To: Board of Supervisors
From: Dr. Ori Tzvieli, Interim Health Services Director
Report Title: Contract Amendment #76-861-1 with David Krivan, M.D. (dba Pine Cone Medical Services)
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Interim Health Services Director, or designee, to execute on behalf of the County Contract Amendment #76-861-1 with David Krivan, M.D. (dba Pine Cone Medical Services), a sole proprietor, effective May 1, 2025, to amend Contract #76-861, to increase the payment limit by $150,000, from $500,000 to a new payment limit of $650,000, to provide additional anesthesiology services at Contra Costa Regional Medical Center (CCRMC) and Contra Costa Health Centers, with no change in the term ending September 30, 2025.
FISCAL IMPACT:
Approval of this Contract Amendment will result in additional contractual service expenditures of up to $150,000 and will be funded 100% by Hospital Enterprise Fund I revenues. (No rate increase)
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.
Approval of Contract Amendment #76-861-1 will allow Contractor to provide additional anesthesiology services at CCRMC and Contra Costa Health Centers through September 30, 2025.
CONSEQUENCE OF NEGATIVE ACTION:
If this Contract Amendment is not approved, the Contract will not have sufficient funds to pay Contractor and members will not have access to Contractor’s additional anesthesiology services which could result in increased wait times for services.