COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health System

DATE:

September 11, 2009

BOARD MEETING DATE:

October 20, 2009

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Jean S. Fraser, Chief, Health System
Susan Ehrlich, MD, MPP, Chief Executive Officer
San Mateo Medical Center

SUBJECT:

Agreement with Mills-Peninsula Health Services

RECOMMENDATION:

Adopt a Resolution:

1.

Authorizing the President of the Board to execute an Agreement with Mills-Peninsula Health Services to provide diagnostic and therapeutic services not available at San Mateo Medical Center for the term October 1, 2009 through September 30, 2011, in an amount not to exceed $500,000; 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

BACKGROUND:

San Mateo County is responsible for providing medical care to its medically indigent adult (MIA) population. San Mateo Medical Center (SMMC) is a general acute care hospital and does not provide certain highly specialized services. A contract with Mills-Peninsula Health Services (Mills) ensures that specialty services are readily available. Services provided under this Agreement are required medical services that are not presently provided at SMMC.

DISCUSSION:

All patients referred to Mills undergo utilization review to minimize hospital stays and maintain control over costs. Health Plan of San Mateo (HPSM) rates have been negotiated in order to maintain or reduce costs of services for tertiary care contracts.

The Health System Redesign Initiative Team and Risk Management have reviewed and approved this Agreement. County Counsel has reviewed and approved the Resolution and 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.

Approval of this Agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by providing patients with access to necessary specialty services not offered at SMMC at a rate favorable to the County. It is expected that most services to patients are provided in-house, and about 3.5% of patients will receive some specialty care from other community providers. By referring patients to Mills, the quality of care and service is insured based on a large program base, rather than trying to provide a non-cost effective service in-house.

Performance Measures:

Measure

FY 2008-09
Actual

FY 2009-10
Projected

Percentage of patient referrals to community providers

3.5%

3.5%

FISCAL IMPACT:

The term of this Agreement is October 1, 2009 through September 30, 2011. The maximum amount the County shall be obligated to pay Contractor is $500,000. Funds in the amount of $187,500 are included in the SMMC FY 2009-10 Adopted Budget and $250,000 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.