COUNTY OF SAN MATEO

Inter-Departmental Correspondence

San Mateo Medical Center

DATE:

February 16, 2006

BOARD MEETING DATE:

March 7, 2006

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Nancy J. Steiger, Chief Executive Officer, San Mateo Medical Center

SUBJECT:

Agreement with Comprehensive Pharmacy Services

RECOMMENDATION:

Adopt a Resolution:

A)

Waiving the Request for Proposal (RFP) process

B)

Authorizing an Agreement with Comprehensive Pharmacy Services for Pharmacy Management Services

C)

Authorizing the Chief Executive Officer of San Mateo Medical Center (SMMC) to execute subsequent Amendments and minor modifications not to exceed $25,000 and to make minor changes in the type of services and activities provided under the agreement.

VISION ALIGNMENT:

Commitments: Ensure basic health and safety for all and Responsive, effective and collaborative government

Goal 5 and 20: Residents have access to healthcare and preventive care and Government decisions are based on careful consideration of future impact, rather than temporary relief or immediate gain.

As the Medical Center services expand and patient volume continues to grow, quality pharmacy care is a critical component of the effective treatment of San Mateo Residents. Cost effective management of pharmacy services allows for increased access and less interventional healthcare.

Performance Measure(s):

Measure

FY 2005-06
Actual

FY 2006-07
Projected

% CMS Conditions of Participation met

100%

100%

Minimum Pharmacy Savings Annually

$120,000

$63,000

(pro-rated for 6 months)

BACKGROUND:

The Pharmacy Department is one of the most highly regulated areas of the medical center. In October 2005, the Director of Pharmacy decided to step down and return to a staff position, recognizing the demands of the job and so that she would have more time for her family. She gave a firm two months notice.

SMMC simultaneously worked with EPS to open recruitment and with a head hunter to find qualified candidates in a field with a severe national and local shortage. EPS’s efforts included: posting the “special recruitment” as the first listing when opening the County webpage, increasing the maximum annual salary twice, 5% each time, shortening the application process, mailing flyers to over 4500 pharmacists in Northern California, and papering the annual Pharmacist Conference which takes place in Sacramento. Both EPS and the head headhunter’s efforts resulted in only five candidates, two of which were qualified and offered the position. Both accepted, but upon notifying their current employers, were offered between 10 to 20% increase in salary, with which SMMC could not compete. Several headhunters continue to offer their services, but with no guarantee of finding a candidate or ensuring that a candidate remains once hired. Without a Director of Pharmacy, the inpatient and outpatient pharmacy at SMMC would have to close due to State Board of Pharmacy laws. The recruitment remains open and to date there are no qualified candidates. Presently a pharmacist from the department has agreed to work out of class until the month of March.

In 2003 SMMC conducted a RFP for Pharmacy Management Services; three companies applied and SMMC chose the most cost effective company, Cardinal. The contract was terminated prematurely as the vendor was unable to fulfill its obligations. SMMC was about to go through a JCAHO survey and still needing assistance, contracted with CPS for a short term agreement to support the newly appointed Director of Pharmacy (recruited from within the department). It was the best JCAHO survey in the history of the Medical Center.

DISCUSSION:

CPS commits to providing a Pharmacy Director, who will provide financial and operational management, manage drug costs, maintain the ongoing savings of the current 340B drug program, enhance clinical and customer service quality via training and development, optimize computer applications as the department implements an entirely new pharmacy system and improve patient outcomes.

The lack of a Pharmacy Director at SMMC is an emergency situation. Recruitment efforts by SMMC and EPS, including assistance of a head hunter have been unsuccessful. CPS has proven itself by its positive performance and collaboration during the 2003 JCAHO survey. SMMC is requesting your Board waive the RFP process and approve an 18 month agreement with CPS.

County Counsel and Risk Management have reviewed and approved the agreement as to format and content.

FISCAL IMPACT:

The term of the Agreement is March 20, 2006 to September 20, 2007. The maximum amount of the Agreement is $492,000. Funds are included in SMMC’s FY2005-06 Adopted Budget . Funds will be included in the Budget Request for FY2006-07.