To: Board of Supervisors
From: Dr. Grant Colfax, Health Services Director
Report Title: Contract Amendment #77-093-4 with Change Healthcare Solutions, LLC
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Health Services Director, or designee, to execute on behalf of the County Contract Amendment #77-093-4 with Change Healthcare Solutions, LLC, a limited liability company, effective October 1, 2025, to amend Contract #77-093-3, to increase the payment limit by $190,000, from $160,000 to a new payment limit of $350,000, for additional professional consulting and management support services with regard to the executive administration of the Contra Costa Health Plan (CCHP) with no change in the term ending June 30, 2026.
FISCAL IMPACT:
Approval of this Contract Amendment will result in additional annual expenditures of up to $190,000 as budgeted by the department and funded 100% by CCHP Enterprise Fund II revenues. (No rate increase)
BACKGROUND:
CCHP has an obligation to provide certain specialized managed care regulatory compliance consulting and management support services for its executive administration team. These professional consulting services will include support in the areas of Quality, Case Management, Utilization Management, Member Services, Operations and Program Redesign. This contractor has been providing such support for CCHP and fostering a deep understanding of the CCHP organization’s mission, values, and long-term objectives since February 2018.
This Contract is entered into under and subject to the following legal authorities: California Government Code §§ 26227 and 31000; Health and Safety Code § 1451. Health Services Personnel approved this Contract to ensure no conflicts with labor relations. Contractor currently cooperates with and participates in CCHP’s Quality Management Program which consists of quality improvement activities to improve the quality of care and services and member experience. Cooperation includes collection and evaluation of performance measurement data and participation in the organization’s clinical and service measure Quality Improvement Programs. Medicare and Medicaid programs have stringent accreditation and compliance standards that healthcare providers such as CCHP must meet. Change Healthcare Solutions, LLC, has a demonstrated history of maintaining the required accreditations and compliance with these federal regulations.
The nature of the managed care regulatory compliance consulting services needed is complex and requires seamless coordination, integration and collaboration with existing programs and systems. This Contract renewal will maintain comprehensive area coverage for the entire CCHP membership and meet the Knox-Keene Act, time and distance mandate required by the State of California Department of Managed Health Care (DMHC) services and assist with the CCHP Single Plan Model which will be effective January 1, 2024. This Contractor has been approved by the Public Works Department’s Purchasing Division on October 30, 2023.
In November 2024, the County Administrator approved and the Purchasing Services Manager executed Contract #77-093-3 with Change Healthcare Solutions, LLC, in an amount not to exceed $160,000, for the provision of professional consulting and management support services for CCHP’s executive administration team, for the period July 1, 2024 through June 30, 2026. Contract delay was due to negotiation of language between Contractor and County. This Contract limits the Contractor’s liability for damages to the fees paid to Contractor by County for the twelve (12) months prior to the month in which the most current event giving rise to the liability occurred. Under the Contract, The Contractor is not liable to the County for certain damages, including indirect or consequential, exemplary, punitive, or special damages. The accompanying HIPAA Business Associate Addendum (BAA) also includes a mutual indemnification provision, which requires each party to save, hold harmless, indemnify and defend the other party for losses suffered as a result of a party’s breach of the BAA.
Approval of Contract Amendment #77-093-4 will allow the Contractor to provide additional professional consulting and management support services to the CCHP executive administration team through June 30, 2026. Contract Amendment delay was due to lack of real time knowledge of expenditures by the division.
CONSEQUENCE OF NEGATIVE ACTION:
If this Contract Amendment is not approved, certain specialized professional consulting and management support services for CCHP will not be provided and may risk County not being in compliance with managed care regulatory and state requirements.