COUNTY OF SAN MATEO

Inter-Departmental Correspondence

San Mateo Medical Center

DATE:

August 24, 2006

BOARD MEETING DATE:

September 12, 2006

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Nancy J. Steiger, Chief Executive Officer

SUBJECT:

Agreement with Daniel Buckley, MD

RECOMMENDATION:

Adopt a resolution authorizing the President of the Board to execute an Agreement with Daniel Buckley, MD to provide ophthalmology services for the period September 1, 2006 through August 31, 2008 in the amount of $127,236.30.

VISION ALIGNMENT:

Commitment: To Ensure Basic Health and Safety for All.

Goal(s): Provide residents access to healthcare and preventive care.

The Agreement contributes to this commitment and goal by providing comprehensive ophthalmology services.

Performance Measure(s):

Measure

FY 2005-06
Actual

FY 2006-07
Projected

Increase overall RVU productivity for ophthalmology services

1321.59

1453.74

Reduce vision loss in diabetics through increased preemptive and preventative HVF, IVF, and GDX diagnostic testing

N/A

>25%

Increase eye care health compliance for patients identified as at high risk for vision loss, especially those with ESRD, diabetes, glaucoma, and hypertension

>50%

>50%

Achieve organizational citizenship rating scores from Administration, Clinic staff, and Peers on all citizenship rating criteria

>80%

>80%

Reduce the risk of healthcare-associated infections and adhere to infection control standards as defined by Joint Commission, Title 22, and other applicable standards.

100%

100%

BACKGROUND/DISCUSSION:

Dr. Daniel Buckley has provided ophthalmology services to the San Mateo Medical Center for the last eight years. In particular, these services include the diagnosis and treatment for diseases of the eye, including glaucoma surgery, cataract surgery, and clinics for eye injury, trauma, or refractive corrections. Services are specifically broken out as: refractions (10%), glaucoma surgery (10%), laser surgery (10%) anterior segment corneal surgery (5%), cataract surgery (10%), ocular plastic surgery (10%), medical eye exams (35%), and YAG/membrane surgery (10%). Patients treated at SMMC have a continuous need for such eye care services and Dr. Buckley offers the hospital the benefits of an experienced provider familiar with the complex nature of the County’s patient base.

In 2004 eye injury, trauma, disease, and surgery services for San Mateo Medical Center were contracted among four ophthalmologists. One of the contractors terminated his contract with the County in January 2005. Another reduced their availability for services in April 2005. Dr. Daniel Buckley and the remaining ophthalmologists increased their availability to cover the service gap.

The original Agreement budget was based on an annual productivity level of 967.27 RBRVS work units with a cushion to cover anticipated increases in surgical cases. Actual productivity levels for Dr. Buckley’s contractual period were 1321.59, 36% above the original amount. The new contract is being funded at an increase of 10% to reflect Dr. Buckley’s assumption of a portion of the terminated contractor’s workload.

Risk Management and County Counsel have also approved the Agreement. The contractor has assured compliance with the County's Contractor Employee Jury Service Ordinance, as well as all other contract provisions that are required by County ordinance and administrative memoranda, including but not limited to insurance, hold harmless, non-discrimination and equal benefits.

TERM AND FISCAL IMPACT:

The term of the agreement is from September 1, 2006 through August 31, 2008. The maximum amount County shall be obligated to reimburse Contractors under this agreement is $127,236.30. The maximum amount of the previous contract was $115,669.38. Funds are included in the San Mateo Medical Center's FY2006-07 tentatively adopted budget and will be requested in future budgets.