HomeMy WebLinkAboutAgreement A-10-674-4 with Dr. Shaeffer, Inc..pdf1
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Ag reement No . 10-67 4-4
AMENDMENT IV TO AGREEMENT
THIS AMENDMENT, hereinafter referred to as Amendment IV, is made and entered into this
3 18th day of June , 2019 by and between the COUNTY OF FRESNO, a Political Subdivision of
4 the State of California , hereinafter referred to as "COUNTY", and each CONTRACTOR to be listed in
5 Exhibit A "List of Contractors" attached hereto and incorporated herein by reference, and collectively
6 hereinafter referred to as "CONTRACTOR(Sr, and such additional CONTRACTOR(S) as may, from
7 time to time during the term of this Agreement, be added or deleted by COUNTY. Reference in this
8 Agreement to party or "parties" shall be understood to refer to COUNTY and each individual
9 CONTRACTOR(S), unless otherwise specified.
10 WHEREAS, the parties entered into that certain Agreement, identified as COUNTY Agreement
11 No . A-10-674 , effective January 1, 2011 , COUNTY Amendment No. 10-674-1, effective December 1,
12 2014, COUNTY Amendment No . 10-674-2, effective June 7, 2016, and COUNTY Amendment No . 10-
13 67 4-3, effective July 11 , 2017, hereinafter collectively referred to as COUNTY Agreement No . 10-67 4,
14 whereby CONTRACTORS agreed to provide medication support services through the delivery of
15 telemed icine ; and
16 WHEREAS, COUNTY and CONTRACTOR(S) now desire to amend the Agreement No . 10-674
17 regarding changes as stated below and restate the Agreement in its entirety.
18 NOW, THEREFORE , for consideration of their mutual promises , covenants and conditions
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19 hereinafter set forth , the sufficiency of which is acknowledged, the parties agree as foll
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20 1. That the existing COUNTY Agreement No . 10-67 4 , beginning on Page r I even ( 11), Line
21 Sixteen (16) with the number "4.3 .1" and ending on Page Twelve (12), Line Seven (7) with the word
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22 "Member" be deleted in its entirety and the following inserted in its place: i
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23 "4 .3.1 Reimbursement -Reimbursement to PROVIDER(S) for rendering Covered
24 Services to Members shall be made at the rate of One Hundred Ninety and No/100 Dollars ($190.00)
25 per hour of scheduled sessions between January 1, 2011 through July 10, 2017. Reimbursement to
26 PROVIDER(S), for rendering 300 or more hours of Covered Services to Members in any given week
27 during the term of this Agreement, shall be made at the rate of One Hundred Ninety-Four and 75/100
28 Dollars ($194 . 75) per hour of scheduled sessions between July 11, 2017 through June 30, 2019; and
-1 -COUNTY OF FRESNO
Fresno, CA
1 Two Hundred Six and 44/100 Dollars ($206.44) per hour of scheduled sessions between July 1, 2019
2 through December 31, 2019. Reimbursement to PROVIDER(S) for rendering less than 300 hours of
3 Covered Services to Members in any given week during the term of this Agreement, shall be made at
4 the rate of Two Hundred and No/100 Dollars ($200.00) per hour of scheduled sessions between July
5 11, 2017 through June 30, 2019; and Two Hundred Twelve and No/100 Dollars ($212.00) per hour of
6 scheduled sessions between July 1, 2019 through December 31, 2019.
7 In no event shall services provided by all PROVIDER(S) pursuant to the MHP exceed a
8 total amount of Six Hundred Sixty Eight Thousand Three Hundred Four and No/100 Dollars
9 ($668,304.00) for the period of January 1, 2011 through June 30, 2011; and One Million Three Hundred
1 O Thirty-Six Thousand Six Hundred Eight and No/100 Dollars ($1,336,608.00) for each twelve month
11 period from July 1, 2011 through June 30, 2014; and One Million Eight Hundred Seventeen Thousand
12 Nine Hundred and No/100 Dollars ($1,817,900.00) for the period of July 1, 2014 through June 30,
13 2015; and One Million Nine Hundred Thirty-Six Thousand Four Hundred Eighty and No/100 Dollars
14 ($1,936,480.00) for the period of July 1, 2015 through June 30, 2016; and Two Million Eight Hundred
15 Five Thousand Nine Hundred Twenty and No/100 Dollars ($2,805,920.00) for the period of July 1, 2016
16 through July 10, 2017; and Five Million Sixty-Three Thousand Five Hundred and No/100 Dollars
17 ($5,063,500.00) for each twelve month period of this Agreement from July 11, 2017 through June 30,
18 2019. Additionally, in no event shall services provided by all PROVIDER(S) pursuant to the MHP
19 exceed a total amount of Two Million Six Hundred Eighty-Three Thousand Seven Hundred Twenty and
20 No/100 Dollars ($2,683,720.00) for the period of July 1, 2019 through December 31, 2019."
21 2.That the existing COUNTY Agreement No. 10-674, beginning on Page Thirteen (13),
22 Line Sixteen (16) with the number "5.1" and ending on Page Thirteen (13), Line Twenty Three (23) with
23 the word "term" be deleted in its entirety and the following inserted in its place:
"5.1 Term 24
25 This Agreement shall become effective on the 1st day of January 2011 and shall
26 terminate on the 30th day of June 2011.
27 This Agreement shall then automatically be extended for eight (8) additional twelve (12)
28 month periods and one (1) six (6) month period upon the same terms and conditions herein set forth,
-2-COUNTY OF FRESNO Fresno, CA
1 unless written notice of non-renewal is given by PROVIDER(S) or COUNTY or COUNTY's DBH
2 Director or designee no later than sixty (60) days prior to the expiration of the Agreement term.11
3 3.That all references in the existing COUNTY Agreement No. 10-67 4 "Revised Exhibit C"
4 be changed to read 11Revised Exhibit C-1 '' where appropriate attached hereto and incorporated herein
5 by reference.
6 4.The parties agree that this Amendment IV is sufficient to amend the Agreement; and that
7 upon execution of this Amendment IV, the Agreement, Amendment I, Amendment 11, Amendment Ill,
8 and Amendment IV together shall be considered the Agreement.
9 The Agreement, as hereby amended, is ratified and continued. All provisions, terms,
10 covenants, conditions and promises contained in the Agreement and not amended herein shall remain
11 in full force and effect. This Amendment IV shall be effective July 1, 2019.
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-3-COUNTY OF FRESNO Fresno, CA
1 IN WITNESS WHEREOF, the parties hereto have executed this Amendment IV to Agreement No.
2 A-10-674 as of the day and year first hereinabove written.
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4 PROVIDER (S):
5 PLEASE SEE SIGNATURE
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PAGES ATTACHED
Fiscal Year (FY)
FY 2010-11
FY 2011-12
FY 2012-13
FY 2013-14
FY 2014-15
FY 2015-16
FY 2016-17
FY 2017-18
FY 2018-19
FY 2019-20
Term Maximum
$ 668,304 (6 months)
$1,336,608
$1,336,608
$1,336,608
$1,817,900
$1,936,480
$2,805,920
$5,063,500
$5,063,500
$2,683,720 (6 months)
Fund/Subclass: 0001/10000
Organization: 5630
Account/Program: 7295/0
COUNTY OF FRESNO
Nathan Magsig,
Chairman of the Board of Supervisors of
the County of Fresno
ATTEST:
Bernice E. Seidel
Clerk of the Board of Supervisors
County of Fresno, State of California
By : 3, >.SR\¢0 ~ O'f)
Deputy
-4-COUNTY OF FRESNO
Fresno, CA
1 PROVIDER
2 DR. JOHN L. SCHAEFFER, INC., A PROFESSIONAL MEDICAL CORPORATION,
3 D.B.A. CALIFORNIA TELEPSYCHIATRISTS
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By:
�
Print Name 1:5 I,,_ lA S'�-�V
Title: fyec,-� dJ(c t;.o
Chairman of the Board, or
President, or any Vice President
By/hy(c>-ltr d_
16 Print Name: S Ii.tr:;) Y:-Judtl<..
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18 Title:
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Secretary (of Corporation), or
any Assistant Secretary, or
Chief Financial Officer, or
any Assistant Treasurer
Mailing Address:
3308 El Camino Avenue, Suite 300-136
Sacramento, CA 95821
Phone No.: (916) 320-4422
Email: j.schaeffer@caltelepsych.com
Contact: John L. Schaeffer, D.O.
- 5 -COUNTY OF FRESNO
Fresno, CA
Revised Exhibit C-1
Page 1 of 3
SCHEDULE OF SERVICES
Provider Name:
Dr. John L. Schaeffer, Inc., A Professional
Medical Corporation DBA California Telepsychiatrists
Provider Type:
Group
Days and Time of Coverage by Program:
Adult Outpatient Services
Monday through Friday (8:00am to 5:00pm)
Children’s Outpatient Services
Monday through Friday (8:00am to 5:00pm)
Older Adult Services
Monday through Friday (8:00am to 5:00pm)
Perinatal Program Services
Monday through Friday (8:00am to 5:00pm)
Conservatorship Team
Monday through Friday (8:00 am to 5:00 pm)
Maximum Total Hours Authorized per Week = 196 hrs/week
Revised Exhibit C-1
Page 2 of 3
SCHEDULE OF SERVICES
FY 2016-17 thru FY 2017-18
Provider Name:
Dr. John L. Schaeffer, Inc., A Professional
Medical Corporation DBA California Telepsychiatrists
Provider Type:
Group
Days and Time of Coverage by Program:
Adult Outpatient Services
Monday through Friday (8:00am to 5:00pm)
Children’s Outpatient Services
Monday through Friday (8:00am to 5:00pm)
Older Adult Services
Monday through Friday (8:00am to 5:00pm)
Perinatal Program Services
Monday through Friday (8:00am to 5:00pm)
Conservatorship Team
Monday through Friday (8:00 am to 5:00 pm)
Maximum Total Hours Authorized per Week = 284 hrs/week
Revised Exhibit C-1
Page 3 of 3
SCHEDULE OF SERVICES
July 1, 2017 thru December 31, 2019
Provider Name:
Dr. John L. Schaeffer, Inc., A Professional
Medical Corporation DBA California Telepsychiatrists
Provider Type:
Group
Days and Time of Coverage by Program:
Adult Outpatient Services
Monday through Friday (8:00am to 5:00pm)
Children’s Outpatient Services
Monday through Friday (8:00am to 5:00pm)
Older Adult Services
Monday through Friday (8:00am to 5:00pm)
Perinatal Program Services
Monday through Friday (8:00am to 5:00pm)
Conservatorship Team
Monday through Friday (8:00 am to 5:00 pm)
Maximum Total Hours Authorized per Week = 500 hrs/week