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HomeMy WebLinkAboutMINUTES - 09131994 - 1.91 To: BOARD OF SUPERVISORS FROM: Mark Finucane, Health Services Director �f Contra By: Elizabeth A. Spooner, Contracts Administrator �S♦a 1. DATE: August 10, 1994 County SUBJECT: Approval of Medical Specialist Contract #24-650-2 with Wendy Eberhardt, M.D. SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION I. RECOMMENDED ACTION: Approve and authorize the Health Services Director or his designee (Lorna Bastian) to execute on behalf of the County, Medical Specialist Contract #24-650-2 with Wendy Eberhardt, M.D. , for the period from September 1, 1994 through August 31, 1995, with a payment limit of $57, 318, for geriatric psychiatry services at the West County Older Adults Clinic. II. FINANCIAL IMPACT: Patients seen by Dr. Eberhardt will be billed by the Health Services Department on, a fee-for-service basis. This position is revenue- producing via third-party payors (Medicare, Medi-Cal, and private insurance) . 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. On September 14, 1993 , the Board of Supervisors approved Medical Specialist Contract #24-650-1 with Wendy Eberhardt, M.D. , to provide a specialized service, geriatric psychiatry, at the West County Older Adults Clinic. Approval of Medical Specialist Contract #24-650-2 will allow Dr. Eberhardt to continue these services through August 31, 1995. CONTINUED ON ATTACHMENT: YES SIGNATURE.,,-' • Q RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMM9,9DATI NOF BOARD COMMITTEE APPROVE OTHER SIGNATURE(S) ACTION OF BOARD ON 13 APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS UNANIMOUS (ABSENT ) I HEREBY CERTIFY THAT THIS IS A TRUE AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN ABSENT: ABSTAIN: TL AND ENTERED ON THE MINUTES OF THE BOARD OF SUPERVISORS ON THE DATE SHOWN. Contact: Lorna Bastian (313-6411) CC: Health Services (Contracts) ATTESTED lz , 199 !f Risk Management Phil BatC jot,CjeA of the Board of Auditor-Controller Supervisors and County Administrator Contractor M382/7.83 BY �1G1 SA: DEPUTY DEPUTY J Contra Costa- Gounty Number, 24-650-2 Standard Form MEDICAL SPECIALIST CONTRACT Fund/Org # 6408 Account # 2861 1. Contract Identification. ` Department: Health Services - Mental Health 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 following named Contractor mutually agree and promise as follows: Contractor: WENDY EBERHARDT, M.D. Medical License # G049305 Capacity: Self-employed individualliq. ayer ID# 342-50-4761 Medical Specialty: Geriatric Psychiatry � Address: 42 Rhinestone Terrace, San Rafael, California 94903 3. Term. The effective date of this Contract is September 1. 199�4 �anit terminates August 31, 1995 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 giving thirty (30) days advance written notice thereof to the other, or may be cancelled immediately by written mutual consent. 5. County's Obligations. County shall make to the Contractor those payments described in Paragraph 1. (Payment) of the attached Additional Provisions which are incorporated herein by reference. 6. Contractor's Obligations. Contractor shall provide those services and carry out that work described in Paragraph 2. (Contractors Obligations) of the attached Additional Provisions. 7. Independent Contractor Status. This Contract is by and between two independent contractors and is not intended to and shall not be construed to create the relationship of ager►, , servant, employee, partnership, joint venture, or association. 8. Modifications and Amendment a. General Amendments. This Co act may be modified or amended by a written document executed by the Contracand the Contra Costa County Board of Supervisors or, after Board approval, ;,its designee. b. Amendment to Attachment B (Schedule) . Attachment B (Schedule) of this Contract may be modified or amended by a written document executed by the Contractor and the Health Services Director or his designee. 9. Insurance and Indemnification. Throughout the term of this Contract, Contractor shall maintain all necessary insurance for services to be provided by Contractor hereunder, including but not limited 'to professional malpractice liability coverage. Malpractice liability insurance shall be in an amount no less than $1,000,000 per claim/$3,000,000 annual aggregate and shall be from a reputable insurance company acceptable to the County. The Contractor's'''insurance carrier shall be the primary coverage. The County will cover those areas, to the extent not covered by the Contractor's carrier, such as administration and teaching responsibilities. Contractor shall provide the County with a valid certificate of insurance evidencing the coverage required by this clause and shall promptly advise County of any and all claims paid by the insurer(s) under said insurance. 1 Contra Costa Cbunty MEDICAL SPECIALIST CONTRACT Number 24-650-2 If a claim is made against County, or its officers, agents, or employees, which arises out of the performance of Contractor's duties under this agreement and Contractor has failed to maintain the insurance policies required under this agreement which would have covered Contractor had the claim been made against him or her, then as to such claims, Contractor shall indemnify and hold the County, and its officers, agents, or employees harmless for that portion of the loss or liability- attributable to Contractor. 10. Assignment. 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 24-650-2 1. Pavment. 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: $61.50 per hour for the provision of consultation, evaluation, training services, and/or medical procedures, as set forth in Paragraph 2. (Contractor's Obligations) below, NOT TO EXCEED a total of 932 hours and a payment limit of $57,120. 2. Contractor's Obligations. a. Oualifications 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. This will be paid at the consultation and training services rate, specified in Paragraph l.a (Payment ) above. 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 24-650-2 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 twelve-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. This special condition is in addition to any and all other terms regarding the maintenance or retention of records under this Contract and is binding on the heirs, successors, assigns and representatives of Contractor. 4. Penalty for Late Submission. When Contractor fails to submit to County a proper demand for payment as specified in Paragraph 1. Payment) 'above, within 30 days of the end of the month in which the contract services upon which the demand is based are actually rendered and the County is unable to obtain reimbursement from the State of California or otherwise, to the extent the County's recovery of funding is prejudiced, County shall not pay Contractor for such services, even though such services were fully provided. 5. Withholding_and FICA Deductions. Notwithstanding Paragraph 7. (Independent Contractor Status) of the Medical Specialist Contract, for purposes of withholding state and federal taxes and Social Security only from payments due, the Contractor will be treated as an employee and the Auditor-Controller will make deductions for these purposes as if Contractor was an employee. Contractor agrees that for all other purposes, Contractor is not a County employee and remains an .independent contractor. Contractor further agrees that the County has no obligation to provide, and Contractor will not be provided with, worker's compensation insurance or fringe benefits, including but not limited to, vacation, sick leave, retirement and health plan coverage. 6. 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: 24-650-2 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 Reguirements. 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 to perform work 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 f ive 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: 24-650-2 Contractor: AENDY EBERHARDT, M.D. SCHEDULE Contractor's schedule is on file with the Mental Health Division's Geriatric Services Program Chief.