CONTRACT AMENDMENT RE BEHAVIORAL HEALTH SERVICES WITH COMMUNITY BRIDGES.PDF

CONTRACT NO: C-86-15-071-3-02 AMENDMENT NO: 2
AMENDMENT TO CONTRACT
Between MARICOPA COUNTY
By and Through
DEPARTMENT OF PUBLIC HEALTH
And COMMUNITY BRIDGES, INC.
I. The above named contract is hereby amended as specified below:
A. Extend the term of this contract one (1) month, through February 28, 2017;
B. Replace Exhibit A, 2.0 Scope of Work, with revised Exhibit A, adding 2.17,
increasing the aggregate, not-to-exceed amount by $65,877, from $100,000 to
$165,877, for the contract term of February 1, 2015 thru February 28, 2017.
II. All other terms and conditions of the original contract shall remain in full force and
effect.
IN WITNESS WHEREOF, the parties agree to the changes indicated herein:
FOR AND ON BEHALF OF FOR AND ON BEHALF OF
MARICOPA COUNTY COMMUNITY BRIDGES, INC.
By: By:
Clint Hickman, Chairman
Board of Supervisors
Date Date
ATTEST ATTEST
Clerk of the Board
Date Date
APPROVED AS TO FORM APPROVED AS TO FORM
Attorney for Maricopa County
Date Date
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EXHIBIT A – SCOPE OF WORK
2.0 SCOPE OF WORK:
2.1 Contractor shall assist in the development of a system for HEALTHCARE FOR THE
HOMELESS (HCH) staff to coordinate services for behavioral health patients who are
SMI, GMH, or have substance abuse issues and seen in the primary care clinic.
2.2 Contractor shall provide assistance in the development of a system for HCH staff to
coordinate appointments for behavioral health patients who are experiencing a behavioral
health crisis and are seen in the primary care clinic.
2.3 Contractor shall provide ongoing services to all uninsured patients who have a GMH
diagnosis and who have a completed HCH referral/screening intake form at time of
service.
2.4 Contractor shall coordinate a referral process to provide services to patients who are
homeless, served on the Human Services Campus, are Title 19 eligible, and have a GMH
or SMI diagnosis.
2.5 Contractor shall coordinate a referral process to provide services to patients who are
homeless, served on the Human Services Campus, are non-Title 19 eligible, and have
SMI diagnosis.
2.6 Contractor shall have the ability to provide services in a language the patient understands
or via an interpreter.
2.7 Contractor should be familiar with providing services to the indigent.
2.8 Contractor should be familiar with services rendered at Health Care for the Homeless.
2.9 Contractor shall provide a monthly invoice which specifies name and date of birth of
patient and cost of service.
2.10 Contractor shall provide comprehensive care management and medication management.
2.11 Contractor shall provide care coordination and health promotion.
2.12 Contractor shall provide a person-centered care plan for each individual that coordinates
and integrates all of his or her clinical and non-clinical health-care related needs and
services.
2.13 Contractor shall provide individual and family support, which includes authorized
representatives.
2.14 Contractor shall provide referrals to community and social support services, including
appropriate follow-up.
2.15 Contractor shall use health information technology to link services, facilitate
communication among team members and between the health team and individual and
family caregivers, and provide feedback to practices.
2.16 The Contractor shall maintain applicable licensure and skills according to the
requirements by State law, Department policies, and licensure agencies.
2.17 This amendment 2 includes funds of $65,877 to pay for the services of three (3)
Emergency Medical Technicians (EMTs) from September 1, 2016, through February 28,
2017, at the overflow emergency shelter(s) for clients using the Saint Vincent de Paul
shelter and the Human Services Campus. EMTs will provide Emergency Medical
Services seven days a week, in 12 hour shifts, from approximately 6:30 pm to 6: 30 am.
Contractor will provide MCPH HCH with a monthly report that includes the names and
dates of birth for all patient encounters that are assessed by the EMTs.
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