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: Second Amendment to Professional Services Agreement with Bay Area Peninsula Anesthesia Associates, Inc. for Anesthesiology Services
RECOMMENDATION:
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Adopt a resolution authorizing a second amendment to the agreement with Bay Area Peninsula Anesthesia Associates, Inc. to provide anesthesiology services, for the term of March 1, 2023 through February 28, 2026, in an amount not to exceed $6,701,890.
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BACKGROUND:
On February 28, 2023, the County entered into an agreement with Bay Area Peninsula Anesthesia Associates, Inc. (BAPAA) for anesthesia provider coverage to San Mateo Medical Center (SMMC) for the term of March 1, 2023 through February 28, 2026, in an amount not to exceed $6,616,890. On March 14, 2024, the parties amended the agreement that assigned additional Medical Director hours to Dr. Currie Lee, BAPAA’s principal, to provide time to support SMMC’s “Integr8 Health” initiative. That amendment increased the “not to exceed” amount of the agreement by $25,000, to an amount not to exceed $6,641,890.
DISCUSSION:
The instant proposal would further amend the agreement to add new endoscopy coverage services each Friday between the hours of 7:30 a.m. and 3:30 p.m. with that service compensated at BAPAA’s current hourly rate of $257.15. Additional clarifying language is also being added to the agreement following discussion with Dr. Lee and his attorney concerning coverage logistics, communications regarding scheduling, adjustment to the group’s list of providers, and a right to offset to the County for services not provided if payment is made in advance but the coverage schedule is later adjusted in good faith. A $60,000 increase in the “not to exceed” amount is being requested for approval to accommodate the expansion of services over the remaining term of the agreement.
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 there will be 0% of case cancellations by anesthesiologists for pre-existing conditions within one month of the operation date (for surgeries scheduled less than 30 days out, within 24 hours of receiving the chart). It is also anticipated that anesthesiologists shall complete patient evaluation no later than 15 minutes prior to the scheduled start time of the first case and within 30 minutes from the end of the previous case for subsequent cases 100% of the time.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Actual |
FY 2025-26 Estimated |
|
Percentage of case cancellations by anesthesiologists for pre-existing conditions within one month of the operation date (for surgeries scheduled less than 30 days out, within 24 hours of receiving the chart). |
0% |
0% |
|
Percentage of time anesthesiologists will complete patient evaluation no later than 15 minutes prior to the scheduled start time of the first case and within 30 minutes from the end of the previous case for subsequent cases. |
100% |
100% |
COMMUNITY IMPACT:
BAPAA’s continued anesthesiology coverage positively impacts health outcomes because delivery of anesthesia services at SMMC, a public safety net hospital, addresses community need. 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 (52%), Hispanic or Latino (63%), and primarily Spanish-speaking (55%). SMMC strives to eliminate bias in the medical profession by providing 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 BAPAA physicians 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 March 1, 2023 through February 28, 2026. The amount of the amended agreement will not exceed $6,701,890 for the remainder of the three-year term, reflecting a $60,000 increase in the agreement’s “not to exceed” amount. Funds in the amount of $60,000 to cover the expansion of anesthesiology coverage to SMMC’s endoscopy clinic each Friday are included in the SMMC FY 2025-26 Adopted Budget. Similar arrangements will be made for future years.
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.