Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise Rogers, Chief, Health System
Chester J. Kunnappilly, MD, Chief Executive Officer, San Mateo Medical Center
Subject: Agreement with Maurer Dermatology Associates to Provide Dermatology Services
RECOMMENDATION:
title
Adopt a resolution authorizing an agreement with Maurer Dermatology Associates to provide dermatology services for the term of December 1, 2017, through November 30, 2019, for an amount not to exceed $1,100,000.
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BACKGROUND:
In January 2011, San Mateo Medical Center (SMMC) entered into an agreement with University of California at San Francisco Medical Center (UCSF) under which Dr. Toby Maurer provided teledermatology screening and dermatology clinic services at SMMC. This agreement converted SMMC’s dermatology services from totally in-person services to a combination of in-person and teledermatology, for which Dr. Maurer or another board-certified physician reviews an electronic image of the affected area to diagnose and treat the patient’s condition.
DISCUSSION:
UCSF has declined to continue contracting with the County for this service. However, given the success of this approach, SMMC now seeks to continue receiving dermatology services through a direct contract with Dr. Toby Maurer. The services provided under this new agreement include 24 hours a day/7 days per week teledermatology coverage and two days per week for a dermatology physician in clinic at SMMC. In addition, the contract will provide for five days per week of advanced practitioner coverage at SMMC and other Health System Clinics.
Most skin problems are non-life threatening, and by using teledermatology to transmit an image of the affected area, appropriate treatment can be prescribed for the patient without having the patient return to SMMC on a clinic day. This frees up time on clinic days for the treatment of more serious and/or life-threatening conditions, such as skin cancers.
County Administrative Memorandum B-1 provides that contracts for physicians are exempt from the Request for Proposals process. This agreement is coming to your Board late due to protracted negotiations.
The agreement and resolution have been reviewed and approved by County Counsel 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).
The agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by providing access to dermatology and teledermatology services to County residents. It is anticipated that 100% of all dermatology services provided will adhere to the infection control standards as defined by the Joint Commission and Title XXII of the State of California, Code Regulations, which will result in the reduced risk of healthcare-associated infections.
PERFORMANCE MEASURE:
|
Measure |
FY 2016-17 Actual |
FY 2017-18 Projected |
|
Percent of dermatology services that adhere to infection control standards as defined by Joint Commission, Title XXII, and other applicable standards |
100% |
100% |
FISCAL IMPACT:
The term of the agreement is December 1, 2017 through November 30, 2019. The amount to be paid under the agreement will not exceed $1,100,000 for the two-year term. Funds in the amount of $420,000 are included in the SMMC FY 2017-18 Adopted Budget. Funds in the amount of $550,000 will be included in the SMMC FY 2018-19 Recommended Budget. Similar arrangements will be made for future years.
The not-to-exceed amount for this contract has doubled compared to the previous agreement, as Dr. Maurer will be providing 2 days of clinic dermatology services under the new agreement. (Under the previous agreement, Dr. Maurer provided only 1 day.) Additionally, Dr. Maurer will provide either a Nurse Practitioner or a Physician’s Assistant for 20 hours per week.
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 are covered by the County’s General Fund contribution to SMMC, and are within the existing annual appropriation.