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 Thien Le, MD for Professional Pain Management and Musculoskeletal Services
RECOMMENDATION:
title
Adopt a resolution authorizing an agreement with Thien Le, MD to provide professional pain management and musculoskeletal services for the term of September 1, 2023, through August 31, 2024, in an amount not to exceed $435,000.
body
BACKGROUND:
San Mateo Medical Center (SMMC) presently independently contracts with two physicians to provide pain management and limited musculoskeletal services to County patients in need of chronic pain relief and nerve blocks during certain procedures. These two physicians provide these services on an outpatient basis, while SMMC’s anesthesiologists provide sedation, pain relief, and nerve blocks for most (but not all) operative cases. Given these staffing levels, there is a present need for an additional pain management physician who can provide epidural and other deep joint injections so that there is a reasonable and sustainable distribution of clinic and surgery coverage among the physicians. Dr. Le has been identified as a good candidate to sustainably fill the need for such services within County Health.
DISCUSSION:
Although exempt from any requirement in County Administrative Memorandum B-1 that Dr. Le’s pain management services be procured through competitive bidding, the County Attorney is satisfied that the agreement has been negotiated at arm’s length, is commercially reasonable, is not undertaken for an inappropriate purpose, and is within the fair market value range for professional pain management services as provided by the County’s fair market value consultant, VMG Health.
County Attorney has reviewed and approved the resolution and agreement 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 Dr. Le will arrive on time for each clinic or surgery block 90% of the time; 85% of patients who complete the Patient Satisfaction Survey would recommend Dr. Le as a provider; and the wait time at SMMC for a patient to obtain an appointment for epidural spinal injection (ESI) will be less than or equal to two weeks 100% of the time.
PERFORMANCE MEASURE:
|
Measure |
FY 2022-23 Actual |
FY 2023-24 Estimated |
|
Percentage of time Dr. Le will arrive on time for each clinic or surgery block |
N/A* |
90% |
|
Percentage of patients who complete the Patient Satisfaction Survey that recommend Dr. Le as a provider |
N/A* |
85% |
|
Percentage of time the wait time at SMMC for a patient to obtain an appointment for an ESI will be less than or equal to two weeks |
N/A* |
100% |
*New measure
FISCAL IMPACT:
The term of the agreement is September 1, 2023, through August 31, 2024. The amount of the agreement is not to exceed $435,000 for the one-year term. Funds in the amount of $362,500 are included in the SMMC FY 2023-2024 Recommended Budget. Funds in the amount of $72,500 are included in the SMMC FY 2024-2025 Recommended 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.