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 No. One to the Agreement with Melissa Selner, DPM for Podiatry Services
RECOMMENDATION:
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Adopt a resolution authorizing a first amendment to the agreement with Melissa Selner, DPM for podiatry services, extending the term of the agreement by three years through October 31, 2029, and increasing the amount of the agreement by $478,800, to an amount not to exceed $957,600.
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BACKGROUND:
San Mateo County is responsible for providing necessary medical care to its medically indigent population. Since 2008, Dr. Selner has provided podiatry services for San Mateo Medical Center (SMMC). Dr. Selner’s current agreement with the County has a term of November 1, 2023 through October 31, 2026 and a maximum fiscal obligation of $478,800. SMMC’s patient population has a high demand for podiatry services, which treats foot and lower leg injuries, as well as ongoing health issues like diabetes that can affect lower extremities.
DISCUSSION:
The proposed amendment to Dr. Selner’s agreement would extend her agreement by an additional three years, for a full term of November 1, 2023 through October 31, 2029. The terms of the agreement remain the same, with clinical services compensated at an hourly rate of $166.25 per hour, or $665 per 4-hour clinic. Dr. Selner will also continue to provide coverage to 240 4-hour outpatient clinics annually.
The rates in the amended 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.
The 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 85% of patients who complete the Patient Satisfaction Survey would recommend Dr. Selner as a provider.
PERFORMANCE MEASURE:
|
Measure |
FY 2026-27 Estimated |
FY 2026-27 Projected |
|
Percentage of patients who complete the Patient Satisfaction Survey would recommend Dr. Selner as a provider |
85% |
85% |
COMMUNITY IMPACT:
Dr. Selner’s continued podiatry coverage will positively impact equitable health outcomes because delivery of podiatry 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. Between June 1, 2025 and June 30, 2026, half of the patients at SMMC were female and half were male, the largest ethnic cohort was Hispanic or Latino (57%), and a plurality primarily spoke Spanish (47%). 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. Selner 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 is November 1, 2023 through October 31, 2029. The amendment increases the amount payable under the agreement by $478,800 to an amount not to exceed $957,600 for the six-year term. Funds in the amount of $159,600 are included in the SMMC FY 2026-27 Adopted Budget. Funds in the amount of $159,600 are included in the SMMC FY 2027-28 Recommended Budget. Similar arrangements will be made for future years.
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.