Title
a. Approve and authorize the Director of Health Services or designee to execute Amendment No. 4 to the Agreement with Oregon Community Health Information Network, Inc. (OCHIN), for the utilization of a combined Electronic Medical Record (EMR) and Practice Management (PM) System extending the term an additional three years (September 1, 2026 through August 31, 2029), for a revised full term of September 1, 2018 through August 31, 2029 and adding $5,434,667 for a revised total agreement amount not to exceed $15,414,667; and
b. Approve and authorize the Director of Health Services or designee to sign up to three (3) future amendments to this Agreement that do not in total exceed 10% ($670,000) of the original Agreement amount and do not significantly change the scope of services, for a revised total not to exceed agreement amount of $16,084,667.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Approve and authorize the Director of Health Services or designee to execute Amendment No. 4 to the Agreement with Oregon Community Health Information Network, Inc. (OCHIN), for the utilization of a combined Electronic Medical Record (EMR) and Practice Management (PM) System extending the term an additional three years (September 1, 2026 through August 31, 2029), for a revised full term of September 1, 2018 through August 31, 2029 and adding $5,434,667 for a revised total agreement amount not to exceed $15,414,667; and
b. Approve and authorize the Director of Health Services or designee to sign up to three (3) future amendments to this Agreement that do not in total exceed 10% ($670,000) of the original Agreement amount and do not significantly change the scope of services, for a revised total not to exceed agreement amount of $16,084,667.
SUMMARY:
Over the years OCHIN has provided valuable health information technology support and services to the Health Department Clinic Services Bureau, incorporating best industry practices to improve patient care delivery and enhance practice management.
Approval of this Amendment No. 4 will maintain uninterrupted access to the Clinic Services’ long-standing OCHIN Epic system, while supporting the incremental costs associated with continued growth from capital expansion projects and new service delivery lines, including the work to add Public Health Bureau’s CCS Medical Therapy Program to the Epic targeting late 2026.
DISCUSSION:
The Health Department Clinic Services Bureau (Clinic Services) operates twelve community clinic sites designated as Federally Qualified Health Centers (FQHCs) which provide preventive primary, dental and specialty medical care services.
Clinic Services has been a member of the OCHIN collaborative since 2007, which allows for access and usage of OCHIN’s Epic, an Electronic Health Record (EHR) and Practice Management (PM) system.
On August 28, 2018, the Board of Supervisors approved Agreement No. A-14094 to replace the previous Agreement with OCHIN by bringing all contract provisions up to current environment standards and in compliance with current federal and state laws protecting the health and personal information of the County’s patients. Amendment No. 1 to Agreement No. A-14094 was executed on July 1, 2020 to add additional services, and Amendment No. 2 was executed on July 1, 2022 to increase the contract amount, and Amendment No. 3 was executed on September 1, 2023 to increase funding and extend the term to August 31, 2026.
Continuation of this long-standing electronic medical record and practice management contract is essential due to the extensive custom enhancements developed to meet the County’s operational, clinical, and reporting needs. Over the years, Clinic Services’ Epic system has been tailored to integrate with internal workflows, adjust for regulatory requirements, and legacy data structures, making it a core component of medical record integrity and service delivery. Replacing or significantly modifying existing customization would require substantial time, cost, and operational disruption.
This work supports the County of Monterey Health Department’s 2025 - 2028 Strategic Plan Goals(s): 4. Deepen Organizational Effectiveness and Support Long-Term Sustainability. It also supports the following of the ten essential public health services, specifically: 1) Monitor health status to identify and solve community health problems; and 3) Inform, educate, and empower people about health issues.
OTHER AGENCY INVOLVEMENT/COMMITTEE ACTIONS:
The Office of the County Counsel and Auditor-Controller have reviewed and approved this agreement as to legal form and fiscal provisions, respectively.
FINANCING:
Sufficient funds are available in FY 2026-27 Adopted Budgets for both Clinic Services Bureau, (1001-400009) and Public Health Bureau (1001-400026). This Agreement is funded in part by revenue generated from Medi-Cal and Medicare. There is no financial impact to the General Fund resulting from approval of this Agreement.
BOARD OF SUPERVISORS STRATEGIC PLAN GOALS:
This Agreement lines up with the goal of sustainable infrastructure for the present and future as it provides valuable health information technology support and services to the Health Department Clinic Services Bureau, incorporating best industry practices to improve patient care delivery and enhance practice management, for more sustainable and efficient processes.
Mark a check next to the related Board of Supervisors Strategic Plan Goals:
____ Well-Being and Quality of Life
_X _ Sustainable Infrastructure for the Present and Future
____ Safe and Resilient Communities
____ Diverse and Thriving Economy
____ Dynamic Organization and Employer of Choice
Prepared by: Prisca Segovia, Management Analyst, 755-4939
Approved by: Elsa Mendoza Jimenez, Director of Health Services, 755-4526
Attachments:
Board Report
Amendment No. 4
Amendment No. 3
Amendment No. 2
Amendment No. 1
Agreement