COUNTY OF SAN MATEO

Inter-Departmental Correspondence

San Mateo Medical Center

DATE:

September 28, 2005

BOARD MEETING DATE:

October 18, 2005

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

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

SUBJECT:

Agreements with Discharge Resource Group, Preferred Healthcare Registry, Inc. and SHC Services, Inc.

RECOMMENDATION:

Adopt a Resolution:

A)

Authorizing the execution of Agreements with Discharge Resource Group, Preferred Healthcare Registry, Inc. and SHC Services, Inc. to provide Outpatient, Acute and Long Term Care Rehabilitation Services at San Mateo Medical Center (SMMC) and all facilities for the term July 1, 2005 to June 30, 2006, in an amount not to exceed $101,000

B)

Authorizing the Chief Executive Officer of San Mateo Medical Center to execute amendments not to exceed $25,000

VISION ALIGNMENT:

Commitment: Ensure basic health and safety for all.

Goal 5: Residents have access to healthcare and preventive care.

These Agreements ensure that mandated therapy services are available to County patients at all times.

Performance Measure(s):

Measure

FY 2005-06
Actual

FY 2006-07
Projected

Percent of patients (Physical Therapy, Occupational Therapy, and Speech Therapy) who receive planned number of treatments per week

90%

90%

A care plan is developed when a patient is referred for therapy services. Using “Standard” practice thresholds, a patient’s treatment is cued to standard practices for frequency and duration. Adequate staffing ensures that treatment frequency is appropriate for each patient.

BACKGROUND:

SMMC is responsible for providing necessary medical care to medically indigent adult population. San Mateo medical Center is certified to provide general rehabilitation services. Services must cover three distinct areas: Acute hospital patients, long tem care residents and ambulatory care. County employees cover physical therapy and occupational therapy. Registry assistance is needed during times of staff absences or high patient census. Every two to three years SMMC establishes contracts with a pool of interested registries that are willing to provide services to respond to SMMC’s needs. Having multiple providers broadens the availability of back-up therapists with specific experience required to serve the diverse populations and needs. County patients frequently present more complex problems that often exceed the capacity of one registry provider. Establishing multiple contracts gives SMMC access to commitments of rates and quality.

DISCUSSION:

In May 2005, Rehabilitation Services issued an RFP to four providers. Three of four registries responded.

Physical Therapy, occupational therapy, and speech therapy are necessary to assist in increasing patients’ functional improvement, resulting in an earlier discharge and/or increased independence in mobility and self-care. Physical therapy services include identification, prevention, remediation, and rehabilitation of acute or prolonged physical dysfunction or pain, with emphasis on ability to perform routing activities. Occupational therapy services include behavior modification training and training in activities of daily living. Speech therapy improves swallowing, speech and cognition. Besides medical/surgical and intensive care areas of the hospital, occupational therapy also serves the acute psychiatric unit.

The resolution is to authorized agreements with three registries: Discharge Resource Group, Preferred Healthcare Registry, Inc. and SHC Services, Inc. Contracting with multiple registries is necessary to maintain the broadest pool of therapy contractors and to provide coverage for mandated therapist positions that can remain vacant for extended periods of time.

The registries provide licensed Physical Therapists, certified Physical Therapy Assistants, Registered Occupational Therapists, Occupational Therapy Assistants and licensed Speech Therapists. SMMC uses rehabilitation therapy registries to provide coverage for temporary absences, vacancies, limited weekend coverage, and fluctuations in patient volume. Regulations and community standards mandate rehabilitation therapy treatment on weekends for those patients whose rehabilitation progress would be diminished by two days of inactivity. Without full coverage, SMMC will not meet full clinical standards required to provide care, will lose revenue and may encounter problems with regulatory agencies such as JCAHO and State Department of Health Services Licensing and Certification. The Department then risks losing certification for rehabilitation services, which could result in patients being referred to other facilities at a higher cost to the County.

County Counsel and Risk Management have reviewed and approved these agreements.

FISCAL IMPACT:

The term of the Agreements is July 1, 2005 to June 30, 2006. The collective maximum amount for the three agreements is $101,000 for the one-year term. Funds for these agreements are included in SMMC’s FY2005-06 Adopted Budget.

1.

General Description of RFP

Provide Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (SPT) and/or Audiology Services

2.

List key evaluation criteria

1) Commitment to the goals of provision of

Rehabilitation Services by qualified rehabilitation

professionals.

2) Experience providing contract therapies in multi-

leveled environments of care (Acute, LTC and

Outpatient)

3) Demonstrated ability to provide the services

requested.

4) Clear understanding of scope of services to be

provided.

5) History of successfully providing similar services.

6) History of successfully managing other contracts

with public or private healthcare agencies.

7) Pricing

3.

Where advertised

N/A

4.

In addition to any advertisement, list others to whom RFP was sent

Discharge Resource Group

On-Call Therapists, Inc.

Preferred Healthcare Registry, Inc.

SHC Services, Inc.

5.

Total number sent to prospective proposers

4

6.

Number of proposals received

3

7.

Who evaluated the proposals

Supervisor, Rehabilitation Services

Speech Therapist, Rehabilitation Services

Nurse Manager, Surgery Department

8.

In alphabetical order, names of proposers (or finalists, if applicable) and location

Discharge Resource Group

400 Oyster Point Blvd., 440

South San Francisco

Preferred Healthcare Registry, Inc.

P.O. Box 17860

San Diego, CA 92177-7860

SHC Services, Inc.

333 Gellert Blvd., Suite 142

Daly City, CA 94015