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COUNTY OF SAN MATEO
Inter-Departmental Correspondence
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Department of Hospital and Clinics
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DATE:
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March 7, 2003
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BOARD MEETING DATE:
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March 25, 2003
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TO:
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Honorable Board of Supervisors
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FROM:
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Nancy J. Steiger, Chief Executive Officer
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SUBJECT:
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Resolution authorizing the Controller to pay non-contract physicians who provide medical services for San Mateo Medical Center.
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Recommendation
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Adopt a resolution authorizing the Controller to pay non-contract physicians who provide medical services for San Mateo Medical Center.
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Background
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From time-to-time it is necessary to augment the county contracted physicians with non-contract physicians because there is not sufficient coverage for specialty care. Examples of shortages are: pediatric on-call coverage, gastroenterology, neurosurgery and dental surgery.
On August 6, 2002, your Board approved Resolution No. 065479 authorizing the Controller to pay all on-call specialists, including but not limited to gastroenterologists, neurosurgeons, and dental surgeons who provide emergency backup when no other medical coverage is available, at 60% of their billed inpatient charges and 50% of their billed outpatient charges. Payments to on-call pediatricians are the lesser of the physicians’ billed charges or the prevailing Medicare Participating Fee Schedule for San Mateo County. These are emergency services which are not available on a 24 hour-basis. For surgical assists, payment is to be made at the prevailing Medicare fee schedule for assists.
The maximum amount allowed under the current resolution is $70,000 for the term February 1, 2002 through March 31, 2003.
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Discussion
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Most on-call specialists were paid under the MASMC agreement. As of March 31, 2002, the San Mateo Medical Center no longer contracts with MASMC. All on-call specialties and most surgical assistants are now paid under the Non-Contract Physician Resolution.
Increased patient activity necessitating emergency services and an increase in the number of on-call specialists and surgical assistants being paid under the Non-Contract Physician Resolution has depleted the $70,000 approved by Resolution No. 06579.
An extension of three months is being requested to enable San Mateo Medical Center to budget for this expense on fiscal year basis. An increase of $70,000 is being requested to allow San Mateo Medical Center to pay pending invoices and future invoices incurred during the three additional months.
If on-call specialists are not available, patients needing these services will be required to be transferred to other providers at a considerably higher county expense. All services are pre-approved through the Case Management unit of the Hospital.
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Vision Alignment
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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 healthcare services to county patients.
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Fiscal Impact
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This resolution increases the maximum amount by $70,000, from $70,000 to $140,000 and extends the term by three months making the new term February 1, 2002 through June 30, 2003.
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