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COUNTY OF SAN MATEOInter-Departmental Correspondence |
Health Services Agency |
DATE: |
January 8, 2003 |
BOARD MEETING DATE: |
January 28, 2003 |
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TO: |
Honorable Board of Supervisors |
FROM: |
Margaret Taylor, Director of Health Services |
Gale Bataille, Director of Mental Health Services |
SUBJECT: |
Agreement with Quest Diagnostics Clinical Laboratories, Inc. |
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Recommendation |
Adopt a resolution authorizing the President of the Board to: |
1. Execute an agreement with Quest Diagnostics Clinical Laboratories, Inc.,
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2. Waive the requirement for compliance with the County ordinance for Equal Benefits for domestic partners, and
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Background |
Quest Diagnostics Clinical Laboratories, Inc. (Quest) has been a provider of outpatient laboratory services for the Health Services Agency since 1995. On December 18, 2001, your Board approved a consolidated agreement with Quest to provide laboratory services for Hospital and Clinics, Correctional Health, Public Health Mobile Clinic, the AIDS Clinic, and Mental Health Services. That agreement expired on June 30, 2002. During the term of that agreement Health Services completed a cost analysis of continuing to outsource these services, which indicated that it would be cost effective to provide most of these services in the San Mateo Medical Center laboratory. It was decided at that time to continue to contract for laboratory services for Mental Health and Correctional Health, due to the clinical need for a larger number of laboratory draw stations, which this contractor can provide. |
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In April of 2002 Mental Health Services issued a RFP for laboratory services. Quest was one of two vendors that responded with proposals, and was subsequently selected to provide these services. Correctional Health is currently reevaluating the possibility of having laboratory analysis conducted at the San Mateo Medical Center. If the implementation of this new process is not complete during the term of the agreement, Correctional Health will conduct an RFP process next year. |
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Discussion |
Quest provides specimen collection materials, specimen transport services, laboratory analysis of specimens, and faxed laboratory results to Mental Health clinics and Correctional Health facilities. Many of the Mental Health clients are on medications for treatment of psychiatric conditions. Laboratory services including blood and urine tests are essential to ensure quality health care. Certain medications require routine monitoring of blood levels to assure safety and effectiveness. Mental Health has always paid for the laboratory services for indigent clients. Under a federal waiver to field test mental health managed care for Medi-Cal eligibles, the Mental Health Division added the responsibility of providing laboratory services for Medi-Cal clients. Quest laboratory services are accessible to clients served through the Mental Health private provider network at Quest laboratory sites countywide. |
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Mental Health has negotiated with Quest for an improved system for delivery of utilization data files, which are required for successful Medi-Cal billing. This agreement includes a payment penalty clause for the late delivery of these files. |
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Correctional Health completes an initial health assessment for all persons who enter the San Mateo County jail system to detect and manage chronic and acute health conditions. Blood analysis is often required for proper diagnosis and treatment plan. Quest has provided this services for many years. |
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Quest is a covered entity under the Health Insurance Portability and Accountability Act (HIPAA) and is required on its own to comply with privacy and data transmission provisions. |
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Quest partially complies with the County's Equal Benefits ordinance. We are requesting that the requirement to comply waived. A memo detailing the reasons for waiver is attached. |
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The Performance Measures for this agreement are below. |
Performance Measures |
2001 - 02 Actual |
2002 - 03 Objective |
Monthly utilization data files will be delivered to Mental Health within ninety (90) days of the end of the month. |
25% |
90% |
Hard copies of test results with an expected turn around time of 24 hours will be provided on time. |
100% |
95% |
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Vision Alignment |
This agreement with Quest Diagnostics, Inc. keeps the commitment to Ensure Basic Health and Safety for All and goal number 8: Help vulnerable people - the aged, disabled, mentally ill, at-risk youth, and others - achieve a better life. This agreement contributes to this commitment by providing clinical laboratory services to clients of Mental Health Services and clients of Correctional Health Services. |
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Fiscal Impact |
The term of the agreement is July 1, 2002 through June 30, 2005. The agreement maximum is $475,000; $40,000 for Correctional Health and $435,000 for Mental Health Services. $145,000 is included in the Mental Health Services budget for FY 2002-03. Of that amount, federal and state Medi-Cal will reimburse 85% or $123,250. The remaining 15%, or $21,750, is the Mental Health net County cost. Correctional Health has included $40,000 in its budget for FY2002-03. |
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This agreement is late due to delayed verification by Quest of their ability to provide timely delivery of required utilization data for Mental Health. |
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We are requesting that the Director of Health Services be given signing authority to execute minor amendments and adjustments up to an aggregate of $25,000 for the term of the agreement. |