Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Nancy Lapolla, MPH, Director, Emergency Medical Services
Subject: Amendment to the Agreement with Stanford Health Care for an EMS Medical Director
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with Stanford Health Care to provide a Medical Director to the Emergency Medical Services division, extending the term of the agreement to June 30, 202, and increasing the amount by $270,400, to an amount not to exceed $638,400.
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BACKGROUND:
California law requires that each local Emergency Medical Services (EMS) agency have a Medical Director who is a physician and specifies that the service may be provided by contract. In collaboration with the Director of EMS, the EMS Medical Director (Medical Director) helps provide oversight and coordination of the countywide EMS system, which includes 911 emergency medical dispatch, fire paramedic first response, and emergency paramedic ground and air ambulance transport services. In addition, the Medical Director is responsible for creating medical treatment protocols, developing medical policies, and conducting medical research, in addition to other duties.
Since March 1, 2013, Dr. Gregory Gilbert has served as the Medical Director.
In December 2015, to update the Medical Director scope of work and ensure a competitive process for the position, a request for letters of interest was sent to the EMS Medical Directors Association of California and emergency physician stakeholder groups within San Mateo County. As a result of that process, EMS conducted panel interviews with interested candidates and in March 2016, Dr. Gilbert was selected to continue in the Medical Director role.
Dr. Gilbert is an employee of Stanford Health Care and, therefore, the County has contracted with Stanford Health Care for the time that Dr. Gilbert serves as the Medical Director.
On June 21, 2016, your Board approved an agreement with Stanford Health Care to provide a Medical Director in an amount not to exceed $108,000 for a term ending on June 30, 2017.
On June 27, 2017, your Board authorized an amendment to the agreement to increase the amount by $260,000, to an amount not to exceed $368,000, and to extend the contract term to June 30, 2019. Additionally, this amendment updated the scope of work to allow the EMS Medical Director to function as a DEA physician registrant to align with local EMS systems best practices in California.
DISCUSSION:
San Mateo County Health is requesting an amendment to the existing agreement to: (1) extend the term to June 30, 2021, and (2) allow for a four-percent salary increase. The extension will allow Dr. Gilbert to continue work in several key areas, including an evidence-based update of the EMS clinical field treatment protocols and ongoing projects related to EMS system performance and oversight. The latter efforts are critical to the transition to the new Emergency Ambulance Services with Advanced Life Support Ambulance Transport and the San Mateo County Pre-Hospital Emergency Medical Services Group (JPA) 9-1-1 system contracts, as well as the ongoing delivery of high quality care.
The resolution contains the County’s standard provision allowing amendment of County’s fiscal obligation by a maximum of $25,000 (in aggregate).
County Contract Compliance has approved a waiver on the three-year-term limit, to allow for a five-year-term agreement.
The amendment and resolution have been reviewed and approved by County Counsel as to form.
This amendment to the agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by providing quality oversight and emergency medical care to the residents of San Mateo County through the 911 System and emergency preparedness activities. It is anticipated that the Medical Director will attend or facilitate 27 clinical quality improvement activities.
PERFORMANCE MEASURE:
|
Measure |
FY 2018-19 Actual |
FY 2019-20 Projected |
|
Number of clinical quality improvement activities attended and/or facilitated by Medical Director |
25 |
27 |
FISCAL IMPACT:
The term of the amended agreement is July 1, 2016 through June 30, 2021. The amount of the agreement is not to exceed $638,400 for the five-year-term. This amendment increases the contract amount by $270,400. This amount has been included in the EMS FY 2019-20 and FY 2020-21 Recommended Budgets. This agreement is 100% funded by Maddy funds, with no associated Net County Cost.