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 Victor Lee, DPM to Provide Podiatry Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Victor Lee, DPM to provide podiatry services for the term of December 1, 2024, through November 30, 2027, in an amount not to exceed $523,776.
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BACKGROUND:
San Mateo County is responsible for providing necessary medical care to its medically and financially vulnerable population. Since 2022, Dr. Lee has provided professional podiatric services at San Mateo Medical Center (SMMC) under contract, treating foot and ankle conditions. Prior to 2022, Dr. Lee provided podiatry services under a group contract between the County and Pacific Foot Care Podiatry Group, Inc.
DISCUSSION:
Under this agreement, on annual basis, Dr. Lee agreed to provide up to 248 four-hour outpatient clinic shifts at SMMC or the County Jail, of which at least 200 clinics must be at SMMC. The contract also stipulates that Dr. Lee may provide alternative surgical services at SMMC’s request in lieu of his regularly scheduled outpatient clinical services.
The rates in the new 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 90% of all established podiatry patients aged 18 years and older with a diagnosis of diabetes mellitus are evaluated for proper footwear and sizing at least once within 12 months.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Estimated |
FY 2024-25 Projected |
|
Percentage of all established podiatry patients aged 18 years and older with a diagnosis of diabetes mellitus evaluated for proper footwear and sizing at least once within 12 months |
90% |
90% |
EQUITY IMPACT:
Dr. Lee’s continued podiatry coverage positively impacts equitable health outcomes for SMMC’s patients by specifically addressing the podiatric 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 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. Lee 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 December 1, 2024, through November 30, 2027. The amount of the agreement is not to exceed $523,776 for the three-year term. Funds in the amount of $101,845 are included in the SMMC FY 2024-25 Adopted Budget. Funds in the amount of $174,592 are included in the SMMC FY 2025-26 Recommended Budget. Similar arrangements will be made for future years.
The non-compounded cost of the agreement is increasing by 15% compared to the prior agreement. The increase is attributable to Dr. Lee’s hourly rate for clinic coverage increasing from $158 per hour to $176 per hour, in line with the rates negotiated with SMMC’s agreement with Pacific Foot Care Podiatry Group, Inc., and nominal expansion of his services to County Jail patients.
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.