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Agenda 09/13/2022 Item #16E 3 (Risk Management Groupo Health Plan)09/13/2022 EXECUTIVE SUMMARY OBJECTIVE: To provide continuing services for Managed Care and Preferred Provider Payor Network to Collier County’s Group Health Plan. CONSIDERATIONS: The Board of Commissioners through the Risk Management Division offers a comprehensive group health insurance program to its employees and their eligible dependents. The program includes a partially self-funded group health plan also known as the “Plan.” In order to properly manage the Plan and control costs, the County employs the services of a Utilization Management and Large Case Management firm as well as a local Physician/Hospital Preferred Provider Network (PPO). Currently, the County utilizes Community Health Partners for these services. Typically, Utilization Management and Large Case Management services are incorporated as part of claims administration services procured under a Group Health Third Party Administration (TPA) Agreement. These services are not based locally with most firms operating outside the State of Florida. Thus, these firms are not familiar with the local physicians and providers in the community. Community Health Partners is the only locally based physician hospital organization that can provide these types of services. This local presence also offers greate r transparency and control to self-insured Plans such as the County’s program, the District School Board’s program and the Collier County Sheriff’s program. On September 26, 2017 (Agenda Item No. 16.E.20), the County entered into Agreement #17 - 7209 “Managed Care & Preferred Provider Payor Network” (“Agreement”) with Naples Physician Hospital Organization, Inc. d/b/a Community Health Partners (“CHP”). The Agreement provides Utilization Management, Large Claims Case Management, and access to CHP’s local physician/hospital network to serve members covered under the Collier County Group Health Plan. CHP was the only proposer for these services. The initial term is for three (3) years with two (2) additional one (1) year renewal periods. The Agreement will expire on December 31, 2022. CHP has demonstrated professional and responsive services during the term of the Agreement and has agreed to an amendment to continue to offer these services. Therefore, given the above, Staff recommends approval of the attached First Amendment to the Agreement. The First Amendment will extend the term of the agreement for a period of three years, beginning January 1, 2023 and ending December 31, 2025 with an option for two (2) additional one-year renewals and update the Schedule 4.7 accordingly. Section Eleven, sub-paragraph 11 of the Collier County Procurement Ordinance 2017-18, as amended, allows the Board to make a finding that it is in the best interest of the County to continue with standardized support services with Naples Physician Hospital Organization, Inc. d/b/a Community Health Partners for Managed Care and Preferred Provider Payor Network access. FISCAL IMPACT: The estimated cost in FY 23 to provide managed care and network services based upon an average enrollment of 2,400 employees is $125,000. Funds have been budgeted within Fund 517, Group Health and Life to fund the program. GROWTH MANAGEMENT IMPACT: There is no growth management impact associated with this item. 16.E.3 Packet Pg. 2763 09/13/2022 LEGAL CONSIDERATIONS: This item is approved as to form and legality and requires majority vote for approval. -RTT RECOMMENDATION: That the Board approves and authorizes the Chairman to execute the First Amendment to Agreement #17-7209 “Managed Care & Preferred Provider Payor Network Agreement” with Physician Hospital Organization, Inc. d/b/a Community Health Partners, approve expenditures under the First Amendment and approve Single Source Waiver, and authorize the expenditures under the First Amendment. PREPARED BY: Jeff Walker, CPCU, ARM, Director, Risk Management ATTACHMENT(S) 1. 17-7209 CHP_Amend#1_VendorSigned (PDF) 2. FY22 Waiver Request 056 - CHP (Managed Care and Network Services) (PDF) 3. 17-7209 2018 Managed Care_Contract_FullExec (PDF) 16.E.3 Packet Pg. 2764 09/13/2022 COLLIER COUNTY Board of County Commissioners Item Number: 16.E.3 Doc ID: 22849 Item Summary: Recommendation to approve the First Amendment to the Agreement # 17-7209 “Managed Care & Preferred Provider Payor Network” with Naples Physician Hospital Organization, Inc. d/b/a Community Health Partners and approve expenditures under the First Amendment and approved Single Source Waiver. Meeting Date: 09/13/2022 Prepared by: Title: Benefits Analyst – Risk Management Name: Sonja Sweet 07/19/2022 4:14 PM Submitted by: Title: Division Director - Risk Management – Risk Management Name: Jeff Walker 07/19/2022 4:14 PM Approved By: Review: Risk Management Jeff Walker Director Review Completed 07/19/2022 4:25 PM Procurement Services Ana Reynoso Level 1 Purchasing Gatekeeper Completed 07/19/2022 4:39 PM Procurement Services Sue Zimmerman Additional Reviewer Completed 07/19/2022 6:55 PM Procurement Services Sara Schneeberger Additional Reviewer Completed 07/20/2022 8:41 AM Office of Management and Budget Debra Windsor Level 3 OMB Gatekeeper Review Completed 07/20/2022 8:49 AM County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 07/21/2022 3:16 PM Office of Management and Budget Susan Usher Additional Reviewer Completed 08/22/2022 1:55 PM County Manager's Office Dan Rodriguez Level 4 County Manager Review Completed 08/30/2022 10:06 AM Board of County Commissioners Geoffrey Willig Meeting Pending 09/13/2022 9:00 AM 16.E.3 Packet Pg. 2765 16.E.3.aPacket Pg. 2766Attachment: 17-7209 CHP_Amend#1_VendorSigned (22849 : CHP Managed Care - First Amendment) 16.E.3.aPacket Pg. 2767Attachment: 17-7209 CHP_Amend#1_VendorSigned (22849 : CHP Managed Care - First Amendment) 16.E.3.aPacket Pg. 2768Attachment: 17-7209 CHP_Amend#1_VendorSigned (22849 : CHP Managed Care - First Amendment) Waiver Request Form Revised 06/17/2021 Instructions Completed waiver requests accompanied by any associated backup documentation (sole source letter, business case, etc.) must be submitted to the division’s Procurement Strategist for any procurement, without competition, in excess of $3,000. Waiver requests greater than $50,000 will require approval by the Board of County Commissioners. Sole source refers to a procurement where the selection of one particular supplier to the exclusion of all others may be based on having only one supplier in the marketplace, proprietary technology, copyright, patent, or a supplier’s unique capability. Single source refers to a procurement directed to one source because of standardization, warranty, geographic territory, or other factors, even though other competitive sources may be available. Requester Name: Division: Item/Service: Vendor Name: Historical Countywide Spend: ______________________ Requested date range: _____________ Not to Exceed Amount per Fiscal Year: __________________ Is there an agreement associated with this waiver to be reviewed by Contracts? Yes No Sole Source Single Source One Time Purchase Multiple Purchases Description of Purchase: Enter a description of the item(s) that will be purchased under this waiver. Purpose: Describe in detail, the public purpose of the requested item(s) and why it is essential to County operations. Information Technology: Select Yes if the products/services are related to Information Technology. If yes, please provide the Purchasing Compliance Code (PCC) number or email approval documentation. Yes No If yes, provide the PCC number:__________________________________________________ 16.E.3.b Packet Pg. 2769 Attachment: FY22 Waiver Request 056 - CHP (Managed Care and Network Services) (22849 : CHP Managed Care - First Amendment) Waiver Request Form Revised 06/17/2021 Justification: Identify the criteria that qualifies this purchase as a sole or single source. Select from the list below. Check all that apply (if box is checked, please make sure to provide an explanation below): Sole Source Only Authorized Vendor or Distributor: Is this vendor the only vendor authorized to sell this product/service? If yes, explain below and provide documentation from the manufacturer confirming claims made by the distributors. No Comparable Product or Service: Is there another vendor who can provide a similar product/service, regardless of cost, convenience, timeliness, etc.? Product Compatibility: Does this product/service provide compatibility with existing equipment that prohibits switching to another comparable brand/vendor? If yes, provide the detailed explanation below, including what would occur if the other brand/vendor were used. Proprietary: Is this product/service proprietary? If yes, provide a detailed explanation below on how its use is restricted by patent, copyright or other applicable laws and provide documentation validating that claim. Single Source Standardization: Is this product/service part of a purchase that the County has already standardized on? If yes, please provide the detailed information below. Date of BCC Standardization: ___________________ BCC Agenda Item number: __________________ Warranty: Is this the only vendor able to complete factory-authorized warranty services on County owned equipment? If yes, provide the documentation verifying the warranty. Geographic Territory: Is this vendor the only vendor authorized to sell this product/service in our region? If yes, provide documentation from the manufacturer confirming those claims. Other Factors: Any other reason not listed above, explain below. Explain: How does this purchase meet the identified sole or single source criteria listed above? 16.E.3.b Packet Pg. 2770 Attachment: FY22 Waiver Request 056 - CHP (Managed Care and Network Services) (22849 : CHP Managed Care - First Amendment) Waiver Request Form Revised 06/17/2021 How was the decision made to use this vendor? Describe in detail if a formal standardization process was performed via Procurement or if there is a historical precedence established for the use of the product, please explain purchase, and use history and the current level of County investment in the product. Explain why it is in the County’s best interest to use this product/service rather than issuing a competitive solicitation: What are the benefits from the continued use? Are there costs that would be incurred if a different vendor/product were used? What would occur if another brand/vendor were used? Explain how this pricing compares to other vendors/products and is it considered to be fair and reasonable: Provide information on historical use and whether pricing has increased/decreased. If sole source and no other product is available, provide the cost for addressing the needs via an alternate approach. Will this purchase obligate us to future ancillary products or services? Either in terms of maintenance or standardization. Yes No If yes, explain what types: 16.E.3.b Packet Pg. 2771 Attachment: FY22 Waiver Request 056 - CHP (Managed Care and Network Services) (22849 : CHP Managed Care - First Amendment) Waiver Request Form Revised 06/17/2021 Market research and market alternatives: When was the last time a market evaluation was performed to determine if either the technology or vendor offerings have changed? Based on the life expectancy of the product, when do you anticipate evaluating the market again? Please attach a detailed market evaluation report should the complexity, duration, and dollar amount of the purchase be a high risk to the County. It is a felony to knowingly circumvent a competitive process for commodities or services by fraudulently specifying sole source. Florida Statute 838.22(2). Requested by: Signature: Date: Division Director: Signature: Date: Department Head: Required if over $50,000 Signature: Date: Procurement Strategist: Signature: Date: Procurement Director: Or designee Signature: Date: For Procurement Use Only: Approved Requesting Additional Information Requires RFI/Intent to Sole Source Rejected Procurement Comments: Current FY Approval Multi-Year Approval Start Date: ______________ End Date: __________ 16.E.3.b Packet Pg. 2772 Attachment: FY22 Waiver Request 056 - CHP (Managed Care and Network Services) (22849 : CHP Managed Care - First Amendment) 16.E.3.cPacket Pg. 2773Attachment: 17-7209 2018 Managed Care_Contract_FullExec (22849 : CHP Managed Care - First Amendment) 16.E.3.cPacket Pg. 2774Attachment: 17-7209 2018 Managed Care_Contract_FullExec (22849 : CHP Managed Care - First Amendment) 16.E.3.cPacket Pg. 2775Attachment: 17-7209 2018 Managed Care_Contract_FullExec (22849 : CHP Managed Care - First Amendment) 16.E.3.cPacket Pg. 2776Attachment: 17-7209 2018 Managed Care_Contract_FullExec (22849 : CHP Managed Care - First Amendment) 16.E.3.cPacket Pg. 2777Attachment: 17-7209 2018 Managed Care_Contract_FullExec (22849 : CHP Managed Care - First Amendment) 16.E.3.cPacket Pg. 2778Attachment: 17-7209 2018 Managed Care_Contract_FullExec (22849 : CHP Managed Care - First Amendment) 16.E.3.cPacket Pg. 2779Attachment: 17-7209 2018 Managed Care_Contract_FullExec (22849 : CHP Managed Care - First Amendment) 16.E.3.cPacket Pg. 2780Attachment: 17-7209 2018 Managed Care_Contract_FullExec (22849 : CHP Managed Care - First Amendment) 16.E.3.cPacket Pg. 2781Attachment: 17-7209 2018 Managed Care_Contract_FullExec (22849 : CHP Managed Care - First Amendment) 16.E.3.cPacket Pg. 2782Attachment: 17-7209 2018 Managed Care_Contract_FullExec (22849 : CHP Managed Care - First Amendment) 16.E.3.cPacket Pg. 2783Attachment: 17-7209 2018 Managed Care_Contract_FullExec (22849 : CHP Managed Care - First Amendment) 16.E.3.cPacket Pg. 2784Attachment: 17-7209 2018 Managed Care_Contract_FullExec (22849 : CHP Managed Care - First Amendment) 16.E.3.cPacket Pg. 2785Attachment: 17-7209 2018 Managed Care_Contract_FullExec (22849 : CHP Managed Care - First Amendment) 16.E.3.cPacket Pg. 2786Attachment: 17-7209 2018 Managed Care_Contract_FullExec (22849 : CHP Managed Care - First Amendment) 16.E.3.cPacket Pg. 2787Attachment: 17-7209 2018 Managed Care_Contract_FullExec (22849 : CHP Managed Care - First Amendment) 16.E.3.cPacket Pg. 2788Attachment: 17-7209 2018 Managed Care_Contract_FullExec (22849 : CHP Managed Care - First Amendment) 16.E.3.cPacket Pg. 2789Attachment: 17-7209 2018 Managed Care_Contract_FullExec (22849 : CHP Managed Care - First Amendment) 16.E.3.cPacket Pg. 2790Attachment: 17-7209 2018 Managed Care_Contract_FullExec (22849 : CHP Managed Care - First Amendment) 16.E.3.cPacket Pg. 2791Attachment: 17-7209 2018 Managed Care_Contract_FullExec (22849 : CHP Managed Care - First Amendment)