Agenda Item AGENDA STAFF REPORT ASR Control 24-001119
MEETING DATE:	12/16/25
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):	Veronica Kelley (714) 834-7024
	Joanne Lim (714) 647-6048

Subject: Approve Amendment No. 1 for Electronic Health Records System

ceo CONCUR

County Counsel Review

Clerk of the Board

Concur

Approved Agreement to Form

Discussion

3 Votes Board Majority

Budgeted: Yes

Current Year Cost: $759,000

Annual Cost: FY 2026-27 $135,000

Staffing Impact:

# of Positions:

Sole Source: Yes

Current Fiscal Year Revenue: N/A

Funding Source: See Financial Impact Section	County Audit in last 3 years: No
Levine Act Review Completed: Yes

Prior Board Action: 5/24/2022 #47

RECOMMENDED ACTION(S):

Approve Amendment No. 1 to the Contract with NaphCare, Inc., for Electronic Health Records System Maintenance and Support Services, effective upon Board approval, through June 30, 2027, to increase the Contract amount by $894,000, for a revised contract total amount not to exceed $5,391,500.

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

SUMMARY:

Approval of Amendment No. 1 to the Contract with NaphCare, Inc. for Electronic Health Records System Maintenance and Support Services will allow Correctional Health Services to continue to provide quality patient care for persons in Orange County custody.

BACKGROUND INFORMATION:

On May 24, 2022, Your Honorable Board of Supervisors (Board) approved the Sole Source Contract for Electronic Health Records System Maintenance and Support Services in an amount not to exceed $4,497,500, for a five-year consecutive term effective July 1, 2022, ending June 30, 2027.

The Electronic Health Records System (EHR) has been implemented successfully within the Health Care Agency (HCA) network and continues to meet all expected business objectives. EHR allows interfaces to other County of Orange external systems while providing real-time data for services delivered to those persons incarcerated and under the authority and control of the Orange County Sheriff's Department (adult inmates), the Probation Department (juveniles charged with a crime) or the Social Services Agency (children in protective care).

EHR systems, including the TechCare system, increase the efficiency and quality of patient care through standardization of documentation, and provides on-time availability and access to information such as lab results and treatment histories. The system helps improve communication and coordination of care amongst providers and reduces transcription errors and inefficiencies inherent in manual paper-based system. Through the use of EHRs, decision support tools are available to improve patient safety and enhance clinical decision-making and offers strong administrative control, increased security and privacy controls of the information stored within.

Scope of Services

The proposed amendment will upgrade the system to the latest, completely new web-based version of the TechCare EHR system. Notable enhancements include functionality expansions, data analytics that support real time dashboards and reporting, upgraded administrative controls that support in-house customization, enhanced security and compliance features, support for the California Advancing and Innovating Medi-Cal (CalAIM) mandates, availability of a patient data access portal, mobile-friendly refreshed user interface for a better user experience, and transition from the county operated environment to a cloud-hosted environment that provides reduced risks and improved performance, scalability and availability.

The Contract is a sole source contract as the EHR TechCare is a proprietary software application with many functionalities, inter-dependencies and interfaces that were custom built and designed for HCA Correctional Health Services. The EHR System requires ownership of the underlying software code, expertise and technical knowledge to understand the many facets of the system when performing upgrades. Only NaphCare, Inc. is allowed to view or manage the source code of the application.

Performance Outcome

The goal of this Amendment is to ensure the continued performance, reliability, and modernization of the EHR system through the upgrade of TechCare to version 5.0 allowing Correctional Health Services to:

•	Keep pace with industry best practices and regulatory requirements.
•	Improve system usability and clinician workflows.
•	Further reduce clinical risk and operational inefficiencies.
•	Maintain secure, uninterrupted care delivery within the correctional health environment.

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.

The Contractor's performance has been confirmed as at least satisfactory. 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.

The Orange County Preference Policy is not applicable to this sole source contract amendment.

HCA requests that the Board authorize the County Procurement Officer or Deputized designee to execute the Amendment to the Contract with NaphCare, Inc., as referenced in the Recommended Action.

FINANCIAL IMPACT:

Appropriations for this Amendment are included in Budget Control 042 FY 2025-26 Budget and will be included in the budgeting process for future years.

Funding Sources:

State: 94% (Providing Access and Transforming Health Grant / California Advancing and Innovating Medi-Cal Grant)

Other: 3% (Transfer-In from Fund 15I)

GF: 3% (Net County Cost)

Should services need to be reduced or terminated due to lack of funding, the Contract contains language that allows HCA to give 30 days’ notice to either terminate or renegotiate the level of services to be provided. The notice will allow HCA adequate time to transition or terminate services to clients if necessary.

STAFFING IMPACT:

N/A

ATTACHMENT(S):

Attachment A – Amendment No. 1 to Contract No. MA-042-22011096 for Electronic Health Records System Maintenance and Support Services with NaphCare, Inc.
Attachment B – Contract Summary Form