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: Agreement with Jacqueline K. Nguyen, MD for Orthopedic and Podiatry Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Jacqueline K. Nguyen, MD for orthopedic services for the term of December 1, 2025 through November 30, 2028, in an amount not to exceed $750,624.
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BACKGROUND:
The County of San Mateo maintains agreements with various orthopedic surgeons to maintain orthopedic specialty coverage at San Mateo Medical Center (SMMC) to fulfill SMMC’s public health mission and to generally satisfy the Emergency Medical Treatment & Labor Act requirements regarding the maintenance of on-call services agreements. Dr. Nguyen first provided services at SMMC in 2022 under a one-year agreement, which was renewed as a two-year agreement in 2023. Dr. Nguyen specializes in orthopedic surgery and “foot and ankle” surgery.
DISCUSSION:
Dr. Nguyen’s previous contract permitted coverage of up to 60 four-hour outpatient orthopedic clinics, 208 hours of operating room time (or equivalently, 52 four-hour operating room blocks), and 84 days of 24-hour unrestricted on-call coverage shifts. Dr. Nguyen was paid $265 per hour for her clinical services, and each 24-hour on-call shift compensated her $1,000 (at just under $42 per hour). The proposed contract maintains the same coverage amounts but increases Dr. Nguyen’s compensation to $329 per hour and increases her on-call coverage stipend to $1,224 per 24-hour shift (at $51 per hour).
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.
The 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 100% of Dr. Nguyen’s patients who use tobacco will receive documented tobacco cessation counseling.
PERFORMANCE MEASURE:
|
Measure |
FY 2025-26 Estimated |
FY 2025-26 Projected |
|
Percentage of Dr. Nguyen’s patients who use tobacco that receive documented tobacco cessation counseling |
100% |
100% |
COMMUNITY IMPACT:
Dr. Nguyen’s continued orthopedic and “foot and ankle” surgery coverage will positively impact health outcomes because delivery of those services at SMMC, a public safety net hospital, addresses community need. 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. Nguyen 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, 2025 through November 30, 2028. The amount of the agreement is not to exceed $750,624 for the three-year term. Funds in the amount of $250,208 are included in the SMMC FY 2025-26 Adopted Budget. Funds in the amount of $250,208 are included in the SMMC FY 2026-27 Recommended Budget.
The payment provisions and levels of services in this contract differ from those of the previous contract due to an increase in hourly compensation rates to be paid to Dr. Nguyen. The annual cost of the new contract represents a 23% increase compared to that of the previous contract.
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.