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: Amendment to the Agreement with Ronald Greenwald, MD for Neurosurgery Services
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with Ronald Greenwald, MD for neurosurgery services, extending the term by three months from August 1, 2022 through July 31, 2025 to the term August 1, 2022 through October 31, 2025, and increasing the not-to-exceed amount by $150,000 to an amount not to exceed $1,800,718.
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BACKGROUND:
Dr. Greenwald has provided neurosurgery services since 1991 at San Mateo Medical Center (SMMC). On August 2, 2022, the County entered into its most recent contract with Dr. Greenwald to provide those services in an amount not to exceed $1,650,718.
DISCUSSION:
Under this amendment, Dr. Greenwald has agreed to continue to provide neurosurgery services for an additional three months to allow for additional time to negotiate a new agreement.
County Administrative Memorandum B-1 provides that contracts for physicians are exempt from the Request for Proposals process.
The rates in Dr. Greenwald’s agreement 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 amendment to the 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 Dr. Greenwald will see inpatient post-ops in person within 24 hours 100% of the time, except for 23-hour observation patients.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Estimated |
FY 2025-26 Projected |
|
Percentage of time Contractor will see inpatient post-ops in person within 24 hours, except for 23-hour observation patients. |
100% |
100% |
COMMUNITY IMPACT:
Dr. Greenwald’s continued neurosurgery coverage will support improved health outcomes by ensuring the delivery of essential services at San Mateo Medical Center (SMMC), the County’s public safety net hospital. SMMC serves a diverse patient population that includes a broad range of races, ethnicities, genders, and gender identities. Over the past 18 months, the largest cohorts of specialty care patients were female (52%), Hispanic or Latino (63%), and primarily Spanish-speaking (55%).
SMMC is committed to reducing bias in healthcare by providing culturally competent training to its physicians and conducting follow-up with patients to help maintain access to specialty care. The Medical Center tracks physician satisfaction survey results and requires Dr. Greenwald to meet with leadership to review patient feedback and identify ways to enhance the patient experience and address potential barriers to care.
FISCAL IMPACT:
The term of the amended agreement is August 1, 2022 through October 31, 2025. The amount of the amended agreement is not to exceed $1,800,718. The amendment increases the contract amount by $150,000. Funds in the amount of $150,000 are included in the SMMC FY 2024-25 Adopted and FY 2025-26 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.