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 General Surgery Agreement with Sutter Bay Medical Foundation, a California nonprofit public benefit corporation dba Palo Alto Medical Foundation for Health Care, Research, and Education to Provide General Surgery Services
RECOMMENDATION:
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Adopt a resolution authorizing a second amendment to the general 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), extending the agreement by three months through March 31, 2025, and increasing the amount of the agreement by $236,967 to an amount not to exceed $3,554,496.
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BACKGROUND:
San Mateo County is responsible for providing necessary medical care to its medically indigent population. This care includes general surgery and the management and supervision of the service. PAMF has provided surgery services at San Mateo Medical Center (SMMC) for the past 16 years.
DISCUSSION:
PAMF requested an extension by this amendment so that it could take until the end of 2024 to collect data prior to commencing negotiations for a renewed agreement. The parties are still in negotiations concerning a renewed agreement. There are no changes in the terms of the agreement other than to extend it until March 31, 2025.
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 surgical site infection rates for general surgery will be less than the higher of (i) 2.5% or (ii) the surgery department average excluding contract providers, 100% of the time.
PERFORMANCE MEASURE:
|
Measure |
FY 2023-24 Actual |
FY 2024-25 Estimated |
|
Percentage of surgical site infection rates for general surgery that will be less than the higher of (i) 2.5% or (ii) the surgery department average excluding Contract providers |
100% |
100% |
EQUITY IMPACT:
PAMF’s continued general 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 July 1, 2021 through December 31, 2024. This amendment will extend the agreement by three months through March 31, 2025. The amount of the agreement is not to exceed $3,554,496 for the three-year, 9-month term, which reflects an additional $236,967 to fund the extension of the agreement at the existing contract rate without any additional change.
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.