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HomeMy WebLinkAboutAgreement A-21-537 with HR Support Inc..pdfAgreement No. 21-537 14th 1 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and year 2 first hereinabove written. 3 CONTRACTOR: 4 5 6 HR Support, Inc. 7 . Rattanaphom Saefung Fanger, CEO 8 9 10 Mail to : 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 18261 Madison Avenue , Castro Valley , CA. 94546 26 FOR ACCOUNTING USE ONLY : ORG No.: 56201018 27 Account No .: 7295 Fund : 0001 28 Subclass 10000 -15- COUNTY OF FRESNO: Steve Branclau,tha irman of the Board of Supervisors of the County of Fresno ATTEST: Bernice E. Seidel Clerk of the Board of Supervisors County of Fresno , State of Cal ifornia By ~•e('.) eputy HRSUPPORT Attachment A Page 1 of 9 SCOPE OF WORK The County of Fresno (County) Department of Public Health (DPH) is in need of temporary vendors to provide COVID and flu vaccine administration teams available for vaccination events. Licensed and unlicensed medical staff (Registered Nurses, Licensed Vocational Nurses and Medical Assistants or support staff with valid licensure and/or certification in the State of California) and clerical staff will be needed to conduct on-call vaccination events and homebound vaccinations. Vaccination events may offer COVID vaccine only or both flu and COVID vaccine. Homebound client vaccination appointments will only be made if the homebound client is getting a COVID vaccination, but flu vaccinations may also be provided at the same time. Please review this Scope of Work carefully as there are some differences between COVID and flu documentation, billing and compensation, and other requirements. Events will be held through employers or through community medical clinic/vaccination events that may be open to the general public or be performed for homebound clients. The vendor will work with County staff to determine the size, date and time of th e clinic request. Lead time to clinic scheduling will generally be 5 days – 4 weeks. The County anticipates clinics may operate up to 6 days per week, providing services to between 50 to 150 patients per clinic. Numbers of patients may be higher or lower depending on turnout. The number of homebound clients receiving flu vaccinations in conjunction with COVID vaccinations will vary. Vendor may also be asked to travel to individual clients’ residences to provide vaccinations to homebound clients. Provision of vaccinations at residences may also include unvaccinated household members and/or caregivers of the homebound client. Lead time to notify vendor of homebound clients needing vaccination will generally be a minimum of 48 hours, but County will attempt to provide longer notice. Clinic and homebound vaccination times will vary as follows: • Monday through Saturday including evenings. • Clinic hours will vary from 2 – 7 hours depending on size of event. • Clinics may be held inside, outside or as a drive thru. • Mobile clinics may be located anywhere within Fresno County. • Vaccinations provided to homebound clients may be located anywhere within Fresno County. • For homebound clients, vendor will be required to contact and schedule vaccination appointments for clients provided by County. However, at its discretion, County may schedule homebound client appointments for specific days/times prior to providing client information to vendor. • Homebound flu vaccinations will be scheduled only in conjunction with COVID vaccinations and could include multiple clients in a day. HRSUPPORT Attachment A Page 2 of 9 • Vendor will be required to work with the venue host to determine if the vendor will need to provide tables, chairs, popups, access to electrical outlets, extension cords, etc. COVID Vaccinations Vendor will provide vaccination and documentation through the appropriate State system (e.g., MY Turn or Interface from allowed electronic medical record) to County residents. Vendor may offer individuals COVID-19 tests during the individual’s post vaccination observation/monitoring period. Vendor may provide COVID-19 tests to clients that are not receiving vaccinations. • Patients served will be dependent on which vaccine is being administered at the event. The Pfizer vaccine is authorized for use in individuals 12 years of age and older. The Moderna and Janssen vaccines are authorized for use in individuals 18 years of age and older. See EUAs issued for each vaccine: o Pfizer EUA: https://www.fda.gov/media/144412/download o Moderna EUA: https://www.fda.gov/media/144637/download. o Janssen EUA: Janssen COVID-19 Vaccine EUA Fact Sheet for Recipients and Caregivers (fda.gov) o Other vaccine requirements may vary. Vendor will be required to adhere to EUA for specific vaccines as additional vaccines are approved by the Food and Drug Administration (FDA). • Vendor will be required to work with the venue host to determine if the vendor will need to provide tables, chairs, popup tents, etc. • At County’s request, vendor may be required to conduct a similar event at the same venue in order to administer required second doses of vaccine. Arrangements for both events shall be made at the same time. Timing of the second event will depend on the recommended second dose frequency: Pfizer is currently 21 days and Moderna is 28 days (see respective EUAs linked above and CDC clinical considerations linked here: https://www.cdc.gov/vaccines/covid-19/info- by-product/clinical-considerations.html ). Janssen vaccine is one dose only. Vendor should always check for CDC and/or vaccine manufacturer updates to these requirements prior to each event. • When applicable, the requirement to conduct a second, similar event, and its timing, are subject to change depending on vaccine availability at the time of the second event and changes in recommended second dose administration timing. • Any extra ancillary supplies not included with vaccine shipment must be supplied by vendor. The County will provide the following: • Venue and direct payment to venue for any rental costs. • Clinic date, time, location and venue contact information. HRSUPPORT Attachment A Page 3 of 9 • County prefers that vendor purchase and utilize their own vaccine storage equipment (refrigerators/freezers/digital data loggers/vaccine transport containers); however, County will loan equipment to providers as available to support vaccination efforts. Note: it is not guaranteed that County will be able to provide all required vaccine storage/transport equipment at any given time, so vendor should work towards purchasing its own equipment. • Vaccine and ancillary supplies as provided by CDPH and CDC. Depending on quantity of vaccine requested, upcoming vaccination clinics, and vaccine shelf-life, vaccine and ancillary supplies may be shipped directly to vendor or picked up at the Fresno County Department of Public Health (FCDPH). This is to be decided via discussion between vendor and County staff prior to distribution of vaccine. Of note, ancillary supplies are only provided by CDC for COVID vaccines; no ancillary supplies have been made available for flu vaccines. • For Pfizer, Moderna, Janssen and potentially other vaccines, we expect the following ancillary supplies to be provided with each 100 vaccine doses. o 105 needles o 105 syringes o 210 alcohol prep pads o 1 needle information card o 100 vaccination cards o 2 disposable face shields o 4 surgical masks • When providing homebound client names to vendor, County will make an effort to identify enough homebound residents and other unvaccinated household members/caregivers in a single residence and/or additional clients located within the same general geographic area so that the number of clients is equal to the number of doses per vial of vaccine being used. • At its discretion, the County may schedule homebound client vaccination appointments for specific days/times prior to providing client information to the vendor. • County will promote the vaccination event site through its website, social media, and/or other means. The vendor will be responsible for the following: • Vendor shall be an approved COVID-19 Vaccine Provider in the California COVID-19 Vaccination Program through the myCAvax portal. • Vendor shall administer the vaccine and enter all vaccinations into the appropriate State system within 24 hours of administration. • Vendor is to provide all office supplies, ancillary medical supplies not included with vaccine, PPE, tables, chairs, tents, etc., when needed. • As mentioned in above section, vaccines are to either be picked up by vendor from FCDPH or shipped directly to vaccine storage site from manufacturer (dependent on quantity of vaccine being requested, upcoming vaccination clinics, and vaccine shelf-life). Per CDPH requirements, if vaccine is picked up by vendor from FCDPH, the redistribution event is to be acknowledged HRSUPPORT Attachment A Page 4 of 9 by vendor in the myCAvax portal. Training on this process can be found at https://cdphvax.my.trailhead.com/en/content/cdphvax/modules/provider- redistributiontransfer/provider-transferredistribution. • Vaccine will be stored, handled, and transferred according to CDC guidelines, such as noted in the CDC’s Vaccine Storage and Handling Toolkit, linked here: https://www.cdc.gov/vaccines/hcp/admin/storage/toolkit/index.html. This applies for potential vaccine pickups from FCDPH as well as mobile vaccination events. • Once vaccine is distributed to vendor, vendor will be responsible for managing vaccine inventory at vaccine storage site. Any unused vaccine on a given clinic date is to be returned to vendor’s vaccine storage site for proper storage and use at a future date. Per CDC requirements, vaccine inventory is to be reported daily to COVID Locating Health at https://covid.locating.health/login. Instructions on onboarding to COVID Locating Health can be found at https://www.vaccines.gov/resources/QSG.for.Provider.Setup_06_04_21_FINAL.pdf . • Any expired vaccine is to be discarded by vendor as medical waste. • Wasted and expired COVID-19 vaccine doses shall be reported to the State through the myCAvax portal. Training on vaccine waste reporting procedures can be viewed here: https://cdphvax.my.trailhead.com/en/content/cdphvax/modules/provider-vaccine- wastage/provider-vaccine-wastage-unit. • Staff in charge of vaccine storage and handling will complete the CDPH training modules at the following website: https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/COVID- 19VaccineTraining.aspx as well as any other required trainings to comply with current recommendations and requirements for COVID-19 vaccines. • Per federal regulations, vendor is required to provide the appropriate EUA document to all vaccine recipients: o Pfizer: https://www.fda.gov/media/144414/download o Moderna: https://www.fda.gov/media/144638/download o Janssen: Janssen COVID-19 Vaccine EUA Fact Sheet for Recipients and Caregivers 04232021 (fda.gov) • COVID-19 vaccination providers are required to report the following adverse events after COVID-19 vaccination, and other adverse events if later revised by CDC, to VAERS: https://vaers.hhs.gov/reportevent.html or calling 1-800-822-7967. • Vaccination administration errors, whether or not associated with an adverse event • Severe COVID-19 illness (e.g., resulting in hospitalization) • Serious adverse events (AE) regardless of causality. Serious AEs are defined as: o Death o A life-threatening AE o Inpatient hospitalization or prolongation of existing hospitalization o Persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions o A congenital anomaly/birth defect o Multisystem Inflammatory Syndrome HRSUPPORT Attachment A Page 5 of 9 • Important medical events that may not result in death, be life-threatening, or require hospitalization may be considered serious when, based upon appropriate medical judgment, they may jeopardize the patient and may require medical or surgical intervention to prevent one of the outcomes listed above • Also report any additional select adverse events and/or any revised safety reporting requirements per FDA’s conditions of authorized use of vaccine(s) throughout the duration of any COVID -19 Vaccine being authorized under an Emergency Use Authorization (EUA). • Vendor must make provision for patients with a history of anaphylaxis (due to any cause) to remain for observation for 30 minutes. For all other persons, observation period is 15 minutes. • In the event of anaphylactic reaction, vendor must maintain appropriate emergency equipment at the event to manage anaphylaxis resulting from vaccination. Such appropriate emergency equipment must also be available when providing vaccinations to homebound clients. See CDC recommended equipment linked here: https://www.cdc.gov/vaccines/covid-19/info-by- product/pfizer/anaphylaxis-management.html. Equipment supply should be sufficient to manage multiple patients experiencing anaphylaxis. Cold Storage Survey (please check as appropriate): We have an ultra-low temperature freezer (temperature capability is -80°C to -60°C/-112°F to - 76°F). Freezer make/model and cubic feet: ________________ We have freezer storage capability (-25°C to -15°C/-13°F to 5°F). Freezer make/model and cubic feet: ____________________ We have refrigerator storage capability (2°C to 8°C/36°F-46°F). Refrigerator make/model and cubic feet: Using County supplied refrigerator. We will pick up and return the vaccine the same day to the County and will make arrangements with County staff on pick up and drop off times. We have qualified container and packout for transport and digital data logger for continuous temperature monitoring during transport. We do not have qualified container and packout for transport and digital data logger for continuous monitoring during transport and will need to borrow from the Department of Public Health. Per the CDC, a “qualified container and packout” are defined as “A type of container and supplies specifically designed for use when packing vaccines for transport. They are passive containers that do not require a power source and are ‘qualified’ through laboratory testing under controlled conditions to ensure they achieve and maintain desired temperatures for a set amount of time.” (https://www.cdc.gov/vaccines/hcp/admin/storage/toolkit/storage-handling-toolkit.pdf) An example of a qualified container is linked here: https://www.vericormed.com/product/cooler- cool-cube-08-vaccine-transport-cooler-at-refrigerated-temperatures-fresh-vaccine-vt-08/ Billing and Compensation for COVID Vaccinations X HRSUPPORT Attachment A Page 6 of 9 Compensation for COVID vaccinations will be based on the below schedule. Additionally, Vendor shall bill patient’s insurance, Medi-Cal, or submit for Federal reimbursement for uninsured patients through the Health Resources and Services Administration’s (NHSA) claims reimbursement program for COVID-19 vaccine administration costs and COVID-19 testing costs. (See link for vaccination reimbursement: https://coviduninsuredclaim.linkhealth.com/get-started.html) • County shall guarantee a minimum of 40 “events” for vendor to provide services no later than March 26, 2022. Events performed as part of Agreement P-21-391 between the County and HR Support shall be credited toward the required 40 events. Additionally, mixed flu and COVID vaccination events shall also be credited toward the 40 events. • An “event” is defined as one (1) standing site clinic, one (1) mobile clinic, or one (1) day of homebound vaccinations. For purposes of this definition, two (2) mobile clinics at two sites in one day would count as two (2) events. Homebound vaccinations shall be considered one event whether there is a single homebound vaccination provided or multiple vaccinations are provided comprising up to a full day of work. • A charge of $1,950.00 shall apply for each of the first 40 events. There shall not be a per event charge for events once 40 events have been provided. • If County fails to provide a minimum of 40 events by March 26, 2022, County shall be responsible for charges of $1,950.00 for each event fewer than the guaranteed 40 events. • Following completion of 40 events, County shall not incur any charges for events that perform a minimum of 50 vaccinations and/or COVID-19 tests in an 8-hour day. • If an event performs fewer than 50 vaccinations and/or COVID-19 tests cumulatively in an 8- hour day, County shall pay a $4,000.00 setup fee for that event. These charges apply to standing site and mobile clinics. These charges do not apply to homebound vaccination visits. • County shall pay a transportation and set up fee of $1,060.00 on a per diem basis for homebound vaccinations, if in a given day the number of vaccinations administered exceeds zero. If the agreement is extended for an additional 12-month term, the following shall apply to COVID vaccination and testing services performed during the additional term: • County shall guarantee a minimum of 40 “events” for vendor to provide services within six months following the start of the 12-month term. Mixed flu and COVID vaccination events shall also be credited toward the 40 events. • An “event” is defined as one (1) standing site clinic, one (1) mobile clinic, or one (1) day of homebound vaccinations. For purposes of this definition, two (2) mobile clinics at two sites in one day would count as two (2) events. Homebound vaccinations shall be considered one event whether there is a single homebound vaccination provided or multiple vaccinations are provided comprising up to a full day of work. HRSUPPORT Attachment A Page 7 of 9 • A charge of $1,950.00 shall apply for each of the first 40 events during the additional 12- month term. There shall not be a per event charge for events once 40 events have been provided. • If County fails to provide a minimum of 40 events within six months of the start of the additional 12-month term, County shall be responsible for charges of $1,950.00 for each event fewer than the guaranteed 40 events. • Following completion of 40 events during an additional 12-month term, County shall not incur any charges for events that perform a minimum of 50 vaccinations and/or COVID-19 tests in an 8-hour day. • If an event performs fewer than 50 vaccinations and/or COVID-19 tests cumulatively in an 8- hour day, County shall pay a $4,000.00 setup fee for that event. These charges apply to standing site and mobile clinics. These charges do not apply to homebound vaccination visits. • County shall pay a transportation and set up fee of $1,060.00 on a per diem basis for homebound vaccinations, if in a given day the number of vaccinations administered exceeds zero. Note: For the purpose of clarification the word “event” includes any venue where the need for a vaccination clinic is required, including but not limited to business organizations, labor camps, packing plants, and specific rural communities. Flu Vaccinations The County will provide the following: • Clinic date, time, location and venue contact information. • Vaccine for clinic. The vendor will be responsible for providing the following: • CAIR Entry: All vaccinations must be entered into the local immunization registry (CAIR) within 14 days of administration. All flu events will be conducted in MyTurn Flu, this will allow tracking of administrations and automatic data exchange to CAIR. Vendor to notify DPH if there are unresolved issues with MyTurn Flu data exchange. • Access to administration data: DPH will coordinate with the Vendor to obtain access to HR Support’s MyTurn account. This data is required for tracking use and accounting for all doses per State requirements. • Vendor is to provide all supplies office and medical, PPE, tables, chairs, tents, etc., when needed. • Would prefer vendor to pick up vaccines from DPH; vendor is responsible for long -term storage. Items needed for transporting vaccine are a hard sided cooler or qualified container/packout (ie, CoolCube) and digital data logger. • Vaccine will be transported according to CDC or VFC recommendations, such as noted at the following website: https://www.eziz.org/assets/docs/IMM-983.pdf • Complete and submit vaccine temperature logs to DPH monthly. HRSUPPORT Attachment A Page 8 of 9 • Return unused/unopened vaccines after all flu events have ended, or as directed by DPH. • Document and notify DPH of any wasted vaccine doses. • Staff in charge of storage and handling, will complete the 5 EZIZ training modules at the following website: https://eziz.org/eziz-training/ (Storing Vaccines, Monitoring Storage Unit Temperatures, Conducting a Vaccine Inventory, Preparing Vaccines, and Administering Vaccines). • Per federal regulations, vendor is required to provide a VIS to patient prior to administering the vaccine. • Per CAIR regulations, the vendor is required to either provide a paper copy of CAIR notification or post CAIR Notification poster near registration. Details regarding notification are available at the following website: http://cairweb.org/cair-disclosure-policy/ Billing and Compensation for flu vaccinations at mixed flu and COVID vaccination events and for flu vaccinations provided during homebound COVID appointments. Compensation rates for COVID only vaccinations rates identified above shall apply for COVID vaccinations provided at mixed events, however, additional charges for flu vaccine administration may be added as follows and should include costs for ancillary supplies: 1. $40.00 per person fee for each person receiving a flu vaccination. 2. During the first term of this agreement a charge of $1,950.00 shall apply to each mixed flu and COVID vaccination event up to 40 events. These 40 events shall be inclusive of COVID only vaccination events performed as part of Agreement P-21-391 and this agreement. There shall not be a per event charge for events once 40 events have been provided. 3. If this agreement is extended for an additional 12-month term, a charge of $1,950 shall apply to each mixed flu and COVID vaccination event for each of the first 40 events. These 40 events shall be inclusive of COVID only vaccination events performed during the additional 12-month term. There shall not be a per event charge for events once 40 events have been provided. Compensation for homebound vaccinations will be based on the number of homebound clients and/or household members/caregivers receiving flu vaccinations at the homebound clients location. $40.00 per person fee for each individual receiving a flu vaccination. Fee applies to homebound clients who are also receiving a COVID vaccinations as well as household members/caregivers, regardless of whether household members/caregivers receive a COVID vaccination at the visit. KEY RESOURCES • CDC's Storage and Handling Toolkit • CDC's COVID-19 Vaccination Information Page • Phase Guidance: HRSUPPORT Attachment A Page 9 of 9 o CDC's Phase 1A Powerpoint o Interim ACIP Guidance o Early NASEM Phase Guidance