10854 MARICOPA COUNTY ATTORNEY'S OFFICE FORENSIC NURSING SERVICES AGREEMENT HH.DOCX

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, reviewing such
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. It is understood by the parties that the information derived from
a forensic interview may be used to assist the forensic nurse examiner with the provision of appropriate
health care resources for such an individual and for 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 in patient 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 medical forensic examinations; 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;
Page 1 of 10

1.2.2. Maintain current CPR certification;
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 forensic nursing science 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 is 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 in a
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
1.3.2.2. Glendale Family Advocacy Center
6830 N. 57th Drive
Glendale, AZ 85301
1.3.2.3. Phoenix Family Advocacy Center
2120 N. Central Avenue
Phoenix, AZ 85004
1.3.2.4. Scottsdale Family Advocacy Center
10225 E. Via Linda
Scottsdale, AZ 85258
1.3.2.5. Southwest Family Advocacy Center
2333 N. PebbleCreek Pkwy, Suite A-200
Goodyear, AZ 85395
1.3.2.6. Chandler Family Advocacy Center
221 E. Boston Street
Chandler, AZ 85244
Page 2 of 10

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.
1.3.4. FNE are members of an interdisciplinary team consisting of Nursing, Law
Enforcement, Legal and Advocacy representation. Duties are as follows:
1.3.4.1. 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;
1.3.4.2. 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;
1.3.4.3. 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;
1.3.4.4. 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;
1.3.4.5. Maintain patient documentation, charting, and the confidentiality of
medical/legal records, including abiding by HIPAA requirements where and
if applicable;
1.3.4.6. Consult with specialists or providers as required and adjust nursing care
process as indicated to ensure optimal medical care; and
1.3.4.7. 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.
Request for forensic nursing examinations between 10 p.m. and 8 a.m. shall
be considered as after hour requests.
1.4. ADDITIONAL REQUIREMENTS OF FNE
1.4.1. Necessary medical equipment will be provided by the Sites listed in section 1.3.2.
above. Sexual assault response kits will be provided by the Arizona Department of
Public Safety. All additional examination supplies will be provided by HonorHealth.
Page 3 of 10

1.4.2. 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.
1.4.3. Medical assistants will be provided by HonorHealth, as needed.
1.4.4. Maintain $1 million of medical malpractice insurance. Certificate of insurance
evidencing such coverage shall be provided to MCAO within two weeks of the
execution of this Agreement.
1.4.5. Provide 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 effectively interact with the multidisciplinary team concept, etc.
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 $700.00
and includes pregnancy testing.
2.2. The rate for each intimate partner domestic violence (strangulation) examination is $600.00.
2.3. In addition to the above rates, the following rates apply to sexual assault, sexual abuse, and
physical abuse examinations:
2.3.1. The rate for medical forensic evidence collection from a non-victim is $250.00.
2.3.2. The rate for a partial medical forensic examination without evidence collection is
$350.00.
2.3.3. Additional laboratory testing, such as cultures for Sexually Transmitted Infections
(STI), NAAT urine collection, bloodwork 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 $1000.00 for providing
such coverage as set forth in section 1.3.4.7. above. This $1000.00 fee is in addition to
the cost of four or fewer exams conducted in a calendar month.
Page 4 of 10

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 assumes sole 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 of HonorHealth’s failure to pay such taxes or
obligations.
2.5. BILLING; METHOD OF PAYMENT
2.5.1. HonorHealth will submit a statement or invoice to MCAO for services rendered by the
15th of each month.
2.5.2. If the number of after hour emergency sexual abuse examinations for pediatrics in any
month is more than four, HonorHealth may not submit an invoice for $1000.00 as
described in section 2.3.4 above.
2.5.3. 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.
2.5.4. HonorHealth understands and agrees that MCAO will not honor any claim for payment
submitted 6 months after date of service.
2.5.5. HonorHealth understands and agrees that MCAO will not process any claim for
payment for services rendered prior to the expiration date of this Agreement 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.
2.6. CHANGES IN COSTS
2.6.1. HonorHealth agrees to continually track the actual costs of the services provided and
maintain an on-going dialog with MCAO regarding adverse fluctuations in costs that
could adversely affect the fiscal sustainability and continuation and growth of the
services.
2.6.2. FNE and MCAO agree to mutually cooperate 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.
Page 5 of 10

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 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 relevant to this Agreement are not sufficient to
support and document that allowable services were provided, MCAO will not pay HonorHealth
or if payment had been paid, HonorHealth will reimburse MCAO for the services not so
adequately supported and/or documented.
3.3. AGREEMENT TERM
This Agreement shall be for a period of two years and begin on July 1, 2021 and expire on June
30, 2023.
3.4. OPTION TO EXTEND AGREEMENT
County and FNE may extend the period of this Agreement for 2 additional years beyond the
original ending date of June 30, 2023. HonorHealth shall be notified by MCAO of its intention
to extend this Agreement period at least 30 calendar days prior to the expiration of the original
Agreement period. 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
3.6.1. HonorHealth may not assign this Agreement or subcontract to another party for
performance of the terms and conditions hereof without the written consent of County.
All correspondence authorizing subcontracting must reference the County Agreement
Number and identify the job project.
3.6.2. 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 turn shall pass-through the costs to MCAO,
without mark-up. A copy of the subcontractor’s invoice must accompany the prime
contractor’s invoice.
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
Page 6 of 10

The provisions of this Agreement relating to payment for services shall become effective when
funds assigned for the purpose of compensating 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 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
HonorHealth warrants that no person or selling agency has been employed or retained to solicit
or secure this Agreement upon an agreement or understanding for a commission, percentage,
brokerage, or contingent fee, excepting bona-fide employees or bona-fide established commercial
or selling agencies maintained by HonorHealth for the purpose of securing 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 full 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 other 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 have service provided by an entity other than HonorHealth if HonorHealth is unable or
fails to provide requested service within the specified time frame.
3.12. COMPLIANCE WITH APPLICABLE LAWS
Each party shall comply with all applicable laws, ordinances, Executive Orders, rules,
regulations, standards, and codes of federal and state government, whether or not specifically
referenced herein. Specifically, the following apply: 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 Title VI and VII of the Federal
Civil Rights Act; the Federal Rehabilitation Act; the Age Discrimination in Employment Act;
American With Disabilities Act and; Arizona Executive Order 99-4 which mandates that all
persons shall have equal access to employment opportunities.
3.13. E-VERIFICATION OF EMPLOYEES
Page 7 of 10

3.13.1. The parties warrant that they are in compliance 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 that relate to their employees and their
compliance with A.R.S. § 23-214, subsection A. The parties further acknowledge that
a breach of such 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
normal 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.
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 to 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
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 against any 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.
This indemnification obligation shall extend to the active or passive negligence of the County, as
indemnitee, but not in the event that the County is solely negligent.
The parties will cooperate in the 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
Page 8 of 10

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 Availability of Funds
provision). Such notice shall be given by personal delivery or by 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 signed by both parties.
3.20. PRIVATE PRACTICE
3.20.1. HonorHealth may engage in service separate 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, that HonorHealth
will advise MCAO in writing as to whether or not at the times 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. 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:
For MCAO: For HonorHealth and/or any FNE:
Maricopa County Attorney’s Office HonorHealth
Grant & Contracts Administrator Director of Community Partnerships
301 W. Jefferson Street, Suite 800 7301 E. 4th Street, Suite 1
Phoenix, AZ 85003 Scottsdale, AZ 85251
with a copy to:
HonorHealth
8125 N. Hayden Road
Scottsdale, AZ 85258
Attn: Legal Department
Remainder of page left intentionally blank
Signature Page to Follow
Page 9 of 10

The parties have executed this Agreement by its duly authorized signatory as of the effective date set forth in
section 3.3 above.
HONORHEALTH MARICOPA COUNTY ATTORNEY
Kim Post, DNP, MBA, RN Allister Adel
Executive Vice President, Chief Operations Officer
Date
Date
APPROVED AS TO FORM:
MARICOPA COUNTY, ARIZONA
Deputy County Attorney
Chairman, Board of Supervisors
Date
Date
ATTEST:
Clerk of the Board
Date
Page 10 of 10