COUNTY OF SAN MATEO Inter-Departmental Correspondence
Health System
DATE:				March 25, 2009
BOARD MEETING DATE:				May 5, 2009
SPECIAL NOTICE/HEARING:				None
VOTE REQUIRED:				Majority
TO:		Honorable Board of Supervisors
FROM:		Jean S. Fraser, Chief, Health System Susan Ehrlich, MD, MPP, Interim Chief Executive Officer San Mateo Medical Center
SUBJECT:		Agreement with Paul R. Linquist, M.D.
RECOMMENDATION:
Adopt a Resolution:
1.	Authorizing the President of the Board to execute an Agreement with Paul R. Linquist, MD to provide specialty orthopedic services for the term April 1, 2009 through March 31, 2011, in an amount not to exceed $250,000; 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: Provide residents 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 2007-08 Projected		FY 2009-10 Projected
Percentage of repeat orthopedic surgery for same diagnosis for one year			<5%		<5%
BACKGROUND:
San Mateo County is responsible for providing necessary medical care to its medically indigent population. Dr. Linquist has provided orthopedic services at San Mateo Medical Center (SMMC) the past twenty years and will continue to provide, at a minimum, the same level of service as the previous Agreement.
DISCUSSION:
The County’s need for these orthopedic services is increasing due to the aging of its patient population. SMMC will continue to meet this growing need through contracts with Dr. Linquist and other orthopedists. In addition, Dr. Linquist will serve as the Chief of Orthopedics and take responsibility for the group call coverage schedule. The Health System Redesign Initiative Team, County Counsel and Risk Management have reviewed and approved this Agreement.
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.
FISCAL IMPACT:
The term of the Agreement is April 1, 2009 through March 31, 2011. The maximum amount payable under this Agreement is $250,000. Each year reflects a decrease of $12,000 in cost over the previous contract year due to a better negotiated rate. Funds in the amount of $31,250 are included in the SMMC FY 2008-09 Adopted Budget, $125,000 is included in the SMMC FY 2009-10 Recommended Budget and $93,750 will be included in the SMMC FY 2010-11 Recommended Budget. 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 is covered by the County’s General Fund contribution to SMMC.