HomeMy WebLinkAboutMINUTES - 04271993 - 1.67 TO: BOARD OF SUPERVISORS
FROM: Mark Finucane, Health Services Director �� Contra
By: Elizabeth A. Spooner, Contracts Administrator
Costa
DATE: April 15, 1993 County
SUBJECT: Approval of Contract Amendment Agreement #26-912-1 with Pauline
Velez, 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 #26-912-1, with Pauline Velez, M.D. , effective
April 30, 1993 , to amend Medical Specialist Contract #26-912,
effective December 1, 1992 through April 30, 1993 , to increase the
payment limit by $28,974 from $36,217 .50 to a new total contract
payment limit of $65, 191. 50, and to' extend the term of the contract
through August 31, 1993 . This Contractor provides services as Chief
of Surgery at Merrithew Memorial Hospital.
II. FINANCIAL IMPACT:
This Contract is included in the Health Services Department's
Enterprise I budget. As appropriate, patients and/or third party
payers will be billed for services.
III. REASONS FOR RECOMMENDATIONS/BACKGROUND:
On January 19, 1993 , the Board approved Medical Specialist Contract
#26-912, with Pauline Velez, M.D. , for provision of services as Chief
of Surgery at Merrithew Memorial Hospital, effective December 1, 1992
through April 30, 1993 .
The Department expected to enter into a contractual agreement with
U.C. Davis Medical School, Department of Surgery for surgical services
by April 30, 1993 . However, due to delays on the part of U.C. Davis
Medical School, it now appears that a contractual agreement with the
university may not be processed until later this year.
Approval of Contract Amendment Agreement #26-912-1 will allow the
Contractor to continue to provide services as Chief of Surgery for
Merrithew Memorial Hospital through August 31, 1993 .
CONTINUED ON ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMME ATION OF BOARD C MMITTEE
APPROVE OTHER
SIGNATURE(S)
ACTION OF BOARD ON APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
UNANIMOUS (ABSENT ) I HEREBY CERTIFY THAT THIS IS A TRUE
AYES:Z 4, NOES: AND CORRECT COPY OF AN ACTION TAKEN
ABSENT: ABSTAIN: _ AND ENTERED ON THE MINUTES OF THE BOARD
Contact: Frank Puglisi, Jr. (370-5100) OF SUPERVISORS ON THE DATE SHOWN.
CC: Health Services (Contracts) ATTESTED
Risk Management Phil Batche ,Clerk Of the Board of
Auditor-Controller Supervisors and County Administrator
Contractor
M382/7-83 BY `! V49&, ' DEPUTY
_ , 0
Contra Costa County Standard Form 1/87
CONTRACT AMENDMENT AGREEMENT
(Purchase of Services) Number 26-912-1
Fund/Org # 6500
Account #
Other #
1. Identification of Contract to be Amended.
Number: 26-912
Effective Date: December 1, 1992
Department: Health Services - Hospital and Clinics
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: PAULINE VELEZ, M.D.
Capacity: Self-employed individual Taxpayer ID # 345-39-4804
Address: 2019 Yolo Avenue, Berkeley, California 94707
3 . Amendment Date. The effective date of this Contract Amendment Agreement
is April 30, 1993 .
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
ATTEST: Phil Batchelor, Clerk of
BOARD OF SUPERVISORS the Board of Supervisors and County
Administrator'
By
Chairman/Designee Deputy
CONTRACTOR
By By XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Self-employed individual 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.
Contra Costa County Standard Form 1/87
APPROVALS/ACKNOWLEDGEMENT
Number 26-912-1
APPROVALS
RECOMMENDED BY DEPARTMENT FORM APPROVED
By By
Designee
APPROVED: COUNTY ADMINISTRATOR
By
ACKNOWLEDGEMENT
State of California ACKNOWLEDGEMENT (By Corporation,
Partnership, or Individual)
County of
The person(s) signing above for Contractor, personally known to me in the
individual or business capacity(ies) stated, or proved to me on the basis of
satisfactory evidence to be the stated individual or the representative(s) of the
partnership or corporation named above in the capacity(ies) stated, personally
appeared before me today and acknowledged that he/she/they executed it, and
acknowledged to me that the partnership named above executed it or acknowledged
to me that the corporation named above executed it pursuant to its bylaws or a
resolution of its board of directors.
Dated:
[Notarial Seal]
Notary Public/Deputy County Clerk
-2-
AMENDMENT SPECIFICATIONS
Number 26-912-1
Inconsideration for Contractor's agreement to provide additional services under the Contract
identified herein, County and Contractor agree to amend said Contract as specified below
while all other parts of the Contract remain in full force and effect:
1. Payment. The payment provisions set forth in Additional Provisions Paragraph 1.
(Payment) , of the Contract is hereby modified to read as follows:
"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 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:
$7.243.50 per month for administrative and training
services in the Department of Surgry as Chief of Surgery
at Merrithew Memorial Hospital, NOT TO EXCEED a total
Payment Limit of $65.191.50. "
2. Extension of Term. The term set forth in Paragraph 3. (Term) , of the Contract is hereby
extended from April 30, 1993 through August 31, 1993.
3. Modified Insurance Requirements. Paragraph 9. (Insurance and Indemnification) of the
Contract is hereby modified to read as follows:
119. Insurance and Indemnification.
a. The County will provide Medical Malpractice Insurance 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.
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. "
Initials:
Contractor County Dept.