HomeMy WebLinkAboutMINUTES - 07141998 - C103-C107 BOARD OF SUPERVISORS �►lob
William Walker, M.D. , Health Services DirectorContra
By: Ginger Marieiro, Contracts Administrator Costa
DATE: June 30, 1998 County
SUBJECT:
Approval of Contract ##24-939-89 with Elizabeth Mertens, M.F.C.C. '
SPECIFIC REQUEST(S)OR RECOMb3MENDA'TWN(S)&BACKGROUND AND JUSTIFICATION
I. REC9i+>lKWffi ACTION
Approve and authorize the Health Services Director,> or his designee
(Donna Wigand) , to execute on behalf of the County, Contract
##24-939-89 with Elizabeth Mertens, M.F.C.C. , for the ; period from
April 1, 1998 through June 30, 1999, to provide Medi-Cal mental,
health specialty services, to be paid in accordance with the rates
set forth in the attached fee schedule.
II. FINANCIAL IMPACT:
This Contract is funded by State and Federal FFP Medi-Cal Funds .
III . REASONS FOR RECOMMEjPATI£')XS/ ACKGR0LTND:
On January 14, 1997, the Board of Supervisors adopted Resolution.
##97/17, authorizing the Health Services Director or his designee
(Donna Wigand, 'LCSW) to contract with the State Department of Mental
Health to assume responsibility for Medi-Cal specialty mental health
services as of July 1, 1997. The implementation date has since been
changed to April 1, 1998 . Responsibility for outpatient specialty
mental health services involves contracts with individual, group and
organizational providers to deliver these services.
Approval of Contract ##24-939-89 will allow the Contractor to provide
mental health specialty services through June 30, 1999 .
CQNTINUED ON A-TTAQ-HMENT, ESXX SjQN6TUR
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVEOTHER
ACTION OF BOARD ON APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
I HEREBY CERTIFY THAT THIS IS A TRUE
UNANIMOUS (ABSENT______j AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
ATTESTED L4 l d
PAT`CdKOR,CLEAKOF THE BOARD OF
SUPERVISORS AND COUNTY ADMINISTRATOR
Contact Person: Donna Wigand (313-641:..1)
CC: Health Services(Contracts)
Risk Management /r
Auditor Controller BY DEPUTY
Contractor
Board Order
page two (2)
CCMHP OUTPATIENT SPECIALTY MENTAL HEALTH SERVICES FEE SCHE-DOLE--Revised 3219197.
CPT CODE PROCEDURE M.0 PhM L.C.S.W. M.F.C.C.
Level 1Codes 90830 Test Administration- 9 hour max 6 $30
90887 Test Scoring- 1hour max 2 $30
90843 individual Psychotherapy- 112 hour $30
90844 Individual Psychotherapy- 1 hour $60 $30 $30 $30
90846 f=amily Thera -without patient $30 $30 $30
90847 Family Therapy-conjoint $30< $30 $30
90853 Group Therapy-per person-per visit-1 1/2hr max $12 $12 $12
90852 Pharmacolo ical management $30
910$70 ECT-Single Seizure $60
X9544 Case Conference- 112 hour $30 $15 $15 $15
X9546 Case Conference- lhour $60 $30 $30 $30
i ospitai Ir►pt. Service 99221 Hospital Care Visit-Initial-30 minutes $30
99222 Hospital Care Visit-Initial-50 minutes $60
99232 l-lospitai Care Visit-Subsequent-30 minutes $35-
Outpatient
30Out atient Consults 99242 Office Consultation New Patient-30 minutes $30
_ 99244 Office Consultation New Patient-60 minutes $60
In a#ictal Consults 99251 inpatient Consultation New Patient-30 minutes $30
99253 Inpatient Consultation New Patient-60 minutes $60
Nursing Fac,Assess 99301 Evaluation and Management-30 minutes $30
99303 Evaluation and Management-60 minutes $60
99311 Subsequent Nursing Facility Care-15 minutes $15
99313 Subsequent Nursing Facility Cate-30 minutes $311
Rest Home et At Svc. 99323 Evaluation of New Patient $60
99333Evaluation of Established Patient $30
Mome Services 99341 Evaluation of New Patient $60
99353'Evatuation of Established Patient $30
•" These are the only outpatient services which CCMHP will authorize and the only
codes for which providers will be reimbursed.
BOARD OF SUPERVISORS
C./0
FROM: `
William Walker, M.D. , Health Services. Director 'Y1 r�" Contra
By: Ginger Marieiro, Contracts Administrator Costa
DATE: June 30, 1:998 County
SUBJECT.
Approval of Contract #24-939-93 with Joseph Sholders, M.D.
SPECIFIC REQUEST(S)OR RECOMMENDATIONS)A BACKGROUND AND JUSTIFICATION
Approve and authorize the Health Services Director,, or his designee
(Donna Wigand) , to execute on behalf of the County, Contract
##24-939-93 with Joseph Sholders, M.D. for the period from April 1,
1998 through June 30, 1999, to provide Medi-Cal mental health
specialty services, to be paid in accordance with the rates set
forth in the attached fee schedule.
II . FINANCIAL IMPACT:
This Contract is funded by State and Federal FFP Medi-Cal Funds.
III . REASONS FOR. RECOMMENDAT-1QNSJBACXGR0_D=
Can January 14, 1997, the Board of Supervisors adapted Resolution
##97/17, authorizing the Health Services Director or his designee.
(Donna Wigand, LCSW) to contract with the State Department of Mental.
Health to assume responsibility for Medi-Cal specialty rental health
services as of July 1, 1997. The implementation date has since been
changed to April 1, 1998 . Responsibility for outpatient specialty
mental health services involves contracts with individual, group and
organizational providers to deliver these services;.
Approval of Contract ##24-939v-93 will allow the Contractor to provide
mental health specialty services through June 30, 1999 .
N D ON 6MACHMENT: XX SIGN6IURE
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
'r-, . A"
ACTION OF BOARD ON ZAPPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
I HERESY CERTIFY THAT THIS IS A TRUE
UNANIMOUS {ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN
AYES. NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT; ABSTAIN; OF SUPERVISORS ON THE DATE SHOWN.
r
ATTESTEDZZ ,/, .. "
rCIBATC R,CLE OF THE BOARD F'
UPERVISORS AND COUNTY ADMINISTRATOR
Contact Person: Donna Wigand (323-6411)
CC. Health Services(Contracts)
Risk Management
Auditor Controller BY DEPUTY
Contractor
Board Order
page two (2)
•CCMHP OUTPATIENT SPECIALTY MENTAL HEALTH SERVICES FEE SCHEDULE--Revised 1219197.
'GPT C€DE PROCEDURE M.C? Ph.p L.C.S.W. M.F.C.C.
Level 1Codes90830 Test Administration- 1 hour max 6 $30
90887 Test Scor'in - lttour max 2) $30
90943 Individual Psychotherapy- 1f2 hour $30
90844 Individual Psychotherapy- 1 hour $60 $30 $30 $30
90846 Family Thera -without patient $30 $30 $30
90847 Family Thera -conjoint $30 $30 $30
90853 Group Therapy-per person-per visit-1 112fir max $12' $12 $12
90862 Pharmacological management $30
90870 ECT-Single Seizure $60
X9544 Case Conference- 1!2 hour $30 $15 $15 $15
X9546 Case Conference- lhour $60 $30 $30 $30
Hospital ingt.Service 99221 Hospital Gare Visit-Initial-30 minutes $30
99222 Hospital Care Visit-Initial-50 minutes $60
99232 Hospital Gare Visit-Subsequent-30 minutes $30
C1ut atient Consults 99242 Office Consultation New Patient-30 minutes $30
99244 Office Consultation New Patient-60 minutes $60
I TAtiev t Consults 99251 inpatient Consultation New Patient-30 minutes 30
99253 inpatient Consultation New Patient-60 rntnutes $60
Nursing Fac Assess 99301 Evaluation and Management-30 minutes $30
99303 Evaluation and Management-60 minutes $60
99311 Subsequent Nursing Facility Care-15 minutes $15
9931) Subsequent Nursing Facility Care-30 minutes $30
Rest Horne et At Svc. 99323 Evaluation of New Patient $60
99333Evaluation of Established Patient $30
Home Services 99341 Evaluation of New Patient $60
99353 Evatuation of Established Patient $30
•*"These are the only outpatient services which CCMHP will authorize and the only
WE"codes for which providers will be reimbursed.
m: BOARD OF SUPERVISORS
FROM: William Walker, M.D. , Health Services Director r.�,. Contra
By: Ginger Marieiro, Contracts Administrator
Costa
DATE: June 23, 1998 County
SUBJECT: Approval of Contract ##24-949-12 with Harva Hayes-Quatro, M.F.C.C.
SPECIFIC FIEQUEST(S)`O R RECOMMENDATIONS)&BACKGROUND AND JUSTIFICATION
I . RECOMMENDED ACTION:
Approve and authorize the Health Services Director, ; or his designee
(Donna Wigand) , to execute on behalf of the County, Contract
##24-949-12 with Harva Hayes-Quatro, M.F.C.C. , for the period from
May 1, 1998 through June 30, 1999, to provide Medi-Cal mental health
specialty services, to be paid in accordance with the rates set
forth in the attached fee schedule .
II . FINANCIAL IMPACT:
This Contract is funded by State and Federal FFP Medi-Cal Funds.
III . REASONS FOR RECt'MMENDATIONS/BACKGROLDM:
On January 14, 1997, the Board of Supervisors adapted Resolution
#97/17, authorizing the Health Services Director >or his designee
(Donna Wigand, LCSW) to contract with the State Department of Mental
Health to assume responsibility for Medi-Cal specialty mental health
services as of 'July 1, 1997 . The implementation date has since been
changed to April 1, 1998 . Responsibility for outpatient specialty
mental health services involves contracts with individual, group and
organizational providers to deliver these services;.
Approval of Contract #24-949-12 will allow the Contractor to provide
mental health specialty services through June 30, 1999 .
CONTINUED ON ATTACHMENT: YES XX SIGNATURE
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIQN
S
ACTION OF BOARD ONtg APPROVED AS RECOMMENDED _ OTHER
VOTE OF SUPERVISORS
I HEREBY CERTIFY THAT THIS IS A TRUE
UNANIMOUS {ABSENT } AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
Z- % 1/. -
ATTESTED
BATOR,CLEW OF THE BOARD OF
SUPERVIS RS AND COUNTY ADMINISTRATOR
Contact Person: Donna. Wigand (313-6411)
CC: Health Services(Contracts)
Risk Management
Auditor Controller BY DEPUTY
Contractor
Beard Order
page two (2)
CCMHP OUTPATIENT SPECIALTY MENTAL HEALTH SERVICES FEE SC1tEDULE--Revised#219197.
CPT CODE PROCEDURE WD Ph.D L.C.SM. F$30
Level 1Codes 94534 Test Adininislratior%11 hour niax 6 $30
9088'7 Test Scarin - thour Lin ax 2 $30
90843 IndividualPsychotherapy- 112 Maur $30
90644 lndividuat Psychotherapy- f hour $60 $30 $30
90846 Faintly Therapy-without atient $3t) $30 $30
94547 Family Thera coar'oint $30 $30 $30
94853 Group Theralry per person-per visit-1 112hr max $12 $12 $12`
90662 Pharrraacofo ft�ea4 $30
94670 ICT Single Seizure $60
X9544 Case Conference- 112 hour $30 $25 $15 $15
XS546 Case Conference- 1 hour $60 $30 $30 $30
Hospital ira.pt.Service 99221 Hospftat Gare Visit-htit iat-30 minutes $30
99222 Hospital Care Visit-Initial-50 inla7ules $60
99232 hospital Care Visit-Subsequent-30 minutes $30
Outpatient Consults 99242 Office Consultation New Patlent-30 minutes $30
99244 Office Consultation New Patient-60 minutes $60
ir!at atient Consults 99251 inpatient Cotisuttalion New Patient-30mini:les_ $30
9925 ltrpatieaat Cortsutatica:a New Patient-60 minutes $6g
Nursing Fac Assess 99301 Evaluation and Management-30 minutes $30
99343 Evataeation and Matiagetrfent-60 rniaautes $60
89311 Subsequent Nursing Facility Care-15 minutes $15
.f 99313 Subsequent Nursing Facility Care-30 minutes $30
Rest 14oame et Al Svc. 99323 Evaluation of New Patient $60
99333Evaluation of Established Patient $30
ttonre Services 99341 Evaluation of New Patient $60
99353 Evaluation of Established Patient $30
immi-;:.Oldes
These are the only outpatient services which CCMHP wilt authorize and the only
for which providers will be reimbursed.
.......-.....I.............................................. .............. ........
..............................................................-
TO: BOARD OF SUPrERVISORS
William Walker, M.D. , Health Services Director
FROM: Contra
By: Ginger Marieiro, Contracts Administrator
Costa
DATE- June 23, 1998 County
SUBJECT: Approval of Contract #24-949-16 with Harinder Auluck, M.D.
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
I . RECOMMENDED ACTION:
Approve and authorize the Health Services Director, or his designee
(Donna Wigand) , to execute on behalf of the County, Contract
#24-949-16 with Harinder Auluck, M.D. , for the period from May 1,
1998 through June 30, 1999, to provide Medi-Cal mental health
specialty services, to be paid in accordance with the rates set
forth in the attached fee schedule.
II . FINANCIAL IMPACT:
This Contract is funded by State and Federal FFP Medi-Cal Funds .
III . REASONS FOR RECOMMENDATIONS/BACKGROUM:
On January 14, 1997, the Board of Supervisors adopted Resolution
#97/17, authorizing the Health Services Director or his designee
(Donna Wigand, LCSW) to contract with the State Department of Mental
Health to assume responsibility for Medi-Cal specialty mental health
services as of July 1, 1997. The implementation date has since been
changed to April 1, 1998 . Responsibility for outpatient specialty
mental health services involves contracts with individual, group and
organizational providers to deliver these services .
Approval of Contract #24-949-16 will allow the Contractor to provide
mental health specialty services through June 30, 1999 .
eoy-',Ld
CONTINUED ON ATTACHMENT: YES SIGNATURE, 2.2� -
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
ACTION OF BOARD ON APPROVED APPROVED AS RECOMMENDED OTHER
17
VOTE OF SUPERVISORS
UNANIMOUS (ABSENT I HEREBY CERTIFY THAT THIS IS A TRUE
AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE.MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
ATTESTED
PlraATCrLOR,cLMX OF THE BOARD OF
ER
ContactPerson: Donna Wigand (313-6411) S1 Rs ADMINISTRATOR
CC: Health Services(Contracts)
Risk Management
Auditor Controller BY _,DEPUTY
Contractor
Board Order
page two (2)
CMRP OUTPATIENT SPECIALTY MENTAL HEALTH SERVICES FEE SCHEDULE--Revised 1219197.
CPT CODE PROCEDURE M.D PhD L.C.S.W. M.F.C.C.
Level iCodes 90830 fest Administration- 1 hour max 6 $30
00887 Test Scoria - lhour max? $30
90843 Individual Psyclioiherapy- 112 hour $30
90844 Individual Psychotherapy- 1 hour $60 $30 $30 $30
90846 Family Therapy-without patient $30 $30 $30
90847 Family Therapy-conjoint $30 $30 $30
$0853 Gfoup Therapy-per person-per visit-i 1/21ir max $12 $12 $12'
90862 Phaimacolsi i}c cal mann emmit $_30_
- 90870 ECT-Single Seizute $60
X9544,Case Conference- 1f2 hour $30 $15 $15 $15
X9546 Case Conference- thour $60 $30 $34 $30
Hospital Inpt.Service 99221 Hospital Care Visit-Initial-30 minutes $30
99222 Hospital Care Visit-Initial-50 minutes $60
99232 Hospital Care Visit-Subsequent-30 minutes $30
Outpatient Consults 59242 Office Consultation New Patient-30 minutes $30
99244 Office Consultation New Patient-60 minutes $60
ttrpatiertt Cortsaits 992SI Inpatient Consultation New Patient-_30_nunules_ $30
99253 litpatiefil Coiisultation New Patient-610 minutesM� $60
Nursing Fac Assess 99301 Evaluation and Managemenl-30 rnintites $30
99303 Evaluation and Mairar entent-60 triitrules _ $60
99311 Subsequent Nurslril}Facility Care-15 minutes $15
t' 99313 Subsequent Nursing Facility Care-30 minutes $30
Rest Hl mne et At Svc. 99323 Evaluation of New Patient $60
99333Evaluation of Established Patient $30
Home Services 99341 Evaluation of New Patient $60
99353 Evaluation of Established Palietit $30
These are the only outpatient services which CCMHP will authorize and the only
codes for which providers will be reimbursed
/01
TO: BOARD OF SUPERVISORS
FROM: William Walker, M.D. , Health Services Director •�f
By: Ginger Mar.ieiro, Contracts Administrator ; Contra
Costa
DATE: June 23, 1998 County
SUBJECT: Approval of Agreement #23-208-2 with Bethel Island Fire Protection
District
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
REC0_MM LND&T_10X(S3 :
Approve and Authorize the Chair, Board of Supervisors, on behalf of
its Health Services Department and its Bethel Island Fire Protection
District, to execute Agreement #23-208-2, in the amount of $106, 161,
for the period from July 1, 1998 through June 30, 1999, for
provision of fire paramedic first responder services in the Bethel
Island Fire Protection District .
FISCAL IMPACT:
Source of funding for this Contract is CSA EM-1 (Measure H) .
BA
CKGROUND/REASON(S) FOR RECOMMENDATION(S) :
In October 1996, the Board of Supervisors authorized the Bethel
Island Fire Protection District, in conjunction with the
Department ' s Emergency Medical Services, to undertake a one-year
pilot paramedic program utilizing part-time paramedic/firefighters
as non-transporting first responder personnel. On December 2, 1997,
the Board approved Contract #23-208-1 which allowed the continuation
of this program through June 30, 1998 .
This program has been well received by the community within the
Bethel Island Fire Protection District and funding is available for
the 1998-99 Fiscal Year.
Approval of Contract #23-208-2 will allow these services to continue
through June 30, 1999 .
C NT NU D ON ,9SIGNATU
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATUREUU.
i
ACTION OF BOARD ON 1' APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
1 HEREBY CERTIFY THAT THIS IS A TRUE
UNANIMOUS {ABSENT } AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
ATTESTED
BA ELO�t� THE BOARD OF
SUPERVISORS AND COUNTY ADMINISTRATOR
Contact Person: William Talker (370-5010)
CC: Health Services(Contracts)
Risk Management
Auditor Controller BY DEPUTY
Contractor
Contra Costa County Number 23-208-2
FIRST RESPONDER (PARAMEDIC) AGREEMENT Fund/Org # 7406
Account # 2406
Other #
1. Contract Identification.
Department: Health Services - Emergency Medical Services
Subject: Emergency Medical Services - First Responder (Paramedic)
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: BETAEL ISLAND FIRE PROTECTION DISTRICT
Capacity: County Governmental District
Address: 3045 Ranch Lane, Bethel Island, California 94511
Mailing Address: P.O. Box 623, Bethel Island, California 94511
3. Term. The effective date of this Contract is July 1, 1998 and it
terminates June 30, 1999 unless sooner terminated as provided herein.
4. County's Obligations. County shall provide, via its emergency ambulance contractor(s) ,
emergency ambulance response to requests for emergency medical services originating
within Contractor's area of response.
5. Contractor's Obligations. Contractor shall provide those services and carry out that
work described in the Service Plan attached hereto which is incorporated herein by
reference, subject to all the terms and conditions contained or incorporated herein.
6. Conditions. This Contract is subject to the General Conditions and Special Conditions
(if any) attached hereto, which are incorporated herein by reference.
8. Prosect. This Contract implements in part the County's Local Emergency Medical
Services Plan in that it provides for emergency medical first responder services.
9. Legal Authority. This Contract is entered into under and subject to the following
legal authorities: Health and Safety Code Sections 1797 et seq. , and California
Government Code §§ 26227 and 31000.
10. Signatures. These signatures attest the parties' agreement hereto:
COUNTY OF CONTRA COSTA CALIFORNIA
BOARD OF SUPERVISORS ATTEST: Phi, Batchelor, Clerk of the Board
of Superv' rrs and County Administrator
By #<.:, -•: By
a-
Chai•z'man/Designe t Deputy
ii
r
CONTRACTOR
;f
By ' By XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
r f y
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
(Designate business apacity A) (Designate business capacity B)
Nate 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 § 1190 and Corporations Code
§ 313) . All signatures must be acknowledged as set forth on page two.
Contra Costa County Standard Form(Rev. 1/95)
APPROVALS/ACKNOWLEDGMENT
Number 23-208-2
APPROVALS
RECOMMENDED BY DEPARTMENT FORM APPROVED
GOUNW COUNSEL
i '
By By
sign a Deputy
APPROVED: COUNTY D INISTRATOR
By:
e n
ACKNOWLEDGMENT
STATE OF CALIFORNIA )
) ss.
COUNTY OF CONTRA COSTA )
On 'Z'01116 1-2, 107,10 before me, ( .•Q ',s/ '.•Q.c',�'.''r „ -
(insert name and title of the officer), personally appeared Z2>"q cr-"b ',c,?,,• /.G.
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 FFICIAL SEAL.
04
Signature GOtarleEt�ou�l/
ACKNOWLEDGMENT(by Corporation, Partnership,or Individual)
(Civil Code 41189)
SERVICE PLAN
Number 23-208-2
I . SERVICE ACTIVITIES . Contractor shall provide prehospital emergency
medical first responder services, within the Bethel Island Fire Protection
District until patient care is assumed by ambulance or receiving facility
personnel . In performing services hereunder, Contractor shall work
cooperatively with the County' s Emergency Medical Service's Agency.
A. Contractor shall provide said prehospital emergency medical first
responder services, without interruption, 24 hours per day, 7 days per week,
during the term of this agreement .
B . Contractor shall provide said prehospital emergency medical first
responder services without regard to the patient' s race, color, national
origin, religious affiliation, age, sex, or ability to pay.
C. Contractor agrees that the performance of services under this
Agreement shall conform to high professional standards and shall comply with
all applicable emergency medical policies and guidelines as established by
the Contra Costa County EMS Medical Agency.
D. Contractor shall designate one staff person with overall
responsibility for EMS program coordination within the Agency.
E. Contractor shall participate in an approved First Responder
Defibrillation program according to Contra Costa County policies and
procedures .
F. Contractor shall request and receive written approval from the
County EMS Agency to conduct a First Responder Paramedic Program. Contractor
shall agree to meet County standards for First Responder Paramedic programs .
II . PERFORMANCE STANDARDS
A. Contractor' s response time on requests for prehospital emergency
medical first responder services originating from within the primary service
area shall meet the following performance standards :
1 . Contractor shall place a first responder unit at the scene of
each emergency call for medical assistance within 5 minutes of its receipt of
the call at the fire dispatch center on not less than 90% of the -responses
within any consecutive thirty-day period.
2 . Contractor' s response times shall be calculated on a monthly
basis to determine compliance with the standard set forth in Section II .A. 1 .
3 . In the event a First Responder Unit is reassigned enroute from
one call to another before arrival at the scene of the first call, the
response time clock sha stop on the first call until the arrival of a
0 initials:
1 6 ontractor County Dept.
SERVICE PLAN
Number 23-208-2
First Responder Unit at the scene of the first call . Each call shall keep
its separate response time measurement .
B . In the monthly calculation of Contractor' s performance to determine
compliance with the response time standards, every emergency request
originating from within Contractor' s primary service area shall be included,
except the following:
1 . In case of a multiple-response incident (e .g. , where more than
one first responder unit is sent to the same incident) , only the response
time of the first-arriving unit staffed and equipped to provide emergency
medical first responder services, shall be counted.
2 . During a Multi-Casualty Incident (MCI) , fire mutual aid, or
declared disaster in the County of Contra Costa, or in a neighboring
jurisdiction which has requested assistance from the County.
3 . Delays resulting from incorrect or inaccurate dispatch
information, disrupted voice or data radio transmission, mobile data terminal
failure, unavoidable telephone communications failure, nonexistent address,
inability to locate patient due to patient departing the scene, delays caused
by traffic secondary to the incident, unavoidable delays caused by road
construction, unavoidable delays caused by trains, or off-road locations .
4 . Delays resulting from adverse weather conditions .
III . PERSONNEL/TRAINING
A. Contractor shall assure that prior to assignment on a first
responder unit, all personnel are oriented to the following:
1 . County EMS policies and procedures
2 . EMS system overview
3 . County Multicasualty Incident Plan
B. Contractor shall establish a critical incident stress debriefing
program and an ongoing stress reduction program for its first responder
personnel .
C. Contractor shall provide all first responder personnel with the
training, Knowledge, and skills to effectively manage patients with
psychiatric, drug/alcohol or other behavioral or stress related problems, as
well as difficult or potentially difficult scenes on an ongoing basis .
Emphasis shall be on techniques for establishing a climate conducive to
effective field management, and for preventing the escalation of potentially
volatile situations .
Initials: 1OZO lk%
2 Contractor County Dept.
SERVICE PLAN
Number 23-208-2
D. Contractor shall offer all currently recommended immunizations and
health screening to its high risk personnel . Contractorshall develop and
strictly enforce policies for infection control and contaminated materials
disposal to decrease the chance of communicable disease exposure in
accordance to existing regulations (Title 8, Division 1, Chapter 4 -
California Code of Regulations, and OSHA 1910 . 1030) .
E. Enhanced EMS First Responder Program - Paramedic.
1 . The County EMS Medical Director shall be designated as the
Bethel Island Fire Protection District Medical Director to oversee medical
aspects of the program including clinical review, quality improvement, and
training.
2 . Contractor shall staff each responding paramedic unit with a
minimum of one paramedic, currently licensed in California and accredited in
Contra Costa County.
3 . All of Contractor' s personnel normally respond to emergency
medical requests shall be currently certified as EMT-I' s or EMT-P' s in
California. (This requirement, however, shall not apply to personnel who are
volunteers or "paid on-call" staff . ) Contractor shall maintain on file at
all times, copies of current and valid credentials for all emergency medical
personnel performing services under this Agreement .
4 . All paramedics shall be currently certified in Advanced
Cardiac Life Support (ACLS) according to American Heart Association standards
prior to performing services under this Agreement.
5 . All paramedics shall successfully complete either a Basic
Trauma Life Support (BTLS) course approved by the American College of
Emergency Physicians or a Prehospital Trauma Life Support (PHTLS) corse
approved by the American College of Surgeons, prior to working as a first
responder paramedic.
& . Contractor shall develop and implement a training program,
approved by the EMS Agency, to prepare non-paramedic responders to assist the
first responder paramedic in providing patient care .
7 . Contractor shall assure that prior to assignment on a first
responder paramedic unit, all personnel are oriented to the following:
a. First Responder Paramedic and EMT-I roles and
responsibilities;
b. Medical radio communications (ambulances, base hospitals,
receiving hospitals, County Communications Center) ; and
C . Medical equipment utilization and maintenance .
Y
initials: X�7V)
3 Contractor County Dept.
_ _ __.
SERVICE PLAN
Number 23-208-2
8 . The Contractor shall establish a "provisional assignment"
program for first responder paramedics subject to approval of the County EMS
Medical Director. The provisional assignment program 'shall provide for
review of each patient contact within 72 hours by the Contractor medical
director until the new first responder paramedic is approved by the County
EMS Medical Director for continued first responder paramedic assignment .
9 . The Contractor' s EMT-I and paramedic personnel shall comply
with all training requirements as established by the State of California and
all applicable provisions of the Contra Costa County Prehospital Care Manual
and EMS Agency policies .
10 . The Contractor agrees to facilitate and encourage its
personnel to participate in relevant training provided by ALS base hospitals :
IV. QUALITY IMPROVEMENT
A. Contractor shall follow Contra Costa County EMS 'Policies regarding
medical Quality Assurance and Quality Improvement .
B. Contractor shall participate in the cre of a comprehensive
medical Quality Improvement Program for the Coup* ::system.
C. Contractor shall implement a :program for gal review and QI,
with medical oversight by an emergency phys '.clan or >red nurse with an
EMS background, which meets County standards .
V. MEDICAL CONTROL. Contractor acknowledges and agrees, that :
A. The Contra Costa County EMS Medical Director shall have overall
responsibility for medical control for all First Responder Defibrillation,
EMT-I Advanced Airway, and Paramedic programs in the county.
B . Medical control is exercised prospectively through policies,
protocols, and training established and approved by the Contra Costa County
EMS Medical Director.
C. Base Hospitals designated by the EMS Medical Director provide on-
line medical direction and consultation on medical and patient related
issues .
D. Retrospective medical control includes monitoring, quality
improvement, incident review, and disciplinary processes conducted by the
provider agency, base hospital, Contra Costa County EMS Agency, and the State
EMS Authority.
Initials:
4 ontractor C unty Dept.
SERVICE PLAN
Number 23-208-2
VI . EQUIPMENT
A. Each First Responder Paramedic Unit shall carry emergency medical
equipment and supplies, consistent with level of training of personnel, as
required by Contra Costa County. Vehicles, equipment and supplies shall be
maintained in good working order, consistent with the manufacturer' s
specifications .
B. Contractor' s plan for replacement of expendable equipment and
supplies shall be self-sufficient and shall not rely on transporting agencies
stock or billing services unless agreed to in writing by transporting
agencies .
C. Contractor, in addition to existing fire radios, shall equip each
first responder paramedic unit used in providing service to the County with
a 4-channel portable radio for communication on County' s MEDARS radio system,
and a cellular telephone for prehospital to base hospital communications .
VII . COOPERATION WITH EVOLVING EMS SYSTEM
A. Contractor agrees to participate and assist in the development of
system changes subject to negotiated costs, if any. Equipment and supply
requirements may be changed by the EMS Agency to meet changes in related
technology.
B. County representatives may, at any time and without notification,
directly observe the Contractor' s facilities and operations . The County
representative shall conduct themselves in a professional and courteous
manner, shall not interfere with the Contractor' s employees in the
performance of their duties and shall at all times be respectful of the
Contractor' s employer/employee relationships .
C. The medical responder with the highest 1. accreditation -
Defibrillation, EMT-I, ,EMT-I Advanced Airway, or Par - on the scene of
a medical emergency is responsible for patient car the patient has
been released to other medical personnel i , the fief. cordance with EMS
policy and procedures, or until the patient is d to appropriate
medical personnel at a designated ambulance receiving facility.
First responder personnel with Paramedic accreditation must be prepared to
accompany the patient in the ambulance to a designated ambulance receiving
facility whenever an appropriate patient turn-over cannot he achieved.
VIII . RECORDS AND REPORTING; REQUIREMENTS
Contractor shall comply with the following record-keeping and reporting
requirements :
Initials: .40IL
5 #onractor County Dept.
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SERVICE PLAN
Number 23-208-2
A. Imylementation Report . Contractor shall report quarterly to the
County its progress in the development, implementation, and operation of
First Responder Paramedic Units .
B . Records . Contractor shall provide, in a timely and regular manner,
all records, information and reports requested by the Medical Director to
evaluate the emergency medical services provided by the Contractor under this
Agreement, including, but not limited to, the following:
1 . Response Data and Performance Report . Contractor shall
maintain data on EMS responses including number of responses, location, date
and time, nature of call, response time (elapse time from 'receipt of call to
time on scene) , and basic patient data from patient care report . Monthly
data reports to be submitted in a form established by County EMS .
2 . Patient Care Report Form. Contractor shall provide
appropriate patient care documentation for every patientcontact in Contra
Costa County, with or without transport . The Contractor shall ensure that a
Contra Costa County Patient Care Report is accurately completed and
distributed according to County EMS Policies and Procedures .
3 . Personnel Reports . The Contractor shall provide a roster of
currently accredited Paramedic personnel to the EMS Agency annually.
IX. PATIENT BILLING. Policies and rates for patient billing shall be
subject to approval by the EMS Agency.
41 ,
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6 Contractor #6unty Dept.
SPECIAL CONDITIM
Number 23-208-2
Insurance. Paragraph 19. (Insurance) of the General Conditions is hereby deleted
in its entirety.
4ontractor
Initials:
County Dept
EXHIBIT A
Number: 23-208-2
PAYMENT PROVISIONS
1 . Payment Limit. County' s total payments to Contractor under this
Contract shall not exceed $106, 161 .
2 . Payment Amounts . Subject to the following Payment Provisions,
County will pay Contractor the following fee as full compensation for
all services, work, expenses or costs provided or incurred by
Contractor:
(a) $8,846 . 69 monthly, payable upon demand, following each
calendar month in which paramedic first responder services are
provided;
(b) A reduction from the monthly payment set forth above, in the
amount $12 . 12 per hour will be made for each hour or portion
thereof that Contractor is not able to provide paramedic first
responder services when such services are not provided for
more than two consecutive hours .
(c) Monthly invoices shall document any periods exceeding two
consecutive hours during which paramedic services were not
available.
Initials :
6on-'tr`ac—tor tounty Dept.
GENERAL CONDITIONS
(Purchase of Services)
1. ComUliance with Law_. Contractor shall be subject to and comply with all Federal, State and local
laws and regulations applicable with respect to its performance under this Contract, including but not limited to,
licensing, employment and purchasing practices; and wages, hours and conditions of employment, including
nondiscrimination.
2. Inspection. Contractor's performance, place of business and records pertaining to this Contract are
subject to monitoring, inspection, review and audit by authorized representatives of the County, the State of
California, and the United States Government.
3. Records. Contractor shall keep and make available for inspectionand copying by authorized
representatives of the County, the State of California, and the United States Government, the Contractor's regular
business records and such additional records pertaining to this Contract as may be required by the County.
a. Retention of Records. The Contractor shall retain all documents pertaining to this Contract for
five years from the date of submission of Contractor's final payment demand or final'Cost Report; for any further
period that is required by law; and until all Federal/State audits are complete and lexceptions resolved for this
contract's funding period. Upon request, Contractor shall make these records available to authorized representatives
of the County, the State of California, and the United States Government.
b. 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 County, 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 thereunder.
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. Reporting Requirements. Pursuant to Government Code Section 7550, Contractor shall include in
all documents or written reports completed and submitted to County in accordance with this Contract, a separate
section listing the numbers and dollar amounts of all contracts and subcontracts relating to the preparation of each
such document or written report. This section shall apply only if the payment limit under this Contract exceeds
$5,000.
5. Termination.
a. Written Notice, This Contract may be terminated by either party, at their sole discretion,upon
thirty-day advance written notice thereof to the other, and may be cancelled immediately by written mutual consent.
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1111. s..�r
GENERAL CGNDMONS
(Purchase of Services)
b. Failure to Perform. The County, upon written notice to Contractor, may immediately terminate
this Contract should the Contractor fail to perform properly any of its obligations hereunder. In the event of such
termination, the County may proceed with the work in any reasonable manner it chooses. The cost to the County
of completing Contractor's performance shall be deducted from any sum due the Contractor under this Contract,
without prejudice to the County's rights otherwise to recover its damages.
C. Cessation ofFundin . Notwithstanding Paragraph 5.a. above, in the event that Federal, State,
or other non-County funding for this Contract ceases, this Contract is terminated without notice.
6. Entire Agreement. This Contract contains all the terms and conditionsagreed upon by the parties.
Except as expressly provided herein, no other understanding, oral or otherwise, regarding the subject matter of this
Contract shall be deemed to exist or to bind any of the parties hereto.
7. Further Specifications for Operating Procedures. Detailed specifications of operating procedures
and budgets required by this Contract, including but not limited to, monitoring, evaluating, auditing, billing, or
regulatory changes, may be developed and set forth in a written Informal Agreement between the Contractor and
the County. Such informal Agreements shall be designated as such and shall not be amendments to this Contract
except to the extent that they further detail or clarify that which is already required'hereunder. Such Informal
Agreements may not enlarge in any manner the scope of this Contract, including any sums of money to be paid the
Contractor as provided herein. Informal Agreements may be approved and signed by the head of the County
Department for which this Contract is made or his designee.
8. Modifications and Amendments.
a. General Amendments. This Contract may be modified or amended by a written document
executed by the Contractor and the Contra Costa County Board of Supervisors or, after Board approval, by its
designee, subject to any required State or Federal approval.
b. Administrative Amendments. Subject to the Payment Limit, the Payment Provisions and the
Service Plan may be amended by a written administrative amendment executed by the Contractor and the County
Administrator or his designee, subject to any required State or Federal approval, provided that such administrative
amendments may not materially change the Payment Provisions or the Service Plan.
9. Disputes. Disagreements between the County and Contractor concerning the meaning, requirements,
or performance of this Contract shall be subject to final determination in writing by the head of the County
Department for which this Contract is made or his designee or in accordance with the applicable procedures (if any)
required by the State or Federal Government.
10. Choice of Law and Personal Jurisdiction.
a. This Contract is made in Contra Costa County and shall be governed and construed in accordance
with the laws of the State of California.
b. Any action relating to this Contract shall be instituted and prosecuted in the courts of Contra
Costa County, State of California.
2
GENERAL CONDMO NS
(Purchase of Services)
11. Conforrnance with Federal and State ReLulations and Laws. ShouldFederal or State regulations
or laws touching upon the subject of this Contract be adopted or revised during the term hereof, this Contract shall
be deemed amended to assure conformance with such Federal or State requirements.
12. No Waiver by County. Subject to Paragraph 9. (Disputes) of these General Conditions, inspections or
approvals, or statements by any officer, agent or employee of the County indicating the Contractor's performance
or any part thereof complies with the requirements of this Contract, or acceptance of the whole or any part of said
performance, or payments therefor, or any combination of these acts, shall not relieve the Contractor's obligation to
fulfill this Contract as prescribed; nor shall the County be thereby estopped from bringing any action for damages
or enforcement arising from any failure to comply with any of the terms and conditions of this Contract.
13. Subcontractand Assignment. This Contract binds the heirs, successors, assigns and representatives of
Contractor. The Contractor shall not enter into subcontracts for any work contemplated under this Contract and
shall not assign this Contract or monies due or to become due, without the prior written consent of the County
Administrator or his designee, subject to any required State or Federal approval.
14. 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 between the parties of agent, servant, employee,
partnership,joint venture or association.
15. Conflicts of Interest. Contractor, its officers, partners, associates, agents, and employees, shall not make,
participate in making, or in any way attempt to use the position afforded them by this Contract to influence any
governmental decision in which he or she knows or has reason to know that he or she has a financial interest under
California Government Code Sections 87100, et seq., or otherwise.
16. Confidentiality. Contractor agrees to comply and to require its officers, partners, associates, agents and
employees 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 applications and records concerning any individual made or kept by Contractor or any public
officer or agency in connection with the administration of or 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 or permit or cause to be published or disclosed, any list of
persons receiving services, except as may be required in the administration of such service. Contractor agrees to
inform all employees, agents and partners of the above provisions, and that any person knowingly and intentionally
disclosing such information other than as authorized by law may be guilty of a misdemeanor.
17. Nondiscriminatory Services. Contractor agrees that all goods and services under this Contract shall be
available to all qualified persons regardless of age, sex, race,religion, color, national origin, or ethnic background,
or handicap, and that none shall be used, in whole or in part, for religious worship or instruction.
18. Indemnification. The Contractor shall defend, indemnify, save, and hold harmless the County and its
officers and employees from any and all claims, costs and liability for any damages, sickness, death, or injury to
person(s) or property, including without limitation all consequential damages, from any cause whatsoever arising
directly or indirectly from or connected with the operations or services of the Contractor or its agents, servants,
3
GENERAL CONDiTLONS
(Purchase of Services)
employees or subcontractors hereunder, save and except claims or litigation arising through the sole negligence or
sole willful misconduct of the County or its officers or employees. Contractor will reimburse the County for any
expenditures, including reasonable attorneys'fees, the County may make by reason of the matters that are the subject
of this indemnification, and if requested by the County will defend any claimsor litigation to which this
indemnification provision applies at the sole cost and expense of the Contractor.
19. Insurance. During the entire term of this Contract and any extension',or modification thereof, the
Contractor shall keep in effect insurance policies meeting the following insurance requirements unless otherwise
expressed in the Special Conditions:
a. Liability Insurance. The Contractor shall provide comprehensive liability insurance, including
coverage for owned and non-owned automobiles, with a minimum combined single limit coverage of$500,000 for
all damages, including consequential damages, due to bodily injury, sickness or disease, or death to any person or
damage to or destruction of property, including the loss of use thereof; arising from each occurrence. Such insurance
shall be endorsed to include the County and its officers and employees as additional insureds as to all services
performed by Contractor under this agreement. Said policies she constitute primary',insurance as to the County,
the State and Federal Governments, and their officers, agents, and employees, so that other insurance policies held
by them or their self-insurance program(s) shall not be required to contribute to any loss covered under the Contrac-
tor's insurance policy or policies.
b. Workers' Compensation. The Contractor shall provide workers' compensation insurance
coverage for its employees.
C. Certificate of Insurance. The Contractor shall provide the County with (a) certificate(s) of
insurance evidencing liability and workers compensation insurance as required herein no later than the effective date
of this Contract. If the Contractor should renew the insurance policy(ies) or acquire either a new insurance
policy(ies) or amend the coverage afforded through an endorsement to the policy at any time during the term of this
Contract, then Contractor shall provide (a) current certificate(s) of insurance.
d. Additional Insurance Provisions. The insurance policies provided by the Contractor shall
include a provision for thirty(30) days written notice to County before cancellation or material changes of the above
specified coverage.
20. Notices. All notices provided for by this Contract shall be in writing and may be delivered by deposit
in the United States mail, postage prepaid. Notices to the County shall be addressed to the head of the County
Department for which this Contract is made. Notices to the Contractor shall be addressed to the Contractor's address
designated herein. The effective date of notice shall be the date of deposit in the mails or of other delivery, except
that the effective date of notice to the County shall be the date of receipt by the head of the County Department for
which this Contract is made.
21. Primacv of General Conditions. Except for Special Conditions which expressly supersede General
Conditions, the Special Conditions (if any) and Service Plan do not limit any term of the General Conditions.
22. Nonrenewal. Contractor understands and agrees that there is no representation, implication, or
understanding that the services provided by Contractor under this Contract will be purchased by County under a new
contract following expiration of termination of this Contract, and waives all rights or claims to notice or hearing
respecting any failure to continue purchase of all or any such services from Contractor.
4
GENERAL CONDITIONS
(Purchase of Services)
23. Possessory Interest. If this Contract results in the Contractor having possession of, claim to or right
to the possession of land or improvements, but does not vest ownership of the land or improvements in the same
person, or if this Contract results in the placement of taxable improvements on tax exempt land (Revenue& Taxation
Code Section 107), such interest or improvements may represent a possessory interest subject to property talc, and
Contractor may be subject to the payment of property taxes levied on such interest. Contractor agrees that this
provision complies with the notice requirements of Revenue& Taxation Code Section 107.6, and waives all rights
to further notice or to damages under that or any comparable statute.
24. No Third-Party Beneficiaries. Notwithstanding mutual recognition that services under this Contract
may provide some aid or assistance to members of the County's population, it is not the intention of either the County
or Contractor that such individuals occupy the position of intended third-party beneficiaries of the obligations
assumed by either party to this Contract.
25. Copyrights and Rights in Data. Contractor shall not publish or transfer any materials produced or
resulting from activities supported by this agreement without the express written consent of the County Admini-
strator. If any material is subject to copyright, the County reserves the right to copyright such and the Contractor
agrees not to copyright such material. If the material is copyrighted, the County reserves a royalty-free,
nonexclusive, and irrevocable license to reproduce, publish, and use such materials,',in whole or in part, and to
authorize others to do so.
26. 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 taw to receive such views.
27. Required Audit. If Contractor is funded by $25,000 or more in federal grant funds in any fiscal year
from any source, Contractor shall provide to County at Contractor's expense an audit conforming to the requirements
set forth in the most current version of Office of Management and Budget Circular A-133. If Contractor is funded
by $25,000 to $100,000 in federal grant funds in any fiscal year from any source, Contractor shall arrange for
conduct of the federally-required audit biennially and shall submit the audit to County in the time, form, and manner
required by the most current version of Office of Management and Budget Circular A-133 and by County. If
Contractor is funded by$100,000 or more in federal grant funds in any fiscal year from any source, Contractor'shall
arrange for the federally-required audit annually and shall submit the audit to the County in the time, form, and
manner required by the most current version of Office of Management and Budget Circular A-133 and by County.
Contractor is solely responsible for arranging for the conduct of the audit, and for its cost, and County may withhold
the estimated cost of the audit or 10 percent of the contract amount, whichever is larger, or the final payment, from.
Contractor until County receives the audit from Contractor.
5