Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Colleen Chawla, Chief, San Mateo County Health
Chester J. Kunnappilly, MD, Chief Executive Officer, San Mateo Medical Center
Subject: Second Amendment to the Agreement with Eva Balint MD PC dba Balint Advisors
RECOMMENDATION:
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Adopt a resolution authorizing a second amendment to the agreement with Eva Balint MD PC dba Balint Advisors, extending the term of the agreement by one (1) year, through April 30, 2027, and increasing the amount of the agreement by $255,000, to an amount not to exceed $510,000.
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BACKGROUND:
In March 2025, San Mateo Medical Center (SMMC) completed a Request for Proposals for a value-based care innovation clinical partner for a three-year period. Eva Balint, LLC was elevated due to their ability to get hands-on in the implementation, as evidenced by prior work in developing and running value-based care and innovation programs and projects, and their ability to align with senior leadership and motivate them toward action. Eva Balint, LLC also has knowledge of health plan operations and prior experience working on the payer side and experience with other public agencies.
On June 10, 2025, Eva Balint, LLC and the County entered into an agreement for value-based care innovation clinical partner services for the term of May 1, 2025, through April 30, 2026, in an amount not to exceed $255,000 (“Agreement”). On November 10, 2025, the Agreement was reassigned from “Eva Balint, LLC” to “Eva Balint MD PC dba Balint Advisors” due to the change in the company’s name.
DISCUSSION:
SMMC’s Health Futures Lab is a unit focused on strategic value-based care innovation that can add capacity and revenue to the organization by piloting models significantly different from current operations. The Health Futures Lab needs an experienced clinical executive who has successfully led innovation projects and is well-versed in managing medical services on both the provider and payor sides.
Dr. Eva Balint has successfully contributed to the Health Futures Lab in this role. She has made pivotal contributions to the primary care access pilot ‘Camino a la Salud’ funded by the Health Plan of San Mateo and the youth behavioral health pilot funded by the San Mateo County Health Foundation. Both of these pilots are contributing to building the value-based care infrastructure within SMMC.
The proposed amendment seeks to facilitate the continuation of Dr. Balint’s role and contribution to the Health Futures Lab at SMMC for the next year by extending the term of the Agreement through April 30, 2027 and increasing the maximum fiscal obligation by an additional $255,000 to $510,000 (“Amendment”).
SMMC Health Futures Lab has raised almost $1 million ($600,000 firmly committed) in external investment from HPSM and the San Mateo County Health Foundation to date. In addition, to ensure that the Lab develops appropriate systems, SMMC requires that both the Lab and any systems it designs, pilots, and launches be able to generate sufficient revenue to be self-sustaining. One key criterion of the Lab’s sustainability is that it must secure outside funding (e.g. philanthropy and grants) to cover its expenses, such as for this Amendment to pay for Dr. Balint’s services.
The County Attorney has reviewed and approved the resolution and Amendment provided that Dr. Balint should not refer any patient to SMMC or cause any services, durable medical equipment, medication, or tests to be ordered there.
The resolution contains the County’s standard provisions allowing further amendment of the County fiscal obligations by a maximum of $25,000 (in aggregate).
PERFORMANCE MEASURE:
|
Measure |
FY 2025-26 Estimated |
FY 2026-27 Projected |
|
Percentage of innovation activities that will correspond to developing the value-based care capabilities within SMMC |
100% |
100% |
COMMUNITY IMPACT:
The Amendment’s value-based care model addresses health disparities by allocating resources based on patient needs and outcomes, making healthcare more equitable and effective. SMMC’s patients span a wide spectrum of races, ethnicities, gender, and gender-identities. Since November 1, 2024, half of the specialty care patients at SMMC were female and half were male, with the largest ethnic cohorts being Hispanic or Latino (58%), and primarily Spanish-speaking (48%).
FISCAL IMPACT:
The Amendment increases the amount payable under the Agreement by $255,000 to an amount not to exceed $510,000. Funds in the amount of $255,000 are included in the SMMC FY 2026-27 Recommended Budget. This Amendment is 100% covered by outside funding (e.g. philanthropy and grants), with no Net County Cost.