Inter-Departmental Correspondence

Health System



January 13, 2011


February 8, 2011







Honorable Board of Supervisors


Jean S. Fraser, Chief, Health System

Susan Ehrlich, MD, MPP, Chief Executive Officer, San Mateo Medical Center

Srija Srinivasan, Director of Strategic Operations, Health System


Memorandum of Agreement with Sequoia Hospital


Adopt a Resolution authorizing the:


President of the Board to execute a Memorandum of Agreement with San Mateo Health Commission doing business as Health Plan of San Mateo and Catholic Healthcare West doing business as Sequoia Hospital for the term January 1, 2011 through December 31, 2012; 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)” to leverage the capacity of all entities in service to the publicly insured and uninsured populations in San Mateo County. We have updated your Board 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 codify the contributions and areas of partnership that have been expanded. These agreements outline the clinical, operational and financial responsibilities of the partner entity, the Health System, and HPSM.


Sequoia Hospital (Sequoia) has been an important partner to the County and HPSM for many years, serving as an inpatient hospital partner for residents living in the southern part of the County. This agreement outlines expanded areas of partnership in obstetric care, through which the Health System, HPSM, Sequoia and several other partners have redesigned roles to facilitate improved geographic access for low-income children and pregnant women.


This agreement outlines Sequoia’s responsibilities in expanding access to obstetric care for up to 100 pregnant women covered by the Medi-Cal program, as well as County responsibilities for coordination of appropriate referrals to and from Sequoia for obstetric and pediatric care, and the provision of prenatal and pediatric care that supports the CHNU obstetric network. The agreement also references a separate agreement between the County and the Palo Alto Medical Foundation, which includes provision of physician services that support Sequoia’s expanded role in services to the Medi-Cal population.


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 for the term January 1, 2011 through December 31, 2012. Sequoia’s expanded services to the Medi-Cal population will be billed directly to the HPSM or fee-for-service Medi-Cal programs. Expenses and revenues for the prenatal and obstetric coordination 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.