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File #: A 25-403    Name: Victoria Chew MD Fourth Amendment
Type: BoS Agreement Status: Natividad Medical Center - Consent
File created: 10/1/2025 In control: Board of Supervisors
On agenda: 10/21/2025 Final action:
Title: a. Authorize the Chief Executive Officer (CEO) for Natividad Medical Center (NMC) or his designee to execute the Fourth Amendment to the Professional Services Agreement (A-14569) with Victoria Chew, M.D. to provide family medicine services, extending the term by twenty-four months (January 1, 2026 to December 31, 2027) for a revised full agreement term of November 1, 2018 to December 31, 2027, and adding $200,000 for a revised total agreement amount not to exceed $600,000 in the aggregate; and b. Authorize the CEO for NMC 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 exceed 10% ($10,000) of the original contract amount and do not increase the total contract amount above $610,000.
Attachments: 1. Board Report, 2. Victoria Chew MD Fourth Amendment, 3. Victoria Chew MD Third Amendment, 4. Victoria Chew MD Second Amendment, 5. Victoria Chew MD First Amendment, 6. Victoria Chew MD Agreement
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Title

a. Authorize the Chief Executive Officer (CEO) for Natividad Medical Center (NMC) or his designee to execute the Fourth Amendment to the Professional Services Agreement (A-14569) with Victoria Chew, M.D. to provide family medicine services, extending the term by twenty-four months (January 1, 2026 to December 31, 2027) for a revised full agreement term of November 1, 2018 to December 31, 2027, and adding $200,000 for a revised total agreement amount not to exceed $600,000 in the aggregate; and

b. Authorize the CEO for NMC 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 exceed 10% ($10,000) of the original contract amount and do not increase the total contract amount above $610,000.

 

Report

RECOMMENDATION:

 

It is recommended the Board of Supervisors:

 

a. Authorize the Chief Executive Officer (CEO) for Natividad Medical Center (NMC) or his designee to execute the Fourth Amendment to the Professional Services Agreement (A-14569) with Victoria Chew, M.D. to provide family medicine services, extending the term by twenty-four months (January 1, 2026 to December 31, 2027) for a revised full agreement term of November 1, 2018 to December 31, 2027, and adding $200,000 for a revised total agreement amount not to exceed $600,000 in the aggregate; and

b. Authorize the CEO for NMC 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 exceed 10% ($10,000) of the original contract amount and do not increase the total contract amount above $610,000.

 

SUMMARY:

 

NMC operates Family Medicine Residency Program affiliated with the University of California’s San Francisco Medical School with a total of 30 residents that practice in multiple settings including the inpatient labor and delivery unit.  It is necessary for the Residency Program to maintain a core team of qualified family medicine physicians made up of employed and independent contractor physicians for patient care and the supervision of its residents.

 

DISCUSSION

 

NMC has an agreement with Dr. Chew to provide family medicine and supervision of resident services for the Residency Program from time to time as needed.  NMC wishes to amend the agreement before the term date to add additional funds and to extend the term by 24 months from the date of expiration so that Dr. Chew can continue to provide the same services without interruption.   Due to unanticipated service demands, Dr. Chew has provided significantly more coverage than originally projected under her current agreement, necessitating a request for additional funds prior to the agreement’s term date to ensure continuity of care and resident supervision. NMC has obtained an independent opinion of fair market value supporting the payment terms.

 

OTHER AGENCY INVOLVEMENT:

 

The Office of County Counsel has reviewed and approved this Fourth Amendment as to legal form, and the Auditor-Controller has reviewed and approved this Amendment as to payment provisions. The Fourth Amendment has also been reviewed and approved by NMC’s Finance Committee and by its Board of Trustees.

 

FINANCING:

 

The cost of this Amendment is $200,000.  The total not to exceed amount of this Agreement is $600,000 for the period November 1, 2018 to December 31, 2027 (109 Months). $100,000 is included in the Fiscal Year 2025/2026 Adopted Budget, the remaining balance will be budgeted in the subsequent fiscal years. Funding will be provided from NMC’s Enterprise Fund 451-9600-6608.

 

 

BOARD OF SUPERVISORS STRATEGIC PLAN GOALS SECTION:

 

The services rendered in this agreement provide Natividad with the additional support it needs to provide reliable and high-quality patient care which improves the health and quality of life for Monterey County residents and their families.

 

_X Well-Being and Quality of Life
__ Sustainable Infrastructure for Present and Future

_   Safe and Resilient Communities

__Diverse and Thriving Economy

__ Administrative

 

 

Prepared by: Jeanne-Ann Balza, Director of Physician Services, 783.2506

Approved by: Charles R. Harris, Chief Executive Officer, 783-2551

 

Attachments:


Board Report

Fourth Amendment

Third Amendment
Second Amendment
First Amendment

Original Agreement

 

Attachments on file with the Clerk of the Board