5th Amendment 08/20/2014 cci
11,11_I_Y
Received c ECUTED
STATE OF FLORIDA
OCT 3 0 2014
COMMISSION FOR THE TRANSPORTATION DISADVANTAGED
MEDICAID NON-EMERGENCY TRANSPORTATION (NET) PROGRAM
Finance Dept. SUBCONTRACTED TRANSPORTATION PROVIDER AGREEMENT
AMENDMENT NO. 5
A-Il9ttf4'00.
This amendment entered into ort-JiIrAt 2014, by and between the Guidance/Care Center, Inc.,
hereinafter called "Coordinator" and Monroe County Board of County Commissioners/Monroe County Social
Services, hereinafter called "Provider".
WITNESSETH:
WHEREAS, this amendment and extension is necessitated by the implementation of Florida's Managed
Medical Assistance Program administered by the Agency of Health Care Administration and is beyond the control
of the Coordinator and/or the Commission for Transportation Disadvantaged.
NOW, THEREFORE, the aforesaid Agreement is hereby amended in the following respects:
1. Services and Performance: The services and performance of the agreement is not changed.
2. Term of Agreement: The term of the agreement is extended and will remain in effect until
August 31, 2014.
3. Compensation and Payment: Effective July 1, 2014. Section I is deleted in its entirety to remove the
previous contract ceiling and is replaced with the following:
For the satisfactory performance of the service and the submittal of Encounter Data as outlined in Exhibit
A, Scope of Service, the Provider shall submit monthly trip data in a format acceptable to the Coordinator.
The Provider will be paid, after the Coordinator has received payment from the Commission, in the
amount of$1.33 per mile, and $3.00 flat rate per client per multiload for Medicaid eligible trips. The
Provider shall submit invoices in a format acceptable to the Coordinator.
4. Exhibit A, Scope of Services: The Coordinator shall pay the Provider upon satisfactory completion of all
terms and conditions specified in the Agreement, per mile or flat rate for each category listed below. The
number of Medicaid recipients for each category shall be provided to the Coordinator monthly.
Medicaid Recipients Enrollment Categories:
Excluded Population
• Children receiving services in a prescribed pediatric extended care center(PPEC)
• Presumptively Eligible Pregnant Women (PEPW)
• Women who are eligible only for breast and cervical cancer services
Voluntary Population
• Recipients who have other creditable health care coverage, excluding Medicare
• Recipients enrolled in the home and community based services waiver pursuant to Chapter 393
needing transportation to a non-waiver Medicaid compensable service, and recipients waiting for
waiver services(Persons with Developmental Disabilities).
Mandatory Population
• Medicaid eligible persons not enrolled in a plan. •
5. Exhibit A, Scope of Services-XI Method of Payment: Effective July 1, 2014, Section C. is deleted in its
entirety.
EXCEPT as hereby modified, amended, or changed, all other terms of the Agreement dated January 1, 2010, and
amendments 1, 2, 3, 4 shall remain in full force and effect.
In witness whereof, the authorized representatives of the parties have executed this AMENDMENT, effective
July 1, 2014.
Guidance/Care Center, Inc. Board
L
ofC Commissioners, Monroe County
URE SIGNATURE
Director of Transportation 07/01/14 1?94G1OK
TITLE DATE TITLEE✓✓ DATE
L�. ly Maureen Grynewicz iV/Gt T Inturpl y
PRINTED NAME PRINTED NAME
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MO OE COUNTY RN
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