Agenda Item



††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† ASR Control 22-000417




legal entity taking action:

Board of Supervisors

board of supervisors district(s):

All Districts

SUBMITTING Agency/Department:

Health Care Agency†† (Approved)

Department contact person(s):

Tammi McConnell (714) 834-8791



Clayton Chau (714) 834-2830



Subject: Amendment No. 1 to Contract for Designated Emergency Services


††††† ceo CONCUR

County Counsel Review

Clerk of the Board


Approved Agreement to Form




3 Votes Board Majority




††† Budgeted: Yes

Current Year Cost: $1,860,724

Annual Cost: N/A




††† Staffing Impact:


# of Positions:

Sole Source: N/A

††† Current Fiscal Year Revenue: N/A

Funding Source: FED: 100% (ELC Expansion Grant)

County Audit in last 3 years: No



††† Prior Board Action: 12/14/2021 #S39A, 3/23/2021 #43, 6/5/2018 #4






Approve Amendment No. 1 to the Contract with various providers for provision of Designated Emergency Services, increasing the not to exceed amount by $1,860,724 for a new revised cumulative total of the same amount for the term of July 1, 2018, through June 30, 2023.




Authorize the County Procurement Officer or Deputized designee to execute Amendment No. 1 to the Contract with various providers, as referenced in the Recommended Action above.







Approval of Amendment No. 1 to the Contract with various providers for Designated Emergency Services will provide improved patient care in the community via near real time access to patient data, as well as increased countywide medical and health situation awareness.





On June 5, 2018, your Honorable Board of Supervisors (Board) approved the Master Agreement with various hospitals for provision of Designated Emergency Services (DES) for the term of July 1, 2018, through June 30, 2023. On March 23, 2021, the Board approved acceptance of the Epidemiology and Laboratory Capacity (ELC) expansion grant, for the term beginning January 15, 2021, through July 31, 2023. On December 14, 2021, the Board approved an ELC grant funded contract with ImageTrend, Inc. to provide technical services to connect the Orange County Medical Emergency Data System (OC-MEDS) to each local emergency receiving hospitalís electronic health record (EHR) system.


Scope of Services

The Health Care Agency (HCA) established the DES Master Agreement to formalize the partnership between Acute Care Hospitals and Orange County (County) in 2003 for emergency management and disaster response. As part of its regulatory responsibility on behalf of the County of Orange, HCA's Emergency Medical Services (EMS) Division has designated certain hospitals as Emergency Receiving Centers (ERC) -based on qualifying criteria. There are 25 Acute Care Hospitals that are designated ERCs which permits those hospitals to receive patients via ambulance from the 9-1-1 EMS system.


A portion of the ELC expansion grant funds have been designated to support bi-directional data exchange between OC-MEDS and each ERCs EHR system. This will allow for near real time exchange, meaning as soon as the data is posted by the end user, of vital patient information between 9-1-1 EMS providers (paramedics, EMTs, etc.) and clinical staff at each ERC, and will provide meaningful data (reports, dashboards, etc.) to aid the County with detecting disease outbreaks and other impacts to the local medical and health care system. A portion of the ELC grant funds support the OC-MEDS software vendor (ImageTrend). The remaining ELC funds are budgeted to support ERCs who have chosen to participate in this project.


Amendment No. 1 will amend the existing DES Master Agreement to add relevant scopes of work and to increase funds available for each participating ERC to assist the designated hospitals with the costs necessary to complete the technical work on the hospital's end of the technical integrations.


Performance Outcomes

The DES Master Agreement requires Acute Care Hospitals to develop and have in place disaster plans and equipment necessary to respond to and mitigate disasters. As HCA is not funding specific services to individual hospitals, there are no performance outcomes in the Master Agreement.


The individual contracts do not currently include subcontracts or pass through to other providers. See Attachment B for Contract Summary Form. The Orange County Preference Policy is not applicable this contract amendment.


HCA requests that the Board approve Amendment No. 1 to the Master Agreement for provision of Designated Emergency Services with various hospitals, as referenced in the Recommended Actions.






Appropriations for this amendment are included in Budget Control 042 FY 2022-23 Budget.


The Master Agreement 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.










Attachment A - Amendment No. 1 to Master Agreement MA-042-22011444 for Designated Emergency Services
Attachment B - Contract Summary Form
Attachment C - Redline Version to Attachment A