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INLAND EMPIRE HEALTH PLAN

Professional Services Agreements,

Contracts and Agreements

UNDER $100,000

Whereby the Chief Executive Officer of IEHP applies his authority to approve purchases

up to $100,000 as authorized by the Governing Board through

Minute Order 14-307 (Purchase of all Goods and Non-Contracted Services from a single vendor in a Fiscal Year)

and

Minute Order 14-308 (Services pursuant to a written contract from a single vendor for a period of one year based on effective date of the contract)

Items in this report are being processed in

conjunction with the

APRIL 13, 2015

Governing Board Meeting

Inland Empire Health Plan

Under $100,000 Report

April 13, 2015

A. ADMINISTRATION (Brad Gilbert, M.D.)

1. Approval Of The Letter Of Engagement For The Retention Of

Polsinelli, LLP For The Provision Of Clinically Integrated Network

Legal Assistance Services Board Action (14-308)

B. FINANCE DEPARTMENT (Laurie Holden)

2. Approval Of A First Amendment To The Professional Services Agreement With

Moss Adams, LLP For Annual Certified Audit Services And Non-Attest

Services For The Inland Empire Health Plan Board Action (14-308)

C. OPERATIONS DEPARTMENT (Rohan Reid)

3. Professional Services Agreement (PSA) With Trigild Commercial

Real Estate, Inc. For Property Management Services Board Action (14-308)

D. INFORMATION TECHNOLOGY DEPARTMENT (Michael Deering)

4. Approval Of The Master Subscription Services Agreement, Services

Order Form And Statement Of Work With For A Learning

Management System) Board Action (14-308)

5. Approval Of A Third Amendment To The Compliance 360 Solution

Agreement With Compliance 360, An SAI Global Company For A

Compliance Management Solution Board Action (14-308)

6. Approval Of The First Amendment To The Professional Services

Agreement With iOffice, Inc. For The Space Management System At

The Atrium Board Action (14-308)

7. Approval Of A New Service Ordering Document Under The Oracle

License And Services Agreement With Oracle For A User Productivity

Kit Board Action (14-308)

8. Approval Of The Fifth Amendment To The Master Services And

License Agreement And Product Schedule With OptumInsight, Inc.

(Formerly Known As Ingenix, Inc.) For Additional Licensing For The

Web.Strat™ Claim Pricing Software Board Action (14-308)

E. MEDICAL SERVICES DEPARTMENT – Clinical (William Henning, D.O.)

9. None

F. MEDICAL SERVICES DEPARTMENT - Operational (Marcia Anderson)

10. Professional Services Agreement with Williams Consulting, Inc. for

NCQA Accreditation Survey Consulting Services- First Amendment Board Acton (14-308)

11. Approval Of Professional Services Agreement with Jennifer Clancy

for Behavioral Health Integration Services Board Acton (14-308)

12. Professional Services Agreement with Home Instead Senior Care –

Riverside for Non-Medical Assistance Services Board Action (14-308)

13. Professional Services Agreement with Home Instead Senior Care –

San Bernardino for Non-Medical Assistance Services Board Action (14-308)



April 13, 2015

14. Second Amendment To The Professional Services Agreement With

MedServ Connections Consulting, LLC For The Provision Of Action

Plan Consulting Services Board Action (14-308)

15. Professional Services Agreement with Mary-Catherin Freier Randall, PhD

for Autism Program Board Action (14-308)

G. PROVIDER NETWORK DEPARTMENT (Kurt Hubler)

16. None

H. MARKETING DEPARTMENT (Susan Arcidiacono)

17. None



April 13, 2015

A. ADMINISTRATION

1. Engagement Letter with Polsinelli, LLP for the Provision of Clinically

Integrated Network Legal Assistance Services

a. Recommended Action

That the Chief Executive Officer of IEHP apply his authority to approve

purchases up to $100,000, previously approved by the Governing Board

through Minute Order 14-308, to approve the Engagement Letter with

Polsinelli, LLP for the provision of Clinically Integrated Network Legal

Assistance Services at a cost not to exceed $100,000.

b. Contact

Brad Gilbert, M.D., Chief Executive Officer

c. Background

IEHP’s two county Medi-Cal enrollment growth has been significantly

greater than projected as previously presented to the IEHP Governing

Board. IEHP reached 1 million Members in January 2015.

Organizing and enhancing the region’s healthcare delivery system is

critical to meet the improved population health “triple aim”, create

positive care experiences and provide cost efficient care. As presented at

the historic Riverside and San Bernardino joint Board of Supervisors

meeting on September 16, 2014, the following initiatives are key:

Enhance both county hospital delivery systems– primary care,

specialty care, acute inpatient, post-discharge care, etc.

Strengthen relationships between both county hospitals and Loma

Linda University Health (LLUH) to facilitate organized and seamless

specialty care

Facilitate clinical and service level medical care, behavioral healthcare

and social services information transfer between service providers and

IEHP

Grow and improve IEHP’s private physician, private hospital and

other private provider relationships to ensure adequate Member access

Increase the number of primary care and specialist physicians in the

Inland Empire



April 13, 2015

In order to accomplish these initiatives, the IEHP Governing Board

approved the Professional Services Agreement with Huron Consulting

Group for Regional Strategic Planning in October 2014 under Resolution

14-241, amended the Agreement in February 2015 under Resolution 15-30

and again in March 2015 under Resolution 15-52. Under this Agreement,

Huron is:

Developing an integrated healthcare network that links both county

healthcare systems, Loma Linda and IEHP

Continuing Riverside County Health System planning that has already

occurred with Huron

Assessing the feasibility of a shared Information Technology (IT)/

Electronic Medical Record (EMR) system between Loma Linda and

the two county health systems

d. Discussion

A key accomplishment for the Clinically Integrated Network (CIN) is a

legal structure that creates a single entity consisting of Loma Linda, both

counties and possibly IEHP. Huron assisted all four entities in identifying

a law firm that could assist with the CIN entity formation. Polsinelli, LLP

was selected after a vetting and interview process.

Polsinelli, LLP is a nationally recognized law firm with one of the largest

concentrations of healthcare attorneys and professionals. Under this

Engagement Letter, Polsinelli, LLP will work collaboratively with Huron

Consulting Group and CIN partners to provide the following legal

services:

Provide a legal counsel and assistance in developing, structuring and

implementing a clinically integrated network involving the Medical

Centers and potentially IEHP; and

Create relationships with other network participants, negotiate

agreements with IEHP and potentially other third party payors and

address other administrative and operational matters.

IEHP will be the initial fiscal agent for payments to Polsinelli, LLP

pending CIN entity creation. All four parties will contribute to the cost of

legal services. The created CIN entity will be the client and make the

payments for any additional legal services.



April 13, 2015

e. Fiscal Impact

The total compensation payable under this Agreement shall not exceed

One Hundred Thousand Dollars ($100,000). IEHP will be responsible for

one fourth of the costs.

[ ] N/A (For Board items which do not have any budgetary impact)

[ ] Included in FY 14/15 Budget

[X] New Expenditure, Not Budgeted

[ ] Revenue, Not Budgeted

f. Attachments

Copy of the Engagement Letter is attached to the Minute Order.

g. Reviewed by Counsel

Staff Counsel



April 13, 2015

B. FINANCE DEPARTMENT

2. Approval Of A First Amendment To The Professional Services Agreement With Moss

Adams, LLP For Annual Certified Audit Services And Non-Attest Services For The


a. Recommended Action (Approve through Minute Order 14-308)

That the Chief Executive Officer of Inland Empire Health Plan (IEHP) apply his

authority to approve purchases up to $100,000 previously approved by the

Governing Board through Minute Order 14-308, to approve the First Amendment

to the Professional Services Agreement with Moss Adams, LLP for Auditing

Services effective July 1, 2015.

b. Contact

Laurie Holden, Chief Financial Officer

c. Background

IEHP is required to undergo an annual audit of its fiscal operations,

mandated by the California Department of Managed Care (DMHC), a

requirement under Knox Keene (license), and the California Department of

Health Care Services (DHCS).

IEHP requires a certified public accounting firm with healthcare knowledge

and expertise to perform the annual audit of IEHP’s financial statements

and fiscal operations.

The Governing Board previously approved Moss Adams, LLP to provide

auditing services through the RFP process on Resolution 04-33 on March 8,

2004, on Resolution 07-01 on January 8, 2007, and again through the RFP

process on Resolutions 09-81 on April 13, 2009 and 12-107 on April 9,

2012.

d. Discussion

Moss Adams LLP, CPAs, has provided certified auditing services to IEHP

for the last three years under the current agreement and for the previous

eight years under prior agreements.

The term of the current Agreement has expired and IEHP management has

proposed to extend the Agreement for another two years.

Sarbanes-Oxley Act (SOX), applicable to publically-traded companies,

requires at a minimum audit partner rotation after five consecutive years of

audit engagement in the event the same audit company is selected to

continue the auditing.

Although IEHP is not subject to SOX, IEHP plans to meet this requirement

to follow best practices.

The PSA and costs for the two years are as follows:

FY 2016 - $82,500

FY 2017 - $84,500



April 13, 2015

e. Fiscal Impact

This Amendment extends the term of the PSA by two years and $167,000. Total

costs are not to exceed $363,500 over five years.


[X] Included in FY 14/15 Budget

[ ] New Expenditure, Not Budgeted


f. Attachments

Copy of the First Amendment is attached to this report.

g. Reviewed By Counsel

Staff Counsel

Managed Care Auditors by Plan Survey Date: February 22, 2012

Plan Model Participant Auditor Local Health Plans Inland Empire Health Plan Moss Adams

Kern Health Systems Brown Armstrong of Bakersfield

Health Plan of San Joaquin Moss Adams

Santa Clara Family Health Plan Moss Adams

San Francisco Health Plan Moss Adams

LA Care Deloitte & Touché

CalViva Health Moss Adams

County Organized Health Systems CalOptima McGladrey & Pullen

Partnership Health Plan of California Moss Adams

Health Plan of San Mateo Moss Adams

Central California Alliance for Health KPMG

Notes: Kern uses Brown Armstrong of Bakersfield California. They are local, have County audit experience, and were

the low bidder.



April 13, 2015

C. OPERATIONS DEPARTMENT

3. Approve The Professional Services Agreement (PSA) With Trigild Commercial Real

Estate, Inc. For Property Management Services


That the Governing Board of the Inland Empire Health Plan approve the Professional

Services Agreement with Trigild Commercial Real Estate, Inc. for Property

Management Services effective March 18, 2015, and auto renew every fiscal year

through June 30, 2021. The total cost of the Agreement is not to exceed $100,000 per

fiscal year.

b. Contact

Rohan Reid, Chief Operations Officer

c. Background

In February 2014, the IEHP Governing Board approved using Cushman and

Wakefield Inc. for Property Management Services. IEHP had completed an

extensive Request for Proposal, and Cushman and Wakefield was selected, with

an date of April 1, 2014 under Order 13-340.

d. Discussion

As building owners, IEHP continues to serve five (5) tenants within the Atrium

building including State Farm, Parsons Engineering, ARS, CTI, and California

Dining Services. Our Property Management company provides the following

services:

Tenant Relations

Tenant Financials

Vendor Relations

Service and equipment procurement

Budgetary review and development

Building Maintenance oversight

After 11 months of service, Cushman and Wakefield has submitted a termination

notice effective April 30, 2015. They chose to terminate due to the scope of services

at our site being limited due to the fact that IEHP manages the space that we occupy

which is the majority of the space at the Atrium. At this time IEHP is in immediate

need of a qualified property management firm. Trigild Commercial Real Estate, Inc.,

was the second most responsive bidder that responded to the IEHP request for

proposal in April 2014. Trigild Commercial Real Estate, Inc. has agreed to our

contract terms and will assume property management services and will coordinate

with Cushman and Wakefield during the transition of services.



April 13, 2015

e. Fiscal Impact

Total compensation payable under this Agreement shall not exceed $100,000 per

fiscal year.





f. Attachments

Copy of the Professional Services Agreement with Trigild Commercial Real Estate

Inc. for Property Management Services is attached to the Minute Order.


Staff Counsel



April 13, 2015

D. INFORMATION TECHNOLOGY DEPARTMENT

4. Approval Of The Master Subscription Services Agreement, Services Order Form And

Statement Of Work With Instructure For A Learning Management System


That the Chief Executive Officer (CEO) of Inland Empire Health Plan (IEHP) apply

his authority to approve purchases up to $100,000 previously approved by the

Governing Board through Minute Order 14-308, to approve the Master Subscription

Services Agreement, Services Order Form and Statement of Work with Instructure

for a Learning Management System at a cost of $93,000 for one (1) year, effective

as of the date of the last signature.

b. Contact

Michael Deering, Chief Information Officer

c. Background

The National Committee for Quality Assurance (NCQA) has released several new

requirements to provide electronic access for Members to participate in managing

their health. The IEHP Health Education Department is seeking an online Learning

Management System (LMS) to support NCQA’s requirements. In addition, the

Centers for Medicaid and Medicare (CMS) have several compliance regulations

that apply to the Human Resources and Compliance Departments to track

regulatory training. To meet this objective, Compliance and Human Resources are

seeking a LMS to support compliance training tracking.

IEHP Medical Services Department has transferred their disease management over

to the Health Education Department to assist with educating Members with asthma,

diabetes and other diseases. In order for the department to support IEHP’s existing

programs, and implement the disease management programs (Breathe Program &

Journey Program) and any upcoming programs, IEHP will need a reliable and

sophisticated platform.

IEHP requires a platform that will allow them to increase efficiency in

implementation and deliver high-quality content using technology to increase

Member engagement (e.g. demonstration of using inhaler, grocery store tour, food

demonstrations, etc.). IEHP’s new Public Policy Participation Committee (PPPC)

Members are currently using email and text to communicate with IEHP, and are

requesting to participate in the Health Education programs online. In addition,

program outcome measures have been constrained by data source silos and

inaccessibility of data.



April 13, 2015

IEHP’s goal is to help improve the health of Members and empower them to stop or

delay progression of chronic diseases by:

Efficiently and accurately tracking Member participation and health

outcomes.

Providing additional modalities to engage the different types of learners.

Improving access to education through online programs.

Increasing member engagement in self-care through quality course

content.

Increasing accuracy and improving productivity.

Enabling effective program evaluation by efficiently and accurately

implementing program processes.

Reporting and enabling interface with other data systems.

Learning Management Systems are all priced based on the amount of users that will

access the system in a one (1) year period of time. In the short term IEHP

anticipates the following:

1,500 internal users, this includes the potential training of vendors.

10,000 external users, this is the estimated amount for members in year

one (1). As the program grows IEHP anticipates 250,000+ members.

d. Discussion

IEHP formed a Learning Management System (LMS) selection committee

made up of IEHP Team Members from Human Resources, Health Education and

IT.

The IEHP LMS selection committee conducted a RFQ (Request for Quote) to

select the LMS. To accomplish this task a comprehensive RFQ document was

assembled and disseminated with the following information:

Information on IEHP and IEHP’s LMS requirements

LMS features list with 300+ features to utilize for comparison

Request for vendor company information

Request for product information

Request for customer references

Pricing

The following vendors were invited to participate in the RFQ process:

Target Solutions (TS) – TS currently hosts several Governmental

agencies in their corporate learning initiatives. In partnership with Special

District Risk Management Authority (SDRMA), Target Solutions provides

LMS benefits to organizations that utilize SDRMA as their Workers

Compensation vendor. IEHP is such an organization, thus IEHP invited

Target Solutions to participate in the RFQ.



April 13, 2015

Instructure, Bridge – Instructure’s product “Canvas” is a leader in the

Higher Education industry with an impressive list of IVY League

Universities and over one (1) million users in their Canvas system.

Instructure recently released their corporate LMS, Bridge. Instructure is

well funded, and known for quality performance. With Instructure’s

superior experience in complex LMS delivery in the Higher Education

space (which is more complicated than Corporate LMS), IEHP included

Instructure in the RFQ to evaluate their corporate tool, Bridge.

Prometheus, Torch – Prometheus has been in the corporate space for

several years and has established some Healthcare companies as clients.

IEHP was introduced to Prometheus, Torch via LA Care. LA Care

currently utilizes Torch to serve the educational needs of the Human

Resources division, and Provider Services. Based upon industry

experience and familiarity, we invited Torch to participate in the RFQ.

Scoring was conducted as a committee, based upon viewing product

demonstrations, meeting with vendors, and reviewing all responses to the RFQ.

Rules for scoring were as follows:

1. Review the feature section for how many Yes' verses how many No's

2. Assess the quality of the product and overall presentation

3. Review how long the company has been in operation

4. Assess the company experience in the LMS space

5. Rank each section 1 to 5 (1 being poor / 5 being excellent)

Highest possible score is 140

(Continued on next page…)



April 13, 2015

Scoring results are as follow:

IEHP - LMS Vendor Scoring Sheet

# Item to score Target

Solutions Bridge Torch

1 Learning Environment DQ 5 4

2 Classroom Mgt - for ILT DQ 4 4

3 Course Upload Types DQ 5 4

4 Built into LMS (Authoring

Tool) DQ 5 0

5 Scorm Compliance Standards DQ 5 4

6 Gamification DQ 3 3

7 General DQ 5 4

8 Event Management DQ 3 4

9 Notifications DQ 4 4

10 Social DQ 4 4

11 E-Commerce (not essential) DQ \ \

12 Administrator DQ 4 5

13 Manager Area DQ 4 4

14 Instructor Area DQ 5 4

15 Mobile DQ 5 3

16 Integration (Data) DQ 5 4

17 Assessment/Survey DQ 5 4

18 Languages DQ 5 3

19 User Interface DQ 5 4

20 Talent/Performance Mgt. (for

HR) DQ 5 3

21 Competency/Skill

Management DQ 4 3

22 Reports DQ 5 4

23 Extended Enterprise DQ 5 4

24 Security DQ 5 2

25 Additional Features (2) DQ 4 4

26 Production Information DQ \ \

27 Learning Experience DQ 5 3

28 Pricing DQ 5 2

Total DQ 119 91



April 13, 2015

DQ - Through the course of due diligence, IEHP discovered that Target Solutions is

not HIPPA compliant, thus they were disqualified from the process.

Product Selection

IEHP selected Instructor’s Bridge Solution based upon overall score, quality of

product and vendor, favorable pricing, and an overall learning experience that will

present well to IEHP Members.

Bridge is a cloud-based education technology platform with advanced Learning

Management System (LMS) functionality. Instructure hosts Bridge as a

subscription service on the state-of-the-technology cloud infrastructure of Amazon

Web Services (AWS). Instructure’s comprehensive implementation and hosting

services include full system monitoring, automated provisioning, “Hands-Free”

update/upgrade services, Basic Support Package, online Standard Training Package,

beta environment, and a test/training instance. The Bridge architecture, AWS

infrastructure, and Instructure’s hosting and support services make Bridge a

reliable, available, extensible, and scalable cloud-based corporate LMS solution.

Annual Activation

Upon approval to proceed with implementation, IEHP will work with Instructure to

strategize, design, configure, train, and deploy the Bridge Solution. Annual

licensing does not begin till the solution launches to Members and Employees.

e. Fiscal Impact

Cost is $93,000 for one (1) year, effective as of the date of the last signature.







April 13, 2015

f. Attachments

A copy of the Master Subscription Services Agreement is attached to the Minute

Order.

A copy of the Services Order Form is attached to the Minute Order.

A copy of the Statement of Work is attached to the Minute Order.

A copy of the Ownership Form is attached to the Minute Order.


Staff Counsel



April 13, 2015


5. Third Amendment To The Compliance 360 Solution Agreement With Compliance 360, An

SAI Global Company For A Compliance Management Solution


That the Chief Executive Officer apply his authority to approve purchases up to

$100,000, as previously approved through MO 14-308, to approve the Third

Amendment, after legal review and approval, to the Compliance 360 Solution

Agreement with SAI Global Company (formerly Compliance 360, Inc.) at a cost not

to exceed $50,000. The Third Amendment extends the term of this agreement for one

(1) year, effective March 31, 2015 through March 30, 2016.

b. Contact


c. Background

In February 2011 through Resolution 11-38, the IEHP Governing Board

approved the capital expenditure with Compliance 360, Inc. for a compliance

management solution. In August 2011 through Resolution 11-229, the IEHP

Governing Board subsequently approved the First Amendment to the

Compliance 360 Solution Agreement authorizing a standalone permanent test

site. In March 2014 through Minute Order 14-43, the IEHP Governing Board

subsequently approved the Second Amendment to the Compliance 360 Solution

Agreement extending the term of the agreement for one (1) year.

d. Discussion

Compliance 360’s enterprise-wide platform enables:

1) full life-cycle management of policies and procedures,

2) centralized management of regulations; ensuring appropriate Team Member

notification of subsequent changes to standard operating procedures,

3) incident management such as fraud hotline tips, potential fraud and abuse

occurrences, audit findings and legal cases, and

4) IEHP to ensure it is “Audit Ready” with the ability to access all current

regulations and laws related to IEHP’s lines of businesses

The Third Amendment extends the term of the Compliance 360 Solution Agreement

for one (1) year at a cost not to exceed $36,540 for the following licenses:

1) Compliance Workspace,

2) Policies with Surveys,

3) Incidents, and

4) Foundation Platform



April 13, 2015

The Compliance Department has evolved in the last year and new Compliance Team

Members require training on the Compliance 360 Solution. The additional $13,460

requested through this Minute Order is for training, plus travel and expenses of the

Compliance 360 consultant.

e. Fiscal Impact

Total cost of the Third Amendment not to exceed $50,000.

[x] N/A (For Board items which do not have any budgetary impact)




f. Attachments

Third Amendment


Staff Counsel



April 13, 2015


6. Approval Of The First Amendment To The Professional Services Agreement With

iOffice, Inc. For The Space Management System At The Atrium



authority to approve purchases up to $100,000 previously approved by the Governing

Board through Minute Order 14-308, to approve the First Amendment to the

Professional Services Agreement with iOffice, Inc. for the Space Management

System At The Atrium. Cost not to exceed an additional $500, which increases the

total compensation payable under this agreement to $65,500, effective upon date of

last signature.

b. Contact


c. Background

In May 2013 through Minute Order 13-49, the Governing Board approved the Capital

Expenditure with iOffice Inc. for the implementation of the Space Management

System at the Atrium at a cost not to exceed $75,000 for one (1) year.

In September 2014 through Minute Order 13-49, the Governing Board approved the

Professional Services Agreement with iOffice, Inc. for the Space Management

System at the Atrium at a cost not to exceed $65,000 for one (1) year.

With the introduction of the iOffice Space Management System, IEHP has been able

to automate a number of business processes including:

Space Planning, which has allowed IEHP to strategically plan not only their move

into their current building, but also their expansions;

Move Management, which has allowed IEHP to submit, manage and complete

requested moves, on both a large scale and small scale; and

Site Visitor Registration and Tracking; and Service Request, which has digitized

and streamlined the process of submitting, reviewing and fulfilling Facilities

orders.

d. Discussion

IEHP’s IT and Facilities departments use iOffice to assist them in move management

for setting up computers, desks, email addresses, etc. for new hire employees and

employees that are transitioning from temporary to permanent positions. They also

do physical moves and title updates for employees that have transferred departments



April 13, 2015

or received promotions. Information currently feeds from the Human Resources

database into iOffice generating move tickets. For these moves a spreadsheet is

generated by iOffice, which lists out tasks for new hire employees, temporary to

permanent employees, transfers, promotions and terminations.

The First Amendment is for an additional statement of work to build, support, and

amend an existing automated import process currently running for receiving user data

from IEHP. The current import process was developed to generate temporary and

permanent move tickets that are triggered by the below rules:

When the employee ID changes (i.e. t64343 to i64343)

Where custom04 = yes

Where the ‘start date’ is greater than yesterday’s date

IEHP is going forward and will be dropping the first letter in front of new employee

records (i.e. 64343) thus forcing iOffice to modify the rules that were created above

for generating temporary and permanent move tickets. The import file shall be placed

in the “in” box folder in the IEHP SFTP (Secured File Transfer Protocol) account for

pickup by iOffice as done in the past.

Chart One (1) below provides a cost breakdown.

Chart 1: Setup Fee(s) For Services

Product Name Quantity Rate Total

Automated Import Process Amendment Setup 4 Hours $125 $500

TOTAL $500

e. Fiscal Impact

Cost not to exceed an additional $500, which increases the total compensation

payable under this agreement to $65,500, effective upon date of last signature.





f. Attachments

Copy of the First Amendment is attached to the Minute Order.

Copy of the Amendment to Existing Import Process is attached to the Minute Order.


Staff Counsel



April 13, 2015


7. Approval Of A New Service Ordering Document Under The Oracle License And

Services Agreement With Oracle For A User Productivity Kit



authority to approve purchases up to $100,000 previously approved by the Governing

Board through Minute Order 14-308, to approve a new service ordering document

under the Oracle License and Services Agreement with Oracle for a User Productivity

Kit (UPK) at a cost not to exceed $20,000 for one (1) year, effective April 1, 2015.

b. Contact


c. Background

IEHP is in need of implementing a Financial Enterprise Reporting Planning (ERP)

system solution to replace their legacy systems, handling GP, GL, AP, AR,

budgeting, forecasting, financial reporting, and procurement. Enterprise Resource

Planning (ERP) systems are software modules that handle the core functions of a

business enterprise, including sales, inventory, purchasing, and accounting. The

modules are integrated so that data and transactions pass between departments, most

commonly using one central database. The latest technology available with these

solutions will facilitate better reporting and budgeting, and will improve

management’s access to departmental reports.

In April 2014, IEHP released a Request for Proposal (RFP) for a Financial

Management Solution. Oracle was selected based on total costs, timeline,

implementer resources, product/service capabilities and proposed methodology ERP

implementation vendor impression.

In December 2014 under Minute Order 14-321, the Governing Board authorized the

Chief Executive Officer to execute the Oracle Fusion ERP Cloud Service Financial

System under the Oracle Software As A Service Agreement at a cost not to exceed

$350,000 for three (3) years.

The User Productivity Kit will be a component of the Fusion ERP Cloud Service

Financial System implementation phase and fall under the Oracle License and

Services Agreement with Oracle executed on August 31, 2011. Under the Oracle

License and Services Agreement, any new license and/or service purchases provided

by Oracle, will be made through ordering documents and will be attached, and made

part of the agreement.



April 13, 2015

d. Discussion

Oracle’s User Productivity Kit (UPK) is a full service on demand training and project

documentation development, and delivery tool for the Fusion ERP Cloud Service

Financial System. Using UPK in every phase of the implementation project lifecycle

contributes greatly to the probability of a successful project and will increase the

benefits for IEHP’s investment in enterprise applications. The UPK provides the

following benefits:

UPK can be used for designing test scripts, job aids, training manual and e-

learning training.

UPK allows customizing training document as per IEHP business process

requirements.

UPK can be used for on boarding training of business applications for new

employees.

UPK helps to reduce training cost by drastically cutting down resource and time

requirement in preparing training documents.

UPK designed test scripts can be used multiple times during bug fixes, patch

testing or upgrade processes.

UPK can also be used for building training documents for non-Oracle

applications.

Pre-built training contents help employees to self-learn Oracle functionalities and

business processes.

IEHP will be purchasing fifty (50) UPK named user licenses. The named user

licenses are for a set number of users that can access the content of the training jobs.

IEHP will also purchase one (1) UPK Developer that will allow a user to create

content for the training jobs. The cost for the UPK named user licenses and

developer is $19,215. IEHP is requesting $20,000 to cover costs and any additional

costs for the User Productivity Kit (UPK). Chart One (1) below provides a cost break

down for the UPK.

Chart 1: UPK Costs

Product Metric Quantity

Unit

Price

List

Price

Net

License

Net

Support

UPK Developer 1 17,500 17,500 $12,250 $2,695

UPK

Application

User 50 100 5,000 $3,500 $770

Sub-Total $15,750 $3,465

Total $19,215



April 13, 2015

e. Fiscal Impact

Cost not to exceed $20,000 for one (1) year, effective April 1, 2015.





f. Attachments

Copy of the Oracle License and Services Agreement is attached to the Minute Order.

Copy of the Ordering Document for the UPK is attached to the Minute Order.


Staff Counsel and County Counsel



April 13, 2015


8. Approval Of The Fifth Amendment To The Master Services And License Agreement

And Product Schedule With OptumInsight, Inc. (Formerly Known As Ingenix, Inc.) For

Additional Licensing For The Web.Strat™ Claim Pricing Software



authority to approve purchases up to $100,000 previously approved by the

Governing Board through Minute Order 14-308, to approve the Fifth Amendment

to the Master Services and License Agreement (MSLA) and Product Schedule with

OptumInsight, Inc. (formerly known as Ingenix, Inc.) for additional licensing for

the Web.Strat™ Claim Pricing Software. Cost not to exceed an additional $50,000,

effective April 1, 2015 through December 10, 2015.

b. Contact


c. Background

In December 2009 through Resolution 09-284, The Governing Board approved the

Master Services and License Agreement (MSLA) with Ingenix, Inc. (OptumInsight,

Inc.). The Governing Board also approved a Product Schedule that is incorporated

into and made a part of the MSLA. The MSLA and Product Schedule were

effective on December 11, 2009. OptumInsight, Inc. provides many services for

IEHP including software, licenses and consulting that fall under the MSLA and

Product Schedule.

In July 2013 through Minute Order 13-193, The Governing Board ratified and

approved the Fourth Amendment to the Master Services and License Agreement

and Product Schedule with OptumInsight, Inc. for the provision of the All Patient

Refined Diagnosis Related Groups (APR DRG) Pricing Software And Licensing for

a total cost not to exceed $92,000 effective July 1, 2013 through December 10,

2015

d. Discussion

IEHP’s Claim’s Department utilizes the APR DRG pricing tool software

(Web.Strat™) to price claims for Med-Cal under the APR DRG payment

methodology. IEHP currently has fifteen (15) concurrent user licenses for the APR

DRG Pricing Software, and due to its rapid growth, IEHP is in need of acquiring

additional licensing. IEHP is requesting to increase their budget under Minute

Order 13-193 for an additional $50,000 for the purchase of licensing. The current

budget of $92,000 under Minute Order 13-193 is for the time period of July 1, 2013

through December 10, 2015, which would make the total compensation payable

under this agreement $142,000. This would fall under Minute Order 14-308 in that



April 13, 2015

the cost does not exceed $100,000 from a single vendor in any one (1) year period

including multi-year contracts.

The Fifth Amendment will provide IEHP with an additional eighty-five (85)

concurrent user licenses, giving IEHP a total of 100 concurrent user licenses. The

concurrent user licenses will allow IEHP employees to have access to the Group A

Software for Web.Strat™. Below is a list of the Group A Software:

Web.Strat™ Medicare Inpatient Base Product

NMPRF

Web.Strat™ Medicare Outpatient Payment System

ONMPRF

Web.Strat™ Medicare IPF Payment System

IPF NMPRF

Web.Strat™ Medicare IRF Payment System

IRF NMPRF

Web.Strat™ Medicare SNF Payment System

SNF NMPRF

Web.Strat™ Batch Processing Module

Web.Strat™ Patient Database Module

OptumInsight, Inc. will pro-rate the cost for the additional eighty-five (85)

concurrent user licenses at cost of $50,000 for the time period of April 1, 2015

through December 10, 2015.

e. Fiscal Impact

Cost not to exceed an additional $50,000, effective April 1, 2015 through December

10, 2015, which increases the total compensation payable under this agreement to

$142,000.





f. Attachments

Copy of the Fifth Amendment is attached to the Minute Order.


Staff Counsel



April 13, 2015

E. MEDICAL SERVICES DEPARTMENT – Clinical (William Henning, D.O.)

9. None



April 13, 2015


10. Professional Services Agreement (PSA) with Diane B. Williams dba Williams

Consulting, Inc. for the Provision of National Committee for Quality Assurance (NCQA)

Accreditation Survey Consulting Services- First Amendment


That the Chief Executive Officer of IEHP apply his authority to approve purchases up

to $100,000, previously approved by the Governing Board through Minute Order 14-

308, to approve the Professional Services Agreement with Williams Consulting, Inc.

for the Provision of National Committee for Quality Assurance (NCQA)

Accreditation Survey Consulting Services- First Amendment at a cost not to exceed

$25,000 per contract year.

b. Contact

Marcia Anderson, Chief of Medical Services

c. Background

The National Committee for Quality Assurance (NCQA) is an accreditation program

that sets Federal and State recognized standards to measure, analyze and improve

health care quality. Federal and State regulations require that health plans meet

NCQA standards to provide Medicare and Medicaid lines of business. As a Medicare

and Medicaid health plan, IEHP must maintain NCQA accreditation to satisfy federal

laws and regulations.

Since 2007, Williams Consulting, Inc. has provided NCQA readiness assessment

consulting services to IEHP which includes:

1) Mock NCQA Health Plan Accreditation survey preparation;

2) Material review (i.e. Quality Management, Quality Improvement, Credentialing

and Re-Credentialing, Members’ Rights and Responsibilities and Medicaid

Benefits and Services);

3) Onsite mock surveys;

4) Written reports with detailed findings for each standard that failed to achieve full

compliance; and

5) Consulting services through audit periods.

The original Agreement was approved by the Governing Board in March 2012 under

Resolution 09-98.

d. Discussion

This Amendment adds an additional term to the Agreement beginning July 1, 2015

through June 30, 2018 and replaces the original fees with a new rate schedule.

The term of this Agreement is effective April 13, 2015.



April 13, 2015

e. Fiscal Impact

The total compensation payable under this Agreement shall not exceed Twenty-Five

Thousand Dollars ($25,000) per contract year.


[X] Included in FY 14/15 Budget



f. Attachments

Copy of the First Amendment is attached to the Minute Order.


Staff Counsel



April 13, 2015


11. Professional Services Agreement (PSA) with Home Instead Senior Care- Riverside for

the Provision of Non-Medical Assistance Services


That the Chief Executive Officer of IEHP apply his authority to approve purchases

up to $100,000, previously approved by the Governing Board through Minute Order

14-308, to approve the Professional Services Agreement with Home Instead Senior

Care- Riverside for the provision of Non-Medical Assistance Services at a cost not

to exceed $100,000 per contract year.

b. Contact


c. Background

IEHP DualChoice Cal MediConnect Plan (Medicare – Medicaid Plan) Members are

eligible for optional services known as Care Plan Options (CPOs) that are not

covered benefits. They are provided at the managed care plan’s discretion. IEHP

makes CPO services available to all Coordinated Care Initiative (CCI) Members on

a case-by-case basis as medically necessary to keep Members at the least restrictive

level of care. IEHP will review and approve CPO services based on IEHP internally

developed and approved criteria. CPO services are offered in accordance with the

CCI guidelines. IEHP provided CPO services include:

1. Meals

2. Transportation

3. Habilitation

4. Palliative/end of life care

5. Personal care services

6. Respite care

7. Home modifications

8. Assistive devices as defined by the State

d. Discussion

For over twenty years, Home Instead Senior Care has provided in-home care

through highly trained caregivers. Under this Agreement, Home Instead Senior

Care- Riverside will provide the following services:

Supplemental Chore

Supplemental Personal Care

Supplemental Protective Supervision

In Home Respite

The term of this Agreement is effective from the date of the last signature (March

27, 2015) through February 28, 2019.



April 13, 2015

e. Fiscal Impact

The total compensation payable under this Agreement shall not exceed One

Hundred Thousand Dollars ($100,000) per contract year.


[] Included in FY 14/15 Budget



f. Attachments

Copy of the Professional Services Agreement is attached to the Minute Order.


Staff Counsel



April 13, 2015


12. Professional Services Agreement with Jennifer Clancy for Behavioral Health Integration

Services


That the Chief Executive Officer of IEHP apply his authority to approve purchases up to

$100,000, previously approved by the Governing Board through Minute Order 14-308, to

approve The Professional Services Agreement with Jennifer Clancy for Behavioral Health

Integration Services at a cost not to exceed $100,000

b. Contact


c. Background

In 2009, IEHP conducted a population health assessment to meet the Triple Aim of positive

patient care experiences, quality/accessible healthcare and cost effective patient management.

Key findings included disconnected physical and mental healthcare services, underutilized

mental health and substance use services and care coordination issues with subcontracted

managed behavioral healthcare organizations. In response, IEHP launched our integrated

Behavioral Health (BH) program on February 1, 2010 with the following objectives:

1) Enable physical and behavioral health care coordination;

2) Increase BH service access while reducing BH costs;

3) Create medical cost offsets via specialized BH service application to high-risk/high-cost

populations;

4) Infuse BH expertise within IEHP to enhance and augment existing capabilities;

5) Implement a BH program that meets National Committee for Quality Assurance (NCQA)

and other regulatory oversight requirements; and

6) Develop and maintain a high-quality BH network that can meet access standards and

allow BH services expansion.

The IEHP Behavioral Health Department’s next step in meeting the Triple Aim and

program objectives is Integrated Health Home (IHH) implementation. IHHs integrate

physical and mental healthcare services for multiple populations including those with

chronic physical health conditions and co-occurring mental health and/or substance use

disorders. IHHs can be implemented in Federally Qualified Health Centers (FQHCs),

local primary care clinics, Independent Physician Associations (IPAs) and behavioral

health clinics/delivery sites.

d. Discussion

Medi-Cal data definitively shows that members with co-occurring physical and mental

health chronic conditions demonstrate significantly higher medical care costs.



April 13, 2015

Inadequate medical and behavioral health/substance abuse service integration at the

point of care contributes to higher costs. One care integration solution is medical and

behavioral health service physical co-location.

Jennifer Clancy has extensive healthcare transformation experience in county,

statewide agency, provider and health plan settings. Under this Agreement, she will

develop IEHP’s behavioral health integration strategy for Integrated Health Home

implementation. This includes the following tasks:

1) Population segmentation;

2) Community health home criteria establishment;

3) Identify selected Provider locations to implement established criteria;

4) Provider readiness assessment;

5) Community health home pilot recommendation;

6) Assess IHH implementation costs;

7) Develop initiative dissemination infrastructure; and

8) Launch IHH initiative

The term of this Agreement is effective March 15, 2015 through December 31, 2015.

After Behavioral Health Integration Strategy development, IEHP will undergo an

implementation phase with selected clinic sites. IEHP will request additional funds at

the June 2015 Governing Board meeting to provide funding at selected delivery sites

for staffing, infrastructure development, technology purchase, etc.

e. Fiscal Impact

The total compensation payable under this Agreement shall not exceed One Hundred

Thousand Dollars ($100,000).





f. Attachments

None


Staff Counsel



April 13, 2015


13. Professional Services Agreement (PSA) with Home Instead Senior Care (San

Bernardino) for the Provision of Non-Medical Assistance Services


That the Chief Executive Officer of IEHP apply his authority to approve purchases up

to $100,000, previously approved by the Governing Board through Minute Order 14-

308, to approve the Professional Services Agreement with Home Instead Senior Care

(San Bernardino) for the provision of Non-Medical Assistance Services at a cost not

to exceed $100,000 per contract year.

b. Contact


c. Background

IEHP DualChoice Cal MediConnect Plan (Medicare – Medicaid Plan) Members are

eligible for optional services known as Care Plan Options (CPOs) that are not covered

benefits. They are provided at the managed care plan’s discretion. IEHP makes CPO

services available to all Coordinated Care Initiative (CCI) Members on a case-by-case

basis as medically necessary to keep Members at the least restrictive level of care.

IEHP will review and approve CPO services based on IEHP internally developed and

approved criteria. CPO services are offered in accordance with the CCI guidelines.

IEHP provided CPO services include:

1) Meals

2) Transportation

3) Habilitation

4) Palliative/end of life care

5) Personal care services

6) Respite care

7) Home modifications

8) Assistive devices as defined by the State

(Continued on following page)



April 13, 2015

d. Discussion

For over twenty years, Home Instead Senior Care has provided housing assistance

and in-home care through highly trained caregivers. Under this Agreement, Home

Instead Senior Care will provide the following services:

Housing Assistance- Minor Home Repair

Housing Assistance- Nonmedical Home Equipment and Supplies

Chore

Personal Care

Respite- In Home

Meal Services

Communication Devices

The term of this Agreement is effective from the date of the last signature (March 13,

2015) through February 28, 2019.

e. Fiscal Impact

The total compensation payable under this Agreement shall not exceed One Hundred






f. Attachments

Copy of the Professional Services Agreement is attached to the Minute Order.


Staff Counsel



April 13, 2015


14. Professional Services Agreement (PSA) with MedServ Connections Consulting, LLC for

the Provision of Action Plan Consulting Services- Second Amendment




14-308, to approve the Professional Services Agreement with MedServ

Connections Consulting, LLC for the provision of Action Plan Consulting Services-

Second Amendment at a cost not to exceed $100,000.

b. Contact


c. Background

IEHP identified the need for policy and procedure (P&P) gap analysis, action plan

development and implementation to ensure IEHP’s Medical Services department

complies with all State and Federal regulations.

MedServ Connections Consulting, LLC is a professional healthcare management

consulting services organization that specializes in compliance management per

State and Federal requirements, P&P development, operating procedure

management and more. Under this Agreement, MedServ Connections Consulting,

LLC will:

Assess, develop and implement a regulatory compliance action plan for the

following Medical and Pharmaceutical Services processes for both Medi-Cal and

Medicare lines of business:

Organization Determinations

Adverse Determinations

Appeals

(Continued on following page)



April 13, 2015

Conduct the following services:

Review specific Policies & Procedures

Assess if practiced processes comply with existing Policies & Procedures

Develop a Gap Analysis

Develop a Prioritized Action Plan which includes but is not limited to:

o Develop training materials

o Write / revise Policies & Procedures

o Develop process flow charts

o Develop online desk-top tools:

Quick Reference Tools

Checklists

o Conduct group training

o Conduct 1:1 training

o Re-audit top priorities

o Re-educate if necessary

The original Agreement was approved by the Governing Board in December 2014

and amended in March 2015 under Resolution 14-308.

d. Discussion

This Amendment adds an additional Agreement term beginning March 18, 2015

through March 31, 2018. The engagement has exceeded the original Agreement

term date due to additional oversight and training.

e. Fiscal Impact

The total compensation payable under this Agreement shall not exceed One

Hundred Thousand Dollars ($100,000).





f. Attachments

A copy of the Second Amendment is attached to the Minute Order.


Staff Counsel



April 13, 2015


15. Professional Services Agreement (PSA) with Mary Catherin Freier Randall, Ph.D. for the

Provision of Consulting Services for the IEHP Behavioral Health Autism Program –

Third Amendment




14-308, to approve the Professional Services Agreement with Mary Catherin Freier

Randall, Ph.D. for the provision of Consulting Services for the IEHP Behavioral

Health Autism Program – Third Amendment at a cost not to exceed $50,000 per

contract year.

b. Contact


c. Background

Governor Jerry Brown ratified Senate Bill 946 on October 9, 2011 which made

healthcare service plans provide behavioral health treatment for pervasive

developmental disorders including Autism Spectrum Disorder (ASD) beginning

July 1, 2012.

Dr. Freier is a pediatric neurodevelopmental psychologist who has ASD clinical

expertise, assessment knowledge, treatment experience and Inland Empire

resources. Under the Agreement, Dr. Freier provides the following services:

1) Assists the Clinical Director of Behavioral Health in developing ASD clinical

guidelines for IEHP's Autism program; and

2) Reviews current ASD clinical guidelines in other regions to help develop

IEHP's Autism program based on best practices.

The Agreement was approved by the Governing Board June 2012 under Resolution

09-98 and renewed in June 2013 under Resolution 13-98.

d. Discussion

This Amendment adds an additional Agreement term beginning July 1, 2015

through June 30, 2017.



April 13, 2015

e. Fiscal Impact

The total compensation payable under this Agreement shall not exceed Fifty



[ X] Included in FY 14/15 Budget



f. Attachments

Copy of the Third Amendment is attached to the Minute Order.


Staff Counsel



April 13, 2015

G. PROVIDER NETWORK DEPARTMENT (Kurt Hubler)

16. None



April 13, 2015

H. MARKETING DEPARTMENT (Susan Arcidiacono)

17. None

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