20070109_att2

Exhibit “A”

I.

For the period November 1, 2005 to October 31, 2006, Contractor shall provide full dental care to 455 homeless individuals living in shelters and/or on the street. Services include the following objectives:

Objective 1.

Contractor will provide 65 service days/visits at four (4) different locations (16-20 visits per location) within San Mateo County.

Objective 2.

Contractor will complete 16-20 patient appointments at each service day location completing a total of no less than 1040 patient appointment.

Objective 3.

Of the 1040 total patient appointments completed, 455 unduplicated homeless individuals will receive full, general dental treatment based on dental needs recommended by an affiliated dentist of Onsite Dental Care Foundation.

II.

For the period November 1, 2006 to April 30, 2007, Contractor shall provide full dental care to 250 homeless individuals living in shelters and/or on the street. Services include the following objectives:

Objective 1.

Contractor will provide 37 service days/visits at four (4) different locations (16-20 visits per location) within San Mateo County.

Objective 2.

Contractor will complete 16-20 patient appointments at each service day location completing a total of no less than 592 patient appointments.

Objective 3.

Of the 592 total patient appointments completed, 290 unduplicated homeless individuals will receive full, general dental treatment based on dental needs recommended by an affiliated dentist of Onsite Dental Care Foundation.

III.

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

A.

Submit Monthly Data Reports by the 10^th day of each month.

B.

Submit Monthly Invoices by the 10^th day of each month.

C.

Attend the monthly HCH Provider Meeting.

D.

Complete Annual Chart Review.

E.

Complete Annual Administrative Review.

F.

Participate in other Continuous Quality Improvement Activities

G.

Submit any other required documentation.



Exhibit “B”
In consideration of the services provided by Contractor in Exhibit “A”, County shall pay Contractor based on the following fee schedule:

A.	County shall pay Contractor $3,055 per dental service day not to exceed 65 service days for the period November 1, 2005 to October 31, 2006.

A.	County shall pay Contractor $3,055 per dental service day not to exceed 37 service days for the period November 1, 2006 to April 30, 2007.

C.	Contractor will invoice monthly. Invoices will be approved by the Health Care for the Homeless Program Director.

D.	The term of this Agreement is November 1, 2005 to April 30, 2007. Maximum payment for services provided under this Agreement will not exceed THREE HUNDRED ELEVEN THOUSAND SIX HUNDRED TEN DOLLARS ($311,610).


Exhibit “A”

I.	For the period November 1, 2005 to October 31, 2006, Contractor shall provide full dental care to 455 homeless individuals living in shelters and/or on the street. Services include the following objectives:

	Objective 1.		Contractor will provide 65 service days/visits at four (4) different locations (16-20 visits per location) within San Mateo County.

	Objective 2.		Contractor will complete 16-20 patient appointments at each service day location completing a total of no less than 1040 patient appointment.

	Objective 3.		Of the 1040 total patient appointments completed, 455 unduplicated homeless individuals will receive full, general dental treatment based on dental needs recommended by an affiliated dentist of Onsite Dental Care Foundation.

II.	For the period November 1, 2006 to April 30, 2007, Contractor shall provide full dental care to 250 homeless individuals living in shelters and/or on the street. Services include the following objectives:

	Objective 1.		Contractor will provide 37 service days/visits at four (4) different locations (16-20 visits per location) within San Mateo County.

	Objective 2.		Contractor will complete 16-20 patient appointments at each service day location completing a total of no less than 592 patient appointments.

	Objective 3.		Of the 592 total patient appointments completed, 290 unduplicated homeless individuals will receive full, general dental treatment based on dental needs recommended by an affiliated dentist of Onsite Dental Care Foundation.

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

	A.	Submit Monthly Data Reports by the 10^th day of each month.
	B.	Submit Monthly Invoices by the 10^th day of each month.
	C.	Attend the monthly HCH Provider Meeting.
	D.	Complete Annual Chart Review.
	E.	Complete Annual Administrative Review.
	F.	Participate in other Continuous Quality Improvement Activities
	G.	Submit any other required documentation.