MOU BETWEEN CHS AND OME 09.26.18(1).DOCX

Memorandum of Understanding between
Maricopa County Correctional Health Services and
Maricopa County Office of the Medical Examiner
This Memorandum of Understanding (“MOU”) is between the Maricopa County Office
of the Medical Examiner (“OME”) and the Maricopa County Department of Correctional
Health Services (“CHS”), together the “Parties.”
PURPOSE:
The purpose of this MOU is to govern the operation and Parties’ participation in the
exchange of Protected Health Information (“PHI”) for purposes authorized by law
including, but not limited to, the purpose of identifying a deceased person, for determining
cause of death, and for other Medical Examiner duties authorized by law (e.g. A.R.S. §§
11-594, 11-597).
TERM:
The Term of this MOU shall become effective on the date this MOU is signed by both
parties and continue until terminated by either party with or without cause, upon thirty
(30) days written notice 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 or performance would
be in violation of the law or order of a court of law.
1. 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. OME means the person, firm, individual or organization employed or contracted
with Maricopa County Office of the Medical Examiner.
E. Director means the Director of CHS.
F. Authorized Use means a decedent’s Protected Health Information (PHI) provided
by CHS to OME may be accessed, used and/or disclosed as authorized by HIPAA
(45 CFR § 164.512(g)) including, but not limited to, the purpose of identifying a
deceased person, for determining cause of death, and for other Medical Examiner
duties authorized by law (e.g. A.R.S. §§ 11-594, 11-597). Authorized Use shall
not include the access, use or disclosure of PHI of living individuals unless the

individual has signed a HIPAA-compliant authorization authorizing disclosure of
his/her PHI to OME, or the disclosure of PHI is otherwise permitted or required
by law. Except when otherwise required by law, access, use and disclosure of PHI
pursuant to this MOU shall be subject to HIPAA’s minimum necessary standard
(45 CFR § 164.502(b)). When reasonable to do so, CHS may rely upon the
representations of OME as to what information is the minimum necessary for their
lawful purpose (45 CFR § 164.514(d)(3)(iii)).
G. 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.
H. Protected Health Information (PHI) 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 that was or is under the
care, safety and medical supervision of CHS.
I. TechCare™ refers to the electronic health record software system licensed by the
County and maintained by CHS.
2. APPLICABLE LAW
The terms of this MOU shall be construed in accordance with applicable federal and state
law.
3. AMENDMENTS
All Amendments to this MOU must be in writing and signed by both parties.
4. RETENTION OF RECORDS
OME and CHS agree to maintain records and other relevant documents to this MOU for
five (5) years after the resolution of any audit.
5. COMPLIANCE MONITORING
OME and CHS shall each monitor their own respective compliance with, and performance
under, the terms and conditions of this MOU.
2 of 4

6. SCOPE
As applicable, and where permitted under federal and state law including, but not limited
to, HIPAA, OME and CHS agree to cooperate and exercise reasonable efforts for the
Authorized Use of PHI, whether through TechCare™, direct electronic feed, or hard
copy. The Parties further agree to sign any other documents or agreements, or implement
procedures, reasonably necessary to accomplish the purpose of this MOU or to otherwise
protect the confidentiality of the information exchanged.
7. CONFIDENTIAL INFORMATION AND SECURITY INCIDENT REPORTING
A. The Parties acknowledge that OME will be provided access to PHI for the
purpose of Authorized Use. OME agrees that its employees and/or agents will be
directed to: (1) not access, retrieve or use PHI outside the scope of Authorized
Use; and (2) treat all PHI as confidential unless disclosure is permitted or required
by law unless disclosure is permitted or required by law.
B. OME will maintain a list of OME-users designated to access TechCare™ and
ensure that each individual user reviews and signs a CHS User Access Agreement
(attached hereto as Exhibit A), a copy of which must be promptly provided to the
CHS Legal Manager.
C. OME will instruct OME staff that in the event of a suspected or actual breach,
incident or emergency involving Protected Health Information (PHI), OME staff
must immediately report the occurrence to the OME official responsible for
ensuring compliance with this MOU, who in turn will notify the CHS Component
Privacy Official or designee of the report. To that effect, OME will post the
following notice in working areas where the TechCare™ EHR App is installed:
Report any suspected security or privacy breach, incident or
emergency involving Protected Health Information (PHI) from
TechCare™ to the CHS Legal Manager, at
CHSLegal@mail.maricopa.gov.
8. WAIVER OF CONFLICT
The Parties to this MOU have chosen attorneys employed by the Civil Services Division
of the Maricopa County Attorney’s Office (“Civil Services Division”) to act as their
attorney for the purpose of reviewing this MOU. In so doing, by their signature below,
each party acknowledges that it is aware that the Civil Services Division will represent
both parties to this MOU, and each party expressly waives any conflict created thereby.
9. ACKNOWLEDGEMENT
By signing below, OME and CHS each acknowledge their own respective role and
responsibilities pursuant to this MOU.
3 of 4

IN WITNESS WHEREOF, THE PARTIES ENTER INTO THIS MOU:
Maricopa County Department of Maricopa County Office of
Correctional Health Services the Medical Examiner
By: _____________________________ By: ___________________________
Name: ___________________________ Name: _________________________
Title: ____________________________ Title: __________________________
Date: ____________________________ Date: __________________________
MOU approved by the Maricopa County Board of Supervisors
BY:
_________________________________ Date: _________________
Chairman, Board of Supervisors
ATTEST:
________________________________ Date: ______________________
Clerk of the Board
Approved as to form:
Attorney for CHS Attorney for OME
________________________________ ________________________________
Deputy County Attorney Deputy County Attorney
Date: ______________________ Date: ______________________
4 of 4