BLUE CROSS BLUE SHIELD ARIZONA HEALTH CHOICE MOU.PDF

MEMORANDUM OF UNDERSTANDING 
Between 
MARICOPA COUNTY AND  
BLUE CROSS BLUE SHIELD ARIZONA HEALTH CHOICE 
 
This Memorandum of Understanding (“MOU”) is entered into effect upon the execution of this document by both 
Parties,  pursuant to the applicable Arizona Health Care Cost Containment System (“AHCCCS”) Contract, with Acute 
Care Center (“ACC”) Health Plan, between BLUE CROSS BLUE SHIELD ARIZONA HEALTH CHOICE 
(“BCBSAZ Health Choice”) and MARICOPA COUNTY by and through its DEPARTMENT OF 
CORRECTIONAL HEALTH SERVICES, (“CHS”). 
 
I. 
PURPOSE: 
 
The purpose of this MOU is to establish a collaborative protocol for effective communication, coordination, 
and continuity of care for individuals eligible for services provided by BCBSAZ Health Choice who are 
also served by CHS. This MOU shall in no way change, modify, or amend the contract between AHCCCS 
and BCBSAZ Health Choice and does not create liability from one party to the other by a party's failure to 
comply with the protocol. Should any information within this MOU conflict with any terms or conditions 
within the AHCCCS contract, the AHCCCS contract shall prevail. 
 
II. 
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 Department of CHS. 
 
D. 
Criminal Justice Information refers to any confidential information collected by criminal justice 
agencies on individuals consisting of identifiable descriptions and notations of arrests, detentions, 
indictments, information, or other formal criminal charges, and any disposition arising therefrom, 
as well as confidential pre-booking or booking personal identifiable information, including date of 
birth, social security number, age, demographic information, projected release dates and release date 
information as defined in 5.U.S.C. § 552 and 5 U.S.C. § 552a. 
 
E. 
Director means the Director of CHS. 
 
F. 
Medical Director means the Medical Director of CHS. 
 
G. 
Authorized Use means Protected Health Information (“PHI”) provided by CHS to BCBSAZ Health 
Choice that shall be used and/or disclosed only as authorized by law including, but not limited to 
the treatment of individuals identified as homeless as needed in order to reduce recidivism. Except 
when otherwise required by law, disclosures of PHI pursuant to this MOU are subject to a minimum 
necessary determination by CHS (45 CFR § 164.502(b)). When reasonable to do so, CHS may rely 
upon the representations of BCBSAZ Health Choice as to what information is the minimum 
necessary for their lawful purpose (45 CFR § 164.514(d) (3) (iii)). Information regarding substance 
use or abuse shall not be disclosed without the express written authorization of the individual. 
 
H. 
Health Insurance Portability and Accountability Act (“HIPAA”) refers collectively to the 
HIPAA of 1996, codified at 42 U.S.C. § 1330d 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 3009, 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.  
 
I. 
Electronic Health Record (“EHR”) refers to the EHR system licensed by the County and 
maintained by CHS. 
 
J. 
PHI shall have the same meaning as defined under HIPAA and includes any information about 
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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 under the care, safety, and 
medical supervision of CHS. 
 
III. 
COLLABORATIVE AGREEMENT BETWEEN CHS AND BCBSAZ HEALTH CHOICE 
 
A. 
Background:  
 
CHS enhances community safety by working in a collaborative partnership with AHCCCS, 
BCBSAZ Health Choice, and its contracted providers to provide research-based prevention and 
intervention services. BCBSAZ Health Choice's contracted providers deliver a range of healthcare 
services and treatment programs for adults and youth with physical health needs, serious mental 
illness, and other mental health and/or substance abuse disorders. 
 
To facilitate the transition of members transitioning out of jails and back into our community, 
collaboration between CHS and BCBSAZ Health Choice is critical to reentry activities. Specifically, 
BCBSAZ Health Choice will collaborate with CHS to accomplish "reach-in" care coordination for 
members who have been incarcerated in the adult correctional system for 20 days or longer and have 
an anticipated release date. "Reach-in" care coordination activities shall begin upon knowledge of a 
member's anticipated release date. BCBSAZ Health Choice will collaborate with CHS to identify 
justice-involved General Mental Health/Substance Use (GMHSU) members in the adult criminal 
justice system with physical and/or behavioral health chronic and/or complex care needs prior to 
member's release. 
 
B. 
Data Sharing and Coordination:  
 
BCBSAZ Health Choice and CHS will partner to accomplish the following: 
 
1. 
Communicate timely data necessary for coordination of care in conformance with all 
applicable administrative orders, state laws and regulations, 42 CFR Part 2 and 164, and 
HIPAA requirements that permit the sharing of written, verbal, and electronic information. 
 
2. 
Use data-sharing MOUs and administrative orders that permit the sharing of written, 
verbal, and electronic information at the time of admission into the facility and at the time 
of discharge. 
 
C. 
Collaborative Protocols:  
 
When BCBSAZ Health Choice becomes aware that a member is incarcerated and is subject to the 
"Reach-In" requirements described above: 
 
1. 
The BCBSAZ Health Choice Point of Contact or designee will complete a Justice 
Transition Form (JTF) for GMHSU members with designated chronic conditions and send 
the JTF to CHS: 
 
a. CHS will confirm diagnosis/chronic condition in the EHR. 
b. CHS will complete the CHS section of the JTF and return it to BCBSAZ Health Choice 
– scan it into the EHR. 
 
2.  
If CHS identifies newly diagnosed chronic care conditions, CHS will complete a JTF and 
send it to BCBSAZ Health Choice Point of Contact or designee. 
 
3.  
If member has a diagnosis of HIV+, Medication Assisted Treatment (MAT), or Substance 
Use/Misuse, the member's written consent to release and share information must be 
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completed and uploaded into the EHR prior to disclosure of the member's identifying 
information. 
 
4.  
If member is in jail 20 days or more with a scheduled release date, the BCBSAZ Health 
Choice Point of Contact or designee will initiate a video or in person visit with the member. 
 
5.  
An applicable provider appointment will be scheduled based on member agreement and 
needs assessment from the video visit to occur within 7 days of scheduled release date. 
 
6.  
The BCBSAZ Health Choice Point of Contact or designee will forward to CHS an 
"Introduction Letter," via secure email, with the following information: 
 
a. Appointment day/time 
b. Clinic name and location 
c. Health Plan Point of Contact (or designee) contact information. 
 
7.  
CHS will place this introduction letter into the member's property which will be provided 
upon jail release. 
 
8.  
CHS and BCBSAZ Health Choice Point of Contact or other health staff may coordinate 
special needs prior to jail release (such as courtesy release, medical equipment, or specific 
medications). 
 
D. 
Communication and Problem Resolving:  
 
CHS and BCBSAZ Health Choice will have quarterly steering committee meetings to build and 
strengthen relationships and address any problems or conflicts. Additionally, BCBSAZ Health 
Choice will identify and extend invitations to CHS, to provider level meetings appropriate for CHS 
participation. 
 
Meetings shall include opportunities for agency cross-training and for identifying, communicating, 
and resolving problems to increase understanding and knowledge of each other's mission, goals and 
how, through agency collaboration, members are provided identified services to improve their health 
and well-being and reduce recidivism. 
 
BCBSAZ Health Choice and CHS will work together to ensure processes from both agencies are 
being practiced. On-going improvement efforts will focus on reducing redundancies and providing 
timely, accurate and relevant information to coordinate services and evaluate outcomes of those 
services. 
 
BCBSAZ Health Choice and CHS will identify key staff who have the authority to assist with 
disputes and find resolutions based on the agreements and best interest of the populations jointly 
served. If necessary, this may include the BCBSAZ Health Choice Chief Medical Officer (or 
designee) and the CHS Mental Health Director. Meetings shall include opportunities to report 
identified gaps and discuss and act on resolutions. 
 
E. 
Joint Training Needs: BCBSAZ Health Choice and its contracted providers and CHS will provide 
cross training opportunities as mutually agreeable needs are identified. 
 
IV.  
SPECIAL TERMS AND CONDITIONS: 
 
A. 
TERM OF MOU: This MOU shall begin upon approval by the Maricopa County Board of 
Supervisors and shall terminate one year thereafter unless otherwise terminated or amended as 
provided herein. By mutual written amendment executed by the Parties’ authorized representatives, 
this MOU may be extended for supplemental periods of 12 months, up to maximum of 48 months. 
 
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B. 
TERMINATION: This MOU may be terminated by either party with prior written notice to the 
other party. Such Notice of Termination by BCBSAZ Health Choice shall be effective 30 calendar 
days after mailing by certified mail, return receipt requested, to CHS. CHS may terminate this MOU, 
in whole or in part, immediately upon providing either written or verbal notice to BCBSAZ Health 
Choice when CHS deems the health or welfare of a patient is endangered. Either party may terminate 
this MOU immediately upon providing written or verbal notice when it deems that performance 
would be in violation of the law or order of a court of law. For any other cause, CHS may terminate 
this MOU upon 30 calendar days after mailing by certified mail, return receipt requested, to 
BCBSAZ Health Choice. 
 
C. 
AMENDMENTS: Any changes to this MOU shall be in writing and signed by both parties.   
 
D. 
BCBSAZ HEALTH CHOICE’s & CHS’ RESPONSIBILITIES: BCBSAZ Health Choice and 
CHS shall operate in a professional manner that conforms to all local, state, and federal codes and 
rules and within the standard of practice for the scope of each of the parties’ responsibilities. 
BCBSAZ Health Choice and CHS shall comply with all federal, state, and local laws, ordinances, 
rules, and regulations applicable to each party’s performance under this MOU. There are no 
financial responsibilities assigned by this MOU; the MOU is intended to allow BCBSAZ Health 
Choice and CHS to work together to better address the needs of the community. 
 
E. 
COMPLIANCE MONITORING: CHS shall conduct periodic quality assurance audits to 
determine BCBSAZ Health Choice’s compliance with, and performance under, the terms and 
conditions of this MOU. 
 
F. 
RETENTION OF RECORDS: BCBSAZ Health Choice and CHS shall maintain records and other 
relevant documents to this MOU for five years following the termination or expiration of the MOU; 
provided however, if any audit questions are unresolved at the end of that five-year period, all 
records and documents relating to such audit questions shall be maintained until those audit 
questions are resolved. 
 
G. 
NON-DISCRIMINATION: To the extent applicable, BCBSAZ Health Choice, in accordance with 
A.R.S. § 41-1461, et seq., shall provide equal employment opportunities for all persons, regardless 
of race, color, creed, religion, sex, age, national origin, disability or political affiliation. BCBSAZ 
HEALTH CHOICE shall comply with the Americans with Disabilities Act. 
 
H. 
EMPLOYMENT VERIFICATION: To the extent applicable, the parties shall comply with 
A.R.S. § 41-4401, all Federal immigration laws and regulations relating to employees, including 
compliance with A.R.S. § 23-214, Subsection A. 
 
I. 
GOVERNING LAWS: This MOU shall be governed by the laws of the State of Arizona. Any 
litigation arising from the MOU, or the performance thereof will be decided in the federal or state 
courts of Maricopa County unless otherwise agreed to between the Parties. 
 
J. 
INDEMNIFICATION: To the fullest extent permitted by law, each party shall defend, indemnify, 
and hold harmless the other party, its agents, representatives, officers, directors, officials, and 
employees for, from and against all claims, damages, losses and expenses, including, but not limited 
to, attorneys’ fees, court costs, expert witness fees, and the cost of appellate proceedings, relating 
to, arising out of, or alleged to have resulted from the negligent acts, errors, omissions or mistakes 
relating to the performance of this MOU. Each party’s duty to defend, indemnify and hold harmless 
the other party, its agents, representatives, officers, directors, officials, and employees shall arise in 
connection with any claim, damage, loss or expense that is attributable to bodily injury, sickness, 
disease, death, or injury to, impairment, or destruction of property, including loss of use resulting 
therefrom, caused by any negligent acts, errors, omissions or mistakes in the party’s performance of 
this MOU including any person for whose acts, errors, omissions or mistakes a party may be legally 
liable. 
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K. 
INSURANCE: BCBSAZ Health Choice, at BCBSAZ Health Choice’s own expense, shall purchase 
and maintain, at a minimum, the herein stipulated insurance from a company or companies duly 
licensed by the State of Arizona and possessing an AM Best, Inc. category rating of B++. In lieu of 
State of Arizona licensing, the stipulated insurance may be purchased from a company or 
companies, which are authorized to do business in the State of Arizona, provided that said insurance 
companies meet the approval of County. The form of any insurance policies and forms must be 
acceptable to County.  
 
All insurance required herein shall be maintained in full force and effect until all work or service 
required to be performed under the terms of the MOU is satisfactorily completed and formally 
accepted. Failure to do so may, at the sole discretion of County, constitute a material breach of this 
MOU. In the event that the insurance required is written on a claims-made basis, BCBSAZ Health 
Choice warrants that any retroactive date under the policy shall precede the effective date of this 
MOU and either continuous coverage will be maintained, or an extended discovery period will be 
exercised for a period of two years beginning at the time work under this MOU is completed. 
BCBSAZ Health Choice’s insurance will be primary insurance as respects County, and any 
insurance or self-insurance maintained by County will not contribute to it.   
 
Any failure to comply with the claim reporting provisions of the insurance policies or any breach of 
an insurance policy warranty shall not affect the County’s right to coverage afforded under the 
insurance policies. The insurance policies may provide coverage that contains deductibles or self-
insured retentions. Such deductible and/or self-insured retentions shall not be applicable with respect 
to the coverage provided to County under such policies. BCBSAZ Health Choice shall be solely 
responsible for the deductible and/or self-insured retention and County, at its option, may require 
BCBSAZ Health Choice to secure payment of such deductibles or self-insured retentions by a surety 
bond or an irrevocable and unconditional letter of credit.  
 
The insurance policies required by this MOU, except Workers’ Compensation and Errors and 
Omissions, shall name County, its agents, representatives, officers, directors, officials, and 
employees as additional insureds. The policies required hereunder, except Workers’ Compensation 
and Errors and Omissions, shall contain a waiver of transfer of rights of recovery (subrogation) 
against County, its agents, representatives, officers, directors, officials, and employees for any 
claims arising out of BCBSAZ Health Choice’s work or service. If available, the insurance policies 
required by this MOU may be combined with Commercial Umbrella Insurance policies to meet the 
minimum limit requirements. If a Commercial Umbrella insurance policy is utilized to meet 
insurance requirements, the Certificate of Insurance shall indicate which lines the Commercial 
Umbrella Insurance covers.   
  
1. 
Commercial General Liability: Commercial General Liability (CGL) insurance and, if 
necessary, Commercial Umbrella insurance with a limit of not less than $1,000,000 for 
each occurrence, $3,000,000 Products/Completed Operations Aggregate, and $3,000,000 
General Aggregate Limit. The policy shall include coverage for premises liability, bodily 
injury, broad form property damage, personal injury, products and completed operations 
and blanket contractual coverage, and shall not contain any provisions which would serve 
to limit third party action over claims. There shall be no endorsement or modifications of 
the CGL limiting the scope of coverage for liability arising from explosion, collapse, or 
underground property damage.  
 
2. 
Workers’ Compensation: Workers’ Compensation insurance to cover obligations 
imposed by Federal and state statutes having jurisdiction of BCBSAZ Health Choice’s 
employees engaged in the performance of the work or services under this MOU; and 
Employer’s Liability insurance of not less than $1,000,000 for each accident, $1,000,000 
disease for each employee, and $1,000,000 disease policy limit. BCBSAZ Health Choice, 
its subcontractors, and sub-subcontractors waive all rights against this MOU and its agents, 
officers, directors, and employees for recovery of damages to the extent these damages are 
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covered by the Workers’ Compensation and Employer’s Liability, or Commercial 
Umbrella Liability insurance obtained by BCBSAZ Health Choice, its subcontractors, and 
its sub-subcontractors pursuant to this MOU.  
 
3. 
Professional Liability Insurance: BCBSAZ Health Choice shall maintain Professional 
Liability insurance which will provide coverage for any and all acts arising out of the work 
or services performed by BCBSAZ Health Choice under the terms of this MOU, with a 
limit of not less than $1,000,000 for each claim, and $3,000,000 aggregate claims.  
 
4. 
Sexual Molestation and Physical Abuse: The policy shall be endorsed to include 
coverage for sexual molestation and physical abuse at limits not less than $1,000,000.00 
per occurrence and $2,000,000.00 aggregate. These limits may be included within a 
General Liability policy, Professional Liability policy or provided by separate endorsement 
with its own limits as required. BCBSAZ Health Choice must provide the following 
statement on their Certificate(s) of Insurance: “Sexual molestation and physical abuse 
coverage is included.” Policies/certificates stating that “Sexual molestation and physical 
abuse coverage is not excluded” do not meet this requirement.  
 
5. 
Cyber, Network Security, and Privacy Liability: Cyber, Network Security and Privacy 
Liability Insurance with a limit of not less than $5,000,000 per occurrence. The policy shall 
include, but not be limited to; coverage for all directors, officers, agents and employees of 
BCBSAZ Health Choice, losses with respect to network risks (such as data breaches, 
unauthorized access or use, and ID theft of data), invasion of privacy (regardless of the 
type of media involved in the loss of private information), crisis management, identity theft 
response costs, breach notification costs, credit remediation, and credit monitoring, 
defense, and claims expenses, regulatory defense costs plus fines and penalties, cyber 
extortion, electronic data restoration expenses (data asset protection), network business 
interruption, computer fraud coverage, funds transfer loss, third-party fidelity, theft, no 
requirement for arrest and conviction, and loss outside the premises of the named insured.  
 
6. 
Certificates of Insurance: Prior to MOU execution, BCBSAZ Health Choice shall furnish 
the County with valid and complete certificates of insurance, or formal endorsements as 
required by the MOU in the form provided by the County, issued by BCBSAZ Health 
Choice’s insurer(s), as evidence that policies providing the required coverage, conditions, 
and limits required by this MOU are in full force and effect. Such certificates shall identify 
this contract number and title. In the event any insurance policy(ies) required by this MOU 
is (are) written on a claims-made basis, coverage shall extend for two years past completion 
and acceptance of BCBSAZ Health Choice’s work or services and as evidenced by annual 
Certificates of Insurance. If a policy does expire during the life of the MOU, a renewal 
certificate must be sent to County 15 calendar days prior to the expiration date. Certificates 
of Insurance shall identify Maricopa County as the additional insured/certificate holder as 
follows:  
  
Maricopa County  
c/o Risk Management  
301 W Jefferson St., Suite 910  
Phoenix, AZ 85003  
  
7. 
Cancellation and Expiration Notice: Applicable to all insurance policies required within 
the insurance requirements of this MOU, BCBSAZ Health Choice’s insurance shall not be 
permitted to expire, be suspended, be canceled, or be materially changed for any reason 
without 30 calendar days prior written notice to Maricopa County. BCBSAZ Health Choice 
must provide notice to Maricopa County, within two business days of receipt, if they 
receive notice of a policy that has been or will be suspended, canceled, materially changed 
for any reason, has expired, or will be expiring. Such notice shall be sent directly to 
Maricopa County Office of Procurement Services and shall be mailed, or hand delivered 
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to 301 W. Jefferson St. Suite 700, Phoenix, AZ 85003.  
  
L. 
EMPLOYMENT: Parties acknowledge that under this MOU no employee or participant of 
BCBSAZ Health Choice is to be considered a County employee, and that no rights of County merit, 
County retirement, or County personnel rules shall accrue to such individual. BCBSAZ Health 
Choice shall have total responsibility for all salaries, wages, bonuses, retirement, withholdings, 
workman's compensation, occupational disease compensation, unemployment compensation, other 
employee benefits, and all taxes and premiums appurtenant thereto concerning such individuals and 
shall save and hold County and CHS harmless with respect thereto. 
 
M. 
NON-JOINT VENTURE: This MOU is not intended to constitute, create, give rise to, or otherwise 
recognize a joint venture MOU, partnership or other formal business association or organization of 
any kind, and the right and obligations of the Parties shall be only those expressly set forth in this 
MOU. 
 
N. 
CONFLICTS OF INTEREST: This MOU is subject to the provisions of A.R.S. § 38-511. 
 
O. 
ARBITRATION: To the extent applicable, the parties, in accordance with A.R.S. §12-1518, agree 
to resolve all disputes arising out of or relating to this MOU through arbitration, after exhausting 
applicable administrative review except as may be required by other applicable statutes. This 
provision does not apply to provider claims disputes or member appeals regarding covered services 
provided by BCBSAZ Health Choice. 
 
P. 
PUBLIC RECORDS: Notwithstanding any other provision of this MOU to the contrary, CHS is 
subject to A.R.S. 39-121 through 39-128 regarding public records. Any provision regarding 
confidentiality is limited to the extent necessary to comply with the provisions of Arizona law. The 
parties acknowledge that BCBSAZ Health Choice is not a public agency subject to public records 
laws but is a private corporation. 
 
Q. 
CONFIDENTIALITY OF RECORDS: 
 
1. 
Neither party shall use or disclose any PHI received from the other in any manner that 
would constitute a violation of this MOU or federal or state law. Each party shall take 
reasonable measures to ensure that its directors, officers, employees, vendors, contractors, 
and agents use or disclose PHI received from the other party in accordance with the 
provisions of this MOU and federal and state law. Each party shall implement all 
appropriate safeguards reasonably necessary to maintain the confidentiality of the 
information accessed through the EHR system. 
 
2. 
Information pertaining to substance abuse will only be shared upon obtaining a release of 
information from the individual in compliance with 42 CFR Part 2. 
 
3. 
Before BCBSAZ Health Choice’s Authorized Users may have access to CHS’ EHR 
system, BCBSAZ Health Choice’s Authorized Users will be required to read and agree to 
the terms of CHS’ user/confidentiality MOU. The parties shall work cooperatively to fulfill 
this requirement and return copies of the executed MOUs, as necessary. 
 
4. 
BCBSAZ Health Choice and its Authorized Users may be provided with Criminal Justice 
Information via the EHR system by CHS for the sole purpose of safely and securely 
providing and/or coordinating treatment and/or healthcare services to patients incarcerated 
in the Maricopa County Jail. BCBSAZ Health Choice shall not use or disclose Criminal 
Justice Information for any other purpose and will treat all Criminal Justice Information as 
confidential as always required by state and federal laws and take reasonable measures to 
maintain the security and confidentiality of such information. BCBSAZ Health Choice 
shall instruct its staff concerning the confidential nature of Criminal Justice Information 
and the applicable prohibitions against its use and disclosure. 
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5. 
Reporting of Unauthorized Use or Disclosure of PHI: CHS and BCBSAZ Health Choice 
shall, within 24 hours of becoming aware or has reason to believe of an unauthorized use 
or disclosure of PHI by either organization; or any of its Authorized Users, officers, 
directors, employees, vendors, contractors, agents or by a third party. Such notice shall be 
made to the following: 
 
      
MARICOPA COUNTY CORRECTIONAL HEALTH SERVICES (CHS) 
Attn: Business Integration Technology (BIT) 
Title: Unauthorized Use or Disclosure of PHI 
Address: 234 N Central Avenue, Suite 5350 
City, State Zip: Phoenix, AZ 85004 
Phone: (602) 506-3127 
Emails: CHSBIT@maricopa.gov and CHSHIMTeam@maricopa.gov  
 
BLUE CROSS BLUE SHIELD ARIZONA HEALTH CHOICE (BCBSAZ Health 
Choice)  
 
 
Attn: Jennifer DeMaris 
Title: Integrated Care Management Manager 
Address: 8220 N. 23rd Avenue 
City, State Zip: Phoenix, AZ 85021 
Phone: 623-352-1346 ext. 5159    
Email: Jennifer.DeMaris@azblue.com 
 
R. 
ASSIGNMENT, DELEGATION, AND EXECUTION: 
 
1. 
Neither party may assign this MOU without the express, written, prior consent of both 
parties, which shall not be unreasonably withheld or delayed. 
 
2. 
This MOU does not imply authority to perform any tasks or accept responsibility. 
 
3. 
Sections and other headings contained in this MOU are for reference purposes and shall 
not affect in any way the meaning or interpretation of this MOU.  
 
4. 
This MOU may be executed in two or more counterparts, each of which shall be deemed 
an original but all of which together shall constitute the same instrument. Faxed, copied, 
digital, and scanned signatures are acceptable as original signatures. 
 
5. 
This MOU contains the entire understanding of the parties hereto with respect to the 
matters covered, and it supersedes all proposals, oral or written, and all other documents 
or communications between the parties relative to the subject matter herein covered, unless 
such documents or communications are specifically included by reference. 
 
6. 
All notices under this MOU given by either  party to the other shall be in writing and shall 
be delivered in person or sent by U.S. Postal Service, postage prepaid and addressed to the 
following individuals: 
 
MARICOPA COUNTY CORRECTIONAL HEALTH SERVICES (CHS) 
Attn:  Lisa Struble 
Title:  CHS Department Director 
Address: 234 N. Central Avenue, Suite 5000 
City, State Zip: Phoenix, AZ 85004 
Phone: (602) 350-1745  
Email: Lisa.Struble@maricopa.gov  
 
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BLUE CROSS BLUE SHIELD ARIZONA HEALTH CHOICE (BCBSAZ 
Health Choice) 
Attn: Jennifer DeMaris 
Title: Integrated Care Management Manager 
Address: 8220 N. 23rd Avenue 
City, State Zip: Phoenix, AZ 85021 
Phone: 623-352-1346 ext. 5159    
Email: Jennifer.DeMaris@azblue.com 
 
7. 
Prior to or simultaneously with the execution of this MOU, BCBSAZ HEALTH CHOICE 
shall provide CHS with proof, satisfactory to the County Attorney, that the individual 
executing this MOU on behalf of BCBSAZ HEALTH CHOICE is legally authorized to 
bind BCBSAZ HEALTH CHOICE. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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IN WITNESS WHEREOF, the parties have executed this MOU as of the respective dates written below. 
 
 
 
BLUE CROSS BLUE SHIELD ARIZONA 
 
MARICOPA COUNTY 
HEALTH CHOICE 
 
 
 
 
BOARD OF SUPERVISORS 
Authorized Individual: 
 
 
 
 
 
 
 
By: 
 
 
 
 
 
  
By:  
 
 
 
 
 
 
Name:   
 
 
 
 
 
Name:   
 
 
 
 
 
Title:   
 
 
 
 
             Title: Chairman, Board of Supervisors 
Date:   
 
 
 
 
 
Date:   
 
 
 
 
 
 
 
 
 
 
 
 
Tax Identification Number: 86-6000472     
 
 
 
                                                 
ATTEST: 
 
 
 
                                                             
By:   
 
 
 
 
 
 
 
                                                            
Name:   
 
 
 
 
 
 
 
 
 
 
 
Title:  Clerk of the Board  
 
 
 
                                                 
Date:   
 
 
 
 
 
 
 
APPROVED AS TO FORM: 
 
 
 
 
 
 
 
By:  
 
 
 
 
 
 
 
 
 
 
 
 
 
Name:   
 
 
 
 
 
 
 
 
 
 
 
 
Title: Deputy County Attorney 
 
 
 
 
 
 
 
Date:   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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Matthew Ladich
10/8/2024 | 9:36 AM MST
Staff Vice President
Docusign Envelope ID: 423421B7-7C5D-4D6A-A4F3-46CB59512DD4
10/8/2024
Davina Bressler