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 Maurer Dermatology Associates to Provide Dermatology Services
RECOMMENDATION:
title
Adopt a resolution authorizing an amendment to the agreement with Maurer Dermatology Associates to provide dermatology services, extending the term by four months through March 31, 2026, in an amount not to exceed $1,829,000.
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BACKGROUND:
In January 2011, San Mateo Medical Center (SMMC) entered into an agreement with the University of California at San Francisco Medical Center (UCSF), under which Dr. Toby Maurer (who was at that time affiliated with UCSF) provided teledermatology screening and dermatology clinic services at SMMC.
In October 2017, Maurer Dermatology Associates (Maurer) and the County entered into an agreement under which Dr. Maurer and her associates provided a range of professional medical dermatology services to the County’s patients, including teledermatology screenings, dermatology clinics, on-call coverage, and the performance of dermatological biopsies.
Effective December 1, 2022, the County entered into a dermatology services agreement in an amount not to exceed $1,629,000 which simplified coverage, eliminated mid-level services, and included biopsy services.
DISCUSSION:
The proposed amendment to the agreement between the County and Maurer seeks to extend the term of the existing agreement by four months, for a term of December 1, 2022, through March 31, 2026. A request is also hereby made to increase the “not to exceed” amount of the agreement by $200,000 to an amount “not to exceed” $1,829,000 over the term of the amended agreement. There is no other change to the agreement. The purpose of the amendment is to create a bridge for the transition of teledermatology (consisting entirely of remote physician-to-physician consultation) services to a new “e-consult” platform integrated with Epic across multiple medical specialties under sub-license from Stanford Healthcare. The parties anticipate that it may take several months for the new “e-consult” platform to go live and in the interests of maintaining the status quo until that occurs, Dr. Maurer is willing to extend the contract on its existing terms. At this time the parties anticipate that once the new “e-consult” platform goes live, Maurer may cease to provide dermatology coverage to the County’s clinics.
The County Attorney has reviewed and approved the resolution and amended 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 there will be 100% adherence to the standard that telephone encounters (TE) and laboratory results must be addressed by responding to the referring physician within 72 hours, and no more than 10 laboratory results and TEs will fail to be addressed within 72 hours in any quarterly period within the calendar year.
PERFORMANCE MEASURE:
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Measure |
FY 2025-26 Estimated |
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TE and laboratory results must be addressed by responding to the referring physician within 72 hours and no more than 10 laboratory results and TE’s will fail to be addressed within 72 hours in any quarterly period within the calendar year. |
100% Adherence to Standard |
COMMUNITY IMPACT:
Maurer’s continued dermatology coverage will positively impact health outcomes because delivery of dermatology 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%). 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 Maurer to meet with SMMC and discuss patient feedback to improve patient satisfaction and remove potential barriers to care.
FISCAL IMPACT:
The term of the amended agreement adds an additional $200,000 for the four-month extension period of December 1, 2025, through March 31, 2026. The amount of the agreement is not to exceed $1,829,000 for the three-year term. Additional funds in the amount of $200,000 are included in the SMMC FY 2025-26 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.