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 Sutter Bay Medical Foundation dba Palo Alto Medical Foundation for Healthcare, Research and Education for General Surgery Services
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with Sutter Bay Medical Foundation dba Palo Alto Medical Foundation for healthcare, research and education for general surgery services, revising the list of contract providers, extending the term by one year to June 30, 2021, and increasing the amount payable thereunder by $1,025,000 to an amount not to exceed $3,075,000.
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BACKGROUND:
San Mateo County is responsible for providing necessary medical care to its medically indigent population. This care includes general surgery, as well as the management and supervision of this service. The Sutter Bay Medical Foundation dba Palo Alto Medical Foundation (PAMF) for healthcare, research and education for surgery group has provided surgery services at San Mateo Medical Center (SMMC) for the past twelve years. Parties entered into a new agreement on June 5, 2018 for the term of July 1, 2018 to June 30, 2020, in an amount not to exceed $2,050,000.
DISCUSSION:
PAMF will continue to provide general surgery services at SMMC through services of doctors familiar with SMMC and its patients. General surgery services are provided under the general direction of the Chief of Surgery and the Chief Medical Officer. Monitoring and evaluation of the quality of services provided by PAMF are accomplished through peer review by the Quality Assurance Committee and the Medical Staff Executive Committee. The level of compensation and related work is based on regional benchmarks for general surgery services.
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).
It is anticipated that general surgery will meet the following performance measures 100% of the time: a Time Out performed prior to surgery and at the end of surgery; a plan of action communicated to the Patient Services Assistant (PSA) and nurse practitioner when a provider is more than 30 minutes late for the state of clinic; documentation completed within 72 hours for each patient with no more than 10 delinquent charts made per month; compliance with SMMC recorded on the Electronic Health Record (EHR); and surgical site infection rates at less than 2.5% of the surgery department average.
PERFORMANCE MEASURE:
|
Measure |
FY 2019-20 Actual |
FY 2020-21 Projected |
|
Percentage of time a Time Out is performed prior to surgery and at the end of surgery |
95% |
100% |
|
Percentage of time a plan of action is communicated to the PSA and nurse practitioner when a provider is more than 30 minutes late for the state of clinic |
95% |
100% |
|
Percentage of time documentation is completed within 72 hours for each patient with no more than 10 delinquent charts per month |
95% |
100% |
|
Percentage of time PAMF is compliant with SMMC EHR |
90% |
100% |
|
Percentage of time surgical site infection rates are less than 2.5% of the surgery department average |
100% |
100% |
FISCAL IMPACT:
The term of the amended agreement is July 1, 2018 through June 30, 2021. This amendment extends the agreement by one year and increases the amount payable by $1,025,000, to an amount not to exceed $3,075,000. Funds in the amount of $1,025,000 will be included in the SMMC FY 2020-21 Recommended Budget.
The payment provisions will remain the same as listed in the existing agreement.
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.