreement (A-12386) with The Camden Group for Engagement Management Services and Business Advisory Guidance regarding the achievement of Strategic Goals identified during NMC's strategic planning process extending the term of the Agreement from January 1, 2013 through December 31, 2014, and adding $980,000 for a revised total Agreement amount not to exceed $1,780,000.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors authorize and direct the Purchasing Manager of Natividad Medical Center (NMC) to execute Amendment No. 2 to the Agreement (A-12386) with The Camden Group for Engagement Management Services and Business Advisory Guidance regarding the achievement of Strategic Goals identified during NMC's strategic planning process extending the term of the Agreement from January 1, 2013 through December 31, 2014, and adding $980,000 for a revised total Agreement amount not to exceed $1,780,000.
SUMMARY/DISCUSSION:
The initial agreement with The Camden Group was for services to lead an NMC strategic planning process which included a situation assessment utilizing internal and external data analyses, interviews, a planning retreat, work group meetings and development of a revised Mission & Vision and identification of Strategic Goals to pursue to drive organizational success in this dynamic, competitive, rapidly changing health care delivery environment.
The Mission, Vision, and Goals are outlined as follows:
The Mission: To continually monitor and improve the health of the people, including the vulnerable, in Monterey County, through coordinated, affordable, high quality health care.
The Vision: To be a health care delivery system that collaborates with other providers to offer accessible, high quality and high value health care services in a financially stable manner.
The Goals:
· Seek strategic partnerships or affiliations
· Improve quality outcomes and increase patient satisfaction
· Improve staff recruitment/retention
· Improve patient centered care
· Increase patient access
· Increase physician integration and alignment
· Move towards population health management
· Attain financial stability
· Fund capital needs
Amendment No. 1 to The Camden Agreement assisted NMC with the development of execution plans with defined deliverables for achievement of Strategic Goals. Amendment No. 1 was approved by this Board on May 21, 2013, however, due to a typo, the Amendment No. 1 stated a term expiration of June 30, 2015 while the Board Report and Board Order stated a term extension only through June 30, 2014. This error was discovered after the Board approval. upon which time the vendor was contacted and informed that the Board approved a term through June 30, 2014 only.
Amendment No. 2 includes important Engagement Management Support and Business Advisory Guidance in terms of providing content expert advice, and market assessment analyses to support the achievement of the following Strategic Goals: Increase physician integration and alignment, seek strategic partnerships or affiliations, improve staff recruitment/retention, and increase patient access.
Engagement Management consists of the following:
· Schedule work group meetings
· Monitor timelines and deadlines
· Provide direction of support of implementation staff
· Coordinate efforts among various goals and ensure all activities are "in sync" with one another
· Prepare work group meeting materials
· Prepare board meeting materials
· Provide status updates at monthly board meetings
· Provide monthly reports to the Board of Supervisors
· Facilitate key meetings (both on-site and via telephone) for work group meetings and ad hoc calls (legal and technical)
Business Advisory services for each goal consist of the following:
· Develop work plans
· Participate in the work group meetings
· Strategy development
· Market assessments including stakeholder meetings, surveys, and analyses of market requirements.
· Select affiliation models and partners
· Obtain participation agreements
· Develop financial and operational plans
· "Go live" assistance
This Amendment No. 2 is requesting that an additional $980,000 be added to the total Agreement amount for a revised total of $1,780,000. The total dollar amount of this agreement prior to this Amendment No. 2 was $800,000 and had actually been fully reached earlier in this Fiscal Year 2013-14 during November 2013. NMC initially circulated for approval an amendment to increase the contract cap in November 2013. Due to internal delays, however, as the budget for future services continued to be revised and refined, the amendment for a $980,000 increase was not presented to the Board until now per this Amendment No. 2. NMC continued to work with the Camden Group and therefore approximately $374,000 of this additional $980,000 is intended to cover services already rendered through March 2014. Fees for new services rendered from this point forward are charged based on hours to complete the various phases. Individual scope of work summaries are approved internally in advance. In the event the specific plans require fewer hours or a decision is made not to proceed with implementation of specific goal phases the fees will be less.
The Camden Group is uniquely qualified to assist NMC in this work. The Camden Group's executive team members are national experts in strategic planning, healthcare reform, delivery system integration and physician alignment. The firm has extensive experience in understanding the California health care landscape through working with California hospitals and healthcare systems. Moreover, the firm has significant public safety net health care system experience having worked with twelve California healthcare districts and ten County hospitals.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved this Amendment No. 2 as to legal form and risk provisions. The Auditor-Controller has reviewed and approved this Amendment No. 2 as to fiscal provisions. Amendment No. 2 originally increased the total Agreement amount up to $2,800,000 which was reviewed by NMC's Finance Committee (11-26-2013) and the Natividad Board of Trustees (12-06-2013). Subsequently, NMC staff further examined then renegotiated the scope of work so as to reduce the total cost of the Agreement and Amendment No. 2 was revised for a current total not to exceed $1,780,000. 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.
FINANCING:
The cost for this Amendment No. 2 is $980,000 for a total Agreement amount not to exceed $1,780,000. $500,000 of this was included in the Fiscal Year 2013/2014 Adopted Budget. Amounts for the remaining year of the Amendment No. 2 will be included in that budget as appropriate. 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: Carol Adams, Asst. Administrator, Planning & Business Development, 783-2556
Approved by: Harry Weis, Chief Executive Officer, 783-2553
Attachments: Amendments No. 2, Original Agreement, and Spend Sheet.
Attachments on file with the Clerk to the Boards Office