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 Crystal Chen, OD for Optometry Services
RECOMMENDATION:
title
Adopt a resolution authorizing an agreement with Crystal Chen, OD to provide optometry services for the term of November 1, 2022, through September 30, 2025, in an amount not to exceed $400,000.
body
BACKGROUND:
San Mateo County is responsible for providing necessary medical care to its medically indigent population, as well as access to services to its general population. Dr. Chen has been providing optometry services at San Mateo Medical Center (SMMC) since 2011.
In November 2020, Dr. Chen entered into an agreement with SMMC to provide optometry services for the term of December 1, 2020, through November 30, 2023, in an amount not to exceed $300,000.
DISCUSSION:
The County has a continuing need for optometry services due to its aging patient population. Dr. Chen has agreed to provide continued optometry services. This agreement with Dr. Chen would align her compensation with the other optometrist contractors at SMMC and make the renewed agreement coterminous with the other optometry coverage contracts on September 30, 2025. Upon the Board’s approval, Dr. Chen’s current agreement would end, and this agreement would go into effect.
Under Dr. Chen’s current agreement, she provides six half-day sessions of ambulatory optometry clinic services per week, with each half-day session consisting of four hours of coverage. Dr. Chen also provides Diabetic Retinopathy Classification (DRC) telemedicine services.
The factors that informed the compensation negotiations with SMMC’s two other optometrist contractors apply equally to Dr. Chen. Dr. Chen offers approximately 65% of her productive clinical practice time to County Health compared to the average full-time optometrist. Review of Dr. Chen’s services by SMMC leadership indicates that the quality and length of time that she has provided her services justifies the offer.
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 the County Attorney 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 70% of patients who complete SMMC’s Patient Satisfaction Survey would recommend the contractor as a provider.
PERFORMANCE MEASURE:
|
Measure |
FY 2022-23 Estimated |
FY 2023-24 Projected |
|
Percentage of patients who complete the Patient Satisfaction Survey that would recommend Contractor as a provider |
70% |
70% |
FISCAL IMPACT:
The term of the agreement is November 1, 2022 through September 30, 2025. The amount of the agreement is not to exceed $400,000 for the three-year term, payable in monthly installments of $11,281.72 plus $401.00 incrementally per additional four-hour clinic as needed. Funds in the amount of $133,333.33 are included in the SMMC FY 2022-23 Adopted Budget.
This contract’s compensation provisions increased from the previous contract by 22%, primarily due to the increase in provider compensation to match the rates offered to the other SMMC optometrist contractors. The latter rates are benchmarked against the 2022 MGMA Provider Compensation Report based on 2021 Data at the 75th percentile for optometrists practicing in federally qualified health centers in MGMA’s western section. Currently Dr. Chen receives a fixed rate of $328.00 per four-hour half-day clinic and $82.00 per hour for DRC telemedicine. The proposed arrangement would continue Dr. Chen’s clinic and DRC telemedicine coverage without change but would raise her incremental four-hour half-day clinic block coverage to $401.00 per clinic - the same rate as the other SMMC optometrist contractors.
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.