To: Board of Supervisors
From: Dr. Grant Colfax, Health Services Director
Report Title: Contract #76-861-2 with David Krivan, M.D. (dba Pine Cone Medical Services)
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Health Services Director, or designee, to execute on behalf of the County Contract #76-861-2 with David Krivan, M.D. (dba Pine Cone Medical Services), a sole proprietor, in an amount not to exceed $500,000, to provide anesthesiology services at Contra Costa Regional Medical Center (CCRMC) and Contra Costa Health Centers, for the period October 1, 2025 through September 30, 2026.
FISCAL IMPACT:
Approval of this Contract will result in annual contractual service expenditures of up to $500,000 funded 100% by Hospital Enterprise Fund I revenues.
BACKGROUND:
Due to the limited number of specialty providers available within the community, CCRMC and Contra Costa Health Centers relies on Contractors to provide necessary specialty health services to its patients. David Krivan, M.D., had been with CCRMC under First Choice Anesthesia Consultants of Northern California, PC since October 2018. Contractor left the medical group and since March 1, 2024 has his own Contract providing anesthesiology services including, but not limited to: clinic coverage, consultation, training, medical and surgical procedures, and on-call coverage.
This Contract is entered into under and subject to the following legal authorities: California Government Code §§ 26227 and 31000; Health and Safety Code § 1451. Health Services Personnel approved this Contract to ensure no conflicts with labor relations. CCRMC's Quality Management, Utilization Management, and Contract Monitor Staff meet regularly to ensure monitoring and performance measures in the Contract are upheld. Per Administrative Bulletin 600.3 CCRMC Physician services are exempt from solicitation requirements.
On March 26, 2024, the Board of Supervisors approved Contract #76-861 with David Krivan, M.D. (dba Pine Cone Medical Services), in an amount not to exceed $500,000 to provide anesthesiology services for the period March 1, 2024 through September 30, 2025.
On May 13, 2025, the Board of Supervisors approved Contract Amendment #76-861-1 with David Krivan, M.D. (dba Pine Cone Medical Services), effective May 1, 2025, to increase the payment limit by $150,000 to $650,000 for additional anesthesiology services with no change in the term.
Approval of Contract #76-861-2 will allow Contractor to continue to provide anesthesiology services at CCRMC and Contra Costa Health Centers through September 30, 2026.
CONSEQUENCE OF NEGATIVE ACTION:
If this Contract is not approved, the necessary specialty anesthesiology services needed for patient care will not be available or will create in-creased wait times due to the limited number of specialty providers available within the community.