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 Sutter Bay Medical Foundation dba Palo Alto Medical Foundation for Healthcare, Research and Education for General Surgery Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Sutter Bay Medical Foundation dba Palo Alto Medical Foundation for Healthcare, Research and Education for general surgery services, for a term of July 1, 2021 to June 30, 2024, in an amount not to exceed $2,843,595.
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BACKGROUND:
San Mateo County is responsible for providing necessary medical care to its medically indigent population. This care includes general surgery, as well as the management and supervision of this service. The Sutter Bay Medical Foundation dba Palo Alto Medical Foundation (PAMF) for Healthcare, Research and Education general surgery group has provided professional services at San Mateo Medical Center (SMMC) for the past 15 years.
DISCUSSION:
PAMF will continue to provide general surgery services at SMMC through services of physicians familiar with SMMC and its patients. General surgery services are provided under the general direction of the Chief of Surgery and the Chief Medical Officer. Monitoring and evaluation of the quality of services provided by PAMF are accomplished through peer review by the Quality Assurance Committee and the Medical Staff Executive Committee. The level of compensation and related work is based on regional benchmarks for general surgery services.
County Administrative Memorandum B-1 provides that contracts for physicians are exempt from the Request for Proposals process.
The agreement and resolution have been reviewed and approved by County Counsel 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 general surgery will meet the following performance measures 95% of the time: A Time Out performed prior to surgery and at the end of surgery; and a plan of action communicated to the Patient Services Assistant (PSA) and nurse practitioner when a provider is more than 30 minutes late for the state of clinic. It is anticipated that general surgery will meet the following performance measures 100% of the time: Documentation completed within 72 hours for each patient with no more than 10 delinquent charts made per month; Central Line Insertion Practice (CLIP) completed within 48 hours of procedure with appropriate documentation to meet California Department of Public Health (CDPH) requirements; compliance with SMMC recorded on the Electronic Health Record (EHR); and surgical site infection rates at less than the higher of i) 2.5% or ii) the surgery department average.
PERFORMANCE MEASURE:
|
Measure |
FY 2020-21 Estimated |
FY 2021-22 Projected |
|
Percentage of time a Time Out is performed prior to surgery and at the end of surgery |
N/A* |
95% |
|
Percentage of time a plan of action is communicated to the PSA and nurse practitioner when a provider is more than 30 minutes late for the state of clinic |
N/A* |
95% |
|
Percentage of time documentation is completed within 72 hours for each patient with no more than 10 delinquent charts per month |
N/A* |
100% |
|
Percentage of time CLIP is completed within 48 hours of procedure with appropriate documentation to meet CDPH requirements |
N/A* |
100% |
|
Percentage of time compliance with SMMC is recorded on the EHR |
N/A* |
100% |
|
Percentage of time surgical site infection rates are less than the higher of i) 2.5% or ii) the surgery department average |
N/A* |
100% |
*New Measure
FISCAL IMPACT:
The term of the agreement is July 1, 2021 through June 30, 2024. The amount of the agreement is not to exceed $2,843,595 for the three-year term. Funds in the amount of $947,865 will be included in the SMMC FY 2021-22 Recommended Budget. Similar arrangements will be made for future years.
There is no increase in payment provisions for this agreement, compared to the previous agreement.
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.