COUNTY OF SAN MATEO

Inter-Departmental Correspondence

San Mateo Medical Center

DATE:

August 11, 2003

BOARD MEETING DATE:

September 9, 2003

TO:

Honorable Board of Supervisors

FROM:

Nancy J. Steiger, Chief Executive Officer

SUBJECT:

Amendment to the Previous Agreement with Mills-Peninsula Hospitals and New Agreement with Mills-Peninsula Hospitals

Recommendation

Adopt a resolution authorizing the President of the Board to 1) execute an Amendment to the previous agreement with Mills-Peninsula Hospitals and 2) execute a new agreement with Mills-Peninsula Hospitals.

Background

San Mateo County is responsible for providing medical care to its medically indigent adult population. San Mateo Medical Center (SMMC) is a general acute care hospital and does not provide certain highly specialized services. SMMC contracts with three local hospitals: Mills-Peninsula Hospitals, Sequoia Hospital District, and Seton Medical Center to ensure that these specialty services are readily available as well as to maintain adequate coverage. Mills-Peninsula Hospitals has been providing tertiary care, acute medical surgical and outpatient services to SMMC's indigent patients since 1983. The majority of referrals to Mills-Peninsula are for outpatient services, including magnetic resonance imaging (MRI) and lithotripsy treatment.

Discussion

In October 2000, your Board approved an agreement with Mills-Peninsula Hospitals with a maximum of $800,000 for the term July 1, 2000 through June 30, 2002. This agreement was subsequently amended to extend the term of the agreement by one year and increase the maximum by $800,000 to cover costs incurred by increased patient activity and to cover the one-year extension.
Patient services necessitating outside services not provided at SMMC have continued to increase causing a depletion of the contract maximum. An increase of $600,000 is being requested to allow San Mateo Medical Center to pay invoices incurred for the increased services provided during the term of the previous agreement.

The services provided under the new agreement are inpatient acute care, intensive care, coronary care, outpatient dialysis, laboratory services, magnetic resonance imaging (MRI) and lithotripsy services. Patients are referred to the Mills-Peninsula by the SMMC physicians using an "Outside Referral Form." This form is reviewed and approved in advance by SMMC's Case Management Department for appropriateness of care, length of stay, etc.

Risk Management and County Counsel have approved this agreement.

Vision Alignment

This amendment 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 providing specialty services to county patients.

Term and Fiscal Impact

The previous agreement is being amended to increase the maximum by $600,000, from $1,600,000 to $2,200,000. The term of the new agreement is two years, July 1, 2003 to June 30, 2005. The maximum amount of the new agreement is $1,200,000. Funds are included in the San Mateo Medical Center's FY2003-04 Adopted Budget and will be included in Budget Request for FY2004-05.