Backup Documents 06/25/2024 Item #16E 1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
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. Risk Risk Management
2. County Attorney's Office County Attorney OfficeC-33 y
4. BCC Office Board of County
Commissioners Cif /O J 7((I2`(
4. Minutes and Records Clerk of Courts Office /D Soa.*.J
7/1/.70A+
7)/44)
5. 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 Vanessa Diaz/Procurement Contact Information 239-252-8947
Contact/Department
Agenda Date Item was June 25,2024 Agenda Item Number 16.E.1.
Approved by the BCC
Type of Document A L Number of Original 1
Attached n/I CA JAI t/1+ Documents Attached
PO number or account N/A Third Amendment Millennium
number if document is to 14-6293 Physician Group,
to be recorded Millennium LLC
Physician Group,
LLC
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 N/A
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 VD
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-throughs and revisions have been initialed 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 VD
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 VD
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's 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 June 25,2024 and all changes made N/A is not
during the meeting have been incorporated in the attached document. The County GS an option for
Attorney's Office has reviewed the changes,if applicable. this line.
9. Initials of attorney verifying that the attached document is the version approved by the r e N/A is not
BCC,all changes directed by the BCC have been made,and the document is ready for the v> an option for
Chairman's signature. this line.
16E 1
THIRD AMENDMENT TO AGREEMENT #1-1-6293
FOR
"COLLIER COUNTY ON-SITE MEDICAL CLINIC"
THIS THIRD AMENDMENT, made and entered into on this 23 day of
, 2024, by and between Millennium Physician Group, LLC (the "Provider" or
"Millennium") and Collier County, a political subdivision of the State of Florida, (the "County" or
"Owner") (collectively, the "Parties"):
WHEREAS, on September 9, 2014 (Agenda Item 16.E.7), the County entered into an
Agreement with Provider, with a commencement date of November 14, 2014,to provide on-site primary
care health services with an initial five-year term with five (5) additional one (1) year renewal terms;
and
WHEREAS, on October 10, 2017 (Agenda Item 16.E.2), the County approved the First
Amendment to the Agreement expanding all four clinic models to include limited pharmacy services
with reimbursement from the County for the actual cost paid by Provider with no additional markup to
the County; and
WHEREAS, on October 8, 2019 (Agenda Item 16.E.3), the County approved the Second
Amendment to the Agreement to replace Exhibit A Scope of Services in its entirety, include pricing for
the next five-year period (Exhibit B-1 Fee Schedule) and renew the Agreement for an additional five (5)
year term with new Agreement set to expire on November 13, 2024.
WHEREAS, the Parties desire to extend the Agreement through December 31, 2025 and
include pricing for the extended period.
NOW, THEREFORE, in consideration of the mutual promises and covenants herein
contained, it is agreed by the Parties as follows:
1. The above recitals are hereby incorporated into this Third Amendment as if fully set forth herein.
2. The Parties agree to the updated pricing as depicted in Exhibit B-2, Provider Pricing, attached
hereto and incorporated herein by reference, which shall take effect on November 14, 2024.
3. The Parties further agree to extend the Agreement through December 31, 2025.
4. All other terms and conditions of the Agreement, as previously amended, shall remain the same.
SIGNATURE PAGE TO FOLLOW
Page 1 of 3
Third Amendment to Agreement#14-6293 CAO
16E 1
IN WITNESS WHEREOF, the Parties have executed this Third Amendment on the date and year
first written above by an authorized person or agent.
ATTEST:
Crystal K. Kinzel, Clerk of the Circuit BOARD OF COUNTY COMMISSIONERS
Court and Comptroller COLLIER COUNTY, FLORIDA
Qy. /O By:
WICh ' lal , Chairman Dated: , ,,I
(SEAL) e t.to.to•Cta. n s
Contractor's Witnesses: CONTRACTOR:
Millennium Physician Group, LLC
:gIat1II.e
3.
I Ty)e/print witness nam�eT 1 TType/print signature and title I
l
01,),,i y
Second Witness Da e
V I I) t ,�1 . ,,A � cS
I Type/print witness nameT
Approved as to Form and Legality:
Carl , anne Sanseverino CAS LiFiclui
Assistant County Attorney
Page 2 of 3
Third Amendment to Agreement #14-6293
CAO
16E
EXHIBIT B-2
PROVIDER PRICING
PRICING YEAR 11
(November 14, 2024 through December 31, 2025)
Estimated Eligible Health Plan Enrollment
Enrollee 2,236
Spouse 1,015
Dependents over age 15 1,025
Main Site Operation on Collier County Complex Grounds
MAIN YEAR 11
Option 1 Rate Total Cost Opt 1
Monthly Staffing cost(state as PEPM) $13.92 $375,426.91
Office, Medical Supplies and Insurance $3.60 $96,620.95
(State as PEPM)
Management Fee(state as PEPM) $2.63 $70,507.18
Implementation Fee(lump sum paid at inception) $0
Total PMPM $20.15 $540,555.04
NORTH YEAR 11
Option 1 Rate Total Cost Opt 1
Monthly Staffing cost(state as PEPM) $7.17 $192,314.56
Office, Medical Supplies and Insurance $1.85 $49,759.79
(State as PEPM)
Management Fee(state as PEPM) $1.35 $36,311.20
Implementation Fee(lump sum paid at inception) $0
Total PMPM $10.38 $279,385.55
Page 3 of 3
Third Amendment to Agreement#14-6293 CAO