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 David Jegge, MD for General Surgery Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with David Jegge, MD to provide general surgery services, for the term of November 1, 2025 through October 31, 2028, in an amount not to exceed $1,295,800.
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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”). Since 2005, Dr. Jegge has provided this service to ensure compliant operation of the hospital and to provide necessary general surgery care to County patients. The proposed agreement would renew Dr. Jegge’s general surgery coverage services for another three years.
DISCUSSION:
There is no change in the amount of coverage Dr. Jegge will provide under the proposed renewed agreement - namely, up to 84 four-hour outpatient general surgery clinics to consult with patients before and after surgery, up to 60 four-hour operating room blocks to provide surgical services, and up to 91 days of 24-hour on-call shifts to respond to emergent patient issues. As discussed in the Fiscal Impact section, below, the only change to Dr. Jegge’s agreement concerns a slight increase in the hourly compensation rate over the new term.
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 80% of patients screened for positive tobacco use will receive cessation counseling.
PERFORMANCE MEASURE:
|
Measure |
FY 2025-26 Estimated |
FY 2026-27 Projected |
|
Percentage of patients screened for positive tobacco use that will receive cessation counseling |
80% |
80% |
COMMUNITY IMPACT:
Dr. Jegge’s continued general surgery coverage will positively impact 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. 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 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. Jegge to meet with SMMC and discuss patient feedback to improve patient satisfaction and remove potential barriers to care.
FISCAL IMPACT:
The term of the agreement is November 1, 2025 through October 31, 2028. The amount of the agreement is not to exceed $1,295,800 for the three-year term. Funds in the amount of $431,934 are included in the SMMC FY 2025-26 Adopted Budget, with the same amount to be included in the recommended and adopted budgets for future contract years.
The total value of the new contract represents a 4% increase compared to that of the previous three-year contract.
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.