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Agenda Item
ASR
Control 21-000221 |
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MEETING DATE: |
06/22/21 |
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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): |
Annette Mugrditchian (714) 834-5026 |
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Jeff Nagel (714) 834-7024 |
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Subject: Contract for Pharmacy
Benefits Manager Quality Assurance 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 2021-22 $200,000 |
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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: 05/24/2016
#58 |
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RECOMMENDED ACTION(S):
Authorize the County Procurement Officer or authorized Deputy to execute the Contract with Pro Pharma Pharmaceutical Consultants, Inc. dba Pro Pharma for Pharmacy Benefits Manager Quality Assurance Services, in an amount not to exceed $1,000,000, effective July 1, 2021, through June 30, 2026.
SUMMARY:
Approval of the Contract with Pro Pharma Pharmaceutical Consultants, Inc. dba Pro Pharma for Pharmacy Benefits Manager Quality Assurance Services will ensure contract compliance and cost effectiveness of medication distribution for the Health Care Agency's Behavioral Health Services and pharmaceutical information resources for California Children's Services.
BACKGROUND INFORMATION:
The Health Care Agency's (HCA) Contract for Pharmacy Benefits Manager Quality Assurance Services has been awarded to Pro Pharma Pharmaceutical Consultants, Inc. dba Pro Pharma (Pro Pharma) as a result of being the sole respondent to multiple competitive solicitations over the past few decades. In order to again ensure that there were no other potential proposers, HCA issued a Request for Proposal (RFP) on February 4, 2016, to which Pro Pharma was again the sole respondent. As a result of the RFP, the proposal from Pro Pharma was deemed responsive and on May 24, 2016, your Honorable Board of Supervisors (Board) approved the Contract with Pro Pharma for Pharmacy Benefits Manager Quality Assurance Services, effective July 1, 2016, through June 30, 2017, renewable for four additional one-year terms, in an amount of $150,000. Being that Pro Pharma has been the sole respondent to numerous competitive solicitations, HCA is requesting approval of a sole source contract at this time.
Behavioral Health Services (BHS)
BHS provides culturally competent and client-centered behavioral health services for all eligible County residents in need of treatment for mental health and substance use issues. BHS is the payer of last resort for medically necessary medications in the treatment of mental illness for County eligible clients seen at various County, contracted and psychiatric facilities throughout Orange County.
HCA currently contracts with Pro Pharma for the provision of Pharmacy Benefits Manager (PBM) Quality Assurance Services. PBM is a complex contract program with specialized elements requiring specialized monitoring and reporting. Pro Pharma provides audits of the contracted PBM, economic analysis of the current PBM activity and assists HCA in controlling the pharmaceutical costs of the BHS Program. Additionally, Pro Pharma performs ongoing reviews of medications prescribed by providers, provides recommendations for inclusion/exclusion of new drugs as they become available and price studies of current medication in the formulary of BHS.
California Children's Services (CCS)
CCS is a state-mandated program that provides care coordination, case management and occupational therapy services to children with special health care needs and rare medical conditions. CCS currently serves approximately 13,700 children who reside in Orange County.
Due to the rare and/or serious medical conditions of the CCS clientele, CCS is often called upon to authorize/approve new and/or experimental medications for off-label uses. Through this Contract, CCS will consult with Pro Pharma staff, on an ad-hoc basis, regarding requested drugs, their efficacy and their appropriateness given the CCS client's condition.
This item is coming to the Board less than 30 days prior to the Contract's start date because of disruptions due to the COVID-19 pandemic. HCA requires this contract in place to prevent a lapse in contract and ensure that services continue to be provided, and is requesting that the Board consider this item now.
The proposed Contract is a sole source contract and a completed Sole Source Request Form is attached to this Agenda Staff Report as Attachment B.
This Contract does not currently include subcontractors or pass through to other providers. See Attachment C for Contract Summary Form.
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 contract award.
HCA requests that the Board authorize the County Procurement Officer or authorized Deputy to execute Contract with Pro Pharma as referenced in the Recommended Action.
FINANCIAL IMPACT:
Appropriations for this Contract will be included in Budget Control 042 FY 2021-22 Budget and will be included in the budgeting process for future years.
Funding Source:
GF: 22%
FED: 1% (SAMHSA)
State: 73% (California Children’s Services, MHSA/Prop 63, Mental Health Realignment, CONREP)
Fees/Other: 4% Federal Medi-Cal Financial Participation, Patient Fees
Should services need to be reduced or terminated due to lack of funding, this Contract contains language that allows HCA to give a 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 - Contract No. MA-042-21011295 with Pro
Pharma Pharmaceutical Consultants, Inc. dba Pro Pharma
Attachment B - Sole Source Justification Form
Attachment C - Contract Summary Form