COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health System

DATE:

January 31, 2011

BOARD MEETING DATE:

April 26, 2011

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

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

SUBJECT:

Agreement with Paul R. Linquist, MD

RECOMMENDATION:

Adopt a Resolution authorizing the:

A)

President of the Board to execute an Agreement with Paul R. Linquist, MD to provide specialty orthopedic services for the term April 1, 2011 through March 31, 2013, for a maximum obligation of $350,000; and

B)

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

BACKGROUND:

San Mateo County is responsible for providing necessary medical care to its medically indigent population. Dr. Linquist has provided orthopedic services at San Mateo Medical Center (SMMC) for more than twenty years and will continue to provide, at a minimum, the same level of service as he has under previous Contracts with the County.

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. Linquist and other orthopedists.

County Administrative Memorandum B-1 provides that contracts for physicians are exempt from the Request for Proposals process, although staff has undertaken inquiries to ensure that this proposed Agreement with Dr. Linquist is advantageous to the County.

DISCUSSION:

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. Linquist has agreed to provide an increased level of 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. In addition, Dr. Linquist will serve as the Chief of Orthopedics and take responsibility for the group call coverage schedule.

The Agreement and Resolution have been reviewed and approved by County Counsel 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:

Measure

FY 2009-10
Actual

FY 2010-11
Projected

Percentage of repeat orthopedic surgeries for the same diagnosis

<5%

<5%

FISCAL IMPACT:

The term of this Agreement is April 1, 2011 through March 31, 2013. The maximum fiscal obligation is $350,000. Funds in the amount of $43,750 are included in the SMMC FY 2010-11 Adopted Budget and $175,000 is included in the SMMC FY 2011-12 Recommended Budget. Similar arrangements will be made for future budget 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.