2024 05 PCH-MCAO CONTRACT AMENDMENT_1_FINAL DRAFT .DOCX
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1 FIRST AMENDMENT TO AGREEMENT FOR SERVICES FOR MINOR VICTIMS BETWEEN MARICOPA COUNTY, BY AND THROUGH MARICOPA COUNTY ATTORNEY’S OFFICE AND PHOENIX CHILDREN’S HOSPITAL This first Amendment to the Agreement Maricopa County, through the Maricopa County Attorney’s Office (“MCAO”) and Phoenix Children’s Hospital, Inc. (“PCH”) (collectively referred to as the “Parties”) is effective upon approval by the Maricopa County Board of Supervisors. RECITALS WHEREAS, the Parties entered into a certain Agreement regarding professional services for medical evaluation and examination in cases of child and other sexual abuse effective July 1, 2023 (the “Agreement”); and NOW, THEREFORE, the Parties hereto amend the Agreement according to the terms and conditions set forth below: 3.0. COMPENSATION AND REIMBURSEMENT As compensation and reimbursement for the services, MCAO shall pay PCH as set forth in Attachment B. ATTACHMENT B - COMPENSATION AND REIMBURSEMENT: Amend sections 1, 2, 3.1, 3.2, 3.6, and 3.7Attachment B to read as set forth below. All other sections of Attachment B remain unchanged. The revised Attachment B is attached to this first Amendmentset forth below. 2 ATTACHMENT B - COMPENSATION AND REIMBURSEMENT: 1. MCAO will reimburse PCH at a rate of $900 for services under Attachment A, Section 3 above. This includes a one-hour pretrial interview with defense counsel, consultation with the assigned prosecutor, and all/any court testimony, including any retrials. 2. MCAO will reimburse PCH at a rate of $365 per interview for Forensic Interview services as provided for in Attachment A, Section 12 above. This includes a one-hour pretrial interview with defense counsel, consultation with the assigned prosecutor, and all/any court testimony, including any retrials. 3. In addition to the rate of reimbursement enumerated in Attachment B, Sections 1 and 2 above, MCAO will reimburse PCH for: 3.1. The actual cost of laboratory tests, but MCAO will not be required to reimburse any costs over $365 per case, provided that a minimum/flat fee of $315 per case shall apply to lab costs in each sexual abuse case. The Parties understand that the nature and number of laboratory tests to be provided are dependent upon many variables, including the patient’s presentation and history or the request of the law enforcement agency; therefore, the Parties agree that in those cases that the Parties mutually agreed upon in advance, additional laboratory tests may be conducted. 3.2. MCAO will reimburse PCH $850 for each postmortem skeletal examination in cases of suspicious deaths of children under two years old without having to consult the Medical Examiner’s Office to gain approval to do the postmortem skeletal survey. 3.3. Medical records review and consultation with prosecutors during case preparation for cases not originally brought to PCH for services described in Attachment A, Section 13 above. These services will be charged at a not-to-exceed rate of $500 per hour. Medical records reviews shall include providing MCAO with a written opinion upon completion and testifying in court as necessary. 3.3.1. At the request of MCAO for records reviewed as outlined in Attachment A, Section 13 above, PCH shall provide, through the Team members, expert witness testimony in court and depositions, attend and participate in joint interviews with both prosecution and defense counsel present, participate with and assist prosecutors with pre-trial preparation, consult with representatives of law enforcement, and participate in case staffing. upon reasonable notice and accommodation of the Team member’s hospital schedules. 3.4. Sexual Maturity Rating services to determine gender and maturity levels based on evidence shall be provided only upon the request of law enforcement at a not-to-exceed amount of $300 per case. 3.5. Review of non-medical records to determine the existence of risks to the health and well- being of a child at the request of law enforcement AND with prior approval from MCAO shall not exceed $300 per case. 3 3.6. Expert testimony by a medical provider in court testimony shall be provided upon request by MCAO at a rate of $315 per hour. This fee is only for those cases not originally brought to PCH for Services as described in Attachment A, Section 7 above. The defense shall pay any pretrial interview requested by the defense at a rate of $250 per hour, prorated in 15- minute increments after the initial hour. If the defense attorney is Office of Public Defender Services (OPDS), PCH will bill MCAO. If the defense attorney is private, MCAO will notify the defense of the need to pay PCH in advance for the cost of the interview based on the length of the interview the defense is requesting. 3.7. Expert witness in-court testimony by a Forensic Interviewer shall be provided upon request by MCAO at a rate of $315 per hour. This fee is only for those cases not originally brought to PCH for Services under Attachment A, Section 12 above. The defense shall pay any pretrial interview requested by the defense at a rate of $200 per hour, prorated in 15-minute increments after the initial hour. If the defense attorney is OPDS, PCH will bill MCAO. If the defense attorney is private, MCAO will notify the defense of the need to pay PCH in advance for the cost of the interview based on the length of the interview the defense is requesting. 3.8. PCH assumes sole and exclusive responsibility for payment of any federal and state income taxes, federal social security taxes, and other mandatory governmental deductions or obligations, including worker's compensation for any and all of its employees, and agrees to hold Maricopa County and MCAO harmless for any and all liability which Maricopa County or MCAO incurs due to PCH’s failure to pay such taxes or obligations. METHOD OF PAYMENT; INVOICE AND TIMELINESS REQUIREMENTS PCH will submit a statement or invoice for services performed the previous month by the 15th of each month. The invoice shall include, at a minimum, the following information regarding each case for which payment is claimed for the Records Review and Reporting or Expert Witness Related Services: the name of the Provider(s); the type of Service provided (Records Review and Reporting or Expert Witness Related Service(s); the date(s) on which each Service was provided. the number of hours devoted by each Provider to furnishing the Service on each date; and the name of the MCAO Deputy County Attorney or another representative who requested the service described on the invoice. MCAO will, within (30) thirty business days from the date of receipt of the PCH statement or invoice, process and remit to PCH a warrant for payment. Should Maricopa County make a disallowance in the claim, in whole or in part, PCH may dispute the disallowance. If PCH has yet to receive payment, PCH will notify Maricopa County of any unpaid invoices within forty-five (45) days of the invoice being sent to facilitate a timely resolution. 4 PCH understands and agrees that Maricopa County will only honor claims for payment submitted up to six months after the service date. PCH understands and agrees that Maricopa County will only process claims for payment for Services rendered after the Agreement's termination date submitted more than (60) sixty days after such termination date with the approval of MCAO. 5 PHOENIX CHILDREN’S HOSPITAL Jared Muenzer, MD Physician-in-chief, coo PCMG Date MARICOPA COUNTY, ARIZONA Chairman, Board of Supervisors Date ATTEST: Clerk of the Board Date MARICOPA COUNTY ATTORNEY Rachel H. Mitchell Date APPROVED AS TO FORM: Deputy County Attorney Date 6 7 8 Attachment B: Services Phoenix Children’s Hospital will provide the services set forth below 1. Assess, plan, and evaluate pediatric patients/victims care as stated in the professional literature and consistent with policies and procedures, standards of care, and clinical competencies of the Team. 2. For examinations requested after normal business hours or on designated holidays, PCH shall be available to examine the child no later than twelve (12) hours from the time of notification of the need for an urgent exam, unless sooner examination is otherwise necessary or designated by the Team or by an MCAO Special Victims Division Senior Attorney. 3. For pediatric patients/alleged victims, conduct medical examination, obtain medical history, perform physical exam, and genital examination including, but not limited to photo documentation and collection of evidence as specified by the approved sexual assault kit. Following the clinical assessment, the medical provider will report findings to law enforcement in accordance with applicable law and maintain the chain of custody. 4. Conduct appropriate laboratory tests, which may include but are not limited to pregnancy tests and STD tests. 5. Team members will conduct sexual maturity rating services to determine gender and maturity levels based on evidence shall be provided only at the request of law enforcement. 6. Provide fact witness testimony in court regarding cases in which the Provider has physically examined the child. Provider will attend and participate in defense interviews and pretrial preparation. will answer questions about their findings and conclusions. MCAO will make every effort to limit the time impact of these pre-trial activities, schedule interviews and meetings at mutually convenient times and locations, and to use the provider’s time efficiently. 7. For cases of record review, the Provider will provide expert testimony upon request and will bill accordingly. The Provider will attend and participate in defense interviews and pre-trail preparation. The Provider will bill for pre-trial preparation hours and defense interviews with all record review cases. The MCAO will make every effort to limit the time impact of these pre-trial activities, schedule interviews and meetings at mutually convenient times and locations, and to use the provider’s time efficiently. 8. Providers will provide consultation regarding cases of child maltreatment in which the provider was the treating medical provider. Phoenix Children’s Hospital understands the provider(s) may be asked to participate in additional case staffing. 9. Maintain appropriate medical documentation and confidentiality. Commented [PA1]: Services are in Attachment A 9 10. Consult with other specialists as required and adjust process as indicated to ensure appropriate medical care 11. Forensic Interviews: 11.1. Forensic Interviews are to be conducted by Contractor through its qualified employees or agents who shall be mutually agreed upon by the parties prior to engaging in any forensic interview. Interviews shall be digitally audio, and video recorded. The contractor will preserve the video recording and provide a copy of the interview to the referring law enforcement agency. The preserved recordings must be retained until destruction is authorized by MCAO. 11.2. The individuals who will be the subject of the Forensic Interview will be those who are referred by law enforcement and shall include but are not limited to, minors who have witnessed or been victims of violence (including child physical abuse) or who have made allegations of sexual assault or abuse, individuals who are mentally challenged or disabled, emotionally challenged or disabled, or present with a behavioral health malady. 11.3. It is understood by the parties that the information derived from a Forensic Interview may be used to assist the examining physician with the provision of appropriate health care services for this individual and for use in any investigation or prosecution of any matter under the jurisdiction of MCAO. 11.4. In addition to conducting the Forensic Interview, Contractor will prepare and produce a report for the MCAO, which documents the Forensic Interview and provides fact witness testimony in court regarding the Forensic Interview. The Forensic Interviewer will attend and participate in defense interviews and pretrial preparation, consult with representatives of law enforcement and prosecution, and be available for consultation as necessary. MCAO will make every effort to minimize the number, frequency and duration of all defense interviews and pretrial preparatory sessions to reduce the impact on Team members’ regular work schedules. 11.5. On occasion, a Forensic Interviewer may be hired to provide expert witness testimony in cases in which the Forensic Interviewer did not see the child. 11.6. Participate in regularly scheduled activities as requested by MCAO. 11.7. The contractor understands that the forensic interviewers may be asked to participate in, upon request and reasonable notice, in multi-disciplinary and interdisciplinary team meetings (MDT’s) consisting of healthcare professionals, law enforcement agencies and attorneys. When the forensic interviewers agree to participate, the service shall be provided at no additional charge. 12. Participate in regularly scheduled activities as requested by MCAO. 13. Records Review and Reporting: 10 13.1. Subject to the availability and professional discretion of the Team members, at the request of MCAO, a Provider will review records, to include medical, law enforcement, and other relevant records of pediatric patients who were not evaluated or treated by the Team member during the relevant hospitalization. The Team member will provide a written report for MCAO based on those records. Team members may decline to conduct such reviews when doing so would interfere with the Team members’ ability to provide effective care to current patients in the Team member’s sole discretion. 13.2. MCAO will provide complete and timely records to be reviewed as described above to the Team members; such records may include records of the Phoenix Children’s Hospital facilities or other facilities that have seen the patient that were separately obtained by MCAO. Unless the Team member is a treating practitioner of the pediatric patient at the specific time of the review, MCAO will not request the Team member to access any hospital records directly and MCAO is solely responsible for obtaining providing applicable records to the reviewing Team member. 13.3. The Team member will provide expert testimony based on the report upon request. The Team member will bill for pretrial preparation hours and defense interviews as well as expert testimony. 14. The Phoenix Children’s Hospital understands that the Team member(s) may be asked to participate, upon request and reasonable notice, in larger multi- and inter-disciplinary teams consisting of healthcare professionals, law enforcement agencies, and attorneys. When Phoenix Children’s Hospital and the Team member(s) agree to participate, this Service shall be provided at no additional charge, unless otherwise agreed in writing. The Phoenix Children’s Hospital reserves the right to refuse to participate, or allow Team members to participate, in any record review or expert witness capacity, in which The Phoenix Children’s Hospital or any of its employees or medical staff members are – or may become – defendants in any legal action filed or threatened by anyone involved in the events giving rise to the involvement or investigation of law enforcement or MCAO. However, once the Team member has agreed to conduct a review, neither Phoenix Children’s Hospital nor the Team member may withdraw from the case. 11 Attachment C: Compensation and Reimbursement 4. MCAO will reimburse Phoenix Children’s Hospital at a rate of $865 for services under Attachment B, Section 3 above. This includes a one-hour pretrial interview with defense counsel, consultation with the assigned prosecutor and court testimony, including any retrials. 5. MCAO will reimburse Phoenix Children’s Hospital at a rate of $350 per interview for Forensic Interview services provided by Phoenix Children’s Hospital as described in Attachment B, Section 2 above. This includes a one-hour pretrial interview with defense counsel, consultation with the assigned prosecutor and court testimony, including any retrials. In addition to the rate of reimbursement enumerated in Attachment C, Sections 1 and 2 above, MCAO will reimburse Phoenix Children’s Hospital for: 6. The actual cost of laboratory tests, but MCAO will not be required to reimburse any costs over $350.00 per case; provided, however, that a minimum/flat fee of $300 per case shall apply to lab costs in each sexual abuse case. The parties understand that the nature and number of laboratory tests to be provided is dependent upon many variables, including the person's presentation and history or the request of the law enforcement agency; therefore, the parties agree that in those cases that are mutually agreed upon by the parties in advance, additional laboratory tests may be conducted. 7. Medical records review and consultation with prosecutors during case preparation for cases that were not originally brought to Phoenix Children’s Hospital for services described in Attachment B, Section 13 above. These services will be charged at a not-to-exceed rate of $500.00 per hour. Medical records reviews shall include providing MCAO with a written opinion upon completion and testifying in court as necessary. 7.1. At the request of MCAO for records reviewed as set forth in Attachment B, Section 13 above, the Phoenix Children’s Hospital shall provide, through the Team members, expert witness testimony in court and depositions, attend and participate in joint interviews with both prosecution and defense counsel present, participate with and assist prosecutors with pre-trial preparation, consult with representatives of law enforcement, and participate in case staffing upon reasonable notice and accommodation of the Team member’s hospital schedules 8. Sexual Maturity Rating services to determine gender and maturity levels based on evidence shall be provided only upon the request of law enforcement at a not-to-exceed amount of $300.00 per case. 9. Review of non-medical records to determine the existence of risks to the health and well-being of a child at the request of law enforcement AND with prior approval from MCAO shall not exceed $300.00 per case. 10. Expert witness in court testimony by a medical provider shall be provided upon request by MCAO at a rate of $300 per hour. This fee is only for those cases not originally brought to Commented [PA2]: Attachment B is compensation and is set forth above 12 Phoenix Children’s Hospital for services as described in Attachment B, section 7 above. Any pretrial interview requested by the defense shall be paid by the defense at a rate of $250 per hour, prorated at 15-minute increments after the initial hour. If the defense attorney is OPDS, Phoenix Children’s Hospital will bill MCAO. If the defense attorney is private, MCAO will notify the defense of the need to pay Phoenix Children’s Hospital in advance for the cost of the interview based on the length of the interview the defense is requesting. 11. Expert witness in-court testimony by Forensic Interviewer shall be provided upon request by MCAO at a rate of $300.00 per hour. This fee is only for those cases not originally brought to Phoenix Children’s Hospital for services under Attachment B, section 11 above. Any pretrial interview requested by the defense shall be paid by the defense at a rate of $200 per hour, prorated in 15-minute increments after the initial hour. If the defense attorney is OPDS, Phoenix Children’s Hospital will bill MCAO. If the defense attorney is private, MCAO will notify the defense of the need to pay Phoenix Children’s Hospital in advance for the cost of the interview based on the length of the interview the defense is requesting. 12. Phoenix Children’s Hospital assumes sole and exclusive responsibility for payment of any federal and state income taxes, federal social security taxes and other mandatory governmental deductions or obligations, including worker's compensation for any and all of its employees, and agrees to hold County and MCAO harmless for any and all liability which the County of MCAO may incur because of Phoenix Children’s Hospital's failure to pay such taxes or obligations. Method of Payment; Invoice and Timeliness Requirements The Phoenix Children’s Hospital will submit a statement or invoice for services performed the previous month by the 15th of each month. The invoice shall include, at a minimum, the following information regarding each case for which payment is claimed for the Records Review and Reporting or Expert Witness Related Services: the name of the Provider(s); the type of Service provided (Records Review and Reporting, or Expert Witness Related Services); the date(s) on which each Service was provided. the number of hours devoted by each Provider to furnishing the Service on each date; and the name of the MCAO deputy county attorney or other representative who requested the Service described on the invoice. MCAO will, within (30) thirty business days from the date of receipt of the Phoenix Children’s Hospital statement or invoice, process and remit to the Phoenix Children’s Hospital a warrant for payment. Should Maricopa County make a disallowance in the claim, in whole or in part, the Phoenix Children’s Hospital may dispute the disallowance. In the event PCH has not received payment, PCH will notify Maricopa County of any unpaid invoices within forty-five (45) days of invoice being sent to facilitate a timely resolution. 13 The Phoenix Children’s Hospital understands and agrees that Maricopa County will not honor any claim for payment submitted more than six months after the date of service. The Phoenix Children’s Hospital understands and agrees that Maricopa County will not process any claim for payment for Services rendered prior to the termination date of this Agreement submitted more than (60) sixty days after such termination date without the approval of MCAO.