COMPLETED BOARD ORDER�"��47
Before the Board of Supervisors in and for the
County of Monterey, State of California
Agreement No: A 11803
a. Approve and authorize the Contracts/Purchasing Officer to sign a two fiscal year term
Professional Services Agreement July 1, 2010 to June 30, 2012) with Psychiatrists
Only, LLC to refer Locum Tenens Psychiatric Service Providers for the provision of
mental health treatment services to adults and children with psychiatric impairments and
disabilities in the annual amount of $90,000 for Fiscal Year FY) 2010-11 and $90,000
for FY 2011-12 for a total Agreement amount of $180,000; and
b. Authorize the Contracts/Purchasing Officer, to sign up to three future amendments to
this agreement where the amendments do not exceed ten percent 10%) and do not
significantly change the scope of work or result in an increase of net county
contribution.
Upon motion of Supervisor Potter, seconded by Supervisor Armenta, and carried by those
members present, the Board hereby:
a. Approved and authorized the Contracts/Purchasing Officer to sign a two fiscal year term
Professional Services Agreement July 1, 2010 to June 30, 2012) with Psychiatrists Only,
LLC to refer Locum Tenens Psychiatric Service Providers for the provision of mental health
treatment services to adults and children with psychiatric impairments and disabilities in the
annual amount of $90,000 for Fiscal Year FY) 2010-11 and $90,000 for FY 2011-12 for a
total Agreement amount of $180,000; and
b. Authorized the Contracts/Purchasing Officer, to sign up to three future amendments to this
agreement where the amendments do not exceed ten percent 10%) and do not significantly
change the scope of work or result in an increase of net county contribution.
PASSED AND ADOPTED this 27th day of July, 2010, by the following vote, to wit:
AYES: Supervisors Armenta, Calcagno, Salinas, Parker, Potter
NOES: None
ABSENT: None
I, Gail T. Borkowski, Clerk of the Board of Supervisors of the County of Monterey, State of California, hereby
certify that the foregoing is a true copy of an original order of said Board of Supervisors duly made and entered in
the minutes thereof of Minute Book 75 for the meeting on July 27, 2010.
Dated: July 28, 2010 Gail T. Borkowski, Clerk of the Board of Supervisors
County of Monterey, State of California
By 1` 1
Deputy
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SIGNED BOARD REPORTX��"��MONTEREY COUNTY BOARD OF SUPERVISORS
MEETING: July 27, 2010 AGENDA NO.: Consent
SUBJECT: a. Approve and authorize the Contracts/Purchasing Officer to sign a two fiscal
year term Professional Services Agreement July 1, 2010 to June 30, 2012)
with Psychiatrists Only, LLC to refer Locum Tenens Psychiatric Service
Providers for the provision of mental health treatment services to adults and
children with psychiatric impairments and disabilities in the annual amount of
$90,000 for Fiscal Year FY) 2010-11 and $90,000 for FY 2011-12 for a total
Agreement amount of $180,000; and
b. Authorize the Contracts/Purchasing Officer, to sign up to three future
amendments to this agreement where the amendments do not exceed 10% and
do not significantly change the scope of work or result in an increase of net
county contribution.
DEPARTMENT: Health
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Approve and authorize the Contracts/Purchasing Officer to sign a two fiscal year term
Professional Services Agreement July 1, 2010 to June 30, 2012) with Psychiatrists Only,
LLC to refer Locum Tenens Psychiatric Service Providers for the provision of mental health
treatment services to adults and children with psychiatric impairments and disabilities in the
annual amount of $90,000 for Fiscal Year FY) 2010-11 and $90,000 for FY 2011-12 for a
total Agreement amount of $180,000; and
b. Authorize the Contracts/Purchasing Officer, to sign up to three future amendments to this
agreement where the amendments do not exceed 10% and do not significantly change the
scope of work or result in an increase of net county contribution.
SUMMARY:
Locum Tenens are licensed Physicians and Healthcare Professionals who are Board Certified,
Board Eligible or have equivalent training and experience. Locum Tenens provide temporary
medical services in accordance with applicable Federal, State, and County laws, rules and
regulations, and policies. Psychiatrists Only, LLC is a Locum Tenens agency that provides
psychiatric health care placement services.
The Monterey County Health Department engages Physicians and Healthcare Professionals who
provide Locum Tenens Psychiatry services in areas of critical medical need where sufficient
permanent staffing is not available. This Professional Services Agreement PSA) will assure the
provision of essential mental health, medication support, primary care and specialty care services
for clients of the Monterey County Health Department's Behavioral Health Bureau during
temporary absences of contracted psychiatrists.
DISCUSSION:
It is mission critical' that the County provide a continuity of mental health care pursuant to the
requirements of the Bronzan-McCorquodale Act California Welfare & Institutions Code Section
5600 et seq.), Part 2.5 of Division 5 of the California Welfare & Institutions Code, and Titles 9
and 22 of the California Code of Regulations.
Furthermore, the Joint Commission that accredits and certifies health care organizations requires
that the Natividad Medical Center NMC)/Behavioral Health Bureau BHB) Inpatient Unit
maintain a staff psychiatrist to client ratio, making it essential that the BHB have access to
temporary physician services on an as needed basis. The Monterey County Health Department
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SIGNED BOARD REPORTX��"��has significantly reduced the reliance on these services, but considers it vital to have access when
needed.
Prior to this PSA, the Monterey County Health Department had arrangements for temporary
psychiatric care services with Psychiatrists Only, LLC through the NMC contract with
Psychiatrists Only, LLC. This practice is being shifted from NMC to BHB since the process is
the responsibility of BHB and it would ensure direct and efficient oversight with Psychiatrists
Only, LLC. Therefore, the Monterey County Health Department is requesting this contractual
Agreement directly with Psychiatrists Only, LLC.
Locum Tenens are hired on a per diem rate applicable to the professional medical specialty,
which has been negotiated with Psychiatrists Only, LLC. The per diem rate is standard for this
type of service and includes allowance for overtime, holiday, and on-call pay as listed in Exhibit
A-Part 2.
This PSA contains the County's standard 30-day no cause" provision Section 7), which
provides that during the term of this Agreement, the County may terminate the Agreement for
any reason by giving written notice of termination to the Contractor at least thirty 30) days prior
to the effective date of termination. This PSA is brought before the Board for approval with the
understanding that CalWorks, AB3632, and Realignment have been proposed for reduction
and/or elimination in the State's Budget May revise. Should the funding be reduced or
terminated, Behavioral Health Bureau will implement a plan to terminate this Agreement as
needed.
OTHER AGENCY INVOLVEMENT:
County Counsel, Auditor-Controller, and Risk Management have reviewed and approved this
Agreement as to legal form, fiscal provisions and insurance requirements. The Contracts/
Purchasing Officer concurs with the contract terms. This Agreement is on file with the Clerk of
the Board.
FINANCING:
This PSA is funded by Realignment 38.41%) and Medicaid--Federal Financial Participation
61.59%). The funds for this Agreement are included in the Health Department's Behavioral
Health HEA002) Unit 8073 Fiscal Year 2010-11 Recommended Budget. Approval of this
action has no impact to the Net County Contribution.
The Agreement is brought before the Board for approval with the understanding that realignment
funding has been proposed for reduction in the State's Budget May Revise. Should the funding
be reduced or terminated, Behavioral Health will implement a plan to transition consumers
receiving services as required and/or terminate this Agreement as needed.
Prepared by:
ud~ C- mc
Gloria Rodriguez, 755-U986
Management Analyst
D
Date: Q~kv O-N- l c7 Date: 7//c////
cc: Mike Miller, Auditor-Controller
Charles J. McKee, County Counsel
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AGREEMENT NO. A-11803 - PSYCH��COUNTY OF MONTEREY AGREEMENT FOR PROFESSIONAL SERVICES
MORE THAN $100,000)*
This Professional Services Agreement Agreement") is made by and between the County of Monterey, a
political subdivision of the State of California hereinafter County") and:
Psychiatrists Only, LLC
hereinafter CONTRACTOR").
In consideration of the mutual covenants and conditions set forth in this Agreement, the parties agree as
follows:
1. SERVICES TO BE PROVIDED. The County hereby engages CONTRACTOR to perform, and
CONTRACTOR hereby agrees to perform, the services described in Exhibit A in conformity with the terms of
this Agreement. The services are generally described as follows:
Provide referral(s) of Locum Tenens Provider(s) for the speciality of psychiatry
2. PAYMENTS BY COUNTY. County shall pay the CONTRACTOR in accordance with the payment
provisions set forth in Exhibit A, subject to the limitations set forth in this Agreement. The total amount
payable by County to CONTRACTOR under this Agreement shall not exceed the sum of $ 180,000
3. TERM OF AGREEMENT. The term of this Agreement is from July 1, 2010 to
June 30, 2012 unless sooner terminated pursuant to the terms of this Agreement. This
Agreement is of no force or effect until signed by both CONTRACTOR and County and with County signing
last, and CONTRACTOR may not commence work before County signs this Agreement.
4. ADDITIONAL PROVISIONS/EXHIBITS. The following attached exhibits are incorporated herein by
reference and constitute a part of this Agreement:
Exhibit A Scope of Services/Payment Provisions
Exhibit B Business Automobile Insurance Endorsement Exemption Justification
Exhibit C Reassignment/Permanent Placement
5. PERFORMANCE STANDARDS.
5.01. CONTRACTOR warrants that CONTRACTOR and CONTRACTOR's agents, employees, and
subcontractors performing services under this Agreement are specially trained, experienced, competent, and
appropriately licensed to perform the work and deliver the services required under this Agreement and are not
employees of the County, or immediate family of an employee of the County.
5.02. CONTRACTOR, its agents, employees, and subcontractors shall perform all work in a safe and
skillful manner and in compliance with all applicable laws and regulations. All work performed under this
Agreement that is required by law to be performed or supervised by licensed personnel shall be performed in
accordance with such licensing requirements.
*Approved by County Board of Supervisors on
PSA over $100,000, Revised 10/09/08 1 of 9 Project ID:
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AGREEMENT NO. A-11803 - PSYCH��5.03. CONTRACTOR shall furnish, at its own expense, all materials, equipment, and personnel necessary
to carry out the terms of this Agreement, except as otherwise specified in this Agreement. CONTRACTOR
shall not use County premises, property including equipment, instruments, or supplies) or personnel for any
purpose other than in the performance of its obligations under this Agreement.
6. PAYMENT CONDITIONS.
6.01. CONTRACTOR shall submit to the Contract Administrator an invoice on a form acceptable to
County. If not otherwise specified, the CONTRACTOR may submit such invoice periodically or at the
completion of services, but in any event, not later than 30 days after completion of services. The invoice shall
set forth the amounts claimed by CONTRACTOR for the previous period, together with an itemized basis for
the amounts claimed, and such other information pertinent to the invoice as the County may require. The
Contract Administrator or his or her designee shall certify the invoice; either in the requested amount or in such
other amount as the County approves in conformity with this Agreement, and shall promptly submit such
invoice to the County Auditor-Controller for payment. The County Auditor-Controller shall pay the amount
certified within 30 days of receiving the certified invoice.
6.02. CONTRACTOR shall not receive reimbursement for travel expenses unless set forth in this
Agreement.
7. TERMINATION.
7.01. During the term of this Agreement, the County may terminate the Agreement for any reason by
giving written notice of termination to the CONTRACTOR at least thirty 30) days prior to the effective date of
termination. Such notice shall set forth the effective date of termination. In the event of such termination, the
amount payable under this Agreement shall be reduced in proportion to the. services provided prior to the date of
termination.
7.02. The County may cancel and terminate this Agreement for good cause effective immediately upon
written notice to CONTRACTOR. Good cause" includes the failure of CONTRACTOR to perform the
required services at the time and in the manner provided under this Agreement. If County terminates this
Agreement for good cause, the County may be relieved of the payment of any consideration to
CONTRACTOR, and the County may proceed with the work in any manner, which County deems proper. The
cost to the County shall be deducted from any sum due the CONTRACTOR under this Agreement.
8. INDEMNIFICATION. CONTRACTOR shall indemnify, defend, and hold harmless the County, its
officers, agents, and employees, from and against any and all claims, liabilities, and losses whatsoever
including damages to property and injuries to or death of persons, court costs, and reasonable attorneys' fees)
occurring or resulting to any and all persons, firms or corporations furnishing or supplying work, services,
materials, or supplies in connection with the performance of this Agreement, and from any and all claims,
liabilities, and losses occurring or resulting to any person, firm, or corporation for damage, injury, or death
arising out of or connected with the CONTRACTOR's performance of this Agreement, unless such claims,
liabilities, or losses arise out of the sole negligence or willful misconduct of the County. CONTRACTOR's
performance" includes CONTRACTOR's action or inaction and the action or inaction of CONTRACTOR's
officers, employees, agents and subcontractors.
PSA over $100,000, Revised 10/09/08 2 of 9 Project ID:
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AGREEMENT NO. A-11803 - PSYCH��9.0 INSURANCE.
9.01 Evidence of Coverage:
Prior to commencement of this Agreement, the Contractor shall provide a Certificate of
Insurance" certifying that coverage as required herein has been obtained. Individual endorsements
executed by the insurance carrier shall accompany the certificate. In addition the Contractor upon
request shall provide a certified copy of the policy or policies.
This verification of coverage shall be sent to the County's, Contracts/Purchasing Department,
unless otherwise directed. The Contractor shall not receive a Notice to Proceed" with the work
under this Agreement until it has obtained all insurance required and such, insurance has been
approved by the County. This approval of insurance shall neither relieve nor decrease the liability
of the Contractor.
9.02 Qualifying Insurers:
All coverage's, except surety, shall be issued by companies which hold a current policy holder's
alphabetic and financial size category rating of not less than A- VII, according to the current
Best's Key Rating Guide or a company of equal financial stability that is approved by the
County's Purchasing Manager.
9.03 Insurance Coverage Requirements:
Without limiting CONTRACTOR's duty to indemnify, CONTRACTOR shall maintain in effect
throughout the term of this Agreement a policy or policies of insurance with the following
minimum limits of liability:
Commercial general liability insurance, including but not limited to premises and operations,
including coverage for Bodily Injury and Property Damage, Personal Injury, Contractual Liability,
Broadform Property Damage, Independent Contractors, Products and Completed Operations, with
a combined single limit for Bodily Injury and Property Damage of not less than $1;000,000 per
occurrence.
Exemption/Modification Justification attached; subject to approval).
Business automobile liability insurance, covering all motor vehicles, including owned, leased,
non-owned, and hired vehicles, used in providing services under this Agreement, with a combined
single limit for Bodily Injury and Property Damage of not less than $1,000,000 per occurrence.
Exemption/Modification Justification attached; subject to approval).
Workers' Compensation Insurance if CONTRACTOR employs others in the performance of this
Agreement, in accordance with California Labor Code section 3700 and with Employer's Liability
limits not less than $1,000,000 each person, $1,000,000 each accident and $1,000,000 each
disease.
Exemption/Modification Justification attached; subject to approval).
PSA over $100,000, Revised 10/09/08 3 of 9 Project ID:
BIB]
40388-U01
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THREE-U012
FUTURE-U012
AMENDMENTS-U012
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AGREEMENT-U012
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AGREEMENT NO. A-11803 - PSYCH��Professional liability insurance, if required for the professional services being provided, e.g.,
those persons authorized by a license to engage in a business or profession regulated by the
California Business and Professions Code), in the amount of not less than $1,000,000 per claim
and $2,000,000 in the aggregate, to cover liability for malpractice or errors or omissions made in
the course of rendering professional services. If professional liability insurance is written on a
claims-made" basis rather than an occurrence basis, the CONTRACTOR shall, upon the
expiration or earlier termination of this Agreement, obtain extended reporting coverage tail
coverage") with the same liability limits. Any such tail coverage shall continue for at least three
years following the expiration or earlier termination of this Agreement.
Exemption/Modification Justification attached; subject to approval).
9.04 Other Insurance Requirements.
All insurance required by this Agreement shall be with a company acceptable to the County and
issued and executed by an admitted insurer authorized to transact Insurance business in the State
of California. Unless otherwise specified by this Agreement, all such insurance shall be written on
an occurrence basis, or, if the policy is not written on an occurrence basis, such policy with the
coverage required herein shall continue in effect for a period of three years following the date
CONTRACTOR completes its performance of services under this Agreement.
Each liability policy shall provide that the County shall be given notice in writing at least thirty
days in advance of any endorsed reduction in coverage or limit, cancellation, or intended non-
renewal thereof. Each policy shall provide coverage for Contractor and additional insureds with
respect to claims arising from each subcontractor, if any, performing work under this Agreement,
or be accompanied by a certificate of insurance from each subcontractor showing each
subcontractor has identical insurance coverage to the above requirements.
Commercial general liability and automobile liability policies shall provide an endorsement
naming the County of Monterey, its officers, agents, and employees as Additional Insureds with
respect to liability arising out of the CONTRACTOR'S work, including ongoing and completed
operations, and shall further provide that such insurance is primary insurance to any insurance or
self-insurance maintained by the County and that the insurance of the Additional Insureds shall
not be called upon to contribute to a loss covered by the CONTRACTOR'S insurance. The
required endorsement form for Commercial General Liability Additional Insured is ISO Form CG
20 10 11-85 or CG 20 10 10 01 in tandem with CG 20 37 10 01 2000). The required
endorsement form for Automobile Additional Insured endorsement is ISO Form CA 20 48 02 99.
Prior to the execution of this Agreement by the County, CONTRACTOR shall file certificates of
insurance with the County's contract administrator and County's Contracts/Purchasing Division,
showing that the CONTRACTOR has in effect the insurance required by this Agreement. The
CONTRACTOR shall file a new or amended certificate of insurance within five calendar days
after any change is made in any insurance policy, which would alter the information on the
certificate then on file. Acceptance or approval of insurance shall in no way modify or change the
indemnification clause in this Agreement, which shall continue in full force and effect.
PSA over $100,000, Revised 10/09/08 4 of 9 Project ID:
BIB]
40388-U01
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OFFICER,-U012
TO-U012
SIGN-U012
UP-U012
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THREE-U012
FUTURE-U012
AMENDMENTS-U012
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AGREEMENT-U012
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AGREEMENT NO. A-11803 - PSYCH��CONTRACTOR shall at all times during the term of this Agreement maintain in force the
insurance coverage required under this Agreement and shall send, without demand by County,
annual certificates to County's Contract Administrator and County's Contracts/Purchasing
Division. If the certificate is not received by the expiration date, County shall notify
CONTRACTOR and CONTRACTOR shall have five calendar days to send in the certificate,
evidencing no lapse in coverage during the interim. Failure by CONTRACTOR to maintain such
insurance is a default of this Agreement, which entitles County, at its sole discretion, to terminate
this Agreement immediately.
10. RECORDS AND CONFIDENTIALITY.
10.01 Confidentiality. CONTRACTOR and its officers, employees, agents, and subcontractors shall
comply with any and all federal, state, and local laws, which provide for the confidentiality of
records and other information. CONTRACTOR shall not disclose any confidential records or other
confidential information received from the County or prepared in connection with the performance
of this Agreement, unless County specifically permits CONTRACTOR to disclose such records or
information. CONTRACTOR shall promptly transmit to County any and all requests for
disclosure of any such confidential records or information. CONTRACTOR shall not use any
confidential information gained by CONTRACTOR in the performance of this Agreement except
for the sole purpose of carrying out CONTRACTOR's obligations under this Agreement.
10.02 County Records. When this Agreement expires or terminates, CONTRACTOR shall return to
County any County records which CONTRACTOR used or received from County to perform
services under this Agreement.
10.03 Maintenance of Records. CONTRACTOR shall prepare, maintain, and preserve all reports and
records that may be required by federal, state, and County rules and regulations related to services
performed under this Agreement. CONTRACTOR shall maintain such records for a period of at
least three years after receipt of final payment under this Agreement. If any litigation, claim,
negotiation, audit exception, or other action relating to this Agreement is pending at the end of the
three year period, then CONTRACTOR shall retain said records until such action is resolved.
10.04 Access to and Audit of Records. The County shall have the right to examine, monitor and audit
all records, documents, conditions, and activities of the CONTRACTOR and its subcontractors
related to services provided under this Agreement. Pursuant to Government Code section 8546.7,
if this Agreement involves the expenditure of public funds in excess of $10,000, the parties to this
Agreement may be subject, at the request of the County or as part of any audit of the County, to
the examination and audit of the State Auditor pertaining to matters connected with the
performance of this Agreement for a period of three years after final payment under the
Agreement.
10.05 Royalties and Inventions. County shall have a royalty-free, exclusive and irrevocable license to
reproduce, publish, and use, and authorize others to do so, all original computer programs,
writings, sound recordings, pictorial reproductions, drawings, and other works of similar nature
produced in the course of or under this Agreement. CONTRACTOR shall not publish any such
material without the prior written approval of County.
PSA over $100,000, Revised 10/09/08 5 of 9 Project ID:
BIB]
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AGREEMENT NO. A-11803 - PSYCH��11. NON-DISCRIMINATION. During the performance of this Agreement, CONTRACTOR, and its
subcontractors, shall not unlawfully discriminate against any person because of race, religious creed, color,
sex, national origin, ancestry, physical disability, mental disability, medical condition, marital status, age
over 40), or sexual orientation, either in CONTRACTOR's employment practices or in the furnishing of
services to recipients. CONTRACTOR shall ensure that the evaluation and treatment of its employees and
applicants for employment and all persons receiving and requesting services are free of such discrimination.
CONTRACTOR and any subcontractor shall, in the performance of this Agreement, fully comply with all
federal, state, and local laws and regulations, which prohibit discrimination. The provision of services
primarily or exclusively to such target population as may be designated in this Agreement shall not be
deemed to be prohibited discrimination.
12. COMPLIANCE WITH TERMS OF STATE OR FEDERAL GRANT. If this Agreement has been or
will be funded with monies received by the County pursuant to a contract with the state or federal
government in which the County is the grantee, CONTRACTOR will comply with all the provisions of said
contract, to the extent applicable to CONTRACTOR as a subgrantee under said contract, and said
provisions shall be deemed a part of this Agreement, as though fully set forth herein. Upon request, County
will deliver a copy of said contract to CONTRACTOR, at no cost to CONTRACTOR.
13. INDEPENDENT CONTRACTOR. In the performance of work, duties, and obligations under this
Agreement, CONTRACTOR is at all times acting and performing as an independent contractor and not as
an employee of the County. No offer or obligation of permanent employment with the County or particular
County department or agency is intended in any manner, and CONTRACTOR shall not become entitled by
virtue of this Agreement to receive from County any form of employee benefits including but not limited to
sick leave, vacation, retirement benefits, workers' compensation coverage, insurance or disability benefits.
CONTRACTOR shall be solely liable for and obligated to pay directly all applicable taxes, including
federal and state income taxes and social security, arising out of CONTRACTOR's performance of this
Agreement. In connection therewith, CONTRACTOR shall defend, indemnify, and hold County harmless
from any and all liability, which County may incur because of CONTRACTOR's failure to pay such taxes.
14. NOTICES. Notices required under this Agreement shall be delivered personally or by first-class, postage
pre-paid mail to the County and CONTRACTOR'S contract administrators at the addresses listed below:
FOR COUNTY:
Wayne W. Clark, Behavioral Health Director
Name and Title
1270 Natividad Road, Salinas, CA 93906
Address
FOR CONTRACTOR:
Adam Karp
Name and Title
Director of Business Development & Marketing
Psychiatrists Only, LLC
2970 Clairmont Road, Ste. 650
Altanta, GA 30329
831-755-4510
800-583-2256
Address
Phone Phone
PSA over $100,000, Revised 10/09/08 6 of 9 Project ID:
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AGREEMENT NO. A-11803 - PSYCH��15. MISCELLANEOUS PROVISIONS.
15.01 Conflict of Interest. CONTRACTOR represents that it presently has no interest and agrees not to
acquire any interest during the term of this Agreement, which would directly or indirectly conflict in
any manner or to any degree with the full and complete performance of the professional services
required to be rendered under this Agreement.
15.02 Amendment. This Agreement may be amended or modified only by an instrument in writing signed
by the County and the CONTRACTOR.
15.03 Waiver. Any waiver of any terms and conditions of this Agreement must be in writing and signed
by the County and the CONTRACTOR. A waiver of any of the terms and conditions of this
Agreement shall not be construed as a waiver of any other terms or conditions in this Agreement.
15.04 Contractor. The term CONTRACTOR" as used in this Agreement includes CONTRACTOR's
officers, agents, and employees acting on CONTRACTOR's behalf in the performance of this
Agreement.
15.05 Disputes. CONTRACTOR shall continue to perform under this Agreement during any dispute.
15.06 Assignment and Subcontracting. The CONTRACTOR shall not assign, sell, or otherwise transfer its
interest or obligations in this Agreement without the prior written consent of the County. None of the
services covered by this Agreement shall be subcontracted without the prior written approval of the
County. Notwithstanding any such subcontract, CONTRACTOR shall continue to be liable for the
performance of all requirements of this Agreement.
15.07 Successors and Assigns. This Agreement and the rights, privileges, duties, and obligations of the
County and CONTRACTOR under this Agreement, to the extent assignable or delegable, shall be
binding upon and inure to the benefit of the parties and their respective successors, permitted
assigns, and heirs.
15.08 Compliance with Applicable Law. The parties shall comply with all applicable federal, state, and
local laws and regulations in performing this Agreement.
15.09 Headings. The headings are for convenience only and shall not be used to interpret the terms of this
Agreement.
15.10 Time is of the Essence. Time is of the essence in each and all of the provisions of this Agreement.
15.11 Governing Law. This Agreement shall be governed by and interpreted under the laws of the State of
California.
15.12 Non-exclusive Agreement. This Agreement is non-exclusive and both County and CONTRACTOR
expressly reserve the right to contract with other entities for the same or similar services.
PSA over $100,000, Revised 10/09/08 7 of 9 Project ID:
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AGREEMENT NO. A-11803 - PSYCH��IN WITNESS WHEREOF, County and CONTRACTOR have executed this Agreement as of the day and
year written below.
Purchasing Officer
CONTRACTOR
Psychiatrists Only, LLC
Contractor's Business Name*
Department Head if applicable)
By:
lure of Chair, President, or
Vice-President)*
By:
Board
o
Date:
Approved as to Form'
By:
Date:
By:
Coun Co sel
h q110
Date: RISK MANAGEME
APPROVED AS TO INDEMNITY/
ApprovedNW fflMiM e G E
UUNTY OF MONTEREY
C
By:
Date: Date:
B
County Board of Supervisors' Agreement Number:
Date:
By:
Date:
Name and Title
6'-1o-za/ a
Si ature oT cretary, Asst. Secretary, CFO,
Tr asurer or sst. Treasurer)*
T /t wt k S e:
Name and Title
wole 40
*INSTRUCTIONS: If CONTRACTOR is a corporation, including limited liability and non-profit corporations, the full
legal name of the corporation shall be set forth above together with the signatures of two specified officers. If
CONTRACTOR is a partnership, the name of the partnership shall be set forth above together with the signature of a
partner who has authority to execute this Agreement on behalf of the partnership. If CONTRACTOR is contracting in an
individual capacity, the individual shall set forth the name of the business, if any, and shall personally sign the Agreement.
Approval by County Counsel is required
AApproval by Auditor-Controller is required
3Approval by Risk Management is necessary only if changes are made in paragraph 8 or 9
PSA over $100,000, Revised 10/09/08 9 of 9 Project ID:
COUNTY OF MONTEREY
f Supervisors if applicable)
BIB]
40388-U01
AGREEMENT-U02
NO.-U02
A-11803-U02
U02
PSYCHIATRISTS-U02
ONLY,-U02
LLC-U02
LI21329-U03
FO21330-U03
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AS89582-U03
AS89584-U03
AI93577-U03
DO93946-U03
C5-U03
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7/29/2010-U04
RIVASR-U04
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APPROVE-U07
AUTHORIZE-U07
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JULY-U012
1,-U012
2010-U012
TO-U012
JUNE-U012
30,-U012
2012)-U012
PSYCHIATRISTS-U012
ONLY,-U012
LLC-U012
TO-U012
REFER-U012
LOCUM-U012
TENENS-U012
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SERVICE-U012
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PROVISION-U012
OF-U012
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CHILDREN-U012
PSYCHIATRIC-U012
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DISABILITIES-U012
IN-U012
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AMOUNT-U012
OF-U012
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FISCAL-U012
YEAR-U012
FY)-U012
2010-11-U012
$90,000-U012
FY-U012
2011-12-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$180,000;-U012
B.-U012
AUTHORIZE-U012
CONTRACTS/PURCHASING-U012
OFFICER,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
SCOPE-U012
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OR-U012
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IN-U012
AN-U012
INCREASE-U012
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NET-U012
COUNTY-U012
CONTRIBUTION.-U012
AGREEMENT NO. A-11803 - PSYCH�� EXHIBIT A
SCOPE OF SERVICES
PART 2 PAYMENT PROVISIONS
1. IDENTIFICATION OF CONTRACTOR
Name: Psychiatrists Only, LLC
Address: 2970 Clairmont Road, Suite 650
Atlanta, GA 30329
800-583-2256
H. SCOPE OF SERVICES
1. WHEREAS, CONTRACTOR shall refer a locum tenens psychiatrist who shall provide
community mental health services in accordance with the requirements of the Bronzan-
McCorquodale Act California Welfare and Institutions Code 5600, et seq.), Part 2.5 of
Division 5 of the California Welfare & Institutions Code, and Titles 9 and 22 of the
California Code of Regulations.
2. Subject to the terms and conditions of this Agreement, CONTRACTOR agrees to refer
locum tenens to COUNTY in the following specialty:
Physician
Psychiatry
III. SERVICES/OJECTIVES BY CONTRACTOR
1. CONTRACTOR shall search, screen, and pre-qualify potential Provider hereinafter
referred to as Provider") meeting job specifications provided by COUNTY.
2. CONTRACTOR shall fully inform COUNTY of Provider's qualifications and provide a
copy of an up-to-date Curriculum Vitae to COUNTY for review, at all times for
Physicians who are Board Certified or Board Eligible.
3. CONTRACTOR shall process a Disciplinary Action report from the Federation of State
Medical Boards for each Provider presented. COUNTY will be notified of any
discrepancies or disciplinary actions against presented physician(s), at all times, at
presentation and/or during the course of COUNTY work.
4. CONTRACTOR shall provide to COUNTY current copies of provider specific
credentialing information as necessary and as follows:
a) Professional Liability Insurance
b) Original & Current California Medical License
c) National Provider Identifier NPI)
d) Drug Enforcement Administration DEA)
e) American Board of Medical Specialty Certification Certificate if applicable)
f) ECFMG if applicable)
g) Driver's License
PSA between Monterey County Health/Behavioral Health and Psychiatrists Only, LLC
FY 2010-11 thru FY 2011-12
Page 1 of 8
BIB]
40388-U01
AGREEMENT-U02
NO.-U02
A-11803-U02
U02
PSYCHIATRISTS-U02
ONLY,-U02
LLC-U02
LI21329-U03
FO21330-U03
FO85769-U03
FO89518-U03
MG89556-U03
AS89582-U03
AS89584-U03
AI93577-U03
DO93946-U03
C5-U03
AGREEMENTS-U03
7/29/2010-U04
RIVASR-U04
15331-U05
16-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
CONTRACTS/PURCHASING-U07
OFFICER-U07
TO-U07
SIGN-U07
A-U07
TWO-U07
FISCAL-U07
YEAR-U07
TERM-U07
PROFESSIONAL-U07
SERVICES-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
7/15/2010-U011
AGREEMENT-U012
JULY-U012
1,-U012
2010-U012
TO-U012
JUNE-U012
30,-U012
2012)-U012
PSYCHIATRISTS-U012
ONLY,-U012
LLC-U012
TO-U012
REFER-U012
LOCUM-U012
TENENS-U012
PSYCHIATRIC-U012
SERVICE-U012
PROVIDERS-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
TREATMENT-U012
SERVICES-U012
TO-U012
ADULTS-U012
CHILDREN-U012
PSYCHIATRIC-U012
IMPAIRMENTS-U012
DISABILITIES-U012
IN-U012
ANNUAL-U012
AMOUNT-U012
OF-U012
$90,000-U012
FISCAL-U012
YEAR-U012
FY)-U012
2010-11-U012
$90,000-U012
FY-U012
2011-12-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$180,000;-U012
B.-U012
AUTHORIZE-U012
CONTRACTS/PURCHASING-U012
OFFICER,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
OF-U012
NET-U012
COUNTY-U012
CONTRIBUTION.-U012
AGREEMENT NO. A-11803 - PSYCH��
5. CONTRACTOR shall verify the Provider's Tuberculosis test and send updated results to
COUNTY, within one 1) year of exam, at all times.
6. CONTRACTOR shall provide to COUNTY three 3) written references and two 2)
facility verifications current, within a two-year time frame) for the Provider at the time
physician is referred to COUNTY, at all times.
7. CONTRACTOR shall conduct preliminary Provider's reference checks and State of
California medical license verification and provide the results of all checks and
verifications to COUNTY, upon COUNTY request.
8. CONTRACTOR shall process a full American Medical Association AMA) Credentials
Verification Report for each Provider presented to verify physician Curriculum Vitae
CV), upon COUNTY request.
9. CONTRACTOR shall refer only Providers eligible to be a Participating Physician" in
the Medicare and Medi-Cal Program in order to permit the COUNTY to bill for
Contracted Services.
10. CONTRACTOR shall notify the COUNTY immediately upon the occurrence of any
event or circumstance, which may affect the completion of the provider's-assignment.
11. If provider fails to start assignment at COUNTY as agreed to/or terminates assignment
early, CONTRACTOR will make best efforts as expeditiously as possible to recruit for a
replacement candidate, subsequent to the approval of the COUNTY at no additional
charge.
IV. SERVICES/OBJECTIVES BY COUNTY
1. COUNTY shall provide CONTRACTOR an accurate practice description, upon
CONTRACTOR request.
2. COUNTY shall provide CONTRACTOR background information regarding the work
site, hospital and/or the community which ever is applicable), upon CONTRACTOR
request.
3. COUNTY shall be responsible for credential verification and privileging of hired
applicants, at all times.
4. COUNTY shall specify to CONTRACTOR specialty need and whether it is for inpatient
care; outpatient care; and whether assignment includes supervision and oversight of
Resident Physicians.
V. SERVICES BY CONTRACTOR REFERRED PROVIDER LOCUM TENENS)
1. CONTRACTOR referred Provider shall perform his or her professional medical duties in
accordance with: a) applicable Federal, State and County laws, rules and regulations, and
policies; b) all rules and regulations generally applicable to physicians practicing medicine
in the state of California; c) applicable requirements of third party payor programs; and d)
Monterey County and Health Department policies, procedures, rules and regulations.
PSA between Monterey County Health/Behavioral Health and Psychiatrists Only, LLC
FY 2010-11 thru FY 2011-12
Page 2 of 8
BIB]
40388-U01
AGREEMENT-U02
NO.-U02
A-11803-U02
U02
PSYCHIATRISTS-U02
ONLY,-U02
LLC-U02
LI21329-U03
FO21330-U03
FO85769-U03
FO89518-U03
MG89556-U03
AS89582-U03
AS89584-U03
AI93577-U03
DO93946-U03
C5-U03
AGREEMENTS-U03
7/29/2010-U04
RIVASR-U04
15331-U05
16-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
CONTRACTS/PURCHASING-U07
OFFICER-U07
TO-U07
SIGN-U07
A-U07
TWO-U07
FISCAL-U07
YEAR-U07
TERM-U07
PROFESSIONAL-U07
SERVICES-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
7/15/2010-U011
AGREEMENT-U012
JULY-U012
1,-U012
2010-U012
TO-U012
JUNE-U012
30,-U012
2012)-U012
PSYCHIATRISTS-U012
ONLY,-U012
LLC-U012
TO-U012
REFER-U012
LOCUM-U012
TENENS-U012
PSYCHIATRIC-U012
SERVICE-U012
PROVIDERS-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
TREATMENT-U012
SERVICES-U012
TO-U012
ADULTS-U012
CHILDREN-U012
PSYCHIATRIC-U012
IMPAIRMENTS-U012
DISABILITIES-U012
IN-U012
ANNUAL-U012
AMOUNT-U012
OF-U012
$90,000-U012
FISCAL-U012
YEAR-U012
FY)-U012
2010-11-U012
$90,000-U012
FY-U012
2011-12-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$180,000;-U012
B.-U012
AUTHORIZE-U012
CONTRACTS/PURCHASING-U012
OFFICER,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
OF-U012
NET-U012
COUNTY-U012
CONTRIBUTION.-U012
AGREEMENT NO. A-11803 - PSYCH��
2. CONTRACTOR referred Provider shall agree to be a Participating Physician" in the
Medicare and Medi-Cal Program in order to permit the COUNTY to bill for Contracted
Services.
3. CONTRACTOR referred Provider shall assure that the medications, procedures and
laboratory testing ordered for each patient, is not only medically necessary for diagnosis
and/or treatment, but also compliant to the specifications of the program.
4. CONTRACTOR referred Provider agrees to complete any billing and credentialing
paperwork prior to, during the duration of, and after rendering service to the COUNTY.
5. CONTRACTOR referred Provider shall possess some experience/knowledge of working
techniques of an electronic health records program system.
PSA between Monterey County Health/Behavioral Health and Psychiatrists Only, LLC
FY 2010-11 thru FY 2011-12
Page 3 of 8
BIB]
40388-U01
AGREEMENT-U02
NO.-U02
A-11803-U02
U02
PSYCHIATRISTS-U02
ONLY,-U02
LLC-U02
LI21329-U03
FO21330-U03
FO85769-U03
FO89518-U03
MG89556-U03
AS89582-U03
AS89584-U03
AI93577-U03
DO93946-U03
C5-U03
AGREEMENTS-U03
7/29/2010-U04
RIVASR-U04
15331-U05
16-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
CONTRACTS/PURCHASING-U07
OFFICER-U07
TO-U07
SIGN-U07
A-U07
TWO-U07
FISCAL-U07
YEAR-U07
TERM-U07
PROFESSIONAL-U07
SERVICES-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
7/15/2010-U011
AGREEMENT-U012
JULY-U012
1,-U012
2010-U012
TO-U012
JUNE-U012
30,-U012
2012)-U012
PSYCHIATRISTS-U012
ONLY,-U012
LLC-U012
TO-U012
REFER-U012
LOCUM-U012
TENENS-U012
PSYCHIATRIC-U012
SERVICE-U012
PROVIDERS-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
TREATMENT-U012
SERVICES-U012
TO-U012
ADULTS-U012
CHILDREN-U012
PSYCHIATRIC-U012
IMPAIRMENTS-U012
DISABILITIES-U012
IN-U012
ANNUAL-U012
AMOUNT-U012
OF-U012
$90,000-U012
FISCAL-U012
YEAR-U012
FY)-U012
2010-11-U012
$90,000-U012
FY-U012
2011-12-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$180,000;-U012
B.-U012
AUTHORIZE-U012
CONTRACTS/PURCHASING-U012
OFFICER,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
OF-U012
NET-U012
COUNTY-U012
CONTRIBUTION.-U012
AGREEMENT NO. A-11803 - PSYCH��
Exhibit A Part 2
Payment Provisions
1. PAYMENT PROVISIONS
A. PAYMENT TYPE
Negotiate Rate NR) with rate established in contract. It is mutually understood and agreed by
both parties that CONTRACTOR shall be compensated under the Agreement in accordance with
Exhibit A Part 2 rate sheet attached hereto.
B. PAYMENT CONDITIONS
1. In order to receive any payment under this Agreement, CONTRACTOR shall submit claims
in such form as may be required by the COUNTY. Specifically, CONTRACTOR shall
submit its claims on a form acceptable to COUNTY so as to reach the COUNTY no later than
the 30th day of the month following the month of service. Upon termination of this
Agreement, CONTRACTOR shall submit its final claim for payment no later than thirty 30)
days after the completion of services. Invoices shall be billed directly to Behavioral Health
Bureau of the Health Department.
2. If CONTRACTOR fails to submit claims for services provided under the term of this
Agreement as described above, the COUNTY may, at its sole discretion, deny payment for
that month of service and disallow the claim.
3. COUNTY shall review and certify CONTRACTOR's claim either in the requested amount or
in such other amount as COUNTY approves in conformity with this Agreement, and shall
then submit such certified claim to the COUNTY Auditor. The Auditor shall pay the claim in
the amount certified by the COUNTY.
4. If COUNTY certifies payment at a lesser amount than the amount requested COUNTY shall
immediately notify the CONTRACTOR in writing of such certification and shall specify the
reason for it. If the CONTRACTOR desires to contest the certification, the CONTRACTOR
must submit a written notice of protest to the COUNTY within 20 days after the
CONTRACTOR's receipt of the COUNTY notice. The parties shall thereafter promptly meet
to review the dispute and resolve it on a mutually acceptable basis. No court action may be
taken on such a dispute until the parties have met and attempted to resolve the dispute in
person.
5. Neither CONTRACTOR nor PROVIDER assigned by CONTRACTOR shall receive
reimbursement for travel, lodging, or meal expenses.
PSA between Monterey County Health/Behavioral Health and Psychiatrists Only, LLC
FY 2010-11 thru FY 2011-12
Page 4 of 8
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40388-U01
AGREEMENT-U02
NO.-U02
A-11803-U02
U02
PSYCHIATRISTS-U02
ONLY,-U02
LLC-U02
LI21329-U03
FO21330-U03
FO85769-U03
FO89518-U03
MG89556-U03
AS89582-U03
AS89584-U03
AI93577-U03
DO93946-U03
C5-U03
AGREEMENTS-U03
7/29/2010-U04
RIVASR-U04
15331-U05
16-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
CONTRACTS/PURCHASING-U07
OFFICER-U07
TO-U07
SIGN-U07
A-U07
TWO-U07
FISCAL-U07
YEAR-U07
TERM-U07
PROFESSIONAL-U07
SERVICES-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
7/15/2010-U011
AGREEMENT-U012
JULY-U012
1,-U012
2010-U012
TO-U012
JUNE-U012
30,-U012
2012)-U012
PSYCHIATRISTS-U012
ONLY,-U012
LLC-U012
TO-U012
REFER-U012
LOCUM-U012
TENENS-U012
PSYCHIATRIC-U012
SERVICE-U012
PROVIDERS-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
TREATMENT-U012
SERVICES-U012
TO-U012
ADULTS-U012
CHILDREN-U012
PSYCHIATRIC-U012
IMPAIRMENTS-U012
DISABILITIES-U012
IN-U012
ANNUAL-U012
AMOUNT-U012
OF-U012
$90,000-U012
FISCAL-U012
YEAR-U012
FY)-U012
2010-11-U012
$90,000-U012
FY-U012
2011-12-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$180,000;-U012
B.-U012
AUTHORIZE-U012
CONTRACTS/PURCHASING-U012
OFFICER,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
OF-U012
NET-U012
COUNTY-U012
CONTRIBUTION.-U012
AGREEMENT NO. A-11803 - PSYCH��
H. MAXIMUM LIABILITY
Subject to the limitation set forth herein, COUNTY shall pay to CONTRACTOR during the term
of this Agreement a maximum amount of $180,000 for services authorized pursuant to this
Exhibit.
FISCAL YEAR LIABILITY AMOUNT
July 1, 2010 to June 30, 2011 $ 90,000
July 1, 2011 to June 30, 2012 $ 90,000
MAXIMUM COUNTY OBLIGATION $180,000
PSA between Monterey County Health/Behavioral Health and Psychiatrists Only, LLC
FY 2010-11 thru FY 2011-12
Page 5 of 8
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AGREEMENT-U02
NO.-U02
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ONLY,-U02
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LI21329-U03
FO21330-U03
FO85769-U03
FO89518-U03
MG89556-U03
AS89582-U03
AS89584-U03
AI93577-U03
DO93946-U03
C5-U03
AGREEMENTS-U03
7/29/2010-U04
RIVASR-U04
15331-U05
16-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
CONTRACTS/PURCHASING-U07
OFFICER-U07
TO-U07
SIGN-U07
A-U07
TWO-U07
FISCAL-U07
YEAR-U07
TERM-U07
PROFESSIONAL-U07
SERVICES-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
7/15/2010-U011
AGREEMENT-U012
JULY-U012
1,-U012
2010-U012
TO-U012
JUNE-U012
30,-U012
2012)-U012
PSYCHIATRISTS-U012
ONLY,-U012
LLC-U012
TO-U012
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TENENS-U012
PSYCHIATRIC-U012
SERVICE-U012
PROVIDERS-U012
PROVISION-U012
OF-U012
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HEALTH-U012
TREATMENT-U012
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TO-U012
ADULTS-U012
CHILDREN-U012
PSYCHIATRIC-U012
IMPAIRMENTS-U012
DISABILITIES-U012
IN-U012
ANNUAL-U012
AMOUNT-U012
OF-U012
$90,000-U012
FISCAL-U012
YEAR-U012
FY)-U012
2010-11-U012
$90,000-U012
FY-U012
2011-12-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
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$180,000;-U012
B.-U012
AUTHORIZE-U012
CONTRACTS/PURCHASING-U012
OFFICER,-U012
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SIGN-U012
UP-U012
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AMENDMENTS-U012
DO-U012
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OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
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OF-U012
NET-U012
COUNTY-U012
CONTRIBUTION.-U012
AGREEMENT NO. A-11803 - PSYCH��E~chibit~A R li
OF
Provis, on r
Psyclita it & e i Itt atient
Psyclua
4.,1 Ablesc~ntOutpattent
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Calls
t,~.e~ssigun~~
r,<Place>rie
$1,296.00 $162.00 $175.00 $180.001 $525.00 $590.00 $19.00 $17,500
$1,240.00 $155.00 $165.00 N/AI N/A $590.00 $19.00 $17,500
N/AI N/A N/A N/AI N/A N/A N/A N/A
$1,320.001 $165.00 $190.00 N/AI N/A N/A $19.00 $17,500
*Neither CONTRACTOR nor PROVIDER assigned by CONTRACTOR shall receive separate reimubrsement for travel, lodging, or meal expenses.
DEFINITIONS:
All Inclusive Rate: Char ed daily and defined as an 8-hour work day.
Premium Hourly Rate: Hourly overtime rate after a 40-hour week.
Weeknight On-Call: Charged nightly to have PROVIDER on-call. Premium hourly rate is charged for all hours of patient contact on-call.
Charged by 24-hour period to have PROVIDER on-call. Premium hourly rate is charged for all hours of patient contact on-
Weekend On-Call: call.
Used for call-only assignments. Charged per 24-hour period. Premium rate is charged for all hours of on-call patient contact
24 Hour-Call: in a 24-hour period.
A rate of one-half of the Daily Rate will be charged for New Year's Day, Memorial Day, Independence Day, Labor Day,
Thanksgiving Day, Christmas Day, or any holiday that is recognized by the COUNTY if PROVIDER remains in the
assignment community, whether or not services are actually provided on those days. If PROVIDER is required to be on-call,
COUNTY will pay the full Daily Rate for PROVIDER for each holiday. If PROVIDER has any patient contact or is required
to report to COUNTY's facility on one of these holidays, COUNTY will pay the full Daily Rate for PROVIDER plus the
Holiday Premium, which includes up to 4 hours of professional services. COUNTY will be charged at the Premium Hourly
Holiday Rate: Rate for all hours performed over 4 hours on any of these holidays.
The administrative service fee is applicable for each calendar day the PROVIDER delivers services through either patient
contact or call availability and includes, but is not limited to, the following services: maintenance of medical malpractice
insurance policy, referencing, verifying licensure, forwarding COUNTY's verification forms to third parties and continuous
Administrative Services-$19 per da follow-up to ensure completed forms are returned to COUNTY in a timely manner, and coordinating travel itineraries.
COUNTY agrees to pay CONTRACTOR a Reassignment Fee as indicated on payment provisions of Exhibit A for the
reassignment of PROVIDER presented to COUNTY or any organization affiliated with COUNTY if such PROVIDER
becomes a permanent employee of COUNTY or an affiliate of COUNTY within eighteen 18) months after such PROVIDER
Reassignment Permanent Placement) Fee: is presented to COUNTY of after PROVIDER ceases to provide services to COUNTY.
BIB]
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AGREEMENT NO. A-11803 - PSYCH��EXHIBIT B
BUSINESS AUTOMOBILE LIABILITY INSURANCE
ENDORSEMENT EXEMPTION JUSTIFICATION
CONTRACTOR NAME: Psychiatrists Only, LLC
Business Automobile Liability Insurance Endorsement
Business Justification:
The CONTRACTOR has provided proof of Business Automobile Liability Insurance at the
COUNTY required limits. Based on the Service Description, the Additional Insured
Endorsement is not required because the CONTRACTOR is located out-of-state and shall not
drive on COUNTY premises. As part of this Agreement, all work transactions by the
CONTRACTOR shall be provided via Telecommunications, Electronic-Mail, Facsimile, Federal
Express/Overnight Mail, and/or U.S. Postage-Mail.
PSA between Monterey County Health/Behavioral Health and Psychiatrists Only, LLC
FY 2010-11 thru FY 2011-12
Page 6 of 8
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40388-U01
AGREEMENT-U02
NO.-U02
A-11803-U02
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PSYCHIATRISTS-U02
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LI21329-U03
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AS89584-U03
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DO93946-U03
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30,-U012
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LOCUM-U012
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SERVICE-U012
PROVIDERS-U012
PROVISION-U012
OF-U012
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HEALTH-U012
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TO-U012
ADULTS-U012
CHILDREN-U012
PSYCHIATRIC-U012
IMPAIRMENTS-U012
DISABILITIES-U012
IN-U012
ANNUAL-U012
AMOUNT-U012
OF-U012
$90,000-U012
FISCAL-U012
YEAR-U012
FY)-U012
2010-11-U012
$90,000-U012
FY-U012
2011-12-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$180,000;-U012
B.-U012
AUTHORIZE-U012
CONTRACTS/PURCHASING-U012
OFFICER,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
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SIGNIFICANTLY-U012
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RESULT-U012
IN-U012
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CONTRIBUTION.-U012
AGREEMENT NO. A-11803 - PSYCH��EXHIBIT C
REASSIGNMENT/PERMANENT PLACEMENT
CONTRACTOR NAME: Psychiatrists Only, LLC
COUNTY agrees to pay CONTRACTOR a Reassignment/Permanent Placement Fee as indicated
on Payment Provisions of Exhibit A Part 2 for the reassignment/permanent placement of
PROVIDER presented to COUNTY or any organization affiliated with COUNTY if such
PROVIDER becomes a permanent employee of COUNTY or an affiliate of COUNTY within
eighteen 18) months after such PROVIDER is presented to COUNTY of after PROVIDER
ceases to provide services to COUNTY.
CONTRACTOR, on behalf of the PROVIDER, shall provide COUNTY with the following:
1. Notification of PROVIDERS that meet the professional qualifications of the COUNTY
and who have expressed a desire for continued information regarding the position(s)
available through COUNTY.
2. Up-to-date Curriculum Vitae.
3. State of California Medical License original & current).
4. Drug Enforcement Administration DEA) Certificate.
5. National Provider Identifier NPI) number.
6. Residency Training Completion.
7. Recent Continuing Medical Education.
8. Three 3) written references and two 2) facility verifications current, within a two-year
time frame).
9. Notification of any Disciplinary Action report(s) from the Federation of State Medical
Boards along with notification of any discrepancies or disciplinary actions against
presented PROVIDER.
10. American Medical Association AMA) Credentials Verification Report, upon COUNTY
request.
11. Verification and results of all reference checks, and any other credentialing
documentation as deemed necessary by COUNTY, upon COUNTY request.
12. American Board of Medical Specialty Board Certification Certificate if applicable)
13. ECFMG if applicable)
PSA between Monterey County Health/Behavioral Health and Psychiatrists Only, LLC
FY 2010-11 thru FY 2011-12
Page 7 of 8
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40388-U01
AGREEMENT-U02
NO.-U02
A-11803-U02
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PSYCHIATRISTS-U02
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LLC-U02
LI21329-U03
FO21330-U03
FO85769-U03
FO89518-U03
MG89556-U03
AS89582-U03
AS89584-U03
AI93577-U03
DO93946-U03
C5-U03
AGREEMENTS-U03
7/29/2010-U04
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15331-U05
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2010-U012
TO-U012
JUNE-U012
30,-U012
2012)-U012
PSYCHIATRISTS-U012
ONLY,-U012
LLC-U012
TO-U012
REFER-U012
LOCUM-U012
TENENS-U012
PSYCHIATRIC-U012
SERVICE-U012
PROVIDERS-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
TREATMENT-U012
SERVICES-U012
TO-U012
ADULTS-U012
CHILDREN-U012
PSYCHIATRIC-U012
IMPAIRMENTS-U012
DISABILITIES-U012
IN-U012
ANNUAL-U012
AMOUNT-U012
OF-U012
$90,000-U012
FISCAL-U012
YEAR-U012
FY)-U012
2010-11-U012
$90,000-U012
FY-U012
2011-12-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$180,000;-U012
B.-U012
AUTHORIZE-U012
CONTRACTS/PURCHASING-U012
OFFICER,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
SCOPE-U012
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WORK-U012
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RESULT-U012
IN-U012
AN-U012
INCREASE-U012
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COUNTY-U012
CONTRIBUTION.-U012
AGREEMENT NO. A-11803 - PSYCH��CONTRACTOR hereby agrees to:
1. Not make job offers to PROVIDER on behalf of the COUNTY. COUNTY will
directly communicate job offer to PROVIDER.
2. Provide assistance in contract negotiations with the PROVIDER, only upon request by
COUNTY.
3. Consult with COUNTY and the PROVIDER regarding relocation dates and facilitation of
other needs of the PROVIDER, as necessary, after successful completion of the
contractual agreement between PROVIDER and COUNTY, only upon request by
COUNTY.
COUNTY hereby agrees to:
1. Designate a representative to coordinate placement activity with CONTRACTOR.
2. Keep the CONTRACTOR informed on a weekly basis the status of negotiations
with PROVIDER.
3. Be responsible for credential verification and privileging of hired PROVIDER.
PSA between Monterey County Health/Behavioral Health and Psychiatrists Only, LLC
FY 2010-11 thru FY 2011-12
Page 8 of 8
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AS89582-U03
AS89584-U03
AI93577-U03
DO93946-U03
C5-U03
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