MERCY CARE - MOU - FINALIZED BY BOS.PDF

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MEMORANDUM OF UNDERSTANDING
Between
MARICOPA COUNTY CORRECTIONAL HEALTH SERVICES
AND MERCY CARE
This Memorandum of Understanding (“MOU”) is ENTERED INTO PURSUANT TO
THE APPLICABLE Arizona Health Care Cost Containment System (AHCCCS)
Contracts with Mercy Care, between Mercy Care and Maricopa County Correctional
Health Services, herein referred to as (CHS).
Mercy Care and CHS desire to enter into a MOU to establish a collaborative protocol for
effective communication, coordination and continuity of care for individuals eligible for
services provided by Mercy Care who are also served by CHS.
1. PURPOSE:
The purpose of this MOU is to establish a collaborative protocol, as described in
Attachment A for effective communication, coordination and continuity of care as
outlined in AMPM Policy 1020 and 1050, for individuals eligible for services provided
by Mercy Care who are also served by CHS. This MOU shall in no way change, modify,
or amend the contract between AHCCCS and Mercy Care and does not create liability
from one party to the other by a party’s failure to comply with the protocol. Should any
information within this MOU conflict with any terms or conditions within the AHCCCS
contract, the AHCCCS contract shall prevail.
2. DEFINITIONS:
As used throughout this MOU, the following terms shall have the meanings set forth
below:
A. MOU means this document and all attachments and amendments hereto.
B. County means Maricopa County.
C. CHS means the person, firm, individual or organization employed or contracted with
Maricopa County Department of Correctional Health Services.
D. Director means the Director of CHS.
E. Medical Director means the Medical Director of CHS.
F. Authorized Use means Protected Health Information provided by CHS to Mercy
Care that shall be used and/or disclosed only as authorized by law including, but not
limited to the treatment of individuals identified as homeless as needed in order to
reduce recidivism. Except when otherwise required by law, disclosures of PHI
pursuant to this MOU are subject to a minimum necessary determination by CHS (45
CFR § 164.502(b)). When reasonable to do so, CHS may rely upon the
representations of Mercy Care as to what information is the minimum necessary for
their lawful purpose (45 CFR § 164.514(d)(3)(iii)). Information regarding substance

use or abuse shall not be disclosed without the express written authorization of the
individual.
. HIPAA refers collectively to the Health Insurance Portability and Accountability Act
of 1996, codified at 42 U.S.C. § 1320d et seq., and the Health Information
Technology for Economic and Clinical Health Act, enacted as Title XIII of the
American Recovery and Reinvestment Act of 2009, codified at 42 U.S.C. § 17921 et
seq., and any current and future regulations promulgated thereunder, including but not
limited to 45 C.F.R. Parts 160 and 164.
. TechCare™ refers to the electronic health record software system licensed by the
County and maintained by CHS.
Protected Health Information (PHD) is defined under HIPAA and includes any
information about health status, provision of health care or any individually
identifiable information including Social Security Number, Age, Sex, Date of Birth,
Patient Identification Number, Medical Record Documentation either paper or
electronic, diagnosis, procedural information and any other information directly
linked and identifiable to a specific individual under the care, safety and medical
supervision of CHS.
. SPECIAL TERMS AND CONDITIONS:
3.1 TERM OF MOU: This MOU shall begin upon approval of the Board of
Supervisors and when all signatures are affixed and fully executed by both
parties and shall terminate a year thereafter unless otherwise terminated or
amended as provided herein. By mutual written amendment executed by the
Parties’ authorized representatives, this MOU may be extended for supplemental
periods of 12 months, up to maximum of 48 months.
3.2. TERMINATION: This MOU may be terminated by either party with prior
written notice to the other party. Such Notice of Termination shall be
effective thirty (30) calendar days after mailing by certified mail, return
receipt requested, to the other party.
3.3. AMENDMENTS: Any changes or amendments to this MOU shall be
effective only if made in writing and signed by both parties. All such changes
or amendments shall be handled by formal amendment and approved by CHS
authorized representative, the CHS Procurement Services Office, and Mercy
Care.
3.4 MERCY CARE & CHS’S RESPONSIBILITY: Mercy Care and CHS shall
cooperate hereunder in a professional manner that conforms to all local, state
and federal codes, rules and within the standard of practice for the scope of
each of the parties’ responsibilities. Merey Care and CHS shall comply with
all federal, state and local laws, ordinances, rules and regulations applicable to
each party’s performance under this MOU. There are no financial
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responsibilities assigned by the MOU; the MOU is simply intended to allow
ACC and CHS to work together to better address the needs of the community.
3.5 NON-DISCRIMINATION: To the extent applicable, Mercy Care, in
accordance with ARS § 41-1461, et seq., shall provide equal employment
opportunities for all persons, regardless of race, color, creed, religion, sex,
age, national origin, disability or political affiliation. Mercy Care shall comply
with the Americans with Disabilities Act.
3.6 EMPLOYMENT VERIFICATION: To the extent applicable, the parties shall
comply with ARS § 41-4401, all Federal immigration laws and regulations
relating to employees, including compliance with A.R.S. § 23-214, Subsection
A.
3.7 GOVERNING LAWS: This MOU shall be governed by the laws of the State
of Arizona.
3.8 CONFLICTS OF INTEREST: To the extent applicable, this MOU is subject
to the provisions of A.R.S. § 38-511 relating to conflicts of interest.
3.9 ARBITRATION: To the extent applicable, the parties, in accordance with
ARS §12-1518, agree to resolve all disputes arising out of or relating to this
MOU through arbitration, after exhausting applicable administrative review
except as may be required by other applicable statutes. This provision does
not apply to provider claims disputes or member appeals regarding covered
services provided by Mercy Care.
3.10 PUBLIC RECORDS: Notwithstanding any other provision of this MOU to the
contrary, the Parities acknowledge that CHS is subject to A.R.S. 39-121
through 39-128 regarding public records. Any provision regarding
confidentiality is limited to the extent necessary to comply with the provisions
of Arizona law. The parties acknowledge that Mercy Care is not a public
agency subject to public records laws but is a private non-profit corporation.
3.1] CONFIDENTIALITY OF RECORDS:
3.11.1 The parties will utilize data sharing agreements and Administrative
Orders that permit the sharing of written, verbal and electronic
information, and will comply with all applicable Administrative Orders,
State and federal law, rules or regulations, as amended from time-to-
time, including but not limited to Health Insurance Portability and
Accountability Act (HIPAA) requirements that permit the sharing of
written, verbal and electronic information (as of the effective date of
those regulations), and 42 CFR Part 2 relative to alcohol and substance
abuse treatment. Third Parties requesting information held by CHS
should be referred to CHS.
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3.11.2 Information pertaining to substance abuse will only be shared upon
obtaining a release of information from the individual in compliance with
42 CFR Part 2.
3.12 ASSIGNMENT AND DELEGATION:
3.12.1 Neither party may assign this MOU without the express, written, prior
consent of both parties, which shall not be unreasonably withheld or
delayed. No consent shall be required where there is an assignment of
the AHCCCS contract by AHCCCS to an affiliated entity of Mercy
Care.
3.12.2 This Agreement MOU does not imply authority to perform any tasks,
or accept responsibility, and does not create any legal obligations or
rights between the parties.
4. SECTIONS AND OTHER HEADINGS CONTAINED IN THIS MOU ARE
FOR REFERENCE PURPOSES ONLY AND SHALL NOT AFFECT IN ANY
WAY THE MEANINING OR INTERPRETATION OF THIS MOU.
4.1 This MOU may be executed in two or more counterparts, each of which shall be
deemed an original but all of which together shall constitute the same instrument.
Faxed, copied and scanned signatures are acceptable as original signatures.
4.2 ENTIRE MOU: This MOU contains the entire understanding of the parties
hereto, and it supersedes all proposals, oral or written, and all other documents
or communications between the parties relative to the subject matter herein
covered, unless such documents or communications are specifically included by
reference.
4.3 NOTICES: All notices under this MOU given by either party to the other
shall be in writing and shall be delivered in person or sent by U.S. Postal Service,
postage prepaid and addressed to the following individuals:
* Remainder of Page Intentionally Left Blank *
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MARICOPA COUNTY CORRECTIONAL HEALTH SERVICES (CHS)
Attn: Tania Lynch
Title: CHS Department Director
Address: 234 N. Central Avenue, Suite 5000
City, State Zip: Phoenix, AZ 85004
Phone: (602) 372-4632
Email: tania.lynch@maricopa.gov
MERCY CARE
Attn: Lorry Bottrill
Title: CEO
Address: 4755 S. 44" Place
City, State Zip: Phoenix, Arizona 85040
Phone: 602-453-8361
Fax: N/A
Email: Lorry.Bottrill@mercycareaz.org
5. ACKNOWLEDGMENT: By signing below, Mercy Care and CHS each
acknowledge their own respective role and responsibilities pursuant to this MOU.
* Remainder of Page Intentionally Left Blank *
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IN WITNESS WHEREOF, the parties have executed this Agreement as of the respective
dates written below.
MARICOPA COUNTY
Mercy Care Authorized Individual:
By:
Name: ly bin
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Title: ! | (WD Title: Chairman, Board of Supervisors
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Date:_
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Poor Mauctl
Fi ayn, 4 FRAN McCARROLL
Name: pre
Title: ) (: S Di} Ae CTOR. Title: Clerk of the Board
Date: Lod i 27 Date: FEB 13 7019
APPROVED AS TO FORM:
_———
By:
Name Dav AOL “Bres sloy
Title: Deputy County Attorney
Date: ( / zz | l rf
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Attachment A
MARICOPA COUNTY CORRECTIONAL HEALTH
MERCY CARE
COLLABORATIVE UNDERSTANDING
Background
The Maricopa County Correctional Health Services (CHS) enhances community safety
by working in a collaborative partnership with AHCCCS, MERCY CARE and its
contracted providers to provide research-based prevention and intervention services.
Mercy Care’s contracted providers deliver a range of health care services and treatment
programs for adults and youth with physical health needs, serious mental illness and
other mental health and/or substance abuse disorders.
To facilitate the transition of members transitioning out of jails and back into our
community, collaboration between CHS and the Mercy Care is critical to reentry
activities. Specifically, Mercy Care will collaborate with CHS to accomplish “reach-in”
care coordination for members who have been incarcerated in the adult correctional
system for 30 days or longer and have an anticipated release date. “Reach-in” care
coordination activities shall begin upon knowledge of a member’s anticipated release
date. Mercy Care will collaborate with CHS to identify justice-involved Seriously
Mentally Ill (SMI) members, and General Mental Health/Substance Use (GMHSU)
members in the adult criminal justice system with physical and/or behavioral health
chronic and/or complex care needs prior to member’s release.
Il. Data Sharing and Coordination
Mercy Care and CHS will partner to:
a) Communicate timely data necessary for coordination of care in conformance with
all applicable administrative orders, state laws and regulations, 42 CFR Part 2, and
Health Insurance Portability and Accountability Act (HIPAA) requirements that
permit the sharing of written, verbal and electronic information, and
b) Utilize data sharing agreements and administrative orders that permit the sharing
of written, verbal and electronic information at the time of admission into the
facility and at the time of discharge.
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III. Collaborative Protocols
When Mercy Care becomes aware that a member is incarcerated, and is subject to the
“Reach-In” requirements, described above:
1, The Mercy Care Point of Contact or designee will complete a Justice Transition Form
(JTF) for SMI members and GMHSU members with designated chronic conditions
and send the JTF to CHS:
a. CHS will confirm diagnosis/chronic condition in TechCare.
b. CHS will complete the CHS section of the JTF and return it to Mercy Care —
scan it into TechCare.
If CHS identifies newly diagnosed chronic care conditions, CHS will complete a JTF
and send it to the Mercy Care Point of Contact or designee.
If member has a diagnosis of HIV+, Medication Assisted Treatment (MAT), or
Substance Use/Misuse, the member’s written consent to release and share information
must be completed and uploaded into TechCare prior to disclosure of the member’s
identifying information.
If member is in jail 30 days or more, the Mercy Care Point of Contact or designee
will initiate a video or in person visit with the member.
An Appointment will be made with member’s Primary Care Physician (PCP) to occur
within 7 days of release.
The Mercy Care Point of Contact or designee will forward to CHS an “Introduction
Letter,” via secure email, with the following information:
a. Appointment day/time
b. Clinic name and location
c. Health Plan Point of Contact (or designee) contact information
7. CHS will place this introduction letter into the member’s property which will be
provided upon jail release.
CHS and the Mercy Care Point of Contact or other health staff may coordinate
special needs prior to jail release (such as courtesy release, medical equipment, or
specific medications).
IV. Co-Location at Initial Appearance for Mercy Care Jail Diversion Staff
Mercy Care and CHS will work together to ensure on-site availability of Mercy Care
Staff in order to facilitate Jail Diversion Activities for the SMI population. This will
include cooperation to enable Mercy Care Jail Diversion staff access to co-located work
stations within the Initial Appearance Courts.
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Proprietary

Provide mechanisms for communication and resolving problems
CHS and Mercy Care will have quarterly steering committee meetings to build and
strengthen relationships and address any problems or conflicts. Additionally, Mercy
Care will identify and extend invitations to CHS, to provider level meetings
appropriate for CHS participation.
Meetings shall include opportunities for agency cross-training and for identifying,
communicating and resolving problems to increase understanding and knowledge
of each other's mission, goals and how, through agency collaboration, members are
provided identified services to improve their health and well-being and reduce
recidivism.
Mercy Care and CHS will work together to ensure processes from both agencies are
being practiced. On-going improvement efforts will focus on reducing
redundancies and providing timely, accurate and relevant information to coordinate
services and evaluate outcomes of those services.
Mercy Care and CHS will identify key staff who have the authority to assist with
disputes and find resolutions based on the agreements and best interest of the
populations jointly served. If necessary, this may include the Mercy Care Chief
Medical Officer (or designee) and the CHS Mental Health Director. Meetings shall
include opportunities to report identified gaps and discuss and act on resolutions.
VI. Identify and address joint training needs
Mercy Care and its contracted providers and CHS will provide cross training
opportunities as mutually agreeable needs are identified.
Proprietary