Both management and bargaining employees are committed to providing excellent medical care for residents of the County. In order to further this objective, the parties agree to form a Primary Care Performance Improvement Committee as outlined below.

The Committee will be organized under the Performance Improvement and Quality Assurance Department of the hospital. The purpose of the Committee will be to jointly discuss and address clinical care issues. There will be regularly scheduled meetings held monthly as set by the Committee for not more than two (2) hours per meeting. Meetings may be cancelled by mutual agreement. The Committee will be comprised of five (5) members of the bargaining unit and up to five (5) representatives selected by management. The five (5) bargaining unit representatives may be paid at the straight time rate up to two

(2) hours each in any one month to attend scheduled committee meetings. Participation shall be considered voluntary. The Committee will determine when meetings are to be held. Other bargaining employees may attend meetings on an ad hoc basis, but must do so on their own time.

The parties will work in good faith to resolve problems raised through this committee in a timely manner. The Committee will not discuss general management issues or issues that are grievable under Section 30 of this MOU.

No later than sixty (60) days after the effective date of the 2022 MOU, the parties will convene the Service Delivery Improvement Committee. The committee will work collaboratively on plan for extending San Mateo Medical Center clinic hours from 8 am to 8 pm a few days per week and a half day on Saturday, and to offer more flexible hours to providers at these clinics, including telemedicine/psychiatry options. The committee will also discuss the issue of pediatrician standby pay.