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: Agreement with Jennifer Burkham, MD to Provide Rheumatology Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Jennifer Burkham, MD to provide rheumatology services for the term of February 1, 2026 through January 31, 2029 in an amount not to exceed $539,928.
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BACKGROUND:
Effective February 1, 2025, Dr. Burkham entered into a one-year contract with the County to provide rheumatology services. The proposed contract would continue Dr. Burkham’s coverage without any change in quantity of coverage for a renewed three-year term.
DISCUSSION:
Dr. Burkham provides up to 104 four-hour blocks of outpatient rheumatology patient care per year. She rarely provides on-call coverage, but her contract provides flexibility to schedule her for up to 15 shifts per month if needed. Two hundred eight hours of supplemental clinical services time annually is also written into her contract to provide extra time for patient care and to finish documentation if her clinic time is insufficient. Dr. Burkham’s previous contract compensated her at a rate of $188 per hour for clinical time and $20 per hour for on-call coverage. The rates in the proposed agreement would increase Dr. Burkham’s hourly compensation to $199 per hour for clinical time and $31 per hour for on-call coverage. The proposed rates match the amounts in the County’s contracts with the other contracted rheumatology specialists, Drs. Gescuk and Myneni.
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.
The 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 that less than 5% of patients (18 years or older) seen by rheumatology will have concurrent prescription for an opioid and benzodiazepine for 30 or more consecutive days (excluding patients in hospice or with cancer).
PERFORMANCE MEASURE:
|
Measure |
FY 2025-26 Estimated |
FY 2026-27 Projected |
|
Percentage of patients (18 years or older) seen by rheumatology that will have concurrent prescription for an opioid and benzodiazepine for 30 or more consecutive days (excluding patients in hospice or with cancer) |
<5% |
<5% |
COMMUNITY IMPACT:
Dr. Burkham’s rheumatology coverage positively impacts health outcomes by meeting community need for the management of chronic painful conditions affecting joints, muscles, and connective tissues. 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 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. Burkham 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 February 1, 2026 through January 31, 2029. The amount of the agreement is not to exceed $539,928 for the three-year term. Funds in the amount of $179,976 will be included in the SMMC FY 2026-27 Recommended Budget with the same accruals budgeted for subsequent contract years.
Although the proposed contract would increase Dr. Burkham’s hourly compensation by 5% for clinical service time and 55% for on-call coverage - as previously noted, the new proposed rates would align with the compensation paid to the County’s other rheumatologists.
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.