THIRD AMENDMENT_MCAO_PHOENIX CHILDREN'S HOSPITAL CONTRACT (REV. 10-29-21).DOCX

Maricopa County — Formal (2021-12-08)

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THIRD AMENDMENT 
TO
AGREEMENT BETWEEN
MARICOPA COUNTY (MARICOPA COUNTY ATTORNEY’S OFFICE)
AND
PHOENIX CHILDREN’S HOSPITAL, INC.
This Third Amendment to the Agreement between Maricopa County (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 April 12, 2017 (the 
“Agreement”); and
WHEREAS, the Agreement was amended through a First Amendment effective November 20, 2019;
WHEREAS, the Agreement was amended through a Second Amendment effective April 08, 2020;
 
WHEREAS, pursuant to Section 5.6 – Term of Agreement, the Agreement is scheduled to terminate on 
the expiration of its three-year term on April 12, 2021; and 
WHEREAS, the parties mutually agreed to extend the Agreement while conducting negotiations for an 
additional term and for other changes as identified in this Third Amendment, and;
WHEREAS, as permitted by the Agreement, the Parties are exercising their option under the Agreement, 
Section 5.7 – Option to Extend, to mutually extend the term of the Agreement while the Parties review 
the terms of the Agreement for future amendment.   
NOW, THEREFORE, the Parties hereto amend the Agreement according to the terms and conditions 
set forth below:
1. Amend Section 1.1- Healthcare Providers and Services
1.1
For purposes of this Agreement, PCH will provide healthcare providers, including 
one or more of the following: physicians, pediatric nurse practitioners, Sexual 
Assault Nurse Examiners (SANE’s) support staff and forensic interviewers 
(collectively referred to as the “Team”, the individual members of the Team are 
sometimes referred to as Providers and listed in Attachment A to this Agreement), 
who will provide the services as set forth in Attachment B (the “Services”) at the 
Advocacy Centers (as listed in Attachment A). PCH's provision of the services at 
any Advocacy Centers listed in Attachment A other than Childhelp Center of 
Arizona is contingent on staff availability.

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2. Amend Section 5.6 – Extend Term of Agreement:
5.6 
The term of this Agreement is effective upon approval by the Maricopa County 
Board of Supervisors through June 30, 2022.
3. Amend Section 2.4 – OTHER REQUIREMENTS:
2.4
Update the list of Team members/providers (with their respective designation, 
address, phone and fax numbers, and email addresses) in Attachment A at intervals 
that are conducive to capture changes and ensure both parties are in receipt of a 
comprehensive that allows for operations to run smoothly. 
4. Amend Section 5.5.3 -- to read as follows:
5.5.3
All records and/or reports prepared by PCH documenting services performed under 
this Agreement shall only be provided to MCAO or the investigating law 
enforcement agency (including, without limitation, the Arizona Department of 
Child Safety) unless release is approved in advance by MCAO or release is 
otherwise required by law.  
5. Attachment A – List of Advocacy Centers and Providers Amend Attachment A with 
revised Attachment A, which is attached to this Third Amendment.
Attachment A: see attached.
6. Attachment B – Services: Amend sections 2 and 11 to read as set forth below. All other 
sections of Attachment B remain unchanged. A revised Attachment B is attached to this 
Third Amendment. 
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.
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.

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C:  Compensation and Reimbursement: Amend section 1, 2, 7, and 8 to read as set 
forth below. All other sections of Attachment C remain unchanged. A revised Attachment 
C is attached to this Third Amendment.
1. MCAO will reimburse Phoenix Children’s Hospital at a rate of $865 per case 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
2. 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 11 above.  This includes a one-hour pretrial interview with 
defense counsel, consultation with the assigned prosecutor and court testimony, 
including any retrials.
7. 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 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.
8. 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.

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PHOENIX CHILDREN’S HOSPITAL, INC.
BY: ________________________________
____________________
      Authorized Representative
Date
MARICOPA COUNTY, ARIZONA (for itself and MCAO)                     
BY:                               
                                        
      Chairman, Board of Supervisors
Date
ATTESTED BY:
                                  
                                       
Clerk of the Board
Date 
APPROVED AS TO FORM:
BY: ________________________________
____________________
      Counsel for Board of Supervisors
Date

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ATTACHMENT A: 
List of Advocacy Centers and Providers (as of the date of execution of the Third Amendment)
Advocacy Centers:
Mesa Family Advocacy Center                                                                                                                                
225 E. 1st Street Suite                                                                                                                                            
Mesa, AZ 85201
Childhelp Center of Arizona                                                                                                                                  
2120 N. Central Ave Suite 130                                                                                                                        
Phoenix, AZ 85004
Southwest Family Advocacy Center                                                                                                                      
2333 N. Pebble Creek Pkwy, Suite A-200                                                                                                     
Goodyear, AZ 85395
Scottsdale Family Advocacy Center
10225 E. Via Linda
Scottsdale, AZ 85258
Chandler Family Advocacy Center
229 E. Boston
Chandler, AZ 85225
Glendale Family Advocacy Center
6830 N. 57th Drive
Glendale, AZ 85225

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Providers/Team members        
1.
Kathryn Coffman, MD
2.
Lisa Kirsch, MD
3.
Haley Dietzman, FNP
4.
Julie Baumgarth, RN, PNP
5.
Kim Yeakel, PNP
6.
Kim Dent, PNP
7. 
Cindy Nelson, PNP
7.
Veronica Anguiano, MA
8.
Linnea Kettering, MA
9.
Stephanie Aceves, MA
10.
Kimberly Bohannon, MA
11.
Kara Mitchell, SANE RN
12.
Sydney Silversmith, SANE RN
13.
Jessica McCormick, SANE RN
14.
Wendy Dutton, MA, PhD, LPC, Forensic Interviewer
15.
Amy B. Heil, Ed.S, Forensic Interviewer
16.
Diane Munoz
17.
Prabodh Hemmady, MD
18.
Narry Savage, MD (begins 8/21)

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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.

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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:

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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.

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Attachment C:  Compensation and Reimbursement 
1. 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.
2. 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: 
3. 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.
4. 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.
4.1. 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
 
5. 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.
6. 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. 
7. 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

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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.
8. 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.
9. 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.

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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.