Inter-Departmental Correspondence


County Manager/Clerk of the Board



July 28, 2008


August 12, 2008







Honorable Board of Supervisors



John L. Maltbie, County Manager



Creation of Health System Department.




Adopt an Ordinance amending and deleting various San Mateo County ordinance code sections to implement the placement of all County health functions within a new Health System Department; and



Adopt an Ordinance amending the Salary Ordinance adding a Chief for the Health System to lead the newly created department.


Vision Alignment

Commitment: Responsive, effective and collaborative government.

Goal 20: Government decisions are based on careful consideration of future impact, rather than temporary relief or immediate gain.

Commitment: Ensure basic health and safety for all.

Goal 5: Residents have access to healthcare and preventive care.


These Ordinances contribute to these commitments and goals by supporting the organization and leadership of County health functions within a single department responsible for the range of health functions performed by the County.



During the past four years, this Board has approved a series of actions related to the County’s leadership on health issues and organization of its health functions. These have included the creation of organizational units that integrate internal expertise as well as community planning efforts led by this Board that have shaped County health efforts within the broader San Mateo County community.


A consistent and widely shared goal among those involved in these efforts is for the County to play a leadership role on local health issues, and leverage its considerable, existing assets in a unified and coordinated manner. This approach must consider the full range of health issues facing the community and embrace roles that range from prevention and community engagement to implementation and delivery of services to a population with complex needs. Feedback received during the County Vision 2025 process provides added support for structuring our health functions in a manner that prioritizes prevention and service integration.



Organization of the full range of County health functions within a single Health System enables the development of a unified health agenda and clear accountability for these functions. Continued partnership between this new Health System and the Health Plan of San Mateo will be integral to achieving this Board’s overall health vision for the community. This structure will improve our ability to work with our wide range of community partners in a coherent manner, and continue our emphasis on collaboration toward achievement of shared goals.


The creation of a “Health System” requires Ordinance changes related to the name of the Department and responsibilities of its administrative leader. The Salary Ordinance Amendment adds a position for this newly created administrative leadership role.


These Ordinances have been reviewed and approved by County Counsel.


Fiscal Impact

There cost impact associated with approval of these Ordinances is $26,412, reflecting the annualized net impact of the new Chief position, which will be absorbed within existing resources. There may be additional one-time expenses associated with the recruitment and appointment of the new Chief. The Preliminarily Approved Health Department and San Mateo Medical Center budgets remain unchanged. Any related changes with budgetary impact will be submitted to you for your consideration.