Inter-Departmental Correspondence

Health System



January 26, 2011


April 12, 2011







Honorable Board of Supervisors


Jean S. Fraser, Chief, Health System
Susan Ehrlich, MD, MPP, Chief Executive Officer
San Mateo Medical Center


Agreement with Gene Bruce, MD



Adopt a Resolution authorizing the:


President of the Board to execute an Agreement with Gene Bruce, MD to provide specialty orthopedic services for the term April 1, 2011 through March 31, 2013, for a maximum obligation of $300,000; 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.



San Mateo County is responsible for providing necessary medical care to its medically indigent population, and access to services to its general population. Dr. Bruce has provided orthopedic services at San Mateo Medical Center (SMMC) for the last nine years and will continue to provide, at a minimum, the same level of service as the previous Agreement.


County Administrative Memorandum B-1 provides that contracts for physicians are exempt from the Request for Proposals process.



The County’s need for these orthopedic services is increasing due to the aging of its patient population. SMMC will continue to meet this growing need through contracts with Dr. Bruce and other orthopedists.


An Agreement with a half-time orthopedist expired on July 31, 2010 and was not renewed. To assist in ensuring the continued availability of orthopedic coverage, Dr. Bruce has agreed to provide urgent surgery, clinic and call coverage until an Agreement can be negotiated with a new orthopedist. This new provider is projected to begin August 1, 2011.


The County Counsel has reviewed and approved this Agreement and Resolution as to form. The Contractor’s insurance has been reviewed and approved by Risk Management.


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 Agreement contributes to the Shared Vision 2025 outcome of a Healthy Community by providing access to specialty orthopedic services to residents of San Mateo County. It is anticipated that less than five percent (5%) of orthopedic surgeries performed will need to be repeated for the same diagnosis, which is an indicator of the highest quality of care.


Performance Measure:


FY 2009-10

FY 2010-11

Percentage of repeat orthopedic surgeries for the same diagnosis





The term of the Agreement is April 1, 2011 through March 31, 2013. The maximum fiscal obligation is $300,000. Funds in the amount of $37,500 are included in the SMMC FY 2010-11 Adopted Budget and $150,000 is included in the SMMC FY 2011-12 Recommended Budget. Similar arrangements will be made for future years.


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.