Rene G. Santiago, Deputy County Executive/Director, SCVHHS Ann Dunkin, Chief Information Officer

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1 County of Santa Clara Santa Clara Valley Health & Hospital System DATE: February 26, 2019 TO: FROM: Board of Supervisors Rene G. Santiago, Deputy County Executive/Director, SCVHHS Ann Dunkin, Chief Information Officer SUBJECT: IT Professional Services RECOMMENDED ACTION Adopt Resolution delegating authority to the County Executive, or designee, to negotiate, execute, amend and terminate agreements with the current eleven supplemental staffing partners for the Santa Clara Health and Hospital System and Technology Services and Solutions, Health System to provide Information Technology professional services, increasing the maximum contract amount by $16,500,000 from $125,592,287 to $142,092,287, and extending the term of the delegation for a nine-month period through December 31, 2019, following approval by County Counsel as to form and legality, and approval by the Office of the County Executive. Delegation of authority shall expire on December 31, An exception to Board of Supervisors Policy , Length of Term of Contracts, has been approved by the Office of Countywide Contracting Management. (Roll Call Vote) FISCAL IMPLICATIONS The recommended action would not require modification to the current Board-approved budgets for Santa Clara Valley Medical Center (SCVMC), Valley Health Plan (VHP), Custody Health Services (CHS), Behavioral Health Services (BHS), or Technology Services and Solutions (TSS). The funds to support the projected expenditure are included in the current year services and supplies appropriations for the various departments, and are included in the recommended budget for FY CONTRACT HISTORY On January 10, 2012, the Board of Supervisors awarded a contract to Epic Systems Corporation for the licenses, implementation costs and support of the Enterprise Core Health Information System, known as HealthLink, for period January 11, 2012 through January 11, 2022, and related actions. On February 7, 2012, the Board adopted a resolution delegating authority to the SCVHHS Board of Supervisors: Mike Wasserman, Cindy Chavez, Dave Cortese, Susan Ellenberg, S. Joseph Simitian Page 1 of 5

2 Chief Healthcare Technology Officer to execute agreements for professional staffing services in support of the HealthLink project and legacy systems. The amount of this initial delegation of authority was $18,000,000. On March 12, 2013, the Board approved the request to increase the delegation of authority amount by $15,425,000 due to difficulty filling permanent positions, staff attrition, and the need for additional technical device consultants. On October 8, 2013, the Board adopted a resolution to increase the delegation of authority by $20,429,653 to support the completion of HealthLink Wave 1, Wave 2 application planning and implementation, and other information technology initiatives. The Board also delegated authority to enter into contracts relating to recruitment and permanent placement services on a contingency fee basis. On June 9, 2015, the Board approved the request to increase the delegation of authority by $16,144,002 to support HealthLink Wave 2 go-live and stabilization, Wave 3 application planning and implementation, and other information technology initiatives through December 31, On June 21, 2016, the Board approved the request to increase the delegation of authority by $15,000,000 to support the implementation variety of information technology projects and data analysis requirements, as well as multiple other information technology initiatives through June 30, On April 11, 2017, the Board approved the request to increase the delegation of authority by $25,593,632 to complete Wave 3 implementation and system stabilization, complete Custody Health and Behavioral Health implementations to HealthLink, the opening of the Sobrato Pavilion, Whole Person Care, and other information technology project management activities through June 30, On June 5, 2018 the Board approved the request to increase the delegation of authority by $15,000,000 to support the implementation variety of information technology projects and data analysis requirements, including HealthLink, which incorporated the Waiver projects, including but not limited, to Whole Person Care, the Quality Incentive Program (QIP) and the Enhanced Payment Program (EPP), as well as multiple other information technology initiatives through March 31, REASONS FOR RECOMMENDATION Pursuant to Board Policy Length of Term of Contracts, SCVHHS obtained approval from the Office of Countywide Contracting Management (OCCM) for an exception to the maximum five (5) year contract term for the eleven (11) supplemental staffing vendors(see attached vendor list). This request is authorized by exception (7) Contracts for project-specific professional services where the length of the project is expected to exceed five years. SCVHHS obtained OCCM approval to extend the contract term for all eleven (11) supplemental staffing vendors through December 31, 2019 to coincide with the end date of the delegation. An increase of $16,500,000 in the delegation amount to $142,092,287 is requested to support the acquisition of O Connor Hospital, St. Louise Regional Hospital, and DePaul Board of Supervisors: Mike Wasserman, Cindy Chavez, Dave Cortese, Susan Ellenberg, S. Joseph Simitian Page 2 of 5

3 Health Center. Extending the term for an additional nine (9) months through December 31, 2019 will ensure that SCVHHS and TSS-HS has sufficient staffing support to implement HealthLink in these three (3) new acquisitions. During this nine-month period TSS-HS will be hiring over seventy (70) FTE s to support HealthLink and other healthcare related applications. This hiring process will take several months, and third-party staffing support will be critical during this transition period. The table below (table 1) details the estimated use of the requested increased delegation. Third Party Needs for Acquisition of O Connor Hospital, St. Louise Regional Hospital, and DePaul Health Center 3rd Party Position Role Purpose Cost TSS Information Systems Analysts End User Device Deployment $316,800 Epic Application Coordinator HealthLink Implementation $3,120,000 Epic Instructional Design HealthLink Implementation $520,000 Project Management Project Coordination $520,000 Infrastructure Engineer Infrastructure planning for new locations $260,000 Data Conversion - Integration Specialist Data Conversion and interoperability Planning $520,000 Non-Epic Application Coordinator non-hl application implementation $1,040,000 VMC Data Analytics Analytics/Reporting Ongoing regulatory and critical reporting $1,560,000 Analytics Senior Quality and BI Consultant Operations Mgmt / Exec Analytics $1,300,000 Epic Architect Operations and Reporting Enable multi-facility reporting/analytics $1,300,000 Estimated Sub Total $10,456,800 Third Party Needs to support Ongoing Projects at TSS-HS, HHS, VMC and VHP TSS HealthLink Implementation Coordinator HealthLink Implementation $131,579 Epic Application Coordinator HealthLink Implementation $1,184,210 Epic Instructional Design HealthLink Implementation $657,894 HealthLink Program Manager Program oversight $131,579 Project Management(non-HealthLink) Project Coordination $131,579 Systems Analyst Assist in the build of the myavatar system $131,579 IS - Citrix Admin (HealthLink) Deploying and maintaining the EPIC client on terminal servers $131,579 VMC Data Analytics Analytics/Reporting Ongoing regulatory and critical reporting $477,272 Analytics Senior Quality and BI Consultant Operations Mgmt / Exec Analytics $954,545 Epic Architect Operations and Reporting Enable multi-facility reporting/analytics $318,181 Valley Health Plan Project Manager Plans and oversees Valley Health Plan projects $250,000 HHS Administration Sr Business Intelligence Developer Architecture and development of Enterprise scale analytic content $750,000 Data Warehouse Developer Report Writer IT Professional Services Augmentation Detail Information management architecture of the Enterprise Data Warehouse $450,000 validates the appropriate technological solutions for various reporting needs; $300,000 Estimated Sub Total $5,999,997 Total Authority Requested $16,456,797 Board of Supervisors: Mike Wasserman, Cindy Chavez, Dave Cortese, Susan Ellenberg, S. Joseph Simitian Page 3 of 5

4 On July 2, 2018, Information Services Department (ISD), Health & Hospital System IS, and Social Services Agency IS consolidated into one single entity, Technology Services & Solutions (TSS). TSS then began to collaborate with County stakeholders to conduct a formal solicitation and establish a large pool of qualified vendors to meet the county-wide needs for IT professional services. The TSS IT Sourcing and Vendor Management group is in the process of conducting a competitive solicitation for the IT professional services currently provided through the referenced contracts. This solicitation process is approximately half complete and the overwhelming response necessitates a further extension of the existing contracts while the thorough evaluation of the large number of proposals received is finalized. SCVHHS and TSS-HS are requesting extensions to the eleven current professional service contracts to allow sufficient time to (1) complete the ongoing solicitation process and establish a pool of qualified vendors for IT professional services, and (2) provide a contractual "bridge" though which in-flight IT projects will receive uninterrupted support until projects are either completed or duties are transitioned to one of the newly awarded professional service providers. CHILD IMPACT The recommended action will have a positive impact on children or youth, in allowing SCVHHS to hire the appropriate resources to advance the technology which underpins the operating departments. SENIOR IMPACT The recommended action will have no/neutral impact on seniors. SSUSTAINABILITY IMPLICATIONS The recommended action will have a positive impact on sustainability, in allowing SCVHHS to hire the appropriate resources to advance the technology which underpins the operating departments. The alternative is to take additional time to implement technological improvements, jeopardizing efficiency and effectiveness. BACKGROUND The $16,500,000 delegation would include approximately eighty (80) resource needs, a large portion of these resource needs will be dedicated to transitioning O Connor Hospital, St. Louise Regional Hospital, and De Paul Health Center into County owned facilities. While the County works to recruit and fill numerous vacancies at these new locations, supplemental staffing resources will be critical to ensuring continuity of care for vulnerable patients located at these health centers. IT Professional Services are for essential temporary roles that will be required to augment SCVHHS and TSS-HS project teams with certified and experienced professionals to work in partnership with key SCVHHS and TSS-HS staff project roles to facilitate the implementation process and ensure the optimal outcome. The work effort for VMC Analytics continues to increase at a faster rate than that which current staff are able complete. Requests for resources fall into key areas: Backfill for Board of Supervisors: Mike Wasserman, Cindy Chavez, Dave Cortese, Susan Ellenberg, S. Joseph Simitian Page 4 of 5

5 Vacancies, Remediation, Expertise for New Development, and Advancement of Analytic Capabilities. The Data Analytics and Reporting group had been unable to satisfactorily fill vacancies because of outdated job descriptions and salaries, and recently been permitted to start Specialized Recruitments, with an interim Job Code, while navigating a better path toward permanent Job Codes. At present, contracted resources are needed to support the prior twenty-nine (29) VMC HealthLink modules, to mine data for mandatory regulatory filings, to backfill for permanent staff deploying new Epic modules and external vendors, and to help Finance collect approximately $410 million annually, especially with PRIME, FQHC Revenue, and GPP, QIP and EPP. Approval of the recommended action supports SCVHHS s Strategic Road Map as it relates to improving system integration and providing integrated care which results in improved access to information and more efficient and effective health care. CONSEQUENCES OF NEGATIVE ACTION Failure to approve the recommended action will impact the availability of experienced resources necessary to support the implementation of a variety of information technology projects and data analytic requirements, HealthLink implementations, Waiver projects and Whole Person Care; as well, as well as multiple other information technology initiatives through FY The ongoing solicitation for a new pool of IT professional service providers will not be completed prior to the current termination date of the referenced contracts. Without the recommended extensions in place, vendors are hesitant to submit proposals for requested engagements and the County will be unable to continue or complete work on in-flight and upcoming projects in a timely manner or with the subject matter expertise needed. Department business need for IT professional services is increasing more rapidly than the current internal supply of staff and expertise to meet the need. Outcomes of defined projects will be further delayed, and County staff will continue to be required to balance operational and project needs of the departments they support. STEPS FOLLOWING APPROVAL Upon completion of expedited processing, the Clerk of the Board will notify Sue Clements and Ida Rosenblum of TSS-HS, and Carlos Austin, Elizabeth Constantino and Lisa Gregg of TSS-IT. ATTACHMENTS: Third Party Staffing Contracts (PDF) Resolution CCO signed (PDF) OCCM B5Y IT Contracts (PDF) Board of Supervisors: Mike Wasserman, Cindy Chavez, Dave Cortese, Susan Ellenberg, S. Joseph Simitian Page 5 of 5