COUNTY OF SAN MATEO

Inter-Departmental Correspondence

San Mateo Medical Center

DATE:

July 12, 2004

BOARD MEETING DATE:

July 27, 2004

TO:

Honorable Board of Supervisors

FROM:

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

SUBJECT:

Agreement with Orthopaedic & Neurological Rehabilitation, Inc.

Recommendation

Resolution Waiving the Request for Proposals Process and Approving a Resolution authorizing the execution of an Agreement with Orthopaedic & Neurological Rehabilitation, Inc. (ONR, Inc.)

Background

ONR, Inc was the company providing Rehabilitation Services when SMMC took over management at the Burlingame Long Term Care (BLTC) site. Acquiring the added beds led to a significant change in patient mix at the two sites. The BLTC facility gradually absorbed the more “long term care residents” while San Mateo Medical Center Long Term Care (SMMC LTC) absorbed the more “acute” patients. A very large influx of patients created a great demand for rehabilitation services, especially at the San Mateo unit. Keeping the existing provider at the Burlingame site for the transition was considered the best short-term solution.

Discussion

Since the first two to three months of Burlingame LTC’s operation, the volume of patients admitted for rehabilitation services at both LTC sites has experienced a growth of as much as 200% to 300% or more compared to previous years. Hiring rehabilitation therapists and developing a strong program at both sites seemed daunting. The strategy was taken to make the immediate investment of resources at SMMC LTC which would create one primary site for rehabilitation services. County Rehab employees will continue to staff the SMMC LTC. And since ONR, Inc. was already in place at BLTC, we will continue an 18-month contract with ONR. This will allow the rehabilitation department time to enhance the program with less disruption of services at both sites. For these reasons, San Mateo Medical Center is requesting a waiver of the Request for Proposal process for rehabilitation services at BLTC.

County Counsel and Risk Management have both reviewed and approved this agreement.

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 by providing rehabilitation Services, physical therapy, speech therapy, and occupational therapy to patients at Burlingame Long Term Care.

Fiscal Impact

The term of this agreement is October 6, 2003 to June 30, 2005. Delay in processing this agreement is due to the ongoing discussions as to whether to use outside contracting or to staff in-house to provide these services. A decision was made to staff speech therapy but to contract occupational therapy and physical therapy at BLTC with ONR, Inc. San Mateo Medical Center will continue to explore the cost effectiveness of in-house staffing to provide these services at BLTC.

The maximum amount of this agreement is $376,000. Funds were included in FY2003-04 start-up budget for the Burlingame Long Term Care facility. Funds are included in FY2004-05 recommended budget for rehabilitation services.