Inter-Departmental Correspondence

Information Services Department



September 17, 2010


November 2, 2010







Honorable Board of Supervisors


Chris Flatmoe, CIO/Director, Information Services

Jean S. Fraser, Chief, Health System

Mary J. Hansell, Director, Family Health Services


Amendment No. 3 to the Agreement with Netsmart Technologies, Inc.



Adopt a Resolution authorizing the:

A. President of the Board to execute Amendment No. 3 to the Agreement with Netsmart Technologies, Inc. for the purchase and implementation of a Management Information System and support services for Family Health Services, increasing the Agreement’s maximum obligation by $889,034, from $3,759,409 to a new total maximum obligation of $4,648,443, with no change to the term of February 26, 2008 through February 28, 2015; and


B. County Purchasing Agent to issue purchase orders for ongoing maintenance and support for this system to be invoiced separately and not subject to the Agreement’s not to exceed amount.



On February 26, 2008, your Board approved Resolution # 069291, which authorized the Information Services Department (ISD) to enter into an Agreement with Netsmart Technologies, Inc. (Netsmart) for the purchase and implementation of a Management Information System (MIS) and support services for Behavioral Health and Recovery Services (BHRS) for the term of February 26, 2008 through February 28, 2015 in the amount of $3,759,409. On October 7, 2010, the parties entered into Amendment No. 1 to update the business associate’s terms of the Agreement and on November 1, 2010, the parties will have entered into Amendment No. 2 to adjust the budget allocations within the Agreement for specific services with no overall change to the term or contract amount.


The Family Health Services Division (FHS) conducted a needs assessment of its case management program and identified the need for an Electronic Health Record (EHR) to replace some obsolete systems and to automate other manual systems. In November 2009, FHS issued a Request for Proposals for the purchase and implementation of a Management Information System and software maintenance and support services. Netsmart was selected as the vendor to meet the County’s requirements. Health System staff and ISD, with concurrence of BHRS, have negotiated Amendment No. 3.



Amendment No. 3 expands the Netsmart contract to provide an integrated FHS Management Information System. The proposed solution will replace several legacy data systems used within FHS and will transfer paper-based case management records into an EHR. With an EHR, clients will receive expedited services, and the system will allow for clients’ timely entrance into the Health System’s continuum of care. Additionally, FHS will be able to track and report on referral sources to determine the efficiency of programs and facilitate continuous improvement. The new system will support the client care, monitoring, and documentation needs of FHS. The scope of the project includes the equipment, software, hosting, and support services required for the installation and operation of the system. This project was included in the 2005 and 2007 Health System Information Technology Strategic Plan. The technology has been reviewed by ISD for compliance with County Technology Standards.


Netsmart, in relation to Amendment No. 3, assures compliance with the County’s Contractor Employee Jury Services 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. Risk Management has reviewed and approved Contractor’s insurance, and County Counsel has reviewed and approved the Amendment and Resolution as to form.


Approval of this Amendment contributes to the Shared Vision 2025 outcome of a Healthy Community by providing an EHR intended to improve coordination of care and the delivery of health services. It is anticipated that 100% of customizations will be completed by the end of FY2010-11, and the test site will be implemented by 01/03/11.


Performance Measures:


FY 2009-10

FY 2010-11

Percentage of customization completed





The term of the Agreement under Amendment No. 3 remains February 26, 2008 through February 28, 2015. The amount of Agreement has been increased by $889,034 from $3,759,409 to $4,648,443. Of the $889,034 allocated to FHS, a contingency reserve of $100,000 has been set aside. Funds have been included in Family Health Services’ FY 2010-11 Adopted Budget. FHS Reserves have been appropriated for the one-time implementation costs associated with the project. Ongoing costs, estimated at approximately $76,000 per year, will be appropriated in future budgets. The Net County Cost associated with this Amendment is estimated at 30%, or $266,710, as the majority of costs will be recovered through Family Health’s various funding sources such as Medical Administrative Activities (MAA) and Targeted Case Management (TCM). .



General description of RFP

Selection of a vendor to provide and support a new integrated Business and Case Management Information System.

There were two RFP’s released.

    The initial RFP was for an integrated information system that incorporated Community Health programs

    The second RFP was a change in scope to only include Family Health Services programs


List key evaluation criteria

    Match between vendor’s proposed application and FHS functional requirements

    Corporate capacity to implement and support the application as indicated by financial strength and stability, proven success with similar projects, references, experience of vendor’s project team and approach to project planning

    Proposed pricing

    Ability to comply with County’s contract requirements


Where advertised

    Distributed to previous vendors who submitted responses from the initial RFP

    Family Health Services website

    San Mateo County website


In addition to any advertisement, list others to whom the RFP announcement was sent

CHAMP Software, Inc.

NetSmart Technologies, Inc.

CH Mack, Inc.


Northrop Grumman Corporation

Persimmony International, Inc.


Atlas Development

Mitchell & McCormick, Inc.

NEC Unified Solutions


Medsphere Systems Corporation


VisionWare, Ltd.



Groupware Technologies, Inc.


eClinical Works



Welligent, Inc.


Total number of RFP’s sent to prospective proposers

Twenty-one (21)


Number of proposals received

Five (5)


Who evaluated the proposals

Kim Pijma, FHS

Ronell Reyna, FHS

Katie DellaMaria, FHS

Glenn Ibarrientos, FHS

Frances Oliden, FHS

Cheryl Clifford, ISD

Viral Mehta, ISD


In alphabetical order, names of proposers (or finalists, if applicable) and location

E-Clinical Works, Westborough, MA

Netsmart Technologies, Great River, NY

Persimmony, Aliso Viejo, CA