COUNTY OF SAN MATEO

Inter-Departmental Correspondence

San Mateo Medical Center

 

DATE:

May 23, 2005

BOARD MEETING DATE:

June 7, 2005

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

 

TO:

Honorable Board of Supervisors

FROM:

Nancy J. Steiger, Chief Executive Officer

SUBJECT:

Agreement with the Regents of the University of California on behalf of the UCSF Medical Center, UCSF Children’s Hospital, and UCSF Medical Group

 

RECOMMENDATION:

Adopt a resolution authorizing the President of the Board to execute an agreement with University of California in San Francisco (UCSF) Medical Center for services provided to medically indigent adult (MIA) patients referred by San Mateo Medical Center.

 

VISION ALIGNMENT:

Commitment: To Ensure Basic Health and Safety for All.

Goal 5: Provide residents access to healthcare and preventive care.

The agreement contributes to this commitment and goal by providing patients access to required services and procedures that are not available at San Mateo Medical Center or any other medical center under contract.

Performance Measure:

Measure

FY2004-05

FY2005-06

Number of patients receiving specialized care at UCSF facilities

60

75

 

BACKGROUND/DISCUSSION:

San Mateo County is responsible for providing necessary medical care to its medically indigent adult (MIA) population. If an MIA patient needs services or procedures not offered at SMMC, the patient is referred to another facility. Preference is given to area facilities with whom San Mateo County contracts.

Occasionally, it is necessary to send San Mateo County Medical Center (SMMC) patients to the UCSF Medical Center for specialized procedures because these procedures are not available on site or at any other medical center that San Mateo County contracts with. Examples of these services are specialty care procedures such as percutaneous nepholithotomy, ileal pouch, gated MRI, and melanoma treatment. Patients are referred to UCSF only when there is no other contracting facility able to provide the required procedure. All referrals to UCSF are authorized by the attending physicians at SMMC and utilization review is provided by the Case Management Department at SMMC.

Final contract agreement was delayed because of prolonged negotiations for rates and terms of service. Final rates of 47% of billed charges for Outpatient Services, a case rate for Inpatient Services, and ancillary and laboratory services tied to the Medicare Fee Schedule. All patients referred to UCSF for tertiary service will continue to undergo utilization review to minimize hospital stays and maintain control over costs.

 

FISCAL IMPACT:

The term of the Agreement is January 1, 2003 through December 31, 2005. The maximum amount the County shall be obligated to pay Contractor is $450,000. Funds are included in the San Mateo Medical Center’s FY2004-05 Adopted Budget and Recommended Budget for FY2005-06.