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: 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, 2019 through September 30, 2021, in an amount not to exceed $800,000.
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BACKGROUND:
Dr. Bryan Gescuk has provided rheumatology services for the past 15 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 rheumatology services at SMMC, consisting of at least three and up to six half-day clinic blocks per week, as well as call services. Additionally, Dr. Gescuk will be providing up to eight hours of administrative services each week, including training and leading providers in the Provider Engagement Group. Dr. Gescuk is well-positioned to perform these services, given his familiarity and experience with SMMC’s patient population and County 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 wait times for rheumatology services will reduce from taking up to 10 days to up to 7 days from when a patient is referred.
PERFORMANCE MEASURE:
|
Measure |
FY 2018-19 Actual |
FY 2019-20 Projected |
|
Patient wait times for rheumatology services from when a patient a referred |
≤ 10 days |
≤ 7 days |
FISCAL IMPACT:
The term of the agreement is October 1, 2019 through September 30, 2021. The amount to be expended under the agreement is not to exceed $800,000 for the two-year term. Funds in the amount of $300,000 are included in the SMMC FY 2019-20 Recommended Budget. Funds in the amount of $400,000 will be included in the SMMC FY 2020-21 Recommended Budget.
The contract’s payment provisions differ from the previous contract. Specifically, there is a 7% increase in compensation per year, due to increased rates published in the 2018 Medical Group Management Association Provider Compensation and Production Report, a tool SMMC uses to benchmark physician contract compensation.
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.