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, a California nonprofit public benefit corporation dba Palo Alto Medical Foundation for Health Care, Research, and Education to Provide General Surgery Services
RECOMMENDATION:
title
Adopt a resolution authorizing an amendment to the general surgery agreement with Palo Alto Medical Foundation (PAMF) to extend the agreement by six months through December 31, 2024, and increase the amount of the agreement by $473,934, to an amount not to exceed $3,317,529.
body
BACKGROUND:
San Mateo County is responsible for providing necessary medical care to its medically indigent population. This care includes general surgery and the management and supervision of the service. PAMF has provided surgery services at San Mateo Medical Center (SMMC) for the past 16 years.
DISCUSSION:
PAMF requested this amendment to extend the term through December 2024 in order to collect data prior to commencing negotiations for a renewed agreement. There are no changes in the terms of the agreement other than to extend it until December 31, 2024.
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 surgical site infection rates are less than the higher of i) 2.5% or ii) the surgery department average 100% of the time.
PERFORMANCE MEASURE:
|
Measure |
FY 2023-24 Actual |
FY 2024-25 Estimated |
|
Percentage of time surgical site infection rates are less than the higher of i) 2.5% or ii) the surgery department average |
100% |
100% |
EQUITY IMPACT:
PAMF’s continued general surgery coverage will positively impact equitable health outcomes because delivery of general surgery services at SMMC, a public safety net hospital, addresses community need. Specifically, in the past 12 months, 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 PAMF 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 presently July 1, 2021, through June 30, 2024. This amendment will extend the agreement by six months through December 31, 2024. The amount of the agreement shall not exceed $3,317,529 for the forty-two-month term, which reflects an additional $473,934 to fund the extension of the agreement at the existing contract rate without any additional change. Funds for the extension 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.