Inter-Departmental Correspondence

Health System



August 16, 2010


September 14, 2010







Honorable Board of Supervisors


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


Amendment to the Agreement with Shelter Network



Adopt a Resolution authorizing the:


President of the Board to execute an amendment to the Agreement with Shelter Network, for the term of January 1, 2009 through December 31, 2011, increasing the number of guaranteed beds by two to six and increasing the amount of the Agreement by $100,000, to a new maximum fiscal obligation of $200,000; and



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.



Shelter Network provides safe housing for the homeless in compliance with San Mateo Medical Center (SMMC)’s discharge plan and timeline as long as the clients are meeting program requirements. In addition to safe housing, Shelter Network provides the basic necessities and practical support, including food, clothing, transportation assistance, phone and laundry access as well as financial assistance as needed and substance abuse counseling until such time as the patients’ next of kin can provide for them.


On May 20, 2010, the County Manager approved a Change Order which amended the Agreement by increasing the number of guaranteed beds each night from one to a total of four and increasing the maximum amount payable from $75,000 to $100,000.



Due to an increase in the number of indigent patients who require a place to stay until their next of kin can be located, the number of beds in the original contract needs to be increased from four beds to six beds. San Mateo County will pay Contractor $45 per night per bed for a guaranteed total of six beds over the remainder of the term. This service greatly reduces the number of hospital administrative days and decreases the amount of financial impact while meeting SMMC’s discharge plan.


The Amendment and Resolution have been reviewed and approved by County Counsel as to form.


The Contractor has assured compliance with the County’s Contractor Employee Jury Service Ordinance, as well as 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.


This Amendment contributes to the Shared Vision 2025 outcome of a Healthy Community by ensuring patient safety and fiscal and compliance responsibility to meet the requirements put forth by the Centers for Medicare and Medicaid Services (CMS), which is the primary payor of SMMC services. It is anticipated that these services will help SMMC obtain a 100% compliance with SMMC’s discharge plan and timeline.


Performance Measure:


FY 2009-10

FY 2010-11

SMMC’s discharge plan and timeline





The term of this Agreement is January 1, 2009 through December 31, 2011. The Amendment increases the Agreement by $100,000 which is in the SMMC tentatively Adopted FY 2010-11 Budget and will be included in the SMMC FY 2011-12 Recommended Budget for a new maximum amount of $200,000.


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.