Inter-Departmental Correspondence

San Mateo Medical Center



May 20, 2004


June 8, 2004



Honorable Board of Supervisors


Nancy J. Steiger, Chief Executive Officer



Agreement with Sequoia Health Services



Adopt a resolution authorizing the President of the Board to execute an agreement with Sequoia Health Services and to waive the RFP process.



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. A contract with Sequoia Health Services ensures that specialty services are readily available.



Services provided under this agreement are for services that require technical capabilities that are not presently provided at San Mateo Medical Center. Most services are in the areas of radiation therapy, noninvasive procedures, cardiac specialty services, sleep lab and medical/surgical acute care.

Rates were negotiated with a decrease of 4% over contracted rates in the previous agreement. In addition, Sequoia Hospital outpatient and lab rates are tied to the Medicare Fee Schedule. All patients referred to Sequoia for tertiary service undergo utilization review to minimize hospital stays and maintain control over costs. San Mateo Medical Center is requesting a waiver of the RFP process because the facility seeks contracts with all area hospitals for tertiary care.


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 term of the agreement with Sequoia Health Services is two years, January 1, 2004 to December 31, 2005. Delay in processing this agreement is due to the negotiations for more favorable rates. San Mateo Medical Center was able to recognize savings of 40%, from a previous contract amount of $600,000 to a current amount of $350,000, through a reduction in rates and patient volume. Funds are included in FY 2004-2005 Hospital and Clinics budget and will be included in subsequent budget requests.