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: Amendment to the Agreement with Ronald Greenwald, MD to Provide Neurosurgery Services
RECOMMENDATION:
title
Adopt a resolution authorizing an amendment to the agreement with Ronald Greenwald, MD to provide neurosurgery services, increasing the amount by $175,000 to an amount not to exceed $850,000.
body
BACKGROUND:
Neurosurgery services are provided under the general direction of the Chief of Surgery at San Mateo Medical Center (SMMC) and include evaluation and treatment of the brain, spinal cord, and peripheral nervous system disease. Neurosurgery services may be provided for brain cancer, brain aneurysms, spinal cord and nerve root impingement syndromes (ruptured/herniated discs), and peripheral nerve impingement syndromes (carpel tunnel). Dr. Greenwald has been providing professional neurosurgery services at SMMC since 1991.
DISCUSSION:
Compared to the estimates on which the initial agreement was based, Dr. Greenwald has provided significantly more inpatient and emergency department consultation and emergency surgical services while on call. As a result, additional funds are needed to pay for Dr. Greenwald’s services through the end of the term of the agreement.
The amendment and resolution have been reviewed and approved by County Counsel as to form.
The amendment contributes to the Shared Vision 2025 outcome of a Healthy Community by providing patient access to the evaluation and treatment of diseases requiring neurosurgery. It is anticipated that the rate of readmission due to surgical site infection is less than 5 percent.
PERFORMANCE MEASURE:
Measure |
FY 2017-18 Actual |
FY 2018-19 Projected |
Rate of readmission due to surgical site infection |
< 5% |
< 5% |
FISCAL IMPACT:
The term of the agreement is July 1, 2017 through June 30, 2019. The amount of the agreement is not to exceed $675,000. This amendment increases the contract amount by $175,000. Funds in the amount of $337,500 are included in the SMMC FY 2018-19 Adopted Budget.
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.