Approve first amendment to Agreement No. 23-119 with Netsmart Technologies, Inc. to increase funding in the amount of $15,000 for 2024-25 for a new contract maximum of $1,965,000 for the period of July 1, 2023 through June 30, 2026 for the provision of computer technical support and maintenance for Avatar Management Information System (the County’s Electronic Health Record “EHR”). (No general fund impact) (Sullivan)

Approve first amendment to Agreement No. 23-119 with Netsmart Technologies, Inc. to increase funding in the amount of $15,000 for 2024-25 for a new contract maximum of $1,965,000 for the period of July 1, 2023 through June 30, 2026 for the provision of computer technical support and maintenance for Avatar Management Information System (the County’s Electronic Health Record “EHR”).

The current Agreement has provided the County with the necessary licenses to continue utilizing Avatar as the County’s Electronic Health Records (EHR) system. It has also allowed Netsmart to continue to provide technical support and maintenance that enables HHSA to fully utilize its database, including remote hosting. More specifically, this effort has allowed HHSA to continue the transmittal of required information to the State Department of Healthcare Services in a timely manner, the completion of State and Federal billing and reporting requirements, and the effective tracking of the clinical services that HHSA provides to consumers.

Avatar was chosen, in part, due to its ability to meet the State and Federal reporting requirements for Medi-Cal Specialty Mental Health Services and Drug Medi-Cal Services as well as the ability to provide technical and physical security as required by the national standards Health Insurance Portability and Accountability Act (HIPAA) of 1996. Avatar can track eligibility, billing, payment application, appointment scheduling, medical records maintenance, and critical data items.

On or about June 6, 2023, the County entered into an agreement with Netsmart Technologies with an initial term of July 1, 2023 through June 30, 2026 with a total contract maximum of $1,950,000.

In addition to support and maintenance services, this Agreement also includes functionality such as:

HHSA request approval of this first amendment which increases funding in the amount of $15,000 for FY2024-25 for a new contract maximum of $1,965,000. The additional funding is needed to cover increased Contractor costs for necessary components of the EHR that support state mandated-interoperability information exchange.

Performance Measures included in this Agreement are as follows:
Due to the nature of this Agreement, historically there have been no associated performance measures. HHSA will work with IT to develop appropriate performance measures for this Agreement by December 31, 2024. 

County Counsel has approved this amendment as to form.
Department of General Services, Procurement Division

On May 10, 2023, the Yolo County Procurement Manager approved a sole/single source procurement for these services.

Procurement reviewed HHSA’s request and determined that it was in the best interest of the County to renew the agreement, based on satisfactory service/reasonable prices and to avoid the interruption of County business. Without a sole source approval and renewal of the agreement with the vendor, the County would have lost their EHR system and had a loss of revenue. Factors considered, included but were not limited to:

1) Avatar is HHSA's sole EHR for Behavioral Health services and is currently expanding access to contracted providers; 2) Satisfactory vendor performance- this vendor has provided Yolo County's EHR Electronic Health Record for more than 20 years and has satisfactorily supplied the associated licenses and system maintenance; 3) Vendor is the sole creator and maintainer of the Avatar system; 4) Vendor works closely with HHSA staff and ensures annual committed funds and any subsequent increases are reasonable and appropriate; and 5) Potential loss of revenue as without these services, the County would be unable to document services provided and thus be unable to claim reimbursement for Medi-Cal services from the state.