Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise Rogers, Chief, Health System
Chester J. Kunnappilly, MD, Chief Executive Officer, San Mateo Medical Center
Subject: Agreement with Bryan Gescuk, MD to Provide Rheumatology Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Bryan Gescuk, MD to provide rheumatology services, for the term of October 1, 2017 through September 30, 2019, in an amount not to exceed $700,000.
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BACKGROUND:
Dr. Bryan Gescuk has provided rheumatology services for the past thirteen years at San Mateo Medical Center (SMMC). Currently, Dr. Gescuk is the only rheumatologist at SMMC.
DISCUSSION:
SMMC is requesting your Board approve an agreement with Dr. Gescuk to continue to provide full-time rheumatology services in the form of 3 to 6 half-day clinic blocks per week, as well as call services. Additionally, Dr. Gescuk will be providing 8 hours of administrative services, including training and leading providers in the Provider Engagement Group. Dr. Gescuk is well-positioned to assume these responsibilities, given his familiarity and experience with SMMC’s patient population administrative functions.
County Administrative Memorandum B-1 provides that contracts for physicians are exempt from the Request for Proposals process.
The agreement and Resolution have been reviewed and approved by County Counsel 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).
The agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by providing rheumatology services to County residents. It is anticipated that patient waiting times for rheumatology services will be less than 10 days.
PERFORMANCE MEASURE:
|
Measure |
FY 2016-17 Actual |
FY 2017-18 Projected |
|
Patient waiting times for rheumatology services |
< two weeks |
< 10 days |
FISCAL IMPACT:
The term of the agreement is October 1, 2017 through September 30, 2019. The amount of the agreement is not to exceed $700,000 for the two-year term. Funds in the amount of $262,500 are included in the SMMC FY 2017-18 Adopted Budget. Funds in the amount of $350,000 will be included in the SMMC FY 2018-19 Recommended Budget.
Despite an increase in the 2017 published rheumatology compensation rate from the Medical Group Management Association, the overall payment provisions are 8% less than the previous agreement due to the provider reducing his administrative services by 7 hours per week.
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 are covered by the County’s General Fund contribution to SMMC, and are within the existing annual appropriation.