COUNTY OF SAN MATEO Inter-Departmental Correspondence
Health System
DATE:				March 25, 2009
BOARD MEETING DATE:				April 28, 2009
SPECIAL NOTICE/HEARING:				None
VOTE REQUIRED:				Majority
TO:		Honorable Board of Supervisors
FROM:		Jean S. Fraser, Chief, Health System Susan Ehrlich, M.D., Interim Chief Executive Officer, San Mateo Medical Center
SUBJECT:		Agreement with Duc Marcel Nguyen, M.D.
RECOMMENDATION:
Adopt a Resolution:
1.	Authorizing the President of the Board to execute an Agreement with Duc Marcel Nguyen, M.D. to provide specialty orthopedic services for the term April 1, 2009 through March 31, 2011, in an amount not to exceed $425,000; and
2.	Authorizing the Chief of the Health System 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: 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 continuing to provide professional, specialty, orthopedic services to residents in the County of San Mateo.
Performance Measure:
Measure			FY 2008-09 Projected		FY 2009-10 Projected
Percentage of repeat orthopedic surgery for the same diagnosis for one year.			<5%		<5%
BACKGROUND:
San Mateo County is responsible for providing necessary medical care to its medically indigent population, and access to services to its general population. This care includes professional specialty orthopedic services and the management and supervision of those services. Duc Marcel Nguyen, M.D. provides professional specialty orthopedic services.
DISCUSSION:
Dr. Nguyen has provided orthopedic services at San Mateo Medical Center (SMMC) for the past seven years and will continue to provide orthopedic services as performed in the previous Agreement. The County need for orthopedic services is increasing. SMMC will be capable of continuing to meet this growing need through contracts with Dr. Nguyen and other orthopedists, including the addition of an orthopedist in January 2009. Orthopedic services are provided under the direction of the Chief Executive Officer of SMMC, the Quality Assurance Committee, and the Executive Committee of the Medical Staff.
The Health System Redesign Initiative Team, County Counsel and Risk Management have reviewed and approved this Agreement.
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.
FISCAL IMPACT:
The term of the Agreement is April 1, 2009 through March 31, 2011. The maximum amount payable under this Agreement is $425,000. The net cost to the County is $48,502 per year less than under the prior Agreement. Funds are included in SMMC’s FY 2008-09 Adopted Budget, and funds will be included in future Recommended Budgets. Expenses at SMMC are covered by fees for services or third-party payors whenever possible. The portion of expenses for services provided to the medically indigent or to those covered by programs that do not meet the full costs of care are covered by the County’s General Fund contribution to SMMC.