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BRANCH OFFICE
3117 OVERSEAS HIGHWAY
MARATHON, FLORIDA 33050
TEL. 1305) 743.9036
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CLERK OF THE CIRCUIT COURT
MONROE COUNTY
500 WHITEHEAD STREET
KEY WEST, FLORIDA 33040
TEL. 1305) 294.4641
November 7, 1988
Richard Matthews, Ph.D., Executive Director
Guidance Clinic of the Upper Keys, Inc.
Post Office Box 363
Tavernier, Florida 33070
Dear Dr. Matthews:
BRANCH OFFICE
P.O. BOX 379
PLANTATION KEY, FLORIDA 33070
TEL. 1305) 852-9253
At a Regular Meeting in formal session on
November 1, 1988, the Board of County Commissioners adopted
Resolution No. 567-1988 authorizing the Mayor/Chairman of
the Board to execute an Agreement for Baker Act Matching
Funds by and between the County and the Guidance Clinic of
the Upper Keys, Inc. concerning funding for Fiscal Year
1988-89.
Enclosed herewith is a certified copy of the sub-
ject Resolution and a fully -executed copy of the Agreement.
Very truly yours,
Danny L. Kolhage
Clerk of Circuit Court
and ex officio Clerk to
Board of County Commissioners
by:
Rosalie L. ,nnolly
Deputy Clerk
Enclosures
cc: Mayor E. Lytton
County Attorney
County Administrator
Finance Department
File
AGREEMENT FOR BARER ACT MATCHING FUNDS
THIS AGREEMENT, made this iS't day of �► ,
1988, between the BOARD OF COUNTY COMMISSIONERS OF MONROE
COUNTY, FLORIDA, hereinafter referred to as "BOARD", and the
GUIDANCE CLINIC OF THE UPPER KEYS, INC., hereinafter referred to
as "CLINIC",
For and in consideration of the mutual covenants made
herein, the parties agree as follows:
(1) The Board shall reimburse the Clinic twenty-five
percent (25%) of total $38,000.00 expenditures for Baker Act
hospital, physician, and crisis stabilization services, as billed
to the Clinic on state approved Baker Act Billing Forms (HRS
1005) 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
Nine Thousand Five Hundred Dollars ($9,500.00) during the period
beginning October 1, 1988, and ending September 30, 1989.
(2) The Clinic shall provide to the Board on a regular
basis a copy of the Baker Act Summary Billing Form from which
reimbursement due the Clinic can be calculated; however, in order
to comply with regulations safeguarding the 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 con-
trolled conditions to qualified auditors for audit purposes. The
Clinic shall also provide the Board all Baker Act statistical
data normally available to the Clinic and make an annual report
to the Board of the expenditure of County funds for the above
specified purposes.
(3) This agreement shall terminate at 11:59 P.M., September
30, 1989 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,
s
provided the Clinic 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
Clinic shall be made payable to the Guidance Clinic of the Upper
Keys, 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 Guidance
Clinic of the Upper Keys, Inc., has caused these presents to be
signed in its name by its President/Board of Directors and
Executive Director all as of the day and year first above writ-
ten.
(Seal)
Attest :DANNY L. I,OLHAGE, Clerk
er
Witnesses
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
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GUIDANCE CLINIC OF THE UPPER
KEYS, INC.
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APPROVED AS iO FORM
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