HomeMy WebLinkAboutMINUTES - 08081995 - C53 TO: BOARD OF SUPERVISORS (��/ ✓✓
FROM: Mark Finucane, Health Services Director Contra
Costa
DATE: July 24, 1995 County
SUBJECT: Approval of Contract Amendment Agreement #26-905-6 with
Howard Sturtz, 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 #26-905-6, with Howard Sturtz, M.D. (Specialty:
Orthopedics) , effective June 30, 1995, to amend Medical Specialist
Contract #26-905-4 (as amended by Contract Amendment Agreement
#26-905-5) . This amendment increases the payment limit by $36, 000,
from $105,689 to a new total payment limit of $141,689 and extends the
term of the agreement through October 31, 1995.
II. FINANCIAL IMPACT:
Cost to the County depends upon utilization. As appropriate, patients
and/or third party payors will be billed for services.
III. REASONS FOR RECOMMENDATIONS/BACKGROUND:
On July 19, 1994, your Board approved Medical Specialist Contract
#26-904-4 (as amended by Contract Amendment Agreement #26-905-5) , and
authorized the Health Services Director to execute on behalf of the
County, twenty-nine Medical Specialist Contracts, which were listed on
an attached addendum, for the provision of professional medical or
dental services to patients at Merrithew Memorial Hospital and Clinics
for the period from July 1, 1994 through June 30, 1995.
Ongoing negotiations are drawing to a close and the purpose of this
Board Order is to provide a mechanism which will assure continuity of
vital services to patients and facilitate payment to the Medical
Specialists for four additional months pending completion of contract
negotiations.
Approval of Contract Amendment #26-905-6 will extend the term of this
Contract and increase the payment limit, allowing the Contractor to
provide additional orthopedic services through October 31, 1995.
CONTINUED ON ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE(S)
ACTION OF BOARD ON � ygLQ�� ��5 APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
y UNANIMOUS (ABSENT ) I HEREBY CERTIFY THAT THIS IS A TRUE
AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN
ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD
OF SUPERVISORS ON THE DATE SHOWN.
Contact: Frank Puglisi, Jr.
CC: Health Services (Contracts) ATTESTED g Ct o1J
Risk Management Phil Batchelo , Clerk of the Board of
Auditor-Controller SuperyiWr3 epd County AdminisUatpr
Contractor .
M382/7-83 BY DEPUTY
jioAra Costa County Standard Form 1/87
CONTRACT AMENDMENT AGREEMENT
(Purchase of Services)
Number 26-905-6
Fund/Org # 6500
Account #
1. Identification of Contract to be Amended.
Number: 26-905-4 (as amended by Contract Extension Agreement #26-905-5)
Effective Date: July 1, 1994
Department: Health Services - Hospital and Clinics
Subject: Orthopedics Services
2 . Parties. The County of Contr . Costa, California (County) , for its
Department named above, and the fol wing named Contractor mutually agree
and promise as follows:
Contractor: HOWARD STURTZ, M.D. 'OVA,edical License # G10274
Capacity: A Professional Corporation Mxpayer ID # 94-1733531
Address: 1479 Ygnacio Valley, Walnut Creek, Cali nia 94598
3 . Amendment Date. The effective date of this Contract Am ndment Agreement
is June 30, 1995.
4 . Amendment Specifications. The Contract identified above is hereby amended
as set fort '• 'n the "Amendment Specifications" attached hereto which are
incorporated h ein by reference.
5. Signatures. These 'c atures attest the parties ' agreement hereto:
COUNTY O ONTRA COSTA. CALIFORNIA
ATTEST: Phil Batchelor, Clerk of
BOARD OF SUPERVISORS the Board of Supervisors and County
Administrator
By By
Chairman/Designee Deputy
CONTRACTOR
By By XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Professional Corporation 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.
/ v
Contra Costa County Standard Form(Rev. 1/95)
APPROVALS/ACKNOWLEDGMENT
Number 26-905-6
APPROVALS
RECOMMENDED BY DEPARTMENT FORM APPROVED
COUNTY COUNSEL
By By
Designee _ Deputy
APPROVED: COUNTY ADMINISTRATOR
By:
Designee
ACKNOWLEDGMENT
STATE OF CALIFORNIA )
ss.
COUNTY OF CONTRA COSTA )
On , before me,
(insert name and title of the officer), personally appeared
personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose
name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same
in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or
the entity upon behalf of which the person(s) acted, executed the instrument.
WITNESS MY HAND AND OFFICIAL SEAL.
(Seal)
Signature
ACKNOWLEDGMENT(by Commtiao,Pumenhip,or Individual)
(04H Code 11189)
AMENDMENT SPECIFICATIONS
Number: 26-905-6
In consideration for Contractor's agreement to continue to provide
services under the Contract identified herein (as amended by
Contract Amendment #26-905-5) , County agrees to extend the term of
the Contract and to increase the Contract payment limit. County
and Contractor agree, therefore, to amend said Contract as
specified below while all other parts of the Contract remain in
full force and effect:
1. Payment Limit Increase. The payment limit set forth in
Amendment Agreement #26-905-5 is hereby increased by $36, 000, from
$105, 689 to a new total Payment Limit of $141,689.
2 . Extension of Term. The term of the Contract specified in
Paragraph 3 . (Term) is hereby extended from June 30, 1995
to October 31, 1995 .
Initials:
Contractor County Dept.