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 Palo Alto Medical Foundation for Health Care, Research and Education


Adopt a Resolution authorizing the:


President of the Board to execute an Agreement with Palo Alto Medical Foundation for Health Care, Research and Education and San Mateo Health Commission doing business as the Health Plan of San Mateo to increase access to medical care for underserved and vulnerable residents for the term September 1, 2009 through August 31, 2011; 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. We updated your Board on these efforts through the 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.


Palo Alto Medical Foundation for Health Care, Research and Education (PAMF) has expanded its operations into San Mateo County and has worked in strong partnership with the County and HPSM to increase its role in serving the County’s publicly- covered and indigent populations. This agreement outlines expanded areas of partnership in three key areas prioritized in the development of the CHNU. Each of these is being contributed by PAMF as part of its charitable and philanthropic mission as a not-for-profit medical foundation.


Under this agreement, PAMF will provide the following: 1) medical subspecialty services that include two half-day clinics per month of pediatric neurology services and four two-week blocks of infectious disease coverage per year at San Mateo Medical Center (SMMC); 2) professional obstetric and pediatric inpatient care for up to 100 mothers per year who are admitted to Sequoia Hospital for their deliveries; and; 3) primary and specialty medical and ancillary services for 300 clients who meet the County’s eligibility requirements for the Access and Care for Everyone (ACE) program and thereby also meet the charity care guidelines established by PAMF. The County’s responsibilities for oversight and coordination of a redesigned obstetric network as part of the CHNU and management of the PAMF ACE partnership are also described in this agreement.


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. It is anticipated that SMMC will provide 244,814 outpatient visits in FY 2010-11.


Performance Measure:


FY 2009-10

FY 2010-11

San Mateo Medical Center number of outpatient visits





The term of the Agreement is September 1, 2009 through August 31, 2011. PAMF’s expanded services to the publicly covered population will be billed directly to the appropriate federal/ state government programs, and services for the ACE population are provided at no cost to the County. Expenses and revenues for the services provided by SMMC are included in the SMMC FY 2010-11 Adopted Budget and revenues and expenses associated with services in future years will be included in those budgets. There is no Net County Cost.