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Agenda Item
ASR
Control 22-000224 |
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MEETING DATE: |
05/24/22 |
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legal entity taking action: |
Board of Supervisors |
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board of supervisors
district(s): |
All Districts |
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SUBMITTING
Agency/Department: |
Health Care Agency
(Approved) |
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Department contact
person(s): |
Adil Siddiqui (714) 834-6619 |
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Clayton Chau (714) 834-2830 |
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Subject: Contract for Electronic
Health Record Maintenance and Support Services
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ceo CONCUR |
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Clerk of the Board |
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Concur |
Approved Agreement to Form |
Discussion |
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3 Votes Board Majority |
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Budgeted: N/A |
Current Year Cost:
N/A |
Annual Cost:
FY 2022-23 $6,830,270 |
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Staffing Impact: |
No |
# of Positions:
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Sole Source:
Yes |
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Current Fiscal Year Revenue: N/A
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Prior Board Action: 11/19/2019
#15, 7/31/2018 #9, 6/6/2017 #33 |
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RECOMMENDED ACTION(S):
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1. |
Approve the Contract with Cerner Corporation for the provision of Electronic Health Record Maintenance, Support and Remote Hosting Services for the term of July 1, 2022, through June 30, 2025, in an amount not to exceed $15,864,934, renewable for an additional two-year term. |
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2. |
Authorize the County Procurement Officer or Deputized designee to execute the Contract Cerner Corporation, as referenced in the Recommended Action above. |
SUMMARY:
Approval of the Contract with Cerner Corporation for the Provision of Electronic Health Record Maintenance, Support and Remote Hosting Services will improve coordination and utilization of shared data through the enhancement of compliance-based controls resulting in a highly secure and scalable system.
BACKGROUND INFORMATION:
The Health Care Agency's (HCA) Integrated Records Information System (IRIS) is a complex, enterprise-wide Electronic Health Record (EHR) system serving both HCA's Mental Health and Recovery Services (MHRS) and Public Health Services (PHS). This system allows support for all clinical documentation, rules based decision support aids, electronic prescriptions for controlled and non-controlled drugs, claims processing and billing to payors, security and privacy compliance with all local, state and federal mandates, operational and clinical reports and various interfaces with external partners, systems and devices. The system helps improve quality and collaboration for care planning and delivery through real-time sharing of health data amongst the care team members through its integrated platform, and with external organizations through standards-based interfaces for continuity and coordination of care, as permitted by applicable laws and regulations. The EHR is certified to be interoperable based on federal standards, and allows the system to share and integrate with other systems that follow similar guidelines. Through this capability, the system can also be leveraged to realize benefits beyond the agency level such as participation in the county wide data integration to assist with other efforts and outcomes.
Prior Board of Supervisors (Board) Actions listed below:
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Board Date |
Contract/Amendment |
Action |
Term |
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6/6/2017 |
Contract |
Board Approved Contract |
July 1, 2017 - June 30, 2020 |
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7/31/2018 |
Amendment No. 1 |
Board Approved Contract |
July 1, 2017 - June 30, 2020 |
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11/19/2019 |
Amendment No. 2 |
Board Approved Contract |
July 1, 2020 - June 30, 2022 |
The Contract includes the continuation of the license to use the existing Cerner Corporation (Cerner) EHR software system and server infrastructure, an augmentation of certain software licenses and inclusion of professional services to help support the continued expansion of the EHR at the Crisis Stabilization Unit within MHRS, implementation of a module to be compliant with the state mandated Controlled Substance Utilization Review and Evaluation System (CURES) which enables providers to review, validate and check prescriptions of controlled substances to clients to avoid over prescriptions, and implementation of the functionality to monitor and control opioid medication prescriptions. In addition, this Contract also includes the transfer of the county-hosted application platform to the Cerner remote hosted environment. With this model, Cerner would remotely house, administer and manage the Cerner EHR suite of solutions that the county is licensed to use. Cerner assumes responsibility for the performance, availability, scalability, capacity, redundancy, monitoring, business continuity related disaster recovery setup, technology currency and security and compliance of the system, including validation of quality of services through service level guarantees. This would also enable better opportunities for interoperability and sharing of data with partners.
The system as a whole continues on its trajectory to support expansion within the Agency, provide support for evolving needs and ensure compliance with regulatory and quality initiatives.
The EHR system is a proprietary system developed by Cerner for the County and only Cerner is capable of and authorized to provide stated system support and related enhancements. For this reason, HCA has not conducted a separate solicitation of bids for these services contained in the proposed Amendment. Sole Source justification has been submitted to the County Procurement Office and the approved Sole Source/Proprietary Request is attached to this Agenda Staff Report as Attachment C.
The Cerner EHR system contains a number of third-party software programs that are integral and necessary for its operation. As such, the Contract contains a number of pass-through provisions (End User Licenses Agreements) that correspond to each of the third-party software programs. These End User License Agreements contain indemnification and limitation of liability provisions regarding their use by County as part of the Cerner's system. The Indemnification provision require the County to indemnify the software program owners for such third-party claims that arise due to County's use of the technologies as not permitted under the End User License Agreement. The limitation of liability provisions limits the County from seeking indirect or consequential loss, special or punitive damages, lost profits, loss of savings, loss of revenues, loss of business, loss of reputation, loss of goodwill, or loss of data with respect to sue of the programs. The limitation of liability provisions also limits the County's remedy for all claims (with the exception of claims for intellectual property claims) to the purchase price paid under the equipment maintenance and support, thus corresponding employee dishonesty insurance has been added. Risk Management has reviewed and approved these non-standard provisions. The completed and approved Risk Assessment Form is attached as Attachment D.
This Contract contains the same mutual indemnification provision, Cerner's liability for all claims, Attorney's Fee provision and Choice of Law Forum provision as agreed upon in the original Contract.
The Orange County Preference Policy is not applicable as this is a Sole Source Contract.
The Contractor’s performance has been confirmed as satisfactory thus far. HCA has verified there are no concerns that must be addressed with respect to Contractor’s ownership/name, litigation status or conflicts with County interests. This Contract does not currently include subcontractors or pass through to other providers. See Attachment B for Contract Summary Form.
Orange County Information Technology is in concurrence with this Contract.
HCA requests that the Board approve the Contract for provision of Maintenance, Support and Remote Hosting Services with Cerner Corporation, as referenced in the Recommended Actions.
FINANCIAL IMPACT:
Appropriations and Revenue for this Contract are included in Budget Control 042 in FY 2022-23 Budget and will be included in the budgeting process for future years.
Funding Sources:
State: 94% (Mental Health Services Act/Prop 63, Mental Health Realignment)
Federal: 5% (Substance Abuse Prevention and Treatment Block Grant)
Fees/Other: 1% (Federal Financial Participation Medi-Cal)
The proposed Contract includes provisions allowing HCA to terminate the Contract, reduce the level of services, and/or renegotiate the levels of services provided, as necessary. This includes a notice that allows HCA adequate time to transition or terminate services to clients, if necessary.
STAFFING IMPACT:
N/A
ATTACHMENT(S):
Attachment A - Contract MA 042-22011557 with Cerner
Corporation for Provision of Electronic Health Record Maintenance, Support, and
Remote Hosting Services
Attachment B - Contract Summary Form
Attachment C - Sole Source Form
Attachment D - Risk Assessment Form