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 Marta Banh, OD to Provide Optometry Services
RECOMMENDATION:
title
Adopt a resolution authorizing an agreement with Marta Banh, OD to provide optometry services, for the term of November 1, 2025 through October 31, 2026, in an amount not to exceed $223,608.
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BACKGROUND:
San Mateo County provides necessary medical care to medically and financially vulnerable patients, including optometry services. Among the optometrists who provide care to the County is Dr. Banh, who has done so since 2013. Providing eye care to County patients is important to ensure that basic eye care is afforded to people who otherwise might not have access to it.
DISCUSSION:
Under the previous agreement for optometry coverage, Dr. Banh agreed to provide at least 264 four-hour optometry clinics and to provide medical leadership as the Medical Director for Optometry at San Mateo Medical Center. She also previously agreed to receive and review diabetic camera images of patients’ eyes from the County’s primary care providers and respond to consultations regarding the possible presence of diabetic retinopathy. Under that agreement, Dr. Banh was paid at the equivalent of a .55 FTE until it was amended to increase her hours and compensation to that of a .60 FTE. Under the proposed agreement, Dr. Banh would provide up to 360 four-hour optometry clinics, will continue to provide diabetic retinopathy consultations to primary care doctors, and will also continue to serve as the Medical Director of Optometry at SMMC. Converted to a “full time equivalent” - Dr. Banh would approximate a .86 FTE excluding time spent responding to diabetic retinopathy consults. Roughly, Dr. Banh is expected to provide approximately 33% more hours of total patient care and administrative service compared to her prior agreement.
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 100% of Dr. Bahn’s diabetic patients will have retinopathy screening documented in their electronic health record.
PERFORMANCE MEASURE:
|
Measure |
FY 2025-26 Estimated |
FY 2025-26 Projected |
|
Percentage of Dr. Bahn’s diabetic patients that have retinopathy screening documented in their electronic health record |
100% |
100% |
COMMUNITY IMPACT:
Dr. Banh’s continued optometry coverage will positively impact health outcomes because delivery of optometry 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. 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. Banh 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 November 1, 2025 through October 31, 2026. The amount of the agreement is not to exceed $223,608 for the one-year term. Funds in the amount of $149,072 are included in the SMMC FY 2025-26 Adopted Budget. Funds in the amount of $74,536 are included in the SMMC FY 2026-27 Recommended Budget.
If Dr. Banh previously worked the same number of hours that she’s willing to work under the proposed agreement, mathematically the annual payment under the prior contract would have been $213,541. The proposed contract therefore represents a 4% increase in compensation per hour worked.
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.