Backup Documents 09/26/2017 Item #16D19 ORIGINAL DOCUMENTS CHECKLIST & ROUTING S
D 19
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney
Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney
Office no later than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with
the exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1. County Attorney Office County Attorney Office
C
2. BCC Office Board of County b '
Commissioners V-^fs"/ 9k2.- V
3. Minutes and Records Clerk of Court's Office
4)6- C, n
4. Procurement Services Procurement Services
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event
one of the addressees above,may need to contact staff for additional or missing information.
Name of Primary Staff Barbara Lance Contact Information 239-252-8998
Contact/ Department /
Agenda Date Item was 91.1244-7" _ 11- Agenda Item Number 16.D
Approved by the BCC
Type of Document Amendment i Number of Original .rl'Q
Attached Documents Attached
PO number or account N/A 12-5854 Managed Care Naples Physician
number if document is Service Hospital
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature STAMP OK 13e- e) J
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be BL
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have beenninitialed by the County Attorney's N/A
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the N A
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's BL
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip N'A
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on 09 017 and all changes made during
the meeting have been incorporated in the attac a document. The County
Attorney's Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the
BCC,all changes directed by the BCC have been made,and the document is ready for t -
Chairman's signature.
16019
AMENDMENT#1 TO THE AMENDED AND RESTATED MANAGED CARE SERVICE
AGREEMENT WITH NAPLES PHYSICIAN HOSPITAL ORGANIZATION,INC.,d/b/a
COMMUNITY HEALTH PARTNERS,MANAGED CARE SERVICE AGREEMENT
This Amendment# 1 to the Amended and Restated Managed Care Service Agreement (the
"Amended and Restated Agreement")effective as of the /(1" day of Se n. , 2017 , (the
"Effective Date"), is entered into by and between Naples Physician Hospital Organization, Inc. d/b/a
Community Health Partners("CHP"or"Contractor")and Collier County,Florida,a political subdivision
of the State of Florida("County").
WITNESSETH:
WHEREAS, on December 13, 2016, Item 16.E.2, an Amended and Restated Agreement was
approved in its entirety and superseded original Agreement# 12-5854 to extend the term thereof at the
same rates and to revise the scope of work to remove those services described as the Smartchoice
Program,Health Advocacy Program and the Workcare Program;and
WHEREAS, the County desires to further amend the Agreement to include case management
chart review and referral services to allow the Operations and Veteran Services Division to assist in client
claims requiring in-depth medical history analysis;and
NOW, THEREFORE, for and in consideration of the mutual covenants contained herein, the
Parties agree to amend the Amended and Restated Agreement as follows:
Words Struckough are deleted; Words Underlined are added
REMAINDER OF PAGE LEFT BLANK INTENTIONALLY
Page 1 of 3
16019
ARTICLE H
PROVISION OF SERVICES
2.3 MANDATORY CASE MANAGEMENT
Community Health Partners(CHP)will be responsible for:
• Monitoring a Covered individual's emerging risk, a condition or diagnosis that may be potentially
significant by utilizing several different methods such as Verisk Medical Intelligence, Notification
request,Pharmacy and TPA reports.
• CHP Registered Nurse Case Managers communicating on a weekly basis until less intensity is needed
as determined by the Case Manager or the Covered Person is dis-enrolled from program.
• Communicating with individuals in the form of letters,phone calls,face to face meeting or encrypted
email.
• CHP Registered Nurse Case Managers, or Medical Doctor (MD) as required, provide medical chart
review and referral services for client claims.
***
SCHEDULE 4.7
PROGRAM FEES
Board of County Commissioners,Collier County,Florida shall pay Community Health Partners monthly
the fees listed below for the Managed Care Programs that are indicated as purchased.The fee(s)shall be
paid upon receipt of a proper invoice and in accordance with Chapter 218,Florida Statutes,also known as
the"Local Government Prompt Payment Act."Fees to be disbursed to:
Community Health Partners
851 Fifth Avenue N. Suite 201
Naples,FL 34102
Utilization Management/Case Management Fee:
CHP Utilization Review Management program with
Large Case Management/Care Coordination including Maternity
Management
$2.60 per employee per month
Case Management Medical Chart review/Referral Services
Registered Nurse $60.00/per hour
Medical Doctor(MD) $125.00/per hour
All other terms and conditions of the Amended and Restated Agreement shall remain in force.
Page 2 of 3
1 6 D 19
IN WITNESS, WHEREOF, the parties have caused this Agreement to be duly executed as of the
Effective Date.
BOARD OF COUNTY COMMISSIONERS
COLLIER C 040 FLORIDA
A 1"1 EST:
Dwight E.Brock,Clerk of Courts
By: //A_I!✓
'ENVY TAY,! ' • I' -7-
By: ' I. 1 ,i '
Dated: C KirilDate: c Z1\�
--Attest as too
(siNture only.;
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w.tiy 'D
,fj. • •
Ap ro,ed as + Form :, ty:
MP
Scott R.Teac s
Deputy County Attorney
NAPLES PHYSICIAN HOSPITAL ORGANIZATION,INC.d/b/a COMMUNITY HEALTH
PARTNERS
ATTEST:
By: fN
AAABrian . of MDCo-Chairman
orporateSeereliteek
Date: \� �r
siet,eLe to;-/-e/
Print Name
BY� eZZ--..
Kevin Cooper,Co-Chairman
Date:
pt.. ."+.242- 1
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