Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise Rogers, Chief, Health System
Chester J. Kunnappilly, MD, Chief Executive Officer, San Mateo Medical Center
Subject: Agreement with Maureen Dudgeon, MD for Palliative and Hospice Care Services
RECOMMENDATION:
title
Adopt a resolution authorizing an agreement with Maureen Dudgeon, MD for palliative and hospice care services for the term of September 1, 2017 through August 31, 2018, in an amount not to exceed $230,000.
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BACKGROUND:
Palliative care offers pain and symptom management and emotional and spiritual support for patients who face a chronic, debilitating, or life-threatening illness. The palliative care specialist works with the patient, their family, and the care team to help improve quality of life during and after treatment for specific medical concerns. The care services are provided in tandem with life-prolonging therapies.
Since 2015, Dr. Maureen Dudgeon has provided palliative and hospice medical services to the patients of San Mateo Medical Center (SMMC) while also assuming the role of Medical Director.
DISCUSSION:
Dr. Dudgeon will continue to provide palliative and hospice care services at SMMC. However, Dr. Dudgeon will discontinue the role of Medical Director, and assume inpatient and outpatient consulting with patient’s families for advanced care planning and bioethical issues on an “as needed” basis. This agreement is coming to your Board late due to protracted negotiations.
County Administrative Memorandum B-1 provides that contracts for physicians are exempt from the Request for Proposals process.
The agreement and resolution have been reviewed and approved by County Counsel 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).
The agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by providing palliative/hospice care services to County residents. Palliative care supports patients in making thoughtful decisions regarding care for late stage disease. It is anticipated that more than 50% of all palliative/hospice care patients discharged from inpatient service will have “Goals-of-Care” completed by discharge or within seven (7) days of discharge.
PERFORMANCE MEASURE:
|
Measure |
FY 2016-17 Actual |
FY 2017-18 Projected |
|
Percentage of all palliative/hospice care patients discharged from inpatient service will have “Goals-of-Care” completed by discharge or within seven (7) days of discharge |
<20% |
>50% |
FISCAL IMPACT:
The term of the agreement is September 1, 2017 through August 31, 2018. The amount of the agreement is not to exceed $230,000 for the one-year term. Funds in the amount of $191,666 are included in the SMMC FY 2017-18 Approved Recommended Budget. Funds in the amount of $38,334 will be included in the SMMC FY 2018-19 Recommended Budget.
Although the not-to-exceed amount of this agreement is unchanged from the previous agreement, the payment provisions and levels of services in this contract differ in that Dr. Dudgeon will no longer be compensated for the role of Medical Director, and will provide inpatient and outpatient consulting with patients’ families for advanced care planning and bioethical issues on an “as needed” basis.
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 are covered by the County’s General Fund contribution to SMMC, and are within the existing annual appropriation.