Extracted text (via pymupdf_layout)
12681 characters
MEMORANDUM OF UNDERSTANDING
This Memorandum of Understanding (“MOU”) serves to confirm the mutual
understandings of the Maricopa County Special Health Care District, dba Maricopa
Integrated Health System and Maricopa Medical Center ("Hospital") and Maricopa County
by and through its Department of Public Health d.b.a. Healthcare for the Homeless Clinic
(“Health Center”) related to their intent to establish arrangements for hospitalization, health care
related services, including specialty care services, discharge planning, and patient tracking in
order to assure appropriate communication and continuity of care for Health Center patients who
receive health care and inpatient services (collectively “Hospital Services”) from Hospital.
Purpose
WHEREAS, Health Center is a Federally Qualified Health Center (“FQHC”) that
receives Federal grant support from the Health Resources and Services Administration
(“HRSA”) within the United States Department of Health and Human Services (“DHHS”),
pursuant to Section 330 of the Public Health Service Act (“Section 330”), to provide, or arrange
for the provision of, high quality, cost-effective, community-based comprehensive primary and
preventive health care and related services (including, but not limited to, ancillary and enabling
services) to medically underserved communities in its service area, regardless of an individual’s
or family’s ability to pay for such services;
WHEREAS, Hospital is part of a public safety-net health system, including Maricopa
Medical Center, that from time-to-time serves as a referral center for Health Center and its
patients for Hospital Services; and,
WHEREAS, Hospital and Health Center have a decades-long relationship working
together to treat many low-income and uninsured residents of Maricopa County and Hospital
accepts patients in need of long-term and extensive chronic illness management, and other
Hospital Services, because of Hospital’s integrated system of care; and
WHEREAS, Section 330 requires that Health Centers develop an ongoing referral
relationship with hospitals, and HRSA requires that Health Centers establish arrangements for
hospitalization, discharge planning, and patient tracking in order to assure appropriate
communication and continuity of care between the FQHC and the hospital; and
WHEREAS, Health Center and Hospital wish to formalize their mutual understandings
of their relationship in order to continue providing access to critical services provided by
Hospital for Health Center patients, to promote the coordination of care for Health Center
patients, and to support the medical home model of care in Maricopa County.
1
NOW, THEREFORE, the parties agree as follows:
I. Health Center’s Services
1. Health Center agrees to provide intake and initial screening and appropriate treatment to
patients presenting to Health Center for the provision of primary and preventive health
care services consistent with Health Center’s federally-approved scope of project
(“FQHC Services”), and to establish and maintain records of such individual’s health
care.
2. Health Center agrees to provide FQHC Services regardless of a patient’s ability to pay,
payor source, or insurance status, subject to capacity limitations, as determined in Health
Center’s sole discretion. Health Center agrees to bill patients who qualify for discounted
services at Health Center in a manner consistent with rules set forth at 42 CFR 51c.303(f)
and the policies of the HRSA as set forth in Policy Information Notice (“PIN”) 2014-02,
which require billing individuals whose annual incomes fall at or below 200% of the
Federal Poverty Level in accordance with a schedule of discounts.
3. If the need for Hospital Services arises, Health Center agrees to assist Health Center
patients in making timely and appropriate referrals to an appropriate health care facility,
including but not limited to Hospital (“Referred Patients”). Where applicable, Health
Center agrees to submit to Hospital written diagnoses and other information necessary for
Hospital to furnish Hospital Services to Referred Patients.
4. Health Center agrees to maintain responsibility for each Referred Patient’s overall
primary care treatment plan, including managing and monitoring such treatment,
provided that such care is consistent with the primary and preventive services furnished
by Health Center within its federally-approved scope of project. As applicable and
necessary, Health Center agrees to furnish appropriate follow-up care to Referred Patients
who are referred back to Health Center. Health Center agrees to be solely responsible for
billing and collecting all payments from appropriate third party payors, funding sources,
and, as applicable, Referred Patients, for any care (including follow-up care) rendered
directly by Health Center.
II. Hospital’s Services
1. Hospital agrees to accept and furnish Hospital Services equally to all Referred Patients,
regardless of their ability to pay, payor source, or insurance status, subject to capacity
limitations, as determined in Hospital’s sole discretion.
2. To the extent that Referred Patients receive Hospital Services from Hospital pursuant to
this MOU, such individuals are considered patients of Hospital. Accordingly, Hospital
agrees to be solely responsible for billing and collecting all payments from appropriate
third party payors, funding sources, and, as applicable, patients, for such services,
observing Hospital’s customary billing, collection, and discount/charity care policies.
3. Hospital agrees to refer Referred Patients back to Health Center for clinically appropriate
primary and preventive follow-up care consistent with Health Center’s federally-
2
approved scope of project, which shall be determined on a case-by-case basis for each
individual Referred Patient.
III. Joint Representations
The parties represent and warrant the following:
1. Health Center and Hospital agree to jointly develop an Admission and Communication
Protocol for the Hospital Services. Such protocol shall describe, among other things, how: (i)
timely and orderly transfers of Referred Patients will be made for planned admissions to
Hospital; (ii) Hospital will inform Health Center of emergency admissions of patients
identifying Health Center as their primary care provider; (iii) Health Center will track
Referred Patients admitted either on a planned or an emergency basis; and (iv) Hospital will
provide Health Center with appropriate discharge planning summaries, which will include:
admission date; discharge date; written admission and discharge diagnoses; as applicable,
other information related to the condition of Referred Patients including any inpatient
procedures performed; discharge medications; and specific recommendations for post-
discharge follow-up care.
2. All clinicians employed or contracted by either party who furnish health care services to
patients under this MOU will: (i) be duly licensed, certified, and/or otherwise qualified to
provide services in the State of Arizona; and (ii) furnish services in accordance with all
relevant federal, state, and local laws and regulations, including, but not limited to, non-
discrimination laws.
3. Each party and its clinicians will be and remain eligible to participate in federal and state
health care programs, including, but not limited to, the Medicaid, Medicare and CHIP
programs.
4. Each party and its clinicians providing services hereunder are covered by a professional
liability insurance policy (malpractice, errors, and omissions) and a security, privacy, and
data breach insurance policy that provides sufficient coverage against professional liabilities
and data breach liabilities that may arise from acts or omissions in connection with or related
to the services furnished pursuant to this MOU.
5. Each party is solely and exclusively liable for services it furnishes directly; Health Center
shall not assume any liability associated with Hospital’s provision of Hospital Services and
other inpatient services, and Hospital shall not assume any liability associated with Health
Center’s provision of FQHC Services.
6. All health and health-related professionals employed by or under contract with either party
retain sole and complete discretion, subject to any valid restriction(s) imposed by
participation in a managed care plan, to refer patients to any and all providers who best meet
the medical needs of such patients.
7. Both Parties acknowledge that all patients have the freedom to choose (and/or request
referral to) any provider of services, and Health Center and Hospital will advise patients of
such right, subject to any valid restriction(s) imposed by participation in a managed care
plan.
3
8. The parties acknowledge and agree that they have freely negotiated the terms of this MOU
and that neither party has offered or received any inducement or other consideration in
exchange for entering into this MOU. Nothing in this MOU requires, is intended to require,
or provides payment or benefit of any kind (directly or indirectly), for the referral of
individuals or business to either party by the other party.
9. The parties retain the authority to contract with other providers.
IV. Term and Termination
The term of this MOU shall commence on May 15, 2017 and continue through December 31,
2017, unless terminated at an earlier date in accordance with this Section. If the parties are in
agreement, this MOU may be renewed for four (4) additional one (1) year terms.
1. This MOU may be terminated, in whole or in part, at any time upon the mutual
agreement of Health Center and Hospital.
2. Either Health Center or Hospital may terminate this MOU without cause upon ninety (90)
days prior written notice to the other party.
3. This MOU may be terminated for cause upon written notice by either Health Center or
Hospital. "Cause" shall include, but is not limited to: (i) a material breach of any term of
this MOU, subject to a thirty (30) day opportunity to cure; (ii) any material change in the
financial condition of either party that reasonably indicates that such party will be unable
to fulfill its obligations pursuant to this MOU; (iii) the loss of required insurance by
either party; (iv) either party’s loss, revocation, or suspension of any license or other
authorization to do business; (v) exclusion or suspension of either party from
participation in federal and/or state health care programs; and (vi) the good faith
determination by Health Center that the health, welfare, and/or safety of patients
receiving care from Hospital is jeopardized by the continuation of this MOU.
V. Notice
All notices permitted or required by this Arrangement shall be in writing and delivered
personally or via USPS first class postage prepaid, Certified and Return Receipt Requested,
addressed to the other Party at the address set forth below:
For the Health Center:
Maricopa County, Healthcare for the Homeless
Clinic Supervisor
220 S. 12th Avenue
Phoenix, AZ 85007
4
For the Hospital:
Wyatt Howell, V. P. Ambulatory Services
2525 E. Roosevelt
Phoenix, AZ 85008
And
Brian Maness, Director of Contracts & Procurement
2601 E. Roosevelt
Phoenix, AZ 85008
VI. Miscellaneous
This MOU (a) constitutes the entire agreement between the parties with respect to the subject
matter hereof, superseding all prior oral or written agreements with respect thereto; (b) may be
amended only by written instrument executed by both parties; (c) may not be assigned by either
party without the written consent of the other party, such consent not to be unreasonably
withheld; (d) shall be binding on and inure to the benefit of the parties hereto and their respective
successors and permitted assigns; (e) shall be interpreted and enforced in accordance with the
laws of the state of Arizona and the federal laws of the United States applicable therein; (f) may
be executed in several counterparts (including by facsimile), each of which shall constitute an
original and all of which, when taken together, shall constitute one MOU; and (g) shall not be
effective until executed by both parties.
Maricopa County Special Health Care
District Maricopa County, by and through its
Department of Public Health, d.b.a.
Healthcare for the Homeless
__________________________________ _________________________________
Signature: Signature:
___________________________________ Denny Barney
Name and Title Chairman, Board of Supervisors
___________________________________ _________________________________
Date Date
APPROVED AS TO FORM: ATTEST:
_________________________________ _________________________________
Attorney for Maricopa County Clerk of the Board
5