CIRCLE THE CITY_SYNAPSE CONTRACT_FINAL 6.25.24 - SIGNED (1).PDF

Maricopa County — Formal (2024-08-07)

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1 
 
 
CONTRACT FOR SERVICES 
MARICOPA COUNTY  
by and through the 
DEPARTMENT OF PUBLIC HEALTH 
4041 N. Central Avenue, #1400, Phoenix, Arizona 85012 
AND 
CIRCLE THE CITY 
 300 W. Clarendon Avenue, Suite 200, Phoenix, Arizona 85013 
 
1. Contract No:  ______________________________  
2.        Contract Type: Service                                                   
3. Contract Amount: $ 30,000      
 
4.        Purpose: Community Health Needs Assessment           
5. Start Date:  August 2, 2024          
 
6.        Expiration Date:  June 30, 2026 
 
______________________________________________________________________________________________________ 
 
This Contract for Services (“Contract”) is entered into by and between Circle the City and Maricopa County, by and through its 
Department of Public Health referred to as the “County” or “Contractor.”  Circle the City and the County are collectively referred 
to as the “Parties” and individually as a “Party.” County, for and in consideration of the covenants and warranties 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 
Contract, its exhibits, attachments, and appendices, including any subcontracts or amendments as set forth herein and in: 
Section I 
- 
General Provisions 
 
Section III 
- 
Compensation 
Section II 
- 
Scope of Work                           Section IV 
- 
Business Associate Agreement  
This Contract contains all the terms and conditions agreed to by the Parties. No other understanding, oral or otherwise, regarding 
the subject matter of this Contract shall be deemed to exist or to bind the Parties. Nothing in this Contract shall be construed as 
consent to any lawsuit or waiver of any defense in a lawsuit brought against the County or Circle the City in any state or federal 
court. 
Legal Notice under this Contract 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: Circle the City 
 
 
 
Phone: (602) 776-0776  
 
Address:  300 W Clarendon Avenue, Suite 200, Phoenix, Arizona 85013 
 
Notice to: 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 Contract: 
 
Circle the City  
 
MARICOPA COUNTY DEPT OF PUBLIC HEALTH 
 
Signature 
 
 
 
Signature 
 
 
Name 
Kim Despres 
 
 
Title 
 
Chairman, Board of Supervisors 
 
Title 
Chief Executive Officer 
 
 
Date 
 
 
Date 
 
 
 
ATTEST: 
Signature 
 
 
 
 
 
 
Date 
Office of the Clerk of the Board 
 
 
 
 
APPROVED 
AS TO FORM: 
 
 
 
 
Signature 
 
 
 
 
Date 
Attorney for Maricopa County 
 
Jun 25, 2024

SECTION I                  
GENERAL PROVISIONS 
 
2 
 
1. 
EFFECT 
 
To the extent the Scope of Work conflicts with the General Provisions, the Scope of Work 
shall control. 
 
2. 
DEFINITIONS 
 
As used throughout this Contract, the following terms shall have the following meanings: 
 
 
A. 
Contract means this document and all exhibits, attachments, appendices, and 
amendments to this Contract. 
 
 
B. 
County means Maricopa County, Arizona. 
     
C. 
Department means the Maricopa County Department of Public Health (MCDPH). 
 
 
D. 
Director means the Director of the Department. 
 
 
E. 
Funding Source means any federal, state, or private agency funding source that 
may impose conditions on the funding that will be passed on to the County. 
 
 
F. 
Designated Record Set means a group of records maintained by or for a covered 
entity that comprises medical and billing records about individuals maintained by 
or for a covered health care provider; enrollment, payment, claim adjudication, and 
case or medical management record systems maintained by or for a health plan, 
and other records that are used in whole or in part, by or for the covered entity to 
make decisions about individuals. 
 
 
G. 
Healthcare Partner means a person or health care facility licensed, certified, or 
otherwise authorized or permitted by law to administer health care in the ordinary 
course of business or practice of a profession. This includes Federally Qualified 
Healthcare Centers (FQHC), or FQHC look-alike. 
 
3. 
GENERAL REQUIREMENTS 
 
 
A. 
The terms of this Contract shall be construed in accordance with Arizona law.  Any 
lawsuit arising out of this Contract shall be brought in the appropriate court in 
Maricopa County, Arizona. 
 
 
B. 
The County shall, without limitation, obtain and maintain all licenses, permits, and 
authority necessary to do business, render services, and perform work under this 
Contract.  
 
 
C. 
The County is an independent Contractor in the performance of work and the 
provision of services under this Contract and is not to be considered an officer, 
employee, or agent of Circle the City. 
 
4. 
AMENDMENTS 
 
All amendments to this Contract shall be in writing and signed by the Parties.

SECTION I                  
GENERAL PROVISIONS 
 
3 
 
5. 
RETENTION OF RECORDS, AUDITS, AND DISALLOWANCES 
 
 
A. 
This provision applies to all financial and programmatic records, supporting 
documents, statistical records, and other records of The County, which are 
reasonably considered as relevant to this Contract. 
 
B. 
The County shall retain all financial books, records, and other documents relevant 
to this Contract for five years after final payment or until after the resolution of any 
audit questions, which could take more than five years, whichever is longer. The 
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 materials. 
 
C. 
The County shall reimburse Circle the City for any payments made under this 
Contract that are disallowed by a federal, state, or Maricopa County audit in the 
amount of the disallowance. 
 
6. 
ASSIGNMENT / SUBCONTRACTING 
 
No rights, liability, obligations, or duties under this Contract may be assigned, delegated, 
or subcontracted by the County or Circle the City without the prior written approval of the 
other Party. Any attempt to assign any portion of this Contract without the written consent 
of the other Party shall be void. Any assignment shall not alter the assigner’s responsibility 
to assure that all the provisions under this Contract are fulfilled by its assignee. All terms 
and conditions in this Contract shall be included in any assignment. 
 
7. 
TERMINATION 
 
A. 
The County or Circle the City may terminate this Contract at any time with at least 
30 days prior written notice to the other Party. Such notice shall be given by 
electronic notice, personal delivery or by Registered or Certified Mail, postage 
prepaid and return receipt requested. 
 
 
B. 
This Contract may be terminated by mutual written agreement of the Parties 
specifying the termination date.  
 
 
C. 
If not terminated by one of the methods stated above, this Contract shall terminate 
on the expiration date of this Contract as stated on the Cover Page. 
 
D. 
If either Party defaults under this Contract and the default continues for more than 
10 days after the effective date of the other Party’s written notice stating the 
specific nature of the default, then the noticing Party may treat the default as a 
breach of this Contract. Upon a breach, the aggrieved Party may exercise any 
remedy available under the law, including the termination of this Contract.  
 
E.  
If more than one activity is funded by this Contract the County may terminate any 
part of the Scope of Work obligations without impairing the remaining obligations.  
 
F. 
This contract is subject to cancellation pursuant to A.R.S. § 38-511. 
 
G.  
If Circle the City terminates this Contract prior to the expiration date, Circle the City

SECTION I                  
GENERAL PROVISIONS 
 
4 
 
will remain responsible for payment to County for all work and services performed 
through the date of termination and for reimbursement to County of all non-
cancellable commitments incurred in the performance of the work or services. 
 
8. 
SEVERABILITY 
 
If a court finds that any provision of this Contract is invalid, all the remaining provisions 
shall remain in full force and effect. 
 
9. 
STRICT COMPLIANCE 
 
The waiver of a breach may only be made by a writing signed by the waiving Party and 
will not constitute a waiver of any other or subsequent breach to affect in any way the 
effectiveness or enforceability of the provision in question. 
 
10. 
FORCE MAJEURE 
 
Neither Party shall be liable for failure of performance, nor incur any liability to the other 
Party on account of any loss or damage resulting from any delay or failure to perform all 
or any part of this Contract if such delay or failure is caused by events, occurrences, or 
causes beyond the reasonable control and without negligence of the Parties.  Such 
events, occurrences, or causes will include Acts of God/Nature (including fire, flood, 
earthquake, storm, hurricane or other natural disaster), war, invasion, act of foreign 
enemies, hostilities (whether war is declared or not), civil war, riots, rebellion, revolution, 
insurrection, military or usurped power or confiscation, terrorist activities, nationalization, 
government sanction, lockout, blockage, embargo, labor dispute, strike, pandemic, 
epidemic, interruption or failure of electricity or telecommunication service.  
 
11. 
COVENANT AGAINST CONTINGENT FEES 
 
Each party warrants that no person or selling agency has been employed or retained to 
solicit or secure this Contract upon an agreement or understanding for a commission, 
percentage, brokerage, or contingent fee.  Either Party may terminate this Contract without 
liability for breach of this warranty.  
 
12. 
SAFEGUARDING CLIENT INFORMATION 
 
The use or disclosure by any Party of any information concerning an eligible person served 
under this Contract is directly limited to the performance of this Contract.  Each Party shall 
safeguard all protected health information as required under the Health Insurance 
Portability and Accountability Act. 
  
13. 
RIGHTS IN PROPERTY AND DATA 
 
Subject to applicable state and federal laws, rules, and regulations, all tangible materials 
purchased or acquired by either Party in performance of this Contract shall remain the 
property of the Party in possession when the Contract terminates.  
 
Subject to applicable state and federal laws, rules, and regulations, the County shall have 
full and complete ownership rights to and the right to reproduce, duplicate, adapt, 
distribute, display, disclose and otherwise use all written and electronic information,

SECTION I                  
GENERAL PROVISIONS 
 
5 
 
recordings, reports, findings, research information, abstracts, results, software, data, 
discoveries, inventions, procedures and processes of services developed by the County 
and any other intangible materials created, prepared or received by the County and its 
subcontractors in performance of this Contract. Circle the City shall have full, complete, 
perpetual, irrevocable and non-transferable rights to reproduce, duplicate, adapt, make 
derivative works, distribute, display, disclose, publish, and otherwise use all intangible 
material solely for no-profit purposes. Circle the City’s right to use the intangible materials 
includes the right to use the intangible materials in connection with its internal, non-profit 
research and educational activities, the right to present at academic or professional 
meetings or symposia and the right to publish in journals, theses, dissertations or 
otherwise while providing proper attribution to the County’s role in the material 
development. 
 
14. 
NON-DISCRIMINATION 
 
The Parties, in connection with any service or other activity under this Contract, shall not 
in any way discriminate against any person on the grounds of race, color, religion, sex, 
national origin, age, or disability. The County shall include a clause to this effect in all 
Subcontracts inuring to the benefit of the County or Circle the City.  
 
15. 
EQUAL EMPLOYMENT OPPORTUNITY 
 
The Parties shall not discriminate against any employee or applicant for employment 
because of race, color, religion, sex, pregnancy, childbirth, or medical conditions related 
to pregnancy or childbirth, political affiliation or religious affiliation or ideas, culture, creed, 
social origin or condition, genetic information, sexual orientation, gender identity or 
expression, national origin, ancestry, age, disability, military service or veteran status, or 
marital status.  The Parties shall take affirmative action to ensure that applicants are 
employed and that employees are treated during employment without regard to their race, 
color, religion, sex, pregnancy, childbirth or medical conditions related to pregnancy or 
childbirth, political affiliation or religious affiliation or ideas, culture, creed, social origin or 
condition, genetic information, sexual orientation, gender identity or expression, national 
origin, ancestry, age, disability, military service or veteran status, or marital status.  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 
Parties 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, as amended 
by Executive Order 2023-01, which mandates that all persons shall have equal access to 
employment opportunities.  The Parties shall also comply with all applicable provisions of 
the Americans with Disabilities Act of 1990 (42 U.S.C. §§ 12101, et seq.). 
 
16. 
RIGHT TO EXTEND CONTRACT 
 
The Contract may be extended by mutual written and signed agreement of the Parties for 
additional terms up to three-years each. The scope of work and costs will be subject to 
renegotiation for each extension.

SECTION I                  
GENERAL PROVISIONS 
 
6 
 
20.       UNIFORM ADMINISTRATIVE REQUIREMENTS 
By entering this Contract, the County agrees to comply with all applicable provisions of 
Title 
2, 
Subtitle 
A, 
Chapter 
II, PART 
200—UNIFORM 
ADMINISTRATIVE 
REQUIREMENTS, COST PRINCIPLES, AND AUDIT REQUIREMENTS FOR FEDERAL 
AWARDS contained in Title 2 C.F.R. § 200 et seq. 
 
22. 
DISPUTE RESOLUTION 
 
The Parties shall meet and confer in an effort to resolve any dispute that arises out of this 
Contract.  In the event that such informal efforts to resolve the dispute are unsuccessful 
in 90 days, the Parties shall resolve the dispute by arbitration pursuant to A.R.S.  § 12-
1518 and  §12-3001, et seq.  
 
23. 
CHANGES 
 
A. 
The Director may, at any time, by written order and with prior written consent of 
Circle the City, make changes within the scope of this Contract in any one or more 
of the following areas: 
 
1) 
Scope of Work activities reflecting changes in the scope of services, 
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 program budgets. 
  
B. 
The Director shall not increase or decrease the maximum reimbursable amount to 
be paid the Contractor without an official amendment to this Contract.  Additionally, 
the Director shall not direct substantive changes in services to be rendered by the 
Contractor. 
 
C. 
Any dispute or disagreement caused by such written order shall constitute a 
"Dispute" within the meaning of the Disputes clause of this Contract and shall be 
administered accordingly. 
 
24. 
SPECIAL REQUIREMENTS 
 
A. 
The County shall use written subcontracts, consultant agreements and Business 
Associate Agreements that conform to federal and state laws and regulations, and 
to the requirements of this Contract 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 County referenced herein. The County is responsible 
for performing under this Contract whether subcontractors are used or affiliates of 
the County are used.  The County shall submit a copy of each Subcontract to Circle 
the City within (15) days of its effective date. 
 
B. 
The County shall include in any subcontracts a provision to the effect that the 
subcontractor agrees that Circle the City shall have access to the subcontractor’s 
facilities and the right to examine any books, documents, and records of the

SECTION I                  
GENERAL PROVISIONS 
 
7 
 
subcontractor, involving transactions related to the subcontract and that such 
books, documents, and records shall not be disposed of except as provided herein. 
 
25. 
INDEMNITY AND INSURANCE:  
 
Each Party (as "Indemnitor"), to the fullest extent permitted by law, agrees to indemnify, 
defend, and hold harmless the other Party (as "Indemnitee") from and against any and all 
claims, losses, liability, costs, or expenses (including reasonable attorney's fees) 
(hereinafter collectively referred to as "claims") arising out of their negligent performance 
of this Contract, but only to the extent that such claims are caused by the act, omission, 
negligence, misconduct, or other fault of the Indemnitor, its officers, officials, agents, 
employees, or volunteers.  
 
26. 
LAWS, RULES, AND REGULATIONS 
 
Circle the City and the County understand and agree that this Contract is subject to all 
applicable state and federal laws, rules, and regulations. 
 
27. 
ADVERTISEMENTS 
 
Except as specifically permitted in this Contract, a Party shall not use the names or 
trademarks of the other Party, or its affiliated entities, in any advertising, publicity, 
endorsement, or promotion unless has provided prior written consent for the particular use 
contemplated. All requests for approval pursuant to this Section must be submitted to the 
Party, at least five business days prior to the date on which a response is needed.  The 
terms of this section survive the termination, expiration, non-renewal, or rescission of this 
Contract.

SECTION II 
                                            SCOPE OF WORK     
8 
 
1.  
BACKGROUND  
  
 
Per the compliance requirements of the Health Resources & Services Administration (HRSA), all 
Federally Qualified Healthcare Centers (FQHC) must conduct an annual review of the boundaries 
of its service areas, including the identification of the medically underserved population(s) within 
that service area. In addition, a community needs assessment will identify the unmet need for 
health services in the service area and/or proposed service area of the center based on the 
population served. Maricopa County Department of Public Health (MCDPH) and the Maricopa 
County Synapse coalition, a coalition of non-profit and federally qualified health care partners, will 
work collaboratively to implement a comprehensive assessment of health needs of residents in 
Maricopa County. 
 
2.  
GOALS 
 
MCDPH is committed to ensuring a comprehensive representation of Maricopa County residents. 
Our goals align with Healthy People 2030 and Public Health 3.0 which is guided by addressing 
social determinants of health, and increasing capacity building and community collaboration.  
o Attain high-quality, longer lives free of preventable disease, disability, injury, and 
premature death. * 
o Eliminate health disparities, achieve health equity, and attain health literacy to improve the 
health and well-being of all. *  
o Create social and physical environments that promote attaining the full potential for health 
and well-being for all. * 
o Promote quality of life, healthy development, and healthy behaviors across all life stages.* 
o Engage leadership, key constituents, and the public across multiple sectors to take action 
and design policies that improve the health and well-being of all. * 
 
*Healthy People 2030 Overarching Goals 
 
Data Collection and Assessments Methodology 
MCDPH uses the Mobilizing for Action through Planning and Partnerships (MAPP), which is a 
community-driven strategic planning process for improving community health. The MAPP 
framework helps communities apply strategic thinking to prioritize public health issues and identify 
resources to address them. MAPP is an interactive process that can improve the efficiency, 
effectiveness, and ultimately the performance for local public health and healthcare systems 
(MAPP, NACCHO.org). For more information visit: https://www.naccho.org/programs/public-
health-infrastructure/performance-improvement/community-health-assessment/mapp  
 
The County conducts the following assessments in alignment with MAPP 2.0: Community Partner 
Assessment, Community Status Assessment, and the Community Context Assessment. These 
assessments are completed through conducting key informant interviews, focus groups, and 
surveys to provide extensive qualitative and quantitative data collection. The County also 
analyzes data sets per Primary Service Area (“PSA”) and conducts comparisons. These 
assessments and analysis are then incorporated with extensive quantitative data sets such as:  
 
o Hospital Discharge Data from ADHS 
o Birth/Death from Vital Records 
o CDC’s Behavioral Risk Factor Surveillance System 
o CDC’s Youth Behavioral Risk Surveillance System 
o Arizona Youth Survey 
o National Cancer Institute-Cancer Registry 
o Healthy People 2030  
o Other sources that address priority

SECTION II              
            SCOPE OF WORK 
 
9 
 
3. 
SERVICE GOALS: 
 
  
Service/ 
Deliverable 
County agrees to: 
Circle the City agrees to: 
Synapse 
Membership    
1. Administer and convene meetings of the 
Community Health Needs Assessment 
Partners Synapse Coalition either virtually or 
in-person at minimum 8 times per year, and to 
convene joint meetings of the Synapse and 
Health Improvement Partnership of Maricopa 
County (HIPMC) at minimum 2 times per year.  
2. Provide Synapse members with calendar 
invites, meeting reminders and minutes, and 
access to a shared folder of meeting 
materials, recordings, and action items. 
3. Provide Synapse members with at 
minimum two county points of contact and 
provide partner with any changes to assigned 
staff and/or contact information within 4 weeks 
of changes. 
1. Assign and allow at minimum 2 and at 
maximum 5 employees of Circle the City to 
actively participate on the Synapse coalition 
as a representative of Circle the City to make 
and/or influence decisions on the 
development and implementation of the 
CHNA process. For decisions requiring 
consensus, Circle the City will have one vote. 
2. Provide representation at Synapse 
meetings to ensure influence on the 
development of CHNA and Synapse work.  
3. Review and update assigned staff contact 
information annually and provide county with 
any changes to assigned staff and/or contact 
information within 4 weeks of changes. 
Partner-
Specific 
CHNA and 
Prioritization 
Strategy 
 
1. Meet with Circle the City individually within 
first 6 months of contract cycle to develop a 
workplan timeline for all deliverables that 
aligns with Circle the City needs and county 
capacity. 
2. Develop a plan for health issue 
prioritization, stakeholder/committee 
engagement, and report format development 
tailored to the healthcare partner. 
3. Maintain reliable communication via virtual 
meetings, emails, and phone calls as needed 
based on the phase of the workplan. County 
will provide reminders about meetings and 
workplan timelines. 
4. Develop meeting agendas and provide 
meeting minutes and timeline updates 
following all virtual meetings. 
5. Set up a process for shared documentation 
according to partner's technology 
permissions, such as Dropbox, SharePoint, 
Trello, etc.  
6. Within one year following the publication of 
Circle the City’s CHNA, meet with Circle the 
City to review the effectiveness of CHNA 
processes, tools, and measures to determine 
adjustments for future cycles. 
 
 
 
 
1a. Meet with county within first 6 months of 
contract cycle to develop a workplan timeline 
for all deliverables that aligns with Circle the 
City needs and county capacity. 
1b. At the beginning of workplan timeline 
development, provide county with 
organization-specific timelines and 
requirements including external CHNA 
submission deadlines, internal 
board/committee timelines, deliverable 
requirements specific to Circle the City, and 
any necessary approval processes. 
2. Develop a plan for health issue 
prioritization, stakeholder/committee 
engagement, and report format development 
tailored to Circle the City’s needs.  
3. Maintain reliable communication via virtual 
meetings, emails, and phone calls as needed 
based on the phase of the workplan. Lack of 
prompt communication from Circle the City 
may result in delays to workplan timelines. 
County is not responsible for making up time 
lost due to delayed communication by Circle 
the City but will work with the partner to 
modify the timeline accordingly. 
4. Review meeting agendas, meeting minutes, 
updated timeline and provide additions, 
corrections, or feedback 
5. Verify Circle the City requirements for 
shared documentation and work with county 
to set up sharing platform such as Dropbox, 
SharePoint, Trello, etc.

SECTION II              
            SCOPE OF WORK 
 
10 
 
Ad-hoc Epi 
time 
 
1. Provide prioritized epidemiology and data 
analysis assistance for non-CHNA related 
requests, up to 15 hours of epi staff time per 
year. Requests beyond 15 hours will be 
reviewed to determine if an additional fee will 
be charged.  
1. Provide requests through public data 
request portal at https://phdra.maricopa.gov/ 
at minimum two weeks in advance of 
requested deadline. 
Coordinated 
CHNA 
Development 
 
1. Once per cycle, coordinate development of 
CHNA tools and measures including the 
community health survey, focus groups, and 
key informant interviews with the guidance of 
the Synapse coalition. County will work to the 
best of their ability to align most updated 
CHNA data collection and analysis to include 
in partner’s deliverables.  
1. Provide timely feedback and direction on 
CHNA tools in line with deadlines established 
by county team, either via participation in 
Synapse meetings or via written response 
within three weeks of request.  
Coordinated 
CHNA Data 
Collection 
 
1. Facilitate data collection of CHNA surveys, 
focus groups, and key informant interviews 
based on strategic sampling goals and a 
targeted regional approach.  
2. Cover the costs of survey development and 
translation, outreach and promotional 
materials, communications, internal staff and 
contracted community outreach partners, and 
data entry using Synapse Fee Fund budget 
and other county budget sources.  
1a. Promote the CHNA survey, focus groups, 
and key informant interviews within Circle the 
City according to organization's policies. This 
may include sharing the survey to staff, 
clients, and community networks via emails, 
social media, physical materials, and tabling 
or attending events.  
 
1b. Help identify non-traditional opportunities 
to promote the CHNA survey in the 
community through marketing strategies and 
public events. 
2. One month prior to the launch of the CHNA 
survey, provide county with a brief written 
description of their intended CHNA survey 
promotional strategy and identify opportunities 
where county can support. 
CHNA Data 
Reporting 
 
1. Provide Synapse partners with CHNA 
survey analysis with measures analyzed by 
county, by region, and for demographic data 
including race/ethnicity, gender, and age.  
2. Provide reports of qualitative focus group 
and key informant interview data, either 
produced in-house or via contracted partner.  
3. Provide up to 20 non-published additional 
qualitative quotes from qualitative dataset to 
support data presentations or reports.  
1. Provide at minimum 2 weeks’ notice for 
additional qualitative quote requests. 
PSA Data 
Analysis 
 
1. Provide the following health indicator data 
(detailed below), according to Circle the City’s 
selection for the following PSAs: 
 
i. Maricopa County PSA 
 
2. Provide a draft of analysis within 60 days of 
Circle the City indicator selection 
3. Provide a final analysis within 30 days of 
Circle the City feedback 
1. Within first 6 months of contract cycle, meet 
with county to develop a workplan timeline for 
CHNA analysis, prioritization, and reporting 
that that aligns with Circle the City needs and 
county capacity. 
2. 90 days before draft analysis is due, 
provide zip codes for Primary Service Areas 
(PSA) of analysis. Zip codes may be modified 
up until indicator request is submitted (60 
days before draft analysis is due). If Maricopa 
County PSA is to be used, this must be 
confirmed 30 days before draft analysis is

SECTION II              
            SCOPE OF WORK 
 
11 
 
Data: Common health indicator report basic 
age-adjusted rates for listed PSAs by the 
following subgroups: overall population, 
gender, race/ethnicity, and age. The 
geography will also include overall Maricopa 
county-level rates for each indicator, as well 
as a summary of county resident 
demographics. Rates include inpatient 
hospitalizations, emergency department visits, 
and deaths. 
Format: Excel workbook including tabs with 
the following information: overall rates per 
indicator, individual tabs for each health 
indicator with rates by subgroup and PSA (if 
FQHC), screenshots from mapping tools, and 
demographics of the PSA, etc. Due to the size 
of the workbook, the data will be sent via 
agreed-upon sharing format. 
Source: The most recently available data 
from Arizona Department of Health Services 
Hospital Discharge Data and Vital Statistics, 
Behavioral Risk Factor Surveillance System, 
Youth Risk Behavioral Survey, PolicyMap, 
Census.gov, and other sources as available. 
Note: each data source has a different lag 
period of when it becomes available, which 
may limit the recency of data provided. 
Census-released population data is needed to 
calculate rates, which may delay analysis of 
any recent data received.  
due. 
3. 60 days before draft indicator analysis is 
due, provide county staff with list of indicator 
request from the “Common health indicator 
list.” If Maricopa County PSA is to be used, 
this must be confirmed 30 days before draft 
analysis is due. 
4. Within 30 days of draft indicator analysis 
submission, provide feedback and request for 
any additional analyses. 
5. Provide at minimum 2 weeks’ notice for any 
additional requests or data modifications.  
Facilitated 
Prioritization 
 
1. Co-design a facilitation strategy for Circle 
the City prioritization sessions and 
presentations to gather feedback and receive 
approval from necessary committees. 
2. Develop a slide deck including up to 35 
slides of data analysis as well as additional 
slides containing background information, 
polling questions, etc. Iterations of slide decks 
throughout the prioritization process may 
involve updating or modifying the content or 
layout of the data analysis slides. 
3. Prepare interactive virtual and/or physical 
materials to generate participant feedback 
and polling.  
4. Provide up to 15 cumulative hours of 
presentation time to boards/committees in a 
virtual or in-person format. Presentation time 
beyond 15 hours may be provided for an 
additional fee.  
1. Co-design a facilitation strategy for Circle 
the City prioritization sessions and 
presentations to gather feedback and receive 
approval from necessary committees. 
2. Provide direction and feedback to county 
regarding presentation content and materials. 
3a. Convene, register, and host presentations 
whether in-person or virtual. 
3b. Schedule presentations requiring county 
staff participation at least 4 weeks in advance 
to ensure staff availability. 
3c. Provide any refreshments or materials 
used during in-person meetings (e.g., poster 
boards, printed materials, etc.). 
CHNA 
Report 
 
1a. Produce one final HRSA-compliant 
Community Health Needs Assessment report1 
following template and deadline determined 
by Circle the City and county for the following 
PSA:  
 
1. Within first 6 months of contract cycle, 
provide county with CHNA submission 
deadlines including internal board/committee 
approval and final HRSA deadline.

SECTION II              
            SCOPE OF WORK 
 
12 
 
Maricopa County PSA 
 
1b. Include 1-2 page executive summary 
embedded in the report for each of the 
following clinics to connect the unique facility 
focus with CHNA qualitative data and data 
provided by Circle the City: 
 
1. 
Family Health Centers 
• 
Downtown Family Health Center 
• 
The Parsons Family Health Center 
 
2. 
Medical Respite Centers 
• 
Downtown Medical Respite Center 
• 
Midtown Medical Respite 
 
3. 
Outreach Team and Street Medicine 
• 
North Valley Neighborhood 
Partnership 
• 
East Valley Neighborhood 
Partnership 
• 
Central Valley Neighborhood 
Partnership  
• 
Central Valley Neighborhood 
Partnership II  
• 
West Valley Neighborhood 
Partnership 
• 
Street Medicine East 
• 
Street Medicine Central  
• 
Mental Health Street Medicine  
 
2. Include relevant, high-level disparities and 
key findings from CHNA Data Reporting, PSA 
Data Analysis, and Facilitated Prioritization.   
3. Provide at least one draft with up to four 
drafts of the report to Circle the City for review 
and approval prior to final draft.  
4. Collaborate with marketing/communications 
team to develop final report/executive 
summary design as requested by Circle the 
City and provided in Word and PDF.  
1According to HRSA posted requirements 
https://bphc.hrsa.gov/compliance/compliance-
manual/chapter3 
2. At the beginning of the report/executive 
summary development process, involve and 
define roles of relevant Circle the City staff 
such as program managers, compliance 
officers, marketing staff, etc. 
3. Provide County with CHNA report template 
or description of report component 
format/content requirements/images, branding 
guidelines as specified by Circle the City 
system office.  
4. Complete designated sections of CHNA 
report specific to Circle the City background. 
5. Provide feedback within two weeks of 
report draft submissions or according to 
agreed-upon timeline.  
6. If desired, produce final report formats 
beyond Word or PDF (e.g., dashboard, 
webpage integration, etc.) 
7. Include Maricopa County Public Health logo 
in final published report and acknowledge 
support of MCDPH CHNA Team.

SECTION III 
                                              COMPENSATION 
13 
 
1. 
COMPENSATION 
 
A. Subject to the availability of funds, Circle the City shall pay the County for the 
services described herein for a sum not to exceed the Contract Amount listed on the 
cover page of this Contract in equal yearly installments of $15,000 over the two-year 
term of this Contract.  
 
B. Circle the City shall pay the County an amount not to exceed (NTE) $30,000 for the 
life of this Contract. Partners can add additional services during the contract cycle. 
Any additional service that is added, the partner will retroactively pay for that service 
for the duration of the contract. Please refer to price sheet for additional services.  
 
  
YR 1 
YR 2 
YR 3 
Yearly Base Amount (includes one PSA analysis) 
N/A 
$12,000 
$12,000 
50% Proration of YR 1 
N/A 
$3,000 
$3,000 
Total Yearly Amount 
 
$15,000 
$15,000 
 
 
2. 
METHOD OF PAYMENT 
 
 
A. 
Invoice with Net 45 terms. 
 
B.       Invoices shall be submitted to: Accountspayable@circlethecity.org 
 
 
 
 
3. 
NOTICE 
 
Any notice given under this Contract shall be sent to the attention of the 
following: 
 
 
Maricopa County 
Department of Public Health,  
Office of Community Empowerment 
Circle the City 
 
4041 N. Central Avenue 
300 W. Clarendon Avenue   
Suite #600 
Suite 200 
Phoenix, AZ 85012 
Phoenix, AZ 85013 
 
Maricopa County  
Department of Public Health 
Grants and Contracts Unit 
 
4041 N. Central Ave #1400 
 
Phoenix, AZ 85012

SECTION IV 
           BUSINESS ASSOCIATE AGREEMENT 
14 
 
 
BUSINESS ASSOCIATE AGREEMENT 
 
This Business Associate Agreement (“BAA”) sets out the responsibilities and obligations 
of Maricopa County Department of Public Health ("Associate") as a Business Associate (as 
defined at 45 C.F.R.§ 160.103) of Circle the City (“Circle the City”) pursuant to the agreement 
between Associate and Circle the City dated ___________________, as well as all future 
agreements entered into by the Parties (collectively, the “Agreement”). Associate and Circle the 
City (individually a "Party" and collectively the "Parties") agree to the terms and conditions of this 
BAA in order to comply with the use and disclosure of Protected Health Information (“PHI”) (as 
defined at 45 C.F.R.§ 160.103) provisions of the Standards for Privacy of Individually Identifiable 
Health Information, at 45 C.F.R. Parts 160 and 164, Subparts A and E, as amended from time to 
time (the “Privacy Rule”); the Security Standards for the Protection of Electronic PHI, 45 C.F.R. 
Parts 160 and 164, Subparts A and C (the "Security Rule"); and the standards for Notification in 
the Case of Breach of Unsecured PHI, 45 C.F.R. Part 164, Subpart D (the "Breach Notification 
Rule") (collectively, the “HIPAA Rules”).  Unless otherwise provided herein, all capitalized terms 
in this BAA will have the same meaning as provided under the HIPAA Rules and HITECH (as 
defined below). Associate and Circle the City will comply with the terms of this BAA for the duration 
of the Agreement and for such other continuing periods as provided in this BAA. This BAA shall 
supersede any and all prior business associate agreements entered into between the Parties. 
 
1. USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION. 
 
a. Performance of Services.  Associate will use and disclose PHI only for those purposes 
necessary to perform its duties, obligations, and functions under the Agreement, or as 
otherwise expressly permitted or required by this BAA or as Required by Law.  Associate 
will not use or further disclose any PHI in violation of this BAA or in a manner that, if done 
by Circle the City, would violate the Privacy Rule. 
 
b. Limited Data Sets.  Associate will limit any uses, disclosures, or requests of PHI to a 
Limited Data Set, as defined in 45 C.F.R. § 164.514(e)(2), or if needed by Associate to 
the minimum necessary PHI required to accomplish the intended purpose of the use, 
disclosure, or request, as defined by the Privacy Rule, pursuant to the Health Information 
Technology for Economic and Clinical Health Act (“HITECH”), and any regulations or 
guidance promulgated thereunder by the Secretary.  For any disclosures of PHI pursuant 
to this BAA, the Party disclosing the PHI shall determine what constitutes the minimum 
necessary to accomplish the intended purpose of the disclosure. 
 
c. Data Aggregation.  Associate may use PHI to perform data aggregation services as 
permitted by 45 C.F.R. § 164.504(e)(2)(i)(B). 
 
d. Associate’s Management and Administration.  Associate may use or disclose PHI for 
the necessary management and administration of Associate, or to carry out the legal 
responsibilities of Associate, provided that if Associate makes a disclosure of PHI: 
 
i. The disclosure is Required by Law; or 
 
ii. Associate first secures written assurances from the receiving party that the 
receiving party will: (i) hold the PHI confidentially; (ii) use or disclose the 
PHI only as required by law or for the purposes for which it was disclosed 
to the recipient; and (iii) notify the Associate of any breaches in the 
confidentiality of the PHI.

SECTION IV 
           BUSINESS ASSOCIATE AGREEMENT 
 
15 
 
 
Notwithstanding the foregoing, the Parties explicitly agree that unless the de-identification 
requirements in Section 1(e) of this BAA are met, Associate’s use of PHI in demonstrating 
its services or product to an outside third party is strictly prohibited by this BAA. 
 
e. De-Identification.  Associate may de-identify the PHI, provided that such de-identification 
is in accordance with 45 C.F.R. § 164.514(b)92) and such resulting de-identified 
information is only used or disclosed for Associate’s internal business purposes.  
Associate may not commercialize or sell the de-identified information to a third party.
 
f. Prohibition on Off-Shoring PHI.  Associate agrees that no PHI may be created, received, 
maintained, accessed, or transmitted outside of the United States of America, which shall 
be construed as one of the fifty United States or one of the United States territories (i.e., 
American Samoa, Guam, Northern Mariana Islands, Puerto Rico, and Virgin Islands). 
 
2. 
SAFEGUARDS FOR PROTECTED HEALTH INFORMATION.  Associate will implement 
appropriate safeguards to prevent any use or disclosure of PHI not otherwise permitted in 
this BAA.  Associate also will implement administrative, physical, and technical safeguards 
to protect the confidentiality, integrity, and availability of the electronic PHI, if any, that 
Associate creates, receives, maintains, or transmits on behalf of Circle the City.  Associate 
will also comply with the applicable requirements of Subpart C of Part 164 of the Security 
Rule in the same manner such provisions apply to Circle the City. 
 
3. 
REPORTS OF IMPERMISSIBLE USE OR DISCLOSURE. 
 
a. Notification of an Impermissible Use or Disclosure of PHI.  Associate will report to 
Circle the City any use or disclosure of PHI not permitted by this BAA, including any 
Breach of Unsecured PHI, as soon as reasonably practicable but in all events, within five 
(5) business days of its discovery. 
 
b. Notification of Security Incidents.  Associate also will report to Circle the City any 
Security Incident of which it becomes aware within five (5) business days of its discovery.  
Notwithstanding the foregoing, Associate and Circle the City acknowledge the ongoing 
existence and occurrence of attempted but unsuccessful Security Incidents that are trivial 
in nature, such as pings and port scans, and Circle the City acknowledges and agrees no 
additional notification to Circle the City of such unsuccessful Security Incidents is required.  
However, to the extent that Associate becomes aware of an unusually high number or 
pattern of unsuccessful Security Incidents due to the repeated acts of a single party, 
Associate shall notify Circle the City of these attempts and provide the name, if available, 
of said party.  At the request of Circle the City, Associate shall use its best efforts to identify 
the date of the Security Incident, Associate’s response to the Security Incident and the 
identification of the party responsible for causing the Security Incident, if known. 
 
c. Content of Notifications.  Associate's notices provided under this Section 3 will include, 
to the extent possible, the identification of each Individual whose PHI has been, or is 
reasonably believed by Associate to have been, accessed, acquired, used, or disclosed 
during or as a result of the impermissible use or disclosure of PHI, or a Security Incident 
(“Security Event”).  Associate shall also provide Circle the City with at least the following 
information: a description of the Security Event, including the date of the Security Event 
and date of discovery, if known; a description of the types of PHI involved in the Security 
Event; any steps Individuals should take to protect themselves from potential harm as a 
result of the Security Event; and any other information requested by Circle the City related

SECTION IV 
           BUSINESS ASSOCIATE AGREEMENT 
 
16 
 
to the Security Event. Associate shall supplement such notice with further information as 
it becomes available, even if such information becomes available after Individuals have 
been notified of the Security Event. 
 
d. Cooperation by Associate. Associate agrees to cooperate with Circle the City in the 
investigation of a Security Event and understands and agrees that Circle the City in its 
sole discretion will determine whether or not a Security Event is a Breach and/or triggers 
notification obligations. 
 
e. Obligation to Provide Notifications. In the event that Associate, or its Workforce 
members or Subcontractors cause a Security Event, or a Security Event occurs while PHI 
is in Associate’s possession or is being transmitted by Associate, Associate agrees that 
Circle the City may, in its sole discretion, require Associate to provide all notifications that 
Circle the City is required to make pursuant to the Breach Notification Rule and any other 
applicable laws.  Circle the City shall have the right to review, direct, and approve or reject 
the contents or manner of such notifications. 
 
f. Cost Reimbursement and Indemnification.  Associate also agrees to indemnify and 
reimburse Circle the City for any costs incurred in investigating, mitigating, and otherwise 
responding to a Security Event caused by Associate or its Workforce or Subcontractors, 
or a Security Event occurs while PHI is in Associate’s possession or is being transmitted 
by Associate, including costs related to providing legally required notifications, as well as 
credit monitoring services for at least one (1) year to the extent the Security Event involved 
social security numbers or financial account information. 
 
4. 
SUBCONTRACTORS. In accordance with 45 C.F.R. §§ 164.308(b)(2) and 
164.502(e)(1)(ii), if Associate provides PHI to a Subcontractor, Associate shall ensure that 
the Subcontractor agrees in writing to substantially the same, but at least as stringent and 
protective as to Circle the City and the PHI, as the restrictions and conditions that apply in 
this BAA to Associate with respect to such information, including the safeguards required 
by Section 2.  Associate shall maintain a list of its Subcontractors and will provide Circle 
the City with a copy of such list upon reasonable request. 
 
5. 
OBLIGATIONS REGARDING ASSOCIATE PERSONNEL.  Associate will appropriately 
inform and train all of its Workforce members (“Associate Personnel”), whose services 
may be used to satisfy Associate’s obligations under the Agreement and this BAA of such 
Associate Personnel’s HIPAA Rule and HITECH obligations so as to enable Associate to 
comply with the terms of this BAA.  Associate represents and warrants that the Associate 
Personnel are under legal obligation to Associate, by contract or otherwise, sufficient to 
enable Associate to fully comply with the provisions of this BAA. 
 
6. 
ACCESS TO PHI. 
 
a. Circle the City Access.  Within five (5) business days of a request by Circle the City for 
access to PHI held by Associate in a Designated Record Set, Associate will make the 
requested PHI available to Circle the City, in the time, manner, and format requested Circle 
the City, including electronically if Associate maintains the PHI electronically and the 
requested form and format is readily producible, or, if not, in a readable electronic form 
and format as agreed to by Circle the City and the Individual.  Any fee that Associate may 
charge for providing the access required hereunder must be reasonable, cost-based, and 
determined in accordance with 45 C.F.R. § 164.524(c)(4).

SECTION IV 
           BUSINESS ASSOCIATE AGREEMENT 
 
17 
 
b. Individual Access.  If an Individual requests access to PHI directly from Associate, 
Associate will notify the Individual that it will forward the request to Circle the City.  Within 
five (5) business days of the request, Associate will forward such request in writing to 
Circle the City.  Circle the City will be responsible for making all determinations regarding 
the grant or denial of an Individual’s request for PHI and Associate will make no such 
determinations.  Only Circle the City will release PHI to the Individual pursuant to such a 
request. 
 
7. 
AMENDMENT OF PHI.  Within five (5) business days of receiving a request from Circle 
the City to amend an Individual’s PHI held by Associate in a Designated Record Set, 
Associate will provide such information to Circle the City for amendment. If Circle the City 
request includes specific information to be included in the PHI as an amendment, Associate 
will incorporate such amendment within five (5) business days of receipt of Circle the City 
request. Associate will forward to Circle the City within five (5) business days any requests 
by Individuals to Associate to amend PHI within its or Circle the City possession. Circle the 
City will be responsible for making all determinations regarding amendments to PHI, and 
Associate will make no such determinations.
8. ACCOUNTING OF DISCLOSURES; REQUESTS FOR DISCLOSURE. 
 
a. Disclosure Records.  Associate agrees to document such disclosures of PHI and 
information related to such disclosures as would be required for Circle the City to respond 
to a request by an Individual for an accounting of disclosures of PHI in accordance with 
45 C.F.R. § 164.528.  As of the compliance date set forth in the regulations promulgated 
under HITECH or as otherwise determined by the Secretary, in addition to the accounting 
of disclosure obligations required under 45 C.F.R. § 164.528, Associate shall account for 
all disclosures of PHI made through an Electronic Health Record in accordance with all 
applicable regulations. 
 
b. Data Regarding Disclosures.  For each disclosure for which Associate must maintain 
documentation under Section 8(a), Associate will record and maintain the following 
information: 
 
 
The date of disclosure.  
 
The name of the entity or person who received the PHI, and the address of 
such entity or person, if known.  
 
A description of the PHI disclosed; and  
 
A brief statement of the purpose of the disclosure. 
 
c. Individual Request for Disclosure Records.  Within five (5) business days of receipt of 
a notice from Circle the City to Associate of an Individual’s request for an accounting of 
disclosures, Associate will provide Circle the City with the record of disclosures requested 
in the notice. 
 
d. Individual Request to Associate.  If an Individual requests an accounting of disclosures 
directly from Associate, Associate will notify the Individual that he or she will receive such 
accounting from Circle the City.  Associate will forward the request to Circle the City within 
five (5) business days of Associate’s receipt of the request and will make its records of 
disclosures available to Circle the City as otherwise provided in this Section.  Circle the 
City will be responsible for preparation and delivery of the records of disclosure to the 
Individual.  Associate will not provide an accounting of its disclosures directly to the 
Individual.

SECTION IV 
           BUSINESS ASSOCIATE AGREEMENT 
 
18 
 
 
e. Survival of Obligations.  Associate’s obligations related to maintaining a disclosure 
record and providing the disclosure record to Circle the City as required by this Section 8 
shall survive for six (6) years from the effective date of the relevant Agreement, Associate 
shall provide Circle the City with its disclosure record which reflects disclosures made by 
Associate over the six (6) years immediately preceding the date of termination. 
 
9. 
REQUESTS FOR RESTRICTIONS.  If Circle the City advises Associate of any changes 
in, or restrictions to the permitted use or disclosure of PHI provided to Associate, Associate 
will restrict use or disclosure of PHI consistent with Circle the City instructions.  If Associate 
receives a request to restrict the disclosure of PHI directly from an Individual, Associate 
shall promptly notify Circle the City of such request, and Circle the City shall be responsible 
for making the determination as to whether Associate shall comply with the Individual's 
request. 
 
10. 
DELEGATION OF OBLIGATIONS.  To the extent Associate is clearly required by the 
terms of the Agreement to carry out Circle the City obligations under the Privacy Rule, 
Associate shall comply with the requirements of the Privacy Rule that apply to Circle the 
City in the performance of such delegated obligations. 
 
11. 
MITIGATION PROCEDURES.  Associate will mitigate, to the maximum extent practicable, 
any harmful effect that is known to Associate arising from its, its Workforce’s, or its 
Subcontractors’ Use or Disclosure of PHI in a manner that violates this BAA. 
 
12. 
 INDEMNIFICATION.  The following indemnification provisions shall apply to this BAA and 
shall survive the termination of the Agreement or this BAA:
 
a. To the fullest extent permitted by law, Associate, its successors, assigns and guarantors, 
shall pay, defend, indemnify and hold harmless Circle the City, its agents, representatives, 
officers, directors, officials and employees from and against all allegations, demands, 
proceedings, investigations or audits by state or federal government agencies, suits, 
actions, claims, damages, liability, penalties, losses, expenses, including but not limited 
to, attorney fees, defense costs, court costs, the cost of appellate proceedings, and the 
costs of responding to and defending against an investigation or audit, and all claim 
adjusting and handling expenses, related to, arising from or out of or resulting from any 
actions, acts, errors, mistakes or omissions caused in whole or part by Associate relating 
to work or services in the performance of this BAA, including but not limited to, any 
Subcontractor, or Associate’s or Subcontractor’s Workforce, regardless of whether or not 
caused in part by the active or passive negligence of a party indemnified hereunder 
including Circle the City, its agents, representatives, officers, directors, officials and 
employees. 
 
b. If any claim, action or proceeding is brought against Circle the City by reason of any event 
that is the subject of this BAA and or described herein, upon demand made by Circle the 
City, Associate, at its sole cost and expense, shall pay, resist or defend such claim or 
action on behalf of Circle the City by an attorney hired by Associate, or if covered by 
insurance, Associate’s insurer, all of which must be approved by Circle the City, which 
approval shall not be unreasonably withheld or delayed.  Circle the City shall cooperate 
with all reasonable efforts in the handling and defense of such claim.  Included in the 
foregoing, Circle the City may engage its own attorney to defend or assist in its defense.  
Any settlement of claims shall fully release and discharge the indemnified parties from any 
further liability for those claims. The release and discharge shall be in writing and shall be

SECTION IV 
           BUSINESS ASSOCIATE AGREEMENT 
 
19 
 
subject to approval by Circle the City, which approval shall not be unreasonably withheld 
or delayed.  If Associate neglects or refuses to defend Circle the City as provided by this 
BAA, any recovery or judgment against Circle the City for a claim covered under this BAA 
shall conclusively establish Associate’s liability to Circle the City in connection with such 
recovery, fine, penalty, or judgment.  Further, if Circle the City desires to settle such 
dispute, Circle the City shall be entitled to settle such dispute in good faith and Associate 
shall be liable for the amount of such settlements.  Regardless of settlement, fine, penalty, 
or judgment, Associate shall be liable for all expenses connected to the defense, including 
reasonable attorney fees, and other investigative and claims adjusting expenses. 
 
c. Any limitations of liability contained in the Agreement shall not apply to the indemnification 
requirements of this Section. 
 
d. In addition to the indemnification obligations set forth herein, Associate shall make itself 
and any Subcontractors or Workforce members assisting Associate in the performance of 
its obligations under the Agreement or this BAA available to Circle the City, at no cost 
Circle the City, to testify as witnesses, or otherwise, in the event of litigation or 
administrative proceedings being commenced against Circle the City, its directors, officers 
or employees based upon a claim of violation of HIPAA, the HITECH Act, the HIPAA 
Rules, or other laws related to security and privacy by Associate or its Subcontractors or 
Workforce members. 
 
e. This Section shall survive termination of this BAA. 
 
13. 
RESPONSIBILITIES UPON TERMINATION. 
 
a. Return of PHI, Destruction.  Within fifteen (15) days of termination of this BAA, Associate 
will return to Circle the City all PHI received from Circle the City or created or received by 
Associate on behalf of Circle the City which Associate maintains in any form or format 
(including copies thereof), and Associate will not maintain or keep in any form or format 
any portion of the PHI.  Alternatively, Associate may, upon Circle the City written consent, 
destroy all such PHI and provide written documentation of such destruction to Associate.  
The requirement to return or destroy such PHI will apply to all Subcontractors of Associate. 
Associate will be responsible for recovering any PHI from such Subcontractors.  If 
Associate cannot obtain the PHI from any Subcontractor, Associate will so notify Circle 
the City and will require that such Subcontractor directly return PHI to Circle the City or 
otherwise destroy such PHI, subject to the terms of this Section. 
 
b. Return or Destruction of PHI Infeasible.  If Associate believes that returning or 
destroying PHI in its or its Subcontractors' possession at the termination of this BAA is 
infeasible, it will provide written notice to Circle the City within five (5) business days of the 
effective date of termination of this BAA.  Such notice will set forth the circumstances that 
Associate believes makes the return or destruction of PHI infeasible and the alternative 
measures that Associate recommends for assuring the continued confidentiality and 
security of the PHI.  Circle the City promptly will notify Associate of whether it agrees that 
the return or destruction of PHI is infeasible.  If Circle the City agrees that return or 
destruction of PHI is infeasible, Associate agrees to extend all protections, limitations, and 
restrictions of this BAA to the PHI retained after termination of this BAA and to limit further 
uses or disclosures to those purposes that make the return or destruction of the PHI 
infeasible.  Any such extended protections, limitations and restrictions will apply to any 
Subcontractors of Associate for whom return, or destruction of PHI is determined by Circle 
the City to be infeasible.  If Circle the City does not agree that the return or destruction of

SECTION IV 
           BUSINESS ASSOCIATE AGREEMENT 
 
20 
 
PHI from Associate or its Subcontractors is infeasible, Circle the City will provide Associate 
with written notice of its decision, and Associate and its Subcontractors will proceed with 
the return or destruction of the PHI pursuant to the terms of this Section within fifteen (15) 
days of the date of Circle the City’s notice. 
 
14. 
TERMINATION.  Circle the City and Associate may immediately terminate this BAA upon 
written notice to the other Party if Circle the City or Associate determines in its discretion 
that the other Party has breached a material term of this BAA.  Alternatively, the non-
breaching Party may elect to provide the breaching Party with thirty (30) days’ advance 
written notice of the breaching Party's breach of any term or condition of this BAA and 
afford the breaching Party the opportunity to cure the breach to the satisfaction of the non-
breaching Party within twenty (20) days of such notice.  If the breaching Party fails to 
timely cure the breach, as determined by the non-Breaching Party, the BAA will terminate 
this BAA as provided in the non-breaching Party's notice. This BAA will automatically 
terminate upon expiration or termination of the last effective Agreement between the 
Parties unless the Parties explicitly agree in writing to extend the term of this BAA beyond 
the expiration or termination of the last effective Agreement. 
 
15. 
ASSOCIATE BOOKS AND RECORDS. 
 
a. Circle the City Access.  Following a Security Event, or for purposes of Circle the City 
responding to a government inquiry or judicial or administrative process, Associate will, 
within five (5) business days of Circle the City written request, make available during 
normal business hours at Associate’s offices, all records, books, agreements, policies, 
and procedures relating to the use or disclosure of PHI for the purpose of allowing Circle 
the City to determine Associate’s compliance with the Agreement and this BAA. 
 
b. Government Access.  Associate will make its internal practices, books and records on 
the use and disclosure of PHI available to the Secretary to the extent required for 
determining compliance with the Privacy Rule.  Notwithstanding this provision, no 
attorney-client, accountant-client, or other legal privilege will be deemed waived by 
Associate or Circle the City as a result of this Section.  Associate shall also make its 
policies and procedures, and documentation required by the Security Rule relating to the 
safeguards in Section 2, available to the Secretary for purposes of determining Circle the 
City and Associate’s compliance with the Security Rule. 
 
16. 
NOTICES.
a. Any notices required under this BAA will be sent to the Parties at the following address by 
first class mail, fax, or hand delivery: 
 
CIRCLE THE CITY      
 
 
            MARICOPA COUNTY DEPARTMENT OF  
 
 
 
 
 
 
 
PUBLIC HEALTH 
 
300 W. Clarendon Ave, Suite 200                      4041 N. Central Avenue, Suite 1400 
Phoenix, AZ 85013                                             Phoenix, AZ 85012 
Email: KDespres@circlethecity.org                    Phone: 602-372-6886                   
 
 
Attn: Kim Despres             
                       Attn: Annie Daymude 
 
b. Any notice, report or other communication required under this BAA shall be in writing and 
shall be delivered personally, telegraphed, emailed, sent by facsimile transmission, or sent 
by U.S. mail.

SECTION IV 
           BUSINESS ASSOCIATE AGREEMENT 
 
21 
 
 
17. 
MISCELLANEOUS. 
 
a. Relationship of Parties.  In the performance of the work, duties and obligations described 
in this BAA or the Agreement, the Parties acknowledge and agree that each Party is at all 
times acting and performing as an independent contractor and at no time shall the 
relationship between the Parties be construed as a partnership, joint venture, employment, 
principal / agent relationship, or master / servant relationship. 
 
b. Regulatory References.  A reference in this BAA to a section in the HIPAA Rules means 
the section as in effect or as amended and for which compliance is required. 
 
c. Amendment.  No change, amendment, or modification of this BAA shall be valid unless 
set forth in writing and agreed to by both Parties.  Notwithstanding the foregoing, the 
Parties acknowledge that state and federal laws relating to electronic data security and 
privacy are rapidly evolving and that amendment of this BAA may be required to ensure 
compliance with such developments.  The Parties specifically agree to take such action 
as may be necessary from time to time for the Parties to comply with the requirements of 
the HIPAA Rules and HITECH.  Circle the City shall provide written notice to Associate to 
the extent that any final regulation or amendment to the HIPAA Rules promulgated by the 
Secretary requires an amendment to this BAA.  The Parties agree to negotiate an 
amendment to this BAA in good faith; however, either Party may terminate this BAA upon 
ninety (90) days written notice to the other Party if the Parties are unable to reach an 
agreement. 
 
d. Interpretation.  Any ambiguity in this BAA shall be resolved to permit Circle the City and 
Associate to comply with the HIPAA Rules and HITECH.  The provisions of this BAA shall 
prevail over any provisions in the Agreement that may conflict or appear inconsistent with 
any provision in this BAA, provided that any provision in the Agreement that is more 
stringent or protective of PHI than the terms of this BAA shall govern. 
 
e. Notice is given that pursuant to A.R.S. § 38-511 the County may cancel any Contract 
without penalty or further obligation within three years after execution of the Contract, if 
any person significantly involved in initiating, negotiating, securing, drafting or creating 
the Contract on behalf of the County is at any time while the Contract or any extension 
of the Contract is in effect, an employee or agent of any other party to the Contract in 
any capacity or consultant to any other party of the Contract with respect to the subject 
matter of the Contract.  Additionally, pursuant to A.R.S § 38-511 the County may recoup 
any fee or commission paid or due to any person significantly involved in initiating, 
negotiating, securing, drafting, or creating the Contract on behalf of the County from any 
other party to the Contract arising as the result of the Contract.

22 
 
IN WITNESS WHEREOF, each Party has caused this BAA to be executed by its duly 
authorized representative. 
 
IN WITNESS WHEREOF, the parties agree to enter into this contract:  
 
 
FOR AND ON BEHALF OF 
          CIRCLE THE CITY 
 
MARICOPA COUNTY 
 
 
 
 
 
By  
 
          By: _____________________ 
Chairman, Board of Supervisors 
 
 
 
          Name: Kim Despres                   
 
Date 
 
 
 
 
 
 
 
 
          Title: Chief Executive Officer         
 
ATTEST: 
          Date: ____________________ 
 
 
 
 
 
 
 
 
 
 
Clerk of the Board 
 
 
 
 
 
Date 
 
 
 
APPROVED AS TO FORM: 
 
 
 
 
 
Attorney for Maricopa County  
 
 
 
 
 
Date 
 
 
Jun 25, 2024

Circle the City_Synapse Contract_FINAL
6.25.24
Final Audit Report
2024-06-26
Created:
2024-06-26
By:
Arthur Orville (arthur.orville@maricopa.gov)
Status:
Signed
Transaction ID:
CBJCHBCAABAAhwKdqVNIpZFLzTOUmlw0O2BOySO3ZQWl
"Circle the City_Synapse Contract_FINAL 6.25.24" History
Document created by Arthur Orville (arthur.orville@maricopa.gov)
2024-06-26 - 0:11:35 AM GMT
Document emailed to Kim Despres (kdespres@circlethecity.org) for signature
2024-06-26 - 0:13:10 AM GMT
Email viewed by Kim Despres (kdespres@circlethecity.org)
2024-06-26 - 1:17:32 AM GMT
Document e-signed by Kim Despres (kdespres@circlethecity.org)
Signature Date: 2024-06-26 - 1:17:54 AM GMT - Time Source: server
Agreement completed.
2024-06-26 - 1:17:54 AM GMT