COUNTY OF SAN MATEO
Inter-Departmental Correspondence

San Mateo Medical Center

DATE:

September 18, 2008

BOARD MEETING DATE:

October 21, 2008

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

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

Charlene Silva, Director

Health Department

SUBJECT:

Second Amendment to the Agreement with Richard Anderson

RECOMMENDATION:

Adopt a resolution:

A.

Authorizing the President of the Board to execute a second Amendment to the Agreement with Richard Anderson to provide consulting assistance for Medicare, Medi-Cal and Federally Qualified Health Center programs; expanding the scope of services to provide financial consulting services related to Health Care Redesign efforts; extending the term by one year to December 31, 2009; increasing the Contractor’s hourly rate from $125 to $165; and increasing funding by $175,000 from $100,000 to $275,000; and

B.

Authorizing the Chief Executive Officer (CEO) of San Mateo Medical Center (SMMC) or 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: Responsive, effective and collaborative government

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

The Amendment contributes to this commitment and goal by providing SMMC and the Health Department access to professional reimbursement knowledge.

Performance Measure(s):

Measure

FY 2008-09
Estimated

FY 2009-10
Projected

Timely completion of annual Medicare, Medi-Cal and OSHPD Cost reports

100%

100%

BACKGROUND:

Richard Anderson has provided support to the County since February 1997 on matters related to federal and state healthcare reimbursement. In April 2007, an inquiry was received from the Office of Inspector General (OIG) requesting costs reporting documentation from 1996 to the present. Mr. Anderson’s contract scope enabled him to provide support for the analysis required to address the federal government’s requirements. That work resulted in additional cost being incurred by SMMC under his current agreement. The first amendment increased funding by $50,000 and was approved by the County Manager’s Office on July 2, 2007.

DISCUSSION:

Mr. Anderson will continue to provide assistance for Medicare, Medi-Cal and Federally Qualified Health Center Programs. He prepares quarterly and annual cost reports, financial analysis for new programs, expansion and/or termination of existing programs, and support for special projects. His extensive knowledge of the Medical Center’s financial and operational functions is an essential asset in the attempt to maximize third party reimbursements and especially to mitigate any potential lost revenue due to the OIG review. This Amendment will allow him to continue these services for another year as well as expand his scope to provide financial consulting services related to the Health System Redesign efforts. More specifically, he will also provide consultation services regarding expanded long-term care capacity on the SMMC campus and overall financial risk and opportunities as we move through Redesign. This Amendment increases his hourly rate from $125 to $165 an hour. He has not raised his rates since 2002, and this new rate is below market for a consultant with his knowledge and experience.

County Counsel has reviewed and approved this amendment. 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 requirements.

FISCAL IMPACT:

The term is extended by one year, for a new term of January 1, 2007, to December 31, 2009. The amount expended for FY 2007-08 is $58.469. The estimated FY 2008-09 amount will be about $ . The increase is due to both the expanded scope of work and increase in hourly rate. The maximum amount of the Agreement is increased by $175,000, from $100,000 to $275,000. Funds are included in SMMC and Health Department’s FY 2008-09 Adopted Budgets and funds will be included in the budget requests for FY 2009-10.