Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Chester J. Kunnappilly, MD, Chief Executive Officer, San Mateo Medical Center
Subject: Agreement with David Martin, MD to Provide Urology Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with David Martin, MD to provide urology services for the term of October 1, 2024 through September 30, 2027, in an amount not to exceed $2,416,860.
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BACKGROUND:
San Mateo County is responsible for providing necessary medical care to its medically indigent population. Since 2012, Dr. David Martin has provided urology services under contract with the County at San Mateo Medical Center (SMMC), treating disorders of the kidney, urethral tract, and bladder. During this time, Dr. Martin also served as SMMC Medical Director of Urology.
DISCUSSION:
Dr. Martin is presently the only urologist providing services at SMMC. Dr. Martin’s previous contract required at least 240 four-hour urology clinics, between 96 and 200 four-hour blocks of operating room coverage, and 48 weekdays of on-call coverage, and 24 weekends of on-call coverage with additional Medical Director duties assigned.
The present agreement would require the same 240 four-hour urology clinics, 96 four-hour operating room blocks, an increase in on-call coverage to 240 weekdays and 2 weekends per month, an increase of 288 hours per year of supplemental clinical services, and 5 hours per month for Medical Director services.
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.
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 since smoking is a known risk for prostate cancer, all Urology patients aged 18 years and older will be screened for tobacco use and will have cessation counseling documented in the electronic health record, with emphasis on ensuring that no disparities between Black patients and non-Black patients exist regarding tobacco screening and counseling.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Estimated |
FY 2025-26 Projected |
|
Since smoking is a known risk for prostate cancer, all Urology patients aged 18 years and older will be screened for tobacco use and will have cessation counseling documented in the electronic health record, with emphasis on ensuring that no disparities between Black patients and non-Black patients exist regarding tobacco screening and counseling |
100% |
100% |
EQUITY IMPACT:
Dr. Martin’s continued urology coverage will positively impact equitable health outcomes because delivery of urology services at SMMC, a public safety net hospital, addresses community need. Specifically, between May 2023 and May 2024, 68.3% of SMMC’s patients were enrolled in Medi-Cal with an additional 6.1% of SMMC’s patients enrolled in the “Access to Care For Everyone” (ACE) program. 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 (56%), Hispanic or Latino (58%), and primarily Spanish speaking (55%). SMMC strives to eliminate bias in the medical profession by providing culturally 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 Dr. Martin 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 October 1, 2024 through September 30, 2027. The amount of the agreement is not to exceed $2,416,860 for the 3-year term. Funds in the amount of $805,620 are included in the SMMC FY 2024-25 Adopted Budget. Funds in the amount of $805,620 are included in the SMMC FY 2025-26 Recommended Budget. Similar arrangements will be made for future years.
The payment provisions and levels of services in this contract differ from that of the previous contract, due to an increase in the amount of on-call coverage provided by the vendor. The total value of the new contract represents a 7% increase compared to that of the previous 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.