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 Seton Medical Center



Adopt a resolution authorizing the President of the Board to execute an amendment to the agreement with Seton Medical Center.



On September 10, 2002, your Board approved, under single resolution, agreements with Catholic Health Care West-West Bay (Sequoia Hospital) and with Seton Medical Center. The term of the agreement with Sequoia Hospital is January 1, 2002 to December 31, 2003 while the agreement with Seton Medical Center is from January 1, 2002 to December 31, 2002.

This amendment extends the term of the agreement with Seton Medical Center to June 30, 2003, making the new term of the agreement, January 1, 2002 to June 30, 2003.

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 currently contracts with Seton Medical Center to ensure that these specialty services are readily available as well as to maintain adequate coverage.



Services provided under this agreement require technical capabilities that are not presently provided at San Mateo Medical Center. Examples of these services include Magnetic Resonance Imaging (MRI), radiation therapy, noninvasive procedures, cardiac specialty services, sleep lab and medical/surgical acute care.

Seton Medical Center outpatient rates are tied to the Medicare Fee Schedule. All patients referred to Seton Hospital for inpatient service undergo utilization review to minimize hospital stays and maintain control over costs.

Health Insurance Portability and Accountability Act of 1996 (HIPAA) language has been incorporated into this amendment.

County Counsel and Risk Management have both reviewed and approved this amendment. Delay in processing this agreement is due to the negotiations by San Mateo Medical Center for better rates.


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 specialty services as well as maintaining adequate coverage to county patients.


Fiscal Impact

The previous agreement is being amended to increase the maximum by $449,000, from $600,000 to $1,049,000. The maximum amount the County shall pay for referrals to Seton shall not exceed $1,049,000. Funds were included in San Mateo Medical Center's FY02-03 Approved Budget.