Single Source Procurement: Healthcare-Associated Infections Surveillance

Healthcare-associated infections (HAIs), including Clostridium difficile and carbapenem-resistent Enterobacteraceae (CRE), are a major public health problem in the U.S. According to the Centers for Disease Control and Prevention (CDC), there were an estimated 722,000 HAIs in US acute care hospitals in 2011, and 75,000 of these patients died during their hospitalizations. A recent CDC report estimated the annual medical costs of HAIs to U.S. hospitals to be between $28 and $45 billion, adjusted to 2007 dollars.

Preventing HAIs is a core element of the Commissioner's Prevention Agenda. In New York State ( NYS), Public Health Law (PHL) §2819 was enacted in July 2005, mandating that acute care hospitals report select hospital-acquired infections to the New York State Department of Health (NYSDOH). This law was created to provide the public with fair, accurate and reliable HAI data to compare hospital infection rates, and to support quality improvement and infection control activities in hospitals. Additionally, the NYSDOH, Division of Epidemiology (DOE) is mandated per Public Health Law (PHL) §§ 2103-2104 and 10 NYCRR § 2.1 and §2.2 to identify, contain and prevent communicable disease outbreaks in healthcare- and community- settings.

The Bureau of Healthcare-Associated Infections does not have sufficient State or HRI staff to meet these critical public health needs, many of which are mandated by Public Health Law. Since 2009, the Bureau has relied on miscellaneous contracts to provide supplemental contract staff to assist with these activities. Currently, the Bureau is investigating a potentially more cost effective method of contracting with individual consultants directly, rather than issuing a Request for Proposals (RFP) for one or more agencies to provide staff. A trial run of the consultant process is in progress. More time is needed to determine if this is a viable alternative to some or all of the positions included in the current contracts with Island Peer Review Organization (IPRO) and New York County Health Services Review Organization (NYCHSRO).

The Department of Health(DOH) Bureau of Healthcare-Associated Infections (BHAI) is requested and received a Contract Reporter Exemption Request to amend the existing miscellaneous contracts with Island Peer Review Organization-IPRO (C-026723) and New York County Health Services Review Organization-NYCHSRO (C-026724) to extend each contract by one year, until 7/31/16. This will allow the Bureau to evaluate the success of the trial consultant process, weigh successes and challenges, and determine the most economic and feasible way to move forward.

Vendor selection is based on the existence of two successful State contracts for the same services procured via a 2010 competitive RFP and the inability to find qualified staff through use of OGS vendor backdrop contracts.

In 2010, the Bureau of Healthcare-Associated Infections (BHAI) released a Request for Proposals (RFP) to assist NYSDOH in conducting enhanced communicable disease surveillance and investigations in healthcare and community settings in the New York City region. These services were required due to critical staffing shortages in the Metropolitan Area Regional Office's (MARO) Epidemiology Program. According to 2011 data, 38% of reported communicable disease outbreaks in the State occur in the MARO region.

Only two bids from IPRO and NYCHSRO were received in response to the 2010 RFP out of over fifty firms solicited, in addition to public postings in both the NYS Contract Reporter and NYSDOH websites. Current five year contracts (no annual renewals) exist with IPRO and NYCHSRO for the period 8/1/10-7/31/15, and fund staff with expertise in epidemiology and infection control who conduct outbreak investigations in both community and healthcare settings in the MARO region.

In the fall of 2012 and again in the spring of 2015, BHAI attempted to recruit qualified temporary nurses through OGS approved vendor contracts and was unsuccessful. In 2012, the eight vendors listed on the OGS website as being able to provide registered nurses in regions 2, 4, and 7 were contacted and asked to provide resumes of qualified candidates. Only two of the eight vendors responded that they could provide qualified candidates. Only one vendor actually supplied a resume, however the candidate did not meet the minimum qualifications.

In March of 2015, six vendors were listed as having contracts to provide registered nurses in regions 1, 2, 3, 4, 5, or 7. Two agencies responded that they would be able to provide qualified candidates, but only one provided resumes. Of the four resumes they sent none of the nurses met the minimum qualifications.

The current contractors have historically been able to provide high quality and appropriately qualified staff for work in NYSDOH regional offices, and have been flexible in working with changing contract terms and amounts based on NYSDOH needs. Additionally, the most efficient and appropriate way to avoid any gaps in essential services is through amending the current contracts.

Procurement / Program Name	Healthcare-Associated Infections Surveillance
Contractor Name(s)	IPRO, NYSHSRO
Contract Period	8/01/2015 – 7/31/2016
Contract Number(s)	IPRP-C026723, NYCHSRO-C026724