Resolution 044-1987
David P. Rice, Ph.D., Executive
Director - Guidance Clinic of
the Middle Keys, Inc.
RESOLUTION NO. 044-1987
A RESOLUTION OF THE BOARD OF COUNTY COMMMIS-
SIONERS OF MONROE COUNTY, FLORIDA,
AUTHORIZING THE MAYOR AND CHAIRMAN OF THE
BOARD TO EXECUTE AN AGREEMENT FOR BAKER ACT
MATCHING FUNDS BY AND BETWEEN THE BOARD AND
THE GUIDANCE CLINIC OF THE MIDDLE KEYS, INC.
CONCERNING FUNDING FOR FISCAL YEAR 1986-87.
BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF
MONROE COUNTY, FLORIDA, as follows:
That the Mayor and Chairman of the Board of County Commis-
sioners of Monroe County, Florida, is hereby authorized to
execute an Agreement for Baker Act Matching funds by and between
the Board and the Guidance Clinic of the Middle Keys, Inc., a
copy of same being attached hereto, concerning funding for fiscal
year 1986-87.
PASSED AND ADOPTED by the Board of County Commissioners of
Monroe County, Florida, at a regular meeting of said Board held
on the ~ t'~ day of -J~ M aG. It-- ~
, A.D. 1987.
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
(SEAL)
Y (f ?i/ n/. d
et- ~oR-h~.5//~
Attes t: DANNY L. I:::'OLIIAGZ, Clerk
-,Q~,IJ~ '&.~
LERK r
!lPP~lf[) AS TO FORM
A 9:U=,9/1.L SupnCfEhCY
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AGREEMENT FOR BAKER ACT MATCHING FUNDS
THIS AGREEMENT, made this
day of
, 198
, by
and between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY,
FLORIDA, hereinafter referred to as "BOARD", and the GUIDANCE CLINIC
'..
OF THE MIDDLE KEYS, INC., hereinafter referred to as "CLINIC",
For and in consideration of the mutual covenants made herein, the
parties hereby agree as follows:
(1) The Board agrees to reimburse the Clinic twenty-five percent
(25%) of total $129,524.00 expenditures for Baker Act hospital,
physician, and crisis stabilization services, as billed to the Clinic
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 Two Thousand Three
Hundred Eighty One Dollars ($32,381.00) during the period beginning
October 1, 1986, and ending September 30, 1987.
(2) The Clinic agrees to 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, copies of individual client
bills will not be available for inspections by the Board for reim-
bursement purposes in order to comply with regulations safeguarding
the patient's right to confidentiality.
Copies of individual client
bills are kept on file in the Clinic business office and will be made
available under controlled condition to qualified auditors for audit
purposes.
The Clinic further agrees to provide the Board any Baker
Act statistical data normally available to the Clinic and to make an
annual report to the Board of the expenditure of County funds for the
above specified purposes.
This agreement shall terminate at 11:59 P.M., September 30, 1987
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 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 Middle 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 Middle 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
written.
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Mayor/Chairman
(Seal)
Attest:
Clerk
GUIDANCE CLINIC OF THE MIDDLE
KEYS, INC.
By ~~;t:::
P esident/Board of Directors
BY~~~
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/Z~/L ~J~HZ
~ Witnesses
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