12/13/1982 AgreementAGREEMENT FOR BAKER ACT
MATCHING FUNDS
THIS AGREEMENT, made this 13th day of December ,
1982, by and between the BOARD OF COUNTY COMMISSIONERS OF MONROE
COUNTY, FLORIDA, hereinafter referred to as "BOARD", and the DADE-
MONROE MENTAL HEALTH BOARD, INC., District XI, hereinafter referred
to as "DISTRICT",
For and in consideration of the mutual covenants made herein,
the parties hereby agree as follows:
(1) The Board agrees to reimburse the District twenty-five
percent (25%) of total District expenditures for Baker Act hos-
pital, physician, and crisis stabilization services, as billed to
the District on state approved Baker Act Billing Forms (HRS 346)
for clients qualifying for such services under applicable state
and federal regulations and eligibility determination procedures.
This cost is not to exceed a total reimbursement of Thirty -Seven
Thousand Four Hundred Ninety Dollars ($37,490) during the period
beginning October 1, 1982 and ending September 30, 1983.
(2) The District agrees to provide to the Board on a
regular basis a copy of the Baker Act Summary Billing Form from
which reimbursement due the District can be calculated; however,
copies of individual client bills will not be available for in-
spections by the Board for reimbursement purposes in order to
comply with regulations safeguarding the patient's right to con-
fidentiality. Copies of individual client bills are kept on file
in the District's business office and will be made available under
controlled condition to qualified auditors for audit purposes.
The District further agrees to provide the Board any Baker Act
statistical data normally available to the District and to make an
annual report to the Board of the expenditure of County funds for
the above specified purposes.
A
This agreement shall terminate at 11:59 P.M., September 30,
1983, and the Board shall not be liable under the terms of this
agreement for any liability incurred after the time of termination;
however, the Board shall be liable for outstanding costs incurred
prior to the termination of this agreement provided the District
submits to the Board the required Baker Act Summary Billing Form
within three (3) weeks of the date of termination of this agreement,
provided, however, that the maximum of reimbursement specified
above is not exceeded. This agreement may also be terminated by
either party upon thirty (30) days written notice delivered by
certified mail to the party receiving notice of termination.
County warrants or checks written for reimbursement to the
District shall be made payable to the Dade -Monroe Mental Health
Board, Inc.
IN WITNESS WHEREOF, the BOARD OF COUNTY COMMISSIONERS OF
MONROE COUNTY, FLORIDA, has caused these presents to be signed
in its name by its Chairman, Board of County Commissioners, and
the Clerk of the Board of County Commissioners, and the Dade -
Monroe Mental Health Board, Inc., District XI, has caused these
presents to be signed in its name by its President and Secretary
of the Board all as of the 13th day of December , 1982.
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By "IX
(SEAL)
ayor airman
(SEAL)
Attest:
Clerk
DADE-MONROE MENTAL HEALTH BOARD, INC.
District XI
By j'1•—�•s
President
AS YV PDAW
Su FKfeeNCTy
BY
Attwraer's Office
Finance Department
RESOLUTION NO. 3z3 -1932
RESOLUTION AUTHORIZING THE CHAIRMAN OF THE BOARD
OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA,
TO EXECUTE AN AGREEMENT FOR BAKER ACT MATCHING
FUNDS BY AND BETWEEN THE BOARD OF COUNTY COMMIS-
SIONERS OF MONROE COUNTY, FLORIDA, AND THE DADE-
MONROE MENTAL HEALTH BOARD. INC., DISTRICT XI.
BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE
COUNTY, FLORIDA, as follows:
That the Chairman of the Board of County Commissioners of
Monroe County, Florida, is hereby authorized to execute an agreement
for Baker Act Matching Funds by and between the Board of County
Commissioners of Monroe County, Florida, and the Dade -Monroe Mental
Health Board, Inc., District XI, a copy of same being attached
hereto.
Passed and adopted by the Board of County Commissioners of
Monroe County, Florida, at a regular meeting held on the 13th
day of
(SEAL)
Attest:
December , A.D. 1982.
Cler
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Mayor/Chairman
P lIED As TO FORM
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