Inter-Departmental Correspondence

San Mateo Medical Center



November 13, 2003


December 2, 2003



Honorable Board of Supervisors


Nancy J. Steiger, Chief Executive Officer, San Mateo Medical Center



Amendment to the Agreement with Psychiatrists Only



Adopt a resolution authorizing the President of the Board to execute an Amendment to the Agreement with Psychiatrists Only to provide temporary psychiatrists to San Mateo Medical Center.



On June 24, 2003, the Chief Executive Officer approved an agreement with Psychiatrists Only to provide temporary psychiatrists to San Mateo Medical Center (SMMC). The term of the agreement is July 15, 2003 to July 14, 2004 and has a maximum amount of $25,000.

At the time of budget preparation, one psychiatrist was hired for the vacancy in Psychiatry Emergency Services (PES). A second psychiatrist who had been offered the position on 3AB, declined the SMMC offer in early July to accept a position in San Francisco. Psychiatrists Only had a psychiatrist who was willing to cover the position and who has also applied for the full time position for SMMC. On August 8, 2003, the Purchasing Agent approved a Change Order to the agreement with Psychiatrists Only increasing the maximum amount by $50,000, from $25,000 to $75,000. The increase allowed SMMC to provide coverage for the vacancy and to pay the $20,000 hiring fee required by Psychiatrists Only if we hired their psychiatrist for 3AB.



The Medical Director attempted to negotiate with the psychiatrist to take a permanent position and although he initially accepted our offer, he ultimately changed his mind after receiving a better offer from another organization. SMMC did not, therefore, have to pay the $20,000 hiring fee. However, Inpatient Psychiatry continued to pay for his services as a temporary psychiatrist and used $50,000 between August 4 and October 17 for the psychiatrist provided by Psychiatrists Only. There is now approximately $23,000 remaining in this contract (coverage is approximately $5,000/week). Fortunately, a new offer has been made and accepted by a former psychiatric resident to fill this full-time position effective November 24th. Meanwhile, another full-time psychiatrist, Dr. Kym, has resigned his position effective October 24th. The $23,000 remaining in the contract will cover about five weeks of temporary psychiatrists for Dr. Kym's position. The request in this proposal is for an additional $150,000, since it is unlikely that the position will be filled within the next six months. The inpatient psychiatric service will attempt to offer the open position to a psychiatric resident graduating in the spring, if the position has not been filled by then.


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 providing Psychiatric services to San Mateo County patients.


Fiscal Impact

The term of the agreement with Psychiatrists Only remains the same, July 15, 2003 to July 14, 2004. The maximum amount of the agreement is increased by $150,000 from $75,000 to $225,000. Funds are included in San Mateo Medical Center's FY2003-04 Approved Budget.