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: Second Amendment to Agreement with Esther Chang, MD Regarding the Provision of Ophthalmology Services
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with Esther Chang, MD for ophthalmology services, increasing the amount by $40,000 to an amount not to exceed $475,000, with no changes to the term.
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BACKGROUND:
On July 1, 2021, the County entered into a three-year agreement with Dr. Chang for the provision of ophthalmology services for an amount not to exceed $410,000 (the “Agreement”). During the term of the Agreement, SMMC asked Dr. Chang to staff additional satellite ophthalmology clinics to meet patient needs. SMMC also asked Dr. Chang to provide stop-gap coverage for County patients when a colleague passed away suddenly. As a result, SMMC expects to run out of approved funds to pay Dr. Chang before the Agreement expires on June 30, 2024. To prevent interruption in service, SMMC entered into a First Amendment to the Agreement, increasing the “not to exceed” amount by $25,000.00 (to $ 435,000) as a bridge pending this approval.
DISCUSSION:
SMMC is requesting permission to add an additional $40,000 to Dr. Chang’s Agreement to prevent coverage gaps in the specialty of ophthalmology through June 30, 2024. This would bring the “not to exceed” amount to $475,000 over the term of Dr. Chang’s Agreement. Neither the First nor Second Amendment changed the compensation rate in Dr. Chang’s Agreement. The only change is to the approved “not to exceed amount”.
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 100% of all cataract surgery services provided will adhere to the infection control standards as defined by the Joint Commission and Title XXII of the State of California Code of Regulations, which will result in reduced risk of healthcare-associated infections.
PERFORMANCE MEASURE:
|
Measure |
FY 2022-23 Actual |
FY 2023-24 Estimated |
|
Percentage of all cataract surgery services provided that will adhere to the infection control standards as defined by the Joint Commission and Title XXII of the State of California, Code of Regulations, which will result in reduced risk of healthcare-associated infections |
100% |
100% |
FISCAL IMPACT:
The total increase in the “not to exceed” amount by the First Amendment ($25,000) and the Second Amendment ($40,000) is $65,000. These increases reflect additional coverage and not an increase in compensation rate. The funds are budgeted in the SMMC 2023-2024 Adopted Budget and 2024-2025 Recommended 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.