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HomeMy WebLinkAboutAgreement A-23-252 Amendment I to Agreement with TCMG.pdf Agreement No. 23-252 1 AMENDMENT NO. 1 TO AGREEMENT 2 THIS AMENDMENT, hereinafter referred to as Amendment No. 1, is made and entered into 3 this 6th day of June 2023, by and between the COUNTY OF FRESNO, a 4 Political Subdivision of the State of California, hereinafter referred to as "COUNTY," and Total Care 5 Medical Group, a California Corporation, whose address is 5361 E. Kings Canyon Road, Fresno, CA 6 93727, hereinafter referred to as "CONTRACTOR." 7 WITNESSETH: 8 WHEREAS, the parties entered into that certain Agreement, identified as COUNTY Agreement 9 No. A-19-187, effective April 23, 2019, hereinafter referred to collectively as COUNTY's Agreement No. 10 A-19-187, for medical incapacity evaluation assessment services and professional services for 11 COUNTY's Departments of Social Services (DSS); and 12 WHEREAS, the parties desire to amend the Agreement regarding changes as stated below and 13 extend the term of this contract. 14 NOW, THEREFORE, in consideration of their mutual promises, covenants and conditions, 15 hereinafter set forth, the sufficiency of which is acknowledged, the parties agree as follows: 16 1. That the existing COUNTY Agreement No. A-19-187, Page two (2), Section three (3) 17 beginning with Line seven (7), with the number "3" and ending on Page two (2), Line thirteen (13)with 18 the word "performance", be deleted and the following inserted in its place: 19 "3. TERM 20 This Agreement shall be effective on the 1st day of May 2019 through and including June 21 30, 2024. 22 2. That the existing COUNTY Agreement No. A-19-187, Page three (3), Section five (5) 23 beginning with Line eight (8), with the number "S' and ending on Page four (4), Line ten (10) with the 24 word "received", be deleted and the following inserted in its place: 25 "4. COMPENSATION/INVOICING 26 County agrees to pay CONTRACTOR and CONTRACTOR agrees to receive compensation as 27 follows: Ninety-Five and No/100 Dollars ($95.00) for each medical assessment. COUNTY's DSS shall 28 -1- I pay for Glycohemoglobin tests when necessary to effectively evaluate an applicant's employability at the 2 rate of Forty-Eight and 50/100 Dollars ($48.50) per Glycohemoglobin test. COUNTY's DSS shall pay for 3 other diagnostic tests when necessary to effectively evaluate an applicant's employability at the rate of 4 Fifty and No/100 Dollars ($50.00) per diagnostic test. COUNTY's DSS shall pay for interpreter services 5 at the rate of One Hundred and No/100 Dollars ($100.00) per assessment, when necessary. In no event 6 shall compensation for actual services performed be in excess of One Hundred and Five Thousand and 7 No/100 Dollars ($105,000.00) for the initial fourteen (14) month period during which this Agreement is in 8 effect, and in no event shall compensation for actual services performed be in excess of Ninety 9 Thousand and No/100 Dollars ($90,000.00) for the subsequent (12) month periods during which this 10 Agreement is in effect. The cumulative total of this Agreement shall not be in excess of Four Hundred 11 and Sixty-Five Thousand and No/100 Dollars ($465,000.00). It is understood that all expenses incidental 12 to CONTRACTOR's performance of services under this Agreement shall be borne by CONTRACTOR. 13 CONTRACTOR shall invoice COUNTY in arrears by the tenth (10th) day of each month for actual expenses incurred and services rendered in the previous month to: 14 DSSlnvoices@FresnoCountyCA.gov. A monthly activity report shall accompany the invoice, reflecting 15 services supported by the invoiced expenditures and be in a form and in such detail as acceptable to 16 COUNTY's DSS. No reimbursement for services shall be made until invoices, reports and outcomes are 17 received, reviewed and approved by COUNTY's DSS. 18 At the discretion of COUNTY's DSS Director or designee, if an invoice is incorrect or is otherwise 19 not in proper form or substance, COUNTY's DSS Director or designee shall have the right to withhold 20 payment as to only that portion of the invoice that is incorrect or improper after five (5) days prior notice 21 to CONTRACTOR. CONTRACTOR agrees to continue to provide services for a period of ninety (90) 22 days after notification of an incorrect or improper invoice. If after the ninety (90) day period, the 23 invoice(s) is still not corrected to COUNTY's DSS satisfaction, COUNTY's DSS Director or designee 24 may elect to terminate this Agreement, pursuant to the termination provisions stated in Section Four (4) 25 of this Agreement. In addition, for invoices received ninety (90) days after the expiration of each term of 26 this Agreement or termination of this Agreement, at the discretion of COUNTY's DSS Director or 2 V designee, COUNTY's DSS shall have the right to deny payment of any additional invoices received. 28 -2- 1 3. That all references in existing COUNTY Agreement No. A-19-187 to Exhibit A shall be 2 changed to read "Revised Exhibit A," where appropriate, which is attached hereto and incorporated 3 herein by this reference. 4 4. The parties agree that this Amendment may be executed by electronic signature as 5 provided in this section. 6 a) An "electronic signature" means any symbol or process intended by an individual 7 signing this Amendment No. 3 to represent their signature, including but not limited to 8 (1) a digital signature; (2) a faxed version of an original handwritten signature; or (3) 9 an electronically scanned and transmitted (for example by PDF document) of a 10 handwritten signature. 11 b) Each electronic signature affixed or attached to this Amendment No. 3 (1) is deemed 12 equivalent to a valid original handwritten signature of the person signing this 13 Amendment No. 3 for all purposes, including but not limited to evidentiary proof in any 14 administrative or judicial proceeding, and (2) has the same force and effect as the valid original handwritten signature of that person. 15 c) The provisions of this section satisfy the requirements of Civil Code section 1633.5, 16 subdivision (b), in the Uniform Electronic Transaction Act (Civil Code, Division 3, Part 17 2, Title 2.5, beginning with Section 1633.1). 18 d) Each party using a digital signature represents that it has undertaken and satisfied 19 the requirements of Government Code section 16.5, subdivision (a), paragraphs (1) 20 through (5), and agree that each other party may rely upon that representation. 21 e) This Amendment No. 3 is not conditioned upon the parties conducting the 22 transactions under it by electronic means and either party may sign this Agreement 23 with an original handwritten signature. 24 5. COUNTY and CONTRACTOR agree that this Amendment No. 1 is sufficient to amend 25 Agreement No. A-19-187 and, that upon execution of this Amendment No. 1, the original Agreement 26 and this Amendment No. 1, shall together be considered the Agreement. 27 The Agreement, as hereby amended, is ratified and continued. All provisions, terms, covenants, 28 conditions and promises contained in this Agreement not amended herein shall remain in full force and -3- I effect. This Amendment No. 1 shall become effective upon execution on the day first written 2 hereinabove. 3 4 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 -4- 1 IN WITNESS WHEREOF, the parties hereto have executed this Amendment I to Agreement No. 2 A-19-187 as of the day and year first hereinabove written. 3 ATTEST: 4 CONTRACTOR: COUNTY OF FRESNO Total Care Medic 5 6 By: S Q in ero, hairman of the Board of Sultyelvisors of the County of Fresno S Print Name: 9 ���►� Title: i 10 Chairman of the Board, or President, or any Vice President 11 ATTEST: BERNICE E. SEIDEL, Clerk 12 Clerk of the Board of Supervisors 13 County of Fresno, State of California 19 By: _ 15 Deputy 16 17 Mailing Address: 18 5361 E. Kings Canyon Rd., Ste. 101 19 Fresno, CA 93727 Phone No.: (559) 251-2225 20 21 FOR ACCOUNTING USE ONLY: 22 Fund/Subclass: 0001/10000 23 Organization: 6645 Account: 7870 29 25 SB:jv 26 27 28 -5- Revised Exhibit A Page 1 of 7 Summary of Services: General Relief Medical Evaluations ORGANIZATION: Total Care Medical Group ADDRESS: 5361 E. Kings Canyon Rd., Ste. 101 Fresno, CA, 93727 TELEPHONE: 559-251-2225, ext. 107 FAX: 559-251-9575 CONTACT: Kelsie Emerzian EMAIL: kelsie(a)totalcaremg.com CONTRACT PERIOD: May 1, 2019 through June 30, 2020 - $105,000 July 1, 2020 through June 30, 2021 - $90,000 (optional) July 1, 2021 through June 30, 2022 - $90,000 (optional) July 1, 2022 through June 30, 2023 - $90,000 (optional) July 1, 2023 through June 30, 2024 - $90,000 (optional) CONTRACT AMOUNT: Not to exceed $465,000 SUMMARY OF SERVICES Total Care Medical Group (CONTRACTOR) will provide medical services, including physical exams and related diagnostic tests, to adults referred for evaluation of ability to be gainfully employed. I. CONTRACTOR SHALL PROVIDE THE FOLLOWING SERVICES FOR DSS: A. CONTRACTOR will provide professional services, including physical exams and related diagnostic tests for the purposes of determining the person's ability to be gainfully employed. B. CONTRACTOR will accept a maximum of five (5) referrals per service day, or equivalent, for physical exams and related diagnostic tests. C. Designate a physician to provide the services under this Agreement, who shall perform services in accordance with appropriate scientific, professional, and ethical standards of the medical profession. At all times they shall act within the policies, rules and regulations of the County of Fresno, the California State Department of Health, state and local statutes, and administrative regulations relating to health services. In the absence of the designated physician, CONTRACTOR agrees to provide an alternate physician, Physician's Assistant (PA) or Family Nurse Practitioner (FNP) to perform all services as described under this Agreement. The names of physician, PA and/or FNP providing services are to be given to DSS at the commencement of the Agreement. In the event there are staffing changes, CONTRACTOR will inform DSS in writing within seven days. D. CONTRACTOR will complete the GR8085 form (Revised Exhibit A pages 4 - 5) during each physical exam, and return all completed forms to DSS within one week. The GR8085 Revised Exhibit A Page 2 of 7 form may be updated from time to time, and CONTRACTOR is required to use the most recent version as provided by COUNTY. E. A copy of the GR8085 form (Revised Exhibit A pages 4 - 5) is to be released to DSS only if applicant gives authorization to CONTRACTOR by signing a copy of the Authorization for Access, Use, and Disclosure of Protected Health Information (Exhibit A pages 6 - 7). CONTRACTOR should receive a copy of the signed release from the client when they arrive for their appointment. Should a client refuse to sign the authorization form, they must be informed that they may still have their Verification of Incapacity form completed, but will be required to return the form to DSS independently. The Authorization for Access, Use, and Disclosure of Protected Health Information form may be updated from time to time, and CONTRACTOR is required to use the most recent version as provided by COUNTY. F. If CONTRACTOR suspects that an applicant may have mental health issues, CONTRACTOR will document finding on the GR8085 form. CONTRACTOR agrees to refer these persons to the appropriate mental health evaluation service as designated by DSS. G. CONTRACTOR will provide the completed GR8085 forms to designated DSS staff via email utilizing 128-Bit Advanced Encryption Standard on a weekly basis. H. CONTRACTOR will provide copies of the medical appointment calendar to DSS no later than the 15th of the month prior to the calendar month. I. CONTRACTOR shall ensure that interpreting and translation services are provided to persons with limited English proficiency. Interpreting services must be provided in-house at no charge when available, or through certified interpreting services when CONTRACTOR's employees are unable to provide interpreting. J. Designate CONTRACTOR staff who will work closely with DSS staff to provide assistance as required for fulfilling the terms of this Agreement. K. CONTRACTOR will meet with DSS staff at a minimum quarterly or as often as needed, for service coordination, problem/issue resolution, information sharing, and review and monitoring of project services and fiscal reports. II. DSS SHALL BE RESPONSIBLE FOR THE FOLLOWING: A. DSS will refer persons applying for General Relief to CONTRACTOR for physical exams and related diagnostic tests in order to determine their incapacity to be gainfully employed. B. DSS will provide persons applying for General Relief with a copy of the GR8085 form and the Authorization for Access, Use, and Disclosure of Protected Health Information form to take to their scheduled physical exam with CONTRACTOR. C. DSS will request applicants, on a voluntary basis, complete and sign an Authorization for Access, Use, and Disclosure of Protected Health Information form before scheduled physical exam in order for CONTRACTOR to release the GR8085 form to DSS staff. Revised Exhibit A Page 3 of 7 D. Designate a DSS staff member to receive GR8085 forms via email utilizing 128-Bit Advanced Encryption Standard on a weekly basis. E. Designate DSS staff who will work closely with CONTRACTOR to provide assistance as required for fulfilling the terms of this Agreement. F. Meet with CONTRACTOR staff at a minimum quarterly or often as needed for service coordination, problem/issue resolution, information sharing, and review and monitoring of project services and fiscal reports. G. DSS will notify CONTRACTOR of any non-English speaking applicants before their scheduled appointment in order for CONTRACTOR to secure appropriate interpreting services. III. FEES FOR SERVICES Fees for services provided under this Agreement shall be as follows: ■ Examinations: $95.00 each. ■ Glycohemoglobin tests: $48.50 each. ■ Other diagnostic tests: $50.00 each. ■ Interpreter services: $100.00 each. Interpreter services may only be billed for outside interpreting services, and only for languages other than Spanish, Hmong, Lao, and Vietnamese. Spanish, Hmong, Lao, and Vietnamese interpreting shall be provided by Total Care Medical Group's in- house staff at no charge. However, exceptions may be made when in-house staff is not available to provide interpreting in these languages at the time of the appointment. co O 1856 O FRESH Revised Exhibit A Paqe 4 of 7 Department of Social-Services Verification of Incapacity Case No.: Case Name: SSN: Date: Worker No.: The following information is needed to determine your eligibility for General Relief. Please return this form by: Medical release authorization: I authorize my medical provider to release the following information: Patient or Representative Signature Date Health Care Provider: Please answer the questions below. 1. Does the patient have a physical or mental health condition that prevents or substantially reduces their ability to engage in work or training? ❑ No (please answer question 9 and sign the form) ❑ Yes (please answer the following questions: 2. Onset date: 3. Expected ❑ Temporary, expect to release patient for work on: duration: ❑ Permanent 4. Are they able to work? ❑ No, please go to no. 5 ❑ Yes, please answer the following questions: Can perform ❑ limited full-time work ❑ limited part-time work 5. Describe how the physical and mental condition reduces their ability to engage in work: 6. Is the physical or mental condition primarily due to drug and/or alcohol abuse? ❑ Yes ❑ No ❑ Unknown 7. Has the patient submitted a disability insurance application for completion? ❑ Yes ❑ No ❑ Unknown If yes, date submitted: GR8085 09-19-17 FileNET: Case Verification Revised Exhibit CO A Page 5 of 7 Department of Social Services p� 1856 p FRESH Verification of Incapacity Case No.: Case Name: SSN: Date: Worker No.: 8. Is the patient receiving or seeking ❑ Yes ❑ No ❑ Unknown treatment? 9. 1 recommend a referral for: ❑ Mental Condition ❑ Physical Condition ❑ None Comments: Signature of Health Care Provider Date Print Name Title Agency Address Phone No. DEA No. GR8085 09-19-17 FileNET: Case Verification Revised Exhibit COtI A Page 6of7 t County of Fresno RETURN TO TABLE OF CONTENTS AUTHORIZATION FOR ACCESS, USE, AND DISCLOSURE OF PROTECTED HEALTH INFORMATION Name: Date of Birth: Last 4 Digits of Social Security Number: Record# Access, Use, and Disclosure of Health Information authorize the access, use, or disclosure of the above named individual's health information, which may contain medical, mental health, or substance abuse history and treatment information, as follows: Name of the organization or individual authorized to access, use, or disclose the information (information to be released from): Address: Name of the organization or individual authorized to receive and use the information (information to be released to): Address: The type and amount of information to be accessed, used, or disclosed is as follows: ❑ Diagnosis ❑ Lab Report ❑ Immunization Record ❑ History & Physical ❑ Medication Record ❑ Progress Note ❑ Assessment ❑ Plan of Care ❑ Other Dates of information from: to: Exception or information I do not want disclosed: This information will be used for the following purpose: ❑ Coordination/Continuity of Care ❑ Legal ❑ Insurance 0 Eligibility for Public Assistance ❑ Social Security Appeal ❑ Disability Claim ❑ Other Restrictions California law does not allow the organization or individual receiving this information to access, use, or make further disclosure of my protected health information unless the organization or individual obtains another authorization from me or unless access, use, and disclosure is specifically required or permitted by law. 2910: Attachment A Revised Exhibit A Page 7 of 7 Authorization for Access, Use, and Rights Disclosure of Protected Health Information understand that I have the following rights with respect to this Authorization: 1 . 1 may refuse to sign this authorization. 2. 1 have a right to receive a copy of this authorization. 3. 1 may revoke this Authorization at any time by signing the revocation at the bottom of this form or by a written notice of revocation signed by me or on my behalf. I can mail it or personally deliver to the following address: understand that the revocation will be effective upon receipt. I understand that the revocation will not apply to information that has already been released in response to this authorization. 4. 1 may not be required to sign this Authorization as a condition to obtaining treatment, payment, or my eligibility for benefits. 5. 1 am entitled to notice if Fresno County will access, use, or disclose the protected health information for marketing and receive payment for the access, use, or disclosure of my protected health information. 6. 1 understand that I may request a restriction or limitation on the protected health information to be accessed, used, or disclosed. 7. 1 understand that information disclosed pursuant to this authorization may be subject to redisclosure by the recipient and may no longer be protected by confidentiality laws including the Health Insurance Portability and Accountability Act (H I PAA). Expiration This Authorization will expire on: If I do not specify an expiration date or event, this authorization will expire in one year. Signature knowingly and voluntarily sign this authorization: Signature Date Printed Name Telephone Number Address If signed by someone other than client/consumer, state your legal relationship to the client/consumer: Witness/Language Interpreter ❑ I revoke this authorization Signature: Date