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AI- 2881   12. B. 12.    
BOC Regular
Meeting Date: 05/16/2019  
Approval of Care Here Medical Services Agreement Renewal
FROM: Jim Dyer, Corporation Counsel, Corporation Counsel
Department: Corporation Counsel  

Resolved, that the Calhoun County Board of Commissioners does approve the renewal of the CareHere Management, PLLC Medical Services Agreement as presented.
Administration recommends approval of the renewed CareHere Management, PLLC Medical Services Agreement.
In October 2018, Calhoun County was informed by the City of Battle Creek that it was withdrawing from the CareHere health care coalition, and that it intended to enter into a new agreement with a different health care provider. The City also informed the County that it would operate its new health care clinic at the then existing CareHere Health and Wellness Center, which was located in the Battle Creek Public Works building.

As a result, the existing partners in the CareHere coalition needed to locate a facility for a new clinic, and negotiate a renewal of the Clinic Service Agreement with CareHere, that had previously been in existence with the City of Battle Creek. All in a very short span of time.

The first step in this process was accomplished at the Board of Commissioners November 15, 2018 meeting with approval of the construction contract to renovate the former Community Corrections building to function as the new CareHere Health and Wellness center. This renovation was successfully completed, on time, and with no interruption of health care or wellness services to the employees of the CareHere coalition.

This agreement implements the compensation and cost sharing arrangement to allow the CareHere coalition to properly function. Since Calhoun County is the owner of the building where the center is located, this agreement is between the County and CareHere. Another agreement, between CareHere, the County and all other members of the coalition establishes the formula for cost sharing of clinic expenses among the partners, as consumers of health care. This agreement establishes the County's relationship with CareHere as landlord, and covers issues related to establishment of the clinic, management of the facility, and allocation and reimbursement of occupancy expenses. The Commission will also be asked to approve the County's participation in the coalition, by approving this separate Shared Clinic Agreement.

A copy of the proposed contract is attached for review. The major features of the renewed CareHere contract include:

1. Provides for a capital contribution by CareHere, capped at $150,000.00 for Building and Security Enhancements including exterior lighting, fencing, security access, parking lot paving, signage, surveillance cameras, and landscaping.
2. Limits clinic wait times to a 15 minute average.
3. Requires CareHere to initially "furnish, outfit and supply"  the clinic up to a cost of $50,000.00, subject to reimbursement for consumable supplies as part of expense sharing arrangement.
4. Sets the standard of care and the types of health care providers supplied by CareHere.
5. Allocates facility use costs among the partners, using a net credit to the County for its share of occupancy expenses and direct billing of these costs to the other partners.
6. Establishes a standardized monthly per employee charge of $25.00 applicable to all participating partners (lowered from the prior contract of $30).
7. Establishes a method for adding additional partners to the coalition.
8. Provides a 5 year contract term, with early termination, with or without specific cause, on 12 months notice after the first two years.
9. Confirms that the clinic, and all improvements created for clinic operation, is County property upon termination.
10. Preserves the status of CareHere and its employee as independent contractors.
As suggested by the Commission. Approval of the agreement is necessary for continued clinic operation.
Administration recommends approval of the renewed CareHere Management, PLLC Medical Services Agreement.

Fiscal Impact
The previous Care Here contract and expenses were factored into the 2019 approved budget. Any changes in the attached 2019 renewal will have a positive financial impact with the transfer of the Clinic to a County owned facility
Care Here Renewed Service Agreement

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