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Home My WebLink AboutAgreement A-25-294 Amendment 4 to Master Agreement for Telemedicine Services.pdf Agreement No. 25-294 1 AMENDMENT NO. 4 TO SERVICE AGREEMENT 2 This Amendment No. 4 to Amendment No. 23-592 is dated June 24, 2025 and 3 is between each Contractor listed in Revised Exhibit A-3 ("Contractor(s)"), and the County of 4 Fresno, a political subdivision of the State of California ("County"). 5 Recitals 6 A. On January 7, 2020, the County and the Contractors entered into Master Agreement No. 7 20-015 ("Agreement"), as amended by County Agreement No. 23-082 (Amendment No. 1) 8 effective February 28, 2023, County Agreement No. 23-306 (Amendment No. 2) effective June 9 20, 2023, and County Agreement No. 23-592 (Amendment No. 3) effective November 7, 2023 10 with Licensed Providers for the Provision of Telemedicine Services to deliver psychiatric 11 services remotely through telehealth modalities to persons served. 12 B. The County and the Contractors now desire to further amend the Agreement to extend 13 the term for an additional three (3) month base and optional three (3) month renewal term and 14 increase the maximum compensation by Three Million, Eight Hundred Eighty-One Thousand, 15 Two Hundred Eighty and No/100 Dollars ($3,881,280.00). 16 The parties therefore agree as follows: 17 1. Term. This Amendment extends the term of the Agreement through September 30, 18 2025. The term of this Agreement may be extended for no more than one three-month period 19 upon written approval of both parties at least thirty (30) days before the first day of the three- 20 month extension period. The County's DBH Director, or designee, is authorized to sign the 21 written approval on behalf of the County based on the Contractor's satisfactory performance. 22 The extension of this Agreement by the County is not a waiver or compromise of any default or 23 breach of this Agreement by the Contractor(s) existing at the time of the extension whether or 24 not known to the County. 25 2. Section 4 of Amendment No. 2 (Agreement No. 23-306) beginning on Page 2, Line 9 26 and ending on Page 3, Line 7 is deleted in its entirety and replaced with the following: 27 A. Reimbursement to Contractors for scheduled service sessions shall be 28 made in accordance with Contractors' corresponding Exhibit B sub-part "Rates of 1 1 Reimbursement" as indicated on Revised Exhibit A-3. It is agreed by all parties 2 that the actual annual fiscal year rate increases listed in each Exhibit B sub-part 3 shall reflect Consumer Price Index (CPI) rate that is released during the last 4 month of the current fiscal year, not to exceed a maximum increase of four (4) 5 percent from the previous fiscal year's rate for each subsequent fiscal year 6 throughout the contract period, not to exceed the maximum annual compensation 7 amount identified below. 8 In no event shall services provided by all Contractor(s) pursuant to the 9 Behavioral Health Plan (BHP), formerly known as Mental Health Plan (MHP), 10 exceed a total amount of Three Million, Four Hundred Fifty-Two Thousand, Eight 11 Hundred and No/100 Dollars ($3,452,800.00) for the period of January 1, 2020 12 through June 30, 2020. In no event shall services provided by all Contractor(s) 13 pursuant to the BHP exceed a total amount of Seven Million, Seventy-Two 14 Thousand and No/100 Dollars ($7,072,000.00)for the period of July 1, 2020 15 through June 30, 2021. In no event shall services provided by all Contractor(s) 16 pursuant to the BHP exceed a total amount of Seven Million, Two Hundred 17 Eighty-Eight Thousand, Three Hundred Twenty and No/100 Dollars 18 ($7,288,320.00) for the period of July 1, 2021 through June 30, 2022. In no 19 event shall services provided by all Contractor(s) pursuant to the BHP exceed a 20 total amount of Seven Million Five Hundred Twenty-Five Thousand Four 21 Hundred Forty and No/100 Dollars ($7,525,440.00) for the period of July 1, 2022 22 through June 30, 2023. In no event shall services provided by all Contractor(s) 23 pursuant to the BHP exceed a total amount of Seven Million, Seven Hundred 24 Sixty-Two Thousand, Five Hundred Sixty and No/100 Dollars ($7,762,560.00) for 25 the period of July 1, 2023 through June 30, 2024. In no event shall services 26 provided by all Contractor(s) pursuant to the BHP exceed a total amount of 27 Seven Million, Seven Hundred Sixty-Two Thousand, Five Hundred Sixty and 28 No/100 Dollars ($7,762,560.00) for the period of July 1, 2024 through June 30, 2 1 2025. In no event shall services provided by all Contractor(s) pursuant to the 2 BHP exceed a total amount of One Million, Nine Hundred Forty Thousand, Six 3 Hundred Forty and No/100 Dollars ($1,940,640.00) for the period of July 1, 2025 4 through September 30, 2025. In no event shall services provided by all 5 Contractor(s) pursuant to the BHP exceed a total amount of One Million, Nine 6 Hundred Forty Thousand, Six Hundred Forty and No/100 Dollars ($1,940,640.00) 7 for the period of October 1, 2025 through December 31, 2025. The maximum 8 amount payable under this Agreement throughout the entire term of this 9 Agreement is Forty-Four Million, Seven Hundred Forty-Four Thousand, Nine 10 Hundred Sixty and No/100 Dollars ($44,744,960.00)." 11 3. When all parties have signed this Amendment No. 4, the Agreement, Amendment No. 1, 12 Amendment No. 2, Amendment No. 3, and this Amendment No. 4 together constitute the 13 Agreement. 14 4. The Contractor represents and warrants to the County that: 15 a. The Contractor is duly authorized and empowered to sign and perform its obligations 16 under this Amendment. 17 b. The individual signing this Amendment on behalf of the Contractor is duly authorized 18 to do so and his or her signature on this Amendment legally binds the Contractor to 19 the terms of this Amendment. 20 5. The parties agree that this Amendment may be executed by electronic signature as 21 provided in this section. 22 a. An "electronic signature" means any symbol or process intended by an individual 23 signing this Amendment to represent their signature, including but not limited to (1) a 24 digital signature; (2) a faxed version of an original handwritten signature; or (3) an 25 electronically scanned and transmitted (for example by PDF document) version of an 26 original handwritten signature. 27 b. Each electronic signature affixed or attached to this Amendment (1) is deemed 28 equivalent to a valid original handwritten signature of the person signing this 3 1 Amendment for all purposes, including but not limited to evidentiary proof in any 2 administrative or judicial proceeding, and (2) has the same force and effect as the 3 valid original handwritten signature of that person. 4 c. The provisions of this section satisfy the requirements of Civil Code section 1633.5, 5 subdivision (b), in the Uniform Electronic Transaction Act (Civil Code, Division 3, Part 6 2, Title 2.5, beginning with section 1633.1). 7 d. Each party using a digital signature represents that it has undertaken and satisfied 8 the requirements of Government Code section 16.5, subdivision (a), paragraphs (1) 9 through (5), and agrees that each other party may rely upon that representation. 10 e. This Amendment is not conditioned upon the parties conducting the transactions 11 under it by electronic means and either party may sign this Amendment with an 12 original handwritten signature. 13 6. This Amendment may be signed in counterparts, each of which is an original, and all of 14 which together constitute this Amendment. 15 7. The Agreement as previously amended and as amended by this Amendment No. 4 is 16 ratified and continued. All provisions of the Agreement as previously amended and not 17 amended by this Amendment No. 4 remain in full force and effect. 18 [SIGNATURE PAGE FOLLOWS] 19 20 21 22 23 24 25 26 27 28 4 1 The.parties are signing this Amendment No, 4 on the date stated in the introductory 2 clause. 3 Please see attached signatures COUNTY OF FRESNO 4 5 6 Ernest Buddy Me es, Chairman of the Board of Supervisors of the County of Fresno 7 Attest: 8 Bernice E. Seidel Clerk of the Board of Supervisors 9 County of Fresno, State of California 10 By: _ 11 Deputy 12 13 For accounting use only: Org No.: 56302999 14 56302175 15 56302246 56302920 Account No.: 7295/0 16 Fund No.: 0001 Subclass No.: 10000 17 18 19 20 21 22 23 24 25 26 27 28 5 1 IN WITNESS WHEREOF, the parties hereto have executed this Amendment 4 to Agreement 2 No. 20-015 as of the date first above set forth. 3 4 THOMAS MILAM MD, INC. 5 dba IRIS TELEHEALTH MEDICAL GROUP 6 7 By: 8 9 Print Name: Thomas Milam 10 Title: Chief Medical officer 11 Chairman of Board,or President or any Vice President 12 Date: 05/27/2025 13 14 15 By: CA-`0-8"A- 16 17 Print Name: Caroline Burton 18 19 Title: CFO Secretary(of Corporation), or any Assistant Secretary, 20 or Chief Financial Officer or any Assistant Treasurer 21 Date: 05/28/2025 22 23 24 Mailing Address: 13740 N. Highway 183, Ste L2#221 25 Austin, TX 78750 26 Phone No.: (888)285-2269 27 Contact: Thomas Milam, MD 28 COUNTY OF FRESNO Fresno,CA 1 IN WITNESS WHEREOF, the parties hereto have executed this Amendment 4 to Agreement 2 No. 20-015 as of the date first above set forth. 3 4 DR. JOHN L. SCHAEFFER, INC., 5 dba AMERICAN TELEPSYCHIATRISTS 6 7 By: 8 9 Print Name: John Schaeffer 10 Title: _Chairman of Board 11 Chairman of Board, or President or any Vice President 12 Date: 5/20/25 13 14 15 By: 16 17 Print Name: _Sheryl Ikeda 18 19 Title: Chief Financial Officer Secretary(of Corporation), or any Assistant Secretary, 2 0 or Chief Financial Officer or any Assistant Treasurer 21 Date: 5/20/25 22 23 24 Mailing Address: 3308 El Camino Ave, #300-136 25 Sacramento, CA 95821 26 Phone No.: (916) 320-4422 27 Contact: Dr. John L. Schaeffer 28 1 - COUNTY OF FRESNO Fresno,CA I IN WITNESS WHEREOF, the parties hereto have executed this Amendment 4 to Agreement 2 No. 20-015 as of the date first above set forth. 3 4 TRADITIONS PSYCHIATRY GROUP, PC 5 DBA TRADITIONS BEHAVIORAL HEALTH 7 BY 8 Print Name: David Spaccarelli 9 10 Title: CEO 11 Chairman of Board, or President or any Vice President 12 Date: 05/22/2025 13 14 By. 15 16 Print Name: Julianne Bharucha 17 18 Title: CFO Secretary (of Corporation), or any Assistant Secretary, 19 or Chief Financial Officer or any Assistant Treasurer 20 Date: 05/22/2025 21 22 Mailing Address: 23 900 Larkspur Landing Circle, Ste 160 Larkspur, CA 94939 24 Phone No.: (513) 289-9006 25 Contact: David Spaccarelli 26 27 28 1 _ COUNTY OF FRESNO Fresno,CA 1 IN WITNESS WHEREOF, the parties hereto have executed this Amendment 4 to Agreement 2 No. 20-015 as of the date first above set forth. 3 4 LOCUMTENENS.COM, LLC 5 6 zac) �'icl�aYo on By: 7arh Ridwirrison(May 22 ML i 5.59 FOTI 7 8 Print Name: Zach Richardson 9 to Tine: Vice President Chairman of Board, or President or any Vice President 11 05/22/2025 12 Date: 13 14 15 By: 16 Print Name: Leslie Kurtz 17 18 Title: CFO 19 Secretary (of Corporation), or any Assistant Secretary, or Chief Financial Officer or any Assistant Treasurer 20 21 Date: 05/22/2025 22 23 Mailing Address: 24 2575 Northwinds Parkway Alpharetta, GA 30009 25 26 Phone No.: (678) 690-7358 Contact:Kristophor Ware 27 28 1 _ COUNTY OF FRESNO Fresno,CA 1 IN WITNESS WHEREOF, the parties hereto have executed this Amendment 4 to Agreement 2 No. 20-015 as of the date first above set forth. 3 4 EXMED, INC. 5 6 By: William Kulka, MD 7 8 Print Name: William Kulka, MD 9 Title: President 10 Chairman of Board, or President or any Vice President 11 Date: 05/21/2025 12 13 14 By, ;roh�Pico oiry ki o Ma}Ll t z l]34 15 16 Print Name: Tony Rico 17 Title: Chief Operating Officer 18 Secretary (of Corporation), or any Assistant Secretary, or Chief Financial Officer or any Assistant Treasurer 19 Date: 05/21/2025 20 21 22 Mailing Address: 3500 West Olive Avenue, Suite 300 23 Burbank, CA 91505 24 Phone No.: (801) 557-3380 25 Contact: Tony Rico, COO 26 27 28 — 1 — COUNTY OF FRESNO Fresno,CA 1 IN WITNESS WHEREOF, the parties hereto have executed this Amendment 4 to Agreement 2 No. 20-015 as of the date first above set forth. 3 4 AMN HEALTHCARE LOCUM TENENS INC. 5 6 J- By: 7 61 8 Print Name: mcirK -20hrdj'�L<v 9 10 Title: D;(eClol- Chairman of Board, or President or any Vice President 11 12 Date: Slzs/zoz-13- 13 14 15 By: 16 Print Name: 17 18 Title: Saes 19 Secretary (of Corporation),or any Assistant Secretary, 20 or Chief Financial Officer or any Assistant Treasurer 21 Date: 22 23 Mailing Address: 24 12400 High Bluff Drive, Suite 500 San Diego, CA 92130 25 26 Phone No.: (470) 592-5803 Contact: Chris Watt 27 28 COUNTY OF FRESNO Fresno,CA 1 IN WITNESS WHEREOF, the parties hereto have executed this Amendment 4 to Agreement 2 No. 20-015 as of the date first above set forth. 3 4 AB STAFFING SOLUTIONS, LLC 5 By: 6 7 Print Name: 8 - 9 Title: 10 Chairman of Board, or President or any Vice President 11 Date: G�L< 12 13 14 By: &wlf d.tf'[dim 15 16 Print Name: Samuel Shelton 17 18 Title: Chief Sales Officer Secretary (of Corporation), or any Assistant Secretary, 19 or Chief Financial Officer or any Assistant Treasurer 20 Date: 05-28-2025 21 22 Mailing Address: 2 3 3451 S. Mercy Road 24 Gilbert, AZ 85297 25 Phone No.: (480) 626-0830 26 Contact: Samuel Shelton, Chief Sales Officer 27 Phone No.: (480) 626-0805 Contact: Vony Middlebrooks, Senior Vice President of Recruitment 28 COUNTY OF FRESNO � Fresno.CA Document Ref:HBHNW-DAYUD-PNTV2-CRXMH ii Docusign Envelope ID: FAE42C9D-3696-44CF-AACC-DFB57FEE43B6 1 IN WITNESS WHEREOF, the parties hereto have executed this Amendment 4 to Agreement 2 No. 20-015 as of the date first above set forth. 3 4 CURATIVE TALENT, LLC 5 Signed by: 6 By: ,bw 7 Print Name: Blake Bear 8 9 Title: senior vice President 10 Chairman of Board, or President or any Vice President 11 Date: 5/28/2025 12 13 DocuSigned by: 14 ,b I�I.AyV L By: 15 16 Print Name: 3onathan Marsh 17 18 Title: svP Secretary (of Corporation), or any Assistant Secretary, 19 or Chief Financial Officer or any Assistant Treasurer 20 Date: 5/29/2025 21 22 23 Mailing Address: 370 Las Colinas Blvd W STE 104 24 Irving, TX 75039 25 Phone No.: (817) 675-4890 26 Contact: Blake Bear, Senior Vice President 27 28 1 - COUNTY OF FRESNO Fresno,CA I IN WITNESS WHEREOF, the parties hereto have executed this Amendment 4 to Agreement 2 No. 20-015 as of the date first above set forth. 3 4 LAVACA STREET VENTURES, LLC 5 dba MONROE & WEISBROD, LLC 6 By: 7 8 Print Name: Celeste Madison 9 10 Title: Chief Executive Officer Chairman of Board, or President or any Vice President 11 12 Date: 5i26i25 13 14 By: X& 15 16 Print Name: Camron Matschek 17 18 Title: Chief Financial Officer 19 Secretary (of Corporation), or any Assistant Secretary, 20 or Chief Financial Officer or any Assistant Treasurer 21 Date: 5/26/25 22 23 Mailing Address: 24 7514 N. Mopac Expressway, Suite 200 Austin, TX 78731 25 26 Phone No.: (512) 270-2886 Contact: Celeste Madison 27 28 1 - COUNTY OF FRESNO Fresno,CA 1 IN WITNESS WHEREOF, the parties hereto have executed this Amendment 4 to Agreement 2 No. 20-015 as of the date first above set forth. 3 4 ORBIT HEALTH, A PROFESSIONAL CORPORATION 5 By: uwaro ,�a ftariaW'MZD 6 7 Print Name: Edward Kaftarian, MD 8 Title: Chairman of the Board 9 Chairman of Board, or President or any Vice President 10 Date: 29/05/2025 11 12 13 By: 14 Print Name: Matthew Crisafulli 15 16 Title: CFO 17 Secretary (of Corporation), or any Assistant Secretary, or Chief Financial Officer or any Assistant Treasurer 18 Date: 28/05/2025 19 20 21 Mailing Address: 26565 West Agoura Road, Suite 200 22 Calabasas, CA 91302 23 Phone No.: (404) 857-7179 Contact: Arshya Vahabzadeh, MD 24 25 26 27 28 - 1 - COUNTY OF FRESNO Fresno,CA Revised Exhibit A-3 TELEMEDICINE SERVICES LIST OF CONTRACTORS CONTRACTOR NAME RATES OF REIMBURSEMENT (Exhibit B sub-part) 1. Thomas Milam MD, Inc. DBA Iris Telehealth Medical Group Revised Exhibit B-1 B 13740 N. Highway 183 Ste, L2 #221 Austin, TX 78750 Attention: Thomas Milam, MD Phone No.: (888) 285-2269 2. John L. Schaeffer, Inc. DBA American Telepsychiatrists Revised Exhibit B-2B 3308 El Camino Ave, #300-136 Sacramento, CA 95821 Attention: John L. Schaeffer, DO Phone No.: (916) 320-4422 3. Traditions Psychiatry Group, Inc. DBA Traditions Behavioral Revised Exhibit B-3A Health 900 Larkspur Landing Circle, Ste 285 Larkspur, CA 94939 Attention: David Spaccarelli Phone No.: (513) 289-9006 4. LocumTenens.com LLC Revised Exhibit B-4A 2575 Northwinds Parkway Alpharetta, GA 30009 Attention: Kristopher Ware Phone No.: (678) 690-7358 5. ExMed, Inc. Revised Exhibit B-5A 3500 West Olive Avenue, Suite 300 Burbank, CA 91505 Attention: Tony Rico, COO Phone No.: (801) 557-3380 6. AMN Healthcare Locum Tenens Inc. Revised Exhibit B-6A (formerly DrWanted.com, LLC) 12400 High Bluff Drive, Suite 500 San Diego, CA 92130 Attention: Mark Zobrosky Phone No.: (404)458-5631 Page 1 of 2 Revised Exhibit A-3 7. AB Staffing Solutions, LLC Revised Exhibit B-7A 3451 S. Mercy Road, Suite 102 Gilbert, AZ 85297 Attention: Samuel Shelton, Chief Sales Officer Phone No.: (480) 626-0830 8. Curative Talent, LLC Revised Exhibit B-8A 370 Las Colinas Blvd W STE 104 Irving, TX 75039 Attention: Kim Hickingbotham Phone No.: (866) 995-6077 9. Lavaca Street Ventures, LLC DBA Monroe & Weisbrod, LLC Revised Exhibit B-9A 7514 N. Mopac Expressway, Suite 200 Austin, TX 78731 Attention: Celeste Madison Phone No.: (512) 270-2886 10. Orbit Health, A Professional Corporation Revised Exhibit B-10A 26565 West Agoura Road, Suite 200 Calabasas, CA 91302 Attention: Arshya Vahabzadeh, MD Phone No.: (404) 857-7179 Page 2 of 2