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HomeMy WebLinkAboutMINUTES - 09141993 - 1.98 / 98 TO: BOARD OF SUPERVISORS nnrr��}} FROM: Mark Finucane, Health Services Director �/"` Cvl ilra By: Elizabeth A. Spooner, Contracts Administrator Costa DATE: August 25, 1993 County SUBJECT: Approval of Medical Specialist Contract #26-912-3 with Pauline Velez, M.D. SPECIFIC REQUEST(S) OR RECOMMENDATION(S) ac 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, Medical Specialist Contract #26-912-3 with Pauline Velez, M.D. , for the period from September 1, 1993 through August 31, 1994, with a payment limit of $117, 000, for professional services as Chief of Surgery for Merrithew Memorial Hospital and Clinics. II. FINANCIAL IMPACT: Cost to the County depends upon utilization. As appropriate, patients and/or third party payers will be billed for services. III. REASONS FOR RECOMMENDATIONS/BACKGROUND: For a number of years the County has contracted with Medical and Dental Specialists to provide specialized professional services which are not otherwise available in its hospital and clinics. Approval of Medical Specialist Contract #26-912-3 will allow Dr. Velez to continue serving as Chief of Surgery for Merrithew Memorial Hospital and Clinics through August 31, 1994 . CONTINUED ON ATTACHMENT: YES SIGNATURE: Q ✓ RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMEN ATI N OF BOARD C MMITTEE APPROVE OTHER SIGNATURE(S) ACTION OF BOARD ON SEP !993APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS UNANIMOUS (ABSENT ) I HEREBY CERTIFY THAT THIS IS A TRUE AYES:1ryVr', V 49 NOES: AND CORRECT COPY OF AN ACTION TAKEN ABSENT: ABSTAIN: `r- AND ENTERED ON THE MINUTES OF THE BOARD Contact: Frank Puglisi, Jr. (370-5100) OF SUPERVISORS ON THE DATE SHOWN. nn SEP 141993 CC: Health Services (Contracts) ATTESTED_ Risk Management Phil Batchelor,Clerk of the Board of Auditor-Controller Sueervisors and CountyAdministratar Contractor M382/7-69 BY ' DEPUTY Contra Costa County Number 26-912-3 Standaid&,Form MEDICAL SPECIALI9T CONTRACT Fund/Org # 6500 Account # 1. Contract Identification. Department: Health Services (Hospital and Clinics Division) Subject: Provision of services in Contractor's medical specialty(ies) 2. Parties. The County of Contra Costa, California (County) , ,for its Department named above, and the follog named Contractor mutually agree and promise as follows: Contractor: PAU N LE . M.D. Medical License # G57839 Capacity: f�-e Ved individual Taxpayer ID# 345=39-4804 Medical Spe a y��hief of Surgery Address: thhampton, Berkeley, California 94707 3. Term. Th ffective date of this Contract is September 1. 1993 and it terminates August 31. 1994 , inclusive, unless sooner terminated as provided herein. 4. Termination. Should Contractor fail to perform properly any of its obligations hereunder, County may terminate this Contract upon written notice to Contractor. This Contract may also be terminated by either party without cause by giv' thirty (30) days advance written notice thereof to the other, or may be cancel - mmiediately by written mutual consent. n 5. County's Obligations . County shall make to the Contract se pa dets described in Paragraph 1. (Payment) of the attached Additional Provi 'otihri�c are incorporated herein by reference. 6. Contractor's Obligations. Contractor shall provide those services and carry out that work described in Paragraph 2. (Contractor's Obligations) of the attached Additional Provisions. 7. Independent Contr htor Status. This Contract is by and between two independent contractors a • i not intended to and shall not be construed to create the relationshi o en , servant, employee, partnership, joint venture, or association. 8. Modific %,a:NJ Amendments. a. G 1 Amendments. This Contract may be modified or amended by a written ument executed by the Contractor and the Contra Costa County Board of Supervisors or, after Board approval, by its designee. b.• Amendment to Attachment B (Schedule) . Attachment B (Sc <e of this Contract may be modified or amended b a written document exe •t he Contractor and y y - y ,;, the Health Services Director or his designee. is 9. Insurance and Indemnification. a. The County will provide Medical Malpractice In` ..."ance coverage under its self- funded Medical Malpractice Trust Fund. b. The Contractor shall defend, save harmless and indemnify the County and its officers, agents and employees from all liabilities and claims for damages for death, sickness or injury to persons or property, including without limitation, all consequential damages, from any cause whatsoever arising from or connected with the operations or the services of the Contractor hereunder, resulting from the conduct, negligent or otherwise, of the Contractor, its agents or employees. 1 Contra Costa County MEDICAL SPECIALIST CONTRACT Number: 26-912-3 C. The County shall defend, save harmless and indemnify the Contractor and its officers, agents and employees from all liabilities and claims for damages for death, sickness or injury to persons or property, including without limitation, all consequential damages, from any cause whatsoever arising from or connected with the operations or the services of the County, resulting from the conduct, negligent or otherwise, of the County or its employees. " 10. Assi¢nment. Contractor shall not assign or transfer any interest hereunder without the express written permission of the Director of County's Health Services Department and prior written approval of the State Department of Health Services. 11. Legal Authority. This Contract is entered into under and is subject to the following legal authorities: California Government Code Sections 26227 and 31000; Health and Safety Code Section 1451, and all legal authorities cited in the attached Prepaid Health Plan Subcontract Requirements, Attachment A. 12. Signatures. These signatures attest the parties' agreement hereto: COUNTY OF CONTRA COSTA, CALIFORNIA CONTRACTOR By By Designee Recommended by Department Dated: By (Form approved by County Counsel) 2 ADDITIONAL PROVISIONS Number 26-912-3 1. Payment. In consideration of Contractor's provision of services as described below, County shall pay Contractor, upon submission of a properly documented demand for payment in the form and manner prescribed by County (Demand Form D-15) , and upon approval of such demand by the head of the County Department for which this Contract is made, or his designee, in accordance with the following fee schedule: $9,750.00 per month for administrative and training services in the Department of Surgery as Chief of Surgery at Merrithew Memorial Hospital and Clinics, but not to exceed a total payment of $117,000.00 during the term of this Contract. 2. Contractor's Obligations. a. Qualifications and Schedule. Contractor hereby certifies and assures that he/she is specially trained, experienced, competent, and licensed to perform special professional services, including medical procedures and consultation and training in medical and therapeutic matters. Contractor shall render such special professional services in his/her medical specialty(ies) for County patients at certain times and locations specified by the Director of County's Health Services Department or his designee as stated in Attachment "B" to this Contract, which is incorporated herein by reference. Amendment of the provisions in Attachment "B" may be made in writing by mutual consent of the Contractor and the Health Services Director or his designee as set forth in Paragraph 8. (Modifications and Amendments) of the signature page of this Contract. b. Vacation Coverage. Contractor shall notify the Health Services Director, or his designee, two weeks in advance of any vacation. At the time of this notification, Contractor shall provide to the Health Services Director, or his designee, the names, addresses, and phone numbers of two physicians qualified to perform specialty services as provided hereunder by Contractor. Prior to supplying said names to County, Contractor shall have talked with these qualified physicians and determined their willingness to provide coverage at Merrithew Memorial Hospital during Contractor's vacation. C. Training of Residents. Contractor agrees to provide teaching and supervision of residents, as requested by the Health Services Director or his designee. d. Patient Records. Contractor will complete his/her patients' records and charts on a timely basis. County may withhold payment, recommend suspension or revocation of hospital privileges, and/or terminate this Contract for failure to comply with this contract provision. e. Rules and Regulations. Contractor agrees to abide by all rules, regulations, procedures and bylaws for the operation of the County's Health Services Department which he/she certifies he/she has read. Contractor also agrees to abide by the rules and regulations of the working unit in which he/she works as well as all legal requirements and Joint Commission on Accreditation of Hospitals (JCAH) standards. f. Contra Costa Health Plan Subcontract Requirements. Contractor shall be subject to the attached Contra Costa Health Plan Subcontract Requirements (Attachment A) which are incorporated herein by reference. Initials: Contractor County Dept. 1 ADDITIONAL PROVISIONS Number 26-912-3 3. Access to Books and Records of Contractor. Subcontractor. Pursuant to Section 1861 (v) (1) of the Social Security Act, and any regulations promulgated thereunder, Contractor shall, upon written request and until the expiration of four years after the furnishing of services pursuant to this Contract, make available to the Secretary of Health and Human Services or to the Comptroller General, or any of their duly authorized representatives, this Contract and books, documents, and records of Contractor that are necessary to certify the nature and extent of all costs and charges hereunder. Further, if Contractor carries out any of the duties of this Contract through a subcontract with a value or cost of $10,000 or more over a tw6lve-month period, such subcontract shall contain a clause to the effect that upon written request and until the expiration of four years after the furnishing of services pursuant to such subcontract, the subcontractor shall make available, to the Secretary or to the Comptroller General, or any of their duly authorized representatives, the subcontract and books, documents, and records of the subcontractor that are necessary to verify the nature and extent of all costs and charges hereunder. 4, Endorsements. Contractor shall not in its capacity as a contractor with Contra Costa County publicly endorse or oppose the use of any particular brand name or commercial product without the prior approval of the Board of Supervisors. In its County contractor capacity, Contractor shall not publicly attribute qualities or lack of qualities to a particular brand name or commercial product in the absence of a well-established and widely-accepted scientific basis for such claims or without the prior approval of the Board of Supervisors. In its County .contractor capacity, Contractor shall not participate or appear in any commercially-produced advertisements designed to promote a particular brand name or commercial product, even if Contractor is not publicly endorsing a product, as long as the Contractor's presence in the advertisement can reasonably be interpreted as an endorsement of the product by or on behalf of Contra Costa County. Notwithstanding the foregoing, Contractor may express its views on products to other contractors, the Board of Supervisors, County officers, or others who may be authorized by the Board of Supervisors or by law to receive such views. Initials: Contractor County Dept. 2 ATTACHMENT A CONTRA COSTA HEALTH PLAN SUBCONTRACT REQUIREMENTS Number 26-912-3 Pursuant to State Department of Health/County Contract #88-94695 (County #29-609-35) , effective January 1, 1989, (or the latest revision) Article X, Subcontracts; requirements of the Waxman-Duffy Prepaid Health Plan Act, (1972) and Knox-Keene Health Care Service Plan Act of 1975; Federal Regulations: 42 CFR 431.504; State Law: W&I Code, Section 14452; State Regulations: Title 22, CAC, Section 53250, the following subcontract requirements are incorporated into the contract referenced by number above: 1. Contractor shall be subject to and comply with all Federal, State, and local laws and regulations and contractual obligations incumbent upon the County under County Contract #29-609-35 and any subsequent amendment thereto. 2. A Contractor providing any basic health care service to Contra Costa Health Plan members (Plan members) shall meet all of the requirements of Chapters 3 and 4, Subdivision 1, Division 3, Title 22, C.A.C. (commencing with Section 51001) which relate to the services the Contractor provides. This specifically includes the requirements of Title 22, C.A.C. Section 53250(e) , a copy of which is attached hereto and incorporated herein by reference as Exhibit A. 3. Contracts shall be public records on file with the State Department of Health Services. The names of the officers and owners of the Contractor, stockholders owning more than ten percent of the stock issued by the Contractor, and major creditors holding more than five percent of the debt of the Contractor are: Owners/Officers: Stockholders owning more than 10% of stock: Creditors holding more than 5% of debt: 4. County and Contractor agree that Contractors compensation hereunder shall not be based in any way on a percentage of the County's compensation from the State Department of Health Services; this agreement does not preclude the establishment of Contractor's rate based on capitation payments pursuant to Welfare and Institutions Code Section 14453. 5. Contractor agrees to submit reports or abstracts of treatment records in relation to Plan members, as appropriate and required by County. 6. Contractor will allow inspection, examination, or copying of financial books and records relating to Plan members or Plan services by the County, the State Department of Health Services, the State Department of Corporations, the U.S. Department Health and Human Services, or their duly authorized representatives. Such books and records shall be made available at all reasonable times at the Contractor's place of business; in a form maintained in accordance with general standards, for a term of at least five years from the close of State's fiscal year in which this Contract is in effect. Initials: Contractor County Dept. -1- ATTACHMENT A CONTRA COSTA HEALTH PLAN SUBCONTRACT REQUIREMENTS 7. Contractor shall not make assignment and/or delegation of this Contract unless it has obtained prior written approval of the other party, the County, and State Department of Health Services. 8. Contractor will hold harmless both the State and Plan members in the event the County cannot or will not pay for services performed for Plan members pursuant to this Contract. 9. Contractor will notify the Department of Health Services and Commissioner of Corporations in the event this Contract is amended or terminated. Notice is considered given when deposited in the U.S. Registered Mail, first class postage prepaid, addressed as follows: Organized Health Services HMO Unit Department of Corporations Department of Health Services 600 South Commonwealth 714 P Street Los Angeles, California 90005 Sacramento, California 95814 10. Nondiscrimination Requirements. a. Nondiscrimination Clause (OCP-1) . (1) During the performance of this Contract, Contractor and its subcontractors shall not unlawfully discriminate against any employee or applicant for employment because of race, religion, color, national origin, ancestry, physical handicap, medical condition, marital status, age (over 40) or sex. Contractor and subcontractors shall insure that the evaluation and treatment of their employees and applicants for employment are free from such discrimination. Contractors and subcontractors shall comply with the provisions of the Fair Employment and Housing Act (Government Code, Section 12900 et seq.) and the applicable regulations promulgated thereunder (California Code of Regulations, Title 2, Section 7285.0 et seq. ) . The applicable regulations of the Fair Employment and Housing Commission implementing Government Code, Section 12990, set forth in Chapter 5 of Division 4 of Title 2 of the California Code of Regulations are incorporated into this Contract by reference and made a part hereof as if set forth in full. Contractor and its subcontractors shall give written notice of their obligations under this clause to labor organizations with which they have a collective bargaining or other agreement. (2) This Contractor shall include the nondiscrimination and compliance provisions of this clause in all subcontracts toperformwork under this Contract. b. Nondiscriminatory Services. The Contractor will not discriminate against Contra Costa Health Plan members or eligible beneficiaries because of race, color, creed, religion, ancestry, marital status, sexual orientation, national origin, age, sex, or physical or mental handicap in accordance with Title VI of the Civil Rights Act of 1964, 42 USC Section 2000d rules and regulations promulgated pursuant thereto, or as otherwise provided by law or regulation. Initials: Contractor County Dept. -2- ATTACHMENT A CONTRA COSTA HEALTH PLAN SUBCONTRACT REQUIREMENTS C. Discrimination Complaints. The Contractor agrees that copies of all grievances alleging discrimination against Contra Costa Health Plan members or eligible beneficiaries because of race, color, creed, sex, religion, age, national origin, ancestry, marital status, sexual orientation, or physical or mental handicap shall be forwarded to the Health Services Director for review and appropriate action. 11. Confidentiality. Contractor agrees to comply with all applicable State or Federal statutes or regulations respecting confidentiality, including but not limited to, the identity of persons served under this Contract, their records, or services provided them, and assures that: a. All records concerning any individual made or kept by Contractor relating to services provided under this Contract will be confidential, and will not be open to examination for any purpose not directly connected with the administration of such service. b. No person will publish or disclose any list of persons receiving services, except as may be required in the administration of such service. Initials: Contractor County Dept. -3- EXHIBIT A TITLE 22 MEDICAL ASSISTANCE PROGRAM Section 53250 (Register 82. No. 39--5-25-82 (p, 1300.39) (e) Each subcontract shall contain: (1) The subcontractor's agreement to make all of its books and records, pertaining to the goods and services furnished under the terms of the subcontract, available for inspection, examination or copying: (A) By the Department, the United States Department of Health and Human Services and the Department of Corporations. (B) At all reasonable times at the subcontractor's place of business, or at such other mutually agreeable location in California. (C) In a form maintained in accordance with the general standards applicable to such book or record keeping. (D) For a term of at least five years from the close of the fiscal year in which the subcontract was in effect. (2) Full disclosure of the method and amount of compensation or other consideration ,to be received by the subcontractor from the plan. (3) Subcontractor's agreement to maintain and make available to the Department, upon request, copies of all sub-subcontracts and to ensure that all sub-subcontracts are in writing and require that the subcontractor: (A) Make all applicable books and records available at all reasonable times for inspection, examination or copying by the Department. (B) Retain such books and records for a term of at least five years from the close of the fiscal year in which the sub-subcontractor is in effect. (4) Subcontractor's agreement to notify the Department in the event the agreement with the Contractor is amended or terminated. Notice to the Department is considered given when properly addressed and deposited in the United States Postal Service as first-class registered mail, postage attached. (5) Subcontractor's agreement that assignment or delegation of the subcontract shall be void unless prior written approval is obtained from the Department in those instances where prior approval . by the Department is required. (6) Subcontractor's agreement to hold harmless both the State and plan members in the event the plan cannot or will not pay for services performed by the subcontractor pursuant to the subcontract. NOTE: Authority cited: Section 14312, Welfare and Institutions Code Reference Section 14452, Welfare and Institutions Code. HISTORY 1. Repealer and new section filed 7-5-78, effective thirtieth day thereafter (Register 78, No. 27) . 2. Amendment of subsection (g) (16) and new subsection (g) (17) filed 10-20-78, effective thirtieth day thereafter (Register 78, No. 42) . 3 . Amendment filed 12-30-81; effective thirtieth day thereafter (Register 82, No. 1) . ATTACHMENT B Contract Number: 26-912-3 Contractor: PAULINE VELEZ, M.D. SCHEDULE Contractor's schedule is on file in the .office of the Medical Staff Secretary.