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COUNTY OF SAN MATEO
Inter-Departmental Correspondence
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Health System
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DATE:
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March 24, 2009
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BOARD MEETING DATE:
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May 19, 2009
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SPECIAL NOTICE/HEARING:
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None
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VOTE REQUIRED:
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Majority
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TO:
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Honorable Board of Supervisors
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FROM:
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Jean S. Fraser, Chief, Health System
Susan Ehrlich, MD, MPP, Interim Chief Executive Officer
San Mateo Medical Center
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SUBJECT:
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Resolution Authorizing the Controller to Pay Non-Contract Physicians for Services at San Mateo Medical Center
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RECOMMENDATION:
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Adopt a Resolution authorizing the Controller to pay non-contract physicians for emergency backup services provided at San Mateo Medical Center and physicians at non-contracted hospital facilities in an amount not to exceed $300,000 for the period July 1, 2009 through June 30, 2011.
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VISION ALIGNMENT:
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Commitment: Ensure basic health and safety for all.
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Goal 5: Residents have access to healthcare and preventive care.
This Resolution contributes to this commitment and goal by addressing the need for highly specialized medical services to County patients.
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Performance Measure:
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Measure
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FY 2008-09 Estimate
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FY 2009-10
Target
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Percentage of patients referred to non-contract physicians for specialty care services
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3.5%
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3.5%
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BACKGROUND:
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Because there is not always sufficient coverage at San Mateo Medical Center (SMMC) for specialty care services, it is sometimes necessary to augment the physicians with whom the County of San Mateo contracts. Examples of shortages include pediatric on-call coverage, gastroenterology, neurosurgery and dermatopathology. Physicians provide emergency backup services to our patients when no other contracted medical coverage or SMMC staff physician is available. In addition, this Resolution covers physician services for patients referred to other facilities (i.e., Stanford Hospital). Because SMMC does not offer the service or surgical procedure, the Resolution authorizes payment of the non-contracted physician who performs the necessary procedure or surgery. Since November 8, 2005, the Board of Supervisors has authorized the Controller to pay non-contract physicians who provide medical services to patients at SMMC. Your Board has recently approved a similar Resolution for non-contract services provided by medical care providers other than physicians.
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DISCUSSION:
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All patient referrals to non-contract physicians for specialty care services must be authorized by SMMC Administration, and utilization review will be concurrently provided by the Case Management Department at SMMC. SMMC has experienced a recent increase in the number of patients seen in the emergency department, clinics, surgery and as hospital inpatients; this is attributed in part to the declining economy.
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The Health System Redesign Initiative Team and County Counsel have reviewed and approved this Resolution.
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FISCAL IMPACT:
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The term of this Resolution is July 1, 2009 through June 30, 2011. Payments under this Resolution will not exceed $300,000 for the term. Funds are included in the SMMC FY2009-10 Recommended Budget and will be included in the SMMC FY2010-11 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.
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