COLLABORATION AGREEMENT.PDF

Keogh Health
CONNECTION
Collaboration Agreement
This non-financial Collaboration Agreement (Agreement") is entered into by and between Keogh Health
Connection ("Keogh") and Maricopa County, administered by its Human Services Department ("County"
or "Collaborating Partner"). Keogh and the County are collectively referred to as the "Parties" and
individually as a "Party". The Parties, for and in consideration of the covenants and conditions set forth in
this Agreement are entering into this Agreement to better serve children and families seeking affordable
health care and other services.
A. PURPOSE
The County will refer individuals to Keogh. Keogh shall be onsite at the Head Start program office
located at 2150-1 South Country Club Road, Suite 7, Mesa, AZ, to provide information to
individuals and determine eligibility for the Affordable Care Act and assist families with
enrollment.
B. TERM
The initial term of the Agreement shall be from November 1, 2016 until October 31, 2020. The
Agreement shall become effective upon execution by all of Parties.
C. RENEWAL
The Agreement may be extended for two (2) additional two-year terms through a written
Amendment.
D. TERMINATION
This Agreement may be terminated by either Party upon thirty (30) days prior written notice to the
other party. Such termination shall be effective upon the expiration of the thirty (30) days unless
otherwise agreed to in writing by the parties.
E. INDEMNIFICATION
Each Party (as "indennnitor") agrees to indemnify, defend, and hold harmless the other Party (as
"indemnitee") from and against any and all claims, losses, liability, costs, or expenses (including
reasonable attorney's fees) (hereinafter collectively referred to as "claims") arising out of the
negligent performance of this Agreement, but only to the extent that such claims which result in
vicarious/derivative liability to the indemnitee are caused by the act, omission, negligence,
misconduct, or other fault of the indemnitor, its officers, officials, agents, employees, or
volunteers.
F. INSURANCE
The Parties shall maintain insurance or funded self-insurance as follows: (i) commercial general
liability insurance coverage with minimum limits of $2,000,000 per occurrence and $4,000,000
annual aggregate; (ii) professional liability insurance coverage with minimum limits of $1,000,000
per occurrence and $3,000,000 annual aggregate; and (iii) workers' compensation insurance to
cover obligations imposed by federal and state statutes applicable to the respective party's
employees engaged in the Program, (iv) The policy shall be endorsed to include coverage for
physical/sexual abuse and molestation. Upon written request, a Party shall provide to the other
3620 N. 4th Ave. Phoenix, AZ 85013 (602) 266-0397
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Party a certificate of insurance evidencing such insurance coverage. Each Party shall
provide thirty (30) calendar days prior written notice to the other Party of any
modification or termination of required insurance.
G. Relationship
The students, faculty, and staff of the County who participate in this program shall not be
considered as employees or students of the Keogh and agents or employees of the
Keogh shall not be considered employees of the County. Accordingly, employees of one
Party shall not be entitled to employee benefits normally provided to bona fide
employees of the other Party. Nothing in this Agreement or its performance except as
provided in A.R.S. § 23-1022(D) shall be construed to result in any person being the
officer, agent, employee, or servant of either Party when such person, absent this
Agreement and the performance thereof, would not in law have such status.
H. Keogh Health Connection agrees to:
1. Accept referrals, provide benefit counseling services and assist with applications
for public benefits and information concerning the Marketplace;
2. Keogh staff will be onsite at the Head Start office on an agreed upon schedule to
be mutually determined. Keogh reserves the right to alter the frequency of onsite
activities depending upon the volume of appointments;
3. Provide information/training to County staff and volunteers regarding public
benefits, eligibility and application processes and Marketplace offerings;
4. List Maricopa County Head Start Program information on Keogh's website as a
referral organization; and
5. Provide data on the number of applications completed and individuals served as
a result of referrals provided by the County.
I. County agrees to:
1. Refer people seeking affordable health care to Keogh for benefits counseling;
2. Provide a private space in which Keogh staff can conduct confidential application
assistance;
3. Provide access to a phone, copier and or fax machine;
4. Invite Keogh to staff meetings and community events such as enrollment dates
or Policy Council meetings to inform staff and volunteers of services;
5. List Keogh on the County's Head Start website and publications as a
collaborating organization; and
6 Refer other organizations to Keogh for consideration as a potential collaborator.
J. Cancellation
1. This Agreement is subject to and incorporates by reference the statutory language of
A.R.S. §38-511.
[Signature Page to Follow]
3620 N. 4th Ave. Phoenix, AZ 85013 (602) 266-0397

IN WITNESS WHEREOF, the parties have executed this Agreement as of the respective dates written
below.
Maricopa County Keogh Health Connection
Representative: Clint L. Hickman Representative: Saundra Johnson
Title: Chairman, Board of Supervisors Title: Executive Director
Signature: Signature:
Date: Date:
Attested to:
Fran McCarroll, Clerk of the Board Date
APPROVED AS TO FORM:
Deputy County Attorney Date
3620 N. 4th Ave. Phoenix, AZ 85013 (602) 266-0397
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