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: Fourth Amendment to Agreement with Scott Oesterling MD, Inc. for OB/GYN services
RECOMMENDATION:
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Adopt a resolution authorizing a fourth amendment to the agreement with Scott Oesterling MD, Inc., extending the term of the agreement by two months through May 31, 2025, and increasing the maximum payable amount of the agreement proportionately by $516,522.34 to an amount not to exceed $10,341,305.84.
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BACKGROUND:
On November 16, 2021, the County entered into an agreement with Scott Oesterling MD, Inc. (the Oesterling Group) to provide OB/GYN services to County patients for the term of January 1, 2022 through December 31, 2024. On December 6, 2021, the parties entered into a first amendment to the agreement to update the List of Approved Providers. On April 1, 2022, the parties entered into a second amendment to the agreement which again updated the List of Approved Providers. On December 10, 2024, the parties entered into a third amendment to the agreement which added an assignment of the providers’ right to bill and collect for their professional medical services to the County, extended the term of the agreement by three months through March 31, 2025, increased the monthly fees paid to the group by 3% effective January 1, 2025 through the remainder of the term, from $250,739 per month to $258,261.17 per month, increased the “not to exceed” amount from $9,050,000 to $9,824,783.50 to account for the remaining payments, and finally, updated the List of Approved Providers in the agreement.
DISCUSSION:
This amendment to the agreement with the Oesterling Group will extend the current agreement by two months to a term of January 1, 2022 through May 31, 2025 and increase the agreement’s “not to exceed” amount from $9,824,783.50 to $10,341,305.84, to account for the additional monthly payments. There are no changes in compensation rate or formula. The purpose of the extension is to allow South County Community Health Center, Inc. dba Ravenswood Family Health Network, a California not for profit public benefit corporation, and Lucile Salter Packard Children’s Hospital at Stanford time to review a proposed definitive agreement that integrates care for low-income OB-GYN patients throughout the County.
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 95% of obstetrics and gynecology consults will be seen by a specialist within 30 days of referral.
PERFORMANCE MEASURE:
|
Measure |
FY 2023-24 Actual |
FY 2024-25 Estimated |
|
Percentage of obstetrics and gynecology consults that will be seen by a specialist within 30 days of referral |
95% |
95% |
EQUITY IMPACT:
The Oesterling Group’s continued OB/GYN coverage positively impacts equitable health outcomes for SMMC’s patients by specifically addressing the obstetric and gynecological needs of the County’s most medically and financially vulnerable patients. 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 (53%), Hispanic or Latino (57%), and primarily Spanish speaking (54%). 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 the providers in the Oesterling Group 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 January 1, 2022 through May 31, 2025. The amendment increases the amount payable under the agreement by $516,522.34 to an amount not to exceed $10,341,305.84 for the 40-month term. Funds in the amount of $516,522.34 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.