Inter-Departmental Correspondence

Health System


April 23, 2010


May 25, 2010






Honorable Board of Supervisors


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


Amendment to Agreement with On-Site Health



Adopt a Resolution:

1) Authorizing the President of the Board to execute an Amendment to the Agreement with On-Site Health to provide dental health care services to homeless individuals in San Mateo County by extending the Agreement’s term to be March 31, 2010 through October 31, 2010, increasing the funding by $68,617.50, for a new maximum fiscal obligation of $137,235, and reflecting the Contractor’s change in name from Onsite Dental Care Foundation to Onsite Health; 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.



San Mateo Medical Center (SMMC) was awarded the Health Care for the Homeless (HCH) grant from the Federal Bureau of Primary Health Care, Health and Resource Services Administration to provide primary, dental, and behavioral health care to the County’s homeless population.


In early 2007 a Request for Proposals was issued and On-Site Health was selected to provide comprehensive dental health care services to individuals who are homeless and/or at risk of being homeless. On-Site Health contracted with the County from November 1, 2008 through October 31, 2009 and again from November 1, 2009 through March 31, 2010.



Onsite Health operates a mobile dental van that provides dental services to homeless individuals through SMMC's HCH Program.  Due to complications from Onsite's cancellation of services during prior contract years (mainly in late 2008 and the summer of 2009), SMMC explored other options for providing dental care to homeless patients.  SMMC has expanded dental services to homeless patients by operating Saturday and weekday evening dental clinics.  Even with the additional dental clinics and operating at current capacity, SMMC continues to experience an increased demand for dental care among homeless patients.  Community contracts are needed to better meet this demand.


The current Onsite contract only covers 6 months, as it was uncertain if the contract would continue.  Given the noteworthy increase in Onsite's performance and communication with SMMC, an amendment is being requested to continue the contract for another 6 months. 


The delay in getting this Amendment completed was failure of the vendor to return the signed Agreement.


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 dental health care services to homeless individuals in San Mateo County. It is anticipated that 50% of dental patients will complete treatment plans within a twelve month period.


Performance Measure(s):


FY 2009-10

FY 2010-11

Percentage of dental patients who complete treatment plans within a twelve month period.





The Amendment extends the term by six months and increases the funding by $68,617.50 for a maximum fiscal obligation of $137,235. Funds in the amount of $102,926.25 are included in SMMC FY 2009-10 Adopted Budget. Funds in the amount $34,308.75 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 are covered by the County’s General Fund contribution to SMMC.