PHOENIX INDIAN MEDICAL CENTER IGA.PDF
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1
INTERGOVERNMENTAL AGREEMENT
MARICOPA COUNTY
by and through the
DEPARTMENT OF PUBLIC HEALTH
4041 N. Central Avenue, #1400, Phoenix, Arizona 85012
1.
Agreement No: C-86-22
2. Agreement Type: Cost Reimbursement
3.
Agreement Amount: $150,000
4. Purpose: HIV Services
5.
Start Date: October 1, 2024 6. Expiration Date: September 30, 2027,
This Agreement is entered into by and between Phoenix Indian Medical Center referred to herein as (“Contractor”), and Maricopa
County, by and through its Department of Public Health (MCDPH) (referred to herein after as “County”) by and through its Ryan
White Part A Program (RWPA) (“the Department”). Contractor and the County are collectively referred to herein as the “Parties”
and individually as a “Party.” Contractor, for and in consideration of the covenants and conditions set forth herein, shall provide
and perform the services as set forth below. All rights and obligations of the Parties shall be governed by the terms of this
Agreement, its exhibits, attachments, and appendices, including any subcontracts or amendments as set forth herein and in:
Section I
-
General Provisions
Section III
-
Work Statement
Section II
-
Special Provisions
Section IV
-
Compensation
This Agreement contains all the terms and conditions agreed to by the Parties. No other understanding, oral or otherwise,
regarding the subject matter of this Agreement shall be deemed to exist or to bind the Parties. Nothing in this Agreement shall
be construed as consent to any lawsuit or waiver of any defense in a lawsuit brought against the County or the Contractor in any
State or federal Court.
Legal Notice under this Agreement shall be given by personal delivery or by registered or certified mail, postage prepaid, return
receipt requested, to the addresses set forth below and shall be effective upon receipt by the Party to whom addressed unless
otherwise indicated in the notice.
Notice to Contractor: Phoenix Indian Medical Center
Phone 602-574-5244
Address: 4212 North 16th Street, Phoenix, Arizona 85016
Notice to Department: MCDPH Grants/Contract Unit
Phone: (602) 372-0674
Address: 4041 North Central Avenue, Suite #1400, Phoenix, Arizona 85012
IN WITNESS WHEREOF, the parties enter into this Agreement:
PHOENIX INDIAN MEDICAL CENTER
MARICOPA COUNTY BOARD OF SUPERVISORS
Signature
Signature
Name
Debra Ward Lund
Name
Title
Chief Executive Officer
Title
Chairman, Board of Supervisors
Date
Date
ATTEST:
Signature
Date
Office of the Clerk of the Board
Pursuant to A.R.S. § 11-952, the Attorney for the Board of
Supervisors has determined that this Intergovernmental
Agreement is within the powers and authority granted under the
laws of the State of Arizona.
Signature
Date
Attorney for Maricopa County
Stephanie A. Aird
-S
Digitally signed by Stephanie A.
Aird -S
Date: 2024.10.08 12:52:55 -07'00'
SECTION I
GENERAL PROVISIONS
2
1.
EFFECT
To the extent the Special Provisions are in conflict with the General Provisions, the Special
Provisions shall control. To the extent the Work Statement(s) and the Special or General
Provisions are in conflict, the Work Statement(s) shall control.
2.
DEFINITIONS
As used throughout this Agreement, the following terms shall have the following meanings:
A.
Agreement means this document and all attachments and amendments hereto.
B.
Contractor means the person, firm or organization listed on the Cover Page of
this Agreement.
C.
County means Maricopa County, Arizona.
D.
Department means the Maricopa County Department of Public Health.
E.
Funding Source means any federal, State, or private agency funding source,
which may impose conditions on the funding that will be passed on to the
Contractor.
F.
Contractor Staff, Employee or Faculty means a person or persons employed
by, contracted with, or retained by the Contractor for the purpose of providing the
services and responsibilities contained in this Contract.
3.
GENERAL REQUIREMENTS
A.
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, and workers’ compensation.
B.
The Contractor is an independent contractor in the performance of work and the
provision of services under this Agreement and is not to be considered an officer,
employee, or agent of the County.
4.
AMENDMENTS
All Amendments to this Agreement must be in writing and signed by authorized persons
for both Parties. All amendments shall clearly state the effective date of the action.
5.
ADEQUACY OF RECORDS
If the Contractor's books, records and other documents related to this Agreement are not
sufficient to support and document that allowable services were provided to eligible clients,
the Contractor shall reimburse the County for the services not adequately supported and
documented.
SECTION I
GENERAL PROVISIONS
3
6.
RETENTION OF RECORDS
A.
This provision applies to all financial and programmatic records, supporting
documents, statistical records, and other records of the County and Contractor that
relate to this Agreement.
B.
The County and Contractor shall retain all financial books, records, and other
documents related to this Agreement for six (6) years after final payment or until
after the resolution of any audit questions, which could be more than six (6) years,
whichever is longer. County, federal, or State auditors, and any other persons duly
authorized by the County, shall have full access to and the right to examine, copy
and make use of any and all such financial books, records and other documents.
7.
ASSIGNMENT AND SUBCONTRACTING
No rights, liability, obligations or duties under this Agreement may be assigned, delegated,
or subcontracted without the prior written approval of the County and Contractor.
8.
AUDIT DISALLOWANCES
A.
The Contractor shall, upon written demand therefore, reimburse the County for any
payments made under this Agreement that are disallowed, by a federal, State or
County audit in the amount of the disallowance, as well as court costs and attorney
fees the County incurs to pursue legal action relating to a disallowance.
B.
If the County determines that a cost for which payment has been made is a
disallowed cost, the County shall notify the Contractor in writing of the disallowance
and the required course of action, which shall be at the option of the County either
to adjust any future claim submitted by the Contractor by the amount of the
disallowance or to require immediate repayment of the disallowed amount by the
Contractor.
C.
The County shall, upon review and agreement of the Parties, remit to the
Contractor any payments determined to have been insufficiently paid, in the
amount of the payment shortfall, as well as court costs and attorney fees the
Contractor incurs to pursue legal action relating to such short payment.
9.
AGREEMENT COMPLIANCE MONITORING
A. County may monitor the Contractor's compliance with, and performance under, the
terms and conditions of this Agreement. On-site visits for compliance monitoring
may be made by the County and/or its grantor agencies at any time during the
Contractor's normal business hours, announced or unannounced. During an on-
site visit, the Contractor shall make its records and documents related to work
performed or services provided under this Agreement available to the County for
inspection and copying.
B. Contractor shall follow and comply with all related corrective action plans and
requirements of site visits and subsequent audits conducted by County and its
representatives. When monetary penalties are imposed or unallowable costs
determined, the County will define how repayment will be made to the County. This
SECTION I
GENERAL PROVISIONS
4
may include decreasing or withholding the Contractor’s monthly billing or requiring
payment to the County.
10.
AVAILABILITY OF FUNDS
A. The provisions of this Agreement relating to the payment for services shall become
effective when funds assigned for the purpose of compensating the Contractor, as
provided herein, are actually available to the County for disbursement. The Department
shall be the sole authority in determining the availability of funds under this Agreement
and the County shall keep the Contractor fully informed as to the availability of funds. The
County shall refer no clients to Contractor for periods of time for which funding is not
available unless at the discretion of both parties, an alternate source of funds is made
available to continue the medical service.
B. If any action is taken by any State agency, federal department, or any other agency or
instrumentality to suspend, decrease, or terminate its fiscal obligations under or in
connection with this Agreement, the County may amend, suspend, decrease, or terminate
its obligations under or in connection with this Agreement. If this Agreement is terminated,
the County shall be liable for payment only for services rendered prior to the effective date
of the termination, provided that such services are performed in accordance with the
provisions of this Agreement. The County shall give written notice of the effective date of
any suspension, amendment, or termination under this section at least ten (10) days in
advance.
C. Funds may not be presently available for performance under this Grant beyond the first
year of the budget term or Grant term. The County may reduce payments or terminate
this Grant without further recourse, obligation, or penalty in the event that insufficient funds
are appropriated in the subsequent budget term. The County shall not be liable for any
purchases or Subgrants entered into by the Grantee in anticipation of such funding. The
Procurement Officer shall have the discretion in determining the availability of funds.
11.
CONTINGENCY RELATING TO OTHER CONTRACTS AND GRANTS
A.
The Contractor shall, during the term of this Agreement, immediately inform the
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 or
reimbursed under this Agreement. Failure by the Contractor to notify the County
of such award shall be considered a material breach of this Agreement and the
County may immediately terminate this Agreement without liability.
B.
County may request, and the Contractor shall provide within a reasonable time,
not exceeding ten (10) working days, a copy of such other contract or grant, when,
in the opinion of the Department, the award of the contract or grant may affect the
costs being paid or reimbursed under this Agreement.
C.
If the County determines that the award to the Contractor of such other contract or
grant has affected the costs being paid or reimbursed under this Agreement, the
County shall prepare an amendment to this Agreement effecting a cost adjustment.
If the Contractor disputes the proposed cost adjustment, the dispute shall be
resolved pursuant to the "Disputes" clause section contained herein.
SECTION I
GENERAL PROVISIONS
5
12.
DEFAULT
For material breach of contractual obligations, or upon the happening of any event which
would jeopardize the ability of the Contractor to perform its contractual obligations, the
County may suspend, modify, or terminate this Agreement immediately upon giving written
notice to the Contractor. Unless expressly stated otherwise this in this Agreement, such
determination will not be made until such time as the disputes process has been
exhausted.
13.
TERMINATION
A.
Either Party may terminate this Agreement at any time by giving the other Party at
least thirty (30) calendar days prior written notice. The notice shall be given by
personal delivery or by registered or certified mail, postage prepaid, return receipt
requested.
B.
This Agreement may be terminated by mutual written agreement of the Parties
specifying the termination date therein.
C.
The County may terminate this Agreement upon twenty-four (24) hours’ notice
when the County deems the health or welfare of a patient is endangered or the
Contractor’s 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 of this
Agreement.
D.
Either Party has the right to terminate this Agreement for cause upon fourteen (14)
working days written notice for any of the following reasons:
(1)
Breach of this Contract which is not corrected within fourteen (14) working
days after written notice thereof or registered mail, return receipt requested.
(2)
Inability to discharge the duties and responsibility under this Contract for a
continual period of 30 days or more.
E.
This contract is subject to cancellation in accordance with the provision of A.R.S.
§ 38-511.
14.
SEVERABILITY
Any provision of this Agreement that is determined to be invalid, void, or illegal by a court
shall in no way affect, impair, or invalidate any other provision hereof, and the remaining
provisions shall remain in full force and effect.
15.
STRICT COMPLIANCE
Acceptance by the County of performance that is not in strict compliance with the terms
of this Agreement shall not be deemed to waive the requirement of strict compliance for
all future performance. All changes in performance obligations under this Agreement must
be in writing and signed by the Parties.
SECTION I
GENERAL PROVISIONS
6
16.
NON-LIABILITY
A. The County and its officers, representatives, agents, and employees shall not be liable
for any act or omission by the Contractor or any subcontractor, employee, officer,
agent, or representative of the Contractor or any subcontractor occurring in the
performance of this Agreement, nor shall they be liable for purchases or contracts
made by the Contractor or any subcontractor in connection with this Agreement.
B. The Contractor and its officers, representatives, agents, and employees shall not be
liable for any act or omission by the County or any County subcontractor, employee,
officer, agent, or representative of the County or any County subcontractor occurring
in the performance of this Agreement, nor shall they be liable for purchases or
contracts made by the County or any County subcontractor in connection with this
Agreement.
18.
COVENANT AGAINST CONTINGENT FEES
The Contractor warrants that no person or entity has been employed or retained to solicit
or secure this Agreement upon an agreement or understanding for a commission,
percentage, brokerage, or contingent fee. For breach or violation of this warranty, the
County may immediately terminate this Agreement without liability.
19.
SAFEGUARDING 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.
County and Contractor shall safeguard confidential and privileged client and patient
information i.e., medical, financial and patient specific information, and shall only disclose
such information in accordance with all applicable federal, state and local laws, rules,
and/or regulations, including the Health Insurance Portability Accountable Act (“HIPAA”).
The use or disclosure by any party of any information concerning a client or patient served
under this Agreement or any other applicable payor contract is directly limited to services
under this Agreement subject to applicable federal, state and local laws, rules and/or
regulations. Contractor’s obligation to maintain the confidentiality of all medical, financial
and patient specific information shall exist after termination or expiration of this Contract.
County shall assist Contractor with regard to Contractors’ obligation to comply with HIPAA.
20.
RIGHTS IN DATA
The Parties shall have the use of data and reports resulting from this Agreement without
cost or other restriction, except as otherwise provided herein or by law. Each Party shall
supply to the other Party, upon request, any available information known to the supplying
Party that is relevant to this Agreement and to the performance hereunder.
21.
OWNERSHIP OF INFORMATION
Subject to applicable state and federal laws, rules and regulations, including, without
limitation, those concerning confidentiality of patient records, the Contractor shall have full
and complete ownership rights to and the sole and exclusive right to inspect, reproduce,
duplicate, adapt, distribute, display, disclose and otherwise use all reports, information,
data and material prepared by the Contractor in performance of the Agreement. County
may examine and may receive copies of such information necessary for County's
performance of this Agreement.
SECTION I
GENERAL PROVISIONS
7
22.
NON-DISCRIMINATION
The Contractor, in connection with any service or other activity under this Agreement, shall
not in any way discriminate against any person on the grounds of race, color, religion, sex,
national origin, age, disability, affiliation or belief. The Contractor shall include this clause
in all of its subcontracts related to this Agreement.
23.
EQUAL EMPLOYMENT OPPORTUNITY
The Contractor shall not discriminate against any employee or applicant for employment
because of race, age, disability, color, religion, sex, or national origin. The Contractor
shall take affirmative action to ensure that applicants are employed and that employees
are treated during employment without regard to their race, age, disability, color, religion,
sex, or national origin. Such action shall include, but is not 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 Titles VI and VII of the Civil Rights Act of 1964, as amended (42 U.S.C. §§
2000a, et seq.); the Rehabilitation Act of 1973, as amended (29 U.S.C. §§ 701, et seq.);
the Age Discrimination in Employment Act of 1967, as amended (29 U.S.C. §§ 621, et
seq.); the Immigration Reform and Control Act of 1986 (Pub. L. No. 99-603) (“IRCA”); and
Arizona Executive Order 2009-09, 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 (42 U.S.C. §§ 12101, et seq.).
24.
RIGHT OF PARTIAL CANCELLATION
If more than one activity is funded by this Agreement, the County reserves the right to
terminate this Agreement or any part thereof based on the Contractor's failure to perform
any part of this Agreement without impairing, invalidating or canceling the remaining Work
Statement obligations.
25.
RIGHT TO EXTEND AGREEMENT
Subject to the availability of funds and acceptable Contractor performance, the Contractor
hereby acknowledges and agrees that the County shall have the right to extend this
Agreement for additional one-year periods, not to exceed a total extended term of five (5)
years, except that the cost will be subject to renegotiation. Any extension of this
Agreement shall be in writing mutually acceptable to the County and the Contractor and
signed by both Parties.
26.
CERTIFICATION REGARDING DEBARMENT AND SUSPENSION
A.
The undersigned, an authorized representative of the Contractor, certifies, to the
best of his or her knowledge and belief, that the Contractor, defined as the primary
participant in accordance with 45 C.F.R. Part 76, and its principals:
1) are not presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from covered transactions by any federal
department or agency;
2) have not within the 3-year period preceding this Agreement been convicted of
SECTION I
GENERAL PROVISIONS
8
or had a civil judgment entered against them for the commission of fraud or a
criminal offense in connection with obtaining, attempting to obtain, or performing a
public (federal, State or local) transaction or contract under a public transaction;
violation of federal or State antitrust statues or commission of embezzlement, theft,
forgery, bribery, falsification or destruction of records, making false statements, or
receiving stolen property;
3) are not presently indicted or otherwise criminally or civilly charged by a
government entity (federal, State or local) with the commission of any of the
offenses enumerated in paragraph (2) of this certification; and
4) have not within the 3-year period preceding this Agreement had one or more
public transactions (federal, State or local) terminated for cause or default.
B.
If the Contractor is not able to provide this certification, an explanation as to why
shall be attached to this Agreement.
C.
The Contractor shall include, without modification, this Paragraph in all lower tier
covered transactions (i.e., transactions with subcontractors) and in all solicitations
for lower tier covered transactions related to this Agreement.
27.
E-VERIFICATION OF EMPLOYEES
The Contractor warrants that it is in compliance with A.R.S. § 41-4401 and further
acknowledges:
A.
That the Contractor and its subcontractors, if any, warrant their compliance with all
federal immigration laws and regulations that relate to their employees and their
compliance with A.R.S. § 23-214;
B.
That a breach of the warranty under subsection A above shall be deemed a
material breach of this Agreement that entitles the County to, among other things,
immediately terminate this Agreement without liability;
C.
That the County and any contracting government entity retains the legal right to
inspect the papers of any contractor or subcontractor employee who works on this
Agreement to ensure that the contractor or subcontractor is complying with the
warranty provided under subsection A above and that the contractor agrees to
make all papers and employment records of said employee(s) available during
normal working hours in order to facilitate such an inspection;
D.
That nothing herein shall make any contractor or subcontractor an agent or
employee of the County or contracting government entity.
28.
DISPOSITION OF PROPERTY
All property acquired with funds provided for in this agreement shall become the property
of the funding source and shall be returned to the funding source after the Agreement
ends.
SECTION I
GENERAL PROVISIONS
9
29.
CIVIL SERVICES DIVISION
The parties to this agreement acknowledge that they are aware that the Civil Services
Division of the Maricopa County Attorney’s Office (Civil Division) may be chosen as the
attorney for other parties to this agreement, and the signing party acknowledges that it is
aware of a potential conflict of interest, and it waives any claim of conflict of interest, which
may arise by virtue of Civil Division’s representation of other parties to this agreement.
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SECTION II
SPECIAL PROVISIONS
10
1.
EFFECT
To the extent that the Special Provisions are in conflict with the General Provisions, the
Special Provisions shall control. To the extent that the Work Statement(s) are in conflict
with the Special or General Provisions, the Work Statement(s) shall control.
2.
DISPUTES
Except as otherwise provided by law, or otherwise specifically agreed to by the Parties,
any dispute not involving a question of law arising out of this Agreement that is not
resolved between the Parties within a reasonable time, which shall not exceed 120 days,
shall be resolved as follows:
A.
Disputes must be filed with the person administering this Agreement for the
County, if one has been appointed, or, if not, with the Procurement Officer,
within ten (10) days from the date the Contractor knew or should have
known the basis of the dispute.
B.
The person administering this Agreement or the Procurement Officer, as
applicable, shall respond in writing to the dispute within fourteen (14) days.
C.
The Contractor may abide by the decision or may appeal the decision to
the Director of the Department within seven (7) days.
D.
Any claim or controversy arising out of or in connection with this Agreement
not resolved in accordance with paragraphs 2.A. through 2.C. above shall
be resolved through the judicial process.
This Paragraph shall not apply to claims arising from bodily injury, death, or property
damage.
3.
CHANGES
A.
The Department may, at any time, by written order, make changes within the
general scope of this Agreement in any one or more of the following areas:
1.
Work Statement activities reflecting changes in funding source or County
regulations, policies, or requirements.
2.
Administrative requirements, such as changes in reporting periods,
frequency of reports, or report formats, required by funding source or
County regulations, policies, or requirements.
3.
Contractor reimbursement schedules and/or program budgets.
B.
The order will not increase or decrease the maximum reimbursable amount to be
paid the Contractor. Additionally, the order will not direct substantive changes in
services to be rendered by the Contractor.
C.
Any dispute or disagreement caused by such order shall constitute a "Dispute"
within the meaning of the Disputes Clause of the Special Provisions of this
Agreement and shall be administered accordingly.
SECTION II
SPECIAL PROVISIONS
11
5.
INSURANCE
A.
The Contractor shall have in effect at all times during the term of this Agreement,
insurance or comparable self-insurance that is adequate to protect the County, its
officers, employees, property, and equipment against the losses set forth below.
The Contractor shall provide the County with a certificate of insurance or a certified
copy of the insurance policy naming the County as an additional insured, or, if the
Contractor is self-insured, shall provide the County with a letter indicating that it is
self-insured.
B.
The following types and amounts of insurance are required as minimums:
1.
Workers’ compensation and unemployment insurance as required by law.
2.
Unemployment insurance as required by Arizona law.
3.
Public liability, bodily injury, and property damage policies that insure
against claims for liability for the Contractor’s negligence or maintenance
of unsafe vehicles, facilities, or equipment brought by clients receiving
services pursuant to this Agreement and by lawful visitors of such clients.
The limits of the policies shall not be less than $2,000,000 per occurrence
and $4,000,000 aggregate.
C.
Automobile and Truck Liability, Bodily Injury and Property Damages:
1.
General liability, each occurrence; $1,000,000
2.
Property damage; $1,000,000
3.
Combined single limit; $1,000,000
D.
Standard minimum deductible amounts are allowable. Any losses applied against
insurance deductible are the sole responsibility of the Contractor.
E.
Professional Liability:
1.
Insurance for the Contractor and its agents, employees, and other staff
shall be maintained with coverage limits of one million dollars ($1,000,000)
per person, three million dollars ($3,000,000) per occurrence.
2
The Contractor agrees that in the event it, or any of its agents, employees,
and other staff working under this Agreement, is named as a defendant in
litigation, or is identified in a written notice of claim, wherein professional
misconduct is alleged, and such allegations arise under the services or
terms of this Agreement, the Contractor will promptly notify the Department
in writing. The duty to notify under this paragraph applies whether or not
the County is alleged to be involved, is named as a party to the matter, or
could be potentially liable as a party.
F.
The Contractor shall immediately inform the Department of any cancellation of its
insurance or any decrease in its lines of coverage at least thirty (30) days before
such action takes place.
SECTION II
SPECIAL PROVISIONS
12
G.
In the event the Contractor(s) is/are a public entity, then the Insurance
Requirements shall not apply. Such public entity shall provide a Certificate of Self-
Insurance. If the Contractor(s) is/are a State of Arizona agency, board,
commission, or university, none of the above shall apply.
6.
SPECIAL REQUIREMENTS
A.
If the use of subcontractors is approved by the County, the Contractor agrees to
use written subcontracts or consultant agreements that conform to federal and
State laws and regulations and the 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. The
Contractor is responsible for performance under this Agreement whether or not
any subcontractors are used. The Contractor shall submit a copy of each
subcontract to the County upon written request.
7.
REPORTING REQUIREMENTS
A.
The Contractor agrees to submit monthly invoices as defined in the Invoice and
Payments section of this agreement.
B.
The Contractor agrees to submit any administrative, programmatic, quality, and/or
fiscal reports requested and at the due date defined by the Department.
C.
The Contractor agrees to comply with and submit annual and semi-annual client-
level and provider-level data as required by Health Resources Service
Administration (HRSA) by the due date(s) defined by the Department.
D.
The Contractor agrees to comply with ARS § 36-621, reporting contagious
diseases. Any employee, subcontractor, or representative of the Contractor
providing services under this contract 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.
8.
STATUTORY RIGHT OF CANCELLATION FOR CONFLICT OF INTEREST
Pursuant to A.R.S. § 38-511, the County may cancel this Agreement without penalty or
further obligation, within three years after execution of this Agreement, if any person
significantly involved in initiating, negotiating, securing, drafting, or creating this
Agreement on behalf of the County is, at any time while this Agreement or any extension
of this Agreement is in effect, an employee or agent of any other Party to this Agreement
in any capacity or is a consultant to any other Party to this Agreement with respect to the
subject matter of this Agreement. In addition, the County may recoup any fee or
commission paid or due to any person significantly involved in initiating, negotiating,
securing, drafting, or creating this Agreement on behalf of the County from any other Party
to this Agreement arising as the result of this Agreement.
SECTION II
SPECIAL PROVISIONS
13
9.
POLICY ON CONFIDENTIALITY
The Contractor and the County understand and agree that this Agreement is subject to all
State and federal laws protecting client confidentiality of medical, behavioral health and
drug treatment information.
10.
LAWS, RULES AND REGULATIONS
The Contractor and the County understand and agree that this Agreement is subject to all
State and federal laws, rules, and regulations that pertain hereto.
11.
340B PROGRAM:
The Contractor understands and agrees that program income generated through the
Health Resources and Services Administration (HRSA) Office of Pharmacy Affairs 340B
program, through the Maricopa Ryan White grant award providing 340B covered entity
status, will be subject to additional program income monitoring requirements that shall be
provided in writing prior to contract award. Additional requirements may include but are
not limited to: annual completion and submission of an independent 340B audit;
submission of monthly aggregate reports of program income generated and detailed
expenditures showing that program income is spent only on Ryan White allowable costs;
enhanced requirements regarding Contractor monitoring of all subrecipients; and
additional reporting requirements in order to ensure that program income is spent within
the same budget period it was generated. The Maricopa County Ryan White Program
Office shall have full authority to monitor these additional requirements as well as others
in order to ensure compliance with the 340B program rules as established by the
Department of Health and Human Services Office of Pharmacy Affairs.
The Contractor shall be eligible to participate in the 340B Drug Pricing Program under this
funding opportunity. Only human immunodeficiency virus (HIV) positive patients who are
determined by the Ryan White Portal to be ineligible for the acquired immunodeficiency
syndrome (AIDS) Drug Assistance Program (ADAP) may participate in a 340B program
under the Ryan White grant. HIV positive patients would need to apply for ADAP for
assistance with HIV medications and a denial must be on file in the Ryan White Portal.
Eligibility for ADAP must be checked annually by the awarded contractor. All clients
enrolled in the Ryan White program except those also enrolled in the Arizona Healthcare
Cost Containment System (AHCCCS), Veterans Administration, or Indian Health Service
must fill their prescriptions through a pharmacy contracted with the Arizona ADAP
program.
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SECTION III
WORK STATEMENT
14
1.
BACKGROUND:
The Phoenix Eligible Metropolitan Area (“EMA”) receives Ryan White HIV/AIDS Part A
and Minority AIDS Initiative federal funds under the Ryan White Treatment Extension Act
of 2009 (the “Act”). This legislation represents the largest dollar investment made by the
federal government specifically for the provision of core medical and essential support
services for low-income people with HIV (PWH) who are uninsured or underinsured. The
purpose of the Act is to improve the quality and availability of care for persons with HIV
and their families. The U.S. Department of Health and Human Services (HSS), Health
Resources and Services Administration (HRSA) administers the RWPA Funds.
2.
PURPOSE:
The Maricopa County Ryan White Program's mission is to provide medically necessary
health care and support services for low-income individuals with HIV infection who do not
have sufficient health care coverage or financial resources for coping with HIV/AIDS.
Maricopa County's Ryan White Part A Program provides services to eligible clients
residing in Maricopa and Pinal Counties. Maricopa County's Ryan White Program
provides funding to subrecipients to support the National HIV/AIDS strategy's goals, which
currently include:
1. Increasing access to care and optimizing health outcomes for people living with
HIV;
2. Reducing HIV related health disparities; and
3. Reducing the number of people who become infected with HIV
By entering into this Agreement, Contractor agrees to provide services to eligible RWPA
clients in service categories that may include:
Medical Case Management
Provides client-centered activities designed to improve health outcomes, such as
assessment of service needs, development and updating of an individualized care
plan, coordinated access to medical care and support services, continuous client
monitoring, treatment adherence counseling, and occasionally assistance in
accessing public and private benefits for which the client may be eligible.
Non-Medical Case Management Services
Supports client-centered activities focused on improving access to and retention
in needed core medical and support services. Provides coordination, guidance,
and assistance in accessing medical, social, community, legal, financial,
employment, vocational, and other needed services, and occasionally help in
accessing public and private programs for which clients may be eligible, based on
activities such as an initial assessment of service needs, development and regular
re-evaluation of an individualized care plan, client monitoring, and timely and
coordinated access to medically appropriate levels of health and support services
and continuity of care.
Outpatient/Ambulatory Health Services
Supports diagnostic and therapeutic services, such as primary care, diagnostic
testing including laboratory testing, treatment adherence, and specialty services
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provided directly to a client by a licensed healthcare provider in an outpatient
medical setting.
Referral for Healthcare and Supportive Services
Supports referral of clients to needed core medical or support services in person or
through telephone, written, or other types of communication; may also include referrals to
assist clients in obtaining access to public or private benefit programs for which they may
be eligible.
3. RESPONSIBILITIES OF THE CONTRACTOR
The purpose of this section is to provide a description of how the Contractor is expected
to utilize the allocated funding to provide the highest quality of service based on HRSA
HIV AIDS Bureau (“HAB") guidelines and monitoring standards set forth to meet the
necessary service provisions of the grant.
A. Program Administration
a. Ensure the program is operated in accordance with:
i. Ryan White HIV/AIDS Program legislation
ii. HAB Policies
iii. HAB National Monitoring Standards (Universal, Fiscal and Part A
Program)
iv. RW Planning Council Standards of Care
v. Conditions of Award (COA)
vi. Terms and conditions set forth by HRSA
vii. All other applicable federal, state and local regulations.
b. Maintain ongoing active participation in mandatory contractor meetings and
trainings.
c. Participate in compliance monitoring conducted by the Maricopa County
RWPA, including but not limited to annual Site Visits, Conditions of Award
reviews, billing reviews, contractor calls, data oversight, and intermittent
customer quality assurance checks. The frequency of monitoring will vary
depending on the service provided.
d. Certify client eligibility prior to providing services.
e. Ensure that County is the payor of last resort.
f. Collaboration with County and other stakeholders:
i. The Contractor shall establish working partnerships with County and
other appropriate entities to facilitate the efficient and accurate
processing of eligibility applications and renewals, complaints, and
appeals.
ii. The Contractor’s staff, especially key personnel, shall meet with and be
accessible to Maricopa County Ryan White Program Part A
(“MCRWPA”) staff on a mutually agreeable and regularly scheduled
basis
as
well
as
any
other
times
as
may
be
needed.
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WORK STATEMENT
16
B. Clinical Quality Management (CQM), Data and Reporting
a. The Contractor shall participate in the Quality Management activities.
b. The Contractor shall utilize and adhere to the most current Standards of Care
as developed by the Phoenix Eligible Metropolitan Area Planning Council.
c. Designate a staff member to serve as the agency’s CQM representative and
select an alternate for occasions when the primary designee is unavailable.
d. Ongoing, active participation in CQM-related meetings, trainings, technical
assistance, and capacity-building activities.
e. Develop and implement an agency-specific quality management plan. The
Contractor shall conduct Quality Improvement projects at the agency level
utilizing the Plan-Do-Study-Act (PDSA) model.
f. Conduct and/or participate in jurisdictional and agency-specific quality
improvement projects and report data per the timeline established with the
County.
g. Additionally, the Contractor shall report quality outcome measures established
by the County per the reporting schedule.
h. The Contractor shall conduct and provide documentation of quality assurance
and improvement activities, including maintenance of client satisfaction
surveys and other mechanisms as designated by the County.
i.
Timely responses to requests for data, reports, and CQM-related assignments.
j.
Deliver presentations about data, performance measures and insight gained
through QI projects.
k. Submit reports required by HRSA, including the RWPAServices Report (RSR).
l.
Submit quarterly reports to the Maricopa County RWPA which shall include:
i. Narrative description of the program’s progress toward accomplishing
goals, objectives, and program activities.
ii. Data and analysis related to performance measures.
iii. Data and analysis related to patient feedback obtained during the
quarter.
iv. Client grievances received during the reporting period, including copies
of the grievances and documentation on how the grievance was
resolved.
v. Current organizational chart; and
vi. Updated list of contacts.
m. Utilization of HRSA-supplied Ryan White CAREWare system. CAREWare is
used for client level data reporting and monthly billing reports, demographic
reports, and various custom reporting.
i. It is required that installation, collection, and reporting of all data
requested by the RWPA via CAREWare within thirty (30) calendar days
of being awarded.
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17
ii. Must participate in technical assistance training and/or informational
presentations for CAREWare at various times scheduled during the
contract year.
iii. Google Authenticator or Win Auth will be required to be installed to
access the Ryan White CAREWare system.
n. The Contractor shall 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).
o. 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.
p. Comply with all Health Insurance Portability Accountable Act (HIPAA) privacy
and security compliance regulations.
q. Track and monitor progress towards performance measurement goals.
Performance measures are required, at minimum, for any Service Category
utilized by 15% or more of clients in the Phoenix Eligible Metropolitan Area.
Performance measures shall be defined by the Maricopa County RWPA and
updated annually.
r. The Contractor will participate in Quality Management trainings sponsored by
the County which are deemed mandatory. The Contractor understands that
non-participation in these types of activities may result in non-compliance with
the Standards of Care as mandated by the Ryan White Act. Further, such non-
participation in Quality Management trainings could result in prompting a
performance monitoring site visit.
C. Fiscal Administration
a. Submit monthly Request for Reimbursement by the 15th calendar day of each
month for the previous month’s services.
b. Establish fiscal and accounting procedures necessary to ensure:
i. The proper disbursal of, and account for grant funds to ensure that all
financial transactions are conducted.
ii. Maintain financial records pertaining to all funded services with
standard accounting principles and procedures and retain all records
and supporting documentation applicable.
iii. Delineate how multiple funding sources for services are allocated
appropriate for its designated intended service.
iv. Program income generated through the Health Resources and
Services Administration (HRSA) Office of Pharmacy Affairs 340B
program, through the Maricopa County RWPA grant award providing
340B covered entity status, will be subject to additional program income
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WORK STATEMENT
18
monitoring requirements. Additional requirements may include but are
not limited to:
1. Annual completion and submission of an independent 340B
audit.
2. Submission of monthly aggregate reports of program income
generated and detailed expenditures showing that program
income is spent only on Ryan White allowable costs.
3. Additional reporting requirements in order to ensure that
program income is spent within the same budget period it was
generated.
4. The Maricopa County Ryan White Program Office shall have full
authority to monitor these additional requirements as well as
others in order to ensure compliance with the 340B program
rules as established by the Department of Health and Human
Services Office of Pharmacy Affairs.
c. Administrative costs are limited to ten percent (10%) of contract total.
D. Information and Communication Systems
a. 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 CAREWare within sixty (60) calendar days of request by the RWPA.
The Contractor agrees to participate in technical assistance training and/or
informational presentations for CAREWare at various times scheduled during
the contract year.
b. 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.
c. The Contractor shall comply with all Health Insurance Portability Accountable
Act (HIPAA) privacy and security compliance regulations, e.g., assignment and
review of user IDs, requiring passwords, protecting Private Health Information.
The Contractor shall also establish a secure e-mail system for confidential
correspondence with stakeholders.
d. The Contractor shall, within the first year of the contract, ensure that all client
forms be adapted and available in accessible formats, including the ability to
be
completed
and
signed
electronically.
e. The Contractor will communicate with clients via text messages, phone call,
video call and in-person as part of providing services. Text message
capabilities must be in place within the first year of the contract for Contractor
to be able to communicate directly with clients.
E. Other Requirements
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WORK STATEMENT
19
a. Contractor shall comply with all policies and procedures as defined in the
current Ryan White Policies and Procedures Manual.
b. 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
c. Contractor shall respond to all requests for information and documentation
solicited by County when they are submitted in writing no later than 72 hours
of receipt of the request. If Contractor is unable to respond to the request within
72 hours, Contractor shall communicate with County regarding a reasonable
timeline.
d. Contractor shall participate in a standardized anonymous Consumer
Satisfaction Survey issued to all program participants at least once during the
contract year.
e. 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.
f. Contractor’s 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.
F. Program Marketing Initiatives
a. 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 Health Resources and Services Administration (HRSA) funding the
following verbiage must be used, “This [project/publication/program/website,
etc.] [is/was] supported by the Health Resources and Services Administration
(HRSA) of the U.S. Department of Health and Human Services (HHS) as part
of an award totaling $XX with XX percentage financed with non-governmental
sources. The contents are those of the author(s) and do not necessarily
represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S.
Government. For more information, please visit HRSA.gov.” Such references
to funding source must be of sufficient size to be clear and legible.
b. Contractor is responsible for advertising Ryan White 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 contract section.
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20
c. 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 contractors 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.
G. References
a. HRSA Ryan White HIV/AIDS Program (https://hab.hrsa.gov/)
b. Ryan White HIV/AIDS Program (RWHAP) National Monitoring Standards for
RWHAP Part A Recipients
(https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/2022-rwhap-
nms-part.pdf)
i. Fiscal Monitoring Standards (pages 72 – 125)
ii. Program Monitoring Standards (pages 4 – 71)
iii. Universal Monitoring Standards (pages 126 – 145)
c. Ryan White HIV/AIDS Program Services: Eligible Individuals & Allowable
Uses of Funds Policy Clarification Notice (PCN) #16-02
(https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/grants/service-
category-pcn-16-02-final.pdf)_
d. The Greater Phoenix Ryan White HIV Services Planning Council Standards of
Care (https://www.maricopa.gov/DocumentCenter/Index/3154)
4.
RESPONSIBILITIES OF COUNTY
A. Provide technical assistance to Contractor to meet the federal grant requirements.
County assistance includes, but is not limited to, creating sample policy templates,
training staff about the award process, training on CAREWare, as well as conducting
Quality Management reviews and Annual Site Visits.
B. Conduct annual monitoring visits, including comprehensive policy and chart reviews,
to ensure compliance with the guidelines and standards of care mentioned above.
C. Provide access to a HIPAA-compliant CAREWare system with client eligibility data.
D. Respond to formal grievances as needed after resolution of the initial grievance
process with Contractor.
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COMPENSATION
21
1.
COMPENSATION
A. The County reserves the right to reallocate funding during the contract period so that
the services provided, and corresponding contract amount may be decreased or
increased, via contract amendment or Task Order, at the discretion of the County.
B. County will pay the Contractor on a monthly basis for approved services and expenses
and in accordance with the reimbursement methodology determined by the County’s
Administrative Agent; either fee-for service or cost. The total funds paid to the
Contractor will be dependent upon the approved invoice according to the
Administrative Agent. County does not guarantee a minimum payment to the
Contractor. County will not reimburse for fee-for-service activities when an
appointment is canceled either by the client or Contractor.
C. The Contractor understands and agrees to notify the County of any deviations or
changes to any budget line of the current budget in place for this contract within 30
days of such change.
D. The Contractor shall be compensated for services provided only by the staff
classifications/positions included/referenced in the current approved budget.
E. Unless specifically allowed and referenced elsewhere in this Agreement, all services
are to be provided at approved Contractor sites and/or venues. Services provided at
non-authorized locations or venues will not be reimbursed by the County.
F. The Contractor shall provide monthly financial and corresponding programmatic
reports per the reporting schedule to the County. If the Contractor is not in compliance
due to non-performance, submission of reports after deadlines, insufficient back-up
statements or improperly completed forms, the Contractor may not be reimbursed, or
reimbursement may be delayed until program compliance issues and any other related
financial consequences are resolved. Furthermore, instances of non-compliance with
billing and reporting requirements may result in the County reducing the Contractor’s
reimbursement by up to 10% of the corresponding month’s billing.
G. The actual amount of compensation will depend on the actual hours worked, services
provided, and related expenses as stated in the current approved budget or as
modified by contract amendment or appropriately executed task order. Any un-
obligated balance of funds at the end of this Agreement period will be returned to the
County in accordance with instructions provided.
H.
The Contractor agrees to notify the Ryan White Program annually when fee
schedules change for services that are required to use AHCCCS fee schedules.
The Contractor must send notification to RyanWhitePartA@Maricopa.Gov of the
updated fee schedule, highlighting affected service codes/units and the effective
date of new fee schedule, at least 30 days prior to the due date of the first affected
invoice. If Contractor does not notify the Ryan White Program in a timely matter,
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COMPENSATION
22
the Ryan White Program reserves the right to not allow Contractor to retro bill for
increased cost of services.
2.
METHOD OF PAYMENT
A. Subject to the availability of funds, County will, within thirty (30) business days from
the date of receipt of the documents enumerated herein, process and remit to the
Contractor a warrant for payment up to the maximum total allowable for services
provided or work performed during the previous month.
B. Payment may be delayed or reduced if invoices are in non-compliance due to late
submission, improperly completed or missing documentation/information or for other
contract non-compliance occurring in the related grant year. Other non-compliance
issues that may delay or reduce payments can be related to any contractual issue and
may not necessarily be related to the bill itself. Should County make a disallowance in
the claim, the claim shall be processed for the reduced amount. If the Contractor
protests the amount or the reason for a disallowance, the protest shall be construed
as a dispute concerning a question of fact within the meaning of the "Disputes" clause
of the Special Provisions of this Contract.
C. The Contractor understands and agrees that County will not honor any claim for
payment submitted 60 calendar days after date of service. The Contractor
understands and agrees that County will not process any claim for payment for
services rendered prior to the end of the contract period which are submitted sixty (60)
calendar days after the end of the contract period without approval of County. For
claims that are subject to AHCCCS Regulation R9-22703.B1, County will not honor
any claim for payment submitted nine months after date of service. Claims submitted
45 calendar days from the last day of the grant year will not be honored or reimbursed.
D. The Contractor agrees to notify the Ryan White Program annually when fee schedules
change for services that are required to use AHCCCS fee schedules. The contractor
must send notification to RyanWhitePartA@Maricopa.Gov of the updated fee
schedule, highlighting affected service codes/units and the effective date of new fee
schedule, at least 30 days prior to the due date of the first affected invoice. If contractor
does not notify Ryan White Program in a timely matter, the Ryan White Program
reserves the right to not allow Contractor to retro bill for increased cost of services.
E. Payments made by County to the Contractor are conditioned upon the timely receipt
of applicable, accurate and complete invoice reports and forms submitted by the
Contractor. All monthly invoices must be supported by auditable documentation,
which is determined to be sufficient, competent evidential matter defined by the
County.
F. The Contractor understands and agrees that Ryan White Program is the payer of last
resort and shall maximize and monitor all other revenue streams including self-pay
and all sources of third-party reimbursements. The Contractor understands and
SECTION IV
COMPENSATION
23
agrees that all client self-pay and third-party payments must be exhausted to offset
program costs before Ryan White funds are used. The Contractor must have policies
and procedures documented and in place to determine and bill these other potential
payment sources. These third-party payers include but are not limited to Regional
Behavioral Health Authority (RBHA), Medicaid (Arizona Health Care Cost
Containment Services/AHCCCS), Arizona Long Term Care System (ALTCS),
TRICARE, Medicare and private/commercial or other insurance.
G. The Contractor will determine eligibility of clients and assist with client enrollment
whenever feasible. Payments collected by the Contractor for Ryan White services
must be recorded as Program Income in the Contractor’s financial management
system and deducted from bills issued to the County. Program income records must
be made available to the County for assurance that such revenues are used to support
related services. The Contractor shall have policies and procedures for handling Ryan
White revenue including program income.
H. The Contractor shall have policies and staff training on the payer of last resort
requirement and how it meets that requirement.
G. The Contractor shall submit monthly invoices to:
Maricopa County Department of Public Health
Ryan White Program
4041 N Central Ave, Suite_700
Phoenix, AZ 85012
E-mail: RyanWhitePartA@maricopa.gov
3.
NOTICE
Any notice given under this Agreement shall be sent to the attention of the following:
Department
Contractor
Maricopa County Department of
Public Health
Phoenix Indian Medical Center
Grants and Contracts Unit
Attn: Grants Administrator
4041 N Central Ave, Suite 1400
4212 North 16th Street
Phoenix, AZ 85012
Phoenix, AZ 85016