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 Lousia Lu, MD to Provide Ophthalmology Services
RECOMMENDATION:
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Adopt a resolution authorizing a second amendment to the agreement with Lousia Lu, MD to continue providing expanded ophthalmology services, extend the term of the agreement through June 30, 2028, and increase the not-to-exceed amount of the agreement by $663,920, to an amount not to exceed $958,352.
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BACKGROUND:
The County and Lousia Lu, MD (“Dr. Lu”) originally entered into an agreement for Dr. Lu to provide 52 4-hour ophthalmology clinics annually for the term of February 1, 2026 through January 31, 2027, in an amount not to exceed $250,432. The parties amended the agreement on April 7, 2026, to add 44 4-hour clinics, raising the total coverage to 96 clinics annually and increasing the not-to-exceed amount to $294,432.
DISCUSSION:
This second amendment would further increase Dr. Lu’s clinic coverage from 96 4-hour clinics annually to 156 4-hour clinics, extend the term of the agreement through June 30, 2028, and increase the not-to-exceed amount of the agreement from $294,432 to $958,352 (“Second Amendment”).
The rates in the Second Amendment 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 the Second Amendment 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 diabetic patients evaluated by Dr. Lu will receive retinopathy screening, if due.
PERFORMANCE MEASURE:
|
Measure |
FY 2026-27 Estimated |
FY 2026-27 Projected |
|
Percentage of diabetic patients evaluated by Dr. Lu that will receive retinopathy screening, if due |
100% |
100% |
COMMUNITY IMPACT:
Dr. Lu’s expanded ophthalmology coverage positively impacts equitable health outcomes because delivery of ophthalmology services at San Mateo Medical Center (SMMC), a public safety net hospital, addresses community need. SMMC’s patients span a wide spectrum of races, ethnicities, gender, and gender-identities. Between September 1, 2025 and August 31, 2026, approximately half of SMMC’s patients were male and half were female, with the largest ethnic cohort being Hispanic or Latino (58%) and primarily Spanish-speaking (48%). 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. Lu to meet with SMMC and discuss patient feedback to improve patient satisfaction and remove potential barriers to care.
FISCAL IMPACT:
The term of the proposed Second Amendment is February 1, 2026 through June 30, 2028 and the not-to-exceed amount is $958,352. The total cost of the Second Amendment is $663,920. Of that amount, $398,352 is included in the SMMC FY 2026-2027 Adopted Budget to cover the cost of the amendment between November 1, 2026 and October 31, 2027. The remaining $265,568 will be included in SMMC’s 2027-2028 Recommended Budget to cover the cost of Dr. Lu’s services between November 1, 2027 and June 30, 2028.
The compensation rates offered to Dr. Lu match the rates offered to SMMC’s ophthalmology panelists for the same services.
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.