COUNTY OF SAN MATEO

Inter-Departmental Correspondence

San Mateo Medical Center

 

DATE:

August 8, 2007

BOARD MEETING DATE:

September 11, 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 Barry Rosen, M.D.

 

RECOMMENDATION:

Adopt a resolution:

1. Authorizing the President of the Board to execute an Agreement with Barry Rosen, M.D. for specialty pain management services for the period August 1, 2007 through July 31, 2008 in an amount not to exceed $290,272.68.

 

2. Authorizing the Chief Executive Officer of San Mateo Medical Center or the Chief Executive Officer’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.

 

Performance Measures:

Measure

FY 2006-07

Actual

FY 2007-08
Target

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

85%

>85%

Assessment from Peers and Clinic Staff of program effectiveness in reducing hospitalization, Emergency Department visits and patient compliance

89%

90%

Assessment from patients of improved quality of life and functionality

89%

90%

 

BACKGROUND:

On August 15, 2006, the San Mateo County Board of Supervisors approved the creation of a chronic pain management clinic to address both the medical need and the excess health resource utilization of patients of San Mateo Medical Center (SMMC) with chronic pain.

 

DISCUSSION:

Pain management services are provided under the general direction of the Medical Director of SMMC. Such care includes the assessment and treatment of chronic pain syndrome. Comprehensive pain management is a service being offered at the SMMC for the past year. Barry Rosen, M.D. is highly recognized in the fields of pain management and addiction treatment. He is the Medical Director and CEO of the Sequoia Center. In September 2006, he established a multidisciplinary team including: a licensed medical social worker, a psychologist, and a nurse practitioner to work with SMMC staff to run pain management services to serve County residents suffering with chronic pain and addiction.

The establishment of a pain management service is a cost containment approach for the assessment and treatment of patients with chronic pain syndrome, including back pain, headaches, cancer, and rheumatologic pain and those patients with concurrent substance abuse issues. A multidisciplinary team provides specific medical and behavioral health services while measuring outcome-based results analyzing frequency of Emergency Department (ED) visits, hospitalization, and improved patient quality of life and functionality,

The results compiled for the first two quarters followed the 53 patients admitted to the Pain Management Clinic (PMC) in the first quarter. From the first to second quarter, for these 53 patients there was a 30% decrease in their ED visits, a 29% decrease in their medical/ specialty clinics and a 56% increase in their psychiatric service use. Across all SMMC services there was an 11% decrease (including the increase in psychiatric services). In addition, there was a 22% decrease in PMC use among these patients from the first to the second quarter. In addition, there was 89.2% patient satisfaction with overall PMC services.

The PMC will continue to evaluate the impact of the program on patients, SMMC service utilization for these patients and the 12 month report will also include an analysis of healthcare costs 12 months prior to PMC referral and the costs during the months after they have received treatment.

The Agreement 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 approved the Agreement.

 

FISCAL IMPACT:

The term of the Agreement is August 1, 2007 through July 31, 2008. The maximum amount of the County shall pay Contractor shall not exceed $290,272.68. The previous Agreement maximum amount the County would pay for August 1, 2006 to July 31, 2007 could not exceed $240,000. This Agreement includes an 8% increase for PMC contracted staff. There is also an increase in the Nurse Practitioner hours of four hours per week. The Nurse Practitioner increase in the number of reimbursable hours represents actual hours worked on a regular basis and will be paid as worked.

Funds are included in the SMMC’s FY2007-08 Tentatively Adopted Budget and will be included in the FY2008-09 Recommended Budget.