COUNTY OF SAN MATEO

Inter-Departmental Correspondence

San Mateo Medical Center

DATE:

May 14, 2007

BOARD MEETING DATE:

June 19, 2007

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Sang-ick Chang, Interim Chief Executive Officer, San Mateo Medical Center

SUBJECT:

Agreement with California Emergency Physicians Medical Group

Recommendation

Adopt a Resolution:

1. Authorizing the President of the Board to execute an Agreement with California Emergency Physicians Medical Group to provide Emergency Medical Services and Correctional Health Services for the period of January 1, 2007 through June 30, 2008, in an amount not to exceed $4,606,588.

2. Authorizing the San Mateo Medical Center (SMMC) Chief Executive Officer (CEO) or the CEO's designee to execute contract amendments which modify the County's maximum fiscal obligation by no more than $25,000 (in aggregate), and/or modify the contract term and/or services so long as the modified term or services is/are within the current or revised fiscal provisions.

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 at SMMC.

Performance Measures:

Measure

FY2005-06

FY2006-07

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

33,781

32,000

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 Medical Group (CEP) has provided the physician and physician assistant staff for the Emergency Department at the San Mateo Medical Center (SMMC) 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. Finally, CEP will continue increased overall emergency room coverage by maintaining the number of shifts for physician assistants (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 2006. Extended negotiations were due to reimbursement and patient triage considerations, lack of SMMC staff, issues related to electronic medical records system allowing emergency department staff to complete electronic charting and nurse documentation on a wireless information system. The Parties reached a tentative agreement, subject to approval of the Board, in June 2007.

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, 2007 through June 30, 2008. The maximum amount the County shall be obligated to pay Contractor is $4,606,588. This agreement represents an 8% increase, without Surge services, in costs over the previous agreement for January 1, 2007 to December 31, 2007, and an increase of 5.9% in January 1, 2008 to June 30, 2008, due to CEP staff reimbursement increases. Funds are included in the San Mateo Medical Center’s FY2006-07 Adopted Budget and are included in the FY2007-08 Recommended Budget.