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 Lucile Salter Packard Children’s Hospital at Stanford to Provide Child Abuse Consultation Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Lucile Salter Packard Children’s Hospital at Stanford for child abuse consultation services for the term of October 1, 2023, through September 30, 2024, in an amount not to exceed $295,000.
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BACKGROUND:
In 2021, on behalf of the County of San Mateo, San Mateo Medical Center (SMMC) engaged Lucile Salter Packard Children’s Hospital at Stanford (LPCH) to provide “expert consultation services” at the Keller Center for Family Violence. These services consisted of child abuse pediatricians providing care to abused minors, providing forensic evaluation services to the County to aid court proceedings, and acting as a liaison among SMMC physicians and nursing professionals to ensure that best practices in treating and evaluating child abuse may be followed.
DISCUSSION:
The proposed agreement between the County and LPCH would be effective October 1, 2023, for a one-year term through September 30, 2024. To fulfill its coverage obligations, LPCH provides Dr. Melissa Egge, board certified by the American Board of Pediatrics (ABP) in the specialty of Child Abuse Pediatrics to provide the onsite coverage to the Keller Center, on-call coverage to respond to consultation requests from SMMC physicians, and forensic expert services in aid of child abuse investigations. Dr. Egge was board certified in pediatrics in 2007, and board certified in child abuse pediatrics in 2011, currently practicing in both areas of certification, and in fulfillment of the ABP’s requirements to maintain certification.
County Attorney has reviewed and approved the resolution and agreement as to form.
The proposed agreement is exempt from competitive procurement requirements under County Administrative Memorandum B-1, Section IV.B.15 due to the provision of physician and urgent medical services.
The resolution contains the County’s standard provisions allowing amendment of the County fiscal obligations by a maximum of $25,000 (in aggregate).
To maintain quality of services and care, in addition to maintaining her ABP credentials, it is anticipated that Dr. Egge or any substitute physician similarly qualified by LPCH will be “up to date” (defined as six hours initial training and updated training every two years) regarding Keller Center exams and protocols based on standards developed by the American Academy of Pediatrics and the American Professional Society on the Abuse of Children.
PERFORMANCE MEASURE:
|
Measure |
FY 2023-24 Estimated |
FY 2024-25 Projected |
|
Percentage of physicians that are up to date regarding Keller Center exams and protocols, based on standards developed by the American Academy of Pediatrics and the American Professional Society on the Abuse of Children |
100% |
100% |
FISCAL IMPACT:
The term of the agreement is October 1, 2023, through September 30, 2024. The amount of the agreement is not to exceed $295,000 for the one-year term. Funds in the amount of $221,250 are included in the SMMC FY 2023-24 Recommended Budget. Funds in the amount of $73,750 are included in the SMMC FY 2024-25 Recommended Budget.
The “not to exceed” (NTE) amount for LPCH’s services for the term of July 1, 2022, through September 30, 2023, was $264,332. The NTE amount of the proposed agreement is $295,000, reflecting an annualized cost increase of approximately 37%. The annualized increase is attributable to 1) the addition of on-call services by amendment during the prior agreement, which were not budgeted at the start of the original agreement, and which expanded the scope of services provided by LPCH, and; 2) a 13% increase in the hourly rate of compensation for physician services compared to the prior agreement. Please note that the increased rates in the new contract are within fair market value according to VMG Health, a nationally recognized medical services valuation firm that relies upon multiple industry-standard provider compensation surveys and aggregates that data.
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.