STEWARD HEALTH CHOICE MOU (FINAL).DOCX

MEMORANDUM OF UNDERSTANDING
Between
MARICOPA COUNTY CORRECTIONAL HEALTH SERVICES
AND STEWARD HEALTH CHOICE ARIZONA
This Memorandum of Understanding (“MOU”) is entered into pursuant to the applicable
Arizona Health Care Cost Containment System (AHCCCS) Contracts with ACC HEALTH
PLAN, between Steward Health Choice Arizona herein referred to as (SHCA) and
MARICOPA COUNTY by and through its DEPARTMENT OF CORRECTIONAL
HEALTH SERVICES, herein referred to as (CHS).
SHCA 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 SHCA 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 SHCA who are also served by CHS. This MOU shall in no way change, modify, or
amend the contract between AHCCCS and SHCA 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. Criminal Justice Information refers to any confidential information collected by
criminal justice agencies on individuals consisting of identifiable descriptions and
notations of arrests, detentions, indictments, information, or other formal criminal
charges, and any disposition arising therefrom, as well as confidential pre-
booking or booking personal identifiable information, including date of birth,
social security number, age, demographic information, projected release dates and
release date information as defined in 5.U.S.C. § 552 and 5 U.S.C. § 552a.
E. Director means the Director of CHS.
F. Medical Director means the Medical Director of CHS.

G. Authorized Use means Protected Health Information provided by CHS to SHCA
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 SHCA 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.
H. 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.
I. TechCare™ refers to the electronic health record software system licensed by the
County and maintained by CHS.
J. Protected Health Information (PHI) shall have the same meaning as 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.
3. SPECIAL TERMS AND CONDITIONS:
A. 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.
B. 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; provided, however, that CHS may terminate this MOU, in
whole or in part, immediately upon providing either written or verbal notice
when CHS deems the health or welfare of a patient is endangered. Either party
may terminate this agreement immediately upon providing written or verbal
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notice when it deems that performance would be in violation of the law or order
of a court of law.
C. 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 SHCA.
D. SHCA & CHS’S RESPONSIBILITIES: SHCA and CHS shall cooperate
hereunder in a professional manner that conforms to all local, state and federal
codes and rules and within the standard of practice for the scope of each of the
parties’ responsibilities. SHCA 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 responsibilities assigned
by the MOU; the MOU is simply intended to allow SHCA and CHS to work
together to better address the needs of the community.
E. COMPLIANCE MONITORING: CHS and SHCA shall each monitor their
own respective compliance with, and performance under, the terms and
conditions of this MOU. Notwithstanding the foregoing, each party may
conduct quality assurance audits from time to time to assess the proper access
and utilization of their respective electronic health records application
systems.
F. RETENTION OF RECORDS: SHCA and CHS agree to maintain records and
other relevant documents to this MOU for five (5) years following the
termination of the MOU; provided however, if any audit questions are
unresolved at the end of that five year period, all records and documents
relating to such audit questions shall be maintained until those audit questions
are resolved.
G. NON-DISCRIMINATION: To the extent applicable, SHCA, 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. SHCA shall comply with the Americans with
Disabilities Act.
H. 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.
I. GOVERNING LAWS: This MOU shall be governed by the laws of the State of
Arizona.
J. INDEMNIFICATION: To the fullest extent permitted by law, each party shall
defend, indemnify, and hold harmless the other party, its agents,
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representatives, officers, directors, officials, and employees for, from and
against all claims, damages, losses and expenses, including, but not limited to,
attorneys’ fees, court costs, expert witness fees, and the cost of appellate
proceedings, relating to, arising out of, or alleged to have resulted from the
negligent acts, errors, omissions or mistakes relating to the performance of
this MOU. Each party’s duty to defend, indemnify and hold harmless the
other party, its agents, representatives, officers, directors, officials, and
employees shall arise in connection with any claim, damage, loss or expense
that is attributable to bodily injury, sickness, disease, death, or injury to,
impairment, or destruction of property, including loss of use resulting
therefrom, caused by any negligent acts, errors, omissions or mistakes in the
party’s performance of this MOU including any person for whose acts, errors,
omissions or mistakes a party may be legally liable.
K. 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.
L. 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 SHCA.
M. PUBLIC RECORDS: Notwithstanding any other provision of this MOU to the
contrary, the Parties 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 SHCA is not a public agency subject to public
records laws but is a private corporation.
N. CONFIDENTIALITY OF RECORDS:
3.14.1 The parties will utilize data sharing agreements (including Attachment
B) 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.
3.14.2 Each party agrees not use or disclose any PHI received from the other in
any manner that would constitute a violation of this MOU or federal or
state law. Each party shall take reasonable measures to ensure that its
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directors, officers, employees, vendors, contractors, and agents use or
disclose PHI received from the other party in accordance with the
provisions of this MOU and federal and state law. Each party further
agrees to implement all appropriate safeguards reasonably necessary to
maintain the confidentiality of the information accessed through the
TechCare™ system.
3.14.3 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.
3.14.4 The Parties acknowledge that before each of the Parties’ Authorized
Users may have access to the other party’s electronic health records
application system, Authorized Users may be required to read and agree
to the terms of the respective party’s user/confidentiality agreement.
Each party agrees to work cooperatively to fulfill this requirement and
return copies of the executed agreements, as necessary.
3.14.5 SHCA acknowledges that it and its Authorized Users might be given
access by CHS via TechCare™ to Criminal Justice Information for the
sole purpose of safely and securely providing and/or coordinating
treatment and/or healthcare services to patients incarcerated in the
Maricopa County Jail. SHCA agrees that it will not use or disclose
Criminal Justice Information for any other purpose, and will treat all
Criminal Justice Information as confidential as required by state and
federal laws at all times and take reasonable measures to maintain the
security and confidentiality of such information. SHCA agrees to instruct
its staff concerning the confidential nature of Criminal Justice
Information and the applicable prohibitions against its use and
disclosure.
3.14.6 REPORTING OF UNAUTHORIZED USE OR DISCLOSURE OF PHI:
CHS and SHCA shall, within twenty-four (24) hours of becoming aware
or has reason to believe of an unauthorized use or disclosure of
TechCare™ PHI by either organization; or any of its Authorized Users,
officers, directors, employees, vendors, contractors, agents or by a third
party. Such notice shall be made to the following:
MARICOPA COUNTY CORRECTIONAL HEALTH SERVICES
(CHS)
Attn: BIT Team
Title:
Address: 234 N Central Avenue, Suite 5350
City, State Zip: Phoenix, AZ 85004
Phone: (602) 506-0897
Email: CHSHIMTEAM@Maricopa.gov
and CHSBIT@Maricopa.gov
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STEWARD HEALTH CHOICE ARIZONA
Attn:
Title:
Address:
City, State Zip Code:
Phone:
Fax:
Email:
Copy To:
Department: HIPAA HITECH Privacy Specialist
O. ASSIGNMENT AND DELEGATION:
3.15.1 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 SHCA.
3.15.2 This Agreement MOU does not imply authority to perform any tasks, or
accept responsibility.
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.
A. 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.
B. 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.
C. 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:
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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
STEWARD HEALTH CHOICE ARIZONA
Attn:
Title:
Address:
City, State Zip:
Phone:
Email:
5. INCORPORATION OF DOCUMENTS: The Parties agree that the following
attachments are made part of this MOU:
A. Attachment A, Collaborative Understanding
B. Attachment B, Data Link Agreement
6. ACKNOWLEDGMENT: By signing below, SHCA 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.
STEWARD HEALTH CHOICE ARIZONA MARICOPA COUNTY
Authorized Individual: BOARD OF SUPERVISORS
By: By:
Name: ________________________ Name:
Title: _________________________ Title: Chairman, Board of Supervisors
Date: Date:
Maricopa County Correctional ATTEST:
Health Services
By: ___
Name: _
Title: MCCHS Director Clerk of the Board
Date: Date:
APPROVED AS TO FORM:
By:
Name:
Title: Deputy County Attorney
Date:
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