COUNTY OF SAN MATEO

Inter-Departmental Correspondence

San Mateo Medical Center

DATE:

October 2, 2002

BOARD MEETING DATE:

October 22, 2002

TO:

Honorable Board of Supervisors

FROM:

Nancy J. Steiger, Chief Executive Officer

SUBJECT:

Amendment to the Agreement with Tender Loving Care Health Care Services, Inc.

Recommendation

Adopt a resolution waiving the Equal Benefits Declaration and authorizing execution of an Amendment to the Agreement with Tender Loving Care Health Care Services, Inc. for provision of home health care services for patients referred by San Mateo Medical Center.

Background

San Mateo County is responsible for providing necessary medical care to its medically indigent adult (MIA) patients. This care includes home health services for patients who have been discharged from the hospital and who require additional home health services. Home health services have been integral to decreasing the overall inpatient length of stay at San Mateo Medical Center (SMMC).

Discussion

Tender Loving Care has provided skilled home health services to medically indigent patients of San Mateo County since 1997. They have consistently provided timely, quality service and maintained JCAHO accreditation. Tender Loving Care Health Care Services, Inc. is no longer able to provide services at the negotiated rates in the existing agreement. Their rates are increasing 50% to 100% dependent upon the type of service required, and the license of the professional staff required. This has been the second rate increase since 1997.

In spite of these increases, Tender Loving Care remains the lowest cost provider. Upon being notified of Tender Loving Care's rate increases, Case Management contacted five vendors who provide home health care. Four of these five would not contract with San Mateo Medical Center. The remaining provider, Mid-Peninsula Home Care Net, proposed rates that are 15% higher than Tender Loving Care's new rate and was not willing to accept County's terms for Medi-Cal pending, which adds a delay to payments.

There are fewer home care agencies available to our organization. Home care agencies are confronted with the same challenges to attract and retain competent nurses and therapists that health care organizations face.

In May 2002, Tender Loving Care Health Care Services, Inc. notified San Mateo Medical Center that Tender Loving Care Health Care Services, Inc. has changed name to Tender Loving Care/Staff Builders Home Health Care. The Amendment also incorporates this change.

This Amendment also incorporates the Equal Benefits Language. San Mateo Medical Center is requesting a waiver of the Equal Benefits Declaration for Tender Loving Care because their benefits currently do not extend to domestic partners. Tender Loving Care will review all benefits including implementation of a Domestic Partners Benefit package at their next contract negotiations in 2004 when their benefits contract expires.

Vision Alignment

This agreement keeps the commitment to Ensure Basic Health and Safety for All and goal number 5: Provide residents access to healthcare and preventive care. The Agreement contributes to this commitment and goal by continuing to provide home health services for patients who have been discharged from the hospital and who require additional home health services

Fiscal Impact

This amendment increases the rates for the services provided by Tender Loving Care. While the prices for services increased approximately 58%, the maximum amount of the agreement remains the same at $150,000. Funds are included in Hospital and Clinics FY2002-03 Approved Budget.