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: Agreement with Remedy Medical Group to Provide Pain Management Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Remedy Medical Group to provide pain management medicine services for the term of December 1, 2022 through November 30, 2024, in an amount not to exceed $404,152.
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BACKGROUND:
San Mateo County is responsible for providing necessary medical care to its medically indigent population, as well as access to services to its general population. Dr. Elaine S. Date, and at various times through her affiliated group practice, Remedy Medical Group, has provided pain management services at San Mateo Medical Center (SMMC) since 2008.
DISCUSSION:
The County has continuing need for pain management services. On behalf of Remedy Medical Group, Dr. Date will continue to provide these services at SMMC and affiliated offsite county clinic locations. Dr. Date’s services include providing patient management services, physician supervision at clinic for behavioral and psychological assessment, medical assessment, and interventional medication management. The proposed agreement continues to leverage Dr. Date’s expertise to provide a balanced approach to treating patients’ pain symptoms.
County Administrative Memorandum B-1 provides that contracts for physicians are exempt from the Request for Proposals process.
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 Dr. Date will arrive on-time, within 15 minutes of the start time, to each clinic 90% of the time, and 70% of patients who complete the Patient Satisfaction Survey would recommend Dr. Date as a provider.
PERFORMANCE MEASURE:
|
Measure |
FY 2022-23 Estimated |
FY 2023-24 Projected |
|
Percentage of time Dr. Date arrives on time for each clinic scheduled Percentage of patients who complete the Patient Satisfaction Survey that recommend Dr. Date as a provider |
90% 70% |
90% 70% |
FISCAL IMPACT:
The term of the agreement is December 1, 2022 through November 30, 2024. The amount of the agreement is not to exceed $404,152 for the two-year term. Funds in the amount of $117,878 are included in the SMMC FY 2022-23 Adopted Budget. Funds in the amount of $202,076 are included in the SMMC FY 2023-24 Recommended Budget.
The total value of the new contract represents a 49% increase compared to that of the previous contract due to changes in Dr. Date’s on-call services. The new contract increases the “per diem” on-call coverage stipend from $300 to $500, a 66% increase. This “per diem” rate for on-call coverage is 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. Additionally, Dr. Date’s on-call and clinical coverage rates match those of her SMMC peers who are in the same service line with similar expertise and quality of care.
The number of Dr. Date’s scheduled on-call days is conservatively estimated at the maximum possible quantity permitted under the contract. Including this conservative estimate in this contract builds a measure of assurance that if there are exigent circumstances due to illness or a public health event, there will be additional authorized capacity for coverage.
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.