1 FIRST AMENDMENT TO SECOND AMENDED RESTATED MASTER TRANSITION IGA (3).DOC

FIRST AMENDMENT
TO THE
SECOND AMENDED AND RESTATED
INTERGOVERNMENTAL
AGREEMENT
BY ANT) BETWEEN
MARICOPA COUNTY
a political subdivision of the State of Arizona
and
MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
a tax-levying public improvement district of the State of Arizona
DATE: February 12, 2014
PARTIES: MARICOPA COUNTY, ARIZONA, a political subdivision of the State of
Arizona ("County"); and
MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT, a tax-levying
public improvement district of the State of Arizona ("District").
RECITALS
A. The District and the County have entered into that certain Second Amended and
Restated Intergovernmental Agreement, dated September 3, 2013, ("Second Amended and
Restated Master Transition IGA"),
B. Pursuant to the provisions set forth in Section 11.8 of the Second Amended and
Restated Master Transition IGA, the parties agree to amend the Second Amended and Restated
Master Transition IGA, as more fully set forth below.
1. NOW THEREFORE, in consideration of the mutual agreements expressed herein, it is
agreed as follows:
A. SECTION 6. SERVICES TO BE PROVIDED BETWEEN THE
COUNTY AND THE DISTRICT.
The current SECTION 6 is deleted in its entirety and replaced with a new
SECTION 6, attached hereto and identified as "REVISED SECTION 6.
SERVICES TO BE PROVIDED BETWEEN THE COUNTY AND THE
DISTRICT.

B. EXHIBIT 10. SERVICE PURCHASES BY COUNTY OR DISTRICT
The current Exhibit 10 is deleted in its entirety and replaced by a new Exhibit 10,
attached hereto and identified as REVISED EXHIBIT 10. SERVICE
PURCHASES BY COUNTY OR DISTRICT
2. All other terms and conditions of the Second Amended and Restated Master Transition IGA,
as amended, shall remain in full force and effect.
3. The Effective Date of this First Amendment to Second Amended and Restated Master
Transition IGA becomes effective as of February 6, 2014.
IN WITNESS WHEREOF, the parties have executed this First Amendment to the Second
Amended and Restated Master Transition IGA.
MARICOPA COUNTY, a political MARICOPA COUNTY SPECIAL
subdivision of the State of Arizona HEALTH CARE DISTRICT, a tax-
levying public improvement district of
the State of Arizona
a,
By: By:
Denny Barney, Chairman Mary A arden, R.N., Chair
Maricopa County Board of Supervisors Marie° ounty Special Health
Care District
ATTEST: ATTEST:
Lam
Clerk of of the Board Clerk of the Board
APPROVED AS TO FORM:
Deputy Maricopa County Attorney K omey for the M
Special Health Care
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REVISED
Exhibit 10
Service Purchases by County or District
(Sections 6.1 and 6.2)
District Purchased Services from County (Section 6.1): For the services listed below, the District
will pay the County at the rate listed below.
Equipment Services: Same rate that County charges other County Departments for such
services
Other: At a mutually agreed upon rate.
County Purchased Services from District (Section 6.2): For Health Care Services provided by
District to MCSO and Correctional Health Patients, County TB Patients, and County Juvenile
Probation Patients (collectively "County Patients"):
1. County shall reimburse the District for Health Care Services provided to County Patients
("Health Care Services").
Minimum Purchase for Fiscal Year 2014. For fiscal year 2014, the County shall
reimburse the District for Health Care Services provided to County Patients in an
amount of at least Five Million Dollars ($5,000,000) at the AHCCCS rates as of the date
of service. In the event that more than $5,000,000 in Health Care Services are provided
in fiscal year 2014, the County will reimburse the District at a rate that will permit the
District to recover its costs of services provided to County Patients.
3. Minimum Purchase for Fiscal Year 2015. For fiscal year 2015, the County shall
reimburse the District for Health Care Services provided to County Patients in an
amount of at least Three Million Dollars ($3,000,000) at the AHCCCS rates as of the
date of service. In the event that more than $3,000,000 in Health Care Services are
provided in fiscal year 2015, the County will reimburse the District at a rate that will
permit the District to recover its costs of services provided to County Patients.
4. Minimum Purchase for Fiscal Year 2016. For fiscal year 2016, the County shall
reimburse the District for Health Care Services provided to County Patients in an
amount of at least One Million Dollars ($1,000,000) at the AHCCCS rates as of the date
of service. In the event that more than $1,000,000 in Health Care Services are provided
in fiscal year 2016, the County will reimburse the District at a rate that will permit the
District to recover its costs of services provided to County Patients.
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5. The District will bill and the County will reimburse the District at the applicable rate as
of the date of service.
6. If the County Patient has health care coverage other than through the County, the District
will first bill the County Patient's payor for the Health Care Services provided.
7. Any payment received by the District from a County Patient's payor during the
applicable fiscal year will be applied as a credit against the amount billed by the District
to the County.
8. In the event that the County Patient's payor fails or refuses to make any payment to the
District or pays the District an amount less than the amount that the County has agreed
to reimburse the District according to the rates set forth in Paragraphs 2, 3, or 4 above
the County will then reimburse the District the difference between the amount that
would have been paid by AHCCCS and the amount paid by the County Patient's payor.
The County and the District agree that the District will ultimately be paid the amount
that would have been paid by AHCCCS for the Services.
9. In addition, the total amounts received by the District from County Patients' payors, will
be applied as a credit against the County's reimbursement obligation for the applicable
fiscal year as set forth in Paragraphs 2, 3, or 4, above.
10. In the event that the total amount paid by the County plus the amounts paid by County
Patients' payors up to the AHCCCS rates, during the applicable fiscal year exceeds the
amounts set forth in Paragraphs 2, 3, or 4, the billing and crediting protocol described
above will apply.
11. Notwithstanding any provision set forth above, no later than ten (10) days after the last
day of any Quarter within a fiscal year, the District will determine the amount of any
outstanding and unpaid bills for Services, notify the County of the unpaid amount and
within thirty (30) days of such notice the County will pay the District the outstanding
unpaid amount.
Other Services: At a mutually agreed upon rate
Effective Date of Exhibit #10: The Effective Date of Exhibit #10 is February 12, 2014
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REVISED SECTION 6. SERVICES TO BE PROVIDED BETWEEN THE COUNTY AND
THE DISTRICT.
6.1 Purchases from County. The District may purchase supplies and utilize County
services according to the terms set forth on Exhibit 10 attached hereto.
6.2 Purchases from District.
6.2.1 Rates. The County may purchase supplies and utilize District services
according to the terms set forth on Exhibit 10 attached hereto.
6.2.2 Minimum Purchase for Fiscal Year 2014. In accordance with the
requirements of A.R.S. § 48-5571, the County shall reimburse the District for health care
services provided in an amount of at least Five Million Dollars ($5,000,000) for fiscal
year 2014 at rates set forth in Exhibit 10.
6.2.3 Minimum Purchase for Fiscal Year 2015. The County shall reimburse the
District for health care services provided in an amount of at least Three Million Dollars
($3,000,000) for fiscal year 2015 at rates set forth in Exhibit 10
6.2.4 Minimum Purchase for Fiscal Year 2016. The County shall reimburse the
District for health care services provided in an amount of at least One Million Dollars
($1,000,000) for fiscal year 2016 at rates set forth in Exhibit 10.
6.3 Invoice and Payment. For services purchased and facilities used pursuant to
Section 6.1 of this Agreement, within thirty (30) days following the receipt of an invoice,
together with supporting data, the party receiving services or using facilities shall pay amounts
due the party rendering the service or permitting the use of facilities. For services purchased
pursuant to Section 6.2 of this Agreement, the provisions set forth in Exhibit 10 shall govern
invoicing and payment.