ORDER ND. c1187
RF'F'RDVRL DF JUHN C. N.F:Y RS F'RDVIDF_R FUR
N,ERR CUUNTY INDIGENT HERLTH F'RUGRRM
Un this the '3rd day of Novemher- 199'x, upon motion made by
Commissioner- Mar^g an, seconded by Commissianer^ Holekamp, the
Co~_ir-t approved by a majority vote of 4-0-1 with Judge Stacy
Rbstaining~ to approve John G. N.ey as the provider for F:err^
Co~_inty Indigent Health F'r^ogr^am, due to the shay^t age of
doctors and the recommendations of Tony Hall and ather^
physicians of the Hospital.
COMMISSIONERS' COURT AGENDA REQUEST
., ..~ r. rr rl Ill AlICL ~.I~.,~,~~.~AL AND FIVE COPIES OF THIS REQUEST AND
DOCUMENTS TO Rc oF~nFwFn Rv THE COURT
MADE BY: R. Gordon Morgan
MEETING DATE: November z3, 1992
OFFICE: Commissioners' Court
TIME PREFERRED:
~~
SUBJECT: (PLEASE BE SPECIFIC) consider contracting with Dr. John C. Key
as a provider for the Kerr County Indigent Health Program. _
EXECUTIVE SESSION REQUESTED: YES NO x
PLEASE STATE REASON FOR EXECUTIVE SESSION
ESTIMATED LENGTH OF PRESENTATION:
PERSONNEL MATTER - NAME OF EMPLOYEE:
NAME OF PERSON ADDRESSING THE COURT: rnmm;sc;~.,P>^ Prt. Iii
Time for suDmitting this request for Court to assure that the matter 15 posted in accordance
with Article 6252-17 1s as follows:
* Meetings held on Monday: 12:00 P.M. previous Wednesday
THIS REQUEST RECEIVED BY: is
THIS REQUEST RECEIVED ON : 11/17/92 ~ 8:14 am
All Agenda Requests will be screened by the County Judge's Office to determine if
adequate information has been prepared for the Court's formal consideration and action
at time of Court meetings. Your cooperation will be appreciated and contribute towards
your request being addressed at the earliest opportunity. See Agenda Request
Guidelines.
JOHN C. KEY, M.D.
FAMILY Mf OICINE
715 HILL COUNTRY DRIVE. SUITE 4
KERRVILL E, TEXAS 78020
TELEPHONE (512) 596-7171
November 9, 1992
Dr. Gordon Morgan
Commissioner's Court
Kerr Couty
County Courthouse
Kerrville, TX
RE: Kerr County Indigent Health Program
Dear Dr. Morgan,
I wish to become a provider for the Kerr County Indigent
Health program. I am currently seeing many of these patients
in my practice, as I am virtually the only physician in town
seeing new patients regardless of their insurance status.
I have an outpatient general/family practice; I do not
hospitalize patients for care, but refer them to local spec-
ialists as needed. Since I do no hospital work, I am not
covered by the current contract with Sid Peterson Memorial
Hospital and its staff.
The County should save considerably by contracting with
our office, as our usual fee for seeing patients is in the
$22-$35 range, somewhat less than an emergency room visit,
:7averthless, I do not feel we would be "competing" with Sid
Peterson and its staff, since most patients that i would see
would have been seen initially at Peterson Hospital and can-
not now see a physician for follow-up in a timely manner.
Thus, I believe it would be to the advantage of all for me
to be a contract provider.
I appreciate your help in this matter, and would be
happy to address any additional concerns.
Yours truly,
J< ~~~Key,
AGRBffiSBNT
(PHYSICIAN - SID PETERSON MEMORIAL HOSPITAL)
This Mandated/~Provi er Agreement is entered into on the
day of _~ ~ 1992, by and between all
Physicians (medics doctors) on staff at SID PSTSRSON
MEMORIAL HOSPITAL as of August 31, 1992, acting by and
through their duly authorized Chief of Staff, John D. Davis,
M.D. (hereinafter called "Physician, whether one or more),
and KERR COUNTY, TEXAS, acting by and through its duly
authorized COUNTY JUDGE, W. G. STACY, as authorized by the
Commissioners' Court of Rerr County, Texas (hereinafter
called "County").
WITNESSETH
WHERSAS, County is required by the Indigent Health Care
and Treatment Act (hereinafter called "Act") to Drovide
certain physician services for its eligible residents;
WHEREAS, County desires to insure that County's
eligible residents receive those mandatory physician
services required by the Act;
WHEREAS, Physician agrees to provide, or to arrange the
provisions of, those mandatory physician services required
by the Act for County's eligible residents;
NOW, THEREFORE, in consideration of the mutual
covenants herein contained, County hereby designates and
Physician hereby agrees to be a Mandated Provider for
mandatory physician services required by the Act or the
Act's regulations to be provided to County's eligible
residents and the parties agree as follows:
1. DSFINZTIONS
All terms shall be as defined in the Act and by the
TEXAS DSPARTMENT OF HUMAN SERVICES, (hereinafter called
"Department") to the extent of the departments rights,
responsibilities and powers under the Act.
2. MANDATED PROVIDER
Physician shall be a mandated provider o! the mandatory
physician services for County's eligible residents, as
defined by the Act. Physician represents that Physician is
duly licensed as a Medical Doctor under the laws of the
State of Texas and is certified for the Medicare program by
the Health Care Financing Administration. Unless otherwise
agreed upon, Physician shall deliver, or arrange to be
delivered, physician services that are considered mandatory
services pursuant to the Act or as defined by the
Department. Such services shall be provided to eligible
residents of County who do not reside within an area that a
7. REIMBURSEMENT PROCEDURES
Phyaician shall present charges for physician services
ahalldereimburse giPhysicianenwithin Cthirty m (30)ly dayauno!
presentation of the charges at the payment rate determined
by the Department.
All payment disputes are to be submitted for binding
resolution to a panel consisting of a Hospital medical staff
member who did not attend the patient, Hospital's
administrator, one Hospital Hoard of Director member, County
Judge, and one County Commissioner.
In the case of emergency physician services rendered to a
patient who is determined in Section 5 not to be eligible
for financial assistance, Physician shall be financially
responsible !or the services rendered to such Datient.
Physician reserves the right to pursue any reasonable
collection effort against such patients. Phyaician shall
have the right to bill eligible patients for non-covered
charges whether the charges are for excluded services or
because the charges are not payable by County due to
provisions o! the Act or payment policies and rates
established by the Department.
8. THIRD PARTY PAYORS
Physician will notify County if any eligible residents have
access to any other sources' of payment for the eligible
services provided, but County shall be responsible for the
payment of such eligible services as provided for herein.
Physician shall notify County of the amounts received from
third party payora and reimburse County for services and
amounts covered under this Agreement.
9. RECORDS
Physician will provide County access to all financial
records necessary to document the Physician's provision of
services. Such access shall be during normal business hours
of the Physician and shall be preceded by notice lrom
County. Such notice shall be received by Physician twenty
four (24) hours in advance of such examination. County shall
hold all medical records in strict confidence so as not to
violate the physician/patient relationship.
County shall obtain a signed authorized medical consent form
from the patient, authorizing the release of his/her medical
records and provide the same to the Physician prior to
receiving any medical records.
10. TERM AND RENEWAL TERMS
The term of this Agreement shall be from September 1, 1992
through August 31, 1993. This Agreement may be renewed for
additional one (1) year terms by written agreement of the
parties at least thirty (30) days prior to the expiration o!
public physician or physician district has a legal
obligation to serve. County shall require its eligible
residents to obtain mandatory physician services from
contracting physicians except in emergency situations, or
when medically inappropriate.
3. COUNTY'S FINANCIAL OBLIGATIONS
County shall reimburse Physician for physician services
provided to eligible residents. County will reimburse
Physician for all normal and reasonable charges for mandated
services up to the maximum amount of services and
reimbursement allowed under the Act. County is not liable
for reimbursement of services which exceed the maximum per
patient limits established by the Act. If Physician
transfers eligible residents of County to a noncontracting
physician for physician services which physician is unable
to provide, County is obligated to reimburse the receiving
physician at the receiving physicians payment rate, but not
to exceed the maximum payment of reimbursement allowed under
the Act or established by the Department. All transfers will
be made to contracting physicians if possible. Per Datient
expenditure limits as established by the Act apply to such
services delivered by the receiving physician.
4. NOTICS
County shall have the duty and responsibility to give
all notices concerning the availability of mandatory
physician services from Hospital.
5. DETERMINATION OF ELIGIBILITY
County shall be responsible for determining whether an
applicant is eligible for financial assistance 8efined by
the Act and shall provide eligible residents with documents
and/or cards which identify persons ea eligible residents.
In the case of a patient who may be eligible seeking non-
emergency services, Physician shall not provide such non-
emergency services until County has determine8 eligibility
of the patient, has notified Physician of the eligibility
decisioa and has approve$ in writing provision of the aon-
emergency services. County must determine eligibility for
non-emergency services within fourteen (14) days from the
date County receives a completed application.
Sligibility requirements and this contract may be modified
at any time by County to reflect any statutory changes in
County's indigent care obligations. Residency 8isputea shall
be resolved by the Department.
6. NOTIFICATION OF PROVISION OF SERVICES
Physician may deliver emergency services to eligible
residents of County without obtaining County approval.
Physician must receive written approval from County before
providing non-emergency services.
the original or any renewal term. County shall reimburse
Physician according to the provisions of this Agreement for
eligible patient who continues to receive eligible physician
services past the expiration of this Agreement.
11. TERMINATION AND RIGHT TO CURS
Either party may terminate this Agreement upon breach
of this Agreement with thirty (30) days prior written
notice, provided the breaching party has been notified
thirty (30) days prior to the termination notice and efforts
to resolve the matter to the terminating party's
satisfaction are unsuccessful. Upon termination as provided
for herein, neither of the parties shall have anp further
duty or obligation to the other except for indsbteduessM~tlMrMrnu~~ ~~~
at the time of termination and indemnification o! the other
party. `,
la. HOLD HARMLESS
Each party agrees to indemnify and hold harmless the
other party and its employees against and from all claims
and actions brought by third parties against the other party
on account of willful, intentional, negligent or illegal
conduct, omissions or bad faith o! the party, its agents or
employees. Physician shall retain sole authority and
responsibility for the services rendered to eligible
patients of County.
13. ASSIGNMENT
Neither party shall assign this Agreement except with
the prior written consent of the other party, except as
provided in Section 5 hereof.
14. HfiADINGS
Section headings are for
and shall not be used to
provision to this Agreement.
convenience of reference only
construe the meaning of any
15. COUNTERPARTS
This Agreement may be executed in anY number ~I;~o~~19 ~~,~~~~~~~~
counterparts, each of which shall be an original, and all'o! ,~„I
which shall together constitute one agreement.
16. OBLIGATIONS AS CONDITION
All obligations of each party to this Agreement are
conditions to further performance of the other party's
continued performance of its obligations under the
Agreement.
17. EXCLUSIVE RIGHTS
Only the parties to this Agreement have the exclusive
right to bring suit to enforce this Agreement and no other
parties may bring suite as a third party beneficiary, or
otherwise, to enforce the Agreement.
18. SEVERANCB
Should any part of this Agreement be invalid or
unenforceable, such invalidity or unenforceability shall not
affect the validity and enforceability of the remaining
portions.
19. LAW
This Agreement shall be construed in accordance with
the laws of the State of Texas.
20. AMENDMENT
This Agreement may not be modified except in writing
executed by both parties to this Agreement.
21. NOTICE
Any notices, demands or communications required,
permitted or desired to be given hereunder shall be deemed
effectively given when personally delivered or mailed by
prepaid certified mail, return receipt requested, addressed
as follows:
Kerr County Judge Chief of Staff
Rerr County Courthouse Sid Peterson Memorial Hospital
700 Main 710 Water Street
Kerrville, Texas 78028 Kerrville, Texas 78028
or such other address and to the attention of such other
person(s) or officer(s) as either party may designate by
written notice.
22. FORCE MAJSURS
Neither Party shall be liable
default for any delay or failure of
Agreement or other interruption from
military authority, acts of public
fires, explosions, earthquakes,
transportation, strikes, or other
either Party's employees or agents
dissimilar cause beyond the reasons
Party. Either party in such even
Agreement.
nor deemed to be in
performance under this
Acts of God, civil or
enemy, war, accidents,
floods, failure of
work interruptions by
i, or any similar or
ble control of either
t may terminate this
23. RELATIONSHIP OF PARTIES
None of the provisions of this Agreement are intended
to create nor shall be deemed construed to create any
relationship between County and Physician other than that of
independent entities contracting with each other hereunder
solely for the purpose of effecting the provisions of this
Agreement. Neither the parties hereto, or any of their
respective officers, directors or employees shall be
construed to be the agent, employee or representative of the
other party.
24. ENTIRB AGREEMENT
This Agreement supersedes all prior agreements between
the parties with respect to the subject matter hereof. This
Agreement is subject to all areas controlled by the Indigent
Health Care an8 Treatment Act, as it may be amended, and by
the Texas Department of Human Services and other applicable
local, state and federal laws, rules or regulations.
IN WITNBS3 WHEREOF, the Parties have caused this
Agreement to be executed by their respective duly authorized
representatives as of the day and year first above written.
SID PETERSON MEMORIAL HOSPITAL
BY:
John D. Davis, M.D.
Chief of Staff
1CERR COUNTY, TEXAS
~/~ ~ r
W. G. Stacy
Xerr County Judge
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