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FY1991 11/14/1990r F1 BRANCH OFFICE 3117 OVERSEAS HIGHWAY MARATHON, FLORIDA 33050 TEL. (305) 743.9036 Dannp 1. Rotbage CLERK OF THE CIRCUIT COURT MONROE COUNTY 500 WHITEHEAD STREET KEY WEST, FLORIDA 33040 TEL. (305) 294-4641 M E M O R A N D U M To: George Harper, Director Management Services Division From: Rosalie L. Connolly, Deputy Clerk Date: November 26, 1990 BRANCH OFFICE P.O. BOX 379 PLANTATION KEY, FLORIDA 33070 TEL. (305) 852-9253 Subject: Guidance Clinic of the Middle Keys, Inc. As you are aware, on November 14, 1990, the Board of County Commissioners approved and authorized execution of a Funding Agreement with the Guidance Clinic of the Middle Keys, Inc. for Fiscal Year 1990-1991, at a total cost not to exceed $364,735.00. Attached is one duplicate original and one Xerox copy of the subject Funding Agreement, now executed and sealed by all parties. The duplicate original should be returned to the Clinic and the Xerox copy kept in your proper departmental records. Rosalie L. onno11y Deputy Clerk Attachments cc: County Attorney County Administrator Finance Director File r AGREEMENT FOR BAKER ACT MATCHING FUNDS AGREEMENT, made this J day of 0, 1990, between the BOARD OF COUNTY COMMISSIC "QuCK M6NR& 2bUNTY, FLORIDA, ("Board") and the GUIDANCE CLINI�J)F: THEj!.KMME KEYS, INC., ("CLINIC"). C �_ I R. CT. t Cl C COUMTULA. In consideration of the mutual covenants made herein, the parties hereby agree as follows: (1) The Board shall reimburse the Clinic twenty-five percent (25%) of total $1,458,940.00 expenditures for Baker Act hospital, physician, and crisis stabilization services, as billed to the Clinic for clients qualifying for such services under applicable state and federal regulations and eligibility determination procedures. This cost shall not exceed a total reimbursement of Three Hundred Sixty Four Thousand Seven Hundred Thirty Five Dollars ($364,735.00) during the period beginning October 1, 1990, and ending September 30, 1991. (2) The Clinic shall also provide to the Board on a regular basis a Baker Act Billing Summary Form from which reimbursement due to the Clinic can be calculated; however, in order to comply with regulations safeguarding patient's right to confidentiality, copies of individual client bills shall not be available for inspection by the Board for reimbursement purposes. Copies of individual client bills shall be kept on file in the Clinic business office and shall be 'made available under controlled conditions to qualified auditors for audit purposes. (3) This agreement shall terminate at 11:59 P.M., September 30, 1991 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 before the termination of this agreement, if the Clinic submits to the Board the required Baker Act Billing Summary Form within three (3) weeks of the date of termination of this agreement; provided, however, that the maximum of reimburse- ment specified above is not exceeded. (4) 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. (5) County warrants or checks written for reimbursement to the Clinic shall be made payable to the Guidance Clinic of the Middle Keys, Inc. (6) The Clinic shall indemnify Monroe County for all claims of any sort that arise from the use of this funding. In this respect, the Clinic shall hold Monroe County harmless and assume all responsibility for any claims or damages resulting from the use of this funding during the time wherein the funding continues. 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 and its Clerk, and the Guidance Clinic of the Middle Keys, Inc., has caused these presents to be signed in its name by its President/Board of Directors and Chief Executive Officer as of the day and year first above written. (Seal) Attest :DANNY L. Y-01EAGE, Clerk ,00f er It itnesses BOARD OF COUNTY COMMISSIONERS OF MONRO COUNTY, FLORIDA By� Playor / Cha rman GUIDANCE CLINIC OF THE MIDDLE KEYS, INC. By, re t oar o rectors 01 B "O�fj Y-P4'-Chief Exedutive Officer APPROVED AS TO FORM AND LEGAL SUFFICIENCY. BY „ \ Attorne Office