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HEALTH SERVICES AGENCY - Executive Director Jayme Bottke
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Requested Action(s)
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a) AGREEMENT - Request approval and authorization for the Executive Director to sign the Agreement with Netsmart Technologies for the provision of electronic health record software licenses, maintenance, and the mandatory implementation of new state requirements for CalAIM, with a maximum compensation not to exceed $2,336,049.16, effective on 5/1/25 and shall terminate 6/30/28
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Financial Impact:
The cost of the agreement is included in the requested annual budgets for budget units 40121, 40131, 40171 and 40251. These are funded through the Mental Health Services Act (MHSA) Capital Facilities and Technology (CFT) Workplan, 1991 Health Realignment, and 2011 Behavioral Health Realignment, client fees, Medi-Cal, and MediCare. There is no impact to the General Fund.
Background Information:
On 6/27/23, the Board of Supervisors approved Misc. Agreement #2023-205 with Netsmart Technologies, Inc. for the MyAvatar electronic health record licensing, maintenance, & support as well as the Revenue Cycle Management (RCM) services. On 9/24/24, the Board of Supervisors approved Amendment No. 1 (Misc. Agreement #2024-305) for the purpose of adding Revenue Cycle Management (RCM) services to the agreement, which is a comprehensive claims submission and remittance management platform that increases first-pass acceptance rates, speeds delivery to payers, and reduces denials of claims being billed to Medicare.
On 12/17/24, the Board of Supervisors approved Amendment No. 2 (Misc. Agreement #2024-377) to increase the maximum compensation and to include Application Management (AMS) consulting services to assist in fulfilling CalAIM requirements set forth by the State.
This agreement’s purpose is to renew the agreement with Netsmart until 6/30/28, as well as add essential services to the scope of work including the implementation of OrderConnect for E-Prescribing and Medication Management of prescriptions, the migration of myAvatar to a Netsmart hosted system and the conversion to the latest version of myAvatar called myAvatar NX.
The migration to a hosted system offers a secure hosting environment for Netsmart solutions. Clients are hosted in fully redundant TIER 3 class data centers with SSAE18-certified operations. Plexus Cloud Hosting is a cost-efficient service that ensures information systems are accessible yet secure, allowing organizations to focus on their core mission: providing the highest quality care possible to the populations they serve.
Key Benefits:
• Lower risk of security breaches
• Increased availability of systems and data
• Enhanced performance of myAvatar and business applications through up to date technology, best practices, skilled resources and regular updates
• Understanding of the needs of healthcare organizations
Key Features:
Security
• Annual third-party audit ensures the highest level of security protection
• Enterprise-level identity and access management platform
• Netsmart-staffed, 24/7, security and network operation centers
• Multi-layered security approach that leverages the NIST Moderate Framework, Zero Trust and Defense in Depth
• Data encrypted in transit and at rest
Reliability
• High-availability infrastructure across regions and availability zones
• N+2 redundancy throughout the production infrastructure stack
• System availability backed by an industry-leading service level agreement
• Monitoring, system updates and vulnerability management included
Compliance
• SSAE18-compliant with annual third-party audit of all security controls
• Meets or exceeds all HIPAA requirements
The conversion to myAvatar NX moves the Electronic Health Record to a fully web-based system eliminating the need to download java to each user’s desktop or laptop. With responsive design users can now easily use any device, including tablets and mobile devices, and quickly transition between devices as needed.
myAvatar NX was built start to finish with the clinician in mind. myAvatarNX has role-based workflows that bring knowledge and quality to the point of care. The new UX is simple, fast, and easy for new and existing users to learn.
The system has been built to drive performance, scale, and reliability. User login now takes a matter of seconds. It is faster for end users and easier for IT teams to keep updated. That means less time waiting on the system for clinicians and less time maintaining it for IT teams.
The state of California is implementing the California Advancing and Innovating Medi-Cal (CalAIM) initiative. The goals of CalAIM are to:
1. Identify and manage comprehensive needs through whole person care approaches and social drivers of health.
2. Improve quality outcomes, reduce health disparities, and transform the delivery system through value based initiatives, modernization, and payment reform.
3. Make Medi-Cal a more consistent and seamless system for enrollees to navigate by reducing complexity and increasing flexibility.
CalAIM continues to require significant changes to service delivery, data collection, outcome measures reporting, financial reporting and client billing. Netsmart Technologies has been assisting the Department in achieving compliance with the complicated changes under CalAIM by providing all necessary software updates, consulting services and training. If not approved, the Department would not have the resources available for completion of training and software development and would be unable to reach compliance for the CalAIM data reporting requirements.