AMENDMENT TO THE AGREEMENT

WITH SOUTH COUNTY COMMUNITY HEALTH CENTER

THIS AGREEMENT, entered into this day of , 2003, by and between the COUNTY OF SAN MATEO (hereinafter called "County") and SOUTH COUNTY COMMUNITY HEALTH CENTER (hereinafter called "Contractor"),

W I T N E S S E T H:

WHEREAS, on February 13, 2002, the parties hereto entered into an agreement (hereinafter referred to as the "Original Agreement") for the furnishing of certain services by Contractor to County as set forth in that Original Agreement, subsequently amended on April 1, 2002; and

WHEREAS, it is now the mutual desire and intent of the parties hereto to amend and clarify that Original Agreement;

NOW, THEREFORE, IT IS HEREBY AGREED between the parties that the Original Agreement is amended as follows:

1.

Paragraph 3., Payments., of the Original Agreement is hereby amended to read as follow:

"2. Payments. In consideration of the services rendered in accordance with all terms, conditions and specifications set forth herein and in Exhibit A, County shall make payments to Contractor in the manner specified herein and in Exhibit A. In the event that County makes any advance payments, Contractor agrees to refund any amounts in excess of the amount owed by County at the time of contract termination. County reserves the right to withhold payment if County determines that the quantity or quality of the work performed is unacceptable. In no even shall total payment for services under this Agreement exceed ONE HUNDRED TWO THOUSAND DOLLARS ($102,000)."

2.

Paragraph 7, Hold Harmless, of the Original Agreement is hereby amended to read as follows:

"7. Hold Harmless. Contractor shall indemnify and defend County, its employees and agents, from any and all claims, damages and liability in any way occasioned by or arising out of negligence of Contractor in the performance of the Agreement, including any sanctions, penalties or claims of damages resulting from Contractor's failure to comply with the requirements set forth in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and all Federal regulations promulgated thereunder, as amended."

3.

Exhibit A is hereby amended to read as follows:

"I.

Description of Services to be Performed by the Contractor

In consideration of the payments described in paragraph II, below, Contractor shall provide the following

A.

Contractor shall meet the following performance targets:

1.

Through information dissemination, Contractor will increase 100 children, youth, and families' understanding and perception of available health programs such as Healthy Families and Medi-Cal (HF/MC), per month.

2.

Plan and organize at least two (2) mass health enrollment events in the South County area.

3.

Assist in enrolling 40 children, youth and families per month into HF/MC.

4.

Organize and convene two (2) Ryan White Title III Agency Collaboration meetings, one (1) leadership forum and 6 (six) monthly Planning Council meetings.

B.

Contractor shall provide the following services:

1.

Inform children and families regarding HF/MC by distributing and presenting culture specific health education and coverage materials at existing community networks such as churches, schools, childcare providers, businesses, and cultural events.

2.

Conduct home visits to provide education and support needed to win the trust of families. Explain and translate HF/MC benefit requirements; collect documentation needed for benefits and either assist with the enrollment process or refer clients to the health access team.

3.

When key staff is not available for enrollment assistance, Contractor will refer eligible individuals to the health access team ensuring that the clients receive health coverage.

4.

Provide re-enrollment assistance.

5.

Improve Community Health Center administrative capacity in the areas of corporate compliance, human resources, integrated program/service development, and staff training/education.

6.

Develop fiscal capacity for such activities as accounting policies and procedures and monthly revenue/expense reports in order to comply with BPHC 330 grant requirements.

7.

Design clinical capacity for integrated care.

8.

Develop a Continuous Quality Improvement (CQI) process.

9.

Participate and provide leadership in the HIV Title III services planning process for south county.

10.

Assist in developing an HIV Services Planning Curriculum for community south county community leaders.

11.

Assist in identifying key south county community leaders and training them to participate in the Ryan White Title III planning process.

12.

Participate and provide leadership in the HIV Title III services planning process for south county.

C.

Contractor shall attend and participate in the following contract related meetings and complete the following reporting requirements on a monthly basis:

1.

At least two of Contractor's key staff for HF/MC outreach will meet with Health Services' HF/MC Community Program Specialist for on-going training on HF/MC outreach and enrollment. Every three months, the Community Access Program Project Director and the Contractor's HF/MC project supervisor will also attend the meetings.

2.

At least two of Contractor's key staff for HF/MC outreach will meet with Health Services' Community Health Advocates (CHAs).

3.

The Contractor's project supervisor and one key staff for HF/MC outreach will attend the Community Based Medi-Cal and Healthy Families Advisory Committee meetings in order to respond to evolving enrollment, coverage and retention issues.

4.

Contractor shall provide a report of the number of children reached through dissemination of outreach materials, screened for eligibility, assisted with HF/MC enrollment, and referred to Community Health Advocates.

5.

Contractor's medical director and executive director, or appropriate level representatives, will attend all Collaboration and monthly Planning Council meetings associated with the Ryan White Title III Planning Grant.

II.

Amount and Method of Payment

A.

In consideration of the services described in paragraph I, above, San Mateo County shall pay Contractor based on the following fee schedule:

1.

After hiring and training at least two staff members on Healthy Families and Medi-Cal enrollment and upon the staff members receiving Richard Heath & Associates (RHA) certification, Contractor will submit an invoice for $4,000.

2.

Contingent on completing the above listed quarterly performance targets, services, meetings, and reporting requirements, Contractor will submit an invoice for $3,000 on a quarterly basis starting March 1, 2002.

3.

After completing a progress report and a financial line-item report on the activities listed in Paragraph I. B. 5, 6, 7, 8, and 9, Contractor will submit an invoice for $65,000.

4.

Contingent upon completion of activities listed in Paragraph I. B. 10 and 11, Contractor will submit an invoice for $7,500 no earlier than January 1, 2003.

5.

Contingent upon completion of activities listed in Paragraph I. B. 12, Contractor will submit an invoice for $7,500 no earlier than June 30, 2003.

B.

The term of this agreement is November 15, 2001 to June 30, 2003. Total payments for services provided under this agreement shall not exceed One Hundred two thousand Dollars ($102,000). Invoices shall be approved by the Community Access Program Project Director and paid within 30 days of receipt of invoice. Invoices related to the Ryan White Title III Planning Grant (II. 4 and 5 above) shall be approved by the Program Services Manager for Community Clinics.

NOW, THEREFORE, IT IS HEREBY AGREED BY THE PARTIES that:

1.

These amendments are hereby incorporated and made a part of the Original Agreement and

subject to all provisions therein.

2.

All provisions of the Original Agreement, including all references to audit and fiscal

management requirements unless otherwise amended hereinabove, shall be binding on all the parties hereto.

3.

All provisions of the Original Agreement, including all monitoring and evaluation

requirements, shall be applicable to all amendments herein.

NOW, THEREFORE, IT IS HEREBY AGREED BY THE PARTIES that the Agreement of February 13, 2002, be amended accordingly.

IN WITNESS WHEREOF, the parties hereto, by their duly authorized representatives, have affixed their hand on the day and year first above written.

COUNTY OF SAN MATEO

SOUTH COUNTY COMMUNITY HEALTH CENTER

By:

By:

President, Board of Supervisors

San Mateo County

Date:

Date:

ATTEST:

By:

Clerk of Said Board

Date: