Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Colleen Chawla, Chief, San Mateo County Health
Chester J. Kunnappilly, MD, Chief Executive Officer, San Mateo Medical Center
Subject: Issuance of Purchase Orders to Cepheid for Lab Supplies
RECOMMENDATION:
title
Adopt a resolution authorizing the County Purchasing Agent to issue purchase orders to Cepheid for lab supplies, for the term of December 30, 2025 through December 29, 2026, in an amount not to exceed $400,000.
body
BACKGROUND:
The San Mateo Medical Center (SMMC) laboratory (lab) owns and utilizes Cepheid’s GeneXpert system. GeneXpert is an on-demand, real-time polymerase chain reaction (PCR) lab instrument that performs rapid testing and provides testing in a single, self-contained, single-use reagent cartridge. The assay is fully automated, allowing for minimal technologist preparation or hands-on time. SMMC currently uses GeneXpert to perform the Xpert Xpress Multiplex Vaginal Panel (MVP) assay to aid in the diagnosis of bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis in symptomatic women from a single swab within an hour. This assay provides clinicians with precise, accurate results and identifies disease states at a much higher percentage than the traditional methods. Additionally, the MVP specimen has a stability of 42 days versus 30 minutes for the traditional method, allowing all SMMC clinics and County services to collect and have samples analyzed without the issue of time. SMMC also uses GeneXpert to perform the Xpert MRSA NxG, an accurate, fast, on-demand PCR test that detects methicillin-resistant Staphylococcus aureus (MRSA) directly from nasal swabs, allowing for the surveillance of MRSA infections for all admitted patients. SMMC Lab monitors the performance of test GeneXpert assays by completing required quality control and verifications, as well as blind sample testing that is correlated with other labs across the United States, which ensures instruments and staff are performing at the highest standards. SMMC will be purchasing these cartridges from Cepheid.
DISCUSSION:
SMMC is requesting this Board waive competitive procurement requirements under County Administrative Memorandum B-1 due to SMMC’s continual need for lab supplies from Cepheid, as Cepheid's Xpert reagent test cartridges are designed and manufactured to only be used with Cepheid’s instruments. Cepheid is currently the sole manufacturer and the only FDA-authorized distributor of the reagent cartridges for the GeneXpert systems to customers within the United States.
County Procurement has reviewed and pre-approved SMMC’s waiver of competitive requirements.
The County Attorney has reviewed and approved the resolution and agreement as to form.
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 lab supplies needed from Cepheid will be filled 100% of the time.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Actual |
FY 2025-26 Estimated |
|
Percentage of time lab supplies are filled by Cepheid |
100% |
100% |
COMMUNITY IMPACT:
Continued usage of the Cepheid’s GeneXpert system at SMMC, a public safety net hospital, addresses community need with timely and accurate diagnostic testing. By providing rapid, high-quality results, this service will reduce diagnostic delays, thereby improving patient outcomes and limiting transmission in the community. SMMC’s patients span a wide spectrum of races, ethnicities, gender, and gender-identities. Within the past 18 months, the largest cohorts of specialty care patients at SMMC were female (52%), Hispanic or Latino (63%), and primarily Spanish-speaking (55%).
FISCAL IMPACT:
The term of the agreement is December 30, 2025 through December 29, 2026. The amount of the agreement is not to exceed $400,000 for the one-year term. Funds in the amount of $200,000 are included in the SMMC FY 2025-26 Adopted Budget. Funds in the amount of $200,000 will be included in the SMMC FY 2026-27 Recommended Budget.
Expenses at SMMC are covered by fees for services or third-party payors whenever possible. The portion of expenses for services provided to the medically indigent or to those covered by programs that do not meet the full costs of care is covered by the County’s General Fund contribution to SMMC and is within the existing annual appropriation.