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HomeMy WebLinkAboutMINUTES - 10181994 - 1.47 TO: BOARD OF SUPERVISORS W7 FROM: Mark Finucane, Health Services Director Contra By: Elizabeth A. Spooner, Contracts AdministratoJEW"Q Costa DATE: October 5, 1994 County SUBJECT: Approval of Contract Extension Agreement #26-879-10 with Lorre Henderson, 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 Extension Agreement #26-879-10, to extend Medical Specialist Contract #26-879-8 (as amended by Contract Extension Agreement #26-879-9) with Lorre Henderson, M.D. (Specialty: Otolaryngology) , to extend the term of the Contract from September 30, 1994 through November 30, 1994. 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: 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. Dr. Henderson has been providing Otolaryngology Services for the County since 1987 . Approval of Contract Extension Agreement #26=879-10. will allow Dr. Lorre Henderson to continue providing professional Otolaryngology Services through November 30, 1994. CONTINUED ON ATTACHMENT: YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMME DATI N OF BOARD C MMITTEE APPROVE OTHER SIGNATURE(S) ACTION OF BOARD ON OCT 1 8 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: AND ENTERED ON THE MINUTES OF THE BOARD OF SUPERVISORS ON THE DATE SHOWN. Contact: Frank Puglisi (370-5100) QCT 1 8 CC: Health Services (Contracts) ATTESTE_ D 10 Risk Management Phil gat Chew,Clerk of the Board of Auditor-Controller Supervisors and CountyAdministrator Contractor M382/7-e3 BY & `, DEPUTY Contra Costa County Number 726-879-10 Standard Form 1/88 SHORT FORM SERVICE Fund/Org # 6500 CONTRACT EXTENSION AGREEMENT Account # Other # 1. Identification of Contract to be Extended. Number: 26-879-8 (as amended by Contract Extension Agreement #26-879-9) Effective Date: July 1, 1 Department: Health Services - tal and Clinics Subject: Provision of services to 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: LORRE HENDERSON, M.D. Capacity: Self-employed individual Medical License # C-41977 Taxpayer ID # 464-76-5609 Address: 16 Crest View Drive Orinda, California 94563 3 . Extension of Term. The term of the above described contract between the parties hereto is hereby extended from September 30, 1994 to November 30 , 1994 unless sooner terminated as provided in said contract. 4. Payment Limit. Including the extended term of the contract, the maximum amount payable by the County under this Contract shall not exceed $Not Applicable. 5. Other Provisions. As to the term during which the above described co fact is extended, the parties mutually agree to those Special Provis" -mss ik any) attached hereto, which are incorporated herein by reference. lop 6. Signatures: These s' atures attest the parties ' agreement hereto: COUNTY OF CONTRA COSTA, CALIFORNIA CONTRACTOR By By Designee Approved: County Administrator (Designate official capacity) By Designee Recommended by Department By (Form approved by County Counsel] Designee