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COUNTY OF SAN MATEO
Inter-Departmental Correspondence
Health System
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DATE:
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March 8, 2010
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BOARD MEETING DATE:
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April 27, 2010
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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, Chief Executive Officer
San Mateo Medical Center
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SUBJECT:
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Amendment to the Agreement with Kaiser Foundation Hospitals
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RECOMMENDATION:
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Adopt a Resolution authorizing the President of the Board to execute a fourth Amendment to the Agreement with Kaiser Foundation Hospitals to provide hospital services, extending the term through March 31, 2010, for a new term of November 1, 2005 through March 31, 2010.
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BACKGROUND:
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In November 2005 the County entered into an Agreement with Kaiser Foundation Hospitals (Kaiser) to provide hospital services for Kaiser patients for a term of three years from November 1, 2005 through October 31, 2008.
When this Agreement was approved by the County Manager, it was anticipated that the amount to be received from Kaiser would not exceed $100,000 for the term of the Agreement. However, the County has received more than $500,000 each fiscal year or $1,112,982 through FY 2007-08. These funds were generated through Kaiser patients receiving services through the San Mateo Medical Center (SMMC) Emergency Department. Due to the proximity to the Kaiser patients’ homes, SMMC may be the nearest Emergency Service Facility.
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DISCUSSION:
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The Agreement between Kaiser and SMMC allowed for the care of Kaiser patients at any department within SMMC, including Burlingame Long Term Care (BLTC). Kaiser and SMMC were unable to agree in negotiations to establish a new Hospital Services Agreement. Kaiser wanted to continue to pay 65% of billed charges, but the hospital is entitled to 100% of billed charges for patients treated through the Emergency Department. Kaiser has requested an Amendment to the existing Hospital Services Agreement to extend the term through March 31, 2010. This extension will allow Kaiser to notify members that there is no longer a contract in place and to relocate Kaiser patients who reside in BLTC.
A Request for Waiver to extend the Agreement beyond three years duration to December 31, 2009 was approved by the County Manager on August 6, 2009. A second waiver to extend the Agreement to March 31, 2010 was approved by the County Manager on March 10, 2010.
The Health System Redesign Initiative Team has reviewed and approved this Amendment. County Counsel has reviewed and approved the Resolution and Amendment as to form.
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.
Approval of this Amendment contributes to the Shared Vision 2025 outcome of a Healthy Community by providing emergency hospital services to patients of Kaiser when needed. It is anticipated that more than 80% of patient satisfaction surveys will rate the service provided by the Emergency Department as good or excellent. A rating of 80% indicates high quality patient care and meets Joint Commission of American Hospital guidelines for accreditation.
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Performance Measure:
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Measure
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FY 2008-09
Actual
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FY 2009-10
Projected
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Percent of patients rating overall satisfaction with Emergency Department visit as good or excellent
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>80%
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>80%
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FISCAL IMPACT:
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The original term of the Agreement is November 1, 2005 through October 31, 2008. The Amendment extends the term of the Agreement through March 31, 2010. 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 does not meet the full costs of care is covered by the County’s General Fund contribution to SMMC.
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