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: Amendment to Vascular Surgery Agreement with Sutter Bay Medical Foundation, a California Nonprofit Public Benefit Corporation dba Palo Alto Medical Foundation for Health Care, Research, and Education (PAMF)
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the vascular surgery agreement with Sutter Bay Medical Foundation, a California Nonprofit Public Benefit Corporation dba Palo Alto Medical Foundation for Health Care, Research, and Education (PAMF), updating the contractor provider list in Exhibit D of the agreement and increasing the “not to exceed” amount of the agreement by $200,000, to an amount not to exceed $1,550,000.
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BACKGROUND:
San Mateo County is responsible for providing necessary medical care to its medically indigent population. This care includes vascular surgery and the management and supervision of the service. PAMF has provided vascular surgery services at San Mateo Medical Center (SMMC) since 2018.
DISCUSSION:
Another vascular surgery provider recently terminated their contract with SMMC. As a result, SMMC needs to amend its existing agreement with PAMF, so that PAMF can provide additional vascular surgery coverage. As a result, the not to exceed amount of the agreement needs to be increased by $200,000 to accommodate this increased demand for patient services over the existing term of the agreement, which is September 1, 2022 through August 31, 2025. Doing so would increase the not to exceed amount from $1,350,000 to $ 1,550,000 over the agreement term with no change in compensation formula or rate. Also, changes in PAMF’s physician staffing necessitate an update of the contractor provider list in Exhibit D.
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 PAMF will continue to meet its existing performance obligations under the amended agreement, with the percentage of surgical site infection rates for vascular surgery remaining below 2.5%.
PERFORMANCE MEASURE:
Measure |
FY 2023-24 Actual |
FY 2024-25 Estimated |
Percentage of surgical site infection rates for vascular surgery |
<2.5% |
<2.5% |
EQUITY IMPACT:
PAMF’s continued vascular surgery coverage positively impacts equitable health outcomes for SMMC’s patients by specifically addressing the surgical needs of the County’s most medically and financially vulnerable patients. 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 PAMF providers 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 presently September 1, 2022 through August 31, 2025. The amount of the agreement is not to exceed $1,550,000 for the 3-year term, which reflects an additional $200,000 to fund services to meet patient need at the existing contract rate without any additional change. Funds for the amendment are budgeted.
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.