2023 07 MCAO-HONORHEALTH CONTRACT_MCAO SIGNED.PDF

AGREEMENT FOR FORENSIC NURSE EXAMINER SERVICES
BETWEEN
MARICOPA COUNTY, BY AND THROUGH MARICOPA COUNTY ATTORNEY’S OFFICE
AND
HONORHEALTH ON BEHALF OF ITS FORENSIC NURSE EXAMINER DEPARTMENT
WHEREAS, Maricopa County (“County”), by and through Maricopa County Attorney’s Office (“MCAO”),
is charged with the responsibility of investigating, gathering evidence, reviewingsuch evidence,and prosecuting
criminal conduct in Maricopa County, including but not limited to, sexual assault, sexual abuse, and intimate
partner domestic violence matters.
WHEREAS, MCAO, in furtherance of its obligation to prosecute sexual assault, sexual abuse, intimate partner
domestic violence matters, and other offenses, is desirous of obtaining the services of forensic nurse examiners
who will assist in conducting medical forensic examinations and the collection of samples/potential evidence of
those referred by MCAO and/or law enforcement, which shall include, but are not limited to, those who are
reporting or have made allegations of sexual assault, sexual abuse, physical abuse, and domestic violence
strangulation.The parties understand that the information derived from a forensic interview may be used toassist
the forensic nurse examiner with the provision of appropriate health care resources for such an individual and
use in any investigation or prosecution of any matter under MCAO’s jurisdiction.
WHEREAS, HonorHealth’s Forensic Nurse Examiner Department is comprised of forensic nurse examiners
(individually and collectively referred to as “FNE”) who possess the knowledge and expertise to provide
specialty health care services and resources to patients who present conditions, symptoms, and injuries that may
indicate sexual assault, sexual abuse, physical abuse, or intimate partner domestic violence strangulation. FNE’s
primary responsibility is to provide personalized, comprehensive medical care to patients that have experienced
interpersonal violence, such as sexual assault, domestic violence, and child abuse. As part of their role, FNE
may gather and collect evidence, conduct medical forensic examinations, or otherwise assist inpatient medical
care in cases of, but not limited to, sexual assault, sexual abuse, physical abuse, or intimate partner domestic
violence strangulation,
NOW, THEREFORE, the parties intending to be legally bound hereto agree to enter this Agreement for
Forensic Nurse Examiner Services (“Agreement”) according to the terms and conditions set forth below:
1.0.
SCOPE OF WORK
1.1.
FORENSIC NURSE EXAMINER SERVICES
HonorHealth agrees to provide MCAO, through HonorHealth’s FNE, services that include
comprehensive medicalforensicexaminations;specialized documentation; timely response;sample
collection; courtroom testimony; and other areas agreed herein as referred by MCAO, including,
but not limited to, cases involving sexual assault, sexual abuse, physical abuse, or intimate partner
domestic violence strangulation.
1.2.
TRAINING,EDUCATION, AND LICENSE
HonorHealth must maintain the following standards and, upon written request from MCAO, will
provide to MCAO documentation that demonstrates the following for HonorHealth and/or
HonorHealth’s employed FNE who is providing services to MCAO under this Agreement:
1.2.1.
Possess a minimum of 2 years RN experience in a practice that applies nursing theory for
decisions regarding forensic nursing practice;
1.2.2.
Maintain current CPR certification;
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1.2.3.
Completion of at least 40 hours in the forensic nursing evaluation of victims of sexual
assault/abuse and/or domestic violence;
1.2.4.
Complete continuing education credits in forensicnursingscience each year and participate
in the peer review process;
1.2.5.
Be a graduate of a National League of Nursing Accredited School of Nursing and possess
an active, current, full and unrestricted Arizona Registered Nurse License;
1.2.6.
HonorHealth and its FNE shall be licensed by any and all accrediting organizations
necessary per state, federal, and local guidelines and are expected to be maintained current
and up to date. HonorHealth, at its sole expense, shall maintain all required education,
certifications, and licensing requirements; and
1.2.7.
FNE, as part of the medical profession, may conduct research as appropriate for improved
clinical practice under the guidelines of an Institutional Review Board (IRB) as deemed
necessary.
1.3.
ROLES & RESPONSIBILITIES
1.3.1.
When assigned, FNE will be accessible and shall be on call and able to respond ina timely
manner 24 hours each day as requested by the appropriate law enforcement agency. The
response time required to a Site (defined below) is 90 minutes.
1.3.2.
The most common sites that FNE respond to are as follows (collectively “Sites” and each
individually a “Site”):
1.3.2.1,
Mesa Family Advocacy Center
225 E. 1st Street, Suite 205
Mesa, AZ 85201
I.3.2.2.
Glendale Family Advocacy Center
6830 N. 57th Drive
Glendale, AZ 85301
I.3.2.3.
Phoenix Family Advocacy Center
2120 N. Central Avenue
Phoenix, AZ 85004
I.3.2.4.
Scottsdale Family Advocacy Center
10225 E. Via Linda
Scottsdale, AZ 85258
I.3.2.5.
Southwest Family Advocacy Center
2333 N. Pebble Creek Pkwy, Suite A-200
Goodyear, AZ 85395
I.3.2.6.
Chandler Family Advocacy Center
221 E. Boston Street
Chandler, AZ 85244
1.3.3.
For the purposes of this Agreement, and in addition to the aforementioned sites, a site will
also include any hospital or licensed care facility in the metropolitan Maricopa County area
and any law enforcement agency location within Maricopa County.
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1.3.4.
FNE are members of an interdisciplinary team consisting of Nursing, Law Enforcement,
Legal, and Advocacy representation. Duties are as follows:
Assess, diagnose, plan, intervene, and evaluate patient care as stated in the
policies and procedures, standards of care, and clinical competencies of
HonorHealth and its FNE Department. Diagnoses are to be made in accordance
with the examination finding and are not clinical diagnoses but nursing
diagnoses;
13.4.1.
Conduct a comprehensive medical forensic examination of each patient,
including a complete medical history, a head-to-toe physical examination,
photographs as appropriate, sample collection, or other potential physical
evidence or documentation as indicated by the patient history or presentation
and specified by the approved sexual assault or domestic violence strangulation
or biological standards kit;
I.3.4.2.
Evaluate the findings of such an examination and report them to law
enforcement as appropriate, and maintain the chain of custody as directed by
MCAO, or in the absence of direction by MCAO, as directed by law
enforcement;
I.3.4.3.
Prepare and participate in pre-trial interviews, provide fact and expert witness
testimony in court, consult with appropriate criminal justice agencies, and
maintain availability as medical forensic subject matter experts as necessary;
I.3.4.4.
Maintain
patient
documentation,
charting,
and
the
confidentiality
of
medical/legal records, including abiding by HIPAA requirements where and if
applicable;
I.3.4.5.
Consult with specialists or providers as required and adjust the nursing care
process as indicated to ensure optimal medical care; and
I.3.4.6.
Provide on-call pediatric SANE (Sexual Assault Nurse Examiner) coverage
from 10 p.m. until 8 a.m. every day to conduct emergency sexual abuse
examinations of children under criteria established by MCAO, outlined in
Procedure and Guidelines for After Hours Child Physicals, a copy of which shall
be provided to HonorHealth, when contacted by law enforcement. Requests for
forensic nuraing examinations between 10 p.m. and 8 a.m. shall be considered
after-hour requests.
I.3.4.7.
1.4.
ADDITIONAL REQUIREMENTS OF FNE
Necessary medical equipment will be provided by the Sites listed in section 1.3.2. above.
The Arizona Department of Public Safety will provide sexual assault response kits.
HonorHealth will provide all additional examination supplies.
1.4.1.
If the Sites listed in section 1.3.2 above are not available to perform lab work, FNE must
provide MCAO with the name and address of the lab that will be retained.
1.4.2.
Medical assistants will be provided by HonorHealth, as needed.
1.4.3.
Maintain $1 million of medical malpractice insurance. The certificate of insurance
evidencing such coverage shall be provided to MCAO within two weeks of the execution
of this Agreement.
1.4.4.
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1.4.5.
Provide a list of collaborating physicians with response times, including names, addresses,
and phone numbers.
1.5.
FNE REPORTING OBLIGATIONS
1.5.1.
An evaluation form must be created and given to the victim to complete, which evaluates
FNE’s customer service skills, response time, etc.
1.5.2.
A quality assurance evaluation form must be created and given to the responding law
enforcement agency to evaluate FNE’s response time, communication skills, services
completed, ability to interact with the multidisciplinary team concept, etc., effectively.
1.5.3.
Every six months HonorHealth will provide a summary report to MCAO of the services
rendered to MCAO during the previous six-month period. The report should include, at
minimum, the number of instances where FNE’s were called out, the law enforcement
agency involved, the police report number, the number of victims, the number of
prosecution/defense interviews, and the number of times FNE testified in court.
2.0.
COMPENSATION
2.1.
The rate for each sexual assault, sexual abuse, and/or physical abuse examination is $850.00 and
includes pregnancy testing.
2.2.
The rate for each intimate partner domestic violence (strangulation) examination is $800.00.
2,3.
In addition to the above rates, the following rates apply tosexual assault, sexual abuse,and physical
abuse examinations:
2.3.1.
The rate for medical forensic evidence collection from a non-victim is $300.00.
2.3.2.
The rate for a partial medical forensic examination without evidence collection is$400.00.
2.3.3.
Additional laboratory testing, such as cultures for Sexually Transmitted Infections (STI),
NAAT urine collection, and Woodwork for HIV or RPR as requested by law enforcement
or MCAO, may be billed at a maximum of $150.00 per case.
2.3.4.
If four or less after hour on-call emergency sexual abuse examinations are requested during
a single calendar month of pediatric SANE (Sexual Assault Nurse Examiner) coverage by
FNE, HonorHealth may invoice MCAO a fee of$1,000.00 for providing such coverage as
set forth in section 1.3.4.7. above. This $1,000.00 fee is in addition to the cost of four or
fewer exams conducted in a calendar month.
2.3.5.
When a FNE physically responds to a Site at any time to conduct a FNE examination and
the examination is unable to be completed for any reason, HonorHealth may invoice
MCAO a fee of $350.00
2.4.
HonorHealth assumessole and exclusive responsibility for payment of any federal and state income
taxes, federal social security taxes, and other mandatory governmental deductions or obligations,
and HonorHealth will hold County and MCAO harmless for any and all liability which County or
MCAO may incur because HonorHealth fails to pay such taxes or obligations.
2.5.
BILLING; OF PAYMENT METHOD
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HonorHealth will submit a statement or invoice to MCAO for services rendered by the 15th
of each month.
2.5.1.
If the number of after-hour emergency sexual abuse examinations for pediatrics in any
month is more than four, HonorHealth may notsubmit an invoicefor$1000.00 as described
in section 2.3.4 above.
2.5.2.
Subject to the availability of funds, MCAO will, within 30 working days from the date of
receipt of the documents enumerated in this section 2.5, process and remit to HonorHealth,
a warrant for payment. Should MCAO make a disallowance in the claim, in whole or in
part, HonorHealth may dispute the disallowance, and any such dispute shall be processed
in accordance with section 3.7.
2.5.3.
HonorHealth understands and agrees that MCAO will not honor any claim for payment
submitted six months after the service date.
2.5.4.
HonorHealth understands and agrees that MCAO will not process any claim for payment
for services rendered prior to this Agreement’s expiration date, which is submitted 90 days
or more after the expiration date without the approval of MCAO. MCAO, in its sole
discretion, may waive the requirement of this section 2.5.5 with respect to a specific claim,
but such a waiver will not be considered as precedent or cause for a waiver regarding any
other claim.
2.5.5.
2.6.
CHANGES IN COSTS
2.6.1.
HonorHealth agrees to continually track the actual costs of the services provided and
maintain an ongoing dialog with MCAO regarding adverse cost fluctuations that could
adversely affect the fiscal sustainability, continuation, and growth of the services.
2.6.2.
FNE and MCAO agree to cooperate mutually to assess cost fluctuations and amend the
compensation structure described above in sections 2.1 through 2.4.
3.0.MISCELLANEOUS TERMS AND CONDITIONS
3.1. GENERAL REQUIREMENTS
3.1.1.
The terms of this Agreement shall be construed in accordance with Arizona law; any action
thereon shall be brought in the appropriate court in the State of Arizona.
3.1.2.
Neither HonorHealth nor its FNE is to be considered an officer, employee, or agent of
MCAO or the County, and by the terms of this Agreement, HonorHealth and its FNE are
independent contractors; the relationship established herein is not one of a joint venture,
partnership, or any other business relationship, other than as set forth by the terms herein.
3.2.
ADEQUACY OF RECORDS
If HonorHealth’s books, records,or documents relevanttothis Agreementare not sufficienttosupport
and document that allowable services were provided, MCAO will not pay HonorHealth, or if the
payment had been paid, HonorHealth will reimburse MCAO for the services not so adequately
supported and/or documented.
3.3.
AGREEMENT TERM
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This Agreement shall be for a period of
years, beginning on July 1, 2023, and expiring on June
30, 2026.
3.4.
OPTION TO EXTEND AGREEMENT
County and FNE may extend the period of this Agreement for two additional years beyond the
original ending date of June 30, 2026. HonorHealth shall be notified by MCAO of its intention to
extend this Agreement period at least 30 calendar days before the original Agreement period
expires. FNE shall thereafter promptly respond if it also desires to extend this Agreement.
3.5.
AMENDMENTS
Any amendments must be in writing and signed by both parties.
3.6.
ASSIGNMENT OR SUBCONTRACTING
HonorHealth may not assign this Agreement or subcontract to another party for the
performance of the terms and conditions hereof without the written consent of the County.
All correspondence authorizing subcontracting must reference the County Agreement
Number and identity the job project.
3.6.1.
A subcontractor’s rate to perform any of the sub-contract services shall not exceed that of the
prime contractor’s rate as outlined in section 2.0 above unless the prime contractor is willing
to absorb any higher rates. The subcontractor’s invoice shall be invoiced directly to the prime
contractor,who in turnshall pass through the costs to MCAO without markup.A copy of the
subcontractor’s invoice must accompany the prime contractor’s invoice.
3.6.2.
3.7.
AUDIT DISALLOWANCES
If at any time it is determined by MCAO that a cost for which payment has been made is a
disallowed cost, MCAO shall notify HonorHealth in writing of the disallowance and the required
course of action, which shall be at the option of MCAO either to adjust any future claim submitted
by HonorHealth by the amount of the disallowance or to require repayment of the disallowed
amount by HonorHealth forthwith issuing a check payable to MCAO.
3.8.
AVAILABILITY OF FUNDS
The provisions of this Agreement relating to payment for services shall become effective when
funds assigned to compensate HonorHealth as herein provided are actually available to MCAO for
disbursement. MCAO shall have the right to terminate this Agreement at any time if MCAO
determines that funds MCAO planned to apply to a payment under this Agreement are or will
become unavailable. MCAO shall be the sole judge and authority in determining the availability of
funds under this Agreement; MCAO shall advise HonorHealth at the earliest reasonable date if
MCAO intends to terminate this Agreement because of funding issues.
3.9.
CONTRACT COMPLIANCE MONITORING
MCAO shall monitor FNE’s compliance with, and performance under, the terms and conditions of
this Agreement. HonorHealth shall make available for inspection and/or copying by MCAO all
records and accounts relating to the work performed or the services provided in this Agreement.
3.10. COVENANT AGAINST CONTINGENT FEES
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three

HonorHealth warrants that no person or selling agency has been employed or retained to solicit or
securethis Agreement upon an agreement or understandingfor a commission, percentage, brokerage,
or contingent fee, excepting bonafide employees or bonafide established commercial or selling
agencies maintained by HonorHealth to secure business. For breach or violation of this warranty,
MCAO shall have the right to terminate this Agreement in accordance with the termination clause
and, at its sole discretion, to deduct from the contracted price or consideration, or otherwise recover,
the total amount of such commission, percentage, brokerage, or contingent fee.
3.11. DEFAULTS
MCAO may suspend, terminate, or modify this Agreement immediately upon written notice to
HonorHealth in the event of a nonperformance of stated objectives or another material breach of
contractual obligations; or upon the happening of any event which would jeopardize the ability of
HonorHealth and its FNE to perform any of its contractual obligations. MCAO reserves the right to
haveserviceprovided by anentity other than HonorHealth if HonorHealth is unableorfailsto provide
the requested service within the specified time frame.
3.12. COMPLIANCE WITH APPLICABLE LAWS
3.12.1. Each party shall comply with all applicable laws, ordinances, Executive Orders, rules,
regulations, standards, and federal and state government codes, whether or not specifically
referenced herein. Specifically, the following applies: Unless exempted under federal law,
the parties shall not discriminate against any employee or applicant for employment
because of race, age, disability, color, religion, sex, or national origin. The parties shall
take affirmative action to ensure that applicants are employed and that employees are
treated during employment without regard to their race,age, disability, color, religion,sex,
or national origin. Such action shall include, but not be limited to, the following:
employment, upgrading, demotion or transfer, recruitment, or recruitment advertising, lay-
off or termination, rates of pay or other forms of compensation, and selection for training,
including apprenticeship. The parties shall, to the extent such provisions apply, comply
with Titles VI and VII of the Federal Civil Rights Act; the Federal Rehabilitation Act; the
Age Discrimination in Employment Act; the Americans with Disabilities Act, Arizona
Executive Order 99-4 which mandates that all persons shall have equal access to
employment opportunities.
3.12.2. HonorHealth agrees to comply with all current laws, rules, and policies governing the
confidentiality of any data provided. HonorHealth further agrees to assume responsibility
for knowing such laws and checking for updates to such laws from time to time.
3.13. E-VERIFICATION OF EMPLOYEES
3.13.1. The parties warrant that they comply with A.R.S.§ 41-4401 and further acknowledge that they
and their subcontractors if any, warrant their compliance with all federal immigration laws and
regulations relating to their employees and their compliance with A.R.S. § 23-214, subsection A.
The parties further acknowledge that a breach ofsuch warranty shall be deemed a material breach
of this Agreement that is subject to penalties up to and including termination of this Agreement.
3.13.2. Further, MCAO retains the legal right to inspect the papers of any contractor or subcontractor
employee who works on this Agreement to ensure that the contractor or subcontractor is
complying with the warranty provided above and that the contractor agrees to make all papers and
employment records of said employee(s) available during regular working hours in order to
facilitate such an inspection.
3.13.3. Nothing herein shall make any contractor or subcontractor an agent or employee of the
contracting government entity.
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3.14. RETENTION OF RECORDS
HonorHealth agrees to retain all financial books, records, and other documents relevant to this
Agreement for five (5) years after final payment or until after the resolution of any audit questions,
which could be more than five (5) years, whichever is longer. MCAO, federal or state auditors and
any other persons duly authorized by MCAO shall have full access to and the right to examine, copy,
and make use of any and all said materials.
3.15.
RIGHTS IN DATA
MCAO shall have the use of data and reports resulting from this Agreement without additional cost
or other restriction except as may be established by law or applicable regulation. Each party shall
supply to the other party, upon request, any available information that is relevant to this Agreement
and the performance hereunder.
3.16.
SEVERABILITY
Any provision of this Agreement which is determined to be invalid, void, or illegal shall in no way
affect, impair, or invalidate any other provision hereof, and remaining provisions shall remain in full
force and effect.
3.17. INDEMNIFICATION
3.17.1. Each party (as “Indemnitor”) agrees, to the extent permitted by law, to indemnify, defend
and hold harmless the other party(as“Indemnitee”)for, from, and againstany claims,losses,
liability, costs, or expenses (including reasonable attorneys’ fees and expert witnesses’ fees)
(hereinafter collectively referred to as “Claim” or “Claims”) arising out of bodily injury of
any person (including death) or property damage, but only to the extent that such Claims
which result in liability to the Indemnitee are caused by the act, omission, negligence,
misconduct, or the other fault of the Indemnitor, its officers, officials, agents, employees or
volunteers.
3.17.2. This indemnification obligation shall extend to theactive or passive negligence of theCounty
as indemnitee but not in the event that the County is solely negligent.
3.17.3. The parties will cooperate in die investigation and defense of any Claim subject to the
indemnification hereunder.The party obligated to indemnify any Claim shall be responsible
for conducting any investigation in defense at its sole cost.
3.18. TERMINATION
This Agreement is subject to cancellation in accordance with the provisions of A.R.S. § 38-511.
Either party may terminate this Agreement at any time, with 60 days’ notice in writing to the other
party (unless terminated by the Board of Supervisors under the Availability of Funds provision).
Such notice shall be given by personal delivery or registered or certified mail. This Agreement may
be terminated by mutual written agreement of the parties specifying the termination date therein.
3.19. STRICT COMPLIANCE
Acceptance by MCAO or HonorHealth of performance not in strict compliance with the terms
hereof shall not be deemed to waive the requirement of strict compliance for all future performance
obligations. All changes in performance obligations under this Agreement must be in writing and
signed by both parties.
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3.20. PRIVATE PRACTICE
3.20.1. HonorHealth may engage in serviceseparate and apart from this Agreement provided that
such practice does not interfere with the performance by HonorHealth and/or its FNE of
its obligations as set forth in this Agreement.
3.20.2. HonorHealth agrees that in the event it or any of its employees are named as a defendant
in litigation wherein professional misconduct is alleged, HonorHealth will advise MCAO
in writing as to whether or not, at the time alleged in the complaint, it or its employees
were engaged in the performance of this Agreement. In the event the alleged conduct did
not occur in connection with the performance of this Agreement, HonorHealth will
indemnify and hold harmless County and MCAO for any and all liability resulting from
the alleged conduct.
3.21. ENFORCEMENT AND PUBLIC RECORDS
3.21.1. Any action to enforce this Agreement shall be brought in the Superior Court of Maricopa
County and under the laws of the State of Arizona. This provision includes the
Arbitration Terms outlined in A.R.S. § 12-1518.
3.21.2. Agreements entered into with MCAO are public records pursuant to A.R.S. § 39-121 et.
seq.
3.22.
UYGHUR FORCED LABOR PREVENTION ACT (ULFPA)
Pursuant to A.R.S. § 35-394, HonorHealth certifies that it is not currently using and agrees
for the duration of this Agreement not to use: any goods or services produced by the forced
labor of ethnic UYGHURs in the People’s Republic of China and HonorHealth shall ensure
and cause all subcontractors to comply with this provision.
3.23.
CONFLICT OF INTEREST
3.23.1. HonorHealth must comply with the regulations prohibiting a conflict of interest.
HonorHealth shall not make any payments, either directly or indirectly, to any person,
partnership, corporation, trust, or other organization that has a substantial interest in
HonorHealth or with which HonorHealth (or any of its directors, officers, owners, trust
certificate holders, or a relative thereof) has a substantial interest unless HonorHealth has
made full written disclosure of the proposed payments to the County and has received
written approval for the payments.
3.23.2. For purposes of this provision, the terms“substantial interest” and “relative” shall have the
meanings prescribed by A.R.S. § 38-502.
3.24. NOTICE
Whenever written notice is required or permitted to be given by either party to the other, such notice
shall have been deemed to have been sufficiently given if personally delivered or deposited in the
United States mail a properly stamped envelope, certified or registered mail, return receipt
requested, addressed to:
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For HonorHealth and/or any FNE:
HonorHealth
Director of Community Partnerships
7301 E. 4lh Street, Suite 1
Scottsdale, AZ 85251
For MCAO:
Maricopa County Attorney’s Office
Contract Administrator
301 W. Jefferson Street, Suite 800
Phoenix, AZ 85003
With a copy to:
HonorHealth
8125 N. Hayden Road
Scottsdale, AZ 85258
Attn: Legal Department
Remainder of the page is left intentionally blank.
Signature Page to Follow
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Digitally signed by Kim Miles
DN: C=US, OU=Civil/Government Advice, O=Maricopa County Attorney's 
Office, CN=Kim Miles, E=milesk@mcao.maricopa.gov
Reason: I am the author of this document
Location: your signing location here
Date: 2023.07.11 09:28:45-07'00'
Foxit PhantomPDF Version: 10.1.11
Kim Miles
07/10/2023
!
The parties have executed this Agreement by its duly authorized signatory as of the effective datesetforth in section
3,3 above.
MARICOPA COUNTY ATTORNEY
HONORHEALTH
Rachel H. Mitchell'
\6rf
e
l
Kim Post, DNP, MBA, RN
Executive Vice President, Chief Operations Officer
Date
June 26, 2023
Date
APPROVED AS TO FORM:
MARICOPA COUNTY, ARIZONA
Deputy County Attorney
Chairman, Board of Supervisors
Date
Date
ATTEST:
Clerk of the Board
Date
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SIGN
SIGN