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 Gordon Mak, MD to Provide Pulmonary and Critical Care Medicine Services
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with Gordon Mak, MD to provide pulmonary and critical care services for the term of October 1, 2022 through September 30, 2025, increasing the “not to exceed” amount by $76,440, to an amount not to exceed $1,752,540.
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BACKGROUND:
San Mateo County is responsible for providing necessary medical care to its medically indigent population. Since 2007, Gordon Mak, MD has provided pulmonary and critical care medicine services at San Mateo Medical Center (SMMC) supporting medical-surgical inpatients and critical care patients. On September 27, 2022, the County entered into its most recent contract with Dr. Mak to provide those services in an amount not to exceed $1,676,100.
DISCUSSION:
At the request of SMMC’s leadership, Dr. Mak provided 39 extra shifts of pulmonary and critical care coverage services pursuant to Exhibit B, Section V. of the agreement. As a result, the “not to exceed” amount of the agreement must be increased by $76,440 to pay Dr. Mak for those services.
County Attorney has reviewed and approved the resolution and the 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 Dr. Mak will review incoming referrals for medical appropriateness within one business day for urgent cases and three business days for routine cases 100% of the time.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Estimated |
FY 2025-26 Projected |
|
Percentage of time Dr. Mak reviews incoming referrals for medical appropriateness within one business day for urgent cases and three business days for routine cases |
100% |
100% |
COMMUNITY IMPACT:
Dr. Mak’s continued pulmonary and critical care medicine coverage positively impacts equitable health outcomes at SMMC, a public safety net hospital, and addresses community need. Demographically, within the past 18 months, the largest cohorts of specialty care patients at SMMC were female (52%), Hispanic or Latino (63%), and primarily Spanish-speaking (55%). SMMC strives to eliminate bias in the medical profession by providing culturally competent training to its physicians and by following up with patients to ensure that they continue to have access to specialized care. SMMC specifically tracks physician satisfaction survey results and requires Dr. Mak to meet with SMMC and discuss patient feedback to improve patient satisfaction and remove potential barriers to care.
FISCAL IMPACT:
The term of the agreement is October 1, 2022 through September 30, 2025. The amount of the agreement is not to exceed $1,752,540 for the three-year term. This amendment increases the contract amount by $76,440. Additional funds in the amount of $76,440 are included in the SMMC FY 2025-26 Adopted Budget to cover the additional 39 shifts of pulmonary and critical care shifts that Dr. Mak provided at SMMC following leadership’s request.
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.