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: Agreement with David Martin, MD for Urology Services
RECOMMENDATION:
title
Adopt a resolution authorizing an amendment to the agreement with David Martin, MD for urology services for the term of October 1, 2024 through September 30, 2027 in an amount not to exceed $2,604,636.
body
BACKGROUND:
San Mateo County is responsible for providing necessary medical care to its medically indigent population. Since 2012, Dr. David Martin has provided urology services under contract with the County at San Mateo Medical Center (SMMC) treating disorders of the kidney, urethral tract, and bladder. During this time, Dr. Martin also served as SMMC’s Medical Director of Urology.
DISCUSSION:
Dr. Martin is presently the only urologist providing services at SMMC. Dr. Martin’s contract requires “at least” 240 four-hour urology clinics, between 96 and 200 four-hour blocks of operating room coverage, and 48 weekdays of on-call coverage, and 24 weekends of on-call coverage with additional Medical Director duties assigned.
The present amendment to the agreement would increase Dr. Martin’s outpatient urology clinics from 240 four-hour urology clinics to 288 clinics annually and increase the “not to exceed” amount of the agreement by $187,776 to cover the cost of the increased number of clinics. There are no other changes to any of the remaining terms of the agreement including compensation rate and formula.
The rates in the agreement as amended 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 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).
Since smoking is a known risk for prostate cancer, it is anticipated that all patients aged 18 years and older seen in Urology will be screened for tobacco use and will have cessation counseling documented in the electronic health record, with emphasis on ensuring that no disparities between Black patients and non-Black patients exist regarding tobacco screening and counseling.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Estimated |
FY 2025-26 Projected |
|
Since smoking is a known risk for prostate cancer, all patients aged 18 years and older seen in Urology will be screened for tobacco use and will have cessation counseling documented in the electronic health record, with emphasis on ensuring that no disparities between Black patients and non-Black patients exist regarding tobacco screening and counseling. |
100% |
100% |
EQUITY IMPACT:
Dr. Martin’s continued urology coverage will positively impact equitable health outcomes because delivery of urology services at SMMC, a public safety net hospital, addresses community need. Specifically, 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 (53%), Hispanic or Latino (57%), and primarily Spanish speaking (54%). SMMC specifically tracks physician satisfaction survey results and requires Dr. Martin 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 October 1, 2024 through September 30, 2027. The amount of the agreement is not to exceed $2,604,636 for the three-year term following amendment. Funds in the annual amount of $868,212 are included in the SMMC FY 2024-25 Adopted 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.