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
Michael del Rosario, Director of Correctional Health Services
Subject: Agreement with Total Renal Care, Inc. to Provide Acute Care Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Clinical Apheresis Services
RECOMMENDATION:
title
Adopt a resolution authorizing an agreement with Total Renal Care, Inc. to provide acute care dialysis, continuous ambulatory peritoneal dialysis, and clinical apheresis services for the term of September 1, 2025 through August 31, 2028, in an amount not to exceed $3,120,000.
body
BACKGROUND:
San Mateo County is responsible for providing medical care to its medically indigent adult population, including acute inpatient dialysis treatment for kidney disease at San Mateo Medical Center (SMMC). Total Renal Care provides specialized staff and equipment to meet patient need for dialysis care. A Request for Proposals for acute care dialysis, continuous ambulatory peritoneal dialysis, and clinical apheresis services was completed in February of 2025.
DISCUSSION:
Total Renal Care, Inc. (Total Renal) was elevated due to their price, quality, and ability to provide a local team to provide specialized services that the County’s healthcare workforce does not provide. They have also been providing dialysis services to SMMC since 1999. Under the proposed agreement, Total Renal would also extend dialysis services to another County Health division, Correctional Health Services (CHS).
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 for at least 95% of hemodialysis treatments, education was provided to the patient and/or family and documented, or education was documented as not appropriate for that treatment.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Estimated |
FY 2025-26 Projected |
|
Percentage of hemodialysis treatments where education was provided to the patient and/or family and documented, or education was documented as not appropriate for that treatment |
≥ 95% |
≥ 95% |
COMMUNITY IMPACT:
Total Renal’s continued dialysis services will positively impact health outcomes by ensuring access to care at San Mateo Medical Center (SMMC), a public safety net hospital that serves a diverse community. SMMC serves a diverse patient population with varying cultural backgrounds, languages, and personal identities. Over the past 18 months, the largest cohorts of specialty care patients at SMMC were female (52%), Hispanic or Latino (63%), and primarily Spanish-speaking (55%). Providing dialysis services at SMMC helps ensure that all patients can access life-saving care.
FISCAL IMPACT:
The term of the agreement is September 1, 2025 through August 31, 2028. The amount of the agreement is not to exceed $3,120,000 for the three-year term. Funds in the amount of $916,667 are included in the SMMC FY 2024-25 Adopted Budget. Funds in the amount of $36,667 are included in the CHS FY 2024-25 Adopted Budget. Funds in the amount of $1,000,000 will be included in the SMMC FY 2025-26 Recommended Budget. Funds in the amount of $40,000 are included in the CHS FY 2025-26 Recommended Budget.
The payment provisions and levels of services in this contract differ from those of the previous contract due to pricing increases for services, as well as an expanded scope. The total value of the new contract represents a 4% increase compared to that of the previous contract due to the increase in pricing and the inclusion of the CHS division.
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.
ATTACHMENT:
RFP Matrix