AGREEMENT AMENDMENT WITH MEDQUIST TRANSCRIPTIONS, LTD

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1 8101 September 12, 2002 The Honorable Board of Supervisors County of Los Angeles 383 Kenneth Hahn Hall of Administration 500 West Temple Street Los Angeles, CA Dear Supervisors: AGREEMENT AMENDMENT WITH MEDQUIST TRANSCRIPTIONS, LTD., FOR THE PROVISION OF MEDICAL TRANSCRIPTION SERVICES TO OLIVE VIEWUCLA MEDICAL CENTER AND HIGH DESERT HOSPITAL (3 rd and 5 th Districts) (3 Votes) IT IS RECOMMENDED THAT YOUR BOARD: Authorize and instruct the Director of Health Services, or his designee, to offer and sign Amendment No. 4 to Agreement No , substantially similar to Exhibit I with Medquist Transcriptions, Ltd., to extend the term and to continue the provision of medical transcription services for Olive ViewUCLA Medical Center and High Desert Hospital on a month-to-month basis for up to nine months, from October 1, 2002 through June 30, 2003, at a maximum cost of $ 494,347, to provide the Department of Health Services with additional time to complete the Request for Qualifications process, and to select a medical transcription services provider(s). PURPOSEJUSTIFICATION OF RECOMMENDED ACTION: In approving this action, the Board is authorizing the Director of Health Services, or his designee, to offer and sign an amendment to the agreement with Medquist Transcriptions, Ltd. (Medquist), to extend the term on a month-to-month basis for up to nine additional months, from October 1, 2002 through June 30, 2003 to continue the provision of medical transcription services for Olive ViewUCLA (OV-UCLA MC) and High Desert Hospital (HDH), pending the Department of Health Services (DHS or Department) completion of the final phases of the RFQ process to select a contract service provider(s). On September 21, 2000, the Chief Administrative Office and Auditor-Controller informed the Department of the change in County policy and procedures, and the new guidelines for the timely submission of contracts for Board approval. However, this amendment was not scheduled for

2 The Honorable Board of Supervisors September 12, 2002 Page 2 placement on the Board's agenda three weeks prior to its effective date, as required under the new policy due to the following: 1) conflicting departmental priorities and 2) a staffing shortage. The current agreement is slated to expire on September 30, FISCAL IMPACT: The total estimated County cost under the amendment is $412,042 for OV-UCLA MC and $82,305 for HDH for a combined maximum total of $494,347, for the nine-month period from October 1, 2002 through June 30, FINANCING: Funding for this amendment is included in the Fiscal Year Board Adopted Budget. FACTS AND PROVISIONSLEGAL REQUIREMENTS: Contract services consist of transcribing and typing various operative reports, discharge summaries, death summaries, and various other medical reports at the request of OV-UCLA MC and HDH. On August 20, 1996, the Board approved the current agreement with Medquist for the provision of services, effective September 1, 1996 through August 31, Under authority delegated to the Director of Health Services, or his designee, the term was extended for six-months, from September 1, 2000 through February 28, On February 20, 2001, the Board approved Amendment No. 1, which extended the term for six-months, from March 1, through August 31, On August 21, 2001, the Board approved Amendment No. 2 to extend the term of the contract on a month-to-month basis effective on September 1, 2001 through December 31, The Board approved Amendment No. 3 to extend the term of the contract on a month-to-month basis effective January 1, 2001 through September 30, The contractor had agreed to bill the County at the per line rate of $0.1375, until September 30, With amendment No. 4, the new negotiated rate per line is $ for HDH and $ for OV- UCLA MC. The new negotiated rate represents a 13% increase for HDH and a 22% increase for OV- UCLA MC. The original rate per line had been for the first two contract years and was increased to for the third contract year and for the fourth contract year. Because the purpose of Amendment No. 4 is to permit the completion of a solicitation process, an analysis for cost-effectiveness pursuant to Proposition A, was not completed. The provision for "Compliance with County's Jury Service Program" has been added to the amendment. The reorganization of DHS will not impact the amendment with Medquist because these services will still be required by the two facilities, and are on an as-needed basis. The administration of each facility covered under the agreement will continue to monitor the contractor's performance, and to assure compliance with the terms and conditions of the agreement. Page 1 of 2

3 Attachment A provides additional information. The Honorable Board of Supervisors September 12, 2002 Page 3 County Counsel has approved Amendment No. 4 (Exhibit I) as to form. CONTRACTING PROCESS: The Department released a RFP for the provision of medical transcription services for OV-UCLA MC and HDH in June 2001; subsequently circumstances required the cancellation of the RFP process. The current amendment will allow the Department to complete the RFP process by June 30, IMPACT ON CURRENT SERVICES (OR PROJECTS): Approval of the amendment will ensure the continuity of medical transcription services through June 30, When approved, this Department requires three signed copies of the Board's action. Respectfully submitted, Thomas L. Garthwaite, M. D. Director and Chief Medical Officer TLG:djj Attachments c: Chief Administrative Officer County Counsel Executive Officer, Board of Supervisors Auditor Controller BLETDJ02.DLJ 9602 Page 2 of 2

4 ATTACHMENT A SUMMARY OF AGREEMENT 1. TYPE OF SERVICE: Medical transcription Services. 2. AGENCY INFORMATION: Medquist Transcriptions, Ltd. Five Greentree Center, Suite 311 Marlton, New Jersey Attention: John Donohoe, President Telephone: (800) Ext TERM: The amendment will become effective on October 1, 2002 and continue through June 30, FINANCIAL INFORMATION: At HDH, it is estimated that an average of 59,000 lines per month will be transcribed at a billable rate of $ ON-LINE, for a monthly average cost of $9,145 and a nine-month Contractor s cost of $82,305. At OVMC, it is estimated that an average of 273,328 lines will be transcribed per month at a billable rate of $ ON-LINE, for a monthly average cost of $45,782, and a nine-month Contractor s cost of $412,042. The County is not obligated to pay the contractor the average calculated rate but only for the lines actually transcribed, up to the maximum obligation. The maximum amount budgeted for the nine-month extension is $494, COUNTY FACILITY SERVED: This agreement covers the provision of medical transcription services for Olive ViewUCLA Medical Center and High Desert Hospital. 6. ACCOUNTABILITY FOR MONITORING AND EVALUATION: The Administration at the two facilities are responsible for monitoring and evaluation of the contractor. 7. APPROVALS: Olive View-UCLA Medical Center: High Desert Hospital: Contracts and Grants: County Counsel (approval as to form): Melinda J. Anderson, Chief Executive Officer Beryl Brooks, Chief Executive Officer Riley Austin, Acting Chief Christina Salseda, Deputy County Counsel Page 3 of 2

5 EXHIBIT l MEDICAL TRANSCRIPTION SERVICES AGREEMENT OLIVE VIEW - UCLA MEDICAL CENTER AND HIGH DESERT HOSPITAL AMENDMENT NO. 4 THIS AMENDMENT is made and entered into this day of, 2002, by and between COUNTY OF LOS ANGELES (hereafter County ), and MEDQUIST TRANSCRIPTIONS, LTD., INC., (hereafter Contractor ). WHEREAS, reference is made to that certain document entitled MEDICAL TRANSCRIPTION SERVICES AGREEMENT, dated August 20, 1996, and further identified as County Agreement No and Amendment Nos. 1 through 3, (hereafter referred to as Agreement ); and WHEREAS, it is the intent of the parties hereto to amend the Agreement to extend its term and make the changes described hereinafter; and WHEREAS, said Agreement provides that changes may be made in the form of a written amendment which is formally approved and executed by both parties. NOW, THEREFORE, the parties hereby agree as follows: 1. This Amendment shall become effective October 1, 2002.

6 2. The term of Agreement is hereby extended on a month-tomonth basis for a maximum of nine (9) months, and, unless sooner terminated, shall expire on June 30, During the extended period, (October 1 through June 30, 2003), Contractor s rate of reimbursement shall be adjusted to include the minimum hourly wage as set forth in Exhibit C Paragraph 4, BILLING AND PAYMENT, shall be amended as follows: 4. BILLING AND PAYMENT: For all services hereunder, Contractor shall bill County monthly, in arrears, in accordance with the fees set forth in Exhibit C-2, (Billing and Payment) attached hereto and incorporated herein by reference. All billings shall clearly reflect and provide reasonable detail of the services for which claim is made and shall reflect the related contract number on the billing statement. Billing shall be made and forwarded to County in accordance with the procedures described in Exhibit A (Statement of Work). County shall pay Contractor within a reasonable period of time following receipt of a complete and correct billing. Submission of incorrect billings by Contractor will result in delayed payment by County. Except as otherwise expressly provided in this Agreement, such fees shall be the sole consideration paid by County to Contractor hereunder

7 5. Paragraph 52,(COMPLIANCE WITH THE COUNTY S JURY SERVICE PROGRAM) shall be added to Agreement as follows: 52. COMPLIANCE WITH THE COUNTY S JURY SERVICE PROGRAM: This Contract is subject to the provisions of the County s ordinance entitled Contractor Employee Jury Service ( Jury Service Program ) as codified in Sections through of the Los Angeles County Code. A. Unless Contractor has demonstrated to the County s satisfaction either that Contractor is not a Contractor as defined under the Jury Service Program (Section of the County Code) or that Contractor qualifies for an exception to the Jury Service Program (Section of the County Code), Contractor shall have and adhere to a written policy that provides that its Employees shall receive from the Contractor, on an annual basis, no less than five days of regular pay for actual jury service. The policy may provide that Employees deposit any fees received for such jury service with the Contractor or that the Contractor deduct from the Employee s regular pay the fees received for jury service. B. For purposes of this Sub-paragraph, ( Contractor ) means a person, partnership, corporation or other entity which has a contract with the County or - 3 -

8 a subcontract with a County Contractor and has received or will receive an aggregate sum of $50,000 or more in any 12-month period under one or more County contracts or subcontracts. Employee means any California resident who is a full-time employee of Contractor. Full-time means 40 hours or more worked per week, or a lesser number of hours if: 1) the lesser number is a recognized industry standard as determined by the County, or (2) Contractor has a long-standing practice that defines the lesser number of hours as full-time. Full-time employees providing short-term, temporary services of 90 days or less within a 12-month period are not considered full-time for purposes of the Jury Service Program. If Contractor uses any subcontractor to perform services for the County under the Contract, the subcontractor shall also be subject to the provisions of this Sub-paragraph. The provisions of this Sub-paragraph shall be inserted into any such subcontract agreement and a copy of the Jury Service Program shall be attached to the agreement. C. If Contractor is not required to comply with the Jury Service Program when the Contract commences, Contractor shall have a continuing obligation to review the applicability of its exception status from the - 4 -

9 Jury Service Program, and Contractor shall immediately notify County if Contractor at any time either comes within the Jury Service Program s definition of Contractor or if Contractor no longer qualifies for an exception to the Jury Service Program. In either event, Contractor shall immediately implement a written policy consistent with the Jury Service Program. The County may also require, at any time during the Contract and at its sole discretion, that Contractor demonstrate to the County s satisfaction that Contractor either continues to remain outside of the Jury Service Program s definition of Contractor andor that Contractor continues to qualify for an exception to the Program. Attached hereto, as Exhibit G, is the required form, County of Los Angeles Contractor Employee Jury Service Program Certification Form and Application for Exception, to be completed by the Contractor. D. Contractor s violation of this Sub-paragraph of the Contract may constitute a material breach of the Contract. In the event of such material breach, County may, in its sole discretion, terminate the Contract andor bar Contractor from the award of future County - 5 -

10 contracts for a period of time consistent with the seriousness of the breach. 6. Except for the changes set forth hereinabove, Agreement shall not be changed in any other respect by this Amendment. IN WITNESS WHEREOF, the Board of Supervisors of the County of Los Angeles has caused this Amendment to be subscribed by its - 6 -

11 Director and Chief Medical Officer of Health Services, and Contractor has caused this Amendment to be subscribed in its behalf by its duly authorized officer, the day, month, and year first above written. COUNTY OF LOS ANGELES By Thomas L. Garthwaite, M.D. Director and Chief Medical Officer MEDQUIST TRANSCRIPTIONS, Ltd. Contractor By Signature APPROVED AS TO FORM: Print Name LLOYD W. PELLMAN County Counsel By TITLE AFFIX CORPORATE SEAL HERE) Counsel APPROVED AS TO CONTRACT ADMINISTRATION: Department of Health Services By Acting Chief, Contracts and Grants Division AMENCD2098.DLJ - 7 -

12 EXHIBIT C-2 BILLING AND PAYMENT Subject to the payment provisions of the body of this Agreement, County shall compensate Contractor hereunder as follows: A. Contractor shall bill County at the following fees for transcribed lined for the following contract years (for portion thereof): FACILITIES ON-LINE NINE (9) MONTH CONTRACTOR S COST HDH $.1550* $ 82,305 OVUCLA MC $.1675** $ 412,042 Total Nine (9) Month On-Line Cost $ 494,347 B. Contractor shall submit to County on a monthly basis an itemized bill, indicating the total number of transcribed lines performed during the month immediately preceding the month in which the billing is submitted. An itemized transcribed line count summary, by report, shall be attached to each monthly billing. Billings shall be submitted to each Medical Center as follows: Services Services *County of Los AngelesDepartment of Health High Desert Hospital Expenditure Management North 60 th Street - West Lancaster, California **County of Los AngelesDepartment of Health Olive View - UCLA Medical Director Expenditure Management Olive View Drive Sylmar, California C. A transcribed line shall constitute any and all typed Characters within a seven (7) inch margin, inclusive of pre-programmed lines; e.g., headers, footers, macros, not requiring character entries. All transcription shall be typed with a ten (10) pitch element.

13 EXHIBIT D PRICE GUARANTEE: In the event of a price decline or should Contractor at any time during the life of this Agreement sell the same services to a similarly situated client in client in the same geographic area and otherwise equivalent terms and conditions, but at prices below these quoted herein, such lower prices shall immediately be extended to County. *** Contract costs may vary depending on workload which may result in monthly costs being more or less than projected. However, the total nine month costs will not exceed the maximum allowable for the contract period.

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