276152 WHITE - CITY CLERK � �: M�,+ 'w ;
PINK - FINANCE GITY OF SAINT PAUL Council ��r�`�}�'J�
CANARV - DEPARTMENT
BLUE - MAVOR File NO.
Council
Presented By Leonard W. Levi �
Referred To Committee: Date
Out of Committee By Date
RESOLVED, that the Council of the City of Saint Paul hereby authorizes and
directs the proper City officials to execute an agreement with the County of Ramsey
and West Side Health Center, whereby the City and County will assist in its
functioning as a neighborhood health center in caring for the medical-health needs
of the citizens of the city and county in the adjacent geographic area; the City's
contribution for the calendar year 1981 being $51,624.50, and said agreement
expi ri ng December 31, 1981 .
Funcing code 03215
COUNC[LMEN Requested by Department of:
Yeas Hunt Nays
Levine � � Communit $@ VIC@5
In Favor
Maddox ,1
McMahon ���
__ Against Y
Showalter
Tedesco
����� JAN 6 �7v� Form A oved b C' e
Adopte y Council: Date C
Ce ified Pas• y Counc' Secretary BY
B � °A�� A
l
Approv�by Mavoc Date A r ve by Mayor for is 'on to Council
\
By �' � 1 — B
�`�� J.4�J 1 7 1981
� •I � • k•�.f..;n A:.� '"': `Y
. . AGREEMENT R' ������
AN AGREEMENT, made and entered into this day of
December, 1980 among the City of Saint Paul, a municipal corporation of the
State of Minnesota, hereinafter referred to as the "City", acting through its
Division of Public Health; the County of Ramsey, a political subdivision of th�
State of Minnesota, hereinoffier referred to as the "Counfiy", ccting through its
Department of Pub�ic Healfih; and West Side Community Health Center, Inc,
' � located at 179 E. Robie Street , Saint Paul, Minnesota,
' hereinafter called "Grantee";
- - WITNESSETH:
In consideration of the services of the Grantee functioninc� as a neighborhood
. health center in ca�ing for the medical-health needs of the citizEns of the City
a
and Cnunty, Phe parties hereto mutually agree as follows: '
1. The City and County wilf each give to the Grantee such sum of money
as reflected on the attached Exhibit A and in the manner set forth herein.
� -
� 2. The sum of money granted by the City and County is for the Grantee's
use during 1981 . No additional or future fund'+ng or assurances thereof wifl be
� pro�rided or honored unless set forth in an omendment to this Agreement or a
separate agreement approved as the free act of the City and County.
_ 3. The County shall pay to the City its contribution as reflected on fx- ,
hibit A in equal installments before Jdnuary 1, April l, July 1, and October 1,
1981 .
4. The City sholl pay to the Grantee its and the County's contribution in
installments os follows: �
,. . , . _ �.. �.. _ _ ._.R� __
. • -2- •
- ., . , . ,
(a) 25% of the total contribution of both the City and County on or
before Janua�y l , 1981 .
(b) 25% of the total contribution of both the City and County on or
before Apri I 1, 1981 .
(c) 25% of the total contribution of both the City and County on or
before July 1, 1981 . .
(d) 25°!0 of the total contribution of both the City and County on or �
t . before� October 1, 1981 . ,
5. The City, acting as the transmittat agent of the contribution of both
the City and County, as set forth in Paragraph 4, shall not be liable to pay to
the Grantee the County's cont�ibution if not received by it from the County
_ , pursuant to Paragraph 3.
6. The Grantee shall on April 20, July 20, October 20, 1981 and '
January 20, 1982 submit to the City an itemized statement of al) Grantee's
.
expenditures, revenue and �eport of services on a form or forms_to be provided
by or approved by the City. The City shall make such reports available to the
County upon receipt. Further, the Gronte� shall preserve all documentation
.' used by it in complyi�g with the statements and reports required by this paro-
� ,; .
graph and sholl be available to the City and County for its review and audit
. as des i red. � = '
;
7. The Grantee shall, with approval of the City, develop and enforce '
a fee schedule for patient charges. Said fee schedule shall be mode available
to the City on January 15, 1981,
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� .� . �3- - a 7 C 1 � =�-.,
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8. The City shall act as the lioison to the Grantee for such day-to-day
. odministration as may be needed and shal) be responsible for:
(a) Reviewing and evaluating the program and fiscal activifiies of the
Grantee and disseminating reporh thereof;
' (b) Providing technical assistance to the Gronfiee in developing and
implementing the fee schedule referenced in Paragraph 7; �
(c) Coordinating activities common to the Division of Public Health of
�
. the City and/or the Public Health Departm�nfi of fihe County ond the Grantee;
(d) . Rendering to the Grantee such other assistance as within the City's
resources.
9. The Grontee shall ensure that:
` (a) Services provided to eligible individuals are fumished without regard
to race, color, creed, sex, age, marital status or fami ly size;
(b) Services are provided with respect for individual privacy and dignity; and
• � (c) Services are provided without coercion and shall not be denied on the
basis of refusal �to participate in research projects or other activities of the
Grantee, or on the basis of ability to pay.
10. The Grantee shall obtain and keep in force at its own expense during
„the term of this �qreement, professiona) liability insurance in fihe amount of Three
- Hundred Thousand Dollars ($300,000). A certificate evidencing such insurance as
being in force during 1981, and co-insuring the City and County, shall be fur-
�ished to the City Attomey for review and approval before January 1, 1981 .
11 . The G�antee shall submit to the City an operational plan of its services
to be provided during the term of this Agreement on or before January 15, 1981 .
m.:-w -..�,..�. -........ _ ,.,.�..
, � ' � � -4-
• ,. , . �
• . L
12. The Grantee shall submit to the City a total operoting budget on fofms
. provided by the City and an operation plan of its services to be provided during
the calendar year 1982 on or before �pri I 30, 1981 ,
13. The Grantee shall obtain a financial and program audit for the period
' of this Ag�eement by a certified public dccountant. This Audit shal) certify to .
compliance with the terms of this grant and budget developed for this grant period. '
7he Grantee shall submit a copy of the oudit report to the City by Apri 1 1, 1982.
The City shall make said report avai leble to the County upon receipt. ' .
14. The Grantee shali make available �elevant background and qualification
summaries of both regula�ly employed and volunteer staff to the City dnd Cc�unty.
15. The Grantee agrees that deviafiions of ten percent (10°!0) or more�. up- �
wards or downwards, from its 1981 ogency budget, and/or additions or deietions
from its 1981 operational plan as approved by the Cifiy and County will be kans-
mitted to �he City and County in a timely f�hion cnd in a manner to 6e determined
• by the City's clinic coordinabr. Such information shall be before the fact and
shalt include pertinent data relative to the planned addition, deletion, or any '
ofiher modification of programs and the subsequent projected budgetary impect for
tF�e controct year ond the following year.
16. The G�antee declares Garv Sande. Director to be the
person responsible for compliance with the te�ms of the Agreement, end its physician,
Luis De Cubas , M.D., as the person responsible for its �
medical services.
17. The City declares its Director of the Department of Communifiy Services
or such designee as �oted in writing by him as the person responsible for compliance
with this Agreement.
� • .
_ , . -5- � ' ��..
" � • � . . . � 7 �, 1
18. The County declares its Executive Director ,or such designee as noted in
writing by him as the person responsible for compliance with this Agreement.
19, The Grantee agrees that at all times under this Agreemenfi, it, and its
employees, agents, and volunteers are independent contractors as to the City, ond
not employees of the City.
20. The Grantee agrees that ot all times under this Agreement, it, and its
employees, agents, and volunfieers are independent confiroctors as to the County,
and not employees of #he County.
21 . The term of this Agreement shall be from January 1, 1981 through
� December 31, 1981 .
IN WITNESS WHEREOF, the parties have set their hands as follows: .
CITY OF SAINT PAUL COUNTY OF RAMSEY �
Fu ing Code; 15 .
r � -
.
By: By:
ayo Board Chairman '
By: By: �
' � Direcfior, Department of Finance Executive Director
and Management Se�vices �
Funds are avai lable
By; l Account' Number:
; ' irecto�, D partme t of �
Community Servi ces Amount: $
,
es t form• By:
'' Budgeting and Accounting
. Assistant City ttomey �
GRANTEE (nsurance Approval �
By:
Risk Manager
By:
Approved as to form:
By:
Assistant County Attorney
,: - � �� � � ---�
� �-
• , APPENDIX A
West Side Aealth Center, Inc.
Revenue Sources - 1981
City of Saint Paul $ 51,624.50
County of Ramsey 51,624.50
Medical Patient Fees - Third Party 59,809.00
Dental Patient Fees - Third Party 26,643.00
� State Family Planning 16,586.00
Individual Contributions 400.00
-- Interest 500.00
Miscellaneous� 770.00
Corporations and Foundations 53,870.00
2
Cooperating Fhnd Drive 1,000.00
TOTAL $ 262,827.00
.
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� � .- . . � . • . •. , .
��d� . . . � .• . .•. . •. �
NAME-AND ADDijESS OF AGENCV
� �� ���� ��� COMPANIES AFFORDING COVERAGES
�� �0�g ����' ����• COMPANV e �� �e•��T��
��Z;.�' �• 5��1 . LETfER A �• PwVL wW�rAl�iaaa7
COMPANV � , . . �
� . LETTER ' . . ..
NAME AND ADDRESS OF INSURED
COMPANY �
LETTER
�� �� �I� �r�� ��i•
1�� �• �BJ.i �• COMPANV D
LETTER
92. P1TiL, �T. 55107
COMPANY C
LETTER `
This is to certity that polities of insuronce listed below have been issued to the insured named above and are in force at this time. Notwithstanding any requirement,term or condition
of any contract or other dxument with respect to which this certificate may be issued or may pertain,the insurance afforded by the policies described herein is subject to all the
terms,exclusions and co�ditions of such policies.
COMPANV POLICV Limits of Liabili in Thousan s
LETTER TVPE OF INSURANCE POLICY NUMBER EXPIRATION DATE EACH qGGREGATE
OCCURRENCE
GENERAL LIABILITY
BODILY INJURY E E
❑COMPREHENSIVE FORM
❑PREMISES—OPERATIONS PROPERTV DAMAGE E $
�EXPLOSION AND COLLAPSE
HAZARD
❑UNDERGROUND HAZARD
�PRODUCTS/COMPLETED
OPERATIONS HAZARD BODILY INJURY AND
❑CONTRACTUAL INSURANCE PROPERTV DAMAGE $ $
� BROAD FORM PROPERTY COMBINED
DAMAGE
❑ INDEPENDENT CONTRACTORS
❑ PERSONAL INJURY PERSONAL INJURY $
AUTOMOBILE LIABILITY aooi�v irv�uRV $
(EACH PERSON)
❑ COMPREHENSIVE FORM BODILY INJURY $
❑ OWNED (EACH ACCIDENT)
❑ HIRED . . PROPERTY DAMAGE b
❑ NON-OWNED BOOILY INJURY AND
PERTY DAMAGE $
COMBINED
EXCESS LIABILITY
BO ILY INJURY AND
❑ UMBRELLA FORM P PERTY DAMAGE $ E
❑ OTHERTHANUMBRELLA
COMBINED
FORM
WORKERS'COMPENSATION STATUTORY
and
EMPLOYERS'LIABILITY $
(EACH ACCIDENT)
OTHER
��t�0 �iRf�i �r�.8�
s Prolessi��sl �.i.ab i'b 5�3J�A� 1/1/82 �,t�4� ��gsts
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES
�i1� �� �� t�� � � �i'�� �� � � ���I��� � � �Z��
�� ������'r� 0� � ����
Cancellation: Should any of the above described policies be cancelled before the expiration date thereof, the issuing com-
pany will endeavor to mail �fl._ days written notice to the below named certificate holder, but failure to
mail such notice shall impose no obligation or liability of any kind upon the company.
NAME AND ADDRESS OF CERTIFICATE HOLDER: / ��.. �
Cit� •f .'Rt.. Ptt�7. DATE ISSUED:
�ivisi�a at' Pabiio �salti
�5� �e�tsr ,ve. �
�t. �s�l., �ts. 551�1 �
.AUTHORIZED REP ATIVE
Atts: Betty Tedesso
ACORD 25(1J9)
,
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,
'' � - OM OL: I2/1975
. . Rav. : 9/8/76
EXPLANATION OF ADMINISTRATIVE ORDERS, � ,:
RESOLQTIONS, AND ORDINANCES ��,ir��i��
�tECEiVED
Date: DECEMBER 17, 1980 , �EC 3 C�
��
Tp: MAYOR GEORGE LATIMER \
, _
�= TNOMqS J. KELLEY
�= COUNC�L RESOLUTTON AUTHQR�Z�NG AGREEMENT BETW�EN C�TY�; COUNTY, AND �
� WEST SIDE HEALTH CENTER
ACTION REQtTESTED:
Approval and s�~gnatures on attacf�ed Resolution
PURPOSE AND RATIONALE FOR Z'$IS ACTION:
Medical-health needs of cotrmtun�ty -
aT�csriErrrs:
Council Resolution
One Copy of Agreement
Insurance Certi�P�'cate