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: Agreement with Cardinal Health Pharmacy Services, LLC to Provide Remote Order Entry Pharmacy Services
RECOMMENDATION:
title
Adopt a resolution authorizing an agreement with Cardinal Health Pharmacy Services, LLC to provide remote order entry pharmacy services for the term of August 1, 2025 through July 31, 2028, in an amount not to exceed $468,000.
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BACKGROUND:
San Mateo Medical Center (SMMC) has been utilizing after-hours remote order entry pharmacy services since 2011. Remote entry pharmacy services ensure SMMC’s patients will receive timely access to critical medications at all hours. 22 Cal. Code Regs. § 70263(e) requires general acute care hospitals to implement a system assuring the availability of prescribed medications 24 hours a day as a condition of licensure. The proposed agreement is needed to maintain compliance with this requirement. The incumbent vendor, Cardinal Health Pharmacy Services, LLC, has continued providing services during the development and administration of the request for proposals process (RFP) to ensure uninterrupted operations. In June 2025, SMMC completed a RFP for after-hours pharmacy remote order entry services. Cardinal was selected as the best vendor to provide remote order entry services to support SMMC and Correctional Health Services (CHS).
DISCUSSION:
This agreement is going to this Board late due to prolonged negotiations with the vendor. This Agreement’s start date begins at the expiration of the previous agreement without lapse so SMMC can compensate Cardinal for services provided during the interim period.
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).
The Information Services Department has reviewed and approved the IT component of this agreement.
It is anticipated that 100% of all after-hours medication orders will be reviewed by a pharmacist.
PERFORMANCE MEASURE:
|
Measure |
FY 2025-26 Estimated |
FY 2026-27 Projected |
|
Percentage of after-hours medication orders reviewed by a pharmacist |
100% |
100% |
COMMUNITY IMPACT:
By continuing to receive after-hours remote entry pharmacy services at SMMC, SMMC’s patients will continue to receive timely access to critical medications regardless of the hours of operation of SMMC’s pharmacy. SMMC’s patients span a wide spectrum of races, ethnicities, gender, and gender-identities. Since November 1, 2024 half of the specialty care patients at SMMC were female and half were male, with the largest ethnic cohorts being Hispanic or Latino (58%), and primarily Spanish speaking (48%).
FISCAL IMPACT:
The term of the agreement is August 1, 2025 through July 31, 2028. The amount of the agreement is not to exceed $468,000 for the three-year term. Funds in the amount of $99,000 are included in the SMMC FY 2025-26 Adopted Budget. Funds in the amount of $44,000 are included in the CHS FY 2025-26 Adopted Budget. Funds in the amount of $108,000 will be included in the SMMC FY 2026-27 Recommended Budget. Funds in the amount of $48,000 will be included in the CHS FY 2026-27 Recommended Budget.
The payment provisions and levels of services in this contract differ from that of the previous contract, due to an increase in the number of medication orders requiring verification by a pharmacist since Epic go-live, as well as the additional services provided to the Correctional Health Services Department. The total value of the new contract represents a 24% increase compared to that of the previous contract.
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.
ATTACHMENT:
1. RFP Matrix