Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Colleen Chawla, Chief, San Mateo County Health
Chester J. Kunnappilly, MD, Chief Executive Officer, San Mateo Medical Center
Subject: Amendment to the Agreement with David Jegge, MD for General Surgery Services
RECOMMENDATION:
title
Adopt a resolution authorizing an amendment to the agreement with David Jegge, MD, extending the term by three months from August 1, 2022 through July 31, 2025 to a term of August 1, 2022 through October 31, 2025 and increasing the not-to-exceed amount by $97,830 to an amount not to exceed $1,337,010.
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BACKGROUND:
San Mateo County is responsible for providing necessary medical care to its medically indigent population. Since 2005, Dr. Jegge has provided general surgery services at San Mateo Medical Center (“SMMC”). On June 26, 2022, the County entered into its most recent contract with Dr. Jegge to provide those services in an amount not to exceed $1,239,180.
DISCUSSION:
Under this amendment, Dr. Jegge has agreed to continue to provide general surgery services for an additional three months to allow for additional time to negotiate a new agreement.
County Administrative Memorandum B-1 provides that contracts for physicians are exempt from the Request for Proposals process.
The rates in Dr. Jegge’s agreement are within fair market value, according to VMG Health, a nationally recognized medical services valuation firm that relies upon multiple industry-standard provider compensation surveys and aggregates that data.
County Attorney has reviewed and approved the resolution and amendment to the agreement as to form.
The resolution contains the County’s standard provisions allowing amendment of the County fiscal obligations by a maximum of $25,000 (in aggregate).
It is anticipated that 100% of general surgery services provided by Dr. Jegge will adhere to the infection control standards as defined by the Joint Commission and Title XXII of the State of California Code of Regulations.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Estimated |
FY 2025-26 Projected |
|
Percentage of general surgery services provided by Dr. Jegge that adhere to the infection control standards as defined by the Joint Commission and Title XXII of the State of California, Code of Regulations |
100% |
100% |
COMMUNITY IMPACT:
Dr. Jegge’s continued general surgery coverage will support improved health outcomes by ensuring the delivery of essential surgical services at San Mateo Medical Center (SMMC), the County’s public safety net hospital. SMMC serves a highly diverse patient population across a broad range of races, ethnicities, genders, and gender identities. In the past 18 months, the largest cohorts of specialty care patients were female (52%), Hispanic or Latino (63%), and primarily Spanish-speaking (55%). SMMC is committed to reducing bias in healthcare by providing culturally responsive training to its physicians and conducting patient follow-ups to help ensure ongoing access to specialty care. The Medical Center actively monitors physician satisfaction survey results and requires Dr. Jegge to meet with leadership to review patient feedback, identify opportunities for improvement, and address any barriers that may affect the patient experience.
FISCAL IMPACT:
The term of the amended agreement is August 1, 2022 through October 31, 2025. The amount of the amended agreement is not to exceed $1,337,010. The amendment increases the contract amount by $97,830. Funds in the amount of $97,830 are included in the SMMC FY 2024-25 Adopted and FY 2025-26 Recommended Budget.
Expenses at SMMC are covered by fees for services or third-party payors whenever possible. The portion of expenses for services provided to the medically indigent or to those covered by programs that do not meet the full costs of care is covered by the County’s General Fund contribution to SMMC and is within the existing annual appropriation.