Inter-Departmental Correspondence

Health System



April 14, 2010


April 27, 2010







Honorable Board of Supervisors


Jean S. Fraser, Chief, Health System


Health System Redesign Initiative Implementation Final Report


Adopt a Resolution accepting the Health System Redesign Initiative implementation final report for the period April 2009 through March 2010.



On March 25, 2008, your Board approved an implementation plan for the Health System Redesign Initiative (Redesign). This plan was developed in follow-up to the in-depth assessment of the County’s role in healthcare delivery completed by Health Management Associates (HMA), accepted by your Board on February 5, 2008, and as the final planning phase recommendations of the Blue Ribbon Task Force on Adult Health Care Coverage Expansion (BRTF), approved by your Board on May 20, 2008. To ensure appropriate leadership and focus on the important policy and programmatic issues identified by these efforts, the County Manager initiated the two-year Redesign initiative involving the senior executives leading the Health System and Health Plan of San Mateo (HPSM).


Your Board has reviewed and accepted reports on the progress of this initiative. The most recent update was accepted on April 14, 2009.



The report details accomplishments in the areas for priority focus during the first half of the Redesign Initiative’s second year:



Eligibility and Administration


ACE Policy and Third Party Administration Implementation


Long-Term Care Integration


Strategic Finance Issues


Community Health Network for the Underserved


For each of these areas, Redesign team members and leaders across the participating organizations developed workplans and initiated cross-Department workgroups to lead the operational changes prioritized to achieve positive client impact and financial improvement. The Redesign oversight group has met regularly to oversee these efforts, identify and act on competing priorities, recommend and implement necessary organizational changes, and ensure unified resource direction aligned with the County’s long-term goals.

The leadership of your Board and the County Manager, as well as involvement of senior executives from each of the major healthcare delivery systems serving San Mateo County has enabled continued progress in creating a “Community Health Network for the Underserved.” This network involves a role for each delivery system in meeting the healthcare needs of the uninsured and underserved. Both of the Health Care Districts operating in the County have supported this work through targeted investments addressing low-income residents within the respective District boundaries. This network will be vital to meeting the vision of access to healthcare for all of the County’s uninsured and publicly-covered residents.

As the Health System has aligned all County health functions within a single department, its leadership team, with the partnership of HPSM, is embedding key aspects of the Redesign Initiative into ongoing structures and planning efforts.

Approval of this Resolution contributes to the Shared Vision 2025 outcome of a Healthy Community by enabling the San Mateo County Health System to strengthen its role as a provider of healthcare services to vulnerable populations and by enlisting key partners in expanding services to uninsured and publicly-covered adults. The percentage of partners rating Health System work as excellent is an indicator of effectiveness in achieving strong partnerships, which will continue to contribute to ongoing collaboration in sustaining the healthcare safety net.

The report details accomplishments in the areas for priority focus during the Redesign Initiative’s second year and represents the Final Report on this effort.

The Resolution has been reviewed and approved by County Counsel.


Performance Measure(s):


FY 2008-09

FY 2009-10

Percentage of Task Force and Strategic Initiative partners rating Policy and Planning work as excellent



*Demonstrates extraordinary effort and satisfaction.



There is no Net County Cost associated with acceptance of this implementation final report. Staff and consultant costs associated with Redesign have been included in the Health System’s FY 2009-10 Adopted Budget. The Redesign Initiative supports cost savings and revenue enhancements included in the FY 2009-10 Adopted Budget for the San Mateo Medical Center which incorporates a $4.4 million General Fund contribution reduction over FY 2008-09.