HomeMy WebLinkAboutMINUTES - 09121995 - C102 TO: BOARD OF SUPERVISORS _
FROMa Mark Finucane, Health Services Director l�Or`ltl'a
Costa
DATE: August 8, 1995 County
SUBJECT: Approval of Contract Amendment Agreement #24-628-4
with Nancy E. Ebbert, 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, Contract
Amendment Agreement #24-628-4, effective June 15, 1995, to amend
Mental Health Specialist Contract #24-628-3 with Nancy E. Ebbert,
M.D. , to increase the Contract Payment Limit by $3,969, from $65,520
to a new total payment limit of $69,489.
II. FINANCIAL IMPACT:
This Contract is funded by County/Realignment funding, off-set by
Medi-Cal, Medicare, private insurance and patient fee collections, and
is included in the Department's Fiscal Budget.
III. REASONS FOR RECOMMENDATIONS/BACKGROUND:
For a number of years the County has contracted with Medical, Dental
and Mental Health Specialists to provide specialized professional
services which are not otherwise available in its hospital and
clinics. On August 2 , 1994, the Board of Supervisors approved Mental
Health Specialist (Novation) Contract #24-628-3 with Nancy E. Ebbert,
M.D. , to, provide professional psychiatric services to County's
patients at Richmond 24th Street Crisis Clinic through June 30, 1995
with a Contract Automatic Extension through December 31, 1995.
Approval of this Contract Amendment will allow Dr. Ebbert to provide
additional hours of professional psychiatric services through June 30,
1995.
CONTINUED ON ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE(S)
ACTION OF BOARD ON APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
UNANIMOUS (ABSENT ) 1 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: Lorna Bastian (313-6411)
CC: Health Services (Contracts) ATTESTED
Risk Management Philea_tcheior,Clerk of the Board of
Auditor—Controller $uvfvvisors and County Administrator
Contractor
M382/7-e8 BY DEPUTY
Contra Costa County Number 24-X628-4
StaDdard. Form 1/87 SHORT FORM SERVICE Fund/Org #' 5974
CONTRACT AMENDMENT AGREEMENT Account # 2320
Other #
1. Identification of Contract to be Amended.
Number: 24-628-3
a
Effective Date: July 1, 1994
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: NANCY E. EBBERT, M.D.
capacity: Self-employed individaxpayer ID #098-40-4596
_ y
Address: 2736 Elmwood Avenue, Berkeley, California 94705
3 . Amendment Date. The effective date of this Contract Amendment Agreement
is June 15, 1995 .
4. Amendment Specifications. The Contract identified above is hereby
amended as set forth in the Amendment Specifications attached hereto
which are incorporated herein by reference.
5. Signatures. These signatures attest the parties' agreement hereto:
COUNTY OF CONTRA COSTA, CALIFORNIA CONTRACTOR
By By
Designee
Approved: County Administrator -.Y?M,FT(Designate business capacity)
By
Designee
Recommended by Department
By [Form approved by County Counsel]
Designee
AMENDMENT SPECIFICATIONS
Number 24-628-4
In consideration for Contractor's agreement to provide additional
hours of service under the Contract identified herein, County
agrees to increase the Contract Payment Limit. County and
Contractor agree therefore to amend said Contract as set forth
below while all other parts of the Contract remain unchanged and in
full force and effect.
Payment Limit Increase. The payment limit set forth in
Contract Paragraph 4. (Payment Limit) is hereby increased by
$3 ,969, from $65. 520 to a new total payment limit of $69,489.
Initials:
Contractor County Dept.