Extracted text (via pymupdf_layout)
45622 characters
SECTION I GENERAL PROVISIONS RYAN WHITE PART A PROGRAM
The Agreement referenced herein is funded by the Health Resources and Services Administration (HRSA), HIV/AIDS
Bureau (HAB), Division of Service Systems, Ryan White CARE Act Title I Program, CFDA number 93.914- HIV Emergency
Relief Projects Grants.
1.0 DEFINITIONS
As used throughout these PROVISIONS, the following terms shall have the meanings set forth:
1.1 AGREEMENT means this document and all attachments and amendments hereto.
1.2 ADMINISTRATIVE AGENT means the Ryan White Part A Program Manager, a County
agent, responsible for Administration of the Grant.
1.3 CLIENT means the Ryan White eligible individual who has completed the eligibility
application process and meets the HIV, Income, residency and third party payer
requirements as outlined in the Ryan White Part A Policy and Procedure Manual.
1.4 CONTRACTOR means the person, firm or organization listed on the Cover page of this
Agreement and who will be the service provider.
1.5 COUNTY means Maricopa County, Arizona.
1.6 DEPARTMENT means the Maricopa County, Ryan White Part A Program {RWPA).
1.7 FUNDING SOURCE means any Federal, State or Private Agency Funding Source that may impose
conditions on the funding that will be passed on to the Contractor.
1.8 PARTIES means all entities associated with this Agreement i.e., the RWPA or Contractors
staff.
1.9 PROGRAM MANAGER means the Manager of the Maricopa County, Ryan White Part A Program.
1.10 RWPA means the Ryan White Part A Program.
1.11 RYAN WHITE PART A PROGRAM POLICY AND PROCEDURE MANUAL is the policy and procedure manual
developed for the Ryan White Part A Program and is as provided on http://www.ryanwhiteparta.com .
2. 0 PURPOSE OF THE PROGRAM. AUTHORITY AND BACKGROUND
The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act was first enacted in 1990 and
subsequently amended several times. Currently, the Act was reauthorized in 2009 and is called the
Ryan White HIV/AIDS Treatment Extension Act of 2009. The authority for this grant program is the Public
Health Service Act Section 2603, 42 USC 300ff-13. The U.S. Department of Health and Human Services (DHHS)
administers the Part A program through the Health Resources and Services Administration (HRSA), HIV/AIDS
Bureau (HAB}, Division of Service System (DSS). The entire CARE Act may be accessed at
http:Uhab.hrsa.gov/abouthab/legislation.html.
Part A funds provide direct financial assistance to Eligible Metropolitan Areas (EMAs) that have been the
most severely affected by the HIV epidemic. Formula and supplemental funding components of the grant
assist EMAs in developing or enhancing access to a comprehensive continuum of high quality, community-
based care for low-income individuals and families with HIV disease. A comprehensive continuum of care
includes primary medical care, HIV-related medications, mental health treatment, substance abuse
treatment, oral health and case management services that assist PLWH/A (People Living with HIV/AIDS) in
accessing treatment of HIV infection that is consistent with Public Health Service (PHS) Treatment Guidelines
(current treatment guidelines are available at www.AIDS info.nih.gov). Comprehensive HIV/AIDS care beyond
these core services also includes access to other health services (e.g., home health care, nutritional, and
rehabilitation service). In addition, this continuum of care may include supportive services that enable
individuals to access and remain in primary medical care (e.g., outreach, transportation, and food services).
2
SECTION I GENERAL PROVISIONS RYAN WHITE PART A PROGRAM
Part A supplemental funds have been awarded since fiscal year {FY) 1999 under the Minority AIDS Initiative
(MAl) to improve the quality of care and health outcomes in communities of color disproportionately
impacted by the HIV epidemic. Funds are to initiate, modify, or expand culturally and linguistically
appropriate HIV care services for disproportionately impacted communities of color. Following
Congressional intent, MAl funds must be used to expand or support new initiatives consistent with these
goals.
MAl funds are subject to special conditions of award, and providers of services funded with MAI funds must
document their use separately from other Part A funds. Progress reports must be provided in a beginning of
year, Mid-Year Progress Report, and end-of-fiscal year Final Progress Report. This information reported is used
to monitor:
• Compliance with the MAI Condition of Award and related requirements;
• Progress in meeting planned objectives;
• Potential grantee technical assistance needs;
• Type and quantity of services delivered and demographics of clients served, and;
• Improvements in access and health outcomes being achieved through these services.
The Contractor should consider how efforts at the local level are consistent with the Ryan White HIV/AIDS
Treatment Extension Act of 2009 which emphasizes the use of funds to address the service needs of
"individuals who know their HIV status and are not receiving primary medical care services and for informing
individuals of and enabling the individuals to utilize the services, giving particular attention to
eliminating disparities in access and services among affected subpopulations and historically
underserved communities" Section 2602 (b)(4)(D}(i).
Additionally, applicants should consider the Impact of the epidemic within the Phoenix EMA, which consists
of Maricopa and Pinal counties. Several studies are available for applicants to review including:
• 2006 Hispanic PLWH/A Needs Assessment
• 2006 African American PLWH/A Needs Assessment
• 2006 PLWH/A Out of Care Needs Assessment
• 2006 Pinal County Needs Assessment
• Phoenix EMA 2006-2009 Comprehensive Plan
All reports can be viewed at the Phoenix EMA Ryan White Planning Council's website at
http://www.ryanwhiteparta.com Moreover, in developing your application you should consider the
HIV/AIDS Bureau (HAB) Guiding Principles indicated below that have significant implications for HIV/AIDS care
services planning.
• The HIV/AIDS epidemic is growing among traditionally underserved and hard-to-reach populations;
• The quality of emerging HIV/AIDS therapies can make a difference in the lives of people living with HIV
disease;
• Changes in the economics of health care are affecting HIV/AIDS care network; and
• Outcomes are a critical component of program performance.
All Care Act funded projects in any service category must participate in the existing community-based
continuum of care. This concept requires that services in a community must be organized to respond to the
individual's or family's changing needs, in order to reduce fragmentation of care. For the Phoenix EMA to
achieve this intent as required by HRSA guidance funded providers will be required to attend meetings
sponsored by the Phoenix EMA Ryan White Planning Council and other management and technical assistance
meetings deemed mandatory by Maricopa County Ryan White Part A Program. Lastly, Part A funds must be
used in a manner consistent with current and future HRSA policies as developed by the Division of Services
Systems, HIV/AIDS Bureau. These policies can be reviewed on the HAB website at http:Uhab.hrsa.gov.
3
SECTION I GENERAL PROVISIONS RYAN WHITE PART A PROGRAM
3.0 RIGHT TO EXTEND AGREEMENT
Subject to availability of funds and acceptable Contractor performance, the Contractor hereby acknowledges and
agrees that the Department shall have the right to extend this Agreement for additional periods, not to exceed a total
term of five (5) years, except that the cost will be subject to renegotiation. Any extension of the Agreement Period
must be mutually acceptable to the Department and the Contractor and signed by both parties in writing.
4.0 AMENDMENTS
All Amendments to this Agreement must be in writing and signed by both parties.
5.0 ASSIGNMENT/SUBCONTRACTING
No rights, liability, obligations or duties under this agreement may be assigned, delegated or subcontracted without
the prior written approval of the County.
6.0 DISPUTES
Except as otherwise provided by law, any dispute arising under this Agreement shall be submitted in accordance with
the Maricopa County Dispute Process as specified in the Maricopa County Procurement Code Section MC1-905 which
is hereby incorporated by reference. The RWPA as required by the federal grantor agency, also has the grievance
procedure specific to Ryan White Part A Program funded services which, depending on the nature of the dispute, may
be invoked by interested parties.
7.0 ALTERNATIVE DISPUTE RESOLUTION
7.1 After the exhaustion of the administrative remedies provided in the Maricopa County Procurement Code, any
agreement dispute in this matter is subject to compulsory arbitration. Provided the parties participate in the
arbitration in good faith, such arbitration is not binding and the parties are entitled to pursue the matter in state
or federal court sitting in Maricopa County for a de novo determination on the law and facts. If the parties cannot
agree on an arbitrator, each party will designate an arbitrator and those two arbitrators will agree on a third
arbitrator. The three arbitrators will then serve as a panel to consider the arbitration. The parties will be equally
responsible for the compensation for the arbitrator(s). The hearing, evidence, and procedure will be in
accordance with Rule 74 of the Arizona Rules of Civil Procedure. Within ten (10) days of the completion of the
hearing the arbitrator(s) shall:
7.1.1 Render a decision;
7.1.2 Notify the parties that the exhibits are available for retrieval; and
7.1.3 Notify the parties of the decision in writing (a letter to the parties or their counsel shall suffice.
7.1.4 Within ten (10) days of the notice of decision, either party may submit to the arbitrator(s) a proposed
form of award or other final disposition, including any form of award for attorneys’ fees and costs. Within
five (5) days of receipt of the foregoing, the opposing party may file objections. Within ten (10) days of
receipt of any objections, the arbitrator(s) shall pass upon the objections and prepare a signed award or
other final disposition and mail copies to all parties or their counsel.
7.2.1 Any party which has appeared and participated in good faith in the arbitration proceedings may appeal
from the award or other final disposition by filing an action in the state or federal court sitting in Maricopa
County within twenty (20) days after date of the award or other final disposition. Unless such action is
dismissed for failure to prosecute, such action will make the award or other final disposition of the
arbitrator(s) a nullity.
8.0 DEFAULT
County may suspend, modify or terminate this Agreement immediately upon written notice to Contractor in the event
of a non-performance of state objectives or other material breach of contractual obligations or upon happening of any
event, which would jeopardize the ability of the Contractor to perform any of its contractual obligations.
9.0 TERMINATION
10.1 County or the Contractor may terminate this Agreement at any time with thirty (30) days prior written
notice to the other party. Such notice shall be given by personal delivery or by Registered or Certified
Mail.
4
SECTION I GENERAL PROVISIONS RYAN WHITE PART A PROGRAM
10.2 This Agreement may be terminated by mutual written agreement of the parties specifying the termination
date herein.
10.3 County may terminate this Agreement upon twenty four (24) hours’ notice when County deems the
health or welfare of a client is endangered or Contractor non-compliance jeopardizes funding source
financial participation. If not terminated by one of the above methods, this Agreement will terminate
upon the expiration date of this Agreement as stated on the Cover Page.
10.0 NON-APPROPRIATION OF FUNDS
Not-withstanding any other provision of this Agreement, it may be terminated if the Maricopa County Board of
Supervisors does not appropriate sufficient monies for the purpose of maintaining this Agreement.
11.0 SEVERABILITY
Any provision of this Agreement which is determined to be invalid, void or illegal shall in no way affect, impair or
invalidate any other provision hereof, and the remaining provisions shall remain in full force and effect.
12.0 GENERAL REQUIREMENTS
13.1 The terms of this Agreement shall be construed in accordance with Arizona law. Any action shall be
brought in the appropriate court in the State of Arizona.
13.2 The Contractor shall, without limitation, obtain and maintain all licenses, permits and authority
necessary to do business, render services, and perform work under this Agreement, and shall comply
with all laws regarding Unemployment Insurance, Disability Insurance and Worker's Compensation.
13.3 The Contractor is an independent Contractor in performance of the work and the provision of services
under this Agreement and is not to be considered an officer, employee, or agent of Maricopa County.
13.0 CONTRACTOR ELIGIBILITY:
Contractors providing services under this Agreement shall be public or non-profit health and social services
providers, and other non-profit community organizations, medical care providers, community-based
organizations, HIV/AIDS service organizations, academic entities, or city, county, state, federal governmental
units. The CARE Act Amendments of 1996 provide for contracting with for-profit entities under certain
limited circumstances. Specifically, the amendments allow Part A funds to be used to provide direct financial
assistance through contracts with private for-profit entities if such entities are the only available provider of
quality HIV care in the area (Sec 2604(b) (2) (A);Section 2631(a) 1). Contractors are prohibited from
serving as conduits to pass on their awards to for-profit entities. To better serve Persons Living with
HIV/AIDS (PLWHA) within the EMA, the Maricopa County Ryan White Part A Program reserves the right, at
its discretion, to Issue multiple contracts within a service category.
All services must be directed to enhance the delivery of services to persons living with HIV, and, in limited,
restricted instances, their families. These funds may not be used for prevention services.
All providers must have documented evidence to substantiate referral relationships on an ongoing basis. All
providers must submit any written agreements with other organizations/entities that serve the community
of persons living with HIV and are 1) service providers and/or 2) points of entry or access to HIV services. All
Contractors shall include copies of such agreements, detailing each agencies/organization's roles and
responsibilities.
14.0 TECHNICAL ASSISTANCE:
The Contractor is strongly encouraged to utilize the Ryan White Part A EMA technical assistance available to
orient new providers at your organization, working through the service goals, service unit definition,
process expected for service provision, and the administrative documentation required to comply with
5
SECTION I GENERAL PROVISIONS RYAN WHITE PART A PROGRAM
Phoenix EMA Standards of Care and reporting requirements. This technical assistance will ensure that your
internal processes meet the standards required and will assist you in fulfilling these requirements such that
invoices are promptly paid.
15.0 ADAQUACY OF RECORDS
If the Contractor's books, records and other documents relevant to this Agreement are not sufficient to
support and document that allowable services were provided to eligible clients the Contractor shall
reimburse Maricopa County for the services not adequately supported and documented.
16.0 COMPLIANCE MONITORING
County shall monitor the Contractor's compliance with, and performance under, the terms and conditions of
the Agreement, on-site visits for compliance monitoring may be made by County and/or its grantor agencies at
any time during the Contractor's normal business hours, announced or unannounced. The Contractor shall make
available for inspection and/or copying by County, all records and accounts relating to the work performed or
the services provided under this Agreement, or similar work and/or service provided under other grants and
contracts.
17.0. CONTINGENCY RELATING TO OTHER CONTRACTS AND GRANTS
17.1 The Contractor shall, during the term of this Agreement, immediately inform County in writing of
the award of any other contract or grant where the award of such contract or grant may affect
either the direct or indirect costs being paid/reimbursed under this Agreement. Failure by the
Contractor to notify County of such award shall be a material breach of the Agreement and County
shall have the right to terminate this Agreement without liability.
17.2. County may request, and the Contractor shall provide within a reasonable time, a copy of any
other contract or grant, when in the opinion of the Ryan White Part A Program Manager, the
award of the other contract or grant may affect the costs being paid or reimbursed under this
Agreement.
17.3 If County determines that the award to the Contractor of such other Federal or State contract or grant
has affected the costs being paid or reimbursed under this Agreement, County shall prepare an
Amendment effecting a cost adjustment. If the Contractor protests the proposed cost adjustment,
the protest shall be construed as a dispute within the meaning of the "Disputes" clause contained
herein.
18.0. STRICT COMPLIANCE
Acceptance by County of performance not in strict compliance with the Agreement’s terms shall not be
deemed to waive the requirement of strict compliance for all future performance obligations. All changes in
performance obligations under this Agreement must be in writing.
19.0 NON-LIABILITY
Maricopa County and its officers, employees, and representatives shall not be liable for any act or
omission by the Contractor or any subcontractor, employee, officer, agent or representative of Contractor
or subcontractors occurring in the performance of this Agreement, nor shall they be liable for purchases
or Contracts made by the Contractor in anticipation of funding hereunder.
20.0 SAFEGUARDING OF CLIENT INFORMATION
The use or disclosure by any party of any information concerning an eligible individual served under this
Agreement is directly limited to the performance of this Agreement.
21.0 RIGHTS IN DATA
6
SECTION I GENERAL PROVISIONS RYAN WHITE PART A PROGRAM
The parties hereto shall have the use of data and reports resulting from this Agreement without costs or
other restriction except as may otherwise be provided herein or by law or applicable regulation. Each party
shall supply to the other party, upon request, any available information that is relevant to this Agreement
and the performance hereunder.
22.0 NON-DISCRIMINATION
The Contractor, in connection with any service or other activity under this Agreement, shall not in any
way discriminate against any client on the grounds of race, color, religion, sex, national origin, age, ability
to pay or handicap. The Contractor shall include a clause to this effect in all subcontracts inuring to the
benefit of the Contractor or County.
23.0 EQUAL EMPLOYMENT OPPORTUNITY
The Contractor will not discriminate against any employee, or applicant for employment because of race,
age, handicap, color, religion, sex or national origin. The Contractor will take affirmative action to ensure
that applicants are employed and that employees are treated during employment without regard to their
race, age, handicap, color, religion, sex or national origin. Such action shall include, but not be limited to the
following: employment, upgrading, demotion or transfer, recruitment or recruitment advertising, lay-off
or termination, rates of pay, or other forms of compensation, and selection for training, including
apprenticeship. The Contractor shall to the extent such provisions apply, comply with Title VI and VII of the
Federal Civil Rights Act: the Federal Rehabilitation Act, the Age Discrimination in Employment Act, the
Immigration Reform and Control Act of 1986 (IRCA) and Arizona Executive Order 99-4 which mandates that all
persons shall have equal access to employment opportunities. The Contractor shall also comply with all
applicable provisions of the Americans with Disabilities Act of 1990.
24.0 REFERRAL RELATIONSHIPS
24.1 Contractors must have documented evidence to substantiate referral relationships on an ongoing
basis consistent with HRSA guidance regarding "Maintaining Appropriate Referral Relationships"
available from the RWPA upon request.
24.2 The Contractor shall have letters of agreement and Memorandums of Understanding (MOUs), or
contracts to document referral relationships with key points of entry. Key points of entry may
include:
• Emergency rooms
• Substance abuse and mental health treatment programs
• Detox(ification) centers
• Detention facilities
• Sexually Transmitted Disease (STD) Clinics
• Homeless shelters
• HIV counseling and testing sites
Additional points of entry:
• Public health departments
• Health care points of entry specified by eligible areas
• Federally Qualified Healthcare Centers (FQHCs)
• Entities such as Ryan White Part C and D grantees
25.0 REQUIREMENTS
7
SECTION I GENERAL PROVISIONS RYAN WHITE PART A PROGRAM
25.1 Contractor shall comply with all policies and procedures as defined in the current Ryan White Part A
Program Policies and Procedures Manual and amended versions.
25.2 Contractor will maintain discrete client files for all individuals served and will secure the necessary
releases of information to allow for review of all pertinent client information by employees of County
and/or their designated representatives. The Contractor will utilize an electronic medical record system
to maintain client medical records as conducted by RWPA.
25.3 Contractor shall respond to all requests for information and documentation solicited by County when
they are submitted in writing no later than seventy two (72) hours of receipt of request.
25.4 Contractor shall participate with a standardized anonymous Consumer Satisfaction Survey issued by
the RWPA program. The survey and procedure is included in the Ryan White Part A Program
Policies and Procedures Manual. Refer to http://www.ryanwhiteparta.com
25.5 Contractor's service locations shall be accessible by public transportation. If service locations are not
accessible by public transportation, the Contractor shall have policies and procedures in place that
describe how it will provide transportation assistance to clients.
25.6 Contractors providing Medicaid eligible services shall be certified to receive Medicaid payments, or
receive a waiver from the U.S. Secretary of Health and Human Services. The Contractor shall
document efforts to receive certification or waiver, and when certified, maintain proof of
certification and file of contracts with Medicaid insurance companies.
26.0 RELEASE OF INFORMATION
26.1 The Contractor agrees to secure from all clients provided services under this Agreement any and all
releases of information or other authorization requested by County. Each client file documenting
the provision of Part A services must contain a current Administrative Agent authorized release form
signed and dated by the client or client's legal representative. Failure to secure such releases from
clients may result in disallowance of all claims to County for covered services provided to eligible
individuals. If service to anonymous clients is specifically allowed and approved by the County
according to the current Ryan White Part A policies and procedures manual or otherwise stated in
writing by the Administrative Agent, this provision does not apply.
26.2 The Contractor agrees to comply with A.R.S. §36-662, access to records. In conducting an investigation
of a reportable communicable disease to the Arizona Department of Health Services and local
health departments may inspect and copy medical or laboratory records in the possession of or
maintained by a health care provider or health care facility which are related to the diagnosis,
treatment and control of the specific communicable disease case reported. Requests for records
shall be made in writing by the appropriate officer of the Arizona Department of Health Services or
local health department and shall specify the communicable disease case and the patient under
investigation.
27. CERTIFICATION OF CLIENT ELEGIBILITY
27.1 The Contractor agrees to determine and certify eligibility as related to the payer of last resort
requirements for all Clients seeking services supported by Ryan White funds, according to the
requirements detailed in the Eligibility section of the current Ryan White Part A Program Policies and
8
SECTION I GENERAL PROVISIONS RYAN WHITE PART A PROGRAM
Procedures Manual.
27.2 The Contractor agrees to have billing, collection, co-pay and sliding fee policies and procedures that do
not deny Clients services for non-payment, inability to produce income documentation, or require full
payment prior to service, or include any other barriers to service based on ability to pay. If the
Contractor charges Clients for services, the Contractor agrees to charge and document Client fees
collected in accordance with their sliding fee schedule. This fee schedule shall be consistent with current
federal guidelines 42 U.S.C. § 300ff-11 et seq.; Public Health Services (PHS) Act § 2605(e). This fee
schedule must be published and made available to the public. If charging fees, the Contractor must have
a fee discount policy, sliding fee schedule, and sliding fee eligibility applications. The Contractor must
track fees charged and paid by clients. The Contractor must have a fee discount policy that includes client
fee caps, including:
27.2.1. Clear responsibility for annually evaluating Clients to establish individual fees and caps.
27.2.2 Tracking of Part A charges or medical expenses inclusive of enrollment fees, deductibles, and
copayments.
27.2.3 Tracking of Part A charges or medical expenses inclusive of enrollment fees, deductibles, and
copayments.
27.2.4 A process for alerting the billing system that client has reached cap and no further charges will
be charged for the remainder of the year.
27.2.5 Documentation of policies, fees, and implementation, including evidence that staff
understand those policies and procedures.
27.2.6 Contractor must have a process for charging, obtaining, and documenting client charges through
a Medical practice information system, either manually or electronically.
The chart below must be followed when developing the fee schedule.
Client Income Fees For Service
Less than or equal to 100% of the official poverty line No fees or charges to be imposed
Greater than 100%,but not exceeding 200%,of the Fees and charges for any calendar year may not
official poverty line exceed 5% of the Client’s annual gross income
Greater than 200%,but not exceeding 300%,of the Fees and charges for any calendar year may not
official poverty line exceed 7% of the Client’s annual gross income
Greater than 300% of the official poverty line Fees and charges for any calendar year may not
exceed 10% of the Clients annual gross income
28. 0 QUALITY MANAGEMENT
28.1 The Contractor will participate in the Quality Management program as detailed in the current Ryan
White Part A Program Policies and Procedures Manual (http://www.ryanwhiteparta.com).
28.2 The Contractor will utilize and adhere to the most current Standards of Care as developed by the Phoenix
Eligible Metropolitan Area Planning Council.
28.3 The Contractor will develop and implement an agency-specific quality management plan for Ryan
White Part A funded services. The Contractor will conduct Quality Improvement projects at the
9
SECTION I GENERAL PROVISIONS RYAN WHITE PART A PROGRAM
agency level utilizing the Plan Do-Check-Act (PDCA) model.
28.4 The Contractor will participate in cost-cutting Quality Improvement projects and report data per the
timeline established with the County. Additionally, the Contractor will report quality outcome
measures established by the County per the reporting schedule.
28.5 The Contractor will participate in the Quality Management activities of the Clinical Quality Management
Committee as requested by the County.
28.6 The Contractor will conduct and provide documentation of quality assurance and improvement
activities, as designated by the County.
28.7 The Contractor will maintain a comprehensive unduplicated client level database of all eligible
clients served as well as demographic and service measures required and submit this information in
the format and frequency as requested by the County. The County will make available to the
Contractor software for the collection of this information (CAREWare).
28.8 The Contractor will maintain consent to serve forms signed by the Clients to gain permission to report
their data to County, State and Federal authorized entities and to view their records as a part of site
visits and quality management review activities.
28.9 The Contractor will participate in Quality Management trainings sponsored by the County, which the
County deemed mandatory. The Contractor understands that non-participation in these types of
activities may result in noncompliance with the Standards of Care as mandated by the Ryan White
Care Act. Further, such non-participation in Quality Management trainings could result in
prompting a performance monitoring site visit.
29.0 REPORTING REQUIREMENTS
29.1 The Contractor agrees to submit monthly invoices as defined in the Invoice and Payments section.
29.2 The Contractor agrees to submit any administrative, programmatic, quality and/or fiscal reports
requested and at the due date defined by the Administrative Agent.
29.3. The Contractor agrees to comply with and submit annual and semi-annual client-level and provider-level
data as required by HRSA by the due date (s} defined by the Administrative Agent.
29.4 The Contractor agrees to comply with A.R.S. § 36-621, reporting contagious diseases. Any employee,
subcontractor or representative of the Contractor providing services under this Agreement, shall
follow the requirements of this law. Specifically, a person who learns that a contagious, epidemic or
infectious disease exists shall immediately make a written report of the particulars to the
appropriate board of health or health department. The report shall include names and residences of
persons afflicted with the disease. If the person reporting is the attending physician he shall report on
the condition of the person afflicted and the status of the disease at least twice each week.
30.0 PROGRAM MARKETING INITIATIVES
30.1 When issuing statements, press releases and/or Internet-based or printed documents describing
projects, programs and/or services funded in whole or in part with Ryan White Part A funds, the
Contractor shall clearly reference the funding source as the federal Department of Health and
Human Services, Health Resources and Services Administration, the Ryan White HIV/AIDS Treatment
Extension Act of 2009 (or current authorized or reauthorized name of Act), and Maricopa County
10
SECTION I GENERAL PROVISIONS RYAN WHITE PART A PROGRAM
Ryan White Part A Program. Such references to funding source must be of sufficient size to be clear
and legible.
30.2 Contractor is responsible for advertising Ryan White Part A-funded services. Such advertisement is to
promote/incorporate the following components: Services available, venues/locations, and hours of
operation. The content of any and all advertising for these services must be in a format allowed by
Local, State and Federal regulations and shall contain the funding language referenced in this
Agreement.
30.3 Contractor is responsible to ensure that all appropriate program descriptions, including hours and
locations, and any changes related to these services are disseminated to the community and other
Ryan White providers to ensure that clients have access to care. The Contractor shall be able to
document and explain this communication process to the Administrative Agent upon request.
31. 0 POLICY ON CONFIDENTIALITY
31.1 The Contractor understands and agrees that this Agreement is subject to all State and Federal laws
protecting Client confidentiality of medical, behavioral health and drug treatment
information.
31.2 The Contractor shall establish and maintain written procedures and controls that ensure the
confidentiality of Client medical information and records.
31.3 In accordance with Section 318 (e) (5} of the Public Health Service Act [42 U.S.C. 247c (e) (5}), no
information obtained in connection with the examination, care or services provided to any
individual under any program which is being carried out with Federal monies shall, without such
individual's consent, be disclosed except as may be necessary to provide services to such individual or as
may be required by laws of the State of Arizona or its political sub-divisions. Information derived
from any such program may be disclosed a). in summary, statistical, or other form; or b). for clinical
research purposes, but only if the identity of the individual diagnosed or provided care under such
program is not disclosed. The Contractor shall comply with the provisions of A.R.S. §36-663 concerning
HIV-related testing; and A.R.S. §36-664 concerning confidentiality; in providing services under this
Agreement.
31.4 Confidential communicable disease related information may only be disclosed as permitted by law,
and consistent with the Ryan White Part A Program Policy Manual.
32. 0 EQUIPMENT
32.1 All equipment and products purchased with grant funds should be American-made.
32.2 The title to any and all equipment acquired through the expenditure of funds received from County
shall remain that of the Department of Health and Human Services, Health Resources and Services
Administration. County must specifically authorize the acquisition of any such equipment in
advance. Upon termination of this Agreement, County may determine the disposition of all such
equipment.
32.3. The Contractor agrees to exercise reasonable control over all equipment purchased with capital outlay
expense funds. All equipment lost, stolen, rendered unusable or no longer required for program
operation must be reported immediately to County for disposition instructions. The Contractor shall
report the physical inventory of all equipment purchased with these funds within sixty (60) days of
receipt of such equipment.
11
SECTION I GENERAL PROVISIONS RYAN WHITE PART A PROGRAM
33. 0 RESTRICTIONS ON USE OF FUNDS
33.1. The Contractor shall not utilize funds made available under this Agreement to make payments for any
item or service to the extent that payment has been made, or can reasonably be expected to be
made, with respect to that item or service:
33.1.1 Under any State compensation program, under any insurance policy, or under any Federal, State,
or County health benefits program; or
33.1.2 By an entity that provides health services on a prepaid basis.
33.2 Funds shall not be used to purchase or improve (other than minor remodeling) any building or other
facility, or to make cash payments to intended recipients of services as referenced in the Arizona
Revised Statutes (ARS) A.R.S. §41-2591, A.A.C. R2-7-701 and Code of Federal Regulations, Chapter 1,
Subchapter e., Part 31, and Public Health Service
Grants Policy Statement.
33.3 The federal Office of General Counsel and County emphasize that Ryan White Act funds may only
support HIV related needs of eligible individuals. All activities and expenditures must reflect an
explicit connection between any service supported with Ryan White Act funds and the intended
recipient's HIV status.
33.4 Contractor is not authorized to provide services anonymously, unless specifically approved for the
service category in which the Contractor is providing services. All services must only be provided to
documented eligible clients as defined in this agreement.
33.5 Ryan White funds shall not be used to finance the services of lobbyists, fundraisers or grant/proposal
writers, nor to support lobbying, fundraising activities and/or the writing of grant/contract proposals.
The Contractor shall have personnel policies and an employee orientation manual that include
regulations that forbid using federal funds to lobby Congress or other Federal personnel.
33.6 The Ryan White Act limits the administrative expenses to not more than 10% of the total grant award.
The Act defines the allowable "administrative activities" to include:
34.6.1 Usual and recognized overhead, including established indirect rates for agencies;
34.6.2 Management and oversight of specific programs funded under this title; and
34.6.3 Other types of program support such as quality assurance, quality control, and related activities.
34.0 USE OF SUBCONTRACTORS
34.1 The use of subcontractors and/or consultants shall be pre-approved by the County. If the use of
subcontractors is approved by County, the Contractor agrees to use written subcontract/consultant
agreements which conform to Federal and State laws, and the regulations and requirements of this
Agreement appropriate to the service or activity covered by the subcontract. These provisions apply
with equal force to the subcontract as if the subcontractor were the Contractor referenced herein.
The Contractor is responsible for Agreement performance whether or not Subcontractors are used.
The Contractor shall submit a copy of each executed subcontract to County within fifteen (15) days
of its effective date.
34.1.1 All subcontract agreements must provide a detailed scope of work, indicating the provisions of
service to be provided by both the Contractor and Subcontractor.
34.1.2 All subcontract agreements must include a detailed budget, identifying all
administrative and direct service costs as defined in the Budget, Revenues and
Expenditures section.
34.1.3 All subcontract agreements must document the qualifications and ability to provide
12
SECTION I GENERAL PROVISIONS RYAN WHITE PART A PROGRAM
services by the subcontracting agency.
34.2 The Contractor agrees to include in any subcontracts a provision to the effect that the subcontractor
agrees that County shall have access to the subcontractor's facilities and the right to examine any
books, documents and records of the subcontractor, involving transactions related to the
subcontract and that such books, documents and records shall not be disposed of except as
provided herein.
34.3 The Contractor shall not enter into a subcontract for any of the work contemplated under this
Agreement except in writing and with prior written approval of the County. Such approval shall
include the review and acceptance by the County of the proposed sub-contractual arrangement
between the Contractor and the subcontractor.
35.0 RYAN WHITE CAREWARE DATA BASE
35.1 RWPA requires the installation and utilization of HRSA-supplied Ryan White CAREWare software.
CAREWare is used for client level data reporting and monthly billing reports, demographic reports,
and various custom reporting. The Contractor agrees to Install, collect, and report all data requested
by the RWPA via RYAN WHITE CAREWare within sixty (60) days of request by the RWPA, or have
systems for client care and level of billing to allow import of billing data into the RWPA CAREWare
System. The Contractor agrees to participate in technical assistance training and/or informational
presentations for CAREWare at various times scheduled during the agreement year.
35.2 The Contractor is responsible for coordinating the installation of the CAREWare software with their
internal information technology staff. CAREWare software is developed by HRSA and requires no
licensing fees. The Contractor will be responsible for the cost of the Virtual Provider Network
(VPN) cards for each user within their organization if applicable.
35.3 The Ryan White Part A O ffice will provide technical assistance to eligible applicants for the
implementation, and end user support for the CAREWare database. In addition, technical assistance
is made available to eligible applicants to integrate CAREWare with proprietary in-house billing
systems on an as needed basis to minimize data entry efforts needed to report client level
demographic and service related data.
36.00 CULTURAL COMPETENCY
36.1 The Contractor shall meet and comply with applicable standards of the federal Culturally and
Linguistically Appropriate Services (CLAS) standards The Contractor shall develop and implement
organizational policies that comply with these standards.
36.2 The Contractor shall recognize linguistic subgroups and provide assistance in overcoming language
barriers by the appropriate inclusion of American Sign Language and languages of clients accessing care.
37.0 THE PHOENIX EMA RYAN WHITE PLANNING COUNCIL
The Phoenix EMA Ryan White Planning Council (PC) is a planning body required under the Part A
authorization. The Chair of the Maricopa County Board of Supervisors serves as the Chief Elected Official for
the Planning Council. Membership of the PC must be reflective of the epidemic within the Phoenix EMA and
includes representatives from a variety of specific groups such as providers of housing and homeless shelters,
HIV prevention services, representatives of individuals who were formerly Federal, State or local prisoners
released from the custody of the penal system and had HIV disease on the date released, other mandated
entities and interested advocates. The PC establishes service priorities, allocates Part A funds, develops a
comprehensive plan, and addresses the efficiency of the grantee's administrative mechanism for rapidly
contracting out funds to service providers.
The PC establishes Directives for service categories that are additional requirements that must be
13
SECTION I GENERAL PROVISIONS RYAN WHITE PART A PROGRAM
incorporated into the program plan along with applicable Standards of Care. These Directives are provided
under the service category description and should also guide prospective applicants in the development of
goals, objectives and a work plan.
38. 0 ADMINISTRATIVE AGENT AND QUALITY MANAGEMENT
Part A funds are awarded to the Chairma n of the Mar icopa Count y Board of S upe rvis ors
who acts as the chief elected official (CEO). The CEO retains ultimate responsibility for submitting grant
applications, ensuring that funds awarded are used appropriately, and complying with reporting or other
requirements. Most CEOs delegate day-to-day responsibility for administering their Part A award to a health
related department within the jurisdiction.
For the purposes of this section, the CEO of the EMA has delegated this responsibility to the Ryan White Part
A Program within Maricopa County. Administrative activities under the authority of the Administrative Agent
include: Routine grant administration and monitoring activities, including the development of applications
for funds, the receipt, monitoring and disbursal of program funds, the development and establishment
of reimbursement and accounting systems, the preparation of routine programmatic and financial
reports, compliance with grant conditions and audit requirements/promulgation of policies and
procedures and continuous quality improvement initiatives.
All activities associated with the County’s contract award procedures, including the development of requests
for proposals, contract proposal review activities, negotiation and awarding of contracts, monitoring of
contracts through telephone consultation, written documentation or onsite visits, reporting on contracts,
and funding reallocation activities. The Administrative Agent will conduct site visits with service providers
to monitor program and fiscal compliance with contracts, and to ensure adherence to the EMA's Standards of
care as developed by the PC.
The lead agency (Contractor) agrees to include in any subcontracts a provision to the effect that the
subcontractor agrees that Maricopa County Ryan White Part A Program shall have access to the
subcontractor's facilities and the right to examine any books, documents, and records of the
subcontractor, involving transactions related to the subcontract. Additionally, Client charts,
care/treatment plans, eligibility requirements, etc., shall be available for inspection.
The Administrative Agent will also provide technical assistance and training that providers may be
required to attend.
The CARE Act requires the establishment of quality management program and quality service indicators for
all Part A programs to ensure that persons living with HIV disease receive those services and that the quality
of those services meet certain criteria, specifically Standards of Care and the Public Health Services treatment
guidelines.
The Maricopa County Ryan White Part A Program has established a Quality Management Program to assess all
services funded under Ryan White Part A Program and to achieve the goals set forth in the CARE Act. All
funded programs are subject to quality management reviews and technical assistance. All agencies must be
able to demonstrate that health and support services supported by Part A funds are consistent with PHS
treatment guidelines and the Standards of Care as established by the Planning Council.
All funded providers will be asked to submit quality management plans to reflect how providers are
ensuring quality services.
14