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BRANCH OFFICE CLERK OF THE CIRCUIT COURT
3117 OVERSEAS HIGHWAY MONROE COUNTY
MARATHON, FLORIDA 33050 500 WHITEHEAD STREET
TEL. (305) 743.9036 KEY WEST, FLORIDA 33040
TEL. (305) 294-4641
II E M O R A N D U M
To: Peter Horton,
Division Director/Community Services
From: Rosalie L. Connolly, Deputy Clerk
Date: December 30, 1991
BRANCH OFFICE
P.O. BOX 379
PLANTATION KEY, FLORIDA 33070
TEL. (305) 852-9253
As you are aware, on December 11, 1991, the Board of County
Commissioners approved and authorized execution of the
amended Agreement for Baker Act Matching Funds with the
Guidance Clinic of the Middle Keys, Inc.
Attached is one duplicate original and one Xerox copy of the
subject Agreement, now executed and sealed by all parties.
The duplicate original (raised seal) should be returned to
the Clinic and the Xerox copy kept in your proper departmen-
tal records.
Rosalie L. C6nnolly
Deputy Clerk
Attachments
cc: County Attorney
County Administrator w/o document
Finance Director
File
r;LE
AGREEMENT FOR BAKER ACT MATCHING FUNDS 191
AGREEMENT, made this day of �� p Ej per, 19919
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY,
FLORIDA, ("Board") and the GUIDANCE CLINIC OF THE MIDDLE KEYS,
INC., ("CLINIC").
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 $1,480,832.00 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. The Clinic shall provide these
services in compliance with Florida Statutes Chapter 394. This
cost shall not exceed a total reimbursement of Three Hundred
Seventy Thousand Two Hundred Eight Dollars ($370,208.00) during
the period beginning October 1, 1991, and ending September 30,
1992.
(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, 1992 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
K
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.
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Playor7ha rman
(Seal)
Attest: DANNY L. KOLHAGE, CLERK
By
e ty er
GUIDANCE CLINIC OF THE MIDDLE
KEYS, INC.
By c .,
Fresic�dnyBoard ot Directors
By
74hie xec t ve cer
APPROVED AS TO FOPM
(FOAL SUl-;MCf
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