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: Amendment to Agreement with Duc Marcel Nguyen, MD for Orthopedic Services
RECOMMENDATION:
title
Adopt a resolution authorizing an amendment to the agreement with Duc Marcel Nguyen, MD to increase supplemental clinical coverage at SMMC, expand the scope of orthopedic services to include treatment of patients at the County Jail, and accordingly increase the amount of the agreement by $213,984 to an amount not to exceed $1,502,592 with no change to the agreement term.
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BACKGROUND:
San Mateo County is responsible for providing necessary medical care to its medically indigent population and access to services to its general population. This obligation includes patients within the custody of the San Mateo County Sheriff’s Office (SO), which must typically be consulted or transferred to San Mateo Medical Center’s (SMMC) campus in the City of San Mateo for treatment, from the SO’s Maguire and/or Maple Street correctional facilities located in Redwood City. Dr. Nguyen has been providing orthopedic services at SMMC for 23 years.
In January 2024, the County and Dr. Nguyen entered into an agreement to provide orthopedic services for the term of April 1, 2024 through March 31, 2027 in an amount not to exceed $1,288,608.
DISCUSSION:
Dr. Nguyen is now willing to extend his services to provide consultation and treatment of patients within SO custody at the Maguire and Maple Street correctional facilities, reducing delays in care and security concerns associated with the transfers of such patients to and from SMMC. Orthopedic consultation and treatment of patients in custody would consist of two four-hour jail clinic rotations per month.
Dr. Nguyen is also willing to expand supplemental clinical coverage services at SMMC to meet community need from 192 hours per year to 288 hours per year.
As a result of these changes, SMMC wishes to amend the agreement with Dr. Nguyen to increase the agreement amount by $213,984, increasing supplemental clinical coverage at SMMC and expanding Dr. Nguyen’s scope of work . No change to the agreement’s compensation rate or methodology is being made by this amendment.
The underlying agreement was previously reviewed by the County Attorney and appeared to be commercially reasonable and within fair market value. This amendment embodies a straightforward expansion of coverage.
County Attorney has reviewed and approved the resolution and first amendment to the 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 85% of patients who complete the Patient Satisfaction Survey will recommend Dr. Nguyen as a provider.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Estimated |
FY 2025-26 Projected |
|
Percentage of patients who complete the Patient Satisfaction Survey that recommend Dr. Nguyen as a provider |
85% |
85% |
FISCAL IMPACT:
The term of the amendment agreement is April 1, 2024 through March 31, 2027. This amendment increases the agreement amount by $213,984 to an amount not to exceed $1,502,592 for the three-year term. The annual increase in cost of $71,328 is expected to fit within SMMC’s Adopted Budget for FY 2023-24 and expected budget for FY 2024-25, with the potential for some form of cost sharing with the Corrections Department if and when any memorandum of understanding between the departments may be developed. Similar arrangements will be made for future years.
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.