UCSF at SFGH March 17, 2015 Sue Carlisle, PhD, MD Vice Dean, SFGH Sue Currin, MSN, RN CEO, SFGH
Agenda UCSF at SFGH UCSF Clinical Operations at SFGH Current Affiliation Agreement (AA) UCSF Clinical Practice Group (CPG) UCSF Educational Operations at SFGH UCSF Research at SFGH Proposed UCSF Research Building at SFGH
UCSF at SFGH The Missions Mission Advance health worldwide through health sciences education, discovery, and patient care. Mission To provide quality health care and trauma services with compassion and respect.
UCSF at SFGH Our Affiliation ~ 1873 Partnership began 1959 First formal affiliation 10 faculty 1994 Current affiliation agreement 237 faculty 2014 ~500 faculty 229 residents
UCSF at SFGH UCSF SOM Dean SOM Vice Dean at SFGH SFGH CEO UCSF SOM Department Chairs* Chief of Clinical Services at SFGH Biomedical Engineering Clinical Labs Anesthesia & Perioperative Neurology Otolaryngology Medical Library Clinical Laboratories Neurosurgery Radiology Clinical Practice Group Computing & Network Services Dermatology OB/GYN & Reproductive Pathology Facilities Family & Community Medicine Ophthalmology Pediatrics Privacy Emergency Medicine Oral & Maxillofacial Surgery Psychiatry Risk Management Medicine Orthorpaedic Surgery Surgery Urology
UCSF Clinical at SFGH Additional Clinical Service Provided CLINICAL SERVICES Respiratory Therapy Anesthesia Tech Workroom Chronic Dialysis HIV Clinic (Ward 86) DIAGNOSTIC SERVICES Clinical Lab Pathology SUPPORT SERVICES Biomedical Engineering Medical Library
FY15 Affiliation Budget $161.3M Main Affiliation Permanent Budget Below-the-Line Activity $143.2M Physician Salaries and Benefits - $69.3M (48%) Resident Salaries and Benefits - $17.3M (12%) Staff Salaries and Benefits* - $50.4M (35%) Supplies and Expenses* - $6.2M (5%) *Staff salaries/benefits and supplies/expense funding primarily supports the following services: Anesthesia Tech Workroom Biomedical Engineering Clinical Laboratories Dialysis Pathology Psychiatry Respiratory Therapy Meaningful Use Funding $2.5M Primarily IT staffing and outside consulting for MU activity that cannot be easily coordinated by the DPH/SFGH. Positions under the direction of City IT personnel. Small allocation for UC physician champion participation. $15.6M Includes MIA, Radiology Equipment, Tertiary Care Contingency, Workorders CBHS, BAPAC, PHAST, etc. * *Below-the-line activity represents nonpermanent, temporary allocations or ad hoc expenses that are billed on an as needed basis as a result of temporary peripheral agreements between UC and SFGH. Also includes DPH dept-to-dept workorders where UC costs are involved.
AA Monitoring Responsible parties SFGH CEO SFGH Vice Dean Monitoring and Evaluation Mechanisms Services, budget and utilization statistics are reviewed by SFGH CEO. Unusual Occurrences (UOs), patient complaints and PI/UM reports are reviewed and handled through the hospital mechanisms established for these purposes and report through the Medical Executive Committee and the Nursing Executive Committee to the Joint Conference Committee. The performance of the Chiefs of Service is reviewed by the SFGH CEO, the Vice Dean and the Chief of Staff for their responsibilities as outlined in the Affiliation Agreement and Medical Staff Bylaws. Since the services purchased from UCSF are fully integrated with SFGH operations, they are also reviewed by the Joint Commission, CA-DPH (licensing) and other regulatory agencies. Purchased physician services are further monitored through quarterly time surveys that are required, and reviewed, by Medicare. Housestaff services are monitored through the comprehensive annual Medicare cost report audit of housestaff payroll and staffing records as part of the reimbursement process for graduate medical education for SFGH.
Affiliation Agreement Monitoring San Francisco Health Commission DPH Director of Public Health UCSF School of Medicine Dean SFGH Chief Executive Officer School Of Medicine Vice Dean at SFGH SFGH Joint Conference Committee Medical Staff Report Medical Credentials Reports Quality Management and Regulatory Affairs Reports Performance Improvement and Patient Safety Report Hospital Administrator s Report
Annual Reporting on AA The SFGH Vice Dean s Office conducts ongoing reconciliation including: Monthly: Payroll and general ledgers are produced and reconciled. Quarterly: Budget status reports are sent to the Department Chiefs and Administrators as a check-and-balance of the budget versus actual spending throughout the year. The following information is provided to the SFGH Administration, verified by SFGH Finance and signed off by SFGH CEO throughout the year: Monthly: Invoices for the affiliation budget. Quarterly: UC contract labor data (staff hours and salary/benefits costs) to the Business Operations Analyst for the SFHN Operational Database. At fiscal close: A reconciled final invoice is provided to SFGH Budget/Accounting reflecting actual costs incurred in each Department for the complete fiscal year. At fiscal close: A physician salary report is provided to SFGH Budget/Accounting reflecting all salary and benefits dollars paid to UCSF physicians, by individual provider and cost center, for the fiscal year. This report reconciles with the physician salary and benefits costs reported in the year-end invoice. At fiscal close: Beginning in FY15/16 we are adding a year-end report to reflect status of spending and the deliverables met with respect to any new initiatives funded for the fiscal year.
Clinical Practice Group (CPG) CPG is a distinct administrative unit within the UCSF School of Medicine with delegated authority to negotiate contracts and to manage all third party health services provided by members of the CPG. Membership in the CPG requires a faculty appointment (either paid or without salary) with UCSF. Board Committees Executive Finance Clinical Metrics & Performance
CPG Activities Billing professional fees for SFGH campus Partnership with SFHN Department of Managed Care and Mercer to evaluate contracting options San Francisco Health Plan Performance Improvement Program
UCSF Education at SFGH UCSF Residents at SFGH School of Medicine 32% intern/resident training in 17 academic departments On average, 900 residents, 350 medical students and 60 clinical fellows annually School of Dentistry 4 residents/day School of Pharmacy Poison Control Center: 3 residents/day School of Nursing 16 graduate nursing students/day
UCSF Research at SFGH The Mission UCSF Research at SFGH is essential to meet both missions: An academic environment allows us to attract, recruit, and retain exceptional faculty, staff, and trainees Innovation and discovery improve clinical care and patient outcomes at SFGH & around the world
UCSF Research at SFGH Translating research to community care Innovative care, research and teaching Local and global focus Brain and Spinal Injury Center Improving rehab UCSF Center for Vulnerable Populations (CVP) Promoting health Reducing disparities Engaging the community
Update on Research Building Why it is needed Obstacles with current space Requirements from UCOP on seismic standing limit ability to stay in red brick buildings beyond 2019 Plans to solve those challenges Interim measures secure occupancy through 2019 Proposal to build a new research building
Update on Research Building Next steps Actions Taken To Date Extensive negotiations between UCSF & CCSF Needs assessment completed Soil samples taken to determine toxicity of soil Initial planning designed Next Steps Finalize term sheet between UCSF & CCSF Obtain approval from Health Commission Obtain approval from UC Regents Obtain approval from the SF Board of Supervisors Secure an architect & begin planning Break ground
Update on Research Building Proposed Location Insert other photo here
Update on Research Building Proposed Location