FTF HKP MOU.PDF

Maricopa County — Formal (2020-03-11)

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MEMORANDUM OF UNDERSTANDING 
Between 
MARICOPA COUNTY 
By and through the 
DEPARTMENT OF PUBLIC HEALTH 
4041 N. Central Avenue, #1400, Phoenix, Arizona 85012 
And 
Happy Kids Pediatrics 
1345 E. Main St., Ste. #201, Mesa, AZ 85203 
Background  
Poor oral health can have a detrimental impact on children's quality of life, their performance at 
school, and their success in life. In fact, more than 51 million school hours are lost each year to 
dental-related illness. 
The Maricopa County Department of Public Health-Office of Oral Health (MCDPH-00H) 
requests that Happy Kids Pediatrics (HKP) join MCDPH-00H in partnership to prevent tooth 
decay and improve the health of their clients. 
This partnership will bring the First Teeth First Program to Happy Kids Pediatrics (various 
locations) Exhibit "A", and will provide dental screenings and fluoride varnish applications to 
children 0-5 years and dental screenings for expectant mothers at no cost to participants. 
The First Teeth First Program has been in existence since 2011 and is funded by First Things First. 
During the 2018-2019 grant period more than 16,000 children were screened throughout Maricopa 
County and over 2,000 expectant mothers received dental screenings. 
Dental screenings and fluoride varnish applications are non-invasive and pain free. Fluoride 
varnish applications are evidence based and have proven safe and effective in the reduction of 
tooth decay. We also know that preventive oral health care is linked to improvements in overall 
health and well-being. With an integrated Medical-Dental delivery system we can expand access 
to care as well as improve patient outcomes. 
This MEMORANDUM OF UNDERSTANDING (MOU) is hereby made and entered into by and between 
the Maricopa County Department of Public Health, hereinafter referred to as MCDPH and the Happy Kids 
Pediatrics, hereinafter referred to as HKP. 
A. 	
PURPOSE 
The purpose of this MOU is to develop a framework of cooperation and partnership between MCDPH, and 
HKP to provide The First Teeth First Program to eligible clients for the prevention of tooth decay. 
B. 	
STATEMENT OF MUTUAL BENEFIT AND INTERESTS

The mutual benefit for both parties is the prevention of tooth decay for clients and referral and navigation 
services to a dental home. 
C. 	
MCDPH SHALL 
• 
Provide registered dental hygienists and bilingual site assistants to conduct basic dental screenings 
to children birth through age 5 and fluoride varnish applications. 
• 
Provide basic dental screenings to expectant mothers. 
• 
Check State Board of Dental Examiners licensing records on licensed MCDPH dental providers; 
conduct background checks of all dental providers. 
• 
Require all staff to have a current fingerprint clearance card on file with the program. 
• 
Provide adequate staffing for shifts assigned to health centers. 
• 
Communicate with clinic manager when services will not be provided at clinic. 
• 
Bring all necessary dental supplies needed to conduct the dental screening activities while on site. 
• 
Provide referral and navigation services to clients in need of a dental home. 
• 
Provide oral health education materials to staff and clients. 
• 
Provide summary reports for each clinic, which will include number of children screened, 
varnished, expectant mothers screened, and clients with urgent dental needs. These reports will be 
provided on a quarterly basis. 
• 
Maintain all client information according to confidentiality requirements. 
• 
Submit fluoride varnish application claims for children two through five years of age on Ai 1CCCS 
that receive fluoride varnish applications by First Teeth First staff. 
D. 	
HAPPY KIDS PEDIATRICS SHALL 
• 
Promote participation in the dental screenings to clients of the clinic. 
• 
Provide adequate physical space at each clinic for dental screenings to be delivered to clients of 
HKP. The space at each clinic will include at a minimum: 
1. Space for FIT staff to complete paperwork and data entry. 
2. Provide storage for dental supplies to be stored on site. 
3. Accessible electrical outlet. 
• 
Communicate with FTF staff when an HKP patient is eligible and interested in FTF services. 
• 
HKP shall encourage patients that are having a well child visit to see FTF for their EPSDT oral 
health screening. 
• 
Communicate if child is there for a well child visit. 
• 
Provide Wi-Fi access to FTF staff for data entry purposes. 
E. IT IS MUTUALLY UNDERSTOOD AND AGREED BY AND BETWEEN THE PARTIES 
THAT: 
1. 	
This instrument is neither a fiscal nor a funds obligation document. Any endeavor or 
transfer of anything of value involving reimbursement or contribution of funds between 
the parties to this instrument will be handled in accordance with applicable laws, 
regulations, and procedures including those for Government procurement and printing. 
Such endeavors will be outlined in separate agreements that shall be made in writing by 
representatives of the parties and shall be independently authorized by appropriate 
statutory authority. This instrument does not provide such authority. Specifically, this 
instrument does not establish authority for noncompetitive award to the cooperator of any 
contract or other agreement. 
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2. 
EFFECTIVE DATE 
This agreement will begin retro-actively as of 08:00 A.M. on March 1, 2020. 
3. 
EXPIRATION DATE 
This agreement will end as of 1 1:59 P.M. on March 1, 2021 but may be 
renewable for an additional one year by mutual consent. 
4. 
MODIFICATION OR AMENDMENT 
Modifications within the scope of the instrument shall be made by mutual consent of the 
parties, by the issuance of a written modification or amendment, signed and dated by all 
parties, prior to any changes being enacted. 
5. 
TERMINATION 
Any of the parties, in writing, may terminate the instrument in whole, or in part, at any 
time before the date of expiration. 
6. 
CLIENT CONFIDENTIALITY 
Both parties understand and concur that this agreement is subject to all State and Federal 
laws protecting client confidentiality. Client/patient confidentiality will be maintained 
equally for all individuals presenting for services whether being provided by HKP or 
MCDPH. The use or disclosure by either party of any information concerning an eligible 
individual served under this agreement is directly limited to the fulfillment of this 
agreement. 
7. 
LAWS, RULES AND REGULATIONS 
Both parties understand and concur that this agreement is subject to all State and Federal 
laws, rules and regulations that pertain hereto. 
8. 
PARTICIPATION IN SIMILAR ACTIVITIES 
This agreement in no way restricts MCDPH or HKP from participating in similar 
activities with other public or private agencies, organizations, and individuals. 
9. 
NON-LIABILITY 
Neither MCDPH, HKP, nor their respective officers and employees shall be liable for 
any act or omission by the other party or other party's subcontractor, employee, officer, 
agent, or representative occurring in the fulfillment of this agreement. 
10. 
INDEMNITY 
MCDPH agrees to indemnify, hold harmless, and defend HKP, its officers and 
employees from and against any and all claims, damages, suits and proceedings, 
regardless of the merits, from liability, punitive damages, costs or expense of every type, 
all or any part thereof arising out of or in connection with or by reason of any negligent 
act or omission of MCDPH or any subcontractors or anyone directly or indirectly 
employed by either MCDPH or any subcontractors in the performance of this MOU. 
MCDPH and its subcontractors shall reimburse I-1KP for its costs, including attorney's 
fees for defense of any litigation arising from such claim. MCDPH shall include a clause 
to this effect in all subcontracts inuring to the benefit of HKP. 
Similarly, HKP agrees to indemnify, hold harmless, and defend MCDPH, its officers and 
employees from and against any and all claims, damages, suits and proceedings, regardless 
of the merits, from liability, punitive damages, costs or expense of every type, all or any 
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part thereof arising out of or in connection with or by reason of any negligent act or 
omission of FIKP or any subcontractors or anyone directly or indirectly employed by either 
HKP or any subcontractors in the performance of this MOU. HKP and its subcontractors 
shall reimburse MCDPH for its costs, including attorney's fees for defense of any litigation 
arising from such claim. HKP shall include a clause to this effect in all subcontracts inuring 
to the benefit of MCDPH and Maricopa County. 
11. 
COMMUNICATION 
Each party agrees to notify the other, in writing, of changes in policy which may affect 
this agreement. Notification is to be made to the attention of the principal contacts 
identified in Section 12 below. 
12. 
PRINCIPAL CONTACTS 
The principal contacts for this agreement are: 
Maricopa County, Department of Public Health 
Berenise Bauer 
First Teeth First Program Coordinator 
Phone: 602-372-4650 
E-mail: Berenise.Bauer maricopa.gov  
Grant/Contract Administrator 
Phone: 602-372-0675 
FAX: 602-506-6885 
Happy Kids Pediatrics 
Roman Carrasco 
Chief Executive Officer 
Phone: 480-659-9696 
romanvcarrasco@gmail.com 
IN WITNESS WHEREOF, the parties agree to the changes indicated herein: 
FOR AND ON BEHALF OF 	
FOR AND ON BEHALF OF 
MARICOPA COUNTY 	
HAPPY KIDS PEDIATRICS 
By 
	 By 	
 
Clint Hickman, Chairman, Board of Supervisors Chief Executive Officer 
Date 
ATTEST: 
Clerk of the Board 
Date 
APPROVED AS TO FORM 
Date 
APPROVED AS TO FORM 
Attorney for Maricopa County 
Date:  
	
Date: 	
 
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EXHIBIT A 
Happy Kids Pediatrics 
1345 E. Main St., Ste. #201 
Mesa, AZ 85203 
CLINIC LOCATION 	
ADDRESS 	
TIME (Weekly Basis) 
GLENDALE — CAMELBACK 	
6710 W Camelback Rd #A 	
TBD 
Glendale, AZ 85303 
GLENDALE 	
3415 W. Glendale Ave. #A-32 	 TBD 
Phoenix, AZ. 85303 
PHOENIX — THOMAS 	
1311 E Thomas Road 	
Mondays & Wednesday 
Phoenix, AZ 85014 	
8 a.m. — 3:30 p.m. 
PHOENIX — SOUTHERN 	 825W. Southern Ave #106 	
TBD 
Phoenix, AZ. 85041 
x 	
x 
Maricopa County 	
Date 	 Contractor 	
Date 
Department Manager or Designee 	
Director or Designee 
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