MCDPH-PUEBLO ACCESS AGREEMENT 20231220 PFP SIGNED.PDF

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ACCESS AGREEMENT 
 
This ACCESS AGREEMENT (“Agreement”) is made and entered into as of the last date of 
signature (the “Effective Date”) by and between Pueblo Family Physicians, LTD., an Arizona professional 
corporation (“Pueblo”) and Maricopa County Department of Public Health ( “U s e r ”)  (individually, 
the “party” and collectively, the “parties”).  
 
I. 
RECITALS 
 
WHEREAS, Pueblo is a covered entity as defined by 45 CFR § 160.103 and therefore is the 
custodian of certain electronically-available Protected Health Information, as defined by 45 CFR § 160.103 
(hereinafter "PHI"); and 
 
WHEREAS, User is a Public Health Authority, as defined by 45 CFR 164.501, that desires to access, 
use, and retain, and to permit its authorized agents, identified more fully below ("User Agents"), to access, 
use, and retain PHI via Pueblo's web-based application ("Patient Information Application") to perform 
communicable disease investigations mandated under the Arizona Administrative Code Title 9, Chapter 6 
and to review PHI related to communicable diseases per Arizona Revised Statutes (A.R.S.) § 36-662 and 
45 CFR § 164.512; and 
 
 
NOW, THEREFORE, in consideration of the mutual promises contained, Pueblo and User agree 
to the terms as defined in this Agreement. 
II. 
AGREEMENT 
 
1. 
Access.  Pueblo will permit User and User Agents to request IDs and passwords as set forth 
and User agrees to transmit electronically or permit electronic access to PHI in accordance with this 
Agreement for the following HIPAA compliant activities:  
 
Activities related to Maricopa County Department of Public Health Investigations 
 
Access will be granted to the User Agents listed on Exhibit A. 
 
2. 
Compliance with Law.  User agrees to comply with, and to ensure that all User Agents, 
including but not limited to, employees, volunteers, officers, partners, subcontractors, and vendors, comply 
with this Agreement and all state and federal laws. 
 
3.   
Administrator and Notice.  User will identify, to Pueblo, an Administrator (User's 
designated representative authorized to assign passwords or IDs to User Agents, and responsible for the 
enforcement of this Agreement) and User Agents accessing the Patient Information Application.  User will 
use best efforts to notify Pueblo within 14 days, but no later than 30 days, after any change in the 
Administrator or User Agent, provided, however, User will immediately terminate Administrator or User 
Agent access when access is not required.  User agrees to accept responsibility for the activities of the 
Administrator and all User Agents and to keep current the written identification of User Agents in Exhibit 
A. 
 
4. 
Access.  If User desires any User Agent to have access to the Patient Information 
Application, Administrator may request a user ID and a password, both of which are necessary to access 
the Patient Information Application.  The Administrator will authorize User Agent's access to different 
portions of the Patient Information Application based upon User Agent’s need for PHI to perform the 
activities identified in Section 1 above, and may delete or limit User Agent’s access.  User will review the

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terms of this Agreement with User Agent.  User will be responsible for User Agent’s compliance, and 
acknowledges and agrees that, in the event of any violation of this Agreement, Pueblo may terminate User 
Agent’s or User’s electronic access to the PHI immediately. 
 
5. 
Requirements.  In order to ensure the confidentiality of PHI, User agrees that: 
 
5.1 
User will ensure that User Agents will only use the PHI when needed, and to the 
extent necessary as authorized by this Agreement and in compliance with state and 
federal laws. 
 
5.2 
Pueblo has implemented a compliance program to ensure compliance with federal, 
state, and local laws and regulations.  User will either (i) train the User Agents 
through User’s own compliance and privacy program, or (ii) require User’s Agents 
to attend Pueblo’s compliance training. 
 
5.3 
User will protect the PHI from distribution, disclosure, reproduction, or 
dissemination in any manner to any person not authorized or entitled by law to 
have access to the PHI. 
 
5.4 
User will be responsible for ensuring that User Agents will not disclose, distribute, 
reproduce or disseminate the PHI in any manner to any person not authorized or 
entitled by law to have access to the PHI. 
 
5.5 
User will limit access to the PHI by User Agents to perform their responsibilities 
by requesting the following: 
• 
Registration form and/or Patient face Sheet 
• 
Medical and Social history/Dictated doctor’s notes 
• 
Reproductive/Sexual history 
• 
Diagnostic Lab Reports 
• 
Treatment/Medication history and Care Plan/Discharge Summary 
 
 
5.6 
User will promptly terminate access to those individuals who are no longer User 
Agents or who no longer have a need to access the Patient Information Application.  
 
5.7 
User will ensure that User Agents and other unauthorized persons do not use any 
User Agent’s user ID or password to gain access to the Patient Information 
Application, and User Agents do not share user IDs or passwords with any other 
person. User Agents are subject to monitoring while accessing the Patient 
Information Application.  
 
5.8 
User will conduct a comprehensive review on an annual basis of all User Agents 
to ensure that each User Agent requires access to the Patient Information 
Application. 
 
5.9 
User acknowledges that none of the PHI will be accessed by, or provided to, any 
individual or company that is not physically located within one of the fifty United 
States or United States Territories. However, PHI may be given to foreign 
government agencies pursuant to 45 CFR 164.512(b)(1)(i). This provision applies 
to work performed by User or any subcontractor utilized by User with any access 
to the PHI provided under this Agreement at all tiers.

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6. 
Insurance and Indemnification. 
 
6.1 
User agrees to indemnify, defend, and hold harmless Pueblo, from and against any 
and all third-party liabilities, damages, claims, or losses incurred by Pueblo to the 
extent arising from any violation by User, User Agents, and subcontractors, of any 
of the provisions of this Agreement, including, but not limited to, any breach of a 
provision dealing with security or unauthorized use or disclosure of PHI. 
 
6.2 
User is a self-insured government entity, pursuant to A.R.S. § 11-981 and the 
Revised Restated Declaration of Trust for Maricopa County, Arizona Self-Insured 
Risk Trust Fund.   
 
7. 
Unauthorized Activities.  
 
 
7.1 
If User suspects or has reason to know that a User Agent or other unauthorized 
person is accessing PHI by using another User Agent's ID or Password, User will 
promptly request suspension of that ID or Password and report the suspected or 
known misuse to the Pueblo Privacy Officer within 5 days of discovering the issue.   
 
7.2 
If User suspects or has reason to know that a User Agent is accessing PHI that the 
User Agent does not reasonably need to perform the activities identified in Section 
1 above, User will promptly request suspension of the User Agent's ID or Password 
and report the suspected or known misuse to the Pueblo Privacy Officer within 5 
days of discovering the issue. 
 
7.3 
Any written report required will be addressed to the Pueblo Privacy Officer, will 
be made via email, and will, at a minimum: 
 
7.3.1 
Identify the PHI that was subject to the unauthorized access and the date 
the unauthorized access occurred. 
 
7.3.2 
Identify the date the unauthorized access was discovered and what, if any, 
additional disclosure of PHI may have occurred. 
 
7.3.3 
Identify what User did or will do to mitigate any harmful effect of the non-
permitted access and how User will prevent the non-permitted access from 
occurring in the future. 
 
8. 
Term and Termination.  This Agreement will be effective on the Effective Date and will 
remain in effect unless terminated by either party for any reason by giving 30 days advance written notice 
to the other party.  Pueblo may terminate this Agreement immediately if it suspects a violation of patient 
confidentially or violation of any other term of use.  
 
9. 
Rules, Regulations, and HIPAA policies.  User agrees to comply, and to ensure that User 
Agents comply, with any User rules, regulations, and policies implementing HIPAA requirements whether 
existing now or in the future.  Should either party determine that modifications to this Agreement are 
necessary to comply with HIPAA regulations or either party’s obligations, then the parties agree to 
negotiate in good faith an amendment to this Agreement and to execute the amendment in order to achieve 
compliance.

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10. 
Patient Information Application.  Pueblo maintains the right to modify the features of the 
platform used to provide the PHI to User at any time.  Pueblo will use best efforts to communicate to User 
any changes in a timely manner. 
 
11.  
Technical Support.  Pueblo agrees to provide technical support to User to troubleshoot 
problems or research data errors related to the Patient Information Application. Pueblo also agrees to train 
a designated User trainer so that this person can train other User staff on the use of the Patient Information 
Application.  Pueblo will not provide training or technical support on the use of PCs, internet browsers, or 
assist with site-specific technical issue that may be unique to User's information systems. 
 
12.  
Confidentiality and Nondisclosure.   
 
12.1 
The parties agree that the PHI and other information accessed, used, and retained 
as a result of this Agreement will remain confidential pursuant to the applicable 
Arizona Revised Statutes, including A.R.S. § 36-662 and § 36-664.   
 
12.2 
The parties understand and agree that this Agreement is subject to all state and 
federal laws protecting client confidentiality of medical, behavioral health, and 
drug treatment information. User is a government entity subject to public records 
laws. Accordingly, notwithstanding any other provision of this Agreement, any 
provision regarding confidentiality is limited to the extent necessary to comply 
with federal and Arizona laws. Should User receive any request for disclosure of 
confidential information related to this Agreement, User will promptly notify 
Pueblo in writing prior to the disclosure date.  
 
13. 
No Referral.  This Agreement is limited solely to Pueblo’s contractual arrangement with 
User to provide access to PHI in accordance with the terms of this Agreement.  The parties acknowledge 
and agree that there is no intent, agreement, understanding, or requirement that User or any other person or 
entity affiliated with User has any obligation to admit, refer, or recommend patients to any facility owned 
or operated by Pueblo. 
 
14. 
Governing Law.  This Agreement will be governed by the laws of the State of Arizona. 
Any disputes shall be filed in the proper court within Maricopa County.  
 
15. 
No Federal Exclusion or Preclusion.  User represents and warrants that it and all personnel 
with access to PHI pursuant to this Agreement are not excluded from participation, and are not otherwise 
ineligible to participate, in a “Federal health care program” as defined in 42 U.S.C. § 1320a-7b(f) or in any 
other government payment program.  User will use reasonable efforts to disclose in writing within ten 
working days any debarment, exclusion, suspension or other event that makes User ineligible to participate 
in the Federal health care programs or in Federal procurement or non-procurement programs. 
 
16. 
Assignment.  This Agreement may not be assigned by either party without the prior written 
consent of the other party.  If consent to an assignment is obtained, this Agreement is binding on the assigns 
of the parties to this Agreement.    
 
17. 
Waiver and Breach.  No waiver of the enforcement or breach of any agreement or provision 
will be deemed a waiver of any preceding or succeeding breach or of the enforcement of any other 
agreement or provision.  No extension of time for performing any obligation or act will be deemed an 
extension of time for performing any other obligation or act.  All rights and remedies in this Agreement are 
cumulative and not exclusive of any rights or remedies otherwise provided by law.

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18. 
Supersede and Replace.  This Agreement is intended to supersede and replace any existing 
oral or written agreements and understandings between the parties regarding the subject matter contained. 
 
19. 
Notices.  Any notice required to be given under this Agreement will be in writing, and will 
be deemed delivered to the party to whom the notice is sent (a) when personally delivered, (b) one business 
day after the same is sent by overnight delivery service or email, or (c) three days after the same is sent by 
certified mail, postage prepaid, addressed to such party at the address that follows or to such other address 
as such party may hereinafter designate in writing: 
 
 
 
For Pueblo: 
 
Pueblo Family Physicians, LTD 
 
 
 
Attn: Rick Johns  
 
 
 
4350 N 19th Ave, Ste 6 
 
 
 
Phoenix, AZ 85015 
 
 
 
Email: rickj@pueblofamilymed.com 
Phone: 602-850-8913 
 
If to User: 
 
Maricopa County Department of Public Health 
 
 
 
Attn:  Joyce Hines 
4041 N. Central Avenue, Suite 600 
 
 
 
Phoenix, AZ  85012 
 
 
 
Email: joyce.hines@maricopa.gov 
 
 
 
Phone:602-372-1716 
 
 
 
 
 
 
 
20. 
Survival.  Any covenant or provision that requires or might require performance after the 
termination or expiration of this Agreement, including, but not limited to, indemnities, confidentiality, and 
insurance requirements, will survive any termination or expiration of this Agreement. 
 
21. 
Entire Agreement.  This Agreement and any attachments/exhibits/schedules contains the 
entire agreement between the parties with respect to the subject matter hereof.  All prior negotiations 
between the parties are merged in this Agreement, and there are no understandings or agreements other 
than those incorporated herein. This Agreement may not be modified except by a written instrument signed 
by both parties to this Agreement. 
 
22.  
Statutory Termination. Pursuant to  A.R.S. § 38-511, User may cancel this Agreement 
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 Agreement on behalf of 
User is at any time while the Agreement or any extension of the Agreement is in effect, an employee or 
agent of any other party to the Agreement in any capacity or consultant to any other party of the contract 
with respect to the subject matter of the Agreement. Additionally, User 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 User 1from any other party to the Agreement arising as the result of the Agreement. 
 
MARICOPA COUNTY 
 
 
 
PUEBLO FAMILY PHYSICIANS, LTD 
 
By:  
  
 
 
 
                  
By:  
  
 
 
 
 
 
Chairman, Board of Supervisors 
Name:   
 
 
 
 
Date:  
 
 
 
 
 
 
Rick Johns

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Title:    
 
 
 
 
ATTEST: 
            
 
 
 
 
Date:    
 
 
 
 
 
 
 
 
 
 
 
 
Clerk of the Board 
            
 
 
 
 
Date:  
 
 
 
 
 
 
APPROVED AS TO FORM:  
 
 
 
 
 
 
 
 
Attorney for Maricopa County  
 
 
Date:   
 
 
 
 
Rick Johns, Practice Administrtator, Pueblo Fam
12/20/2023

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EXHIBIT A 
USER AGENTS 
Name of Group Admin – ____________________  
Mailing Address – _________________________ 
Phone number –  __________________________ 
Email address – ___________________________ 
 
TITLE 
EMPLOYEE NAME 
EMAIL ADDRESS 
PHONE NUMBER 
EMPLOYEE ID 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Rick Johns
4350 N 19th Ave STE 6, Phoenix AZ  85015
602-850-8913
rickj@pueblofamilymed.com