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COUNTY OF SAN MATEO
Inter-Departmental Correspondence
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San Mateo Medical Center
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DATE:
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July 12, 2006
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BOARD MEETING DATE:
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August 1, 2006
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SPECIAL NOTICE/HEARING:
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None
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VOTE REQUIRED:
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Majority
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TO:
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Honorable Board of Supervisors
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FROM:
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Nancy J. Steiger, Chief Executive Officer
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SUBJECT:
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Amendment to the Agreement with Associated Medical Specialists
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RECOMMENDATION:
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Adopt a resolution authorizing the President of the Board to execute an Amendment to the Agreement with Associated Medical Specialists (AMS) to provide internal medicine services increasing the maximum Agreement obligation by $185,910 from $11,483,514 to $11,669,424.
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VISION ALIGNMENT:
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Commitment: To Ensure Basic Health and Safety for All.
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Goal(s): Provide residents access to healthcare and preventive care.
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The Amendment contributes to this commitment and goal by continuing to provide internal medicine services, including cardiology and mental health, to county patients.
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Performance Measure(s):
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Measure
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FY 2004-05
Actual
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FY 2005-06
Estimated
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Number of clinic visits and admissions for internal medicine.
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6,870
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7,500
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BACKGROUND:
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San Mateo County is responsible for providing necessary basic medical care to its medically indigent population. This care includes internal medicine services. Since 1975, Associated Medical Specialists (AMS) has provided these internal medicine services, including cardiology, oncology, gastroenterology, rheumatology, endocrinology, pulmonology, and critical care, as well as the management and supervision of those services. For the period of April 1, 2002 through March 30, 2005, AMS also expanded their role to include conducting history and physicals for mental health patients and provision of on-call coverage for the Burlingame Long Term Care facility.
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DISCUSSION:
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The San Mateo Medical Center has operated under a hybrid model of internal medicine that includes both hospitalist and subspecialty services. Performance indicators were included in this and most physician contracts through FY2004-05 to incentivize optimal delivery of care. The bonus language has since been removed as the physician contracts were converted from a flat reimbursement to pay based on productivity, but the bonus to AMS is the last payment that remains outstanding.
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The original Agreement budget of $9,913,512 was based on a three year contractual period and included performance incentives. The first Amendment extended the contract to September 30, 2005 and increased funding to $11,483,514 to cover base reimbursement. This second Amendment period is for an increase in funding of $185,910 to fulfill the bonus reimbursement for exceeding the established performance incentives for the last year of the contract.
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The Amendment includes all provisions that are required by county ordinance and administrative memoranda, including but not limited to insurance, hold harmless, non-discrimination, equal benefits and jury service policy. Risk Management and County Counsel have also approved the Amendment.
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FISCAL IMPACT:
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The term of the previous Agreement is not being amended. The maximum amount the County shall be obligated to pay Contractor is increased by $185,910 from $11,483,514 to $11,669,424. Funds are included in the San Mateo Medical Center’s FY2006-07 tentatively adopted budget.
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