COUNTY OF SAN MATEO

Inter-Departmental Correspondence

San Mateo Medical Center

DATE:

November 6, 2008

BOARD MEETING DATE:

December 9,2008

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Sang-ick Chang, MD, Chief Executive Officer ,San Mateo Medical Center

SUBJECT:

Agreement with PharMerica

RECOMMENDATION:

Adopt a resolution:

A.

Waiving the Request for Proposal (RFP) process

B.

Authorizing the execution of an Agreement with PharMerica to provide

pharmaceutical services and infusion services to residents of San Mateo

Medical Center (SMMC) Long-Term Care (LTC) Services (both Main Campus and Burlingame Long Term Care (BLTC)), for the term of July 1, 2008 to June 30, 2010, in an amount not to exceed $958,667

C.

Authorizing the Chief Executive Officer (CEO) of SMMC or the CEO'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

VISION ALIGNMENT:

Commitment: Ensure Basic Health and Safety for All.

Goal 5: Provide residents access to healthcare and preventive care.

The agreement contributes to the goal by providing pharmacy services, including all medications and IV therapy, to residents of SMMC LTC Services.

Performance Measure(s):

Measure

FY 2008-09

FY2009-10

Percent of time that medication for long-term care is delivered timely

95%

98%

Percent of time that drug regimen review is provided monthly

100%

100%

Timely delivery of pharmacy services ensures efficient care to SMMC LTC residents. A constant drug regimen review of resident charts assures appropriateness of drug therapy for each resident and awareness of any drug side effects, protecting the resident from adverse drug reactions.

BACKGROUND:

Regulatory requirement states that SMMC LTC Services is to have a clinical pharmacist for regular medication review and administration.

In April 2005, SMMC conducted a Request for Proposal (RFP) for pharmacy services. The RFP was sent to the two pharmaceutical vendors in the Bay Area that specialize in long-term care pharmacy services. Medisave and PharMerica submitted proposals and gave a presentation of their services to SMMC LTC Services staff. The contract to provide pharmacy services to SMMC LTC residents was awarded to PharMerica. The award was based on cost, evidence of adequate staffing to provide clearly defined services, evidence of ability to provide full scope of services, evidence of systems in place to provide timely delivery of medications and supplies, evidence of successful regulatory compliance, knowledge of regulatory requirements, availability of clinical pharmacists, and quality improvement measures in place.

DISCUSSION:

PharMerica has been providing pharmacy services to SMMC since 1989. PharMerica is familiar with SMMC’s system, and meets all of its regulatory long-term care requirements.

The previous Agreement with PharMerica was for three years with a maximum amount of $1,692,000. SMMC currently has fewer beds in its long-term care facilities; therefore, the maximum amount of the new Agreement will be $733,333 less.

SMMC is requesting a waiver of the RFP process. An assessment by SMMC concluded that it is more cost effective and less disruptive to good resident care to remain with a known entity that meets all of SMMC requirements, while providing continuous and excellent services. Conducting an RFP will possibly result in transitioning to a new vendor, requiring training on SMMC policies and procedures. Future plans are to bring this pharmaceutical and infusion service in-house, possibly in the FY 2009-11 time period. It will require more than one fiscal year to accomplish this transition.

County Counsel and Risk Management have reviewed and approved this Agreement.

The contractor has assured compliance with the County's Contractor Employee Jury Service Ordinance, as well as with 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.

FISCAL IMPACT:

The term of the Agreement is July 1, 2008 to June 30, 2010 with a maximum amount not to exceed $958,667. Funds are included in SMMC’s FY2008-09 Adopted Budget and funds will be included in the budget requests for FY2009-10.