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PSYCHOLOGICAL SERVICES t I LETTER OF AGREEMENT This letter represents a summary of the agreement between Profes- sional Psychological Services (PPS) and The City of Clearwater. PPS agrees to extend its program to provide the City of Clearwater with comprehensive, integrated mental health and chemical dependency care effective January 1, 1996. PPS agrees to provide the full-range of services for employees and eligible dependents in need of mental health, alcohol or substance abuse treatment on both an in- and outpatient basis. The Employee Assistance Program (EAP) includes three (3) sessions at no cost to the employee plus supervisory training, mandatory referrals and fitness-for-duty evaluations. PPS will continue to assume clinical responsibility for all eligible members residing both in- and outside the Tampa Bay area. PPS will continue to assume full financial risk for the provision of all services without any further financial obligation from the City. PPS agrees to a capitation rate of $8.71 Per Employee Per Month. The City agrees to remit payment to PPS by the end of the month in which services are provided. Any annual increases in the capitation rate shall be negotiated with the City. PPS agrees to provide mental health and chemical dependency care within the following plan of benefits: OUTPATIENT MENTAL HEALTH, ALCOHOL/SUBSTANCE ABUSE SERVICES: * No deductible. * Thirty (30) visits per calendar year. * No copayment for visits 1 thru 3 (EAP benefit) . * Copayment of $10 for visits 4-30. * Copayment of $20 per day for intensive outpatient treatment program up to 30 days per year. * Copayment of $10 per hour for standard psychological testing of personality and educational concerns. INPATIENT MENTAL HEALTH, ALCOHOL/SUBSTANCE ABUSE SERVICES: * Deductible of $200 per inpatient admission. * Thirty (30) days per calendar year. * Maximum of five (5) days per year for medical detoxification due to alcohol/substance abuse. * Maximum of three (3) hospitalizations lifetime for medical detoxification. PPS and The City of Clearwater look forward to continuing our successful relationship as symbolized in the signatures below on JAN - 1 1996 this date, ~~ William L. Kale, Ph.D. President EliZab~~la City M nager ,r (!