CN-640000-CL068.pdf

This is a standard contract between the State of Florida, Department of Health and Surgery Center of Naples for Comprehensive Tubal Ligation Support Services. The contract is specifically a Program Specific Model Attachment I (PSMAI) that outlines the provision of tubal ligation and/or salpingectomy support services for clients referred by the Department. The contract is governed by federal regulations including Title X of the Public Health Service Act, 42 CFR Part 50, and Florida Statutes such as Section 381.0051.

The contract is a fixed-price, unit cost arrangement with a total dollar amount not to exceed $10,400.00, subject to fund availability. The provider will be paid $800 per tubal ligation and/or salpingectomy support service, with a maximum of 13 services during the contract period. Payment is contingent upon completed services, including a pre-procedure office visit, the actual tubal ligation or salpingectomy procedure, and associated documentation. The contract is effective from 07/01/2024 to 06/30/2025, with the option to terminate with 30 days' notice. The services must be provided to clients who are at least 21 years old, have given informed consent, and meet specific federal and state regulatory requirements. The contract may be renewed for up to three years under the same terms, contingent on satisfactory performance and fund availability.