Inter-Departmental Correspondence

Health System



August 16, 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


Amendment to Agreement with Jackson & Coker Locum Tenens, LLC



Adopt a Resolution authorizing the:


President of the Board to execute an Amendment to the Agreement with Jackson & Coker Locum Tenens, LLC to provide locum tenens services by increasing the maximum amount payable by $255,000, from $95,000, to $350,000 with no change to the term of the Agreement; and



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.



Locum Tenens services are medical services provided by physicians who substitute for another physician. These independent physicians must be Board Certified in their specialty and credentialed by the Medical Staff Office of the San Mateo Medical Center (SMMC). In December 2009 an Agreement was signed with Jackson & Coker Locum Tenens, LLC (Jackson & Coker) to provide part-time specialty coverage for the term December 1, 2009 through November 30, 2011 in an amount not to exceed $25,000. On February 2, 2010, the Agreement was amended to increase the maximum fiscal obligation by $70,000 for a new maximum fiscal obligation of $95,000. This increase was needed to provide part-time dermatology coverage when the contracted dermatologist accepted a full time position in the private sector.



SMMC has discontinued a contract with an orthopedist. There is a need for temporary Orthopedic clinic, surgery and call services until a part-time orthopedist is located and the County is able to complete a contract. This Amendment will allow for the provision of dermatology and orthopedic services until new providers can be identified and contracted with.


A Request for Proposals (RFP) was not published at the beginning of this Contract as the original amount of $25,000 requires a quote from three vendors who provide the same services. An RFP will be developed and published for locum tenen services prior to the end of this Agreement.


County Counsel has reviewed and approved the Amendment and Resolution 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.


This Amendment contributes to the Shared Vision 2025 outcome of a Healthy Community by providing patients with access to non-emergency urgent care. In addition, this allows the locum tenens physicians to treat SMMC patients through Clinics and Surgery. 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 Joint Commission of American 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 December 1, 2009 through November 30, 2011. The maximum amount of the Agreement is $350,000. Of the funds to pay for these services, $164,000 is included in the SMMC FY 2010-11 Adopted Budget and $91,000 will be included in the SMMC FY 2011-12 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.