Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Chester J. Kunnappilly, MD, Chief Executive Officer, San Mateo Medical Center
Scott Gilman, Director, Behavioral Health and Recovery Services
Lisa Mancini, Director, Aging and Adult Services
Cassius Lockett, Director, Public Health Policy and Planning
Subject: Agreement with KaiNexus
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with KaiNexus to provide an information system for tracking problem identification and resolution while caring for clients with complex needs throughout San Mateo County Health, for the term of December 10, 2019 through December 9, 2022, in an amount not to exceed $316,800.
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BACKGROUND:
Clients with complex needs have co-occurring chronic physical conditions, as well as mental health and substance-use challenges; many are food and housing insecure or homeless and live in poverty or are conserved. Because of the complexity of these clients’ needs, and the necessity for quick efficient intervention and coordination of services, it is critical to identify and resolve problems when delivering care to these clients. It is also important to be able to spread these problems’ solutions across San Mateo County Health (SMC Health), since many of these clients receive services from all or some combination of the following SMC Health divisions: Behavioral Health and Recovery Services (BHRS), the San Mateo Medical Center (SMMC), Aging and Adult Services, and/or Public Health Policy and Planning through its Whole Person Care/Bridges to Wellness (WPC) programs.
DISCUSSION:
SMC Health does not have a single information system to track problem identification, resolution, and spread of solutions. SMC Health currently tracks problems identified by staff using a SharePoint-based application that has many limitations. Most notably, the application is not integrated with the safety and reporting systems used by BHRS and SMMC, making the tracking and resolution of problems difficult, especially for the great proportion of the cases that involve multiple SMC Health divisions. Despite these difficulties, these different systems have collectively recorded more than 4,000 problems and their resolutions since our effort to systematize problem-solving began in 2017.
SMC Health issued a request for proposals on December 19, 2018 to explore an integrated solution, and elevated one of the proponents on February 13, 2019: KaiNexus. KaiNexus is a cloud-hosted solution that provides access to reliable and real-time information and was designed to track problem-solving efforts to accelerate improvements. Dashboards, notifications, and a searchable knowledge repository in the platform ensure no opportunities to improve are missed or forgotten. Assignments and prioritization features ensure that staff can transparently identify priority, responsibility, and status of each problem-solving activity, including “return on improvement”. Because all this information is housed in a single platform, there is no need to reproduce or recreate work, eliminating the waste of overproduction and duplicated efforts. A “readiness workgroup” of key stakeholders from the aforementioned SMC Health divisions has been meeting regularly to achieve a successful integration of problem solving across SMC Health. Staff time currently invested in manual reporting and unnecessary duplication will decrease, while reliability of the problem-solving process will increase.
In June 2019, the State of California approved SMC Health’s use of WPC funds to acquire and implement a customizable technology platform to track problem identification and resolution, in support of meeting the intended goal of improving outcomes for clients with complex needs. The funds are restricted to this purpose and cannot be redirected to other purposes.
The agreement and resolution have been reviewed and approved by County Counsel as to form. ISD has reviewed and approved the IT component of this agreement.
The resolution contains the County’s standard provisions allowing amendment of the County fiscal obligations by a maximum of $25,000 (in aggregate). It is anticipated that SMC Health will experience a 20% increase in problems solved to root across all its divisions.
PERFORMANCE MEASURE:
|
Measure |
FY 2019-20 Estimated |
FY 2020-21 Projected |
|
Percentage increase in number of problems solved to root across all SMC Health divisions |
N/A* |
20% |
*New measure
FISCAL IMPACT:
The term of the agreement is December 10, 2019 through December 9, 2022. The amount of the agreement is not to exceed $316,800 for the three-year term. Of this amount, $110,000 has been included in SMC Health’s FY2019-20 Adopted Budget and $110,000 will be included in SMC Health’s FY2020-21 Recommended Budget. Please note that the cost of this contract will be offset by one-time savings of $72,175, which are remaining from an existing support agreement with Planet Technologies, the vendor that developed and maintains SMMC’s reporting system. Future year funding will be covered by dedicated technology funding available through Behavioral Health and Recovery Services (BHRS). Funding is 100% covered by the WPC grant, with no Net County Cost.