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 to the Agreement with Royal Ambulance, Inc. to Provide Non-Emergent Patient Transport Services
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with Royal Ambulance, Inc. to provide non-emergent patient transport services and increase the maximum amount payable by $199,000, to an amount not to exceed $914,000, with no change to the agreement term.
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BACKGROUND:
San Mateo Medical Center (SMMC) often needs non-emergent patient transport service to transfer patients to other facilities for continuity of care, typically for testing and other services that may not be available at SMMC, such as cardiac catheterizations, nuclear med scans, CT scans, dialysis services, and other hospitalization for admissions. Generally, the transport vendor bills the patient’s insurance company for the transportation service and SMMC is the payor of last resort, except in the case of the uninsured and lateral transfers (transfers between hospitals for continuity of care and/or testing).
In August 2021, SMMC completed a Request for Proposals for non-emergent patient transport services. Royal Ambulance, Inc. (Royal) was identified as the superior proposal due to their cost and broad variety of special services offered.
Due to timing, in September 2021, SMMC and Royal entered into a departmental level agreement for the term of November 1, 2021, through October 31, 2024, in an amount not to exceed $200,000. There have been several amendments increasing the agreement’s “not to exceed” amount to $715,000 covering SMMC, Aging and Adult Services, and Behavioral Health and Recovery Services.
DISCUSSION:
Although the work was completed by Royal for the term of this agreement, the “not to exceed amount” pertaining to SMMC’s portion of the agreement with Royal must now be amended in order to pay the remaining invoices outstanding from Royal. This amendment will increase the “not to exceed” amount by $199,000.
This amendment is coming to this Board late due to underestimating the cost of the trips requested from Royal. SMMC identified a breakdown during the reconciliation process for service invoices and have put in place additional steps to reduce future delays.
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 100% of pre-scheduled transports shall arrive within 15 minutes of scheduled pickup time.
PERFORMANCE MEASURE:
|
Measure |
FY 2023-24 Actual |
FY 2024-25 Estimated |
|
Percentage of time that pre-scheduled transports arrive within 15 minutes of scheduled pickup time |
100% |
100% |
EQUITY IMPACT:
Royal’s patient transportation services positively impact equitable health outcomes because transportation 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%).
FISCAL IMPACT:
The term of the amended agreement is November 1, 2021, through October 31, 2024. The amendment increases the amount payable under the agreement by $199,000 to an amount not to exceed $914,000 for the three-year term. Funds in the amount of $199,000 are included in the SMMC FY 2024-25 Adopted 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.