Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Chester J. Kunnappilly, MD, Chief Executive Officer, San Mateo Medical Center
Subject: Agreement with Paul R. Holland, M.D., Inc. to Provide Ophthalmology Services
RECOMMENDATION:
title
Adopt a resolution authorizing an agreement with Paul R. Holland, M.D., INC. to provide ophthalmology services for the term of September 1, 2024, through August 31, 2025, in an amount not to exceed $241,520.
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BACKGROUND:
San Mateo County is responsible for providing necessary medical care to its medically indigent population. This includes services for ophthalmology disorders. The County’s need for ophthalmology services is increasing due to the aging of its patient population.
DISCUSSION:
Dr. Holland provided ophthalmology services to the County intermittently between 2010 and 2019. Beginning with this contract, Dr. Holland will provide 128 4-hour outpatient ophthalmology clinics, up to 24 4-hour blocks of surgical services, and up to 121 24-hour shifts of on-call coverage. Dr. Holland’s hourly compensation rates match SMMC’s other contracted ophthalmologists at $250 per hour for clinic coverage, $275 per hour for operating room coverage, and $30 per hour for on-call coverage.
The rates in Dr. Holland’s contract 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 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 the following performance measures will be met during the term of Dr. Holland’s agreement:
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Estimated |
FY 2024-25 Projected |
|
100% of diabetic patients evaluated by Contractor shall receive retinopathy screening, if due |
100% |
100% |
EQUITY IMPACT:
Dr. Holland’s ophthalmology coverage will positively impact equitable health outcomes because delivery of ophthalmology services at SMMC, a public safety net hospital, addresses community need. Specifically, in between May 2023 and May 2024 68.3% of SMMC’s patients were enrolled in Medi-Cal with an additional 6.1% of SMMC’s patients enrolled in the “Access to Care for Everyone” (ACE) program. 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 (56%), Hispanic or Latino (58%), 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. Holland 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 September 1, 2024, through August 31, 2025. The amount of the agreement is not to exceed $241,520 for the 1-year term. Funds in the amount of $241,520 are included in the SMMC FY 2024-25 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.