HomeMy WebLinkAboutAgreement A-22-270 with CalMHSA.pdf DocuSign Envelope ID:92BD4B38-AD13-4BC7-8070-E06D40C58956
Agreement No. 22-270
Program Name: Semi-Statewide Enterprise Health
Record Date June 21, 2022
CALIFORNIA MENTAL HEALTH SERVICES AUTHORITY
PARTICIPATION AGREEMENT
COVER SHEET
1. Fresno County("Participant")desires to participate in the Program identified below.
Name of Program: Semi-Statewide Enterprise Health Record
2. California Mental Health Services Authority ("CalMHSA") and Participant acknowledge
that the Program will be governed by CalMHSA's Joint Powers Agreement and its Bylaws,
and by this Participation Agreement. The following exhibits are intended to clarify how
the provisions of those documents will be applied to this particular Program.
0 Exhibit A Program Description
0 Exhibit B General Terms and Conditions
0 Exhibit C Participant-Specific Committed Funding and Payment Terms
0 Exhibit D Participant Contingency Budget
3. The first installment of$1,109,997 is due from Participant within 30 days of execution of
this Agreement.
4. The term of Participant's participation in the Program will commence on July 1, 2022
through March 18, 2029, unless sooner terminated pursuant to the terms of this
Agreement.
S. Authorized Signatures:
CaIMHS DocuSigned by:
Signed Vr' Qwttt' NQV Name (Printed): Dr. Arnie Miller, Psy.D., MFT
Title: Executive Director Date:6/29/2022
Participant:
Signed: L �,ll, Name (Printed): Brian Pacheco
Title: Chairman of the Board of
Supervisors of the County of Fresno Dated
ATTEST:
BERNICE E.SEIDEL
Clerk of the Board of Supervisors
County of Fresno,St to of California
By
Depu
Fresno County—Exhibit A—Program Description
Page 1 of 14
Agreement No.
Program Name: Semi-Statewide Enterprise Health Record
Date
EXHIBIT A—PROGRAM DESCRIPTION
I. Name of Program: Semi-Statewide Enterprise Health Record
II. Term of Program: CalMHSA and Streamline Healthcare Solutions, LLC("Contractor") have
entered into a seven (7) year contract, beginning March 18, 2022 and terminating on
March 18, 2029. CalMHSA has the option to extend the Program with the Contractor for
up to three (3) additional one (1) year periods.
III. Program Objective and Overview:
Objective:
The Program will include the development and implementation of a Semi-Statewide
Enterprise Health Record ("EHR").
Overview:
The goal of CalMHSA's effort is to partner with the Contractor and participating counties
("Participants") to configure a California-centric Enterprise Health Record that will then
be implemented across multiple counties. Through this multi-county collaborative effort,
the Enterprise Health Record will support counties' core business requirements and
address all regulatory requirements specific to the State of California by establishing
consistent workflows, configuration, and functionality that will support:
• Centralized application administration
• Standardized training and end-user support
• Shared technical services
• A common baseline against which new updates for State and federal mandate can
be defined/applied
• The creation of a learning community across the participating counties
By being grounded in clinical best practices and State objectives, the semi-statewide
implementation will act as a catalyst for better use of data to drive performance
outcomes.
CalMHSA has entered into a Master Services Agreement (MSA) with Contractor to
develop an EHR that will provide these functions.
Pursuant to the MSA, Contractor will develop and implement "SmartCare Base", a fully
integrated, web based EHR system designed for program, billing and revenue
management. SmartCare Base focuses on behavioral healthcare providers and
organizations that offer psychiatric inpatient, outpatient, residential and community-
based programs. SmartCare Base includes clinical and administrative functionality for
client intake and registration; admissions, discharges and transfers; referrals and
Fresno County—Exhibit A—Program Description
Page 2 of 14
Agreement No.
Program Name: Semi-Statewide Enterprise Health Record
Date
inquiries; appointment scheduling; individual care planning; assessments and progress
notes; electronic signatures; prescription medication ordering; document management;
point-of-service document scanning; authorizations tracking; compliance monitoring; and
productivity and outcomes measurement tools (i.e., forms and reporting tools associated
with Participant-identified evidence-based practices, etc.).The features for revenue cycle
management include service billing and authorization tracking; service, payer, insurance
plans and rules management; claims generation; tracking denials; and nightly billing
processes to automate many of these functions.
In addition, SmartCare Base will meet the requirements of Medi-Cal, the State of
California's version of Medicaid.This includes the ability to capture the data,transmit and
monitor the submission process, provide reporting capabilities, check or confirm Medi-
Cal Eligibility, Treatment Authorization Request (TAR) creation and submission as well as
Medi-Cal required elements for proper claim submission. Contractor will support and
include ongoing and new updates as required by the State of California for the following:
Reporting and Forms:
■ CaIOMS: California Outcomes Measurements System
■ CSI Reporting: Client Services Information
■ TADT: Timely Access Data Tool
■ NACT: Network Adequacy Certification Tool
■ OIG Audits: Office of Inspector General
■ ASAM: American Society of Addiction Medicine
■ ANSA: Adult Needs and Strengths
■ CANS: Child and Adolescent Needs and Strengths
■ PSC-35: Pediatric Symptom Checklist
■ FSP: Full Service Partnership
■ HCAI: Department of Health Care Access and Information (Formerly OSHPD: Office
of Statewide Health Planning and Development)
Billing Support:
■ UMDAP: Uniform Method of Determining Ability to Pay
■ 270/271 Connector for Medi-Cal
■ Share of Cost Clearance Integration
■ MEDS/MMEF Medi-Cal Eligibility Data System, Medi-Cal Monthly Extract File
Import
■ Core/Custom updates to 837P and 8371
■ Billing Delay Reason Code Documentation
Fresno County—Exhibit A—Program Description
Page 3 of 14
Agreement No.
Program Name: Semi-Statewide Enterprise Health Record
Date
Finally, CaIMHSA, on behalf of Participants, will assure achievement of measurable deliverables
to assure Participant compliance and attestation as required by the California Advancing and
Innovating Medi-Cal (CaIAIM) Behavioral Health Quality Improvement Program (BHQIP).
(the remainder of this page is intentionally left blank)
Fresno County—Exhibit A—Program Description
Page 4 of 14
Agreement No.
Program Name: Semi-Statewide Enterprise Health Record
Date
EXHIBIT B—GENERAL TERMS AND CONDITIONS
I. Definitions
The following terms, as used throughout this Participation Agreement, shall be construed
to have the following meaning, unless otherwise apparent from the context in which they
are used:
A. CaIMHSA— California Mental Health Services Authority, a Joint Powers Authority
(JPA) created by counties in 2009 at the instigation of the California Mental Health
Directors Association to jointly develop and fund mental health services and
education programs.
B. Member — An organization County or City (or JPA of two or more Counties) that
has joined CalMHSA and executed the CalMHSA Joint Powers Agreement.
C. Mental Health Services Act (MHSA)—A law initially known as Proposition 63 in the
November 2004 election that added sections to the Welfare and Institutions Code
providing funding to counties for the expansion of mental health prevention and
treatment services.
D. Department of Health Care Services (DHCS)—The California Department of Health
Care Services responsible for behavioral health functions.
E. Participant—Any County or City participating in the Program either as Member of
CaIMHSA or under a Memorandum of Understanding with CaIMHSA.
F. Program—The program identified in the Cover Sheet.
G. Committed Funds — Any funding specified for fees associated with solution
subscriptions and/or professional services that the Participant has committed to
the Program through this Participation Agreement.
H. Contingency Funds—Any funding secured by the Participant for future, as-needed
solution subscriptions and/or professional services. Through the execution of
subsequent Amendment(s) to this Participation Agreement, funding
augmentations may be incorporated for future purchases and services.
II. Responsibilities
A. Responsibilities of CaIMHSA:
1. Act as the Fiscal and Administrative agent for the Program.
2. Invoice and collect funds from Participant for the Program.
3. Manage funds received through the Program, consistent with the
requirements of any applicable laws, regulations, guidelines and/or
contractual obligations.
Fresno County—Exhibit B— General Terms and Conditions
Page 5 of 14
Agreement No.
Program Name: Semi-Statewide Enterprise Health Record
Date
4. During implementation activities, work closely with the Contractor to
coordinate on development and implementation of the EHR, including:
a. Development of customizations and customer extensions during
implementation and post go-live
b. Setup and configuration of hosted infrastructure
C. Installation of licensed product and services
d. Setup and configuration of SmartCare Base environments for
implementation
e. Ongoing support and maintenance of environments during
implementation
f. Assure and Support access for Participant implementation team
5. Assure Contractor submits the following:
a. At least ten (10) claims per each Participant that pass the Strategic
National Implementation Process (SNIP) edit;
b. At least ten (10) Drug Medi-Cal (DMC) claims per each Participant
that are approved (including DMC-ODS or DMC claims); and
C. At least ten (10) Specialty Mental Health Services (SMHS) claims
per each Participant that are subsequently approved.
6. On behalf of each Participant, assure Contractor submits to DHCS the
following attestations and supporting documents from Contractor as also
may be required:
a. The changes needed to the Semi-Statewide EHR claiming system
have been assessed, including updated Current Procedural
Terminology (CPT) codes sets and have been incorporated into the
contract with Contractor.
b. All new claiming rates have been loaded into each Participant's
instances of SmartCare Base.
C. The Fast Healthcare Interoperability Resources Application
Programming Interface (FHIR API) implementation is underway.
d. The implementation of the FHIR API has been completed.
e. The process of mapping data elements to the United States Core
Data for Interoperability (USCDI) has begun.
f. The documentation outlining mapped data elements to the USCDI
has begun.
Fresno County—Exhibit 8— General Terms and Conditions
Page 6 of 14
Agreement No.
Program Name: Semi-Statewide Enterprise Health Record
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g. Certification that data elements have been successfully mapped to
USCDI, inclusive of completed mapping documentation.
7. Assure Contractor submits/Provides a copy of a test data sharing
transaction log or a deidentified Health Level 7 (HL7) test message (or
other equivalent documentation) to and from the Managed Care
Organizations (MCOs) or Health Information Exchange (HIE) and each
Participant.
8. Assure Contractor submits a log of successful Fast Healthcare
Interoperability Resources (FHIR)transactions(de-identified)to DHCS over
a two-month period in Calendar Year (CY) 2023.
9. After "Go-Live" of the EHR within the Participant's jurisdiction, oversee
and work closely with the Contractor to ensure compliance with the MSA.
10. Monitor and administer the MSA on behalf of Participants.
11. Provide regular fiscal reports to Participant and/or other public agencies
with a right to such reports.
12. Comply with CaIMHSA's Joint Powers Agreement (JPA) and Bylaws.
B. Responsibilities of Participant:
1. Timely transfer of the funding amount for the Program as specified in
Section V, Fiscal Provisions.
2. Provide CaIMHSA, Contractor and any other parties deemed necessary
with requested information and assistance in order to fulfill the purpose
of the Program.
3. Perform any and all requested assessments of the Program and provide
feedback on Program performance.
4. Acknowledge that funds contributed by Participant shall be pursuant to
the allocation formula adopted set forth in Exhibit C.
5. Comply with applicable laws, regulations, guidelines, contractual
agreements, JPA, and Bylaws.
III. Amendment
This Participation Agreement may be supplemented, amended, or modified only by the
Fresno County—Exhibit 8— General Terms and Conditions
Page 7 of 14
Agreement No.
Program Name: Semi-Statewide Enterprise Health Record
Date
mutual agreement of CaIMHSA and the Participant, expressed in writing and signed by
authorized representatives of both parties.
IV. Withdrawal, Cancellation, and Termination
A. Participant may withdraw from the Program and terminate the Participation
Agreement upon six (6) months' written notice in accordance with Section VII.
B. The withdrawal of Participant from the Program shall not automatically
terminate Participant's responsibility for its share of the expense and liabilities of
the Program. The contributions of current and past Participants are chargeable
for their respective share of unavoidable expenses and liabilities arising during
the period of their participation.
C. Upon cancellation, termination, or other conclusion of the Program, any funds
remaining undisbursed after CaIMHSA satisfies all obligations arising from the
administration of the Program shall be returned to Participant. Unused funds
paid for a joint effort will be returned pro rata to Participant in proportion to
payments made. Adjustments may be made if a disproportionate benefit was
conveyed on a particular Participant. Excess funds at the conclusion of
Participant-specific efforts will be returned to the particular Participant that paid
them.
V. Fiscal Provisions
A. The total maximum amount of this Participation Agreement shall not exceed
$10,806,504 forthe term of this Agreement as found in EXHIBIT C—PARTICIPANT-
SPECIFIC FUNDING AND PAYMENT TERMS and EXHIBIT D - PARTICIPANT
CONTINGENCY BUDGET, which have been made part of this Agreement.
B. Payment Terms
1. Participant's Estimated Annual Costs and specific Payment Terms for
Committed Funds throughout the term of the Participant Agreement are
identified in EXHIBIT C — PARTICIPANT-SPECIFIC FUNDING AND PAYMENT
TERMS. EXHIBIT D — PARTICIPANT CONTINGENCY BUDGET identifies
additional funds to be made available to accommodate expected user growth,
development and other professional services anticipated to be executed
within the term of the Agreement.
2. Each payment is subject to variance based on several factors, including but not
limited to the total number of Participants, total number of
subscriptions/users, the implementation phase selected, the total
development cost, and annual CPI Increase.
3. Wherever Participant's actual annual costs for participation in the Program
exceed the Estimated Annual Cost, Participant agrees to pay CaIMHSA for the
Fresno County—Exhibit 8— General Terms and Conditions
Page 8 of 14
Agreement No.
Program Name: Semi-Statewide Enterprise Health Record
Date
difference. Payment of said difference to CalMHSA shall be contingent upon
Participant's pre-approval of any services/costs that will cause spending to
exceed Estimated Annual Cost (as reflected in Exhibit C and Exhibit D).
C. This is a Multi-County Program. Participants will share the costs of planning,
administration, and evaluation in the same proportions as their overall
contributions.
VI. Limitation of Liability and Indemnification
A. CalMHSA is responsible only for funds as instructed and authorized by
Participants. CalMHSA is not liable for damages beyond the amount of any funds
which are identified on the cover page of this Agreement, without authorization
or contrary to Participant's instructions.
B. CalMHSA is not undertaking responsibility for the provision of mental health
services, including but not limited to: performing client assessments, creation of
case or treatment plans, providing or arranging services, and/or selecting,
contracting with, or supervising and/or monitoring providers (collectively,
"mental health services"). Participant will defend and indemnify CaIMHSA for any
claim, demand, disallowance, suit, or damages arising from Participant's acts or
omissions in connection with the provision of mental health services.
VII. Notice
All notices under this Participation Agreement shall be provided 1) by personal delivery,
nationally recognized courier service or mailed by U.S. registered or certified mail, return
receipt requested, postage prepaid; AND 2) by email. All notices shall be provided to the
respective party at the addresses and email addresses set forth below, and shall be
deemed received upon the other party's receipt.
Either party may change its designee for notice by giving notice of the same and their
relevant address information.
If to CalMHSA:
Name: Laura Li Position: Chief Administrative Officer, CaIMHSA
Address: 1610 Arden Way, Suite 175, Sacramento, CA 95815
Email: laura.li@calmhsa.org Telephone: (279) 234-0700
CC Email to: Randall Keen/Manatt Email: RKeen@manatt.com
If to Participant:
Name: Susan Holt Position: Director, Department of Behavioral Health, County of Fresno
Address: 1925 E. Dakota Avenue, Fresno, CA 93726
Email: sholt@fresnocountyca.gov Telephone: (559) 600-7905
CC to: Maryann Le, Deputy Director, Department of Behavioral Health, County of Fresno
Email: mle@fresnocountyca.gov
Fresno County—Exhibit 8— General Terms and Conditions
Page 9 of 14
Agreement No.
Program Name: Semi-Statewide Enterprise Health Record
Date
EXHIBIT C— PARTICIPANT-SPECIFIC COMMITTED FUNDING AND PAYMENT TERMS
Committed Funding
The total maximum amount of Participant-Specific Committed Funding in this Participation Agreement shall not exceed
$9,462,177 for the period of Participant Agreement execution through March 18, 2029 as follows:
Description Unit(s) 7/1/22-6/30/23 7/1/23-6/30/24 7/1/24-6/30/25 7/1/25-6/30/26 7/1/26-6/30/27 7/1/27-6/30/28 7/1/28-3/18/29
SmartCare L
Total Amount by Fiscal Year $ 2,752,043.85 $ 1,252,623.40 $ 1,167,498.70 $ 1,168,558.71 $ 1,169,650.52 $ 1,170,775.09 $ 781,026.43
Total Participant-Specific Committed Funds 1$ 9,462,177
Fresno County Exhibit C—Participant-Specific Committed Funding and Payment Terms
Page 10 of 14
Agreement No.
Program Name: Semi-Statewide Enterprise Health Record
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Committed Funds Payment Terms
Description Fee Type Description Payment Term
Participant Instance Installation Participant Instance Installation Fee One-Time Fee to be invoiced upon Participant Agreement
includes: Execution. Payment of invoices are due within 30 days of
• Setup& Configuration of hosted receipt
infrastructure
• Installation of licensed product and
services
• Setup and configuration of SmartCare
environments for implementation
• Ongoing support& maintenance of
environments during implementation
• Support access for and Participant
implementation team
System Acquisition Fee •This cost covers the "Core" CalMHSA One-Time Fee to be invoiced upon Participant Agreement
Installation of SmartCare Execution. Payment of invoices are due within 30 days of
•This cost is also associated with receipt
establishing an agreement between
Streamline and CaIMHSA which secured
discounted pricing and other
considerations
Initial Development Fee (Customization and This cost covers the identified One-Time Fee to be invoiced upon Participant Agreement
Security) development items to be delivered Execution. Payment of invoices are due within 30 days of
during the implementation effort receipt
Discretionary Development Budget This cost establishes a shared budget to One-Time Fee to be invoiced upon Participant Agreement
address as-yet unidentified items Execution. Payment of invoices are due within 30 days of
receipt
Professional Services Implementation Monthly Fees are initiated upon Payment of invoices are due within 30 days of receipt
Participation Agreement execution and
paid throughout the entire phase of each
Participant's Implementation
Fresno County Exhibit C—Participant-Specific Committed Funding and Payment Terms
Page 11 of 14
Agreement No.
Program Name: Semi-Statewide Enterprise Health Record
Date
SmartCare HIE/ MCO Interface via FHIR One-Time Fee associated with the One-Time Fee to be invoiced upon Participant Agreement
Implementation implementation efforts to support Execution. Payment of invoices are due within 30 days of
specific variable modules selected by the receipt
Participant
Disaster Recovery Implementation One-Time Fee associated with the One-Time Fee to be invoiced upon Participant Agreement
professional services to establish Execution. Payment of invoices are due within 30 days of
infrastructure within the cloud receipt
datacenter to support Disaster Recovery
SmartCare CaIMHSA Package Subscription The "SmartCare CaIMHSA Package" is the
primary subscription which includes:
•Use of the EHR
•Cloud Hosting of the Software/System For this initial Participant Agreement,these monthly fees
(99.95% Up-Time) will be initiated two months prior to the Implementation
•CaIMHSA Support of the System (Tier 1) Phase assigned to the Participant.
•Contractor Support and Maintenance of
the System (Tier 2) After Go-Live, increases or reductions of subscriptions as
SmartCare Rx Prescribers Subscription Integrated Surescripts Certified requested by Participant will prompt an associated
subscription based on individual adjustment to the monthly fees and an Amendment to
prescriber,which allows users to this Participant Agreement
prescribe medications to patients that
can be electronically submitted, printed Subscription shall be invoiced monthly throughout the
or faxed directly to the pharmacy. remaining term of the Participant Agreement. Payment of
SmartCare HIE/ MCO Interface via FHIR Module to integrate with Health invoices are due within 30 days of receipt.
Information Exchange (HIE) or Managed
Care Organization (MCO)to share client
demographic and health information.
Fresno County Exhibit C—Participant-Specific Committed Funding and Payment Terms
Page 12 of 14
Agreement No.
Program Name: Semi-Statewide Enterprise Health Record
Date
Disaster Recovery Subscription Disaster recovery subscription provides
the infrastructure and as-needed services
to assure Participant's ability to access to
the Enterprise Health Record (EHR) after
events like a natural disaster, cyber
attack, etc. Disaster recovery relies upon
the replication of data and computer
processing in an off-premises location
not affected by the disaster. With this
subscription, should such an event occur,
access to the EH will be re-established
within 4 hours with data loss not to
exceed 15 minutes.
SmartCare Add-On Hosting Storage Subscription for 250 gigs of storage.
Subscription Additional storage can be purchased as
needed.
Annual 3% Fee Increase -Subscription All Subscription Fees will increase by 3%
annually
Fresno County Exhibit C—Participant-Specific Committed Funding and Payment Terms
Page 13 of 14
Agreement No.
Program Name: Semi-Statewide Enterprise Health Record
Date
EXHIBIT D— PARTICIPANT CONTINGENCY BUDGET
Participant Contingency Budget
Given current expected user growth, development and professional services related to future projects anticipated to be
implemented within the term of this Agreement, a maximum total Participant Contingency Budget of $1,344,327 is also
included and is defined as follows:
7/1/22- 7/1/23 - 7/1/24- 7/1/25- 7/1/26- 7/1/27- 7/1/28-
Description 6/30/23 6/30/24 6/30/25 6/30/26 6/30/27 6/30/28 3/18/29
Subscription Costs for Anticipated User
Growth(25 additional SmartCare users per $ 38,409.33 $ 38,409.33 $ 38,409.33 $ 38,409.33 $ 38,409.33 $ 38,409.33 $ 38,409.33
year and 5 additional Prescribers)
Subscription Costs for Additional Modules $ 25,619.02 $ 25,619.02 $ 25,619.02 $ 25,619.02 $ 25,619.02 $ 25,619.02 $ 25,619.02
Discretionary Development Budget for $ 64,009.15 $ 64,009.15 $ 64,009.15 $ 64,009.15 $ 64,009.15 $ 64,009.15 $ 64,009.15
Participant Specific Requirements
Professional Services $ 64,009.15 $ 64,009.15 $ 64,009.15 $ 64,009.15 $ 64,009.15 $ 64,009.15 $ 64,009.15
Total Amount by Fiscal Year $ 192,046.64 $ 192,046.64 $ 192,046.64 $ 192,046.64 $ 192,046.64 $ 192,046.64 $ 192,046.64
Total Participant Contingency Funds $ 1,344,327
Fresno County Exhibit D—Participant Contingency Budget
Page 14 of 14
PARTICIPATION AGREEMENT BETWEEN THE COUNTY OF FRESNO
AND
CALIFORNIA MENTAL HEALTH SERVICES AUTHORITY
Term: July 1,2022 through March 18, 2029
FOR FRESNO COUNTY ACCOUNTING USE ONLY:
Fund/Subclass: 0001/10000
Organization: 5630
Account/Program: 7295/0