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: Second Amendment to the Vascular Surgery Agreement with Sutter Bay Medical Foundation, a California Nonprofit Public Benefit Corporation dba Palo Alto Medical Foundation for Health Care, Research, and Education
RECOMMENDATION:
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Adopt a resolution authorizing a second amendment to the vascular surgery agreement with Sutter Bay Medical Foundation, a California nonprofit public benefit corporation dba Palo Alto Medical Foundation for Health Care, Research, and Education (PAMF), extending the term of the agreement by three months, increasing the “not to exceed” amount of the agreement to $1,679,167, and updating the contractor provider list attached as Exhibit D to the agreement.
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BACKGROUND:
San Mateo County is responsible for providing necessary medical care to its medically indigent population. This care includes vascular surgery and the management and supervision of the service. PAMF has provided vascular surgery services at San Mateo Medical Center (SMMC) since 2018.
DISCUSSION:
On July 22, 2025, following negotiations that appeared to be settled, PAMF respectfully requested that the County agree to extend the vascular surgery services coverage agreement at SMMC by three months. To accommodate the extension, the “not to exceed amount” of the agreement needs to be increased by $129,167, to an amount “not to exceed” $1,679,167. At PAMF’s request, the amendment also updates the list of PAMF’s providers.
The County Attorney has reviewed and approved the resolution and 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 there will be less than 2.5% of surgical site infection rates for vascular surgery.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Actual |
FY 2025-26 Estimated |
|
Percentage of surgical site infection rates for vascular surgery |
<2.5% |
<2.5% |
COMMUNITY IMPACT:
PAMF’s continued vascular surgery coverage positively impacts health outcomes for SMMC’s patients by specifically addressing the surgical needs of the County’s most medically and financially vulnerable patients. SMMC’s patients span a wide spectrum of races, ethnicities, gender, and gender-identities. 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 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 PAMF providers to meet with SMMC and discuss patient feedback to improve patient satisfaction and remove potential barriers to care.
FISCAL IMPACT:
Following the extension, the term of the agreement would presently be September 1, 2022 through November 30, 2025. The amount of the agreement is not to exceed $1,679,167 for the 39-month term, which reflects an additional $129,167 to be included in the SMMC FY 2025-26 Recommended Budget to fund services during the extended term to meet patient need at the existing contract rate without any additional change. Funds for the amendment are budgeted.
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.