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: Agreement with Crystal Chen, OD to Provide Optometry Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Crystal Chen, OD to provide optometry services for the term of November 1, 2026 through October 31, 2029, in an amount not to exceed $677,520.
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BACKGROUND:
San Mateo County provides necessary medical care to medically and financially vulnerable patients, including optometry services. Among the optometrists who provide care to the County is Dr. Chen, who has done so since 2011. Providing eye care to County patients is important to ensure that basic eye care is afforded to people who otherwise might not have access to it.
DISCUSSION:
Under the previous one-year agreement for optometry coverage, Dr. Chen agreed to provide up to 345 4-hour optometry clinics. She also agreed to receive and review diabetic camera images of patients’ eyes from the County’s primary care providers and respond to consultations regarding the possible presence of diabetic retinopathy. Under the previous agreement, Dr. Chen was compensated at a rate of $121 per hour for clinic coverage and $85 per hour for supplemental diabetic retinopathy reads and interpretations consulted by the County’s primary care physicians. The proposed agreement would broaden Dr. Chen’s annual clinic coverage to 432 4-hour optometry blocks, expand the term of the agreement to three years, and increase the hourly rate for Dr. Chen’s clinic coverage to $125 per hour in agreement year 1, $129 per hour in agreement year 2, and $131 per hour in agreement year 3.
The rates in the new contract 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 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 100% of Dr. Chen’s diabetic patients will have retinopathy screening documented in the electronic health record.
PERFORMANCE MEASURE:
|
Measure |
FY 2026-27 Estimated |
FY 2027-28 Projected |
|
Percentage of Dr. Chen’s diabetic patients that have retinopathy screening documented in the electronic health record |
100% |
100% |
COMMUNITY IMPACT:
Dr. Chen’s continued optometry coverage will positively impact equitable health outcomes because delivery of optometry services at San Mateo Medical Center, a public safety net hospital, addresses community need. SMMC’s patients span a wide spectrum of races, ethnicities, gender, and gender-identities. Since November 1, 2024, half of the specialty care patients at SMMC were female, half were male, 58% were Hispanic or Latino, and 48% were primarily Spanish-speaking. 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. Chen to meet with SMMC to discuss patient feedback to improve patient satisfaction and remove potential barriers to care.
FISCAL IMPACT:
The term of the agreement is November 1, 2026 through October 31, 2029. The amount of the agreement is not to exceed $677,520 for the three-year term. Funds in the amount of $220,080 are included in SMMC’s FY 2026-2027 adopted budget. Funds in the amount of $226,992 will be included in SMMC’s FY 2027-2028 recommended budget. Similar arrangements are made for future years. Dr. Chen’s compensation will increase by 2% in the first agreement year, 3% in the second agreement year, and 1.5% in the third agreement year.
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.