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 Vijay Pottathil, MD for Gastroenterology Services
RECOMMENDATION:
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Adopt a resolution authorizing an amendment to the agreement with Vijay Pottathil, MD, increasing the maximum amount of the agreement by $105,000, to an amount not to exceed $2,105,000 with no change to the agreement term.
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BACKGROUND:
The County entered into an agreement with Vijay Pottahil, MD for gastroenterology services for the term of February 1, 2020, through January 31, 2023, in an amount not to exceed $2,000,000.
In August 2022 San Mateo Medical Center (SMMC) requested Dr. Pottathil to provide more gastroenterology coverage under the existing agreement, in response to the sudden departure of another gastroenterologist. The request was necessary to avoid gaps in gastroenterologist coverage and delay in patient care.
DISCUSSION:
In late January 2023, SMMC Accounting indicated there was not enough authorized funds to pay Dr. Pottahil’s anticipated December 2022 and January 2023 invoices. Because of the increase in coverage provided by Dr. Pottathil, it is anticipated that the not to exceed amount under the agreement must be increased by $105,000 to a total amount not to exceed $2,105,000 to provide sufficient authority to pay Dr. Pottathil for his services through January 31, 2023. No other change to the agreement is proposed.
This item is coming to this Board late because SMMC invoices are paid after services are provided, and the increase in Dr. Pottahil’s coverage resulted in using more funds than budgeted. Going forward, SMMC is adopting an invoicing process that will track when additional services require an increase in a provider contract’s not to exceed amount.
County Attorney has reviewed and approved the resolution and amendment 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 for emergency room and inpatient services involving gastroenterology, the number of patients requiring transfer to outside facilities will decrease by 50%.
PERFORMANCE MEASURE:
|
Measure |
FY 2021-22 Actual |
FY 2022-23 Estimated |
|
Percentage decrease in number of patients requiring transfer to outside facilities, for emergency room and inpatient services involving gastroenterology |
50% |
50% |
FISCAL IMPACT:
The term of the amended agreement is February 1, 2020, through January 31, 2023. The amount of the amended agreement is not to exceed $2,105,000 for the three-year term. Funds for an amount not to exceed $ 2,000,000 were previously budgeted. Additional funds in the amount of $105,000 are included in the SMMC FY 2022-23 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 is covered by the County’s General Fund contribution to SMMC and is within the existing annual appropriation.