HomeMy WebLinkAboutMINUTES - 09141993 - 1.103 TO: BOARD OF SUPERVISORS
FROM: Mark Finucaner Health Services Director Contra
By: Elizabeth A. Spooner, Contracts Administrator COSta
DATE: /August 25, 1993 County
1
SUBJECT: Approval of Contract Amendment Agreement #26-912-2
with Pauline Velez, M.D.
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
I. RECOMMENDED ACTION:
Approve and authorize the Health Services Director, or his designee
(Frank Puglisi, Jr. ) , to execute on behalf of the County, Contract
Amendment Agreement #26-912-2, effective July 1, 1993, to amend
Medical Specialist Contract #26-912 (as amended) , with Pauline Velez,
M.D. , to increase the payment limit by $5, 000 from $65, 191. 50 to a new
total contract payment limit of $70, 191. 50.
II. FINANCIAL IMPACT:
This Contract is included in the Health Services Department's
Enterprise I budget. As appropriate, patients and/or third party
payers will be billed for services.
III. REASONS FOR RECOMMENDATIONS/BACKGROUND:
On January 19, 1993 , the Board approved Medical Specialist Contract
#26-912, with Pauline Velez, M.D. , for provision of services as Chief
of Surgery at Merrithew Memorial Hospital, effective December 1, 1992
through April 30, 1993 . Contract Amendment Agreement #26-912-1, which
was approved by the Board on April 27, 1993 , extended the term of the
Contract to August 31, 1993 .
In addition to providing services at Merrithew Memorial Hospital and.,.,,. -.„-.-�
Clinics as Chief of Surgery, Dr. Velez also works as Chief ` of
Outpatient Surgery for the Veterans Administration. Beginning July 1,
1993, Dr. Velez's hours at the Veterans Administration were reduced,
with a corresponding increase in her hours at Merrithew.
Approval of Contract Amendment Agreement #26-912-2 , will provide
payment to Dr. Velez for the additional hours she worked for the
County through August 31, 1993 .
CONTINUED ON ATTACHMENT: YES SIGNATURE: ( /
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMME ATI N OF BOARD COM ITTEE
APPROVE OTHER
SIGNATURE(S)
11P
ACTION OF BOARD ON !993APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
UNANIMOUS (ABSENT ) I HEREBY CERTIFY THAT THIS IS A TRUE
AYES: :r, 9, t NOES: AND CORRECT COPY OF AN ACTION TAKEN
ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD
Contact: Frank Puglisi, Jr. (370-5100) OF SUPERVISORS ON THE DATE SHOWN.
SEp i 4 1993
CC: Health Services (Contracts) ATTESTED
Risk Management Phil Batchelor,CIA of the Board of .
Auditor-Controller Supervisors and CountyAdministrator
Contractor
M3e2/7-e3 BY ' DEPUTY
Contra Costa County Standard Form 1/87
CONTRACT AMENDMENT AGREEMENT
(Purchase of Services) Number 26-912-2
Fund/Org # 6500
Account #
Other #
1. Identification of Contract to be Amended.
Number: 26-912 (asended by Contract Amendment Agreement #26-912-1)
OW
Effective Date: eceler 1, 1992
Department: Services - Hospital and Clinics
Subject: o,,�i ion of services in Contractor's medical pecialty(ies)
2 . Parties. he County of Contra Costa, Californi ew,N'
u y) , for its
Department named above, and the following named ra or mutually
agree and promise as follows:
Contractor: PAULINE VELEZ, M.D.
Capacity: Self-employed individual T yer ID # 345-39-4804
Address: 116 Southhampton, Berkeley, Cali
IT) 94707
3 . Amendment Date. The effective date of this Contract Amendment Agreement
is July 1, 1993 .
4. Amendment Syecirfltcations. The Contract identified above is hereby
amended as sett forth in the "Amendment Specifications" attached hereto
which are i o',' or ed herein by reference.
5. Signa. hese signatures attest the parties' agreement hereto:
COUNTY OF CONTRA COSTA, CALIFORNIA
ATTEST: Phil Batchelor, Clerk of
BOARD OF SUPERVISORS the Board of Supe 'isors and County
Administrator
By .3
Chairman/Designee 'f2� eputy
CONTRACTOR
By By XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Self-employed individual XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
(Designate business capacity A) (Designate business capacity B)
Note to Contractor: For corporations (profit or nonprofit), the contract must be signed by
two officers. Signature A must be that of the president or vice-president and Signature B
must be that of the secretary or assistant secretary (Civil Code Section 1190 and
Corporations Code Section 313) . All signatures must be acknowledged as set forth on page
two.
Contra Costa County Standard Form 1/87
APPROVALS/ACKNOWLEDGEMENT
Number 26-912-2
APPROVALS
RECOMMENDED BY DEPARTMENT FORM APPROVED
By By
Designee
APPROVED: COUNTY ADMINISTRATOR
By
ACKNOWLEDGEMENT
State of California ACKNOWLEDGEMENT (By Corporation,
Partnership, or Individual)
County of
The person(s) signing above for Contractor, personally known to me in the
individual or business capacity(ies) stated, or proved to me on the basis of
satisfactory evidence to be the stated individual or the representatives) of the
partnership or corporation named above in the capacity(ies) stated, personally
appeared before me today and acknowledged that he/she/they executed it, and
acknowledged to me that the partnership named above executed it or acknowledged
to me that the corporation named above executed it pursuant to its bylaws or a
resolution of its board of directors.
Dated:
[Notarial Seal]
Notary Public/Deputy County Clerk
-2-
t j
AMENDMENT SPECIFICATIONS
Number 26-912-2
In consideration for Contractor's agreement to provide additional
services under the Contract identified herein, County agrees to
increase the Contract Payment Limit. County and Contractor agree,
therefore, to amend said Contract (as amended) as specified below
while all other parts of the Contract (as amended) remain in full
force and effect:
Increase in Payments to Contractor and the Contract Pavment Limit.
a. The Payment to Contractor, specified in Amendment
Specifications Paragraph 1. (Payment) of Contract Amendment
Agreement #26-912-1, is hereby increased by X2 , 478 . 11 per month,
from $7 , 243 . 50 per month to a new total of $9,731. 61 per month.
b. The Contract Payment Limit, specified in Amendment
Specifications Paragraph 1. (Payment) of Contract Amendment
Agreement #26-912-1, is hereby increased by $5 , 000, from a total of
$65. 191.50, to a new total Contract Payment Limit of $70, 191.50 .
Initials:
Contractor County Dept.