Title
a. Authorize the Chief Executive Officer (CEO) for Natividad Medical Center (NMC) or his designee to execute the Third Amendment to the Professional and Call Coverage Services Agreement (A-14417) with Boris H. Borazjani MD, Inc. to provide acute care surgical services, extending the term by twelve months (July 1, 2025 to June 30, 2026) for a revised full agreement term of July 1, 2019 to June 30, 2026, but with no change to the aggregate not to exceed amount of $1,100,000; and
b. Authorize the CEO or his designee to sign up to three (3) future amendments to this agreement where the total amendments do not significantly change the scope of work, do not cause an increase of more than 10% ($50,000) of the original contract amount of the original contract amount and do not increase the total contract amount above $1,150,000.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Authorize the Chief Executive Officer (CEO) for Natividad Medical Center (NMC) or his designee to execute the Third Amendment to the Professional and Call Coverage Services Agreement (A-14417) with Boris H. Borazjani MD, Inc. to provide acute care surgical services, extending the term by twelve months (July 1, 2025 to June 30, 2026) for a revised full agreement term of July 1, 2019 to June 30, 2026, but with no change to the aggregate not to exceed amount of $1,100,000; and
b. Authorize the CEO or his designee to sign up to three (3) future amendments to this agreement where the total amendments do not significantly change the scope of work, do not cause an increase of more than 10% ($50,000) of the original contract amount of the original contract amount and do not increase the total contract amount above $1,150,000.
SUMMARY/DISCUSSION:
Natividad received its designation as the Level II Trauma Center for Monterey County in January 2015. The American College of Surgeons requires acute critical care surgeons to be available in-house with a 15-minute response time for Level II Trauma Centers. In order to provide 24/7 care, it is necessary to maintain a core team of quality surgeons made up of employed and independent contract physicians to provide daily call coverage in the Emergency Department and follow-up care to patients in the Intensive Care Unit.
Natividad would like to enter into an agreement with Boris H. Borazjani MD, Inc., for which Dr. Borazjani, a board-certified fellowship trained trauma surgeon provides general and critical care surgical services as part of the comprehensive trauma services required for a Level II Trauma Center. Dr. Borazjani will participate in the on-call panel and will be paid a daily rate for the coverage services, which may increase due to availability and the need for coverage, but the rate of pay for services remains the same. NMC has obtained an independent opinion of fair market value supporting the payment terms of this Agreement.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved this Agreement as to legal form. Auditor-Controller has reviewed and approved this Agreement as to fiscal provisions. The Agreement has also been reviewed and approved by Natividad’s Finance Committee and Board of Trustees.
FINANCING:
There is no cost for this amendment. The total not to exceed amount of this agreement is $1,100,000. The actual cost is contingent upon Dr. Borazjani’s participation in the call panel which may fluctuate based on his availability. Natividad has agreements with multiple providers to ensure sufficient coverage of the trauma services where the total expenditure will not exceed $1,300,000 annually which is included in Fiscal Year 2023/2024 adopted budget. The remaining balance will be budgeted in subsequent fiscal years. There is no impact to the General Fund.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
The services rendered in this agreement provide Natividad with the additional support it needs in order to provide reliable and high-quality patient care which improves the health and quality of life for patients and their families.
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Prepared by: Jeanne-Ann Balza, Director of Physician Services, 783.2506
Approved by: Dr. Charles R. Harris, Chief Executive Officer, 783.2553
Attachments:
Third Amendment
Second Amendment
First Amendment
Agreement