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COUNTY OF SAN MATEO
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Inter-Departmental Correspondence
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Health Department
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DATE:
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September 14, 2007
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BOARD MEETING DATE:
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September 25, 2007
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SPECIAL NOTICE/HEARING:
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None
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VOTE REQUIRED:
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Majority
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TO:
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Honorable Board of Supervisors
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FROM:
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Charlene A. Silva, Director of Health
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Sang-ick Chang, Interim CEO, San Mateo Medical Center
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Gale Bataille, Interim Director, Behavioral Health & Recovery Services
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SUBJECT:
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Agreement with MedImpact Healthcare Systems, Inc.
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RECOMMENDATION:
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Adopt a Resolution:
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1) Waiving the Request for Proposals requirement for pharmacy benefit management services; and
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2) Authorizing the President of the Board to execute an Agreement with MedImpact Healthcare Systems, Inc. to provide pharmacy benefit management services for Mental Health Services and for the Well Program at the San Mateo Medical Center for the term of July 1, 2007 through December 31, 2008, for a maximum obligation of $13,244,000; and
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3) Authorizing the Director of Health or the Director's designee to execute contract amendments which modify the County's maximum fiscal obligation by no more than $25,000 (in aggregate) and/or modify the contract term and/or services so long as the modified term or services is/are within the current or revised fiscal provisions.
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VISION ALIGNMENT:
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Commitment: Ensure basic health and safety for all.
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Goal 8: Help vulnerable people—the aged, disabled, mentally ill, at risk youth and others—achieve a better quality of life.
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The Agreement contributes to this commitment and goal through the provision of pharmacy benefits management (PBM) services to increase the cost effectiveness and availability of pharmacy services.
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Performance Measures:
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FY 2006-07 Actual
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FY 2007-08 Projected
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Turnaround time for claims processing – monthly goal of 98% within four seconds.
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Average 1.5 seconds
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Average 1.5 seconds
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System downtime not to exceed 1%.
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99% system availability
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99% system availability
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BACKGROUND:
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MedImpact was selected to provide PBM services through a Request for Proposals (RFP) process in 2002 for Mental Health Services and SMMC. That RFP asked for providers for a five-year contract period. MedImpact also provides PBM services for the Health Plan of San Mateo (HPSM).
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This contractor provides the following services: an extensive network of community pharmacies; a member eligibility service; a physician eligibility list that keeps up-to-date records of all the authorized prescribers in the county; maintenance of a database of all the medications authorized; benefit administration; and data reporting that allows tracking medications prescribed and dispensed to individual clients. MedImpact serves indigent Mental Health Services clients and clients served by the Mental Health Plan, as well as indigent patients of the San Mateo Medical Center (SMMC) enrolled in the WELL Program. SMMC patients are able to have prescriptions filled at local community pharmacies and at the SMMC pharmacy, substantially improving access to services.
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DISCUSSION:
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Mental Health Services and SMMC are requesting a waiver of the RFP process requirement for PBM services for an 18-month period in order to match our RFP cycle with that of the HPSM. Having the same PBM provider for the many shared clients between Mental Health Services, SMMC and the HPSM will provide administrative efficiencies and cost reductions. The current HPSM contract goes through December 31, 2008.
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County Counsel and Risk Management have reviewed and approved the Agreement. The contractor has assured compliance with the County's Contractor Employee Jury Service Ordinance, as well as all other contract provisions that are required by County ordinance and administrative memoranda, including but not limited to insurance, hold harmless, non-discrimination and equal benefits. The Agreement with MedImpact is on the Continuing Resolution.
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FISCAL IMPACT:
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The term of this Agreement is July 1, 2007 through December 31, 2008. The maximum obligation is $13,244,000. The maximum for Mental Health Services for FY 2007-08 is $8,400,000, which has been included in the Mental Health Services tentatively Adopted FY 2007-08 Budget. Of that amount, State and Federal Medi-Cal will fund $7,140,000 and sales tax provided through realignment will fund $840,000. The Net County Cost is $420,000. Similar arrangements will be in place for FY 2008-09. The maximum obligation for WELL Program services for FY 2007-08 is $136,000 which is included in the SMMC tentatively Adopted FY 2007-08 Budget.
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