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: Amendment One to the Agreement with Sanford E. Roberts III, MD, Professional Corporation, a California Professional Corporation for General Surgery Services
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with Sanford E. Roberts III, MD, Professional Corporation, a California professional corporation, to provide general surgery services for the term of December 1, 2025 through December 31, 2028, increasing the not-to-exceed amount by $1,584,550, for a new amount not-to-exceed $2,284,410.
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BACKGROUND:
General surgery physician coverage is required by the State of California to operate San Mateo Medical Center (SMMC) under “Title 22” general acute care hospital licensing requirements (see 22 Cal. Code Regs. § 70225 “Surgical Services Staff”).
Sanford E. Roberts III, MD (“Dr. Roberts”) filled a gap in coverage when Palo Alto Medical Foundation ceased general surgery services at SMMC effective January 1, 2026. That same month, Dr. Roberts requested, and SMMC consented to, assignment and assumption of his agreement by his professional corporation, Sanford E. Roberts III, MD, Professional Corporation. The assigned agreement provided that Dr. Roberts would cover up to 72 4-hour outpatient general surgery clinics to consult with patients before and after surgery, up to 158 4-hour operating room blocks to provide surgical services, and up to 140 days of 24-hour on-call shifts to respond to emergent patient issues. Under the agreement, Dr. Roberts is compensated via his professional corporation at a rate of $409 per hour for clinical services and $54 per hour unrestricted for on-call coverage.
DISCUSSION:
The proposed (“Amendment”) expands Dr. Roberts’ coverage of general surgical services at SMMC. Under the Amendment, effective November 1, 2026, through his professional corporation, Dr. Roberts will provide up to 80 4-hour outpatient general surgery clinics to consult with patients before and after surgery, up to 169 4-hour operating room blocks to provide surgical services, up to 140 days of 24-hour on-call shifts to respond to emergent patient issues, up to 300 hours of supplemental clinical services annually, and up to 10 hours per month of Medical Director services in the specialty of general surgery. The compensation terms and formula remain unchanged. Medical Director and supplemental clinical services will also be compensated at a rate of $409 per hour. The Amendment additionally extends the term of the agreement through December 31, 2028, and increases the not-to-exceed amount by $1,584,550 to $2,284,410.
The rates in the 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 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 surgical site infection rates for general surgery will be less than 1.6%.
PERFORMANCE MEASURE:
|
Measure |
FY 2025-26 Actual |
FY 2026-2027 Estimated |
|
Surgical site infection rates for general surgery |
2.9% |
<1.6% |
COMMUNITY IMPACT:
Dr. Roberts’s general surgery coverage will positively impact equitable health outcomes because delivery of general surgery services at SMMC, a public safety net hospital, addresses community need and is legally required by the State of California to maintain SMMC’s general acute care hospital license. SMMC’s patients span a wide spectrum of races, ethnicities, gender, and gender-identities. Between September 1, 2025 and August 31, 2026, half of the patients at SMMC were female and half were male, with the largest ethnic cohort being Hispanic or Latino (58%), and a plurality being 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. Roberts to meet with SMMC and discuss patient feedback to improve patient satisfaction and remove potential barriers to care.
FISCAL IMPACT:
The term of the Amendment is December 1, 2025 through December 31, 2028, and increases the not-to-exceed amount by $1,584,550. Funds in the amount of $731,331 are included in the SMMC FY 2026-27 Adopted Budget. Funds in the amount of $853,219 will be included in the SMMC FY 2027-28 Recommended 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.