Inter-Departmental Correspondence

Health System



August 18, 2010


October 5, 2010







Honorable Board of Supervisors


Jean S. Fraser, Chief, Health System
Susan Ehrlich, MD, MPP, Chief Executive Officer

San Mateo Medical Center


Agreement with California Emergency Physicians Medical Group



Adopt a Resolution authorizing the:


President of the Board to execute an Agreement with California Emergency Physicians Medical Group to provide Emergency Medical Services and Correctional Health Services for the term of July 1, 2010 through June 30, 2011, for an amount not to exceed $4,290,000; 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.



California Emergency Physicians Medical Group (CEP) has provided the physician and physician assistant staff for the Emergency Department (ED) at the San Mateo Medical Center (SMMC) for the last several years and provides ED coverage at twenty-two other Northern California hospitals. This group offers the hospital the benefits of a large practice with diverse specialization and administrative support.



CEP will continue to provide Board Certified ED physicians twenty-four hours a day, seven days a week. They will also provide coverage for the Health System’s Correctional Health Division and have agreed to increase overall ED coverage by augmenting the number of shifts for physicians, increasing annual physician time by 2555 hours, to a total of 14,235 physician hours, to provide adequate ED coverage. This is necessary to accommodate the increase in ED patient volume. In addition, CEP will continue to provide medical supervision for Psychiatric Emergency Services (PES) residents and restraint authority for PES patients in the absence of on-site psychiatry attending staff.


The level of ED staffing is determined by a staffing model based on industry standards. There is no increase in hourly compensation for physicians or physician assistants from the previous Agreement.


The Health System Redesign Initiative Team has reviewed and approved this Agreement. The Contractor’s insurance has been reviewed and approved by Risk Management. County Counsel has reviewed and approved the Resolution and Agreement 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 Agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by providing patients with access to emergency services. In addition, this allows the ED to treat medical emergencies and intervene in life threatening situations. It is anticipated that a patient satisfaction rating of more than 3.5 on a 4 point scale will be maintained and is an indicator of quality patient care and meets the Joint Commission hospital guidelines for accreditation.


Performance Measure:


FY 2009-10

FY 2010-11

Patient satisfaction on a four point scale





The term of the Agreement is July 1, 2010 through June 30, 2011. The maximum amount of the Agreement is $ 4,290,000. Funds in the amount of $219,240 are included in the Correctional Health FY 2010-11 Adopted Budget. Funds in the amount of $4,070,760 are included in the SMMC FY 2010-11 Adopted 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.