2023-08-15 VI. E. Exhibit 7 • •
Exhibit 7
08/15/2023
PIGGY:ACK AGREEMENT ADDENDUM NUMBER 6 BETWEEN
THE CITY OF OKEECHOBEE AND
OKEECHOBEE MEDICAL PROVIDERS, INC.
THIS PIGGYBACK AGREEMENT ADDENDUM NUMBER 6 ("Addendum") is made by and
between the CITY OF OKEECHOBEE (hereinafter the "CITY"), and OKEECHOBEE
MEDICAL PROVIDERS, INC., a subsidiary of Treasure Coast Medical Associates
(hereinafter "TCMA" or "PROVIDER").
WHEREAS, CITY desires to procure healthcare services with and through medical
professionals duly licensed and qualified to provide such services and to manage and
operate an employee health center;
WHEREAS, Okeechobee County entered into a contract with PROVIDER on or about
October 1, 2020 and has extended said contract thereafter through various renewals
(hereinafter collectively "County Agreement");
WHEREAS, CITY originally entered into a piggyback agreement with PROVIDER on or
about October 3, 2017 and has extended said agreement thereafter through various
addenda (hereinafter, the piggyback agreement and addenda shall be referred to
collectively as the "Piggyback Agreement");
WHEREAS, CITY is required to amend the Piggyback Agreement to incorporate the newly-
enacted Florida Statutes Section 287.05701;
WHEREAS, Certain CITY employees presently do not to participate in 'the group health
insurance plan through the group health insurance provided through the CITY due to cost
issues;
WHEREAS, the Piggyback Agreement may enable certain CITY employees and their
eligible dependents to participate in the medical services with PROVIDER; and
WHEREAS, as described in the Piggyback Agreement, the fees would be through payroll
deduction, or if retired, fees must be paid prior 'to the 25th of the month, for benefits to be
paid for the following month. For those employees not participating in employee health
insurance the city will pay the monthly fee;
NOW, THEREFORE, in consideration of the promises and mutual covenants contained
herein and for other good and valuable considerations, the receipt and sufficiency of which
are hereby mutually acknowledged, the parties agree as follows:
1. Recitals. The above recitals are true and correct and are incorporated into 'this
Addendum by reference.
2. Terms and Conditions. This Addendum shall, except as otherwise stated herein,
be subject to the terms and conditions of the County Agreement, which is attached
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and incorporated herein as Exhibit A. and the Piggyback Agreement, which
is attached and incorporated herein as Exhibit B.
3. Effective Date. This Addendum shall become effective on August 14, 2023
4. Term. This Addendum shall expire on September 30, 2024.
5. Termination. The parties adopt and incorporate the provisions of Section 3.2 of
the County Agreement into this Addendum as the method of termination.
6. Extensions. This Addendum may be extended, from time to time, utilizing
an addendum.
7. Public Records. Pursuant to Florida Statutes § 119.0701, to the extent
PROVIDER is performing services on behalf of the CITY, PROVIDER shall
adhere to the Florida public records laws as set forth in Exhibit B, Section 7.
8. Amendment to Piggyback Agreement. The "Agreement to Piggyback a
Contract for Services Bid by Another Governmental Entity", dated October 3,
2017 and incorporated herein as part of Exhibit A, is hereby amended to add
the following section 8:
8. RESPONSIBLE VENDOR DETERMINATION: TCMA is hereby notified that
Section 287.05701, Florida Statutes, requires that the City of Okeechobee may
not request documentation of, or consider, a vendor's social, political, or
ideological interests when determining if the vendor is a responsible vendor.
9. Reimbursable Operating Expenses. Exhibit C, attached hereto and
incorporated by reference, sets forth the Reimbursable Operating
Expenses applicable to participants.
10. Monthly Administration Fee. Exhibit D, attached hereto and incorporated by
reference, sets forth the Monthly Administration Fee.
[SIGNATURE PAGE FOLLOWS]
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IN WITNESS WHEREOF, the CITY and PROVIDER have made and executed this
Addendum to the Piggyback Agreement.
AS TO THE CITY: AS TO THE PROVIDER
Dowling R. Watford, Jr., Mayor Issy Rossman
CEO, TCMA Care
ATTEST: WITNESSES:
Lane Gamiotea, City Clerk Signature
Signature
REVIEWED FOR LEGAL SUFFICIENCY:
John J. Fumero, City Attorney
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TC MAi
TREASURE COAST
MEDICAL ASSOCIATES
OKEECHOBEE BOARD OF COUNTY
COMMISSIONERS,
CLERK OF THE COURT, SUPERVISOR OF
ELECTIONS, SHERIFF, PROPERTY APPRAISER,
AND TAX COLLECTOR
Okeechobee County
Employee Hea t
Center
CONTRACT
AUGUST 13, 2020
OKEECHOBEE MEDICAL PROVIDERS, INC
3405 NW Federal Highway Jensen Beach, Fl 34457
EXHIBIT A
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OKEECHOBEE COUNTY EMPLOYEE HEALTH CENTER AGREEMENT
THIS OKEECHOBEE COUNTY EMPLOYEE HEALTH CENTER
AGREEMENT (the "Agreement") is made by and between Okeechobee Medical Providers,
INC., a Florida corporation and subsidiary of Treasure Coast Medical Associate's Inc, with an
address of 3405 NW Federal Highway, Jensen Beach, FL 34957 ("Provider"), and the
OKEECHOBEE COUNTY BOARD OF COUNTY COMMISSIONERS, a political
subdivision of the State of Florida (individually "BOARD OF COUNTY
COMMISSIONERS"), OKEECHOBEE COUNTY CLERK OF THE CIRCUIT COURT
AND COMPTROLLER, a Constitutional Officer of the State of Florida (individually the
"Clerk"), OKEECHOBEE COUNTY SUPERVISOR OF ELECTIONS, a Constitutional
Officer of the State of Florida (individually "Supervisor"), OKEECHOBEE COUNTY
SHERIFF, a Constitutional Officer of the State of Florida (individually "Sheriff),
OKEECHOBEE COUNTY PROPERTY APPRAISER, a Constitutional Officer of the
State of Florida (individually "Property Appraiser"), and OKEECHOBEE COUNTY TAX
COLLECTOR, a Constitutional Officer of the State of Florida (individually "Tax
Collector"), with a mailing address of 304 NW 2nd Street Okeechobee, FL 34972 ( collectively
the "County").
RECITALS:
WHEREAS, Okeechobee County seeks to provide access to quality health care and to
improve the health and wellness of its employees and other eligible persons through the
provision of central services at its Employee Health Center located at (TCMA Urgent
Care Facility Okeechobee, FL); and
WHEREAS, Okeechobee County specifically wishes to offer urgent care, primary
care, and occupational health services including but not limited to evaluation and treatment of
work related injuries and illnesses, occupational health exams, health assessments, call support,
immunizations, injections, exams and screenings, prescription dispensing, disease
management and primary case management at Okeechobee County Employee Health
Center to its employees and other eligible persons; and
WHEREAS, Provider is a provider of health care services and employs or contracts with
Medical Professionals duly licensed and qualified to provide such services and to manage and
operate Okeechobee County's Employee Health Center;and
WHEREAS, it is the desire of the parties hereto to enter into a contractual agreement
whereby Provider will provide central and management services under the terms and conditions
herein.
NOW, THEREFORE, in consideration of the promises and the mutual covenants
contained herein, the parties hereto do agree as follows.
EXHIBIT A
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DEFINITIONS
"Administrative Fee"shall have the meaning set forth in Section 4.1.
"Central Services"or"Services"shall have the meaning set forth in Section 1.1.
"Covered Persons" shall mean (i) Eligible Employees, (ii) Eligible Dependents (spouses and
children), and (iii) Retirees.
"Effective Date" shall have the meaning set forth in Section 3.1.
"Eligible Dependent" means an individual enrolled as a qualified dependent of a Okeechobee
County employee or COBRA participant currently participating in the Okeechobee County's
health insurance plan for General Employees. The minimum age shall be established by Provider
based upon the Medical Professionals' expertise but in any event the minimum age established
shall not be less than 3 months old.
"Eligible Employee" means a current, regular status employee or COBRA participant who is
currently participating in Okeechobee County's health insurance plans. An eligible employee is
also an employee or dependent that is not participating in Okeechobee County's health insurance
plan but does pay Okeechobee County to utilize TCMAi Urgent Care facilities.
"ERR" shall mean Provider's electronic health records system.
"HIPAA" shall mean the Health Insurance Portability and Accountability Act of 1996, as
amended.
"Management Services" shall have the meaning set forth in Section 1.2.
"Medical Assistant"shall mean a certified medical assistant and x-ray technician duly licensed in
the State of Florida to provide medical assistance to the Medical Professionals.
"Medical Professionals" shall mean a Physician, Physician Assistant, Nurse Practitioner, as
described herein, or other professional duly licensed in the State of Florida to provide medical
services.
"Nurse Practitioner" shall mean an Advanced Registered Nurse Practitioner ("ARNP")
appropriately licensed within the State of Florida operating within the scope of their license.
"Personnel"shall collectively refer to the Medical Professionals and any supportpersonnel.
"Physician"shall mean a board certified or board eligible Medical Doctor("M.D.") or Doctor of
Osteopathic Medicine ("D.O.")appropriately licensed in the State of Florida operating within the
scope of their license and licensed to dispense pre-packaged medications.
"Physician Assistant" means a Physician Assistant appropriately licensed within the State of
Florida operating within the scope of their license.
EXHIBIT A 2
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"Prospective Employees"shall mean post offer applicants for employment with the Okeechobee
County who are eligible to receive pre-employment physicals and drug testing at the Okeechobee
County's Employee Health Center.
"Protected Health Information" or "PHI" shall mean information as defined by the Health
Insurance Portability and Accountability Act of 1996, as amended, and by all federal and state
privacy requirements.
"Reimbursable Operating Expenses" shall have the meaning set forth in Exhibit E.
"Services"shall refer collectively to the Central Services and the Management Services.
"Supplies" shall mean the supplies reasonably necessary for the delivery of the Central Services
including but not limited to pharmaceuticals, dressings, bandages, syringes, blood draw supplies,
patient forms, and information.
"Workers' Compensation Services" shall mean services provided in accordance with Chapter
440, Florida Statutes.
ARTICLE I
COVENANTS AND RESPONSIBILITIES OF PROVIDER
1.1 Central Services. Provider shall provide those central services set forth in the Scope of
central services attached hereto as ExhibitA and incorporated herein("Central Services").
a. Workers' Compensation. The central services shall include Worker's Compensation
services provided that prior to treating Okeechobee County employees for injuries on
the job, Provider shall establish written protocols in compliance with Chapter 440,
Florida Statutes. Provider shall provide the protocols to the Okeechobee County's
Project Representative for Okeechobee County's review prior to the Effective Date of
this Agreement. Any fines or assessments issued by the State of Florida to either
Okeechobee County or Provider for failure to comply with Section 440.13, Florida
Statutes, shall be the responsibility of Provider.
b. Physicals and Drug Screens. Provider shall, in consultation with Okeechobee
County's Project Representative and Risk Manager, develop minimum standards for
all physicals and drug screening. The minimum standard for pre-employment physical
results will be; 4 business days from the day the employee comes to Okeechobee
County's Employee Health Clinic for the evaluation. The drug screening results
minimum standard will be 4 business days, depending on the need of the drug screen
being sent out to a lab for the chain of custody process.Copy of Physical Form attached
hereto as Exhibit G.
EXHIBIT A 3
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c. Claims. All Division of Worker's Compensation claim required forms shall be sent to
Okeechobee County's Risk Management and Okeechobee County's third party
administrator by end of Okeechobee County's Employee Health Center's business
day. Results of all drug and alcohol testing in connection with Worker's Compensation
claims must be sent to Okeechobee County's Risk Management by end of
Okeechobee County's Employee Health Center's business day.Provider acknowledges
that Okeechobee County desires to accommodate any and all temporary physical
restrictions placed on an employee.
d. Laboratory Testing. The procedure for any tests that cannot be provided at
Okeechobee County's Employee Health Center will be; The patient will be given a
prescription for the test to be taken to a lab that is an in-network with the patient's
Health PIan to avoid any out of pocket expense for Okeechobee County or for the
patient.
1.2 Management Services. Provider shall provide those management and administrative
services necessary for the effective and efficient operation of Okeechobee County's Employee
Health Center, subject to the reasonable policies set forth by Okeechobee County, as more
specifically described in the Scope of Management Services attached hereto as Exhibit B and
incorporated in this Agreement("Management Services"). As part of the Management Services,
Provider shall administer Health Risk Assessments to all Okeechobee County employees and will
offer the programs to Eligible Employees at no additional cost.
1.3 Licensing. Provider shall obtain and maintain in good standing all licenses required to
provide the Services at Okeechobee County's Employee Health Center at the sole cost of the
Provider.
1.4 Personnel.
a.Provider will provide a sufficient number of Medical Professionals and/or support
personnel as needed, based on number of visits, to perform the Central Services for
Okeechobee County's Employee Health Center. Staffing for Okeechobee
County's Employee County Health Center shall include a Physician, and or Nurse
Practitioner/Physician's Assistant, Medical Assistant/BXMO or Radiology Tech and
Receptionist.
1.5 Standards of Medical Professional's Performance. Provider shall contract with
the Medical Professionals such that all Medical Professionals providing services at
Okeechobee County's Employee Health Center are obligated to perform or deliver the following:
a. The Medical Professionals shall determine their own means and methods of providing
the Services with oversight and quality control functions performed by Provider.
b. Referrals by the Medical Professionals for additional medical care shall be made
according to evidence based medicine and best practice protocols and will be tracked
through Provider's Electronic Medical Records Program. Unless patient preferences
EXHIBIT A 4
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dictate otherwise, the Medical Professionals shall use their best efforts to utilize the
providers in Okeechobee County's applicable health plan networks or
Okeechobee County's Third Party Administrator's provider network for Workers'
Compensation, as applicable, taking into account geographical convenience for the
employee.
c. The Medical Professionals shall comply with all applicable laws and regulations with
respect to the licensing and regulations of medical professionals.
d. The Medical Professionals shall provide the Services in a manner consistent with all
applicable laws and regulations and in a professional manner consistent with medical
services provided in the community.
e. The Medical Professionals shall maintain, during the term of this Agreement,
appropriate credentials including (i) a duly issued and active license to practice
medicine in the State of Florida without limitation or restriction;(ii)good standing with
his or her profession and state professional association; (iii) the absence of any license
restriction, revocation or suspension; (iv) the absence of any involuntary restriction
placed on his or her federal Drug Enforcement Administration ("DEA") registration;
and (v)the absence of any conviction of a felony.
f. In the event that any Medical Professional(i)has his or her license restricted, revoked
or suspended, (ii) has an involuntary restriction placed on his or her federal DEA
registration, (iii) is convicted of a felony; or(iv) is no longer in good standing with his
or her profession and/or state, Provider shall immediately remove that Medical
Professional and replace such Medical Professional with another Medical Professional
that meets the requirements of this Agreement. Provider shall replace any Medical
Assistant who has his or her professional license, restricted, revoked or suspended, is
convicted or a felony, or is no longer in good standing with his or her professional or
state professional or state licensing authority.
g. Provider shall require the Medical Professional to ensure that any Medical Assistant
complies with the requirements of this Section 1.5.
1.6 Training and Expertise. Provider represents and warrants that the person or persons
performing the Services specified herein have the requisite training, licenses, and expertise
necessary to fully and satisfactorily complete their obligations hereunder. Provider agrees that if
further training or expertise is or becomes necessary or is required to fully and satisfactorily
complete their obligations that Provider, or the person or persons employed by Provider, shall
obtain such training, licenses, or expertise. This provision shall not apply to the costs of any
continuing education included as a Benefit. Provider further acknowledges that Okeechobee
County shall have no responsibility or duty to provide any such training, licenses or expertise for
Provider which may be necessary or required of Provider in order to fully and satisfactorily
complete its obligations, and that any fees in connection therewith shall be borne solely by
Provider, and not Okeechobee County. Prior to commencement of the Services under this
Agreement, Provider shall provide to Okeechobee County reasonable evidence of the
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EXHIBIT A
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qualifications of such Personnel. Provider will ensure that all Personnel complete and pass
background checks to verify licensing and training.
1.7 Quality of Work. Provider represents and warrants that:
a. the Services to be performed under this Agreement shall be accomplished in a
professional and competent manner consistent with the level of care and skill ordinarily
exercised in the trade under similar circumstances.
b. all deliverables and Services provided under this Agreement will be of merchantable
quality and fit for the particular purposes of Okeechobee County.
c. Provider will comply with all applicable federal,state and local laws,rules,regulations
and orders in connection with the performance of its obligations hereunder.
d. Provider shall establish protocols for the operation of Okeechobee County's
Employee Health Center for use by the Personnel and shall,upon request,provide such
protocols to Okeechobee County. Such protocols shall remain the proprietary
information of Provider and shall be returned to Provider after the expiration or earlier
termination of this Agreement;and
1.8 Hours of Operation. Provider shall provide the Services at Okeechobee County's
Employee Health Center a minimum of sixty-eight (68) hours per week in accordance with the
schedule attached hereto as Exhibit 0. Any modifications to the operating schedule based on
demand are subject to Okeechobee County's prior written approval. A minimum of at least
one of the Physician, Physician Assistant or Nurse Practitioner shall always be on site that the
facility is open.
1.9 Eligibility. Eligibility to receive Central Services is limited to Covered Persons.
Provider shall verify that a person coming to Okeechobee County's Employee Health Center is a
Covered Person and Okeechobee County shall require Covered Persons to produce photo
identification.
1.10 Compliance with Laws. Provider covenants and agrees that it and any of its subcontractors
and agents are bound by and will observe and perform all duties required under all applicable local,
state and federal laws, ordinances, rules and regulations including but not limited to Title VII of
the Civil Rights Act of 1964 (Pub. L. 88-352), as amended, Occupational Safety and Health Act
of 1970 29 U.S. C. Section 651 et seq., as amended, Employee Retirement Income Security Act
of 1974, the Health Insurance Portability and Accountability Act of 1996, as amended, the
Consolidated Omnibus Budget Reconciliation Act, the Social Security Act, the United States Fair
Labor Standards Act and the Immigration Reform and Control Act. Provider further covenants
and agrees that with respect to laws applicable to the establishment or maintenance of an on-site
health center, Provider shall take any and all actions necessary to conform to such laws.
1.11 Project Representative. Provider hereby designates Jonathan M. Adelberg MD FAEP
Medical Director TCMA, as Provider's project representative ("Provider Project
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EXHIBIT A
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Representative") to represent Provider in all of its dealings with Okeechobee County relating to
the operation and management of Okeechobee County's Employee County Health Center.
Provider may replace the Project Representative at its sole discretion upon prior written notice to
Okeechobee County.
1.12 Dispensing Pre-Packaged Prescriptions. The facility shall dispense pre-packaged
prescription drugs to Covered Persons. The basic formulary will be determined based on the
prescription utilization and financial benefit to Okeechobee County versus costs through the
insurance plan or as agreed upon should changes and adjustments be desired by Okeechobee
County in accordance with the dispensing laws of the State of Florida. All medications will be
stocked in accordance with applicable regulations. No controlled substances will be stocked.
Provider will track and make every reasonable effort to maintain inventory levels necessary to
meet patient needs as forecasted through expected utilization with the understanding the Medical
Professional maintains autonomy when it comes to medication prescribing and determining what
is medically necessary with regard to patient care.
1.13 Provider shall allow Covered Persons to utilize the Stuart Urgent Care facility located at
3405 NW Federal Hwy., Jensen Beach, FL 34957, Okeechobee Urgent Care located at 305 NE
Park Street, Okeechobee, and Highlands Urgent Care located at 7195 S George Blvd. , Sebring FL
33875 at no additional charge to the Okeechobee County or the Covered Persons.
ARTICLE II
COVENANTS AND RESPONSIBILITIES OF THE OKEECHOBEE COUNTY
2.1 Utilities and Cleaning. The Provider will be responsible for maintaining the Utilities and
cleaning of the facility.
2.2 Covered Persons. The County shall provide access to Okeechobee County's Employee
Health Center only to Covered Persons as defined above, unless otherwise agreed to by the
parties. Okeechobee County will make its best efforts to ensure that Covered Persons are aware
of the availability of Provider's Services. Prior to the first (1') of each month, Okeechobee
County shall provide Provider a listing of all "Covered Persons" in mutually agreed upon file
format. Okeechobee County shall identify Prospective Employees on an ongoing, as needed
basis.
2.3 Project Representative. Okeechobee County hereby designates the following project
representatives to represent Okeechobee County in all of its dealings with Provider relating to the
operation and management of Okeechobee County Employee Health Center:
Robbie Chartier, County Administrator
Clerk of the Circuit Court& Comptroller
Property Appraiser
Sheriff
Supervisor of Elections
Tax Collector
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EXHIBIT A
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ARTICLE III
TERM AND TERMINATION
3.1 Term. This Agreement shall commence on October 1, 2020 (Effective Date) and shall
continue for a term of three (3)years. Unless terminated as provided for herein, the County shall
have the exclusive right to renew the Agreement for a maximum of two (2) consecutive one (1)
year terms prior to the expiration of each term of the Agreement. Any such renewal shall be by
written contract amendment duly executed by the parties.
3.2 Termination.
a. The County and Okeechobee Medical Providers, Inc. shall have the right to
terminate this Agreement, in whole or in part, with or without cause, and for its convenience, upon
ninety (90)days written notice to Provider or County.
b. Either party shall have the right to terminate this Agreement, with cause, upon the
default by the other party of any term, covenant or condition of this Agreement, where such
default continues for a period of fourteen (14) business days after the defaulting party receives
written notice from the other party specifying the existence of the default, or beyond the time
reasonable necessary for cure if the default is of a nature to require more than fourteen (14)
business days to remedy and the defaulting party is making diligent, good faith efforts to cure
such default.
c. In the event of termination, the County shall compensate Provider for all
authorized services satisfactorily performed through the termination date under the payment terms
contained in this Agreement.
d. Provider shall immediately deliver all documents, written information, electronic
data and other materials concerning Okeechobee County Employee Health Center in its
possession to the County and shall cooperate in transition of the Services to appropriate parties at
the direction of the County.
e. Upon termination, this Agreement shall have no further force or effect and the
parties shall be relieved of all further liability hereunder, except that the provisions of this Section
and the provisions regarding the right to audit, property rights, insurance, indemnification,
governing law and litigation shall survive termination of this Agreement and remain in full force
and effect.
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EXHIBIT A
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ARTICLE IV
ADMINISTRATIVE FEES AND REIMBURSABLE EXPENSES
4.1 Administrative Fee and Medical Staffing Costs.The Services by Provider,and the performance of
all of its other duties and obligations as set forth in this Agreement,the County shall pay Provider an
administrative fee outlined in Exhibit H "Monthly Administration Fee".
4.2 Reimbursable Expenses. The County shall reimburse Provider for:
a. the pass-through operating expenses identified in the summary attached hereto as
Exhibit E,(collectively,the"Reimbursable Operating Expenses").No other expense shall be
passed through to the County without the County's prior written consent.
4.3 Best Obtainable Prices. In purchasing and replenishing supplies, Provider shall use
reasonable efforts to find the best obtainable prices.The County's obligation to reimburse Provider
shall be"at cost"and less any applicable discounts,rebates and other savings passed on to Provider
by suppliers and without any additional mark up or overhead charge.
4.4 Invoices. Two invoices shall be prepared monthly:
a. Administrative Fee: Prior to the beginning of each month starting at the Effective Date,
Provider will submit an invoice based on the Eligible Employee headcount provided
by the County for that month.
b. Reimbursable Expenses: By the 15th of each month, Provider will submit an invoice
for Reimbursable Expenses incurred/invoiced during the previous calendar month.
4.5 Payment of Fees and Reimbursable Expenses will be made in accordance with the Local
Government Prompt Payment Act, Section 218.70, et al., Florida Statutes, as amended, which
provides prompt payment, interest payments, a dispute resolution process and payments for all
purchases be made in a timely manner for properly executed invoices by local governmental
entities.
4.6 No payment made under this Agreement shall be conclusive evidence of the performance
of this Agreement by Provider,either wholly or in part, and no payment shall be construed to be
an acceptance of or to relieve Provider of liability for the defective,faulty or incomplete rendition
of the Services.
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EXHIBIT A
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ARTICLE V
RECORDS
5.1 Medical Records. Provider shall maintain medical records for each Covered Person who
receives services performed by Provider at Okeechobee County Employee Health Center in a
professional manner consistent with the accepted practice of the community in which the
Physician and any Medical Professionals provide the services and applicable law. Such medical
records shall be the property of Provider. Provider shall be solely responsible for the storage,
maintenance, and confidentiality of such records in accordance with the provisions of Section
8.2 below. Provider shall be responsible for fulfilling all requirements imposed by state, local
and federal law with respect to the preparation, maintenance, security, disclosures, and retention
of medical records. Provider agrees to keep and maintain any medical records for the longer of
seven (7) years or as required by Florida law. Upon expiration or earlier termination of this
Agreement, Provider agrees, to the extent permitted by applicable law, with proper consent, to
provide an electronic medical record to a successor on-site Okeechobee County Employee
County Health Center vendor or doctor. At County's election and in accordance with applicable
federal and state law, Provider shall deliver the electronic medical records to a designee of the
County to maintain the records in accordance with Florida law. Provider shall provide Covered
Persons with copies of their medical records upon request.
ARTICLE VI
REPORTING AND RIGHT TO AUDIT
6.1 Right to Audit. Provider shall maintain adequate records for the Services performed under
this Agreement for five (5) years following completion of the Services, or conclusion of any
litigation regarding this Agreement. The County shall have the right to audit Provider's books and
records, at the County's expense, upon prior notice, with regard to the Services provided to the
County under this Agreement. Provider shall allow the County or its representative to interview
all current or former employees to discuss matters pertinent to this Agreement. If an audit
inspection in accordance with this section discloses overpricing or overcharges(of any nature) by
Provider to the County in excess of one-half of one percent(.5%)of the total contract billings,(1)
the reasonable costs of the County's Internal Audit department shall be reimbursed to the County
by Provider and (2) a 15% penalty of the overpricing or overcharges shall be assessed. Any
adjustments and/or payments which must be made as a result of the audit inspection,including any
interest, audit costs and penalties shall be made by Provider within 45 days from presentation of
County's findings to Provider. Failure by Provider to permit such audit shall be grounds for
termination of this Agreement by the County.
6.2 Reporting Requirements. Provider shall provide the reports detailed on Exhibit F in
accordance with the frequency described therein. All reports shall be submitted to the County's
Project Representative. All reports due monthly. All reports due monthly shall be due on the
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EXHIBIT A
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fifteenth of the month; No additional fees shall be charged to the County by Provider for the
provision of these reports, data or information.
6.3 Application of Law to Audit and Reporting Requirements. Notwithstanding the preceding
Section 6.1 and 6.2 and as more particularly set forth in Section 8 below,nothing in this Agreement
nor in the County's policies shall require Provider to violate any federal or state law or regulation
regarding the confidentiality of such medical information. The County shall ensure that it and any
third party conducting an audit shall be duly authorized by Covered Persons to obtain and review
the records.
ARTICLE VII
INDEMNIFICATION AND INSURANCE
7.1 Indemnification. Provider agrees to indemnify,defend,save and hold harmless County, its
commissioners,officers,agents and employees,from any claim,demand,suit,loss,cost or expense
for any damages that may be asserted, claimed or recovered against or from County, its
commissioners, officials, agents, or employees by reason of any damage to property or personal
injury, including death and which damage,injury or death arises out of or is incidental to or in any
way connected with Provider's performance of the Services or caused by or arising out of(a) any
act, omission, default or negligence of Provider in the provision of the Services under this
Agreement; (b) property damage or personal injury, which damage, injury or death arises out of
or is incidental to or in any way connected with Provider's execution of Services under this
Agreement; or (c) the violation of federal, state, county or municipal laws, ordinances or
regulations by Provider. This indemnification includes, but is not limited to, the performance of
this Agreement by Provider or any act or omission of Provider, its Personnel, agents, servants,
contractors, patrons, guests or invitees and includes any costs, attorneys' fees, expenses and
liabilities incurred in the defense of any such claims or the investigation thereof. Provider agrees
to pay all claims and losses and shall defend all suits, in the name of County, its employees, and
officers, including but not limited to appellate proceedings, and shall pay all costs,judgments and
attorneys' fees which may issue thereon. County reserves the right to select its own legal counsel
to conduct any defense in any such proceeding and all costs and fees associated therewith shall be
the responsibility of Provider under this indemnification provision. To the extent considered
necessary by County, any sums due Provider under this Agreement may be retained by County
until all of County's claims for indemnification have been resolved,and any amount withheld shall
not be subject to the payment of interest by County. This indemnification agreement is separate
and apart from, and in no way limited by, any insurance provided pursuant to this Agreement or
otherwise. This paragraph shall not be construed to require Provider to indemnify County for its
own negligence,or intentional acts of County,its agents or employees. Nothing in this Agreement
shall be deemed to be a waiver of the County's sovereign immunity under Section 768.28, Florida
Statutes. This clause shall survive the expiration or termination of this Agreement.
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EXHIBIT A
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7.2 Insurance.
a. Provider shall purchase from and maintain, in a company or companies lawfully
authorized to do business in Florida, such insurance as will protect the County from claims set
forth below which may arise out of or result from performance under this Agreement by Provider,
or by a subcontractor of Provider, or by anyone directly or indirectly employed by Provider,or by
anyone for whose acts Provider may be liable.
b. Coverage shall be maintained without interruption from the effective date of this
Agreement until date of final payment and termination of any coverage required to be maintained
after final payment. Any liability coverage on claims made basis shall remain effective for two
(2) years after final payment. If any of the required insurance coverages are required to remain in
force after final payment, an additional certificate evidencing continuation of such coverage shall
be submitted along with the application for final payment.
c. The County shall be provided a minimum of thirty (30)days prior written notice of
any adverse material change, including any reduction, non-renewal or cancellation of Provider's
required insurance coverage,or any increase in Provider's self-insurance retention.
d. Evidence of insurance, being a current ACORD certificate of insurance or its
equivalent, executed by the insurer, or its agent or broker, evidencing that a policy of insurance
and any required endorsements have been issued by the agent/broker shall be delivered to County
prior to execution of this Agreement. The Certificate of Insurance shall be dated and show the
name of the insured,the specific Agreement by name and contract number,the name of the insurer,
the number of the policy, its effective date, and its termination date.
e. All required insurance (except Workers" Compensation and Professional Liability)
shall include an Additional Insured endorsement identifying the County as an Additional Insured
and Loss Payee. No costs shall be paid by the County for an additional insured endorsement.
f. Required Coverage: Provider shall maintain following liability coverage, in the
limits specified:
Comprehensive General Liability: Not less than $1,000,000.00 Combined
Single Limit per each occurrence and $2,000,000 aggregate, with bodily injury
limits. May not be subject to a self-insured retention or deductible exceeding
$25,000.
Worker's Compensation: Worker's Compensation and Employer's Liability
Insurance with limits of Employer's Liability Insurance not less than $500,000
"each accident," $500,000 "disease policy limit," and $500,000 "disease each
employee."
Professional Liability or Errors and Omissions: Professional liability insurance
(including technology errors, omissions, and medical malpractice) with a limit of
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EXHIBIT A
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not less than Two-Hundred and Fifty thousand$250,000.00 each occurrence in the
aggregate covering Provider and all Medical Professionals, including appropriate
prior acts coverage for the period of time the Provider provided services to the
County of$750,000.00.
g. Workers' compensation, employers' liability,general liability and policies shall provide a
waiver of subrogation in favor of the County.
h. Provider's insurance shall be deemed primary and non-contributory with respect to any
insurance or self-insurance carried by the County for liability arising out of operations
under this Agreement.
ARTICLE XIII
RECORDS
8.1 Public Records Act. It is understood by the parties that the County is subject to the
provisions of the Florida Public Records Act, Section 119.011 et seq, Florida Statutes, and that
absent any exemptions or provisions for confidentiality contained in state or federal statutes,
generated records may be open to the public for inspection and copying.Provider shall allow public
access to all documents,papers, letters or other material subject to the provisions of Chapter 119,
Florida Statutes, and made or received by Provider in conjunction with this Agreement. Failure
by Provider to grant such public access shall be grounds for immediate unilateral cancellation of
this Agreement by the County. Should Provider assert any exemptions to the requirements of the
Florida Public Records Act and related law,the burden of establishing such exemption, by way of
injunctive or other relief as provided by law, shall be upon Provider. Provider consents to the
County's enforcement of Provider's Chapter 119 requirements, by all legal means, including, but
not limited to, a mandatory injunction, whereupon Provider must pay all court costs and
reasonable attorney's fees incurred by the County. IF PROVIDER HAS QUESTIONS
REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO
PROVIDER'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT,
CONTACT THE CUSTODIAN OF PUBLIC RECORDS, ROBBIE L. CHARTIER, COUNTY
ADMINISTRATOR, AT 863-763-6441, EXT 1; publicrecords@co.okeechobee.fl.us; MAILING
ADDRESS: 304 NW 2nd Street, ROOM 123, OKEECHOBEE, FL 34972.
8.2 Covered Person Records. Provider and the County agree that they will adopt such policies and
procedures, execute such written amendments to this Agreement or enter into such other
agreement(s) as may be required to make their activities under the Agreement compliant with the
Federal Health Information Technology for Economic and Central Health Act of 2009 ("HITECH
Act"), the Administrative Simplification Provisions of the Health Insurance Portability and
Accountability Act of 1996, as codified at 42 U.S.C.A. 1320d-8 ("HIPAA"), and any current and
future regulations promulgated under either the HITECH Act or HIPAA, including without
limitation the federal privacy standards contained in 45 C.F.R. Parts 160 and 164 and the federal
security standards contained in 45 C.F.R. Parts 160, 162 and 164 as amended, and other applicable
local, state and federal privacy laws. In furtherance of this agreement, Provider and the County
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EXHIBIT A
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will execute the "Business Associate Agreement". Provider shall take steps to safeguard the
confidentiality and privacy of member/participant identifiable information and to prevent
unauthorized disclosure of the same by its employees and agents. The County acknowledges that
in receiving or otherwise dealing with any records or information about Covered Persons receiving
treatment for alcohol or drug abuse, Provider may be bound by the provisions of the federal
regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records (42 C.F.R. Part
2, as amended from time to time), as well as any state laws that govern HIV/AIDS and mental
health treatment. Provider, at the Provider's expense, will resist in judicial proceedings any effort
to obtain access to such records or information relating to the Central Services except such access
as is expressly permitted by the aforementioned federal regulations and/or State law and will notify
the County of any such judicial proceedings.
The parties acknowledge that certain records and documents created or maintained by Provider
may constitute employment records not subject to HIPAA and others may include protected health
information ("PHI") as that term is defined by HIPAA. The parties shall collaboratively develop
policies and procedures to segregate PHI subject to HIPAA and other state and federal privacy
laws from employment records and to ensure the parties preserve the privacy and confidentiality
of PHI in accordance with HIPAA and other applicable state and federal laws. Except for
employment records not subject to HIPAA, Provider shall not provide documents containing PHI
to the County without written authorization from the Covered Person.
The obligations created by this section shall remain in effect indefinitely and shall survive the
termination or cessation of this Agreement.
8_3 Confidential and Proprietary Information. Provider and County agree that all materials
containing confidential and proprietary information developed in whole or in part or produced by
either party shall not be disclosed to any third party without the written consent of the other party,
except as necessary to implement the terms of this Agreement and only on a need to know basis,
unless disclosure is required by the Florida Public Records Act.
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EXHIBIT A
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ARTICLE IX
GENERAL PROVISIONS
9.1 Upon adoption of any state or federal legislation or upon the issuance of a determination
by a governmental entity, a Medicare carrier or intermediary, or an independent third party
absolutely acceptable to each party that the arrangement evidenced by this Agreement violated any
Federal or State law, rule, or regulation, including fraud and abuse issues, this Agreement shall
terminate within sixty (60) days thereafter or sooner if such determination so advises; provided
however, that in the event that such a determination is issued, the County may elect to continue
this Agreement by reorganizing its internal structure or its agreements so that such are in
accordance with the law, rule, or regulation in question. In such event, within sixty (60) days of
the issuance of such determination, the County shall deliver notice to Provider of its intentions to
continue this Agreement as provided herein. In such case, the terms and conditions of this
Agreement shall remain in full force and effect.
9.2 Notices. All notices, offers, requests,demands and other communications pursuant to this
Agreement shall be given in writing by personal delivery, by prepaid first class registered or
certified mail properly addressed with appropriate postage paid thereon, tele copier, facsimile
transmission or e mail, and shall be deemed to be duly given and received on the date of delivery
if delivered personally,on the second day after the deposit in the United States Mail if mailed,
upon acknowledgment of receipt of electronic transmission if sent by tele copier or facsimile
transmission or e mail.Notices shall be sent to the parties at the following addresses:
If to Provider:
Okeechobee Medical Providers, Inc.
3405 NW Federal Highway
Jensen Beach, FL 34957
Attn: J. Michael Adelberg, MD, FAEP
President and Regional Medical Director
Facsimile No.: (772)-232-9383
If to County:
Okeechobee County
Attn: Robbie Chartier, County Administrator
304 NW 2nd Street, Room 123
Okeechobee, FL 34972
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and
Okeechobee Sheriff
Attn:Noel Stephen, Sheriff
504 NW 4th Street
Okeechobee, FL 34972
With a Copy to:
Wade C. Vose,Esq.
324 W. Morse Blvd.
Winter Park, Florida 32789
Phone: 407-645-3735 ext. 1020
Or to such other address as any party may have furnished to the others in writing in accordance
herewith,except that notices of change of address shall only be effective upon receipt.
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9.3 Independent Contractor. Provider acknowledges and agrees that it is an independent
contractor of the County and is not an employee of the County. Provider more specifically
acknowledges that: it will not be eligible to participate in any employee benefit maintained by the
County;will not be covered by the County's workers' compensation insurance;will be solely and
exclusively responsible for payment of all federal and state income,social security,unemployment
and disability taxes due in respect of all compensation and/or other consideration paid by the
County to Provider hereunder. Provider acknowledges that it shall have no authority to bind
County to any contractual or other obligation whatsoever. Provider shall be entitled to seek and
accept other engagements and/or employment during the term of this Agreement so long as such
other employment or engagements do not interfere with the performance of Provider's duties under
this Agreement. Provider shall be responsible to the County for all work or services performed by
Provider or any person or firm engaged as a sub-consultant or subcontractor to perform work in
fulfillment of this Agreement.
9.4 Waiver. Any waiver by either party of any one or more of the covenants, conditions, or
provisions of this Agreement, shall not be construed to be a waiver of any subsequent or other
breach of the same or any covenant, condition or provision of this Agreement.
9.5 Headings. The headings contained in this Agreement are provided for convenience only
and shall not be considered in construing, interpreting or enforcing this Agreement.
9.6 Non-Assignability. This Agreement may not be assigned by either party without the
express prior written consent of the other party which may be given or withheld by the other party
in its sole discretion.
9.7 Governing Law; Jurisdiction; Venue; Litigation. This Agreement shall be construed and
interpreted,and the rights of the parties hereto determined, in accordance with Florida law without
regard to conflicts of law provisions. The County and Provider submit to the jurisdiction of Florida
courts and federal courts located in Florida. The parties agree that proper venue for any suit
concerning this Agreement shall be Okeechobee County, Florida, or the Federal Southern District
of Florida. Provider agrees to waive all defenses to any suit filed in Florida based upon improper
venue or forum nonconveniens. To encourage prompt and equitable resolution of any litigation,
each party hereby waives its rights to a trial by jury in any litigation related to this Agreement.
9.8 Attorneys' Fees. In the event of any litigations to enforce the terms of this Agreement,the
prevailing party shall be entitled to reasonable attorney's fees and costs which are directly
attributed to such litigation both at the trial and appellate level.
9.9 Severability. In the event that any term or provision of this Agreement shall to any extent
be held invalid or unenforceable, it is agreed that the remainder of this Agreement, (or the
application of such terms or provision to persons or circumstances other than those as to which it
is held invalid or unenforceable), shall not be affected and every other term and provision of this
Agreement shall be deemed valid and enforceable to the maximum extent permitted by law.
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EXHIBIT A
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9.10 Gender; Number. Whenever the context of this Agreement requires, the masculine gender
shall include the feminine or neutral,and the singular number shall include the plural.
9.11 Third-Party Beneficiary. Provider and the County acknowledge that nothing contained in
this Agreement is intended to nor shall it cause any person, including any individual partner of
Provider, or entity, or any Covered Person, to become a third-party beneficiary of any of the
provisions or obligations of this Agreement.
9.12 Section and Other Headings. The article and other headings contained in this Agreement
are for reference purposes only and shall not affect in any way the meaning or interpretation of
this Agreement.
9.13 Counterparts. This Agreement may be executed in one or more counterparts, all of which
together shall constitute only one Agreement.
9.14 Non-Discrimination. In performing under this Agreement, Provider shall not discriminate
against any person because of race, color, religion, sex, gender identity or expression, genetic
information, national origin,age,disability, familial status, marital status or sexual orientation.
9.15 Public Entity Crimes Act. Provider represents that the execution of this Agreement will
not violate the Public Entity Crimes Act (Section 287.133, Florida Statutes), and certifies that
Consultant and its sub-consultants under this Agreement have not been placed on the convicted
vendor list maintained by the State of Florida Department of Management Services within 36
months from the date of submitting a proposal for this Agreement or entering into this Agreement.
Violation of this section may result in termination of this Agreement and recovery of all monies
paid hereto,and may result in debarment from County's competitive procurement activities.
9.16 Unauthorized Aliens/Patriot's Act. The knowing employment by Provider or its sub-
consultants of any alien not authorized to work by the immigration laws or the Attorney General
of the United States is prohibited and shall be a default of this Agreement which results in unilateral
termination. In the event that Provider is notified or becomes aware of such default,Provider shall
take steps as are necessary to terminate said employment with 24 hours of notification or actual
knowledge that an alien is being employed. Provider's failure to take such steps as are necessary
to terminate the employment of any said alien within 24 hours of notification or actual knowledge
that an alien is being employed shall be grounds for immediate termination of this Agreement and
unilateral termination. Provider shall take all commercially reasonable precautions to ensure that
it and its sub-consultants do not employ persons who are not authorized to work by the immigration
laws or the Attorney General of the United States. Provider further represents that it is not in
violation of any laws relating to terrorism or money laundering, including the Executive Order No.
13224 on Terrorist Financing and/or the Uniting and Strengthening America by Providing
Appropriate Tools Required to Intercept and Obstruct Terrorism Act of 2001 (Public Law 107-
56.,the"Patriot Act"). Provider represents it is not a Prohibited Person under the Executive Order
or Patriot Act.
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EXHIBIT A
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9.17 Representations and Warranties.
a. Provider hereby represents and warrants to the County that it has full power and
authority to enter into and fully perform its obligations without the need for any further
corporate or governmental consents or approvals, and that the persons executing this
Agreement are authorized to execute and deliver it.
b. Provider represents and warrants that it and its representatives providing services
hereunder:(i)are not currently excluded,debarred,or otherwise ineligible to participate
in the Federal health care programs as defined in 42 U.S.C. Section 1320a-7b(f) (the
"Federal health care programs"); (ii) are not convicted of a criminal offense related to
the provision of health care items or services but have not yet been excluded,debarred
or otherwise declared ineligible to participate in the Federal health care programs,and
(iii) are not under investigation or otherwise aware of any circumstances which may
result in the party or any of its representatives being excluded from participation in the
Federal health care programs. This will be an ongoing representation and warranty
during the term of this Agreement and Provider will immediately notify the County of
any change in status of the representation and warranty set forth in this section. Any
breach of this Section will give the County the right to immediately terminate this
Agreement for cause.
c. Provider represents that it is duly licensed to perform the Services under this Agreement
and that it will continue to maintain all licenses and approvals required to conduct its
business.
d. Provider warrants that it has not employed or retained any company or person, other
than a bona fide employee working solely for Provider, to solicit or secure this
Agreement and that it has not paid or agreed to pay any person,company, corporation,
individual, or firm, other than a bona fide employee working solely for Provider, any
fee, commission, percentage, gift, or any other consideration contingent upon or
resulting from the award or making of this Agreement. In the event of a breach or
violation of this provision by Provider,the County shall have the right to terminate the
Agreement without liability and, at its discretion, to deduct from the fee, or otherwise
recover, the full amount of such fee,commission,percentage,gift, or consideration.
9.18 Ethics; Conflicts of Interest.
a. Provider represents that it has not given or accepted a kickback in relation to this
Agreement and has not solicited this Agreement by payment or acceptance of a gratuity
or offer of employment.
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EXHIBIT A
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b. Provider represents that it has not solicited this contract by payment of a gift or gratuity
or offer of employment to any official, employee of the County or any County agency
or selection committee.
c. Provider represents that it does not employ, directly or indirectly, the County
Administrator, members of the County commission or any official, department
director, head of any County agency, member of any board, committee or agency of
the County, or the Clerk, the Supervisor, or any employee of the Clerk or Supervisor.
d. Provider represents that it does not employ, directly or indirectly, any official of the
County. Provider represents that it does not employ, directly or indirectly, any
employee or member of any board, committee or agency of the County who, alone or
together with his household members, own at least five percent(5%)of the total assets
and/or common stock of Provider.
e. Provider represents that it has not knowingly given,directly or indirectly,any gift with
a value greater than $100 in the aggregate in any calendar year to the County
Administrator, members of the County commission, any department director or head
of any County agency, any employee of the County or any County agency, the Clerk,
the Supervisor, or any employee of the Clerk or Supervisor, or any member of aboard
that provides regulation, oversight, management or policy-setting recommendations
regarding Provider or its business.
f. Provider represents that it presently has no interest and shall acquire no interest,either
direct or indirect, which would conflict in any manner with its performance under this
Agreement. Provider further represents that no person having any interest shall be
employed or engaged by it for said Services.
g. Provider, its officers, personnel, subsidiaries and subcontractors shall not have or hold
any continuing or frequently recurring employment, contractual relationship, business
association or other circumstance which may influence or appear to influence
Provider's exercise of judgment or quality of the Services being provided under this
Agreement. Provider, its officers, personnel, subsidiaries and subcontractors shall not
perform consulting work for any third party that would in any way be in conflict with
the Services to be provided to the County under this Agreement.
h. Provider, its officers, personnel, subsidiaries, and subcontractors shall not, during the
term of this Agreement, serve as an expert witness against County in any legal or
administrative proceeding unless compelled by court process. Further, Provideragrees
that such persons shall not give sworn testimony or issue a report or writing, as an
expression of his or her expert opinion, which is adverse or prejudicial to the interests
of County or in connection with any pending or threatened legal or administrative
proceeding. The limitations of this section shall not preclude such persons from
representing themselves in any action or in any administrative or legal proceeding.
20
EXHIBIT A
111
•
i. Provider shall promptly notify the County in writing by certified mail of all potential
conflicts of interest or any event described in this Section. Said notification shall
identify the prospective business interest or circumstance and the nature of work that
Provider intends to undertake and shall request the opinion of the County as to whether
such association, interest or circumstance would, in the opinion of the County,
constitute a conflict of interest if entered into by Provider. The County agrees to notify
Provider by certified mail of its opinion within thirty (30) calendar days of receipt of
the said notification and request for opinion. If, in the opinion of the County, the
prospective business association, interest or circumstance would not constitute a
conflict of interest by Provider, the County shall so state in its opinion and Provider
may, at its option, enter into said association, interest or circumstance and it shall be
deemed not in conflict of interest with respect to services provided to the County by
Provider under this Agreement.
j. In the event Provider is permitted to utilize subcontractors to perform any services
required by this Agreement,Provider agrees to prohibit such subcontractors,by written
contract, from having any conflicts as within the meaning of this section.
9.19 Taxes.Provider understands that in performing the Services for the County,Provider is not
exempt from paying sales tax to Provider's suppliers for materials required for Provider to perform
under this Agreement. Provider shall not be authorized to use the County's tax exemption number
for purchasing supplies or materials.
9.20 Availability of Funds. This Agreement is expressly conditioned upon the availability of
funds lawfully appropriated and available for the purposes set out herein as determined in the sole
discretion of the Board. If funding for this Agreement is in multiple fiscal years, funds must be
appropriated each year prior to costs being incurred. Nothing in this paragraph shall prevent the
making of contracts with a term of more than one year,but any contract so made shall be executory
only for the value of the services to be rendered or paid for in succeeding fiscal years. In the event
funds to finance this Agreement become unavailable, the County may terminate this Agreement
upon no less than sixty days (60) to Provider. The County shall be the sole and final authority as
to the availability of funds.
9.21 Force Majeure. Any deadline provided for in this Agreement may be extended,as provided
in this paragraph, if the deadline is not met because of one of the following conditions occurring
with respect to that particular project or parcel: fire,strike,explosion,power blackout,earthquake,
volcanic action, flood, war, civil disturbances,terrorist acts,hurricanes and acts of God,provided
the non-performing party and its subcontractors are without fault in causing such default or delay,
and such default or delay could not have been prevented by reasonable precautions and cannot
reasonably be circumvented by the non-performing party through the use of alternate sources,
workaround plans or other means. When one of the foregoing conditions interferes with contract
performance, then the party affected may be excused from performance on a day-for-day basis to
the extent such parry's obligations relate to the performance so interfered with; provided that no
such extension shall be made unless notice thereof is presented by Provider to County in writing
21
EXHIBIT A
•
within ten(10)business days after the start of the occurrence of such delay,and Provider shall use
best efforts to perform its obligations during such period of delay, and notify County of its
abatement or cessation; and further provided, the party so affected shall use reasonable efforts to
remedy or remove such causes of non-performance. The party so affected shall not be entitled to
any additional compensation by reason of any day-for-day extension hereunder.
9.22 Audit. Provider understands and agrees that in addition to all other remedies and
consequences provided by law,the failure of Provider or its subcontractor to fully cooperate with
the County's Auditor when requested may be deemed by the County to be a material breach of this
Agreement justifying its termination.
9.23 Entire Agreement; This Agreement, including Exhibits which are incorporated into this
Agreement in their entirety, embody the entire agreement and understanding of the parties with
respect to the subject matter of this Agreement and supersede all prior and contemporaneous
agreements and understandings, oral or written, relating to said subject matter. This Agreement
may only be modified by written amendment executed by the County and Provider. The Chairman
of the County Board of Commissioners shall have the authority to execute amendments to this
Agreement for changes relating to the operation of Okeechobee County Employee County
Health Center such as staffing levels,performance guarantees and hours of operation.
22
EXHIBIT A
• •
IN WITNESS WHEREOF the parties hereto have caused the Agreement to be executed by their
duly authorized representatives as of the day and year first above written.
COUNTY OF OKEECHOBEE
By:
_ J
Terry W. Burroughs, airman
Date: -
Attest: L
By ;�') ��"Cl�,✓�t=�,� `� 1- -.0// C,%4%
i
Sharon Robertson, Clerk of the Circuit Court&Comptroller
Date: 0S////k7cj(.'
By: •
Office of the County Attorney
Approved as to form and legality
OKEE BEE COUNTY
CLE F THE CIRCUIT AND COM TROLLER
Sitar o i o Clerk of thg Circuit,urt_z B
Dat . d&I
OKEE BEE COUNTY
SUPE VI OR 0 E-LEC IONS
By:
Diane H g n, Su ervi or ti
Date:
23
EXHIBIT A
• •
OKEECHOBEE OUNTY
SHERIFF
By
Noel Stephen, Shell
-lie
Q CJ i ;1
OKEECHOBEE COUNTY
PROPERTY APPRAISER
By: f
Mickey Bandi, Prtrty Appraiser
Date: U
OKEECHOBEE COUNTY
TAX COLLECTOR
By: L,2JL Wit A "
Celeste Watford, Tax Co1
Date:
OKEECHOBEE MEDICAL PROVIDERS, INC.,
a Florida corporation
By: %
Name: Jonathan M. A elb AEP President
Date:
Witness: ri h 1
24
EXHIBIT A
• •
EXHIBIT LIST
Exhibit A Scope of Central Services
Exhibit B Scope of Management Services
Exhibit C Invoice Samples
Exhibit D Operating Hours Schedule
Exhibit E Reimbursable Operating Expenses
Exhibit F Reporting Requirements
Exhibit G Physical Form
Exhibit H Monthly Administration Fee
Exhibit I HSA Plans
25
EXHIBIT A
• •
EXHIBIT A
SCOPE OF CENTRAL SERVICES
PRIMARY.OCCUPATLONAI JIEALTH.AND URGENT CARE
The Central Services to be performed by the Medical Professionals at the Okeechobee County
Employee County Health Center are to be determined by the Medical Professionals but
generally shall include those services normally provided in a primary medical care facility as
permitted by the licensure of the Medical Professionals, and by the equipment and physical
restrictions of the facility, and at a minimum shall include the following services:
• Chronic illness evaluation, treatment and management (i.e., diabetes, high
cholesterol,hypertension,asthma,obesity)
• Acute Conditions (i.e., sore throats, ears ache, head ache, cough, sinus, strains,
sprains,musculoskeletal problems,acute urinary complaints).
• Primary Care, health risk assessments, preventative and disease management
strategies including one-on-one health education counseling to high risk employees
• Reasonable accommodations determinations — consult with Director of Human
Resources and the County's Risk Manager with regard to reasonable accommodations for
employees with medical conditions that have altered their ability to perform an essential
job task.
• Occupational Conditions
o On the Job Injuries/Work-related injuries or illnesses
o Minor surgical procedures,within the scope of the Medical Professional,
such as sutures for laceration treatment,etc.
o Pre-employment and routine physicals
o Pre-employment, random, reasonable suspicion and post-accident drug
testing
Medications
Class examples include, but are not limited to the following:
o Anti-infective
o Antihypertensive
o Anti-hyperlipidemics
o Antidepressants
o Anti-diabetics
o Antihistamines
o Acid-reflux medications
o Antibiotics
o Hypertensive& cardiac medications
o Anti-lipids
o Pulmonary
o Gastro Intestinal
26
EXHIBIT A
• •
o Psychiatric
o Vaccinations
Medical Surveillance
• Drug Screen/Alcohol - Collect pre-employment samples; urine for random and
reasonable suspicion; breathalyzer for alcohol in compliance with collective bargaining
agreements and County policy. Administer random selection program and post
rehabilitation random testing. Provide Medical Review Officer and reporting services.
Exams
• Pre-Employment- Coordinating/conducting physicals, drug screening, medical
history,audiometric testing, biometrics, etc.
• Fitness for Duty - Conduct fitness for duty exams for both work related cases and
for employees returning from personal medical leave.
• Department of Transportation/Commercial Driver's License exams
• County Exams
Labs
• Onsite collection of specimens and blood draws
• Manage lab provider arrangement to include logistics for specimen pick up,
• Reporting of results to medical providers
• System integration of lab data within medical records system
Governmental Regulations and Compliance
Ensure compliance with all applicable medical and government regulations for CLIA,OSHA,and
DOT.
Long Term Prevention Programs Available
Provider will work closely with the County for the purpose of financial review, reporting, as well
as to identify major cost drivers. Provider will make recommendations and develop strategies for
the County to mitigate such costs. Some of these services are listed below.
• Health Risk Assessment provided through the County's insurance carrier with
comprehensive lab analysis provided at the Okeechobee County Employee County Health
Center will help to proactively identify patient health risks
• Aggregate data analysis from your employee population to develop the right
programs for your Pharmaceutical Program Management
• Aggregate Central data analysis to determine wellness effectiveness on population
health
• Physician/Nurse "Reach Out" Program to communicate with people with the
greatest health risks
27
EXHIBIT A
• •
• Population Health Management programs targeted for the greatest impact(obesity,
diabetes, high blood pressure,etc.)
• Disease/Case Management—Provider's providers will proactively promote disease
case management
• Health Education Training
Performance Requirements:
• Provider shall report the results of routine annual employee physicals required by
the County and post-offer physicals within three (3) business days of the date of the initial
patient visit. Results of Post-Offer Physicals must be e mailed to the Director of Human
Resources or their designee.Results of routine employee annual physicals shall bee mailed
to the County's Risk Manager or designee.
• Provider shall report the results of complex post-offer physicals and periodic
physicals requiring MRI's and/or Cardiac Stress Testing within five (5) business days of
the date of the initial patient visit.
• Appointments for Fitness-for-Duty evaluations must be scheduled by Provider
within 48 business (i.e. Monday-Friday) hours.
• Provider shall use its best efforts to timely respond to all County voicemails and e
mails by day's end.
28
EXHIBIT A
• •
EXHIBIT B
SCOPE OF MANAGEMENT SERVICES
• Manage and supervise daily operation of the Okeechobee County Employee
County Health Center in accordance with all applicable local, state, and federal laws.
• Obtain and maintain all necessary licenses,certifications,and accreditations for the
operation of the Okeechobee County Employee County Health Center.
• Recruit, employ, and supervise all medical and non-medical staff necessary forthe
operation of the Okeechobee County Employee County Health Center.
• Provide appropriate physician supervision for nurse practitioners and other licensed
staff.
• Prepare reports of operations and activity required by the County or the state, local
or federal regulatory agencies and,where applicable,deliver to County's Risk Management
and third party administrator by the end of the work day.
• Maintain patient files as required by industry standards and applicable laws
including an electronic medical record.
• Purchase equipment and supplies necessary for the operation of the Okeechobee
County Employee County Health Center.
• Maintain, or arrange for the maintenance of all technical, mechanical or electronic
equipment used in the operation of the Okeechobee County Employee County Health
Center.
• Regularly assess and recommend cost-saving measures while maintaining high
quality of care.
• Participate in meetings with the County at the reasonable request of the County.
• Provide newsletter and internet health portal services.
• Maintain practice management system and electronic medical record system.
• Provide customer service line
• Online system for scheduling appointments according to Section
• Provide Medical Supply and Equipment inventory management
• Participate in the County's annual health fair(if applicable)
• Contract for disposal of biomedical waste
29
EXHIBIT A
• •
EXHIBIT C
INVOICE SAMPLES
Monthly. the Admin fee will be invoiced in the following format:
TC11:1\4 .41
1111fr
Treasure Coast Medical Associates,Inc.
invoice
In account with: Okeechobee County Board of
Invoice No: 2165 County Commissioners
For:Nov 2017 Admin Fee for Health Clinic
Invoice Date Invoice Terms Billing Contact
Aurora Gnarl
10 27.2017 Net 10 days agnadfptcmahealthcare.cnm
ITEM DESCRIPTION TOTAL
1 BOCC: 556,00 X 124 S6,944,00
2 Clerk of Court: S56.00 X 35 S1,960.00
3 Supervisor of Elections: S56 n0 x 3 $168.00
4 Sheriff: 556 x 190 510,640.00
5 Property Appraiser: 556 a 10 S560.00
0 Tax Collector: 556 a 14 57a4.00
Balance Due:I 521.056.00
ADDRESS PHONE FAX WEB
...105 NW Federal liwy
Jensen Beach,FL :iss7 (772)692 8082 (772)232-9211 www.tcmahealthr.are.com
30
EXHIBIT A
• •
Monthly. the pass-through costs will be invoiced in the following format:
.1.C�
Treasure Coast Medical Associates.Inc.
Invoice
Invoice No: 9999 In account with: BOCC
Pass Through: Labs and Meds: Mar 2018
Invoice Date Invoice Terms Billing Contact
Aurora Gnad
4/15/2013 Net 10 days agnad(gtcmahealthcare.com
ITEMI DESCRIPTION TOTAL
County Commissioner
1 Meds Dispensed:Labs Ordered S1,053.26
Less Start-up Deposit remaining (5475.38)
Amount Duei(Credit to roll forward) 5577.88
Coun Clerk of Court
2 Meds Dispensed!Labs Ordered $63.51
Less Start-up Deposit remaining _ ($214.50)
Amount Duei(Credit to roll forward) (S150.99)
Supervisor of Elections
3 Meds Dispensed;Labs Ordered 5102.56
Less Start-up Deposit remaining (S254.95)
Amount Duei(Credit to roll forward) (S152.39)
Sheriff
3 ,Meds Dispensed;Labs Ordered — =S
Less Startup Deposit remaining J
Amount Due(Credit to roll forward) >i I; 7.02
Property Appraiser
3 Meds Dispensed;Labs Ordered 3102.56
Less Start-up Deposit iomasi:ing (5254 95)
Amount Duei(Credit to roll forward) IS152.39)
Tax Collector
3 Meds Dispensed!Labs Ordered 568.62
Less Start-up Deposit remaining (S105.35)
Amount Duei(Credit to roll forward) _ (S36.73)
Balance Li.;:) S1,272.40
ADDRESS PHONE FAX WEB
3405 NW Federal Hwy
Jensen Beach,FL 34957 (772)692-8082 (772)232-9211 www.tcin heaIthcare.com
Each invoice will be supported with a listing of the meds dispensed/labs ordered for each
constituency.
31
EXHIBIT A
• •
EXHIBIT D
OPERATING HOURS SCHEDULE
1. Hours of Operation:
The hours of operation at the time of execution of this agreement are set as follows.
Monday 8:00 am—7:00pm
Tuesday 8:00 am—7:00pm
Wednesday 8:00 am—7:00pm
Thursday 8:00 am—7:00pm
Friday 8:00 am—7:00pm
Saturday 8:00 am—3:00pm
Sunday 9:00 am—3:00 pm
2. Holidays:
The County Employee Health Center shall be closed on the following holidays:
• From 1:00 pm on New Year's Eve,
• New Year's Day,
• Memorial Day,
• Independence Day,
• Labor Day,
• Thanksgiving Day,
• From 1:00 pm on Christmas Eve,and
• Christmas Day.
3. As mutually agreed by both parties,adjustments which satisfy patients/employees can
be made to this schedule.
32
EXHIBIT A
• •
EXHIBIT E
REIMBURSABLE OPERATING EXPENSES
The only operating expenses that will be invoiced are the costs incurred for labs ordered,
medications dispensed, X-ray over reads, and any other tests,equipment,or external contracted
services which are agreed upon by the constituency for whom the tests,equipment, or contracted
services are required. These pass-through expenses will only be for employees, dependents, and
retirees that are on the County's medical plan.
For the patients that are not on Okeechobee County's medical insurance plan,the patient and not
Okeechobee County will need to pay for these services.
Medication: A prescription will be sent to the pharmacy of their choosing.
Vaccinations: The patient will need to pay the self-pay price for any vaccinations needed
that TCMAi keeps in stock.
Labs: The patient will be given a requisition form to have their labs drawn at an outside
laboratory.
X-Ray Over Reads: The patient will need to pay $8.50 per view for any X-Rays
performed in office. This fee will need to be paid before the X-Ray is performed. If the fee for
the over reads increases by TCMAi's vendor, this expense will be reflected in the charge for the
patient.
Durable Medical Equipment: DME is not covered in this contract. Any DME needed
will be paid for by the patient and not Okeechobee County.
EXHIBIT A
• •
EXHIBIT F
REPORTING RFLOUIREMENTS
Frequency Data Reported
Monthly Details of available County Employee Health
Center hours—data including clinic hours and
available appointment/patient visits
Monthly Number of visits each week. This data should
include type of visit(Provider,Nurse only
and will compare the number of visits to the
available visits Health Center.
Monthly Patient Demographics(age and gender of
patients) categorized by covered:
• Employees,
• Dependent Spouses,
• Dependent Children, and
where applicable,
• Retirees
Monthly Types of visits-this data should show total
number of visits and percentages for:
• Workers compensation
injuries,
• Wellness type visits,and
• Episodic/acute care.
Monthly Immediate (at time of appointment)patient
satisfaction survey
Annually Aggregate Patient Survey Results
EXHIBIT A
• •
EXHIBIT G
Physical Form
11:\tAi Treasure Coast Medical Associates, Inc.
TCIti1Ai Physical
Employee Name Exam Date
1 M F 2 Height 3.Weight 3 Blood Pressure
5 Temperature Oral/Tympanic 6 Resting Pulse
7 Visual Acuity Corrected/Not Corrected Right left Both
PhYticiN Eaamrnat1on
Norma Abnorma-
F ie d of Vrgion
auditory Acuer
Head Eve:.Ear: No:*.Throat.Neck,and Th froid
Heart/ErG
lung/Thora.
Abdomen
Sk;n
Neuroto<<c
;pine
E.trem.ae: _—_-
Ur nai041
Compiete Brood Count
r
E cod Chemstr.Pane
rubercu o::$><m Tel.
Hepatit's Test
Co or Perception
i hereby attest that i have examined the above-named env.'n,r..,and find him/her capab? _f perfcrrnmt the
eaent ai hwxtaons of their job
hereb-, attest that have examined the above-rained emp ogee and find him/her not capab'e of perform:nC the
_scent ai function;of thee job
Phy:aoan Name Phv:actin S,;nature Date
3405 NW Federal Hwy,Jensen Beach.FL 34957
(Ph.)772-692-8082(Fax)772.232-9383
EXHIBIT A
•
EXHIBIT H
Monthly Administration Fee
The participants authorized to utilize the clinic include both employees,their dependents and
retirees on Okeechobee County's medical plan and employees and their dependents that are not
on Okeechobee County's medical plan. The participants that are on the County's medical plan
will have the administration fee paid for by Okeechobee County. The participants that are not on
the County's medical plan will pay Okeechobee County for the administration fee and in return
Okeechobee County will pay Okeechobee Medical Providers, Inc. for their administration fee for
those not on the County's medical plan.
The monthly administration fee will be billed as follows:
If there are at least 800 total participants, the administration fee=$40.00 per person
If there are less than 800 total participants,the administration fee=$56.00 perperson
Two monthly rosters will be sent to TCMAi at least 5 days before the start of the month with a
breakdown of eligible employees for the clinic. One roster will have all participants that are on
Okeechobee County's medical plan. A second roster will have all participants that are not on
Okeechobee County's medical plan.
EXHIBIT A
• •
EXHIBIT I
HSA Plans
For any Okeechobee County patient that participates in the HSA plan offered through the County,
there will be a$15 fee per visit. This fee will be collected for each visit for any patient with the
HSA. It is mandated that the patient must notify the medical office before their visit that they are
participating in the HSA plan.
EXHIBIT A
• •
AGREEMENT TO PIGGYBACK A CONTRACT FOR SERVICES BID BY ANOTHER
GOVERNMENTAL ENTITY
WHEREAS. OKEECHOBEE COUNTY, 312 N.W. 3rd Street, Okeechobee, Florida 34972, a political
subdivision of the State of Florida, entered into an agreement dated September 26 2017, u copy of which is
attached hereto, with TREASURE COAST MEDICAL ASSOCIATES, INC. ("TCMA"), 3405 N.W. Federal
Highway, Jensen Beach, Florida 34957, a Florida Corporation, to provide medical services for the County,
and
WHEREAS. the CITY OF OKEECHOBEE ("City"), 55 S.E. 3fd Avenue, Okeechobee, Florida 34974,
a Florida Municipal Corporation has the legal authority under Chapter Two, Section 2-289 of the City of
Okeechobee Code of Ordinances to "piggyback" onto a contract procured pursuant to Florida Statute §287.057
by another governmental entity when seeking to utilize the same or similar products or services provided for in
the said Contract: and
WHEREAS, the City desires to "piggyback" onto the above referenced Contract between Okeechobee
County, Florida and TCMA for utilization of the same or similar products or services ("Work')
NOW THEREFORE, having found it to be in the public interest,
1. That TCMA affirms and ratifies the terms and conditions of the above referenced Contract with
Okeechobee County, Florida and agrees to provide or perform services set forth therein for the City in
accordance with the same terms of said Contract, the terms of which are fully incorporated herein,
which are binding on the parties, and as more specifically set forth in the attached exhibit(s)
2. The City agrees to utilize the services or products of TCMA in a mariner and upon the terms and
conditions as set forth in the Contract between Okeechobee County, Florida and TCMA, which is for
the provision of quality health care and improve wellness among employees through the provision of
central services at the Employee Health Center located at 305 East North Park Street, Okeechobee,
Florida (TCMA Urgent Care Okeechobee)
3. 1hat this Agreement contemplates administrative and functional amendments to the TCMA Contract
with Okeechobee County, Florida, Section 9.2, such as designated persons and address for
notifications and contact between the City and TCMA which may be accomplished by separate letter of
understanding between the City and TCMA. Presently, all contact and notifications to the City shall be:
Marcos Montes De Oca, City Administrator, with copies to: India Riedel, Finance Director, 55 S.E. 3`d
Avenue, Okeechobee, Florida 34974.
4. ADDITIONAL COSTS AND SERVICES: Covered employees are described in Section 2.1 of the
Contract This Contract between the City and TCMA provides for cost of services for each employee
for the City, and for those employees who have elected to add family members on their City health
insurance plan, each additional insured dependent in the family and City retirees, are also entitled to
the provision of services of TCMA, at no additional cost. In addition, TCMA will provide its services
under the Contract to dependents of employees who are not on the City insurance plan, billed at a
discount in fees and costs as determined by TCMA. Further, occupational related medical services (i.e.
workers compensation cases) shall be provided to employees under the terms set forth in Section 1.1
of the Contract, and at a cost to be determined, but represented to be approximately ten percent (10%)
less than current City costs for such services.
5. PASS THROUGH EXPENSES The City shall not be required to place an advance deposit with TCMA
as does Okeechobee County in Exhibit "D" of the Contract, for the provision of prescription drugs. All
prescription medications, as well as lab work, shall be provided at cost to patients on a pass through
Page 1 of 3
EXHIBIT B
• •
basis, and invoiced separately to the City. These costs shall be in addition to the total monthly base
costs set forth in the City pricing proposal (Exhibit A)
6. TERMINATION: As provided in Section 3.2 of the TCMA Contract.
7. PUBLIC RECORDS: The legislature has amended Chapter 119 Florida Statutes, Section .0701
thereof, to expand the obligation of local government to include into all contracts certain language that
relates to public records, which is made a pan of this contract.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION
OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY
TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT,
CONTACT THE CUSTODIAN OF PUBLIC RECORDS FOR THE CITY OF
OKEECHOBEE AT:
CITY CLERK'S OFFICE
55 S.E. 3rd Avenue
Okeechobee, FL. 34972
(863) 763-3372 ext. 9814
Igamiotea@cityofokeechobee.corn
Subject to state and Federal privacy laws protecting and relating to release of medical records, reports
and findings, the Contractor/TCMA shall adhere to Florida public records laws, including the following:
a Keep and maintain public records required by the City to perform the services, and upon request of
the custodian of records for the City, provide the City with a copy of the requested records or allow
the records to be copied or inspected within a reasonable time at a cost that does not exceed the
cost allowed in Chapter 119 or as otherwise provided by law.
b Ensure that public records that are exempt or confidential and exempt from public records
disclosure requirements are not disclosed except as authorized by law for the duration of this
contract term and following completion of the contract if the Contractor does not transfer the
records to the City.
c. Upon completion of the contract, transfer, at no cost, to the City all public records in possession of
the Contractor or thereafter keep and maintain public records required by the City to perform the
service. If the Contractor transfers all public records to the City upon completion of the contract,
the Contractor shall destroy any duplicate public records that are exempt or confidential and
exempt from public records disclosure requirements. If the Contractor keeps and maintains public
records upon completion of the contract, the Contractor shall meet all applicable requirements for
retaining public records. All records stored electronically must be provided to the City, upon request
of the City Clerk, in a format that is compatible with the information technology systems of the City.
Noncompliance.
a. A request to inspect or copy public records relating to the City's contract for services must be made
directly to the City. If the City does not possess the requested records, the City shall immediately
notify the Contractor of the request, and the Contractor must provide the records to the City or
allow the records to be inspected or copied within a reasonable time. A reasonable time is defined
as within eight (8) business days.
Page 2 of 3
EXHIBIT B
• •
h. If the Contractor does not comply with the request of the City for the records.. the City shall
enforce the contract provisions in accordance with the contract
r. If the Contractor fails to provide the public records to the City within a reasonable time, the
Contractor may be subject to the penalties under Chapter 119.10.
Civil Action.
a It a civil action is filed against a Contractor to compel production of public records relating to the
City's contract for professional services, the court shall assess and award against the Contractor
the reasonable costs of enforcement, including reasonable attorney fees. If'
1. -I he court determines that the Contractor unlawfully refused to comply with the public records
request within a reasonable time; and
2. At least eight (8) business days before filing the action, the plaintiff provided written, notice of the
public records request, includinu a statement that the Contractor has not complied with the
request, to the City and to the Contractor.
b. A notice complies with the above if it is sent to the custodian of public records for the City and to
the Contractor at the Contractor's address listed on its contract with the City, or to the
Contractor's registered agent, Such notices must be sent by common carrier delivery service or by
registered, Global Express Guaranteed, or certified mail, with postage or shipping paid by the
sender and with evidence of delivery, which may be in an electronic format.
c. A Contractor who complies with a public records request within eight (8) business days after the
notice is sent is not liable for the reasonable costs of enforcement.
Approved by the City of Okeechobee City Council this 3rd day of October, 2017.
✓
CITY OF O _ECHOBE[ TR[ASURE G� S EDI� SSOCIATES, INC.
A/tr______ ___r_i_
Li / /
Duwlt/ty fl Z� attoro, Jr., Mayor Dr. Joria an d lbAQ rg F
Preside , 1�MA I
ATTEST: •
// ,.'
- Q71
I ane Gamiotea,`CMC, City Clerk STATE OF FLORIDA
COUNTY OF WOO/OW-1
REVIEWED FOR LEGAL SUFFICIENCY:
\...__.Yj-A) \ - 6\319 tZ--___ � �R
John R. Cook, City Attorney 1 NO A JBl_ C, State of Florida
Tl,e ,foregoing was executed before me this IA4f' day of
, 2017, by Dr. Jonathan M. Adelbcrg, who
personally swore or affirmed that he is authorized to execute
this Agreement and thereby bind the Corporation.
BOBBIE JO JENKINS
°• A. comrtrrscron il FF 975408
real/stamp' s
k!y eommissron :xprres
�`-`rll�,r"c March Z4, 2020
r'arac 3 of 3
EXHIBIT B
• •
Exhibit "A"
CM Treasure ure C oa s -Medic-at'1ssocia e s; Inc.
City of Okeechobee
Employee Health Program
Pricing Proposal
Assuniptions:
1. Monthly, the City will be billed for Administrative Fees & Reimbursable Expenses
for Staffing.
2. Lab Costs: Fees for Labs will he billed cum-telly
Ivieaication Costs: 'To Be Discussed
4. This Pricing Proposal covers Employee I lealth Services. Occupational Services
will be addressed separately, outside this proposal.
Administrative Fees & Reimbursable Expenses includes all Fees and Expenses outlined
in this Proposal.
Monthly Administrative Fee:
• PEPM at $17 PEPM; Employee count to be provided monthly by City.
Monthly Reimbursable Expenses:
• Staffing allocated at a flat monthly fee of $1,50U.
Quarterly Reimbursable Expenses
• All labs drawn/processed
Medications: Based on outcome of discussion
Example of Monthly Invoice (based on 63 Eligible Employees):
Adrnin Fee
PEPM —63 Eligible Employees $ 1,071
Reimbursable Expenses:
Staffing Allocation $ 1,500
Zotal Monthly Invoice Anioullt: $ 2.571
3405 NVN Federal Hwy,Jensen Beach,FL 34957
(Ph.)772-692-8082 (Fax) 772-232-9383
EXHIBIT B
• •
EXHIBIT C
REIMBURSABLE OPERATING EXPENSES
The only operating expenses that will be invoiced are the costs incurred for labs ordered,
medications dispensed, X-ray over reads, and any other tests, equipment, or external contracted
services which are agreed upon by the constituency for whom the tests, equipment, or contracted
services are required. These pass-through expenses will only be for employees, dependents, and
retirees that are on the City of Okeechobee's medical plan.
For the patients that are not on City of Okeechobee's medical insurance plan,the patient and not the City of
Okeechobee will need to pay for these services.
Medication: A prescription will be sent to the pharmacy of their choosing.
Vaccinations: The patient will need to pay the self-pay price for any vaccinations needed that
TCMA keeps in stock.
Labs: The patient will be given a requisition form to have their labs drawn at an outside
laboratory.
X-Ray Over Reads: The patient will need to pay $8.50 per view for any X-Rays
performed in office. This fee will need to be paid before the X-Ray is performed. If the fee for the
over reads increases by Okeechobee Medical Providers, Inc., this expense will be reflected in the
charge for the patient.
Durable Medical Equipment("DME"): DME is not covered in this contract. Any DME
needed will be paid for by the patient and not the City of Okeechobee.
•
• •
EXHIBIT D
MONTHLY ADMINISTRATION FEE
The participants authorized to utilize the clinic include both employees, their dependents and
retirees on City of Okeechobee's medical plan and employees and their dependents that are not on
City of Okeechobee's medical plan. The participants that are on the City's medical plan will have
the administration fee paid for by the City of Okeechobee. The participants that are not on the
City's medical plan will pay the City of Okeechobee for the administration fee and in return the
City of Okeechobee will pay Okeechobee Medical Providers, Inc. for their administration fee for
those not on the City's medical plan.
The monthly administration fee will be billed as follows:
If there are at least 800 total participants, the administration fee= $40.00 per person
If there are less than 800 total participants, the administration fee= $56.00 per person
Two monthly rosters will be sent to Okeechobee Medical Providers, Inc. at least 5 days before the
start of the month with a breakdown of eligible employees for the clinic. One roster will have all
participants that are on the City of Okeechobee's medical plan.A second roster will have all participants
that are not on the City of Okeechobee medical plan.