Inter-Departmental Correspondence

Health System



September 29, 2010


November 2, 2010







Honorable Board of Supervisors


Jean S. Fraser, Chief, Health System

Dr. Susan Ehrlich, CEO, San Mateo Medical Center

Srija Srinivasan, Director of Strategic Operations, Health System


Agreement with Lucile Packard Children’s Hospital


Adopt a Resolution authorizing the:


President of the Board to execute an Agreement with Lucile Packard Children’s Hospital and San Mateo Health Commission doing business as the Health Plan of San Mateo for obstetric and pediatric services for the term June 1, 2010 through May 31, 2012, for a maximum obligation of $1,453,500; and



Chief of 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.



In early 2008 the Health System and the Health Plan of San Mateo (HPSM) initiated the planning and development of strengthened partnerships with each of the major healthcare provider organizations serving San Mateo County. Collectively, these partnerships comprise a “Community Health Network for the Underserved (CHNU)” that leverages the capacity of all entities in service to the publicly insured and uninsured populations in San Mateo County. Your Board was updated on these efforts through regular reports delineating the milestones achieved in developing the CHNU as part of the Health System Redesign Initiative. Your Board accepted the final report of the Redesign Initiative in April, 2010.


The Health System has developed agreements with CHNU participants to formalize the contributions and areas of partnership that have been agreed upon. These agreements outline the clinical, operational and financial responsibilities of the partner entity, the Health System, and HPSM.



Lucile Packard Children’s Hospital (LPCH) has been an important partner to the County and HPSM for many years, serving as a critical healthcare resource for children and their families. The agreement outlines expanded areas of partnership in obstetric and pediatric care, through which the Health System, HPSM, LPCH and several other partners have redesigned roles to facilitate: 1)improved geographic access for low-income children and pregnant women, 2) more effective stratification of the services referred to LPCH as the major tertiary and quarternary pediatric service provider for our region, and 3) support for the County to achieve greater sustainability in its role as a healthcare provider.


Included in this agreement are: 1) support of $300,000 per year for obstetric medical direction that guides and coordinates a redesigned network of care for Medi-Cal deliveries; 2) support of $406,500 in the first year and $447,000 in the second year for two pediatricians in San Mateo Medical Center (SMMC) clinics in southern San Mateo County to expand the County’s pediatric primary care capacity; 3) a commitment that LPCH will exert its best efforts to secure $2 million in capital support for a consolidated SMMC south county ambulatory clinic; and 4) County responsibilities for oversight and coordination of a redesigned obstetric network as part of the CHNU. The obstetric and pediatric services will be provided by current medical staff at SMMC.


County Counsel has reviewed and approved the Agreement and Resolution as to form.


The Agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by supporting the Health System’s financial sustainability in the provision of healthcare services. This measure is a function of the enhanced funding for pediatric and obstetric staffing. It is anticipated that SMMC will provide 65,000 pediatric visits in FY 2010-11.


Performance Measure:


FY 2009-10

FY 2010-11

San Mateo Medical Center number of pediatric visits



*projection was established prior to the finalization of the FY 2009-10 actuals; revision will be considered at a later date



The term of the Agreement is June 1, 2010 through May 31, 2012. The funding provided will total $1,453,500 in operating funding and $2 million in capital support for a consolidated South County Clinic. $706,500 is included in the SMMC FY 2010-11 Adopted Budget and $747,000 will be included in the SMMC FY 2011-12 Recommended Budget. Any funding associated with the South County Clinic will be brought to your Board and an Appropriation Transfer request will be presented for approval. There is no Net County Cost.