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 Michael Trindade, MD to Provide Orthopedic Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Michael Trindade, MD to provide orthopedic services for the term of March 1, 2024, through February 28, 2026, for an amount not to exceed $1,167,456.
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BACKGROUND:
Dr. Trindade has been providing orthopedic services to patients at San Mateo Medical Center (SMMC) since August 2011. Dr. Trindade has also provided medical director services, providing leadership as SMMC’s Medical Director for Orthopedics.
DISCUSSION:
The County meets community need for orthopedic services through its contract with Dr. Trindade and other orthopedists. For this proposed agreement renewal, Dr. Trindade will add one four-hour County jail clinic per week to the services he provides to SMMC, which consist of medical director services, on-call coverage, outpatient clinic coverage, operating room coverage, and supplemental coverage.
County Administrative Memorandum B-1 provides that contracts for physicians are exempt from the County’s competitive procurement requirements. However, every physician contract for SMMC is evaluated for reasonableness and to ensure that the services are being provided within fair market value. The rates in the new contract 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 agreement as to form, and believes the contract to be reasonable and within fair market value.
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. Trindade will arrive on time (within 15 minutes of the clinic and surgical start time[s]) 90% of the time and that 85% of patients who complete the Patient Satisfaction Survey would recommend Dr. Trindade as a provider.
PERFORMANCE MEASURE:
|
Measure |
FY 2023-24 Estimated |
FY 2024-25 Projected |
|
Percentage of time Dr. Trindade arrives on time for each surgery and clinic scheduled |
90% |
90% |
|
Percentage of patients who complete the Patient Satisfaction Survey who would recommend Dr. Trindade as a provider |
85% |
85% |
FISCAL IMPACT:
The term of the agreement is March 1, 2024, through February 28, 2026. The amount of the agreement is not to exceed $1,167,456 for the two-year term. Funds in the amount of $194,573 are expected to be included in the SMMC FY 2023-24 Adopted Budget. Funds in the amount of $583,728 are expected to be included in the SMMC FY 2024-25 Recommended Budget. Similar arrangements will be made for future years.
The payment provisions in the agreement increase the cost of Dr. Trindade’s services at SMMC by eight percent (8%) compared to his previous contract. However, Dr. Trindade’s hourly compensation will be exactly the same as the other orthopedists currently providing coverage at SMMC. When the additional jail coverage is considered, the total annual increase in cost is 24% compared to Dr. Trindade’s prior agreement with no jail coverage.
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.