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12
City of Pleasanton
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CITY CLERK
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AGENDA PACKETS
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2021
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030221
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12
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3/1/2021 2:13:05 PM
Creation date
2/25/2021 9:12:10 AM
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CITY CLERK
CITY CLERK - TYPE
AGENDA REPORT
DOCUMENT DATE
3/2/2021
DESTRUCT DATE
15Y
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EXHIBIT C <br /> REPORTING REQUIREMENTS <br /> Axis shall provide to City a Quarterly Update Report by each of the following dates: <br /> Reporting Period: Due to City by: <br /> April 1 through June 30, 2021 July 20, 2021 <br /> July 1 through September 30, 2021 October 20, 2021 <br /> October 1 through December 30, 2021 January 20, 2022 <br /> January 1, through March 30, 2021 April 20, 2022 <br /> Each Quarterly Update Report shall include the following information: <br /> 1. Number of visits provided <br /> 2. Number of referrals provided <br /> 3. Number of referrals to emergency departments <br /> 4. Number of referrals to PD/5150's <br /> 5. Patient demographic date (inclusive of zip code, ethnicity, gender, age) <br /> 6. Payer type (insurance/Medi-Cal/Medicare/other) <br /> 7. Number of patients using psychiatry services <br /> Consulting Services Agreement between City of Dublin and April 1, 2021 <br /> Axis Community Health for Mental Health Urgent Care Services Pilot Program Exhibit C— Page 1 of 1 <br />
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