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: Third Amendment to Agreement with Pacific Foot Podiatry Group, Inc. to Provide Podiatry Services
RECOMMENDATION:
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Adopt a resolution authorizing a third amendment to the agreement with Pacific Foot Podiatry Group, Inc. to provide podiatry services for the term of December 1, 2021 through November 30, 2024, to an amount not to exceed $1,050,000.
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BACKGROUND:
San Mateo County is responsible for providing necessary medical care to its medically indigent population. Since February 1, 2010, Pacific Foot Care Podiatry (Pacific) has provided podiatry services at San Mateo Medical Center under contract, treating foot and ankle conditions. During that time, Pacific’s principal, Dr. Richard Woo, has served as SMMC’s Medical Director of Podiatry. On January 25, 2022, the Board of Supervisors originally approved a contract with Pacific for the term of March 1, 2022 through February 28, 2025, in an amount not to exceed $1,550,000. On February 3, 2022, San Mateo Medical Center (SMMC) and Pacific amended the agreement changing the term from March 1, 2022 through February 28, 2025, to December 1, 2021 through November 30, 2024, without changing the fiscal obligation. On May 1, 2022, SMMC and Pacific entered into a second amendment to the agreement, proportionately reducing the maximum payable amount of the agreement from $1,550,000 to $950,000, due to one of Pacific’s podiatrists leaving the group causing a reduction in coverage. Of note, the podiatrist that left Pacific entered into a separate agreement with the County to provide podiatric services, meaning that the County did not lose coverage, nor did it realize any cost savings within that service line.
DISCUSSION:
Since that time, Pacific has provided expanded coverage to meet community need, requiring this amendment to increase the maximum payable amount of the agreement by $100,000 from $950,000, to an amount not to exceed $1,050,000, to ensure adequate approved funds through November 30, 2024.
County Attorney has reviewed and approved the amendment and resolution 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 Pacific will review incoming referrals within one business day for urgent cases and three business days for routine cases 100% of the time.
PERFORMANCE MEASURE:
|
Measure |
FY 2023-24 Actual |
FY 2024-25 Estimated |
|
Percentage of the time Pacific reviews incoming referrals within one business day for urgent cases and three business days for routine cases |
100% |
100% |
EQUITY IMPACT:
Pacific’s continued podiatry coverage will positively impact equitable health outcomes because delivery of podiatric services at SMMC, a public safety net hospital, addresses community need. Specifically, in the past 12 months, 68.3% of SMMC’s patients were enrolled in Medi-Cal, with an additional 6.1% of SMMC’s patients enrolled in the “Access to Care For Everyone” program. 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 (56%), Hispanic or Latino (58%), 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. Woo, Pacific’s principal, to meet with SMMC and discuss patient feedback to improve patient satisfaction and remove potential barriers to care.
FISCAL IMPACT:
The term of the amended agreement is December 1, 2021 through November 30, 2024. The amount of the agreement is not to exceed $950,000. The amendment increases the amount payable under the agreement by $100,000, to an amount not to exceed $1,050,000 for the 3-year term. Funds in the amount of $100,000 are included in the SMMC FY 2024-25 Adopted Budget.
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.