IGA BETWEEN MCCHS AND ADCRR 1021.PDF

ADCRR Tracking No. 21-128-31

INTERGOVERNMENTAL AGREEMENT
Between
MARICOPA COUNTY CORRECTIONAL HEALTH SERVICES
AND
ARIZONA DEPARTMENT OF CORRECTIONS REHABILITATION & REENTRY

This Intergovernmental Agreement (“Agreement”) provides a binding Agreement
between Maricopa County (the “County”) by and through its Department of
Correctional Health Services (“CHS”) and the State of Arizona by and through its
Arizona Department of Corrections Rehabilitation & Reentry (“ADCRR”)
(collectively, the “Parties”).

J. STATUTORY AUTHORIZATION:

The Parties are authorized to enter into this Agreement pursuant to A.R.S. § 11-952. Per
ARS. § 31-132, the County has the following obligation: “Prior to or at the same time
a prisoner is transferred from a county jail facility to a state department of corrections
facility by a county, a copy of the prisoner’s county jail medical record file, including
the prisoner’s mental health file, or a standardized medical record summary shall be
transferred.”

2. PURPOSE:

CHS maintains an electronic health records software system, specifically a licensed
TechCare™ system, that contains electronically stored medical information about
patients, including protected health information (PHI) as defined below. The purpose of
this Agreement is to set forth the terms and conditions under which ADCRR and its
authorized users will be allowed to access the CHS TechCare™ system in order to
access patient information needed to provide and/or coordinate treatment and/or
healthcare services to patients, as well as to facilitate the County’s compliance with its
duties set forth under A.R.S. § 31-132. The additional purpose of this Agreement is to
agree that ADCRR’s access to the TechCare™ system maintained by CHS shall serve as
the method of delivery of the medical records of prisoners who are being transferred
from the County’s jail facilities to ADCRR’s correctional facilities, delivery of which is
required by A.R.S. § 31-132,

2. DEFINITIONS:
As used in this Agreement, the following terms shafl have the meanings set forth below:

A. Authorized Use means the use and exchange of electronic health records in
TechCare for treatment, payment, and/or healthcare operations where permitted
under federal and state law, including, but not limited to, A.R.S. § 31-132,
HIPAA and 42 CFR Part 2. Circumstances for Authorized Use include the
following: (i) the subject patient has signed an authorization for the release of his
or her protected health information and/or protected substance abuse treatment
information on a form that meets the requirements of HIPAA and/or 42 CFR Part
2, as applicable; (ii) a court order directs release of the patient’s records to the

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ADCRR Tracking No. 21-128-31

recipient; or (iii) an exception under federal and/or state law applies, such as for
the purpose of treatment as defined under HIPAA.

. Authorized Users refers to ADCRR and its respective employees and contracted

healthcare providers, or other specifically authorized persons identified by the
parties, who are authorized to use the TechCare system to access patient
electronic health records for Authorized Use.

Criminal Justice Information refers to any confidential information collected by
criminal justice agencies on individuals consisting of identifiable descriptions and
notations of arrests, detentions, indictments, information, or other formal criminal
charges, and any disposition arising therefrom, as well as confidential pre-
booking or booking personal identifiable information, including date of birth,
social security number, age, demographic information, projected release dates and
release date information as defined in 5.U.S.C. § 552 and 5 U.S.C. § 552a.

42 CER Part 2 refers to the laws governing confidentiality for people seeking
treatment for substance use disorders from federally assisted programs.

HIPAA refers collectively to the Health Insurance Portability and Accountability
Act of 1996, codified at 42 U.S.C. § 1320d et seq., and the Health Information
Technology for Economic and Clinical Health Act, enacted as Title XIII of the
American Recovery and Reinvestment Act of 2009, codified at 42 U.S.C. § 17921
et seq., and any current and future regulations promulgated thereunder, including
but not limited to 45 C.F.R. Parts 160 and 164.

Protected Health Information (PHI) shall have the same meaning as defined
under HIPAA and includes any information about health status, provision of
health care or any individually identifiable information including Social Security
Number, Age, Sex, Date of Birth, Patient Identification Number, Medical Record
Documentation either paper or electronic, diagnosis, procedural information and
any other information directly linked and identifiable to a specific individual
under the care, safety and medical supervision of CHS.

TechCare™ (TechCare) refers to the electronic health records software system
licensed by the County and maintained by CHS.

. SCOPE:

Transmission of A.R.S. § 31-132 Medical Summaries: To communicate timely
data necessary for coordination of care and to comply with the requirements of
A.R.S. § 31-132 and all applicable administrative orders, state laws and
regulations, the Parties agree that TechCare shall serve as the means for ADCRR
to acquire copies of prisoners’ county jail medical record files, including prisoner
mental health files, and any standardized prisoner medical record summaries
(together, “Prisoner Medical Files”). CHS shall ensure that Prisoner Medical
Files meeting the requirements set forth in A.R.S. § 31-132 are available in

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TechCare to ADCRR and its designated Authorized Users (the “ADCRR
Authorized Users”) (further addressed below) concerning prisoners who are
subject to transfer, prior to or at the same time a prisoner is transferred from a
County jail facility to an ADCRR correctional facility.

Provided that Prisoner Medical Files ate available for ADCRR and its ADCRR
Authorized Users to access in TechCare, and unless requested, CHS shall not be
responsible for transferring or otherwise transmitting such records to ADCRR,
whether via facsimile, hand delivery, email, or other method. ADCRR
acknowledges and agrees that CHS shall have no responsibility for monitoring or
confirming that ADCRR Authorized Users have acquired the Prisoner Medical
Files.

B. Access and Security:

1. Access. ADCRR’s Authorized Users (the “ADCRR Authorized Users”)
may access electronic health records in TechCare, when Authorized Use is
permitted, Access shall be limited to “read only” files that cannot be
modified or altered. Account request forms for login credentials must be
obtained and returned to the CHS BIT Team (contact information below).

2. ADCRR as Super User. ADCRR, as an authorizing agent and super
user, shall be responsible for assigning a limited number of authorized
users to act as ADCRR’s agents by using assigned login credentials to
access TechCare. ADCRR shall be the managing supervisor of the
ADCRR Authorized Users and shail be responsible for the implementation
of and adherence to appropriate user [D/password security procedures.
ADCRR warrants that the ADCRR Authorized Users shall be authorized
only to the extent necessary to perform their functions on behalf of
ADCRR; each of the ADCRR Authorized Users shall be held to the same
standard of confidentiality applicable to ADCRR; and ADCRR shall be
responsible for the use and access of TechCare by any such ADCRR
Authorized User. ADCRR shall ensure controlled access for each such
ADCRR Authorized User and to promptly terminate access should an
ADCRR Authorized User no longer be authorized to have access to
TechCare.

3. Individual User Access Agreements, ADCRR acknowledges that before
each of its ADCRR Authorized Users may have access to TechCare,
Authorized Users shall be required to read and agree to the terms of
CHS’s individual User Access Agreement, attached as Exhibit A.
ADCRR agrees to work cooperatively to fulfill this requirement and return
copies of the executed agreements to the CHS BIT Team.

4. User IDs and Passwords. ADCRR will assure that when any individual
ADCRR Authorized User, employee, agent, or vendor, who may have had
access to TechCare, is terminated, the user ID and access code (password)
used by the individual for TechCare is deactivated by submitting an

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account termination request to the CHS BIT Team. ADCRR and ADCRR
Authorized Users shall not divulge or share account user IDs and/or
passwords. Any account information that has been compromised shall be
changed immediately by notifying the CHS BIT Team. CHS may require
ADCRR and/or ADCRR’s designated agent to periodically provide
written confirmation that the ADCRR Authorized Users on file are current
providers for ADCRR and in need of access to TechCare for the purposes
of continuity of care of prisoners.

C. TechCare Maintenance and Technical Issues: CHS shall, through normal
procedures, manage TechCare user provisioning. CHS shall supply TechCare
application changes to ADCRR as needed. ADCRR shall not be responsible to
pay TechCare maintenance fees or modification fees; provided however, any
maintenance fees or modification fees specifically associated with ADCRR’s
and/or ADCRR Authorized User’s access to TechCare shall be the responsibility
of ADCRR. Any technical issues with TechCare should be immediately reported
to the CHS BIT Team.

D. Confidentiality of Medical Records: ADCRR understands that information
available through TechCare is confidential, electronic PHI. ADCRR agrees to
preserve, and to cause its ADCRR Authorized Users to preserve, such information
as confidential in accordance with HIPAA and applicable state law. ADCRR will
immediately notify, and cause its ADCRR Authorized Users to immediately
notify, the CHS BIT Team if any TechCare portal security measures or PHI have
been compromised in any way, if there are any system errors, inaccuracies, faults,
or if TechCare is being used for unauthorized use or disclosure of PHI. ADCRR
agrees not to use or disclose any PHI received from CHS and/or the TechCare
system in any manner that would constitute a violation of this Agreement or
federal or state law. ADCRR shall take reasonable measures to ensure that its
directors, officers, employees, vendors, contractors, and agents use or disclose
PHI received from CHS and/or the TechCare system in accordance with the
provisions of this Agreement and federal and state law. ADCRR further agrees to
implement all appropriate safeguards and training reasonably necessary to
maintain the confidentiality of the information accessed from CHS and/or through
the TechCare system.

E. Confidentiality of Criminal Justice Information: ADCRR acknowledges that
it and its ADCRR Authorized Users might be given access by CHS via TechCare
to Criminal Justice Information for the sole purpose of safely and securely
providing and/or coordinating treatment and/or healthcare services to patients
who are or have been incarcerated in the County jails. ADCRR agrees that it will
treat, and will cause its ADCRR Authorized Users to treat, all Criminal Justice
Information as confidential as required by state and federal laws at all times and
take reasonable measures to maintain the security and confidentiality of such
information. ADCRR further agrees to instruct its directors, officers, employees,
vendors, contractors, and agents concerning the confidential nature of Criminal
Justice Information and the applicable prohibitions against its use and disclosure.

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ADCRR Tracking No. 21-128-31

Duty to Report Misuse. If ADCRR or any ADCRR Authorized Users become
aware of or suspect fraudulent activity or any other activity that may threaten the
security of the TechCare system or CHS inmate protected health information,
ADCRR and/or ADCRR Authorized Users must report such activity to the CHS
BIT Team immediately. ADCRR and/or ADCRR Authorized Users shall notify
the CHS BIT Team within no less than twenty-four (24) hours of becoming aware
of an unauthorized access of TechCare or unauthorized use or disclosure of PHI
accessed via TechCare, whether by a member of its organization or by a third
party. All notices to the CHS BIT Team shall be made to the following:

CHS BIT Team

234 N Central Avenue, Suite 5350
Phoenix, AZ 85004

Phone: (602) 359-5083

Email: CHSBIT@Maricopa.gov

No Warranty: CHS does not warrant the TechCare system or the data
maintained in TechCare. The TechCare portal and its content is provided on an
“gs is” basis, and CHS makes no representation that any data sent to or from, or
residing at, the TechCare system are safe from destruction, corruption,
misdirection, or service interruption. ADCRR acknowledges and agrees that use
of the TechCare system is at ADCRR’s own risk.

. Compliance Auditing: ADCRR and CHS shall each monitor their own

respective compliance with, and performance under, the terms and conditions of
this Agreement. Notwithstanding the foregoing, CHS reserves the right to audit
account activity by ADCRR Authorized Users at any time, with or without notice,
to ensure compliance with the terms of this Agreement, the terms of the individual
User Access Agreement, and to assess the proper access and utilization of the
TechCare system.

. SPECIAL TERMS AND CONDITIONS:

TERM: The term of this Agreement shall be five (5) years from the date this
Agreement is executed by the Parties hereto. This Agreement may be renewed
for one additional five (5) year term unless terminated by either party
providing written notice to the other party of its intent to terminate. Notice of
termination by one party shal] be given to the other party not Jess than sixty
(60) days prior to the expiration of the term of this Agreement.

TERMINATION: This Agreement may be terminated by either party with or
without cause, upon thirty (30) days written notice to the other party; provided,
however, that CHS may terminate this Agreement, in whole or in part,
immediately upon providing either written or verbal notice when CHS deems
ADCRR is in breach of this Agreement or the health or welfare of a patient is
endangered. Either party may terminate this agreement immediately upon

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providing written or verbal notice when it deems that performance would be in
violation of the law or order of a court of law.

AMENDMENTS: Any changes or amendments to this Agreement shall be
effective only if made in writing and signed by both parties. All such changes
or amendments shall be handled by formal amendment and approved by
Maricopa County and ADCRR.

RETENTION OF RECORDS: Pursuant to A.R.S. §§35-214 and 215,
ADCRR and CHS agree to maintain records and other relevant documents to
this Agreement for six (6) years following the termination of the Agreement,
or longer if required by applicable records retentions schedules; provided
however, if any audit questions are unresolved at the end of that period, all
records and documents relating to such audit questions shall be maintained
until those audit questions are resolved. Upon request of either party to this
Agreement, a legible copy of all such records shall be produced at the
administrative office of the requesting party, or at the office of the State
Auditor General. The original of all such records shall also be available and
produced for inspection and audit when requested by either party or the
Auditor General to verify authenticity of copy.

MUTUAL RESPONSIBILITIES: ADCRR and CHS shall cooperate
hereunder in a professional manner that conforms to all local, state and federal
codes, rules and within the standard of practice for the scope of each of the
parties’ responsibilities. ADCRR and CHS shall comply with all federal, state
and local laws, ordinances, rules and regulations applicable to each party’s
performance under this Agreement. There are no financial responsibilities
assigned by the Agreement; the Agreement is simply intended to allow
ADCRR and CHS to work together to better address continuity of care upon
the transfer of jail inmates/patients to ADCRR custody. This Agreement does
not relieve ADCRR or CHS of any obligation or responsibility imposed on
either of them by law.

NON-DISCRIMINATION: The Parties shall comply with Executive Order
75-5 as modified by Executive Order 2009-09, and all other applicable state
and federal employment Jaws and regulations, including the Americans with
Disabilities Act. The Parties agree to provide equal employment opportunities
for all persons, regardless of race, gender, religion, color, national origin, age,
disability, sexual orientation, gender identity (including transgender status),
pregnancy, veteran status, political affiliation, and genetic information.

E-VERIFY. The Parties warrant compliance with all Federal immigration
laws and regulations relating to employees and compliance with A.R.S. § 41-
4401 and A.R.S. § 23-214(A).

GOVERNING LAWS: This Agreement shall be governed by the laws of the
State of Arizona.

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4.10

4.11

4.12

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ADCRR Tracking No. 21-128-31

INDEMNIFICATION:

Each party (as “Indemnitor”) agrees to defend, indemnify, 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 bodily injury of any person
(including death) or property damage, but only to the extent that such Claims
which result in vicarious/derivative liability to the Indemnitee are caused by
the act, omission, negligence, misconduct, or other fault of the Indemnitor, its
officers, officials, agents, employees, or volunteers. The State of Arizona,
(State Agency) is self-insured per A.R.S. § 41-621. The County is self
insured.

CONFLICTS OF INTEREST: To the extent applicable, this Agreement is
subject to the provisions of A.R.S. § 38-511 relating to conflicts of interest.

ARBITRATION: To the extent applicable, the parties, in accordance with
ARS. § 12-1518, agree to resolve all disputes arising out of or relating to this
Agreement through arbitration, after exhausting applicable administrative
review except as may be required by other applicable statutes.

PUBLIC RECORDS: Notwithstanding any other provision of this Agreement
to the contrary, the parties acknowledge that they are each subject to A.R.S. §
39-121 through § 39-128 regarding public records. Any provision regarding
confidentiality is limited to the extent necessary to comply with the provisions
of Arizona law.

FUNDING: This Agreement is not an obligation of or a commitment of
funds, or a basis for a transfer of funds, but rather a statement of
understanding between the Parties concerning the sharing and use of
information related to the purposes of this Agreement. Expenditures by each
party are subject to that party’s budgetary processes and to the availability of
funds and resources pursuant to applicable laws, regulations, and policies of
the respective parties.

RELATIONSHIP OF PARTIES: No parties to this Agreement shall be
deemed to be the employee or agent of another party to this Agreement.

ASSIGNMENT AND DELEGATION:

4.15.1 Neither party may assign this Agreement without the express, written,
prior consent of both parties, which shall not be unreasonably withheld
or delayed. Such written consent, if given, shall not in any manner
relieve the assignor ftom liability for the performance of this
Agreement by its assignees.

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4.15.2 This Agreement does not imply authority to perform any tasks or
accept responsibility.

5. SECTIONS AND OTHER HEADINGS CONTAINED IN THIS AGREEMENT
ARE FOR REFERENCE PURPOSES ONLY AND SHALL NOT AFFECT IN
ANY WAY THE MEANINING OR INTERPRETATION OF THIS
AGREEMENT:

5.1

5.2

5.3

This Agreement may be executed in two or more counterparts, each of which
shall be deemed an original but all of which together shall constitute the same
instrument. Copied, scanned, and digital signatures are acceptable as original
signatures.

ENTIRE AGREEMENT: This Agreement, together with the Attachment
hereto, contains the entire understanding of the parties hereto, and it supersedes
all proposals, oral or written, and all other documents or communications
between the parties relative to the subject matter herein covered, unless such
documents or communications are specifically included by reference.

NOTICES: With the exception of notices provided to the CHS BIT Team per
section 3 of this Agreement, all notices under this Agreement given by either
party to the other shall be in writing and shall be delivered in person, email, or
sent by U.S. Postal Service, postage prepaid and addressed to the following
individuals:

CBS

Attn: Tania Lynch

Title: CHS Department Director

Address: 234 N. Central Avenue, Suite 5000
City, State Zip: Phoenix, AZ 85004

Phone: (602) 372-4632

Email: tania.lynch@maricopa.gov
ADCRR

Attn: Denel Pickering

Title: Chief Procurement Officer
Address: 1645 West Jefferson Street
City, State Zip: Phoenix, Arizona 85007
Phone: 602-542-1172

Email: dpickering@azadc.gov

* Signature Page to Follow *

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ACKNOWLEDGMENT: By signing below, ADCRR and CHS each acknowledge their
own respeotive role and responsibilities pursuant to this Agreement,

dates written below,

WITNESS WHEREOF, the parties have executed this Agreement as of the respective

ARIZONA DEPARTMENT OF
CORRECTIONS REHABILITATION
AND REENTRY

By: SA
Name:
Title:

AN
Date, Ss

By: Nw
Naine:

Title: —~
Date; . LZ
By:

Name: Denel Pickerfig

Title: “Gaal. ) Officer
Date: FL . a)

APPROVED AS TO FORM:

By:

Title: General Counsel, ADCRR
Date:

MARICOPA COUNTY

By;
Name: _

Title: Chaitman, Board of Supervisors
Date:

By:
Name:

Title: Clerk of the Board

Date: L

By: ox,
Name; TAwW 2) I)
Title: Digectot of CHS

Date:__/0 Y Lad

APPROVED AS TO FORM:

By: Stun ZX Lovase

“thon TT, Kao
Title: Deputy County Attorney

Date: /0 7 2 /

OFFICE OF THE ARIZONA ATTORNEY GENERAL

STATE GOVERNMENT DIVISION
AGENCY COUNSEL SECTION

MarK BRNOVICH ,
ATTORNEY GENERAL

INTERGOVERNMENTAL AGREEMENT DETERMINATION

Attorney General Contract No,_KR-2021-0038 which is an Agreement
between public agencies, has beén reviewed pursuant to ARS. § 11-952 by the undersigned
Assistant Attorney General, who has determined that it is in the proper form and is within the
powers granted under the laws of the State of Arizona to those Parties to the Agreement
represented by the Attorney General.

Dated thig 2!” day of Sephembet sort,

MARK BRNOVICH
ATTORNEY GENERAL

Seal

Assistant Attomey General

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