COUNTY OF SAN MATEO Inter-Departmental Correspondence
San Mateo Medical Center
DATE:				October 30, 2008
BOARD MEETING DATE:				January 6, 2009
SPECIAL NOTICE/HEARING:				None
VOTE REQUIRED:				Majority
TO:		Honorable Board of Supervisors
FROM:		Sang-ick Chang, MD, Chief Executive Officer, San Mateo Medical Center
SUBJECT:		Agreement with Scott Oesterling, MD
RECOMMENDATION:
Adopt a resolution:
A.	Authorizing the execution of an Agreement with Scott Oesterling, MD to provide obstetrics and gynecology services in the amount of $4,012,905.60 for the term January 1, 2009 through December 31, 2010.
B.	Authorizing the Chief Executive Officer (CEO) of San Mateo Medical Center (SMMC) 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: Ensure Basic Health and Safety for All.
Goal 5: Residents have access to healthcare and preventive care.
The Amendment to the Agreement contributes to this commitment and goal by providing comprehensive obstetrics and gynecology services.
Performance Measure(s):
Measure			2007-08 Actual		2008-09 Projected
Number of vaginal, operative, and cesarean deliveries			1215		1215
Rates of preterm delivery < 15%			< 15%		< 15%
Percent of cesarean deliveries			21.4%		<25%
BACKGROUND/DISCUSSION:
The group represented by Scott Oesterling, M.D. has a long history of providing obstetrics and gynecology services to SMMC. In particular, these disciplines serve as the basis for routine evaluation and treatment of pre-, intra-, and post-partum care (obstetrics) and the evaluation, diagnosis, treatment, and monitoring of uterine, ovarian, endometrial, and vaginal disease (gynecology). SMMC has a continuous need for obstetrics and gynecology services, and Dr. Oesterling’s group offers the hospital the benefits of experienced practitioners familiar with the complex nature of the County’s patient base.
At this time, all SMMC obstetrics (OB) patients are delivered at Lucille Packard Children’s Hospital at Stanford. Through the leadership of the County Manager’s Office and the Health System Redesign team, the private hospital and physician groups are planning to redistribute these deliveries to other hospital and physician providers in the County. This will improve the quality of care and patient experience by enabling women to deliver their children closer to home, and at the same time will involve other community providers in the OB system of care for the underserved. This effort is an important part of planning to implement the Blue Ribbon Task Force recommendations and the Community Health Network for the Underserved.
The terms and conditions in the Agreement are essentially the same as those between the County and Dr. Oesterling in the Agreement dated August 15, 2006, except that the list of providers has been updated, and that the new Agreement reflects an annual savings of $79,589.20 per year from the prior Agreement.
The Health System Redesign Initiative Team and County Counsel have reviewed and approved this Amendment. 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.
TERM AND FISCAL IMPACT:
The term of the Agreement is January 1, 2009 through December 31, 2010. The maximum amount payable under this Agreement is $4,012,905.60. Funds are included in SMMC’s FY2008-09 Recommended Budget, and funds will be included in the budget request for FY 2009-10.