ARIZONA PHYSICIANS IPA INC. DBA UNITEDHEALTHCARE COMMUNITY PLAN (UHCCP) MOU (2).PDF

MEMORANDUM OF UNDERSTANDING 
Between 
MARICOPA COUNTY AND  
ARIZONA PHYSICIANS IPA, INC. DBA UNITED HEALTHCARE COMMUNITY PLAN 
 
This Memorandum of Understanding (“MOU”) is entered into pursuant to the applicable Arizona Health Care Cost 
Containment System (“AHCCCS”) Contract, with Acute Care Center (“ACC”) Health Plan, between ARIZONA 
PHYSICIANS IPA, INC. D/B/A UNITEDHEALTHCARE COMMUNITY PLAN (“UHCCP”) 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 UHCCP who are also served by CHS. 
This MOU shall in no way change, modify, or amend the contract between AHCCCS and UHCCP 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 UHCCP 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 UHCCP 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 UHCCP 
 
A. 
Background:  
 
CHS enhances community safety by working in a collaborative partnership with AHCCCS, Arizona 
Physicians IPA, Inc. d/b/a UHCCP, and its contracted providers to provide research-based 
prevention and intervention services. UHCCP'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 UHCCP is critical to reentry activities. Specifically, UHCCP 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. UHCCP 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:  
 
UHCCP 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 UHCCP becomes aware that a member is incarcerated and is subject to the "Reach-In" 
requirements described above: 
 
1. 
The UHCCP 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 UHCCP - scan 
     it into the EHR. 
 
2.  
If CHS identifies newly diagnosed chronic care conditions, CHS will complete a JTF and 
send it to UHCCP 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 
completed and uploaded into the EHR prior to disclosure of the member's identifying 
information. 
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4.  
If member is in jail 20 days or more, the UHCCP Point of Contact or designee will initiate 
a video or in person visit with the member. 
 
5.  
An appointment will be made with member's Primary Care Physician (PCP) to occur within 
7 days of release. 
 
6.  
The UHCCP 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 UHCCP 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 UHCCP will have quarterly steering committee meetings to build and strengthen 
relationships and address any problems or conflicts. Additionally, UHCCP 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. 
 
UHCCP 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. 
 
UHCCP 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 UHCCP 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: UHCCP 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 36 months after the date of the signature thereafter unless otherwise 
terminated or amended as provided herein.  
B. 
TERMINATION: This MOU may be terminated by either party with prior written notice to the 
other party. Such Notice of Termination by UHCCP 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 UHCCP 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 
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days after mailing by certified mail, return receipt requested, to UHCCP. 
 
C. 
AMENDMENTS: Any changes to this MOU shall be in writing and signed by both parties.   
 
D. 
UHCCP’s & CHS’ RESPONSIBILITIES: UHCCP 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. UHCCP 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 UHCCP 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 UHCCP’s compliance with, and performance under, the terms and conditions of this 
MOU. 
 
F. 
RETENTION OF RECORDS: UHCCP 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, UHCCP, 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. UHCCP 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. 
 
K. 
INSURANCE: UHCCP, at UHCCP’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 
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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, UHCCP 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. UHCCP’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. UHCCP shall be solely responsible for the 
deductible and/or self-insured retention and County, at its option, may require UHCCP 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 UHCCP’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 UHCCP’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. UHCCP, 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 covered by the 
Workers’ Compensation and Employer’s Liability, or Commercial Umbrella Liability 
insurance obtained by UHCCP, its subcontractors, and its sub-subcontractors pursuant to 
this MOU.  
 
3. 
Professional Liability Insurance: UHCCP shall maintain Professional Liability insurance 
which will provide coverage for any and all acts arising out of the work or services 
performed by UHCCP 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 
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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. UHCCP 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 
UHCCP, 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, UHCCP 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 UHCCP’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 UHCCP’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, UHCCP’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. UHCCP 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 to 301 W. Jefferson St. 
Suite 700, Phoenix, AZ 85003.  
  
L. 
EMPLOYMENT: Parties acknowledge that under this MOU no employee or participant of 
UHCCP 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. UHCCP 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 
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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 UHCCP. 
 
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 UHCCP 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 UHCCP’s Authorized Users may have access to CHS’ EHR system, UHCCP’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. 
UHCCP 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. UHCCP 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. UHCCP shall instruct its staff concerning the 
confidential nature of Criminal Justice Information and the applicable prohibitions against 
its use and disclosure. 
  
5. 
Reporting of Unauthorized Use or Disclosure of PHI: CHS and UHCCP 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 
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Phone: (602) 506-3127 
Emails: CHSBIT@maricopa.gov and CHSHIMTeam@maricopa.gov  
 
ARIZONA PHYSICIANS IPA, INC. DBA UNITED HEALTHCARE COMMUNITY 
PLAN 
Attn: Mary Krawczyk    
Title: Judicial Program Supervisor  
Address: 1 East Washington, Suite 900  
City, State Zip: Phoenix, AZ 85004  
Phone: 602-255-8995 
Email: mary_krawczyk@uhc.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  
 
 
ARIZONA PHYSICIANS IPA, INC. DBA UNITED HEALTHCARE 
COMMUNITY PLAN 
Attn: Mary Krawczyk    
Title: Judicial Program Supervisor  
Address: 1 East Washington, Suite 900  
City, State Zip: Phoenix, AZ 85004  
Phone: 602-255-8995 
Email: mary_krawczyk@uhc.com       
 
7. 
Prior to or simultaneously with the execution of this MOU, UHCCP shall provide CHS 
with proof, satisfactory to the County Attorney, that the individual executing this MOU on 
behalf of UHCCP is legally authorized to bind UHCCP. 
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IN WITNESS WHEREOF, the parties have executed this MOU as of the respective dates written below. 
 
 
 
ARIZONA PHYSICIANS IPA, INC. DBA UNITED 
 MARICOPA COUNTY 
HEALTHCARE COMMUNITY PLAN  
 
BOARD OF SUPERVISORS 
Authorized Individual: 
 
 
 
 
 
 
 
By: 
 
 
 
 
 
  
By:  
 
 
 
 
 
 
Name:  Jean Kalbacher  
 
 
 
Name:   
 
 
 
 
 
Title:  CEO UHCCP  
 
 
             Title: Chairman, Board of Supervisors 
Date:   
 
 
 
 
 
Date:   
 
 
 
 
 
 
 
 
 
                                                 
ATTEST: 
 
 
 
                                                             
By:   
 
 
 
 
 
 
 
                                                            
Name:   
 
 
 
 
 
 
 
 
 
 
 
Title:  Clerk of the Board  
 
 
 
                                                 
Date:   
 
 
 
 
 
 
 
APPROVED AS TO FORM: 
 
 
 
 
 
 
 
By:  
 
 
 
 
 
 
 
 
 
 
 
 
 
Name:   
 
 
 
 
 
 
 
 
 
 
 
 
Title: Deputy County Attorney 
 
 
 
 
 
 
 
Date:   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
10/8/2024
Docusign Envelope ID: 1CDF7BCA-BD60-4542-A715-830898E0DD31
Davina Bressler
10/8/2024