20070501_m

COUNTY OF SAN MATEO

Inter-Departmental Correspondence

San Mateo Medical Center

DATE:

April 11, 2007

BOARD MEETING DATE:

SPECIAL NOTICE/ HEARING:

VOTE REQUIRED:

May 1, 2007

None

Majority

TO:

Honorable Board of Supervisors

FROM:

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

SUBJECT:

Amendment to the Sublease Agreement between the County of San Mateo with Carmichael & Associates, Inc.

RECOMMENDATION:

Adopt a resolution authorizing the President of the Board of Supervisors to execute an Amendment to the Sublease Agreement with Carmichael & Associates, Inc., adopted on January 9, 2007 to provide management services to San Mateo Medical Center contract physicians at Mariner Medical Center. The term of this Amendment to the Sublease Agreement will be from February 1, 2007 through January 31, 2008. This Amendment adds $200,000 to the Sublease Agreement and increases the amount from $491,400 to $691,400. The term of the Sublease Agreement remains January 1, 2007 through January 1, 2010.

VISION ALIGNMENT:

Commitment: This Amendment to the Agreement keeps the commitment to Ensure Basic Health and Safety for All.

Goal 5: Provide residents access to healthcare and preventive care. The amendment to the agreement contributes to this commitment and goal by improving the continuum of medical care available on the Mid-Peninsula.

BACKGROUND:

This Board of Supervisors authorized the County to Sublease space at Mariner Medical Center, 1241 East Hillsdale Boulevard, in Foster City, for use by San Mateo Medical Center (SMMC) contracted physicians for the provision of specialist medical services. The goal in doing so is to improve the continuum of medical care available in the Mid-Peninsula and to broaden the SMMC’s patient and payor mix. In order to most efficiently achieve these goals, the SMMC recommends that the County amend the Sublease Agreement with the sublessor, Carmichael & Associates, Inc., which also occupies space at Mariner Medical Center, to provide for office management services.

Performance Measure(s):

Measure

FY 2005-06

Actual

FY 2006-07
Projected

Commercial Insurance Revenue as a Percent of SMMC Revenue

4%

4.5%

DISCUSSION:

SMMC’s contracted physicians have begun to provide specialist medical services at the County’s subleased space at 1241 East Hillsdale Boulevard. However, in order to appropriately support these physicians, the County requires office management services. Carmichael & Associates, Inc., from whom the County Subleases its space at Mariner Medical Center, also occupies space at the location, from which it provides primary medical care services. Because of its location and the nature of its operations, Carmichael & Associates, Inc. is uniquely suited to provide SMMC with the support it requires for its operations at Mariner Medical Center in a cost-effective manner. The SMMC therefore recommends waiver of the RFP process for this Amendment to the Sublease Agreement.

Services provided by Carmichael & Associates would include office management services, office and medical equipment, and clerical and clinical support services. The management fee payable to Carmichael & Associates, Inc. includes both a flat monthly payment and a variable amount that depends on the total number of patient encounters by the SMMC contracted doctors at Mariner Medical Center. In no event will the amount payable for the one year term of the Agreement, February 1, 2007 through January 31, 2008, exceed $200,000.

County Counsel has reviewed and approved this Agreement. Risk Management has approved the insurance coverage.

The contractor has assured compliance with the County’s Contractor Employee Jury Service Ordinance and administrative memoranda, including but not limited to insurance, hold harmless, non-discrimination and equal benefits.

FISCAL IMPACT:

Projections of increased revenues for SMMC vary over the term of the contract because of start up costs and the delayed impact of effective marketing. However, SMMC anticipates that its operations at Mariner Medical Center will result in a broadening of its patient and payor mix and that increased reimbursement will result in an expanded revenue stream for the County. In no event shall the County’s total fiscal obligation under this Amendment exceed TWO HUNDRED THOUSAND DOLLARS, $200,000.



COUNTY OF SAN MATEO Inter-Departmental Correspondence
San Mateo Medical Center

DATE:		April 11, 2007
BOARD MEETING DATE: SPECIAL NOTICE/ HEARING: VOTE REQUIRED:		May 1, 2007 None Majority

TO:	Honorable Board of Supervisors
FROM:	Nancy J. Steiger, Chief Executive Officer San Mateo Medical Center

SUBJECT:	Amendment to the Sublease Agreement between the County of San Mateo with Carmichael & Associates, Inc.

RECOMMENDATION:
Adopt a resolution authorizing the President of the Board of Supervisors to execute an Amendment to the Sublease Agreement with Carmichael & Associates, Inc., adopted on January 9, 2007 to provide management services to San Mateo Medical Center contract physicians at Mariner Medical Center. The term of this Amendment to the Sublease Agreement will be from February 1, 2007 through January 31, 2008. This Amendment adds $200,000 to the Sublease Agreement and increases the amount from $491,400 to $691,400. The term of the Sublease Agreement remains January 1, 2007 through January 1, 2010.

VISION ALIGNMENT:
Commitment: This Amendment to the Agreement keeps the commitment to Ensure Basic Health and Safety for All. Goal 5: Provide residents access to healthcare and preventive care. The amendment to the agreement contributes to this commitment and goal by improving the continuum of medical care available on the Mid-Peninsula.

BACKGROUND:
This Board of Supervisors authorized the County to Sublease space at Mariner Medical Center, 1241 East Hillsdale Boulevard, in Foster City, for use by San Mateo Medical Center (SMMC) contracted physicians for the provision of specialist medical services. The goal in doing so is to improve the continuum of medical care available in the Mid-Peninsula and to broaden the SMMC’s patient and payor mix. In order to most efficiently achieve these goals, the SMMC recommends that the County amend the Sublease Agreement with the sublessor, Carmichael & Associates, Inc., which also occupies space at Mariner Medical Center, to provide for office management services.
Performance Measure(s): Measure FY 2005-06 Actual FY 2006-07 Projected Commercial Insurance Revenue as a Percent of SMMC Revenue 4% 4.5%
DISCUSSION:
SMMC’s contracted physicians have begun to provide specialist medical services at the County’s subleased space at 1241 East Hillsdale Boulevard. However, in order to appropriately support these physicians, the County requires office management services. Carmichael & Associates, Inc., from whom the County Subleases its space at Mariner Medical Center, also occupies space at the location, from which it provides primary medical care services. Because of its location and the nature of its operations, Carmichael & Associates, Inc. is uniquely suited to provide SMMC with the support it requires for its operations at Mariner Medical Center in a cost-effective manner. The SMMC therefore recommends waiver of the RFP process for this Amendment to the Sublease Agreement. Services provided by Carmichael & Associates would include office management services, office and medical equipment, and clerical and clinical support services. The management fee payable to Carmichael & Associates, Inc. includes both a flat monthly payment and a variable amount that depends on the total number of patient encounters by the SMMC contracted doctors at Mariner Medical Center. In no event will the amount payable for the one year term of the Agreement, February 1, 2007 through January 31, 2008, exceed $200,000.

County Counsel has reviewed and approved this Agreement. Risk Management has approved the insurance coverage.

The contractor has assured compliance with the County’s Contractor Employee Jury Service Ordinance and administrative memoranda, including but not limited to insurance, hold harmless, non-discrimination and equal benefits.
FISCAL IMPACT: Projections of increased revenues for SMMC vary over the term of the contract because of start up costs and the delayed impact of effective marketing. However, SMMC anticipates that its operations at Mariner Medical Center will result in a broadening of its patient and payor mix and that increased reimbursement will result in an expanded revenue stream for the County. In no event shall the County’s total fiscal obligation under this Amendment exceed TWO HUNDRED THOUSAND DOLLARS, $200,000.