COUNTY OF SAN MATEO

Inter-Departmental Correspondence

San Mateo Medical Center

DATE:

March 17, 2006

BOARD MEETING DATE:

April 4, 2006

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Nancy J. Steiger, Chief Executive Officer

SUBJECT:

Agreement with California Emergency Physicians

Recommendation

Adopt a resolution authorizing the President of the Board to execute an Agreement with California Emergency Physicians to provide Emergency Medical Services for the period of January 1, 2006 through December 31, 2006, in an amount not to exceed $2,691,282.20

Vision Alignment

Commitment: To Ensure Basic Health and Safety for All.

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

The Agreement contributes to this commitment and goal by providing twenty-four hour coverage of Emergency Room services.

Performance Measure:

Measure

FY2005-06

FY2006-07

Number of patients seen in the emergency room on an annual basis.

31,432

33,407

Time to antibiotics for pneumonia

< 150 min (mean)

< 150 min (mean)

Blood culture before first antibiotics for pneumonia

>90%

>90%

Aspirin at arrival for acute myocardial infarction

>95%

>95%

Beta blocker at arrival

>95%

>95%

Thrombolytic agent received within 30 minutes of hospital arrival

>95%

>95%

Reduce mean ER cycle time (registration to discharge)

-20%

-20%

Background/Discussion

California Emergency Physicians (CEP) has provided the physician and physician assistant staff for the Emergency Department at the San Mateo Medical Center for the last several years. Their group offers the hospital the benefits of a large practice with diverse specialization and administrative support.

Under this contract CEP will continue to provide board certified emergency room physicians twenty four hours a day, seven days a week. They will also provide coverage for correctional health and the Keller Center for Family Violence Intervention. Finally, CEP will increase overall emergency room coverage by increasing the number of shifts for physician extenders (PAs) during the week and weekend peak time. These physicians shall also provide medical supervision for Psychiatric Emergency Services (PES) residents and restraint authority for PES patients in the absence of on-site psychiatry attending staff.

SMMC originally entered into contract extension discussions with CEP in October 2005. Extended negotiations were due to reimbursement considerations taking into account the medical center’s proposal to implement a new PICIS Ibex electronic medical records system allowing emergency department staff to complete electronic charting, physician order entry, patient triage, and nurse documentation on a wireless information system. Both parties reached an agreement in February 2006.

This Agreement incorporates current HIPAA language. Risk Management and County Counsel have approved the Agreement.

Term and Fiscal Impact

The term of the Agreement is January 1, 2006 through December 31, 2006. The maximum amount the County shall be obligated to pay Contractor is $2,691,282.20. This agreement represents a 5.4% increase over the previous agreement due to additional staff requirements based on volume increase. Funds are included in the San Mateo Medical Center’s FY2005-06 Adopted Budget and will be included in the FY2006-07 Recommended Budget.