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CONTRACT CORRECTIONAL ULTRASOUND
SERVICES AND RADIOGRAPHIC READINGS
230176-RFP
This contract is entered into this 1th day of September, 2023 by and between Maricopa County
(“County”), a political subdivision of the State of Arizona, and Kan-Di-Ki-LLC dba TridentCare, an Arizona
corporation (“Contractor”) to provide ultrasound services and/or radiographic readings for Correctional
Health Services (CHS).
1.0
CONTRACT TERM
1.1
This contract is for a term of two years, beginning on the 13th of September, 2023
and ending the 31st of August, 2025 .
2.0
OPTION TO RENEW
The County may, at its option and with the concurrence of the Contractor, renew the term of this
contract up to a maximum of four additional year(s), (or at the County’s sole discretion, extend the
contract on a month-to-month basis for a maximum of six months after expiration). The Contractor
shall be notified in writing by the Office of Procurement Services of the County’s intention to renew
the contract term at least 60 calendar days prior to the expiration of the original contract term.
3.0
CONTRACT COMPLETION
In preparation for contract completion, the Contractor shall make all reasonable efforts for an
orderly transition of its duties and responsibilities to another provider and/or to the County. This
may include, but is not limited to, preparation of a transition plan and cooperation with the County
or other providers in the transition. The transition includes the transfer of all records and other data
in the possession, custody, or control of the Contractor that are required to be provided to the
County either by the terms of this agreement or as a matter of law. The provisions of this clause
shall survive the expiration or termination of this agreement.
4.0
PRICE ADJUSTMENTS
Any requests for reasonable price adjustments must be submitted 60 calendar days prior to
contract expiration. Requests for adjustment in cost of labor and/or materials must be supported
by appropriate documentation. The reasonableness of the request will be determined by comparing
the request with the Consumer Price Index or by performing a market survey. If County agrees to
the adjusted price terms, County shall issue written approval of the change and provide an updated
version of the contract. The new change shall not be in effect until the date stipulated on the
updated version of the contract.
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5.0
PAYMENTS
5.1
As consideration for performance of the duties described herein, County shall pay
Contractor the sum(s) stated in Exhibit D – Pricing Sheet.
5.2
Payment shall be made upon the County’s receipt of a properly completed invoice.
5.3
INVOICES
5.3.1
The Contractor shall submit one legible copy of their detailed invoice before
payment(s) will be made. Incomplete invoices will not be processed. At a
minimum, the invoice must provide the following information:
•
Company name, address, and contact information
•
County bill-to name and contact information
•
Contract serial number
•
County purchase order number
•
Project name and/or number
•
Invoice number and date
•
Payment terms
•
Date of service or delivery
•
Quantity
•
Contract item number(s)
•
Arrival and completion time
•
Description of purchase (product or services)
•
Pricing per unit of purchase
•
Extended price
•
Freight (if applicable)
•
Mileage with rate (if applicable)
•
Total amount due
5.3.2
Problems regarding billing or invoicing shall be directed to the department as listed
on the purchase order.
5.3.3
Payment shall only be made to the Contractor by Accounts Payable through the
Maricopa County Vendor Express Payment Program. This is an electronic funds
transfer (EFT) process. After contract award, the Contractor shall complete the
Vendor Registration Form accessible from the County Department of Finance
Vendor
Registration
Web
Site
https://www.maricopa.gov/5169/Vendor-
Information.
5.3.4
Discounts offered in the contract shall be calculated based on the date a properly
completed invoice is received by the County.
5.3.5
EFT payments to the routing and account numbers designated by the Contractor
shall include the details on the specific invoices that the payment covers. The
Contractor is required to discuss remittance delivery capabilities with their
designated financial institution for access to those details.
5.4
APPLICABLE TAXES
5.4.1
It is the responsibility of the Contractor to determine any and all applicable taxes
and include those taxes in their proposal. The legal liability to remit the tax is on
the entity conducting business in Arizona. Tax is not a determining factor in
contract award.
5.4.2
The County will look at the price or offer submitted and will not deduct, add, or alter
pricing based on speculation or application of any taxes, nor will the County
provide Contractor any advice or guidance regarding taxes. If you have questions
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regarding your tax liability, seek advice from a tax professional prior to submitting
your bid. You may also find information at https://www.azdor.gov/Business.aspx.
Once your bid is submitted, the offer is valid for the time specified in this solicitation,
regardless of mistake or omission of tax liability. If the County finds overpayment
of a project due to tax consideration that was not due, the Contractor will be liable
to the County for that amount, and by contracting with the County agrees to remit
any overpayments back to the County for miscalculations on taxes included in a
bid price.
5.4.3
Tax Indemnification: Contractor and all subcontractors shall pay all Federal, State,
and local taxes applicable to their operation and any persons employed by the
Contractor. Contractor shall, and require all subcontractors to, hold Maricopa
County harmless from any responsibility for taxes, damages, and interest, if
applicable, contributions required under Federal and/or State and local laws and
regulations, and any other costs including: transaction privilege taxes,
unemployment
compensation
insurance,
Social
Security,
and
workers’
compensation. Contractor may be required to establish, to the satisfaction of
County, that any and all fees and taxes due to the City or the State of Arizona for
any license or transaction privilege taxes, use taxes, or similar excise taxes are
currently paid (except for matters under legal protest).
6.0
AVAILABILITY OF FUNDS
6.1
The provisions of this contract relating to payment for services shall become effective when
funds assigned for the purpose of compensating the Contractor as herein provided are
actually available to County for disbursement. The County shall be the sole judge and
authority in determining the availability of funds under this contract. County shall keep the
Contractor fully informed as to the availability of funds.
6.2
If any action is taken by, any State agency, Federal department, or any other agency or
instrumentality to suspend, decrease, or terminate its fiscal obligations under, or in
connection with, this contract, County may amend, suspend, decrease, or terminate its
obligations under, or in connection with, this contract. In the event of termination, County
shall be liable for payment only for services rendered prior to the effective date of the
termination, provided that such services are performed in accordance with the provisions
of this contract. County shall give written notice of the effective date of any suspension,
amendment, or termination under this section, at least 10 days in advance.
7.0
DUTIES
7.1
The Contractor shall perform all duties stated in Exhibit B – Scope of Work, or as otherwise
directed in writing by the procurement officer.
7.2
During the contract term, County may provide Contractor’s personnel with adequate
workspace for consultants and such other related facilities as may be required by
Contractor to carry out its contractual obligations.
8.0
TERMS AND CONDITIONS
8.1
INDEMNIFICATION
8.1.1
To the fullest extent permitted by law, and to the extent that claims, damages,
losses, or expenses are not covered and paid by insurance purchased by the
contractor, the contractor shall defend, indemnify, and hold harmless the County
(as Owner), its agents, representatives, officers, directors, officials, and employees
from and against all claims, damages, losses, and expenses (including, but not
limited to attorneys' fees, court costs, expert witness fees, and the costs and
attorneys' fees for appellate proceedings) arising out of, or alleged to have resulted
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from, the negligent acts, errors, omissions, or mistakes relating to the performance
of this contract.
8.1.2
Contractor's duty to defend, indemnify, and hold harmless the County, its agents,
representatives, officers, directors, officials, and employees shall arise in
connection with any claim, damage, loss, or expense that is attributable to bodily
injury, sickness, disease, death, or injury to, impairment of, or destruction of
tangible property, including loss of use resulting therefrom, caused by negligent
acts, errors, omissions, or mistakes in the performance of this contract, but only to
the extent caused by the negligent acts or omissions of the contractor, a
subcontractor, anyone directly or indirectly employed by them, or anyone for
whose acts they may be liable, regardless of whether or not such claim, damage,
loss, or expense is caused in part by a party indemnified hereunder.
8.1.3
The amount and type of insurance coverage requirements set forth herein will in
no way be construed as limiting the scope of the indemnity in this section.
8.1.4
The scope of this indemnification does not extend to the sole negligence of County.
8.2
INSURANCE
8.2.1
Contractor, at Contractor’s own expense, shall purchase and maintain, at a
minimum, the herein stipulated insurance from a company or companies duly
licensed by the State of Arizona and possessing an AM Best, Inc. category rating
of B++. In lieu of State of Arizona licensing, the stipulated insurance may be
purchased from a company or companies, which are authorized to do business in
the State of Arizona, provided that said insurance companies meet the approval of
County. The form of any insurance policies and forms must be acceptable to
County.
8.2.2
All insurance required herein shall be maintained in full force and effect until all
work or service required to be performed under the terms of the contract is
satisfactorily completed and formally accepted. Failure to do so may, at the sole
discretion of County, constitute a material breach of this contract.
8.2.3
In the event that the insurance required is written on a claims-made basis,
Contractor warrants that any retroactive date under the policy shall precede the
effective date of this contract and either continuous coverage will be maintained,
or an extended discovery period will be exercised for a period of two years
beginning at the time work under this contract is completed.
8.2.4
Contractor’s insurance shall be primary insurance as respects County, and any
insurance or self-insurance maintained by County shall not contribute to it.
8.2.5
Any failure to comply with the claim reporting provisions of the insurance policies
or any breach of an insurance policy warranty shall not affect the County’s right to
coverage afforded under the insurance policies.
8.2.6
The insurance policies may provide coverage that contains deductibles or self-
insured retentions. Such deductible and/or self-insured retentions shall not be
applicable with respect to the coverage provided to County under such policies.
Contractor shall be solely responsible for the deductible and/or self-insured
retention and County, at its option, may require Contractor to secure payment of
such deductibles or self-insured retentions by a surety bond or an irrevocable and
unconditional letter of credit.
8.2.7
The insurance policies required by this contract, except Workers’ Compensation
and Errors and Omissions, shall name County, its agents, representatives, officers,
directors, officials, and employees as additional insureds.
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8.2.8
The policies required hereunder, except Workers’ Compensation and Errors and
Omissions, shall contain a waiver of transfer of rights of recovery (subrogation)
against County, its agents, representatives, officers, directors, officials, and
employees for any claims arising out of Contractor’s work or service.
8.2.9
If available, the insurance policies required by this contract may be combined with
Commercial Umbrella Insurance policies to meet the minimum limit requirements.
If a Commercial Umbrella insurance policy is utilized to meet insurance
requirements, the Certificate of Insurance shall indicate which lines the
Commercial Umbrella Insurance covers.
8.2.9.1 Commercial General Liability
Commercial General Liability (CGL) insurance and, if necessary,
Commercial Umbrella insurance with a limit of not less than $1,000,000
for each occurrence, $2,000,000 Products/Completed Operations
Aggregate, and $2,000,000 General Aggregate Limit. The policy shall
include coverage for premises liability, bodily injury, broad form property
damage, personal injury, products and completed operations and blanket
contractual coverage, and shall not contain any provisions which would
serve to limit third party action over claims. There shall be no endorsement
or modifications of the CGL limiting the scope of coverage for liability
arising from explosion, collapse, or underground property damage.
8.2.9.2 Workers’ Compensation
8.2.9.2.1 Workers’ compensation insurance to cover obligations imposed
by Federal and State statutes having jurisdiction of Contractor’s
employees engaged in the performance of the work or services
under this contract; and Employer’s Liability insurance of not
less than $1,000,000 for each accident, $1,000,000 disease for
each employee, and $1,000,000 disease policy limit.
8.2.9.3.2 Contractor, its subcontractors, and sub-subcontractors waive all
rights against this contract and its agents, officers, directors, and
employees for recovery of damages to the extent these
damages are covered by the workers’ compensation and
Employer’s Liability or Commercial Umbrella Liability insurance
obtained by Contractor, its subcontractors, and its sub-
subcontractors pursuant to this contract.
8.2.9.3 Professional Liability Insurance
Contractor shall maintain Professional Liability insurance which will
provide coverage for any and all acts arising out of the work or services
performed by the contractor under the terms of this contract, with a limit of
not less than $2,000,000 for each claim, and $4,000,000 aggregate
claims.
8.2.9.4 Cyber, Network Security, and Privacy Liability
Cyber, Network Security and Privacy Liability Insurance with a limit of not
less than $5,000,000 per occurrence. The policy shall include, but not be
limited to; coverage for all directors, officers, agents and employees of the
Contractor, losses with respect to network risks (such as data breaches,
unauthorized access or use, and ID theft of data), invasion of privacy
(regardless of the type of media involved in the loss of private information),
crisis management, identity theft response costs, breach notification costs,
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credit remediation, and credit monitoring, defense, and claims expenses,
regulatory defense costs plus fines and penalties, cyber extortion,
electronic data restoration expenses (data asset protection), network
business interruption, computer fraud coverage, funds transfer loss, third-
party fidelity, theft, no requirement for arrest and conviction, and loss
outside the premises of the named insured.
8.2.9.5 Sexual Molestation and Physical Abuse
The policy shall be endorsed to include coverage for sexual molestation
and physical abuse at limits not less than $1,000,000.00 per occurrence
and $2,000,000.00 aggregate. These limits may be included within a
General Liability policy, Professional Liability policy or provided by
separate endorsement with its own limits as required. Contractor must
provide the following statement on their Certificate(s) of Insurance:
“Sexual molestation and physical abuse coverage is included.”
Policies/certificates stating that “Sexual molestation and physical abuse
coverage is not excluded” do not meet this requirement.
8.2.10 Certificates of Insurance
8.2.10.1 Prior to contract award, Contractor shall furnish the County with valid
and complete Certificates of Insurance, or formal endorsements as
required by the contract in the form provided by the County, issued by
Contractor’s insurer(s), as evidence that policies providing the required
coverage, conditions and limits required by this contract are in full force
and effect. Such certificates shall identify this contract number and title.
8.2.10.2 In the event any insurance policy(ies) required by this contract is (are)
written on a claims-made basis, coverage shall extend for two years past
completion and acceptance of Contractor’s work or services and as
evidenced by annual certificates of insurance.
8.2.10.3 If a policy does expire during the life of the Contract, a renewal certificate
must be sent to County 15 calendar days prior to the expiration date.
8.2.10.4 Certificates of Insurance shall identify Maricopa County as the additional
insured/certificate holder as follows:
Maricopa County
c/o Risk Management
301 W Jefferson St., Suite 910
Phoenix, AZ 85003
8.2.11 Cancellation and Expiration Notice
Applicable to all insurance policies required within the insurance requirements of
this contract, Contractor’s insurance shall not be permitted to expire, be
suspended, be canceled, or be materially changed for any reason without 30 days
prior written notice to Maricopa County. Contractor must provide to Maricopa
County, within two business days of receipt, if they receive notice of a policy that
has been or will be suspended, canceled, materially changed for any reason, has
expired, or will be expiring. Such notice shall be sent directly to Maricopa County
Office of Procurement Services and shall be mailed, or hand delivered to 301 W.
Jefferson St. Suite 700, Phoenix, AZ 85003, or emailed to the procurement officer
noted in the solicitation.
SERIAL 230176-RFP
8.3
FORCE MAJEURE
8.3.1
Neither party shall be liable for failure of performance, nor incur any liability to the
other party on account of any loss or damage resulting from any delay or failure to
perform all or any part of this contract, if such delay or failure is caused by events,
occurrences, or causes beyond the reasonable control and without negligence of
the parties. Such events, occurrences, or causes include, but are not limited to,
acts of God/nature (including fire, flood, earthquake, storm, hurricane, or other
natural disaster), war, invasion, act of foreign enemies, hostilities (whether war is
declared or not), civil war, riots, rebellion, revolution, insurrection, military or
usurped power or confiscation, terrorist activities, nationalization, government
sanction, lockout, blockage, embargo, labor dispute, strike, and interruption or
failure of electricity or telecommunication service, and pandemic.
8.3.2
Each party, as applicable, shall give the other party notice of its inability to perform
and particulars in reasonable detail of the cause of the inability. Each party must
use best efforts to remedy the situation and remove, as soon as practicable, the
cause of its inability to perform or comply.
8.3.3
The party asserting Force Majeure as a cause for non-performance shall have the
burden of proving that reasonable steps were taken to minimize delay or damages
caused by foreseeable events, that all non-excused obligations were substantially
fulfilled, and that the other party was timely notified of the likelihood or actual
occurrence which would justify such an assertion, so that other prudent
precautions could be contemplated.
8.4
ORDERING AUTHORITY
Any request for purchase shall be accompanied by a valid purchase order issued by a
County department or directed by a Certified Agency Procurement Aid (CAPA) with a
purchase card for payment.
8.5
PROCUREMENT CARD ORDERING CAPABILITY
County may opt to use a procurement card (Visa or Master Card) to make payment for
orders under this contract.
8.6
INTERNET ORDERING CAPABILITY
It is the intent of Maricopa County to use the Internet to communicate and to place orders
under this contract.
8.7
NO MINIMUM OR MAXIMUM PURCHASE OBLIGATION
This contract does not guarantee any minimum or maximum purchases will be made.
Orders will only be placed under this contract when the County identifies a need and proper
authorization and documentation have been approved.
8.8
PURCHASE ORDERS
8.8.1
County reserves the right to cancel purchase orders within a reasonable period of
time after issuance. Should a purchase order be canceled, the County agrees to
reimburse the Contractor for actual and documentable costs incurred by the
Contractor in response to the purchase order. The County will not reimburse the
Contractor for any costs incurred after receipt of County notice of cancellation, or
for lost profits, or for shipment of product prior to issuance of purchase order.
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8.8.2
Contractor agrees to accept verbal notification of cancellation of purchase orders
from the County procurement officer with written notification to follow. Contractor
specifically acknowledges to be bound by this cancellation policy.
8.9
BACKGROUND CHECK
Respondents may be required to pass multiple background checks (e.g., Sheriff’s Office,
County Attorney's Office, Courts, as well as Maricopa County general government) to
determine if the respondent is acceptable to do business with the County. This applies to,
but is not limited to, the company, subcontractors, and employees, and the failure to pass
these checks shall deem the respondent non-responsible.
8.10
SUSPENSION OF WORK
The procurement officer may order the Contractor, in writing, to suspend, delay, or interrupt
all or any part of the work of this contract for the period of time that the procurement officer
determines appropriate for the convenience of the County. No adjustment shall be made
under this clause for any suspension, delay, or interruption to the extent that performance
would have been so suspended, delayed, or interrupted by any other cause, including the
fault or negligence of the Contractor. No request for adjustment under this clause shall be
granted unless the claim, in an amount stated, is asserted in writing as soon as practicable
after the termination of the suspension, delay, or interruption, but not later than the date of
final payment under the contract.
8.11
STOP WORK ORDER
8.11.1 The procurement officer may, at any time, by written order to the Contractor,
require the Contractor to stop all, or any part, of the work called for by this contract
for a period of 90 calendar days after the order is delivered to the Contractor, and
for any further period to which the parties may agree. The order shall be specifically
identified as a stop work order issued under this clause. Upon receipt of the order,
the Contractor shall immediately comply with its terms and take all reasonable
steps to minimize the incurrence of costs allocable to the work covered by the order
during the period of work stoppage. Within a period of 90 calendar days after a
stop work order is delivered to the Contractor, or within any extension of that period
to which the parties shall have agreed, the procurement officer shall either:
8.11.1.1 cancel the stop work order; or
8.11.1.2 terminate the work covered by the order as provided in the Termination
for Default or the Termination for Convenience clause of this contract.
8.11.1.3 The procurement officer may make an equitable adjustment in the
delivery schedule and/or contract price, and the contract shall be
modified, in writing, accordingly, if the Contractor demonstrates that the
stop work order resulted in an increase in costs to the Contractor
8.12
TERMINATION FOR CONVENIENCE
Maricopa County may terminate the resultant contract for convenience by providing 60
calendar days advance notice to the Contractor.
8.13
TERMINATION FOR DEFAULT
8.13.1 The County may, by written Notice of Default to the Contractor, terminate this
contract in whole or in part if the Contractor fails to:
8.13.1.1 deliver the supplies or to perform the services within the time specified
in this contract or any extension;
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8.13.1.2 make progress, so as to endanger performance of this contract; or
8.13.1.3 perform any of the other provisions of this contract.
8.13.2 The County’s right to terminate this contract under these subparagraphs may be
exercised if the Contractor does not cure such failure within 10 business days (or
more if authorized in writing by the County) after receipt of a Notice to Cure from
the procurement officer specifying the failure.
8.14
PERFORMANCE
It shall be the Contractor’s responsibility to meet the proposed performance requirements.
Maricopa County reserves the right to obtain services on the open market in the event the
Contractor fails to perform, and any price differential will be charged against the Contractor.
8.15
CONTRACTOR EMPLOYEE MANAGEMENT
8.15.1 Contractor shall endeavor to maintain the personnel proposed in their proposal
throughout the performance of this contract.
8.15.2 If Contractor personnel’s employment status changes, Contractor shall provide
County a list of proposed replacements with equivalent or greater experience.
8.15.3 Under no circumstances shall the implementation schedule to be impacted by a
personnel change on the part of the Contractor.
8.15.4 Contractor shall not reassign any key personnel identified in their proposal without
the express consent of the County.
8.15.5 County reserves the right to immediately remove from its premises any Contractor
personnel it determines to be a risk to County operations.
8.15.6 County reserves the right to request the replacement of any Contractor personnel
at any time, for any reason.
8.16
TRAINING
8.16.1 Following the confirmation of CHS users’ access to the radiology application or
web portal, the contractor will provide the following:
8.16.1.1 At least one “train the trainer” class to designated employed CHS users
to review navigation of the contractor’s radiology application or web
portal.
8.16.1.2 Support for recent trainees for the initial duration of the go-live period
and for at least 90 days thereafter.
8.17
WARRANTY OF SERVICES
8.17.1 The Contractor warrants that all services provided hereunder will conform to the
requirements of the contract, including all descriptions, specifications, and
attachments made a part of this contract. County’s acceptance of services or
goods provided by the Contractor shall not relieve the Contractor from its
obligations under this warranty.
8.17.2 In addition to its other remedies, County may, at the Contractor's expense, require
prompt correction of any services failing to meet the Contractor's warranty herein.
Services corrected by the Contractor shall be subject to all the provisions of this
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contract in the manner and to the same extent as services originally furnished
hereunder.
8.18
INSPECTION OF SERVICES
8.18.1 The Contractor shall provide and maintain an inspection system acceptable to
County covering the services under this contract. Complete records of all
inspection work performed by the Contractor shall be maintained and made
available to County during contract performance and for as long afterwards as the
contract requires.
8.18.2 County has the right to inspect and test all services called for by the contract, to
the extent practicable at all times and places during the term of the contract.
County shall perform inspections and tests in a manner that will not unduly delay
the work.
8.18.3 If any of the services do not conform to contract requirements, County may require
the Contractor to perform the services again in conformity with contract
requirements, at no cost to the County. When the defects in services cannot be
corrected by re-performance, County may:
8.18.3.1 require the Contractor to take necessary action to ensure that future
performance conforms to contract requirements; and
8.18.3.2 reduce the contract price to reflect the reduced value of the services
performed.
8.18.4 If the Contractor fails to promptly perform the services again or to take the
necessary action to ensure future performance in conformity with contract
requirements, County may:
8.18.4.1 by contract or otherwise, perform the services and charge to the
Contractor, through direct billing or through payment reduction, any cost
incurred by County that is directly related to the performance of such
service; or
8.18.4.2 terminate the contract for default.
8.19
USAGE REPORT
The contractor shall furnish the County a usage report at the end of the month to support
the invoice, delineating the acquisition activity governed by the contract. The format of the
report shall be approved by the County and shall disclose the quantity and dollar value of
each contract item by individual unit of measure. At a minimum, the usage report must
provide the following information:
x
Invoice number and date
x
First and last name of the patient
x
Patient’s booking number
x
Facility
x
Payment terms
x
Date of service
x
Contract item number(s)
x
Description of service
x
Current Procedural Terminology (CPT) Code with description
x
International Classification of Diseases (ICD)-10 Coded (Diagnosis Code)
x
Pricing per unit of purchase
x
Total amount due
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8.20
STATUTORY RIGHT OF CANCELLATION FOR CONFLICT OF INTEREST
Notice is given that, pursuant to A.R.S. § 38-511, the County may cancel any contract
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
contract on behalf of the County is at any time, while the contract or any extension of the
contract is in effect, an employee or agent of any other party to the contract in any capacity
or consultant to any other party of the contract with respect to the subject matter of the
contract. Additionally, pursuant to A.R.S. § 38-511, the County 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 the County from any other party to
the contract arising as the result of the contract.
8.21
OFFSET FOR DAMAGES
In addition to all other remedies at Law or Equity, the County may offset from any money
due to the Contractor any amounts Contractor owes to the County for damages resulting
from breach or deficiencies in performance of the contract.
8.22
SUBCONTRACTING
8.22.1 The Contractor may not assign to another Contractor or subcontract to another
party for performance of the terms and conditions hereof without the written
consent of the County. All correspondence authorizing subcontracting must
reference the bid serial number and identify the job or project.
8.22.2 The subcontractor’s rate for the job shall not exceed that of the prime Contractor’s
rate, as bid in the pricing section, unless the prime Contractor is willing to absorb
any higher rates. The subcontractor’s invoice shall be invoiced directly to the prime
Contractor, who in turn shall pass-through the costs to the County, without mark-
up. A copy of the subcontractor’s invoice must accompany the prime Contractor’s
invoice.
8.23
AMENDMENTS
All amendments to this contract shall be in writing and approved/signed by both parties.
Maricopa County Office of Procurement Services shall be responsible for approving all
amendments for Maricopa County.
8.24
ADDITIONS/DELETIONS OF REQUIREMENTS
The County reserves the right to add and/or delete materials and services to a contract. If
a service requirement is deleted, payment to the Contractor will be reduced proportionately,
to the amount of service reduced in accordance with the bid price. If additional materials
or services are required from a contract, prices for such additions will be negotiated
between the Contractor and the County.
8.25
RIGHTS IN DATA
8.25.1 The County shall have the use of data and reports resulting from a contract without
additional cost or other restriction except as may be established by law or
applicable regulation. Each party shall supply to the other party, upon request, any
available information that is relevant to a contract and to the performance
thereunder.
8.25.2 Data, records, reports, and all other information generated for the County by a third
party as the result of a contract are the property of the County and shall be provided
in a format designated by the County or shall be and remain accessible to the
County into perpetuity.
SERIAL 230176-RFP
8.26
ACCESS TO AND RETENTION OF RECORDS FOR THE PURPOSE OF AUDIT AND/OR
OTHER REVIEW
8.26.1 In accordance with Section MC1-372 of the Maricopa County Procurement Code,
the Contractor agrees to retain (physical or digital copies of) all books, records,
accounts, statements, reports, files, and other records and back-up documentation
relevant to this contract for six years after final payment or until after the resolution
of any audit questions, which could be more than six years, whichever is longest.
The County, Federal or State auditors and any other persons duly authorized by
the department shall have full access to and the right to examine, copy, and make
use of, any and all said materials.
8.26.2 If the Contractor’s books, records, accounts, statements, reports, files, and other
records and back-up documentation relevant to this contract are not sufficient to
support and document that requested services were provided, the Contractor shall
reimburse Maricopa County for the services not so adequately supported and
documented.
8.27
AUDIT DISALLOWANCES
If at any time it is determined by the County that a cost for which payment has been made
is a disallowed cost, the County shall notify the Contractor in writing of the disallowance.
The course of action to address the disallowance shall be at sole discretion of the County,
and may include either an adjustment to future invoices, request for credit, request for a
check, or a deduction from current invoices submitted by the Contractor equal to the
amount of the disallowance, or to require reimbursement forthwith of the disallowed amount
by the Contractor by issuing a check payable to Maricopa County.
8.28
STRICT COMPLIANCE
Acceptance by County of a performance that is not in strict compliance with the terms of
the contract shall not be deemed to be a waiver of strict compliance with respect to all other
terms of the contract.
8.29
VALIDITY
The invalidity, in whole or in part, of any provision of this contract shall not void or affect
the validity of any other provision of the contract.
8.30
SEVERABILITY
The removal, in whole or in part, of any provision of this contract shall not void or affect the
validity of any other provision of this contract.
8.31
RELATIONSHIPS
8.31.1 In the performance of the services described herein, the Contractor shall act solely
as an independent Contractor, and nothing herein or implied herein shall at any
time be construed as to create the relationship of employer and employee, co-
employee, partnership, principal and agent, or joint venture between the County
and the Contractor.
8.31.2 The County reserves the right of final approval on proposed staff. Also, upon
request by the County, the Contractor will be required to remove any employees
working on County projects and substitute personnel based on the discretion of
the County within two business days, unless previously approved by the County.
SERIAL 230176-RFP
8.32
NON-DISCRIMINATION
Contractor agrees to comply with all provisions and requirements of Arizona Executive
Order 2009-09, including flow down of all provisions and requirements to any
subcontractors. Executive Order 2009-09 supersedes Executive Order 99-4 and amends
Executive Order 75-5 and is hereby incorporated into this contract as if set forth in full
herein. During the performance of this contract, Contractor shall not discriminate against
any employee, client, or any other individual in any way because of that person’s age, race,
creed, color, religion, sex, disability, or national origin. (Arizona Executive Order 2009-09
can be viewed at https://apps.azsos.gov/public_services/register/2009/46/governor.pdf).
8.33
WRITTEN CERTIFICATION PURSUANT to A.R.S. § 35-393.01
If vendor engages in for-profit activity and has 10 or more employees, and if this agreement
has a value of $100,000 or more, vendor certifies it is not currently engaged in, and agrees
for the duration of this agreement to not engage in, a boycott of goods or services from
Israel. This certification does not apply to a boycott prohibited by 50 U.S.C. § 4842 or a
regulation issued pursuant to 50 U.S.C. § 4842.
8.34
CERTIFICATION REGARDING DEBARMENT AND SUSPENSION
8.34.1 The undersigned (authorized official signing on behalf of the Contractor) certifies
to the best of his or her knowledge and belief that the Contractor, its current
officers, and directors:
8.34.1.1 are not presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from being awarded any
contract or grant by any United States department or agency or any
state, or local jurisdiction;
8.34.1.2 have not within a three-year period preceding this contract:
8.34.1.2.1 been convicted of fraud or any criminal offense in
connection with obtaining, attempting to obtain, or as the
result of performing a government entity (Federal, State or
local) transaction or contract; or
8.34.1.2.2 been convicted of violation of any Federal or State antitrust
statutes or conviction for embezzlement, theft, forgery,
bribery, falsification or destruction of records, making false
statements, or receiving stolen property regarding a
government entity transaction or contract;
8.34.1.3 are not presently indicted or criminally charged by a government entity
(Federal, State or local) with commission of any criminal offenses in
connection with obtaining, attempting to obtain, or as the result of
performing a government entity public (Federal, State or local)
transaction or contract;
8.34.1.4 are not presently facing any civil charges from any governmental entity
regarding obtaining, attempting to obtain, or from performing any
governmental entity contract or other transaction; and
8.34.1.5 have not within a three-year period preceding this contract had any
public transaction (Federal, State, or local) terminated for cause or
default.
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8.34.2 If any of the above circumstances described in the paragraph are applicable to the
entity submitting a bid for this requirement, include with your bid an explanation of
the matter including any final resolution.
8.34.3 The Contractor shall include, without modification, this clause in all lower tier
covered transactions (i.e., transactions with subcontractors or sub-subcontractors)
and in all solicitations for lower tier covered transactions related to this contract. If
this clause is applicable to a subcontractor or sub-subcontractor, the Contractor
shall include the information required by this clause with their bid.
8.35
VERIFICATION REGARDING COMPLIANCE WITH A.R.S. § 41-4401 AND FEDERAL
IMMIGRATION LAWS AND REGULATIONS
8.35.1 By entering into the contract, the Contractor warrants compliance with the
Immigration and Nationality Act (INA using E-Verify) and all other Federal
immigration laws and regulations related to the immigration status of its employees
and A.R.S. § 23-214(A). The Contractor shall obtain statements from its
subcontractors certifying compliance and shall furnish the statements to the
procurement officer upon request. These warranties shall remain in effect through
the term of the contract. The Contractor and its subcontractors shall also maintain
Employment Eligibility Verification forms (I-9) as required by the Immigration Reform
and Control Act of 1986, as amended from time to time, for all employees performing
work under the contract and verify employee compliance using the E-Verify system
and shall keep a record of the verification for the duration of the employee’s
employment or at least three years, whichever is longer. I-9 forms are available for
download at www.uscis.gov.
8.35.2 The County retains the legal right to inspect documents of Contractor and
subcontractor employees performing work under this contract to verify compliance
with paragraph 8.35.1 of this section. Contractor and subcontractor shall be given
reasonable notice of the County’s intent to inspect and shall make the documents
available at the time and date specified. Should the County suspect or find that the
Contractor or any of its subcontractors are not in compliance, the County will
consider this a material breach of the contract and may pursue any and all remedies
allowed by law, including, but not limited to: suspension of work, termination of the
contract for default, and suspension and/or debarment of the Contractor. All costs
necessary to verify compliance are the responsibility of the Contractor.
8.36
CONTRACTOR EMPLOYEE WHISTLEBLOWER RIGHTS AND REQUIREMENT TO
INFORM EMPLOYEES OF WHISTLEBLOWER RIGHTS
8.36.1 The parties agree that this contract and employees working on this contract will be
subject to the Contractor employee whistleblower protections established by Title
41 U.S.C. § 4712 and Section 3.908 of the Federal Acquisition Regulation.
8.36.2 Contractor shall inform its employees in writing, in the predominant language of
the workforce, of employee whistleblower rights and protections under 41 U.S.C.
§ 4712, as described in Section 3.908 of the Federal Acquisition Regulation.
Documentation of such employee notification must be kept on file by Contractor
and copies provided to County upon request.
8.36.3 Contractor shall insert the substance of this clause, including this paragraph, in all
subcontracts over the simplified acquisition threshold ($250,000 as of fiscal year
2018).
8.37
CONTRACTOR LICENSE REQUIREMENT
8.37.1 The Contractor shall procure all permits, insurance, and licenses, and pay the
charges and fees necessary and incidental to the lawful conduct of his/her
SERIAL 230176-RFP
business, and as necessary complete any requirements, by any and all
governmental or non-governmental entities as mandated to maintain compliance
with and remain in good standing. The Contractor shall keep fully informed of
existing and future trade or industry requirements, and Federal, State, and local
laws, ordinances, and regulations which in any manner affect the fulfillment of a
contract and shall comply with the same. Contractor shall immediately notify both
Office of Procurement Services and the department of any and all changes
concerning permits, insurance, or licenses.
8.37.2 Contractor furnishing finished products, materials, or articles of merchandise that
will require installation or attachment as part of the contract shall possess any
licenses required. Contractor is not relieved of its obligation to obtain and possess
the required licenses by subcontracting of the labor portion of the contract.
Contractors are advised to contact the Arizona Registrar of Contractors, Chief of
Licensing, to ascertain licensing requirements for a particular contract. Contractor
shall identify which license(s), if any, the Registrar of Contractors requires for
performance of the contract.
8.38
INFLUENCE
8.38.1 As prescribed in MC1-1203 of the Maricopa County Procurement Code, any effort
to influence an employee or agent to breach the Maricopa County Ethical Code of
Conduct or any ethical conduct, may be grounds for disbarment or suspension
under MC1-902.
8.38.2 An attempt to influence includes, but is not limited to:
8.38.2.1 A person offering or providing a gratuity, gift, tip, present, donation,
money, entertainment or educational passes or tickets, or any type of
valuable contribution or subsidy that is offered or given with the intent to
influence a decision, obtain a contract, garner favorable treatment, or
gain favorable consideration of any kind.
8.38.3 If a person attempts to influence any employee or agent of Maricopa County, the
chief procurement officer, or his designee, reserves the right to seek any remedy
provided by the Maricopa County Procurement Code, any remedy in equity or in
the law, or any remedy provided by this contract.
8.39
CONFIDENTIAL INFORMATION
8.39.1 Any information obtained in the course of performing this contract may include
information that is proprietary or confidential to the County. This provision
establishes the Contractor’s obligation regarding such information.
8.39.2 The Contractor shall establish and maintain procedures and controls that are
adequate to assure that no information contained in its records and/or obtained
from the County or from others in carrying out its functions (services) under the
contract shall be used by or disclosed by it, its agents, officers, or employees,
except as required to efficiently perform duties under the contract. The Contractor’s
procedures and controls, at a minimum, must be the same procedures and controls
it uses to protect its own proprietary or confidential information. If, at any time
during the duration of the contract, the County determines that the procedures and
controls in place are not adequate, the Contractor shall institute any new and/or
additional measures requested by the County within 15 business days of the
written request to do so.
8.39.3 Any requests to the Contractor for County proprietary or confidential information
shall be referred to the County for review and approval, prior to any dissemination.
SERIAL 230176-RFP
8.40
PUBLIC RECORDS
Under Arizona law, all offers submitted and opened are public records and must be
retained by the County at the Maricopa County Office of Procurement Services. Offers shall
be open to public inspection and copying after contract award and execution, except for
such offers or sections thereof determined to contain proprietary or confidential information
by the Office of Procurement Services. If an offeror believes that information in its offer or
any resulting contract should not be released in response to a public record request, under
Arizona law, the offeror shall indicate the specific information deemed confidential or
proprietary and submit a statement with its offer detailing the reasons that the information
should not be disclosed. Such reasons shall include the specific harm or prejudice which
may arise from disclosure. The records manager of the Office of Procurement Services
shall determine whether the identified information is confidential pursuant to the Maricopa
County Procurement Code.
8.41
INTEGRATION
This contract represents the entire and integrated agreement between the parties and
supersedes
all
prior
negotiations,
proposals,
communications,
understandings,
representations, or agreements, whether oral or written, expressed, or implied.
8.42
UNIFORM ADMINISTRATIVE REQUIREMENTS
By entering into this contract, the Contractor agrees to comply with all applicable provisions
of
Title
2,
Subtitle
A,
Chapter
II,
Part
200—UNIFORM
ADMINISTRATIVE
REQUIREMENTS, COST PRINCIPLES, AND AUDIT REQUIREMENTS FOR FEDERAL
AWARDS contained in Title 2 C.F.R. § 200 et seq.
8.43
GOVERNING LAW
This contract shall be governed by the laws of the State of Arizona. Venue for any actions
or lawsuits involving this contract will be in Maricopa County Superior Court, Phoenix,
Arizona.
8.44
FORCED LABOR
8.44.1 By submitting a bid for this solicitation and/or entering into a contract as a result of
this solicitation, contractor agrees to comply with all applicable portions of Arizona
Revised Statutes Section 35-394. Contracting; procurement; prohibition; written
certification; remedy; termination; exception; definitions.
8.44.2 Contractor certifies that it does not currently, and agrees for the duration of the
contract, that it will not use:
8.44.2.1 The forced labor of ethnic Uyghurs in the People’s Republic of China.
8.44.2.2 Any goods or services produced by the forced labor of ethnic Uyghurs
in the People’s Republic of China.
8.44.2.3 Any contractors, subcontractors or suppliers that use the forced labor or
any good or services produced by the forced labor of ethnic Uyghurs in
the People’s Republic of China.
8.44.3 If contractor becomes aware during the term of the agreement that contractor is
not in compliance with this paragraph, the contractor shall notify the County within
five business days after becoming aware of the noncompliance. If the contractor
fails to provide a written certification to the County that the contractor has remedied
the noncompliance within 180 days after notifying the County of its noncompliance,
then the agreement terminates, except that if the agreement termination date
SERIAL 230176-RFP
occurs before the end the 180-day period, the agreement terminates on the
agreement termination date.
8.45
PRICES
Contractor warrants that prices extended to County under this contract are no higher than
those paid by any other customer for these or similar services.
8.46
ORDER OF PRECEDENCE
In the event of a conflict in the provisions of this contract and Contractor’s license
agreement, if applicable, the terms of this contract shall prevail.
8.47
UNIQUE ENTITY IDENTIFIER (UEI) AND SYSTEM FOR AWARD MANAGEMENT
REGISTRATION
All contractors that receive federal funding must have a UEI number through
https://sam.gov/content/entity-registration. Contractor must also remain current with the
System for Award Management www.sam.gov throughout the term of the contract.
8.48
RELIGIOUS ACTIVITIES
The contractor agrees that costs, planned or claimed, including costs incurred, shall not
include any expense for any religious activity.
8.49
POLITICAL ACTIVITY PROHIBITED
None of the funds, materials, property, or services contributed by the County or the
contractor under the agreement shall be used in the performance of this agreement for any
partisan political activity, or to further the election or defeat of any candidate for public
office.
8.50
EQUAL EMPLOYMENT OPPORTUNITY
8.50.1 The contractor shall not discriminate against any employee or applicant for
employment because of race, age, disability, color, religion, sex, or national origin.
The contractor shall take affirmative action to ensure applicants are employed and
that employees are treated during employment without regard to their race, age,
disability, color, religion, sex, or national origin. Such action shall include but is not
limited to the following: employment, upgrading, demotion or transfer, recruitment,
or recruitment advertising, lay-off or termination, rates of pay or other forms of
compensation, and selection for training, including apprenticeship.
8.50.2 Contractor shall comply with the following provisions:
8.50.2.1 Title VI and VII of the Civil Rights Act of 1964, as amended (42 U.S.C.
§§ 2000a, et seq.);
8.50.2.2 The Rehabilitation Act of 1973, as amended (29 U.S.C. §§ 701, et seq.);
8.50.2.3 The Age Discrimination in Employment Act of 1967, as amended
(29U.S.C. §§ 621, et seq.);
8.50.2.4 The Americans With Disabilities Act of 1990 (42 U.S.C. §§ 12101, et
seq.); and Arizona Executive Order 2009-09, as amended, et seq. which
mandates that all persons shall have equal access to employment
opportunities.
SERIAL 230176-RFP
8.50.2.5 Contractor understands that the United States has the right to seek
judicial enforcement of this assurance.
8.51
CERTIFICATION REGARDING LOBBYING
8.51.1 Contractor certifies, to the best of their knowledge and belief, that:
8.51.1.1 No federal appropriated funds have been paid or will be paid, by or on
behalf of the contractor, to any person for influencing or attempting to
influence an officer or employee of any agency. This applies to a
Member of Congress, an officer or employee of Congress, or an
employee of a Member of Congress in connection with the awarding of
any federal contract, the making of any federal grant. Including the
making of any federal, loan the entering into of any cooperative
agreement, and the extension, continuation, renewal, amendment, or
modification of any federal contract, grant, loan, or cooperative
agreement.
8.51.2 If any funds other than federal appropriated funds, have been paid or will be paid
to any person for influencing or attempting to influence an officer or employee of
any agency, member of Congress, an officer or employee of Congress, or an
employee of a member of Congress in connection with this federal contract, grant,
loan, or cooperative agreement, the undersigned shall complete and submit
Standard Form-LLL, “Disclosure Form to Report Lobbying,” in accordance with its
instructions.
8.51.3 Contractor shall include Lobbying Certification language in the award documents
for all subcontractors (including sub-grants, and contract under grants, loans, and
cooperative agreements) and that all sub-recipients shall certify and disclose
accordingly.
8.51.1.3.1 The Lobbying Certification is a material representation of fact upon
which reliance was placed when this transaction is made or entered into.
Submission of this certification is prerequisite for making or entering into
this transaction imposed by section 1352, Title 31, U.S. Code. Any
successful proposer(s) who fail to file the required certification shall be
subject to a civil penalty of not less than $10,000.00 and not more than
$100,000.00 for each such failure.
8.52
CLEAN AIR ACT & CLEAN WATER ACT
Contractor must comply with all applicable standards, orders, or requirements issued under
section 306 of the Clean Air Act (42 U.S.C. 1857(h), section 508 of the Clean Water Act
(33 U.S.C. 1368) Executive Order 11738, and Environmental Protection Agency
regulations (40 CFR part 15).
8.53
ENERGY POLICY AND CONSERVATION ACT
Contractor must adhere to the standards and policies relating to energy efficiency, which
are contained in the State energy conservation plan issued in compliance with the Energy
Policy and Conservation Act (Pub. L. 94-163, 89 Stat.871).
8.54
INCORPORATION OF DOCUMENTS
8.54.1 The following are to be attached to and made part of this Contract:
8.54.1.1 Exhibit A – Vendor Information and Pricing
8.54.1.2 Exhibit B – Scope of Work
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8.54.1.3 Exhibit C - Correctional Health Services Business Associates
Agreement (BAA)
8.55
NOTICES
All notices given pursuant to the terms of this contract shall be addressed to:
For County:
Maricopa County
Office of Procurement Services
301 W. Jefferson St. Suite 700
Phoenix, Arizona 85003-1647
For Contractor:
Ms. Desiree Turner
Kan-Di-Ki LLC dba TridentCare
15200 Stagg Street #1
Van Nuys, CA 91405
8.56
INQUIRIES
8.56.1 Inquiries concerning information herein must be submitted prior to the question
deadline date/time posted in the e-procurement platform, Periscope S2G, using
the link in the “Q&A” tab.
8.56.2 Administrative telephone/email inquiries shall be addressed to:
ANDREA STUPKA, PROCUREMENT OFFICER
TELEPHONE: (602) 506-3504
Andrea.Stupka@maricopa.gov
8.56.3 Inquiries may be submitted by telephone but must be followed up in writing. No
oral communication is binding on Maricopa County.
SERIAL 230176-RFP
IN WITNESS WHEREOF, this contract is executed on the date set forth above.
CONTRACTOR
AUTHORIZED SIGNATURE
PRINTED NAME AND TITLE
ADDRESS
DATE
MARICOPA COUNTY
CHAIRMAN, BOARD OF SUPERVISORS
DATE
ATTESTED:
CLERK OF THE BOARD
DATE
APPROVED AS TO FORM:
DEPUTY COUNTY ATTORNEY
DATE
Desiree Turner, VP of Sales
08/24/2023
6WDJJ6WUHHW9DQ1X\V&$
SERIAL 230176-RFP
ATTACHMENT A: VENDOR INFORMATION AND PRICING
COMPANY NAME:
Kan-Di-Ki LLC
DOING BUSINESS AS (dba):
TridentCare
MAILING ADDRESS:
15200 Stagg Street #1, Van Nuys, CA 91405
REMIT TO ADDRESS:
P.O. BOX 6676210, Dallas, TX 75267-6192
TELEPHONE NUMBER:
818-549-1880
FAX NUMBER:
602-343-6588
WWW ADDRESS:
www.tridentcare.com
REPRESENTATIVE NAME:
Desiree Turner
REPRESENTATIVE TELEPHONE NUMBER:
510-506-8716
REPRESENTATIVE EMAIL ADDRESS
desiree.turner@tridentcare.com
YES
NO
REBATE
WILL ALLOW OTHER GOVERNMENTAL ENTITIES TO
PURCHASE FROM THIS CONTRACT:
WILL ACCEPT PROCUREMENT CARD FOR PAYMENT:
PAYMENT TERMS:
NET 30 DAYS
1.0 PRICING:
ITEM DESCRIPTION
INDICATE (+) or
(-) AHCCCS
Pricing
INDICATE
(+) or (-)
Pricing
1.1 Pricing (Radiology Pricing): Indicate a percentage
of applicable AHCCCS rates. For example - if bid
price is at AHCCCS rates, indicate 100 percent, if bid
price is 40 percent below AHCCCS rates indicate 60
percent.
50
%
1.2 Pricing (Ultrasound Pricing): Indicate a
percentage of applicable AHCCCS rates. For
example - if bid price is at AHCCCS rates, indicate
100 percent, if bid price is 10 percent above AHCCCS
rates indicate 110 percent.
150
%
SERIAL 230176-RFP
ATTACHMENT B: SCOPE OF WORK
1.
INTENT
1.1.
Maricopa County (County) seeks a singular contractor or multiple contractors to provide
ultrasound services and/or radiographic readings for Correctional Health Services (CHS).
CHS is responsible for providing ultrasound services and radiographic readings for all
incarcerated patients in the County jails and will accomplish this via contractor(s) per this
resulting contract. CHS estimates approximately 7,400 x-rays and 570 ultrasound
examinations are performed annually.
1.2.
CHS providers order ultrasounds and radiographic studies based on medical necessity on
an “as needed” basis. Therefore, the County provides no guarantee as to the actual
number of ultrasound services and radiographic readings that will occur annually. Given
the associated security, labor, and cost issues, proposals requiring incarcerated patients
to be transported off-site for these services will not be considered. All contractors entering
the County jails are subject to Maricopa County Sheriff’s Office (MCSO) security
regulations to maintain a safe correctional environment.
1.3.
CHS will administer the awarded contract.
1.4.
The County reserves the right to add additional contractors, at the County’s sole discretion,
in cases where the currently listed contractors are of an insufficient number or skill set to
satisfy the County’s needs.
1.5.
The County intends to award this contract to a sole contractor but reserves the right to
award this contract to multiple contractors, if necessary. The County reserves the right to
award in whole or in part, by item or group of items, by section or geographic area, or make
multiple awards, where such action serves the County’s best interest.
2.
SCOPE OF WORK
2.1.
BACKGROUND
2.1.1.
The County jail system is the fourth largest in the United States, with a daily
population of approximately 7,000 inmates, a maximum capacity of 8,925 inmates,
and an estimated 100,000 bookings annually, and approximately 250,000 patient
encounters per year. CHS provides professional health care services for all
incarcerated patients within the County jail system 24 hours per day, 7 days per
week, and 365 days per year. Professional health care services are delivered
within the scope of practice as determined by state licensing boards and meet the
standard of care in the community. CHS is accredited by the National Commission
on Correctional Health Care (NCCHC), the national agency responsible for
establishing quality standards for correctional health care.
2.2.
SERVICE REQUIREMENTS
2.2.1.
Ultrasound services and sonographic readings. Contractor shall:
2.2.1.1.
Accept routine orders for ultrasound services from CHS providers via
the inbound portion of the bi-directional Electronic Health Record (EHR)
interface to the contractor’s radiology application or web portal (See
Section 2.4.4.1.3.1). Emergent orders for ultrasounds are sent out to the
hospital.
2.2.1.2.
Provide multiple currently certified sonographer/ultrasound technologist
personnel (employees of the contractor or subcontractors) to perform
onsite mobile ultrasound services for a minimum of 128 days annually
for eight hours per day to complete approximately 570 ultrasound
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images/sonographic studies annually. The contractor is responsible for
ensuring all the following:
2.2.1.2.1.
A minimum of one sonographer/ultrasound technologist is
present onsite to capture all ultrasound images/perform
sonographic studies.
2.2.1.2.2.
Replacement
coverage
for
sonographer/ultrasound
technologist absences to avoid the accrual of backlog of
orders with delayed or non-completion. Failure to provide
replacement coverage for absences will result in service
credits at the following rates:
2.2.1.2.2.1.
First Occurrence = $25.00
2.2.1.2.2.2.
Second Occurrence = $50.00
2.2.1.2.2.3.
Third and Subsequent Occurrences =
$100.00
2.2.1.3.
Provide portable ultrasound machines and bring all required equipment
and supplies onsite to perform mobile ultrasound services.
2.2.1.3.1.
All
equipment
shall
be
maintained
in
proper
working/operating condition and in compliance with
regulatory and industry standards pursuant to the
manufacturer’s guidelines. County will provide onsite
utilities, such as electricity, outlets, etcetera for contractor’s
equipment.
2.2.1.3.1.1.
Contractor
shall
ensure
that
portable
ultrasound machines are properly functioning
and operational for the full 8-hours during the
estimated 128 days annually.
2.2.1.3.1.2.
Contractor is responsible for providing all
preventive
maintenance,
recalibration,
repairs, upkeep, updating, servicing, and
possible replacement of all ultrasound
equipment throughout the life of the contract,
without additional cost or fees to the County.
2.2.1.3.1.2.1.
Outages/downtime
for
preventive
maintenance,
recalibration,
repairs,
upkeep, updating, servicing
shall
be
planned
accordingly to avoid any
disruptions to patient care
for the full 8-hours during
the estimated 128 days
annually.
2.2.1.3.1.2.2.
Contractor
shall
provide
maintenance logs to CHS
upon request.
2.2.1.3.1.3.
Contractor and CHS agree that from time to
time equivalent or state of the art supplies
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and/or equipment may become available.
Contractor reserves the right to substitute
any of the items listed above with no less
than an equivalent product following written
approval by CHS.
2.2.1.3.2.
All supplies shall meet the latest health, safety and
technology standards, rules, and regulations.
2.2.1.4.
Use the adequate space as designated by CHS to perform the mobile
ultrasound services as detailed in the resulting contract. CHS will
provide sufficient security for the contractor’s sonographer/ultrasound
technologist personnel to provide ultrasound services to incarcerated
patients in collaboration with MCSO detention escorts.
2.2.1.5.
Perform onsite mobile ultrasound services on a mutually agreed upon
schedule. Based on previous volume of approximately 570 ultrasound
images/sonographic studies annually, CHS expects that a full eight-hour
day at each location as specified below for an annual estimate of 128
days across all locations will be necessary for the contractor’s
sonographer/ultrasound technologist personnel to keep up with the flow
of incoming orders and avoid any disruption to patient care. CHS
reserves the right to increase the provision of ultrasound services to
include additional days or at additional clinic locations within the County
jails in the future to meet patients’ needs. The expected mutually agreed
upon schedule is as follows:
2.2.1.5.1.
One eight-hour day per week (estimated 52 days annually)
at Estrella Jail Outpatient Clinic 2939, West Durango Road,
Phoenix, AZ 85009.
2.2.1.5.2.
One eight-hour day per week (estimated 52 days annually)
at Lower Buckeye Jail Outpatient Clinic, 3250 West Lower
Buckeye Road, Phoenix, AZ 85009.
2.2.1.5.3.
One eight-hour day every four weeks (estimated 12 days
annually) at Fourth Avenue Jail Outpatient Clinic, 201 South
4th Avenue, Phoenix, AZ 85003.
2.2.1.5.4.
One eight-hour day every four weeks (estimated 12 days
annually) at Watkins Jail Outpatient Clinic, 2680 South 28th
Drive, Phoenix, AZ 85009.
2.2.1.6.
Be responsible for tracking and performing open orders at each clinic
location on the next scheduled clinic day. A backlog corresponds to an
ultrasound order that is incomplete within 30 days (See Section 2.2.1.9)
If a backlog occurs, the contractor shall provide additional staff and
equipment to eliminate the backlog within 15 days.
2.2.1.7.
Submit requested schedule changes for approval to CHS in writing a
minimum of 30 days before the requested schedule change. To ensure
adequate MCSO detention escorts are available to provide security and
avoid any disruption to patient care, all requested scheduled changes
must be approved.
2.2.1.8.
Perform mobile ultrasound examination on incarcerated patients per
CHS providers’ orders, including but not limited to the following:
2.2.1.8.1.
Abdominal ultrasounds
SERIAL 230176-RFP
2.2.1.8.2.
Pelvic (with and without transvaginal probe) ultrasounds
2.2.1.8.3.
Breast ultrasounds
2.2.1.8.4.
Thyroid ultrasounds
2.2.1.8.5.
Vascular ultrasounds
2.2.1.8.6.
Obstetric ultrasounds
2.2.1.8.7.
Renal ultrasounds
2.2.1.8.8.
Scrotal ultrasounds
2.2.1.9.
Perform mobile ultrasound examinations within 30 days of the date
ordered. Absent circumstances outside of the contractor’s control,
failure to perform ultrasound examinations within 45 days may result in
service credits at the following rates:
2.2.1.9.1.
First Occurrence = $25.00
2.2.1.9.2.
Second Occurrence = $50.00
2.2.1.9.3.
Third and Subsequent Occurrences = $100.00
2.2.1.10. Ensure the sonographer/ultrasound technologist personnel accurately
captures quality ultrasound images during the performance of
sonographic studies at each examination that meet the standard of care
in the community.
2.2.1.11. Ensure the sonographer/ultrasound technologist personnel submits
documentation in the EHR at the conclusion of the examination and
before leaving the clinic.
2.2.1.12. Maintain all original ultrasound images/sonographic studies pursuant to
current state and federal retention schedules.
2.2.1.13. Provide
and
deliver
ultrasound
images/sonographic
studies
electronically to CHS and to any specialty clinics upon request.
2.2.1.13.1. This only applies if the contractor is unable to transmit all
ultrasound images/sonographic studies from the ultrasound
equipment to CHS’ Picture Archiving and Communication
System (PACS) (See Section 2.4.4.1.1).
2.2.1.14. Electronically receive ultrasound images/sonographic studies via the
inbound interface for the contractor’s radiologist personnel’s review (See
Section 2.4.4.1.1).
2.2.1.15. Provide multiple, currently licensed and board-certified radiologist
personnel (employees of the contractor or subcontractors) to provide
accurate sonographic readings for all ultrasound images/sonographic
studies.
2.2.1.16. Electronically submit the contractor’s radiologist personnel’s diagnostic
and interpretive sonographic reports via the outbound portion of the
EHR interface within 24 hours for all completed ultrasound
images/sonographic studies (regardless of the time received) (See
SERIAL 230176-RFP
Section 2.4.4.1.3.2). Emergent ultrasound x-ray studies would be read
at the hospital.
2.2.1.17. Initiate a phone call to the on-call CHS provider when, in the opinion of
the contractor’s radiologist personnel, there is or may be an urgent need
for a CHS provider to take immediate action to ensure the health and
safety of the patient as a result of the sonographic reading.
2.2.1.17.1. Follow up with an email to the CHS provider when unable
to reach via phone.
2.2.2.
Radiographic Readings. Contractor shall:
2.2.2.1.
Accept routine orders for radiographic readings from CHS providers via
the inbound portion of the bi-directional EHR interface to the contractor’s
radiology application or web portal (See Section 2.4.4.1.3.1). Emergent
x-ray orders are sent out to the hospital.
2.2.2.1.1.
CHS
radiology
technologists
capture
x-ray
images/radiographic studies on site at three different x-ray
clinics, located at Fourth Avenue Jail, Lower Buckeye Jail,
and Watkins Jail (addresses provided in Sections 2.2.1.5.3,
2.2.1.5.2, and 2.2.1.5.4, respectively).
2.2.2.2.
Electronically receive x-ray images/radiographic studies for the
contractor’s radiologist personnel’s review via the inbound PACS
interface to the contractor’s radiology application or web portal during
regular business hours Monday through Friday, 8:00 a.m. to 5:00 p.m.
MST (See Section 2.4.4.1.2).
2.2.2.3.
Provide multiple, currently licensed and board-certified radiologist
personnel (employees of the contractor or subcontractors) to provide
accurate radiographic readings.
2.2.2.4.
Electronically submit the contractor’s radiologist personnel’s diagnostic
and interpretive radiographic reports via the outbound portion of the
EHR interface within six hours of the receipt of electronic submission for
all completed x-ray studies (regardless of the time received) (See
Section 2.4.4.1.3.2). Emergent x-ray studies would be read at the
hospital.
2.2.2.5.
Initiate a phone call to the on-call CHS provider when, in the opinion of
the contractor’s radiologist personnel, there is or may be an urgent need
for a CHS provider to take immediate action to ensure the health and
safety of the patient as a result of the radiographic reading.
2.2.2.5.1.
Follow up with an email to the CHS provider when unable
to reach via phone.
2.2.3.
All services. Contractor shall:
2.2.3.1.
Have a minimum of five years of experience providing professional
ultrasound
services
and/or
radiographic/sonographic
readings,
preferably in a correctional environment of similar size and population
as the County jail system.
2.2.3.2.
Maintain a primary Point of Contact (POC) for all issues related to the
resulting contract and provide current contact information at all times.
SERIAL 230176-RFP
2.2.3.3.
Maintain current licensure with the Arizona Regulatory Commission and
to do business in the State of Arizona.
2.2.3.4.
Have the personnel (employees of the contractor or subcontractors) and
equipment to perform the requested services within the required
timeframes at all times throughout the life of the resulting contract.
2.2.3.5.
Provide all personnel (employees of the contractor or subcontractors),
labor, materials, equipment, equipment maintenance, transportation,
travel, licenses, permits, certifications, and any other items necessary to
render services pursuant to the resulting contract.
2.2.3.6.
Ensure all its personnel (employees of the contractor or subcontractors)
accomplish the following:
2.2.3.6.1.
Pass a Federal, state, and local criminal background check
before performing any work as detailed in the resulting
contract and accessing any County data. Any employee
who fails the background check shall not have any access
to County data unless specifically authorized by the County
in writing. The contractor shall make background check
procedures available for inspection at any time upon
request from the County.
2.2.3.6.2.
Have required training, experience, and continuing
education records on file to provide services in full
compliance with all applicable provisions of current
governing federal, state, and local laws, statutes, rules, and
regulations relating to the performance of ultrasound
services and radiographic/sonographic readings throughout
the duration of the resulting contract. Contractor shall
provide access to these records upon the County’s request.
2.2.3.6.3.
Demonstrate competence to provide services within their
scope of practice, while maintaining applicable guidelines
for care, statutes, standards, and regulations set forth by
federal and state laws, and licensing organizations
throughout the duration of the resulting contract.
2.2.3.6.4.
Follow standard of care guidelines in effect at CHS, the
NCCHC and the American Board of Radiology (ABR), Joint
Commission on Accreditation of Healthcare Organizations
(JCAHO) throughout the duration of the resulting contract.
2.2.3.7.
Maintain a Continuous Quality Improvement (CQI) program that
includes the following at a minimum:
2.2.3.7.1.
Quality assurance and quality control measures:
2.2.3.7.1.1.
Contractor randomly selects a minimum of 10
percent of all ultrasound images/sonographic
studies for review to confirm technical quality.
2.2.3.7.1.2.
Contractor randomly selects a minimum of
2.5 percent of diagnostic and interpretive
sonographic reports for review to confirm
accuracy.
SERIAL 230176-RFP
2.2.3.7.1.3.
Contractor randomly selects a minimum of
2.5 percent of diagnostic and interpretive
radiographic reports for review to confirm
accuracy.
2.2.3.7.2.
Safety and infection control measures: Contractor provides
safeguards, safety devices, protective equipment, and take
any other necessary actions, as determined by the
contractor or the County, to reasonably protect the life,
health, and safety of all employees, personnel, and patients
encountered during the performance of work for the
resulting contract.
2.2.3.7.3.
Risk management: Contractor works collaboratively with
CHS in the collection and reporting of data and in the
development of indicators to be measured to identify trends
and mitigate risk upon request.
2.2.3.8.
Provide phone consultation to CHS providers and radiology
technologists on an “as needed” basis during regular business hours
Monday through Friday, 8:00 a.m. to 5:00 p.m. MST.
2.2.3.9.
Ensure an orderly transition from one contractor to the next.
2.2.4.
All services performed outside of the awarded contract will be at the sole risk and
expense of the contractor.
2.3.
PERSONNEL REQUIREMENTS
2.3.1.
Qualifications for each sonographers/ultrasound technologists (before selection).
Contractor shall submit:
2.3.1.1.
Copy of Professional Certification: A current, valid, unrestricted,
professional certification as a Registered Diagnostic Medical
Sonographer (RDMS) from the American Registry for Diagnostic
Medical Sonography (ARDMS).
2.3.1.1.1.
An updated copy of the renewed certification must be
provided to CHSOnboard@maricopa.gov for ongoing
compliance before expiration in accordance with NCCHC
Standard J-C-01 Credentials; and as detailed in CHS
Standard Operating Procedure (SOP) J-C-01 Credentials.
2.3.1.1.1.1.
Contractor shall immediately notify both the
Office of Procurement Services (OPS) and
CHSOnboard@maricopa.gov of any and all
changes
concerning
certifications
any
pending
disciplinary
Board
action
or
probationary status on the contractor’s
professional certification.
2.3.1.1.1.2.
At a minimum, contractor must notify
CHSOnboard@maricopa.gov
in
writing
within three days after an awareness the
professional certification lapses or is denied,
suspended,
revoked,
terminated,
relinquished, or made subject to probation or
any other restriction.
SERIAL 230176-RFP
2.3.1.2.
Copy of current, completed Primary Source Verification (PSV) to
investigate and verify whether the contractor’s sonographers/ultrasound
technologist personnel have any current, pending, or prior disciplinary
board actions in accordance with NCCHC Standard J-C-01 Credentials;
and as detailed in CHS SOP J-C-01 Credentials.
2.3.1.2.1.
PSVs for sonographers/ultrasound technologists are
obtained
via
the
following
link:
https://www.ardms.org/maintain-certification/registrant-
support/statusverification/.
2.3.1.2.2.
Contractor agrees to perform and submit subsequent PSVs
to CHSOnboard@maricopa.gov for ongoing compliance at
the following timeframes after contract award:
2.3.1.2.2.1.
On an annual basis.
2.3.1.2.2.2.
Upon certification renewal.
2.3.1.2.2.3.
Upon request from CHS.
2.3.2.
Onboarding documentation for each sonographers/ultrasound technologists (after
selection). Contractor shall submit:
2.3.2.1.
Onboarding Packet: CHS requires using the most updated version of
the Onboarding Packet, available online at the following link:
https://www.maricopa.gov/DocumentCenter/View/76039/Onboarding-
Packet. The Onboarding Packet must be completed and submitted with
all required supporting documentation to CHSOnboard@maricopa.gov.
2.3.2.1.1.
Onboarding Checklist. Required demographic information.
2.3.2.1.1.1.
Legal name (first middle last format)
2.3.2.1.1.2.
Preferred name (if applicable)
2.3.2.1.1.3.
Date of birth (DOB)
2.3.2.1.1.4.
Last four digits of social security number
(SSN)
2.3.2.1.1.5.
Phone number
2.3.2.1.1.6.
Email address
2.3.2.1.1.7.
Position
2.3.2.1.2.
Onboarding Packet Forms. Required forms that must be
completed and signed:
2.3.2.1.2.1.
Prison
Rape
Elimination
Act
(PREA)
Acknowledgement.
2.3.2.1.2.2.
MCSO
Application
for
Courtesy
Identification.
2.3.2.1.2.3.
Maricopa County Security Services Division
Security Background Check Application.
SERIAL 230176-RFP
2.3.2.1.2.4.
Contractor Identification (ID) form.
2.3.2.1.2.5.
Parking Agreement form.
2.3.2.1.2.6.
Attestation for Drug-Free Workplace.
2.3.2.1.3.
Required supporting documentation that must be submitted
with the Onboarding Packet:
2.3.2.1.3.1.
Copies of the front and back of a current,
valid, unrestricted driver’s license.
2.3.2.1.3.2.
Copy of current, completed Basic Life
Support
(BLS)
certification
to
support
successful
completion
of
the
national
cognitive
and
skills
evaluations
in
accordance with the curriculum of the
American Heart Association (AHA) for the
healthcare providers. Cognitive and skills
evaluation
includes
Cardio-Pulmonary
Resuscitation (CPR) and Automatic External
Defibrillator (AED). CHS requires an “in-
person
skills
test”
with
a
“hands-on
demonstration.” BLS certification of training
from an online educator will not be accepted.
Certification is valid for two years. An
updated copy of BLS re-certification must be
provided to CHSOnboard@maricopa.gov
prior to expiration in accordance with
NCCHC
Standard
J-C-03
Professional
Development; and as detailed in SOP J-C-03
Professional Development. BLS certification
is available from MCSO at no cost to the
contractor.
The
following
link
(http://ahainstructornetwork.americanheart.o
rg/AHAECC/classConnector.jsp?pid=ahaec
c.classconnector.home) provides a search
engine for upcoming AHA classes in the
community, for which the contractor is
responsible for any associated cost.
2.3.2.1.3.3.
Copy of current tuberculosis (TB) test: TB
test types include TB skin test/Purified
Protein Derivative (PPD), QuantiFERON
(QFT)-TB Gold blood test, chest x-ray, and
TB symptom questionnaire. TB test results
include positive and negative. TB test date is
when the contactor obtained the TB test
result reading. TB test results are valid for
one year following the TB test date until TB
test expiration. An updated copy of TB results
must be provided annually to CHS prior to
expiration in accordance with NCCHC
Standard J-C-09 Orientation for Health Staff;
and as detailed in CHS SOP J-C-09
Orientation for Health Staff.
SERIAL 230176-RFP
2.3.2.1.3.3.1.
For non-reactors, an annual
TB
skin
test/PPD
is
required.
2.3.2.1.3.3.2.
For reactors, a QFT-TB
Gold blood test -OR- a
chest x-ray is required
every five years and a TB
symptom questionnaire to
document
asymptomatic
status is required annually.
2.3.2.1.3.4.
Copy of completed Hepatitis B vaccine
series, titer testing to confirm immunity
status, or a signed Hepatitis B declination
statement for any contractor who is not
immune
and
refuses
the
vaccine
in
accordance with NCCHC Standard J-C-09,
Orientation for Health Staff; and as detailed
in CHS SOP J-C-09 Orientation for Health
Staff.
2.3.2.1.3.5.
Copy of completed Measles, Mumps, and
Rubella (MMR) vaccine series or titer testing
to confirm immunity status in accordance
with NCCHC Standard J-C-09, Orientation
for Health Staff; and as detailed in CHS SOP
J-C-09 Orientation for Health Staff.
2.3.2.1.3.6.
Copy
of
completed
Varicella
vaccine
documentation, titer testing to confirm
immunity status, or a signed attestation of
past chickenpox in accordance with NCCHC
Standard J-C-09 Orientation for Health Staff;
and as detailed in CHS SOP J-C-09
Orientation for Health Staff.
2.3.3.
Background
clearances
for
sonographers/ultrasound
technologists
after
submission of the onboarding documentation (There is no cost to the contractor
associated with these additional background investigations):
2.3.3.1.
MCSO Background Clearance and Fingerprinting
2.3.3.1.1.
All contractors who perform onsite services for CHS must
complete
the
MCSO
background
clearance
and
fingerprinting.
2.3.3.1.2.
The
initial
MCSO
background
clearance
involves
processing the following: See Section 2.3.2.1.2.1 PREA
Acknowledgement
and
Section
2.3.2.1.2.2
MCSO
Application for Courtesy Identification. CHS submits these
two forms to MCSO, which determines if the contractor may
proceed to the fingerprinting process.
2.3.3.1.3.
The fingerprinting process is performed by appointment
only onsite at the MCSO Training Center located at 2627 S.
35th Avenue, Phoenix, AZ 85009. Fingerprints are verified
with the Federal Bureau of Investigation (FBI). The
fingerprinting process must be repeated by the contractor if
SERIAL 230176-RFP
there is a break in service or if no work has been performed
during the past six months.
2.3.3.1.4.
The results of the MCSO background clearance and
fingerprinting will determine if the contractor is eligible to
perform services for CHS.
2.3.3.1.5.
Contractors who fail to pass the MCSO background
clearance and fingerprinting are ineligible to perform work
for CHS. CHS is not responsible, nor informed, of the
reasons
that
individuals
maybe
rejected,
as
all
determinations are made by MCSO.
2.3.3.2.
Security Services Background Clearance
2.3.3.2.1.
All contractors who perform onsite services for CHS and
receive the County contractor badges to independently
navigate the jails must complete the Security Services
background clearance.
2.3.3.2.2.
The Security Services background clearance involves
processing the following: See Section 2.3.2.1.2.3 Maricopa
County Security Services Division Security Background
Check Application, Section 2.3.2.1.2.4 Contractor ID Form,
Section 2.3.2.1.2.5 Parking Agreement Form. CHS submits
these three forms and Section 2.3.2.1.3.1 Copies of front
and back of a current, valid, unrestricted driver’s license to
Security Services.
2.3.3.2.3.
The results of the Security Services background clearance
will determine if the contractor is eligible to perform services
for CHS.
2.3.3.2.4.
Contractors who fail to pass the Security Services
background clearance are ineligible to perform work for
CHS. CHS is not responsible, nor informed, of the reasons
that individuals maybe rejected, as all determinations are
made by Security Services.
2.3.3.3.
Successful completion of both MCSO and Security Services background
clearances corresponds to the issuance of badges and eligibility to
schedule the onsite orientation.
2.3.4.
Badges for sonographers/ultrasound technologists
2.3.4.1.
Contractor shall obtain the County contractor badge prior to classroom
orientation from Security Services at 301 W. Jefferson Street, Suite 160,
Phoenix, AZ 85003. The County contractor badge contains a
photograph of the contractor, their full name, and position to signify
affiliation with the County. Contractors must carry this badge while on
duty and inside of the jail facilities and are required to present this badge
upon request. There is no cost to the contractor for the initial County
contractor badge. If the contractor loses the County contractor badge,
Security Services charges a $12.00 replacement fee, for which the
contractor is responsible.
2.3.4.2.
Contractor shall be issued a CHS badge during classroom orientation.
The CHS badge contains a photograph of the contractor and their
position to signify affiliation with CHS and must be visibly displayed and
SERIAL 230176-RFP
worn on the upper part of the body while on duty and inside of the jail
facilities. The CHS badge contains an expiration date of 12 months. The
contractor is responsible for obtaining a renewed CHS badge prior to
expiration. There is no cost to the contractor for the initial, renewed, or
replacement CHS badges.
2.3.4.3.
All contractors must immediately report lost or stolen badges to the CHS
contract administrator for security reasons.
2.3.4.4.
All contractors must surrender their badges upon termination for security
reasons.
2.3.5.
Onsite orientation for sonographers/ultrasound technologists
2.3.5.1.
All contractors are required to attend an orientation before performing
any onsite work for CHS.
2.3.5.2.
Contractors are only eligible to schedule the onsite orientation following
successful background clearance.
2.3.5.3.
CHS Onboard (CHSOnboard@maricopa.gov) coordinates scheduling
the onsite orientation.
2.3.5.4.
CHS Education (CHS.Education@maricopa.gov) administers the onsite
orientation.
2.3.5.5.
The onsite orientation consists of formal instruction designed to
familiarize all contractor’s personnel with CHS and MCSO policies,
procedures, and security issues while providing services for CHS.
2.3.5.6.
Before attending the onsite orientation, the contractor’s personnel must
review the Contractor Information Packet; available online at the
following
link:
https://www.maricopa.gov/DocumentCenter/View/76559/Contractor-
Information-Packet.
2.3.5.7.
Successful completion of the onsite orientation training program results
in documentation verifying attendance at and completion of the following
topics: Introduction to CHS, PREA, Environmental Safety, Infection
Control/Bloodborne Pathogens, and Health Insurance Portability and
Accountability Act (HIPAA).
2.3.6.
General Requirements
2.3.6.1.
Contractor and contractor’s personnel must do all the following while
performing services for CHS:
2.3.6.1.1.
Ensure all its personnel (employees of the contractor or
subcontractors) possess and maintain current valid
professional licenses, certifications, and board certifications
if applicable, as required to perform the services detailed in
this contract and within their scope of practice as
determined by regulatory licensing/certification boards.
2.3.6.1.2.
Adhere to and model the code of ethics associated with their
license/certification.
2.3.6.1.3.
Comply with Occupational Safety and Health Administration
(OSHA) standards and regulations.
SERIAL 230176-RFP
2.3.6.1.4.
Comply with applicable County policies, such as those
related to the safekeeping of Protected Health Information
(PHI), including A2611: Use of Technology Resources.
CHS will provide the contractor with copies of applicable
County policies.
2.3.6.1.5.
Maintain patient confidentiality and ensure the safekeeping
of PHI in accordance with HIPAA rules and regulatory
standards.
2.3.6.1.6.
Use secured/encrypted email communications whenever
PHI or other confidential/sensitive information is included.
2.3.6.1.7.
Comply with all MCSO policies, procedures, and security
regulations while onsite in the County jails. Non-restricted
MCSO Detention policies and procedures are available
online at the following link: https://www.mcso.org/general-
info/mcso-policies/detention-policies-and-procedures.
2.3.6.1.8.
Comply with the CHS dress code and visibly display/wear
their CHS badge on the upper part of the body while onsite.
2.3.6.1.9.
Carry their assigned County contractor badge and present
this badge upon request while onsite.
2.3.6.1.10. Comply with CHS policies, SOPs, and Clinical Practice
Guidelines. CHS will provide the contractor with access to
these resources.
2.3.6.2.
Contractor bears full responsibility for the contractor’s personnel
compliance with all applicable requirements as detailed in this
agreement.
2.4.
TECHNICAL REQUIREMENTS
2.4.1.
Environment
2.4.1.1.
CHS operates within the wider interdepartmental County secured
network maintained by the Office of Enterprise Technology (OET).
2.4.1.2.
OET and Integrated Criminal Justice Information System (ICJIS) handle
the architecture and maintenance of networks, as well as the interfaces
for data exchange between County departments and with external
organizations/agencies.
2.4.2.
Electronic Health Record (EHR)
2.4.2.1.
CHS currently uses TechCare® version 4.5, a correctional-health-
focused EHR system, procured from NaphCare, Inc. in all clinic
locations.
2.4.2.1.1.
CHS is currently in the implementation phase of a new EHR
system through Fusion, which is anticipated to go live by
April 2025.
2.4.2.1.2.
The contractor is responsible for collaborating with any EHR
system that the CHS uses at no additional cost to the
County.
SERIAL 230176-RFP
2.4.2.2.
The EHR manages comprehensive documentation of procedures,
evaluations, and other forms of health care services CHS provides to
incarcerated patients.
2.4.2.3.
The
EHR
allows
orders
for
ultrasound
services
and
radiographic/sonographic readings to be entered and electronically
transmitted from the point where the order originates through an inbound
interface to the contractor’s radiology application or web portal, thus
minimizing delays/medical errors, eliminating lost paperwork, and
making information readily accessible.
2.4.2.4.
CHS shall provide the contractor with EHR access as needed to fulfill
the requirements of this contract.
2.4.2.4.1.
CHS will grant the contractor’s sonographer/ultrasound
technologist personnel onsite access to the EHR and
provide onsite computers to enter all patient documentation
in
the
EHR.
CHS
requires
the
contractor’s
sonographer/ultrasound technologist personnel complete
all patient documentation on site immediately following the
examination and before leaving the clinic.
2.4.3.
Picture Archiving and Communication System (PACS)
2.4.3.1.
CHS currently uses Image Quality (iQ) IMAGE® procured from
Ackermann Imaging, Inc.
2.4.3.2.
The PACS serves as the backbone of radiology workflows:
2.4.3.2.1.
Securely stores and tracks x-ray and ultrasound exam
orders for patients from the EHR.
2.4.3.2.2.
Allows onsite CHS radiology technologists to capture x-ray
images/radiographic studies.
2.4.3.2.3.
Securely stores and manages completed studies in an
organized and readily accessible manner.
2.4.4.
Interfaces
2.4.4.1.
Contractor shall provide the following three seamless interfaces (See
Exhibit 5 - Interface Diagrams) and maintain these interfaces throughout
the life of the contract:
2.4.4.1.1.
An inbound interface from the ultrasound machines, either
to the CHS’ PACS (preferred) -OR- through the County
network directly to the contractor’s radiology application or
web portal. This interface facilitates the receipt of the exam
details, known as the “technician sheet,” and the ultrasound
images/sonographic studies via Digital Imaging and
Communications in Medicine (DICOM) format to the
contractor’s radiologist personnel to perform sonographic
readings.
2.4.4.1.2.
An inbound interface from CHS’ PACS to the contractor’s
radiology application or web portal. This interface facilitates
the receipt of x-ray images/radiographic studies (DICOM) to
SERIAL 230176-RFP
the
contractor’s
radiologist
personnel
to
perform
radiographic readings.
2.4.4.1.3.
A bi-directional interface between CHS’ EHR and the
contractor’s radiology application or web portal. This bi-
directional interface facilitates both of the following:
2.4.4.1.3.1.
The inbound receipt of orders for ultrasound
services
and
radiographic/sonographic
readings via Health Level Seven (HL7)
format from the EHR to contractor’s radiology
application or web portal.
2.4.4.1.3.2.
The outbound transmission of diagnostic and
interpretive
radiographic/sonographic
reading reports as performed by the
contractor’s radiologist personnel (HL7) from
the contractor’s radiology application or web
portal to the EHR for the CHS providers’
review.
2.4.4.2.
Contractor shall ensure the following for these interfaces throughout the
life of the contract:
2.4.4.2.1.
Meet security requirements per OET and ICJIS.
2.4.4.2.2.
Integration with ICJIS via Virtual Private Network (VPN)
tunnels.
2.4.4.2.3.
Transmit data securely using HL7 standards with no delay
in service.
2.4.4.2.4.
Accepts inbound updates in real-time, e.g., receive,
process, and provide acknowledgment of interface
messages in the following circumstances:
2.4.4.2.4.1.
Order updates transmitted from the EHR
(See Section 2.4.4.1.3.1).
2.4.4.2.4.2.
Ultrasound
images/sonographic
studies
transmitted via the inbound interface (See
Section 2.4.4.1.1).
2.4.4.2.4.3.
X-ray
images/radiographic
studies
transmitted via the inbound interface from the
PACS (See Section 2.4.4.1.2).
2.4.4.2.5.
Provides
outbound
diagnostic
and
interpretive
sonographic/radiographic reading reports via the outbound
portion of the EHR interface in real-time (See Section
2.4.4.1.3.2).
2.4.4.3.
Contractor shall develop, implement, and complete the fully operational
interfaces within 180 days of the County’s notice of contract award to
prevent any disruption to patient care.
2.4.4.3.1.
The contractor shall provide an implementation plan to meet
this material requirement within their proposal.
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2.4.4.4.
Contractor shall demonstrate complete interface compatibility without
any errors within 180 days of the County’s notice of contract award and
before implementation.
2.4.4.4.1.
Failure to complete the fully operational interfaces within
180 days of the County’s notice of contract award may
result in liquidated damages to the County of $300.00 for
each day that the interfaces are not fully operational. The
assessment of liquidated damages is in addition to all other
remedies available to the County, including Termination for
Default (See Section 10.13 in Draft Contract).
2.4.4.5.
Contractor is solely responsible for all costs associated with
development,
testing,
configuration,
and
any
future
required
modifications for the interfaces to be compatible with the current
equipment and systems in place at CHS.
2.4.4.6.
Contractor shall provide ongoing technical support on an “as needed”
basis during regular business hours Monday through Friday, 8:00 a.m.
to 5:00 p.m. MST to assist with the development and maintenance of
the interfaces as changes occur, throughout the life of the contract,
without additional cost or fees .
2.4.5.
Software Application
2.4.5.1.
Contractor must have a radiology application or web portal.
2.4.5.1.1.
Online access
2.4.5.1.1.1.
Contractor shall provide portal access to the
radiology application or web portal for
approximately five employed CHS users.
2.4.5.1.1.1.1.
Each user requires unique
login credentials, consisting
of a user identification and
password.
2.4.5.1.2.
Availability
2.4.5.1.2.1.
The contractor’s radiology application or web
portal shall be available to accommodate
patient care 24 hours per day, 7 days per
week, and 365 days per year.
2.4.5.1.2.1.1.
Any information systems
required
for
proper
functionally of the hosted
application must have 99.6
percent uptime during CHS
hours of operation: 24 hours
per day, 7 days per week,
and 365 days per year.
Uptime
measurements
must be met for all servers
and their connectivity to the
internet
or
dedicated
connection to the County,
whichever is applicable.
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2.4.5.1.2.1.2.
An
industry-recognized
backup methodology must
be employed, including the
use of off-site storage. The
contractor
must
make
backup
procedures
and
logs available at any time
upon
request
from
the
County.
2.4.5.1.2.1.3.
Application response time,
defined as the time it takes
to complete render the user
interface after a user action,
must be less than three
seconds
under
normal
conditions.
Unacceptable
response times shall be
considered to make the
program unavailable and
will count against the 99.6
percent uptime metric.
2.4.5.1.3.
Connectivity
2.4.5.1.3.1.
The contractor’s radiology application or web
portal shall be hosted using one of the
following options.
2.4.5.1.3.1.1.
The
contractor’s
own
servers.
2.4.5.1.3.1.2.
A third-party hosting site
that would be accessed via
high
speed
private
or
dedicated leased lines and
connecting to the County’s
VPN via the internet.
2.4.5.1.3.2.
Where applicable, contractor connectivity will
utilize a commercial Internet Service Provider
(ISP) with VPN or similar tunneling.
2.4.5.1.3.3.
Contractor is solely responsible for all costs
associated with networking equipment at the
contractor’s site.
2.4.5.1.3.4.
The contractor’s radiology application or web
portal shall serve as a backup in the event
CHS’ EHR system is down and continue to
provide the diagnostic and interpretive
radiographic/sonographic reading reports
without delay.
2.4.5.2.
Contractor shall provide Computerized Results Reporting within the
radiology application or web portal.
2.4.5.2.1.
The Computerized Results Reporting shall:
SERIAL 230176-RFP
2.4.5.2.1.1.
Be in portable document format (PDF) and
printable.
2.4.5.2.1.1.1.
Contractor shall coordinate
with CHS to determine the
preferred
format
for
Computerized
Results
Reporting
that
will
be
consistent across all CHS
clinic locations.
2.4.5.2.1.2.
Be immediately available upon completion of
the sonographic and radiographic readings
via direct portal access to the radiology
application or web portal.
2.4.5.2.1.3.
Be electronically transmitted to the EHR
using HL7 standards via the outbound
portion of the EHR interface.
2.4.5.2.1.3.1.
Contractor is required to
make
any
necessary
changes to ensure that
results are automatically
downloaded
to
the
respective patient’s EHR
and available for the CHS
provider’s
review
and
approved sign-off.
2.4.5.2.1.4.
Remain retrievable for the entirety of the
contract term and at least until all data is
transferred to the EHR via the outbound
portion of the EHR interface.
2.4.5.3.
Contractor shall provide all future hardware and software modifications,
including but not limited to updating and upgrading all radiology
application or web portal and computer programming, as changes occur,
throughout the life of the contract, without additional cost or fees.
2.4.6.
Compliance
2.4.6.1.
Contractor shall provide all licensed products, equipment, and services
in full compliance with all applicable governing laws, statutes, rules, and
regulations at the federal, state, and local levels, including (but not
limited to):
2.4.6.1.1.
HL7 standards: https://www.hl7.org/implement/standards
2.4.6.1.2.
HIPAA
rules
and
regulatory
standards:
https://www.hhs.gov/hipaa/for-professionals/index.html
2.4.6.1.3.
Health Information Technology for Economic and Clinical
Health (HITECH) Act Enforcement Interim Final Rule:
https://www.hhs.gov/hipaa/for-professionals/special-
topics/hitech-act-enforcement-interim-final-rule/index.html
2.4.6.1.4.
NCCHC standards: https://www.ncchc.org/standards/
SERIAL 230176-RFP
2.4.6.1.5.
Criminal Justice Information System (CJIS) security policy:
https://www.fbi.gov/services/cjis
2.4.6.2.
Contractor shall make compliance reports, audit findings, and third-party
attestations available to the County upon request.
2.4.6.3.
Contractor shall notify the County, in writing, within 24 hours of a
confirmed violation of the compliance requirement. The notification must
include any information provided by the regulatory body.
2.4.6.4.
Contractor shall agree to all terms set forth in the Attachment C -
Correctional Health Services Business Associate Agreement (BAA).
The BAA must be maintained for the life of the contract.
2.4.7.
Breach Notification
2.4.7.1.
Contractor shall be required to report all suspected security breaches
within 24 hours of detection in writing to the County.
2.4.7.2.
Contractor shall be obligated to fully cooperate in investigations of all
suspected security breaches.
2.4.7.3.
Contractor shall bear the sole responsibility and total cost of any security
breach and/or data loss for which the County has no control.
2.4.7.4.
Breach notification requirements shall be determined by all applicable
laws and contracts including, but not limited to, Arizona Revised
Statutes (A.R.S.) § 44-7501 and requirements as detailed in Section
2.4.6 Compliance.
2.4.8.
Data Security
2.4.8.1.
Data and database must be secured/encrypted always using the
Advanced Encryption Standard (AES) with a minimum of a 128-bit key
at all times.
2.4.8.2.
Backups to removable media must be encrypted using the AES with a
minimum of a 128-bit key. At no time shall the key be stored on the
backup media in clear text, including but not limited to table labels. The
contractor must make backup procedures and logs available at any time
upon request from the County.
2.4.8.3.
Hosted applications must support encrypted protocols for sensitive data.
Preferred encryption protocols are Transport Layer Security (TLS) or
Internet Protocol Security (IPsec). Encryption ciphers must use at least
a 128-bit key length. Hashing algorithms used must be of the Secure
Hash Algorithm (SHA) family. The minimum acceptable algorithm shall
be SHA-2.
2.4.8.4.
Contractor must provide a third-party security/risk assessment report,
e.g., System and Organization Controls 2 (SOC 2) on an annual basis -
OR- agree to allow a security assessment to be performed by the County
or authorized subcontractor of the County. Contractor shall indicate their
agreement to provide these results upon request.
2.4.8.5.
Contractor must maintain a Non-Disclosure Agreement (NDA) with the
County. All contractor’s personnel must maintain an NDA with the
contractor.
SERIAL 230176-RFP
2.4.8.6.
No County data shall be transferred or made available to a third party
without the express, written consent of the County.
2.4.8.7.
No County data shall be transferred, transmitted, or stored outside the
United States for any reason without the express, written consent of the
County.
2.4.8.8.
Contractor shall make their information security incident response policy
and procedure available to the County upon request.
2.4.9.
Information System Authorization, Authentication, and Auditing
2.4.9.1.
The contractor’s radiology application or web portal shall:
2.4.9.1.1.
Support County password policy requirements, such as
minimum length, mixed case, numerals, and non-
alphanumeric characters and forced expiration.
2.4.9.1.1.1.
Single Sign On (SSO) capabilities are
desired.
2.4.9.1.2.
Support the ability to disable or lock out user accounts after
a given number of login failures.
2.4.9.1.3.
Log all material user actions, including but not limited to,
logon and log off.
2.4.9.1.4.
Log all material administrator actions, including but not
limited to, user creation, user deleting, password resets,
and privilege level changes.
2.4.9.1.5.
Log failed login attempts.
2.4.10. Data Retention
2.4.10.1. CHS retains ownership of data stored on the contractor’s software
application following non-renewal or termination of the contract.
2.4.10.2. The contractor shall also be responsible for ensuring the timely and
secure transfer of all data stored on the contractor’s software application
in an industry-standard format while maintaining integrity of the data to
a new software application or the PACS as determined by CHS.
2.4.10.3. Contractor shall promptly destroy all offline copies of County data at the
time it ceases to be useful. Destruction procedures must be made
available to the County upon request.
2.4.10.4. At the conclusion of the contract, all County data and working papers
must be returned to the County and all contractor copies destroyed.
Contractor must confirm in writing to the County that all data was
destroyed in accordance with this agreement and state the methodology
used.
2.4.11. Training
2.4.11.1. Following the confirmation of CHS users’ access to the radiology
application or web portal, the contractor will provide the following:
SERIAL 230176-RFP
2.4.11.1.1. At least one “train the trainer” class to designated employed
CHS users to review navigation of the contractor’s radiology
application or web portal.
2.4.11.1.2. Support for recent trainees for the initial duration of the go-
live period and for at least 90 days thereafter.
2.4.12. County Email
2.4.12.1. CHS requires the contractor’s sonographer/ultrasound technologist
personnel/subcontractors to exclusively use their secured county email
addresses to conduct all county business with CHS.
2.4.12.1.1. The
contractor’s
sonographer/ultrasound
technologist
personnel/subcontractors will be provided a secured county
email address during the onsite orientation.
SERIAL 230176-RFP
CONTRACTOR RESPONSE
SUPPLEMENTAL QUESTIONNAIRE
Please respond to the questions in the same chronological order as specified below. Please include the
questions before your responses. If the question does not apply, please use “N/A” for “Not Applicable.”
1) Services: Identify the services you are willing to provide:
A - Onsite mobile ultrasound services (See Section 2.2.1.1 through Section 2.2.1.13)
B- Sonographic readings (See Section 2.2.1.14 through Section 2.2.1.17)
C- Radiographic readings (See Section 2.2.2.1 through Section 2.2.2.5)
2) Volume: Correctional Health Services (CHS) estimates approximately 7,400 x-ray exams and 570 ultrasounds
are performed annually (See Section 1.1). Outline your plan to meet the volume requirements for ultrasound
services, and/or sonographic/radiographic readings.
a) Rely, through the contracted physicians, provides interpretation of radiology and cardiology
studies, including Ultrasound and X-Ray exams. Through June 2023, Rely reports on an average
of 151,000 X-Ray exams and 23,000 Ultrasound exams per month, including exams associated
with the Maricopa County Jail.
b) Rely currently contracts with more than 75 licensed Physicians, including 30 Arizona licensed
Radiologists to enable it to fulfill its obligations under this Agreement. The Company will add
additional physicians as needed to process requests for privileges as expeditiously as possible.
Rely will be fully responsible for assuring that each Physician performs services in compliance
with the provisions of this Agreement and otherwise abides by the terms of this Agreement.
c) Rely provides its Services 7 days per week. All services are performed promptly. Rely will provide
routine ultrasound exam interpretations within 24 hours and X-Ray exam interpretations within 6
hours. Reports will be provided within the above designated timelines.
d) Ultrasound Operations can schedule 38 Clinics annually. Each Clinic involves 15 exams.
3) Qualifications: Describe the qualifications of your proposed personnel; specify the proposed number of each
type of personnel to handle the workload and identify any subcontractors that may be used to perform
ultrasound services and/or sonographic/radiographic readings (See Sections 2.2.1.2, 2.2.1.15, and 2.2.2.3).
a) All sonographers are registered through ARDMS, CCI, or ARRT (S) and/or (VS).
4) Equipment and Supplies: If applicable, list all required equipment and supplies necessary to perform ultrasound
services, and specify the make, model number, and capabilities (See Section 2.2.1.3). Describe the
frequency/schedule of preventive maintenance, recalibration, and updates and indicate your commitment to
ensure that outages/downtime do not disrupt patient care, e.g. Is alternative equipment available? (See Section
2.2.1.3.2).
a) The following US machines can/will be used.
a. Mindray MX7
b. Mindray M8
c. Mindray M7
d. Alpinion Ecube
e. GE Logic
b) The following supplies will be brought on site:
Ultrasound gel- Manufacturer: Parker
Transeptic spray- Manufacturer: Parker
Sono wipes- Manufacturer: McKesson
Nitrile gloves
5) Schedule: If applicable, indicate your ability to provide onsite mobile ultrasound services on the proposed
schedule (See Section 2.2.1.5). Provide a detailed description of how you will ensure cross-coverage for
absences (See Section 2.2.1.2.2).
SERIAL 230176-RFP
a) We will have a team of 5 to 7 sonographers that will be servicing the account. This will eliminate
missed clinics due to absences.
6) Backlog: If applicable, describe your plan to address both current (e.g., n = 50 orders) and future backlogs of
ultrasound orders (See Section 2.2.1.6).
a) We will hold 2-3 large clinics where multiple sonographers are on site conducting exams to bring
any and all backlog up to a current status within the first 180 days.
7) Readings: Provide an outline of your methodology to perform accurate sonographic and/or radiographic
readings and indicate your ability to meet the requirements for reporting timeframes and additional notifications
(See Sections 2.2.1.16, 2.2.1.17, 2.2.2.4, and 2.2.2.5).
a) (2.2.1.16 ultrasound) (2.2.2.5 x-ray) Rely through the contracted physicians will provide the
interpretation of radiology and ultrasound studies providing these services through our EMR / HL7
workflow. All services shall be performed promptly and Rely will provide routine Ultrasound exam
interpretations within 24 hours, 7- (2.2.2.4) and routine X-Ray exam interpretations within 6 hours
(STAT exams interpretations within 60 minutes). Reports will be sent via HL& interface, and or faxed
to the clinic within the contracted time frame.
b) (2.2.1.17) (2.2.2.5 x-ray) Rely shall provide all reports and records required by Maricopa limited to x-
ray and ultrasounds pertaining to the Services rendered to Maricopa’s patients in a timely basis. If any
report reflects a critical finding, Rely will immediately convey such results to appropriate personnel by
phone, (2.2.1.17.1) an email will be sent to the designated email address on file, in the even we are
unable to reach a staff member by phone.
c) Rely will provide reports in a standard format and will make available Physicians to provide consults
services for all reports. Consultations will be performed upon request of the referring physician or
referring physician staff member. All request for consultation will be called or emailed to Rely Support
staff at 972.468.3590, xray@relyradiology.com . A radiologist will call back within 2 hours for routine
and 30 min for stat.
d) Rely will contract with an adequate number of Physicians to enable it to fulfil its obligations under the
agreement. Rely will be fully responsible for assuring that each Physician performs services in
compliance with the provisions of this agreement and otherwise abides by the terms of this agreement.
8) Experience:
Provide
an
overview
of
your
experience
providing
ultrasound
services
and/or
radiographic/sonographic readings and demonstrate at least five years, preferably in a correctional environment
of similar size and population as the Maricopa County jail system (See Section 2.2.3.1).
a) TridentCare has extensive experience servicing the medical imaging needs of correctional clients.
We currently service almost 2,000 correctional locations nationwide, including 15 state DOC
contracts. We also have over 30 years’ experience operating in this environment. We work with
city, county, state, and federal governments.
9) Point of Contact (POC): Identify a primary POC for all issues related to the resulting contract and provide contact
information (See Section 2.2.3.2).
a) The POC for this contract will be:
Greg Ward, R.T. (R)(ARRT)
Vice President, Correctional Markets
Mobile Phone: (615)714-4561
Email: greg.ward@tridentcare.com
10) Licensure: Submit a copy of your licensure with the Arizona Regulatory Commission and licensure to do
business in the State of Arizona (See Section 2.2.3.3).
a) See separate attachments.
SERIAL 230176-RFP
11) Quality: Describe your quality assurance and quality control measures and elaborate on any additional
Continuous Quality Improvement (CQI) protocols in place (See Section 2.2.3.7.1).
a) See separate attachment.
12) Consultation: Provide a description of your phone consultation services available to CHS providers and
radiology technologists on an “as needed” basis during regular business hours Monday through Friday, 8:00
a.m. to 5:00 p.m. MST (See Section 2.2.3.8).
a) Physician Consult Request: A consultation request can be placed Monday through Friday, 8:00
a.m. to 5:00 p.m. MST. You can place the consult by calling 972.468.3590 or sending an email to:
xray@relyradiology.com.
Information required to place the consult request:
i)
Claim or associated number on the report you would like the consult for
ii) Reason for consult “Try to be as specific as possible for reason.”
iii) Person requesting the consult “First, Last name” relationship to patient.
iv) Best time for Consult
v) Best contact phone number
vi) We will get the consultation set up and with our reading physician.
13) Certifications and Primary Source Verification (PSVs): If applicable, provide copies of the certifications and
PSVs for each of your sonographer/ultrasound technologist personnel (See Section 2.3.1).
a) See separate attachments.
14) Interfaces: Describe your use of electronic interfacing capacity with current clients: Specify how long that
interface has been in place and cite current and past examples of configurations (See Section 2.4.4.1).
a) HL7 Orders (ORM) and Results (ORU) are available and typically aligned to v2.x standards. Both
interfaces are currently active for Maricopa since February 2021 in support of Rely reading
services.
b) DICOM transmission is facilitated via site-to-site VPN for both inbound and outbound image
transfer.
15) Ultrasound Transmission: Describe your capability for transmitting all ultrasound studies from your portable
ultrasound equipment to CHS’ Picture Archiving and Communication System (PACS) (See Section 2.4.4.1.1).
If unable to do so, describe your plan to provide and deliver ultrasound images/sonographic studies
electronically to CHS (See Section 2.2.1.13).
a) We can route all studies by common DICOM attributes including modality and customer identifiers.
We regularly route customer imaging acquired by our own technicians back to customer PACS or
intermediaries such as PowerShare. We can route all studies by common DICOM attributes
including modality and customer identifiers. We regularly route customer imaging acquired by our
own technicians back to customer PACS or intermediaries such as PowerShare.
16) Reports: Describe your capability for providing electronic reports (See Sections 2.4.4.1.3.2 and 2.4.5.2).
Describe current or past electronic reports and provide detailed examples for consideration. Two to three pages
of the response should be reserved for detailed report examples.
a) Reports can be delivered via HL7 ORU, PDF attachment via TCO web portal or fax. HL7 reporting
formats are defined by receiving systems/EMR unless they support the receipt of embedded PDF.
17) Implementation: Provide your implementation plan to accomplish the required interfaces within 180 days of
the County’s notice of contract award (See Sections 2.4.4.3 and 2.4.4.4).
SERIAL 230176-RFP
a) We have a dedicated integration team which is governed by multidisciplinary stakeholders. This
activity would be prioritized, and resources allocated as soon as we receive third party
requirements. Our typical implementation time is generally 90 days or less for highly complex
integrations. Lesser complexity or existing vendor interfaces generally are completed within 30
days.
18) Radiology application or web portal: Provide an overview of your radiology application or web portal to facilitate
the receipt of ultrasound images/sonographic studies and/or x-ray images/radiographic studies (See Section
2.4.5.1). If applicable, provide a transition plan from the current contractor’s radiology application or web portal.
a) Electronic orders for imaging studies may be submitted via our TCO portal or third-party integration
(HL7). Internally, this information integrates to our PACS via HL7 which binds the associated study
images via common identifiers. Our PACS systems have receivers for both internal and external
imaging data (site-to-site VPN required).
19) Connectivity: Specify the connectivity for the hosting of your radiology application or web portal (See Section
2.4.5.1.3.1).
a) Site-to-site VPN is required for all inbound/outbound imaging and HL7 data transmission. Our TCO
web portal is only accessible via HTTPS protocol.
CLARIFICATON QUESTIONS
1- CHS is requesting ultrasound services for a minimum of 128 days annually. Are you able to
increase the number of days per year to provide ultrasound services as compared to quantity
listed on your proposal (n = 38 days annually)?
2- 15 ultrasounds per day is probably not feasible due to staffing issues, refusals, etc. If you are
unable to increase the number of days per year to provide ultrasound services, can you please
provide clarification on the schedule for the proposed 38 days across all four jail clinic locations?
This was requested in Attachment E Supplementary Questionnaire Question #5, but seemingly
overlooked, “If applicable, indicate your ability to provide onsite mobile ultrasound services on the
proposed schedule (See Section 2.2.1.5).”
3- Would you consider increasing your proposed personnel or recruiting a subcontractor to meet
CHS’ request for ultrasound services for a minimum of 128 days annually?
Response to Clarification Questions
Our submission had an error, but we intend to be able to provide services 138 days annually. Hopefully
that answers questions 1 & 2. With regards to question 3, contractor is willing to further increase our
proposed staff along with the clinic days beyond the proposed 138 days if deemed necessary by CHS.
SERIAL 230176-RFP
ATTACHMENT C: CORRECTIONAL HEALTH SERVICES BUSINESS ASSOCIATES
AGREEMENT (BAA)
WHEREAS, CONTRACTOR has agreed to provide certain administrative services, activities or functions
in connection with the Plan (Services) pursuant to a master contract for services pursuant to RFP No.
230176-RFP (Master Services Agreement) between CONTRACTOR and Employer (Sponsor); and
WHEREAS, the parties desire to enter into this Business Associate Agreement (Agreement), effective upon
the earlier of the Master Services Agreement effective date or the date of first receipt of protected health
information (PHI) from the Plan or Sponsor by CONTRACTOR, as set forth below for the purpose of
addressing the following law, as amended and clarified by the HIPAA Omnibus Rule or any regulation, rule
or guidance that may be issued after the effective date of this Agreement:
x
The Health Information Technology for Economic and Clinical Health Act (HITECH) enacted as
part of the American Recovery and Reinvestment Act of 2009 and the regulations promulgated
thereunder relating to the privacy and security of protected health information;
x
The “Standards for Privacy of Individually Identifiable Health Information,” 45 CFR Part 160
(specifically recognizing here 45 CFR Part 160, Subparts C, D, and E (“Enforcement Rule”)) and
Part 164, Subparts A and E (Privacy Rule);
x
The “Standards for Electronic Transactions,” 45 CFR Part 160, Subpart A and Part 162, Subpart A
and Subparts I through R (“Electronic Transaction Rule”);
x
The “Security Standards for the Protection of Electronic Protected Health Information,” 45 CFR Part
160 and Part 164, Subparts A and C (“Security Rule”); and
x
The “Standards for Breach Notification for Unsecured Protected Health Information,” 45 CFR Part
160 and Part 164, Subparts A and D (“Breach Notification Rule”).
NOW, THEREFORE, in consideration of the premises and other good and valuable consideration, the
receipt and sufficiency of which are hereby acknowledged, the Plan and CONTRACTOR agree as follows:
ARTICLE 1 DEFINITIONS
1.1
“Agent” shall have the meaning given to it in Section 1.1. As provided by the Health
Insurance Portability and Accountability Act (HIPAA) an Agent and a Subcontractor are two
separate types of arrangements.
1.2
“Breach” shall have the meaning given to it by 45 CFR § 164.402.
1.3
“Business Associate” shall have the meaning given to it by 45 CFR § 160.103.
1.4
“Designated Record Set” shall have the meaning given to it by 45 CFR § 164.501.
1.5
“Health Care Operations” shall have the same meaning given to it in 45 CFR § 164.501.
1.6
“HIPAA” shall mean, collectively, the Privacy Rule, the Electronic Transaction Rule, the
Security Rule, and/or the Breach Notification Rule, each as amended and clarified by the
HIPAA Omnibus Rule.
1.7
“HIPAA Omnibus Rule” shall mean the “Modifications to the HIPAA Privacy, Security,
Enforcement, and Breach Notification Rules under the HITECH Act and the Genetic
Information Nondiscrimination Act (GINA),” 78 Federal Register 5566 (January 25, 2013).
1.8
“Individual” shall mean the person who is the subject of PHI and shall include a person who
qualifies as a personal representative in accordance with 45 CFR § 164.502(g).
SERIAL 230176-RFP
1.9
“Individual Rights Requests” shall mean requests under Article 3.
1.10
“Payment” shall have the same meaning given to it in 45 CFR § 164.501.
1.11
“PHI” or “protected health information”, defined at 45 CFR § 160.103, shall mean any
information, whether oral or recorded in any form or medium, that: (i) relates to the past,
present or future physical or mental health or condition of an Individual; the provision of
health care to an Individual; or the past, present or future payment for the provision of
health care to an Individual; and (ii) identifies the Individual or with respect to which there
is a reasonable basis to believe the information can be used to identify the Individual
1.12
“Plan” shall have the same meaning given to it as the group health plan or plans of the
Sponsor as set forth in 45 CFR § 160.103.
1.13
“Plan Administration Functions” shall have the same meaning given to it in 45 CFR §
164.504.
1.14
“Plan Administrator” shall mean the entity, individual, group or committee appointed by the
Sponsor, or its successor or successors with the authority to administer the Plan.
1.15
“Privacy Official” shall mean the person designated by the Plan to serve as its privacy
official within the meaning of 45 CFR § 164.530(a), and any person to whom the Privacy
Official has delegated any of his or her duties or responsibilities.
1.16
“Protected Information” shall mean PHI received from the Plan or created, received,
maintained or transmitted by CONTRACTOR on behalf of the Plan.
1.17
“Required by Law” shall have the same meaning given to it in 45 CFR § 164.103.
1.18
“Secretary” shall mean the Secretary of the United States Department of Health and
Human Services.
1.19
“Services” shall mean the activities, functions, and/or services that CONTRACTOR from
time to time renders to or on behalf of the Plan to the extent that those activities, functions,
and/or services are covered by HIPAA.
1.20
“Subcontractor” shall have the same meaning given to it in 45 CFR § 160.103.
1.21
“Unsecured PHI” shall mean Protected Information that is not secured through the use of
a technology or methodology that renders such Protected Information unusable,
unreadable or indecipherable to unauthorized individuals as specified in 45 CFR § 164.402.
ARTICLE 2 OBLIGATIONS AND ACTIVITIES OF CONTRACTOR
2.1
Status of CONTRACTOR. CONTRACTOR acknowledges and agrees that it is a Business
Associate of the Plan for purposes of the Privacy Rule.
2.2
Permitted Uses and Disclosures of Protected Information.
(a)
Permitted Uses. CONTRACTOR shall not use Protected Information other than as
permitted by this Agreement. CONTRACTOR may use Protected Information: (i)
in connection with the performance, management and administration of the
Services; (ii) for the proper business management and administration of
CONTRACTOR; (iii) to carry out CONTRACTOR’s legal responsibilities; (iv) to
report violations of law consistent with 45 CFR § 164.502(j); (v) to the extent and
for any purpose authorized by an Individual under 45 CFR § 164.508; and (vi) for
any purpose provided that no data is identifiable and data has been de-identified
pursuant to 45 CFR § 164.514(b) (including the separate de-identification guidance
issued by the Secretary on November 26, 2012). Notwithstanding the foregoing
SERIAL 230176-RFP
sentence, CONTRACTOR shall not use Protected Information in any manner that
violates the Privacy Rule, or that would violate the Privacy Rule if so, used by the
Plan (except for the purposes specified under 45 CFR § 164.504(e)(2)(i)(A) and
(B)).
(b)
Permitted Disclosures. CONTRACTOR shall not disclose Protected Information
other than as permitted by this Agreement. CONTRACTOR may disclose
Protected Information: (i) in connection with the performance, management and
administration of the Services; (ii) to report violations of law consistent with 45 CFR
§ 164.502(j); (iii) to the extent and for any purpose authorized by an Individual
under 45 CFR § 164.508; and (iv) for any purpose provided that no data is
identifiable and data has been de-identified pursuant to 45 CFR § 164.514(b)
(including the separate de-identification guidance issued by the Secretary on
November 26, 2012). In addition, CONTRACTOR may also disclose Protected
Information to a third party for the proper business management and administration
of CONTRACTOR and to carry out CONTRACTOR’s legal responsibilities,
provided that the disclosure is Required by Law or CONTRACTOR obtains, prior
to the disclosure: (i) reasonable assurances from the third party that the Protected
Information will be held confidentially and used or further disclosed only as
Required by Law or for the purpose for which it was disclosed to the third party;
and (ii) an agreement from the third party that the third party will notify
CONTRACTOR immediately of any instances in which it knows the confidentiality
of the information has been breached. Further, CONTRACTOR shall disclose,
upon request, Protected Information to the Sponsor for Plan Administration
Functions and to designated Sponsor employees (or designated Business
Associates of the Plan) who are working for or on behalf of the Plan for purposes
of Payment and Health Care Operations (including claims assistance activities)
consistent with 45 CFR § 164.506(c)(1). Notwithstanding the foregoing,
CONTRACTOR shall not disclose Protected Information in any manner that
violates the Privacy Rule, or that would violate the Privacy Rule if so, disclosed by
the Plan (except for the purposes specified under 45 CFR § 164.504(e)(2)(i)(A)
and (B)).
(c)
Minimum Necessary. To the extent required by the Privacy Rule, CONTRACTOR
shall only request, use, and/or disclose the minimum amount of Protected
Information necessary to accomplish the purpose of the request, use, and/or
disclosure. For this purpose, the determination of what constitutes the minimum
necessary amount of Protected Information shall be determined in accordance with
Section 164.502(b) of the Privacy Rule.
(d)
Direct Application of Privacy Rules. CONTRACTOR shall not use and/or disclose
Protected Information or provide any Services that require the use and/or
disclosure of Protected Information unless such use and/or disclosure directly
complies with this Section 2.2 and Sections 164.502(a)(3) and 164.504(e) of the
Privacy Rule.
(e)
GINA Provisions. Notwithstanding subsections (a) through (c) above,
CONTRACTOR shall not use and/or disclose Protected Information that is genetic
information for underwriting purposes, as set forth in 45 CFR § 164.502(a)(5).
2.3
Safeguards. CONTRACTOR shall maintain and use appropriate and commercially
reasonable safeguards to prevent use and/or disclosure of Protected Information other
than as permitted or required in this Agreement.
2.4
Reports of Prohibited Disclosures. If CONTRACTOR becomes aware of a disclosure of an
Individual’s Protected Information by CONTRACTOR and the disclosure violated the
provisions of this Agreement, CONTRACTOR must inform the Privacy Official regarding
the prohibited disclosure of the Individual’s Protected Information. To the extent that a
disclosure described in this Section 2.4 also constitutes a Breach of Unsecured PHI, the
SERIAL 230176-RFP
provisions of this Section 2.4 shall not apply, but rather the provisions of Section 2.8 shall
apply.
2.5
Agents and Subcontractors. CONTRACTOR shall require each of its authorized
representatives, agents, and entities (collectively, “Agents”) to whom CONTRACTOR
provides Protected Information on behalf of the Plan to agree to observe the restrictions
on use and disclosure of the Protected Information imposed upon CONTRACTOR by this
Agreement and the Privacy Rule. In addition, CONTRACTOR shall enter into a business
associate agreement with each of its Subcontractors which meets the requirements of the
Privacy Rule, including the requirements set forth in 45 CFR § 164.504(e).
2.6
Access by Secretary. CONTRACTOR shall make available to the Secretary
CONTRACTOR’s internal practices, books, and records (including its policies and
procedures) relating to CONTRACTOR’s use and disclosure of Protected Information for
the purpose of enabling the Secretary to assess the Plan’s and/or CONTRACTOR’s
compliance with HIPAA. CONTRACTOR shall inform the Privacy Official of any request
sent by the Secretary on behalf of the Plan that is received by CONTRACTOR, unless it is
prohibited by applicable law from doing so.
2.7
Mitigation. CONTRACTOR agrees to mitigate, to the extent practicable, any harmful effect
that is known to CONTRACTOR of a use or disclosure of Protected Information by
CONTRACTOR in violation of the requirements of this Agreement and provide any notice
and remediation that either CONTRACTOR or the Plan is required to provide by any
applicable law in connection with such actual or suspected Breach. Where a Breach
involves PHI data elements that reasonably could lead to identity theft, CONTRACTOR
shall provide credit monitoring or other commercially reasonable identity theft mitigation
service for the affected individuals for one year.
2.8
Notice of Breach of Unsecured PHI.
(a)
CONTRACTOR Requirements. Upon CONTRACTOR’s discovery of a Breach of
Unsecured PHI by CONTRACTOR, CONTRACTOR shall –
(1)
Pursuant to the requirements set forth in subsection (c) below, provide
written notice of the Breach to the Privacy Official, as soon as
administratively practicable, but no later than 10 business days after the
Breach is discovered, and
(2)
Pursuant to the requirements set forth in subsection (b) below, provide
written notice of the Breach, on behalf of the Plan, without unreasonable
delay and in no case later than 60 calendar days after discovery of a
Breach as authorized under 45 CFR § 164.404 or such later date as is
authorized under 45 CFR § 164.412 to:
(i)
each Individual whose Unsecured PHI has been, or is
reasonably believed by CONTRACTOR to have been,
accessed, acquired, used or disclosed as a result of the
Breach;
(ii)
the media to the extent required under 45 CFR § 164.406;
and
(iii)
the Secretary to the extent required under 45 CFR §
164.408 (unless the Plan has elected to provide this
notification and has informed CONTRACTOR); and
(3)
If the Breach involves less than 500 individuals, maintain a log or other
documentation of the Breach which contains such information as would
be required to be included if the log were maintained by the Plan
SERIAL 230176-RFP
pursuant to 45 CFR § 164.408, and provide such log to the Plan within
five business days of the Plan’s written request.
(b)
Notice Requirements. This subsection (b) provides the following special rules that
shall each be applicable to the provisions of Section 2.8(a)(2) –
(1)
The date that a Breach is discovered shall be determined by
CONTRACTOR, in its sole discretion, in accordance with the Breach
Notification Rule.
(2)
The content, form, and delivery of each of the notices required by
Section 2.8(a)(2) shall comply in all respects with the breach notification
provisions applicable to the Plan, as set forth in the Breach Notification
Rule.
(3)
CONTRACTOR shall send the notices described in Section 2.8(a)(2)(i)
to each Individual using the address on file with CONTRACTOR (or as
may be otherwise provided by the Plan). If the notice to any Individual is
returned as undeliverable, CONTRACTOR shall make one additional
attempt to deliver the notice to the Individual using such information as
is reasonably available to it or shall take other action required by the
Breach Notification Rule.
(4)
With respect to notices required under Section 2.8(a)(2)(i) and (ii),
CONTRACTOR and the Privacy Official shall cooperate in all respects
regarding the drafting and the content of the notices. To that end, before
sending any notice to any Individual or the media under Section
2.8(a)(2)(i) or (ii), CONTRACTOR shall first provide a draft of the notice
to the Privacy Official. The Privacy Official shall have 10 business days
(plus any reasonable extensions) to either approve CONTRACTOR’s
draft of the notice or revise the language of the notice. Alternatively, the
Privacy Official may elect to draft the notice for review by
CONTRACTOR. Once CONTRACTOR and the Privacy Official agree
on the final content of the notice, CONTRACTOR shall send the notice
to the Individuals and/or the media based on the requirements of the
Breach Notification Rule.
(c)
Privacy Official Notice. The notice to the Privacy Official pursuant to Section
2.8(a)(1) shall include any information available to CONTRACTOR that is required
to be included in a notification to an Individual under 45 CFR § 164.404(c). To the
extent that CONTRACTOR does not have the information to be provided in the
prior sentence when it is required to notify the Privacy Official, CONTRACTOR
shall provide such information as soon as administratively practicable after such
information becomes available. Upon the Plan’s written request, CONTRACTOR
shall provide such additional information regarding the Breach as may be
reasonably requested from time-to-time by the Plan.
(d)
Notice Fees. CONTRACTOR reserves the right to charge reasonable, cost-based
fees for sending the notices required by this Section 2.8 should a Breach be due
to actions on the part of the Sponsor, the Plan or any other entity (other than
CONTRACTOR, its Agents or Subcontractors).
(e)
Remuneration. CONTRACTOR shall not directly or indirectly receive any
remuneration in exchange for PHI or Use or Disclose PHI for marketing or
fundraising purposes.
SERIAL 230176-RFP
ARTICLE 3 INDIVIDUAL RIGHTS REQUIREMENTS
3.1
Designated Record Sets.
(a)
General. CONTRACTOR agrees to maintain a Designated Record Set for the Plan
in a manner and form that will allow the Plan to provide access and amendment
rights to an Individual with respect to the Individual's Protected Information in
conformance with 45 CFR §§ 164.524 and 164.526.
(b)
Access to Protected Information. Upon request from the Plan, CONTRACTOR
shall process and respond to a request by an Individual for access to an
Individual’s Protected Information that is maintained by CONTRACTOR in a
Designated Record Set pursuant to 45 CFR § 164.524 (an “Access Request”).
CONTRACTOR shall respond to such Access Request by furnishing such
Protected Information to the Plan within a timeframe that reasonably allows the
Plan to satisfy the timeframes required by 45 CFR § 164.524. If the Protected
Information that is requested is maintained electronically and the Individual
requests an electronic copy of such information, CONTRACTOR will provide
access to the information in an electronic format that complies with 45 CFR §
164.524(c)(2)(ii). Thereafter, the Plan will be responsible for sending such
information to the Individual.
(c)
Amendment
to
Protected
Information.
Upon
request
from
the
Plan,
CONTRACTOR shall process a request by an Individual for amendment to an
Individual’s Protected Information that is maintained by CONTRACTOR in a
Designated Record Set pursuant to 45 CFR § 164.526 (an Amendment Request).
CONTRACTOR shall process such Amendment Request within a timeframe that
reasonably allows the Plan to satisfy the timeframes required by 45 CFR §
164.526.
(d)
Coordination with Privacy Official. CONTRACTOR shall coordinate and cooperate
with the Privacy Official (or any other person designated by the Plan Administrator
for this purpose) regarding all processing, recordkeeping, and documentation
issues relating to Access Requests and Amendment Requests. Notwithstanding
the foregoing, CONTRACTOR shall not be obligated to coordinate with the Privacy
Official if an Individual files an Access Request or an Amendment Request with
CONTRACTOR and such request is directed solely to CONTRACTOR.
3.2
Accounting of Disclosures of Protected Information.
(a)
Documentation of Disclosures. CONTRACTOR agrees to document and maintain
a log of any and all disclosures from and after the date or dates required by 45
CFR § 164.528 made by CONTRACTOR of Protected Information in a manner and
form that will allow the Plan to provide to an Individual an accounting of disclosures
or other applicable report of the Individual's Protected Information in compliance
with and based on the requirements of 45 CFR § 164.528.
(b)
Accounting Requests. Upon request from the Plan, CONTRACTOR shall process
and respond to a request by an Individual for an accounting of disclosures or other
applicable report of an Individual’s Protected Information pursuant to the
requirements of 45 CFR § 164.528 (an “Accounting Request”). CONTRACTOR
shall furnish such accounting relating to the Accounting Request to the Plan within
a timeframe that reasonably allows the Plan to satisfy the timeframes required by
45 CFR § 164.528. Thereafter, the Plan will be responsible for sending such
information to the Individual.
(c)
Coordination with Privacy Official. CONTRACTOR shall coordinate and cooperate
with the Privacy Official (or any other person designated by the Plan Administrator
for this purpose) regarding all processing, recordkeeping, and documentation
SERIAL 230176-RFP
issues relating to Accounting Requests. Notwithstanding the foregoing,
CONTRACTOR shall not be obligated to coordinate with the Privacy Official if an
Individual files an Accounting Request with CONTRACTOR and such request is
directed solely to CONTRACTOR.
3.3
Privacy Protection Requests
(a)
Restriction Requests on Uses and Disclosures. The Plan and CONTRACTOR on
behalf of the Plan shall not agree to a restriction on the use or disclosure of
Protected Information pursuant to 45 CFR § 164.522(a) without first consulting with
the other party. CONTRACTOR is not obligated to implement any restriction, if
such restriction would hinder Health Care Operations or the Services
CONTRACTOR provides to the Plan, unless such restriction would otherwise be
required by 45 CFR § 164.522(a).
(b)
Confidential Communication Requests. CONTRACTOR shall implement any
reasonable requests by Individuals relating to a request to receive communications
of Protected Information by alternative means or at alternative locations to the
extent required by 45 CFR § 164.522(b).
(c)
Coordination with Privacy Official. CONTRACTOR shall coordinate and cooperate
with the Privacy Official (or any other person designated by the Plan Administrator
for this purpose) regarding all processing, recordkeeping, and documentation
issues relating to requests under this Section 3.3.
ARTICLE 4 ELECTRONIC TRANSACTION RULE
4.1
Business Associate Requirements. CONTRACTOR acknowledges that it is a Business
Associate of the Plan for purposes of the Electronic Transaction Rule. CONTRACTOR
agrees that it shall comply with all Electronic Transaction Rule requirements that may be
applicable to CONTRACTOR with respect to the Services it provides to and on behalf of
the Plan. CONTRACTOR shall also require each of its Agents and Subcontractors to whom
CONTRACTOR provides Protected Information that is received from or created or received
by CONTRACTOR on behalf of the Plan, to provide assurances, in writing, that they will
comply with the applicable requirements of the Electronic Transaction Rule.
4.2
Sponsor Transmissions. The Sponsor hereby represents and warrants that all electronic
transmissions with respect to the Plan between the Sponsor (either directly or through its
designated agent) and CONTRACTOR relating to enrollment and disenrollment
information and premium payment information as each are covered by the Electronic
Transaction Rule are sent or received by the Sponsor (either directly or through its
designated agent) in the Sponsor’s capacity as an employer and are not sent or received
by the Plan or are not subject to HIPAA for other reasons, such as that the information is
an employment record and not PHI.
ARTICLE 5 OBLIGATIONS OF PLAN
5.1
Privacy Notice. Upon request, the Plan will provide CONTRACTOR with a copy of its notice
of privacy practices pursuant to 45 CFR § 164.520.
5.2
Authorizations. The Plan will notify CONTRACTOR of any changes in or revocations of
Individual authorizations for use or disclosure of Protected Information to the extent that
such changes or revocations may affect CONTRACTOR’s use or disclosure of Protected
Information.
5.3
Officials. The Plan will notify CONTRACTOR of the current name and contact information
of the Plan Administrator, the Privacy Official, and any other person that has the authority
to act on behalf of the Plan with respect to the provisions contained in this Agreement.
SERIAL 230176-RFP
5.4
Plan. Sponsor represents that its Plan documents include specific provisions to restrict the
use or disclosure of PHI and to ensure adequate procedural safeguards and accounting
mechanisms for such uses or disclosures, in accordance with the Privacy Rule.
5.5
Standard Requirements for Group Health Plans. The Plan represents and warrants that:
(a) its plan documents, in accordance with 45 CFR § 164.504(f), allow the Plan to receive
Protected Information; (b) it has received a certification from the Sponsor in accordance
with 45 CFR § 164.504(f)(2)(ii) and will provide a copy of such certification to
CONTRACTOR upon request; (c) the plan document amendments permit the Plan to
receive Protected Information (including detailed invoices, reports, and statements from
CONTRACTOR); and (d) the Plan has determined, through its own policies and procedures
and in compliance with 45 CFR § 164.502(b), that the Protected Information that it receives
from CONTRACTOR (including the detailed invoices, reports, and statements) contains
the minimum information necessary for the Plan to carry out its Payment and Health Care
Operations activities.
5.6
Sponsor agrees and understands that the Plan is independently responsible for the security
of all PHI in its possession (electronic or otherwise), including all PHI that it receives from
outside sources including the Business Associate.
ARTICLE 6 AMENDMENT AND TERMINATION
6.1
Amendment. No change, modification or attempted waiver of any of the provisions of this
Agreement shall be binding upon any party hereto unless reduced to writing and signed by
both parties. CONTRACTOR agrees to take such action as is necessary to amend this
Agreement from time to time as the Plan reasonably determines necessary to comply with
HIPAA, or any other applicable law, rule or regulation.
6.2
Term. The Term of this Agreement shall be effective on the Effective Date (unless
otherwise noted herein) and shall terminate when all of the Protected Information received
from the Plan or created or received by CONTRACTOR on behalf of the Plan, is destroyed
in accordance with the Plan’s authorization or is returned to the Plan (or its designated
agents) pursuant to Section 6.4.
6.3
Termination. If one party to this Agreement (“Non-Breaching Party”) has knowledge of a
material violation of this Agreement by the other party to this Agreement (“Breaching
Party”), as determined in good faith by the Non-Breaching Party, the Non-Breaching Party
must promptly:
(a)
Provide an opportunity for the Breaching Party to end and to cure the material
violation within a reasonable time specified by the Non-Breaching Party, and if the
Breaching Party does not end and cure the material violation within such time
(including reasonable extensions that the Non-Breaching Party determines are
necessary) to the satisfaction of the Non-Breaching Party, the Non-Breaching
Party shall immediately terminate the Services rendered by CONTRACTOR and
any agreement or contract related thereto; or
(b)
If a cure is not possible as determined by the Non-Breaching Party in its sole
discretion, the Non-Breaching Party shall immediately terminate the Services
rendered by CONTRACTOR and any agreement or contract related thereto.
6.4
Effect of Termination. Upon termination pursuant to Section 6.3, the Plan within a
reasonable time thereafter must inform CONTRACTOR to either destroy or return to the
Plan (or any agents designated by the Plan) the Protected Information that CONTRACTOR
and its Agents and Subcontractors maintain in any form, and CONTRACTOR and its
Agents and Subcontractors shall retain no copies of the Protected Information.
SERIAL 230176-RFP
However, in many situations’ CONTRACTOR maintains one or more backup copies of Protected
Information for auditing, data management, and other related purposes and CONTRACTOR has
determined that destruction of all copies of Protected Information that it maintains is infeasible.
Therefore, after termination of the Services and pursuant to 45 CFR § 164.504(e)(2)(ii)(J), this Agreement
shall remain in effect, and CONTRACTOR shall continue to observe and shall ensure that its Agents and
Subcontractors continue to observe its obligations under this Agreement to the extent copies of the
Protected Information are retained by CONTRACTOR and shall limit further uses and disclosures of
Protected Information to the purposes that make its return or destruction infeasible and that are consistent
with the Privacy Rule.
ARTICLE 7 ELECTRONIC SECURITY STANDARDS
7.1
Definitions. When used in this Article, the following terms shall have the meanings set forth
as follows:
(a)
“Electronic Media” shall have the meaning given to it in 45 CFR § 160.103.
(b)
“Electronic Protected Information” shall mean Protected Information received from
the Plan or created, received, maintained or transmitted by CONTRACTOR on
behalf of the Plan that is transmitted by Electronic Media or maintained in
Electronic Media.
(c)
“Security Incident” shall have the meaning given to it in 45 CFR § 164.304.
7.2
Requirements. Pursuant to 45 CFR § 164.314(a)(2)(i), CONTRACTOR shall:
(a)
Comply with the applicable requirements of the Security Rule, including the
requirement
that
CONTRACTOR
implement,
maintain
and
document
administrative, physical, and technical safeguards that reasonably and
appropriately protect the confidentiality, integrity, and availability of Electronic
Protected Information to the extent required by the Security Rule;
(b)
Report (pursuant to the terms and conditions of Section 7.3) to the Privacy Official
(or such other person designated for this purpose) any Security Incident of which
CONTRACTOR becomes aware and which occurred during the applicable
reporting period;
(c)
Require each of its Agents to whom CONTRACTOR provides Electronic Protected
Information to agree to implement administrative, physical, and technical
safeguards that reasonably and appropriately protect the confidentiality, integrity,
and availability of the Electronic Protected Information that is provided to the Agent
to the extent required by the Security Rule; and
(d)
Enter into a contract or other arrangement with each of its Subcontractors that
create, receive, maintain or transmit Electronic Protected Information on behalf of
CONTRACTOR pursuant to which the Subcontractor agrees to comply with the
applicable requirements of the Security Rule.
7.3
Reporting Protocols. All reports required by Section 7.2(b) shall be provided pursuant to
the terms and conditions specified in this section.
(a)
Attempted Security Incidents. Reporting for any Security Incident involving the
attempted unauthorized access, use, disclosure, modification or destruction of
Electronic Protected Information (collectively, an “Attempted Security Incident”)
shall be provided pursuant to the standard reporting protocols of CONTRACTOR
(as determined by CONTRACTOR).
SERIAL 230176-RFP
(b)
Successful Security Incident. Reporting for any Security Incident involving the
successful unauthorized access, use, disclosure, modification or destruction of
Electronic Protected Information (collectively, a “Successful Security Incident”)
shall be provided to the Plan pursuant to the standard reporting protocols of
CONTRACTOR (as determined by CONTRACTOR), provided that: (i) the reports
shall at a minimum include the date of the incident, the parties involved (if known,
including the names of Individuals affected), a description of the Successful
Security Incident, a description of the Electronic Protected Information involved in
the incident, and any action taken to mitigate the impact of the Successful Security
Incident and/or prevent its future recurrence; and (ii) the reports shall satisfy the
minimum requirements for Security Incident reporting that may be required from
time to time by the Secretary. In addition, Successful Security Incidents shall be
reported to the Plan as soon as administratively practicable after the occurrence
of the incident taking into account the severity and nature of the incident.
Notwithstanding the foregoing, the Plan may request details about one or more
Successful Security Incidents, and CONTRACTOR shall have 30 days thereafter
to furnish the requested information.
(c)
Breach of Unsecured PHI. To the extent that a Security Incident described in this
Section 7.3 also constitutes a Breach of Unsecured PHI, the provisions of this
Section 7.3 shall not apply, but rather the provisions of Section 2.8 shall apply.
7.4
Mitigation. CONTRACTOR agrees to mitigate, to the extent practicable, any harmful effect
that is known to CONTRACTOR relating to any Successful Security Incident and provide
any notice and remediation that either CONTRACTOR or the Plan is required to provide
by any applicable law in connection with such Security Incident. Where the Security
Incident involves data elements that reasonably could lead to identity theft, CONTRACTOR
shall provide credit monitoring or other commercially reasonable identity theft mitigation
service for the affected individuals for one year.
7.5
Access by Secretary. CONTRACTOR shall make available to the Secretary
CONTRACTOR’s internal practices, books and records (including its policies and
procedures) relating to the safeguards established by CONTRACTOR with respect to
Electronic Protected Information for the purpose of enabling the Secretary to assess
CONTRACTOR and/or the Plan’s compliance with the Security Rule. CONTRACTOR shall
inform the Privacy Official of any request sent by the Secretary on behalf of the Plan that
is received by CONTRACTOR, unless CONTRACTOR is prevented by applicable law from
doing so.
ARTICLE 8 GENERAL
8.1
Other Agreements. The Plan and CONTRACTOR acknowledge and affirm that this
Agreement is in no way intended to address or cover all aspects of the relationship of the
Plan and CONTRACTOR and of the Services that are rendered by CONTRACTOR to and
on behalf of the Plan. Rather, this Agreement deals only with those matters that are
specifically addressed herein. Further, this Agreement supersedes any prior business
associate agreements entered into by CONTRACTOR and the Plan (or any predecessor
to the Plan) and shall apply to all Protected Information existing as of the effective date of
this Agreement or created or received thereafter while this Agreement is in effect.
8.2
Indemnification. Any indemnification relating to violations of this Agreement by
CONTRACTOR or the Plan (or the Sponsor on behalf of the Plan) shall be addressed to
the extent applicable by the Master Services Agreement.
8.3
Severability. The provisions of this Agreement shall be severable, and the invalidity or
unenforceability of any provision (or part thereof) of this Agreement shall in no way affect
the validity or enforceability of any other provisions (or remaining part thereof). If any part
of any provision contained in this Agreement is determined by a court of competent
jurisdiction, or by any administrative tribunal, to be invalid, illegal or incapable of being
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enforced, then the court or tribunal shall interpret such provisions in a manner so as to
enforce them to the fullest extent of the law.
8.4
Interpretation. The provisions of this Agreement shall be interpreted in a manner intended
to achieve compliance with HIPAA. Whenever the Agreement uses the term “including”
followed by a specific item or items, or there is a passage having a similar effect, such
passages of the Agreement shall be construed as if the phrase “without limitation” followed
such term (or otherwise applied to such passage in a manner that avoids limitations on its
breadth of application). Where the term “and/or” is used in this Agreement, the provision
that includes the term shall have the meaning the provision would have if “and” replaced
“and/or,” but it shall also have the meaning the provision would have if “or” replaced
“and/or.” Any reference to a section or provision of HIPAA shall include any amendment or
clarification of such section or provision contained in the HIPAA Omnibus Rule and any
regulation, rule or guidance issued by the Secretary following the effective date of this
Agreement.
8.5
Binding Effect. The provisions of this Agreement shall be binding upon and shall inure to
the benefit of the parties hereto and their heirs, assigns and successors in interest. The
Plan shall have the right to assign this Agreement to any successor or surviving health
plan, and all covenants and agreements hereunder shall inure to the benefit of and be
enforceable by any such assignee.
8.6
No Third-Party Beneficiaries. Nothing express or implied in this Agreement is intended to
confer, and nothing herein shall confer, upon any person other than the parties hereto any
rights, remedies, obligations or liabilities whatsoever.
8.7
Applicable Law and Disputes. The provisions of this Agreement shall be construed and
administered to, and its validity and enforceability determined under HIPAA. To the extent
that HIPAA is not applicable in a particular circumstance, the provisions of this Agreement
shall be construed and administered to, and its validity and enforceability determined under
the Employee Retirement Income Security Act of 1974, as amended (ERISA). In the event
that HIPAA and ERISA do not preempt state law in a particular circumstance, the laws of
the State of North Dakota shall govern. In the event of any conflict of state laws, the laws
of the State of Arizona shall prevail. The parties agree that any claim or action arising from
this Agreement can only be brought in the United States District Court for the District of
Arizona, and both parties’ consent to such jurisdiction and venue. Any disputes between
the parties arising under this Agreement shall be resolved in accordance with the dispute
resolution procedures, if any, set forth in the Master Services Agreement.
8.8
State Privacy and Security Laws.
(a)
General. Pursuant to 45 CFR § 160.203, CONTRACTOR and the Plan
acknowledge that HIPAA only preempts state laws which are contrary to a HIPAA
standard, requirement or implementation specification, provided that state laws
which relate to the privacy of Protected Information and are more stringent than
the Privacy Rule are not preempted. Accordingly, the parties acknowledge that
certain State Privacy Laws affecting the privacy and/or security of personally
identifiable information (e.g., name, address, age, and social security number)
relating to a Plan participant or beneficiary (“Privacy Restricted Data”) may apply
to the Services provided by CONTRACTOR to the extent such State Privacy Laws
are not preempted by HIPAA. For purposes of this Section 8.8, “State Privacy
Laws” shall mean any applicable state and local privacy laws governing the
creation, collection, storage, maintenance, access, modification, transmission, use
or disclosure of Privacy Restricted Data.
(b)
State Privacy Laws. All Privacy Restricted Data created, collected, received or
obtained by or on behalf of CONTRACTOR in the course of performing its Services
shall be created, collected, received, obtained, stored, maintained, accessed,
modified, transmitted, used, and disclosed in accordance with any and all
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applicable State Privacy Laws. CONTRACTOR shall at all times perform the
Services in accordance with the State Privacy Laws and as not to cause the
Sponsor or the Plan to be in violation of the State Privacy Laws. CONTRACTOR
shall be fully responsible for any creation, collection, receipt, access, storage,
maintenance, modification, transmission, use, and disclosure of Privacy Restricted
Data performed by or on behalf of CONTRACTOR that is in violation of any State
Privacy Laws. CONTRACTOR shall remedy and mitigate the damages of any
breach of privacy, security, integrity or confidentiality with respect to the
unauthorized creation, collection, receipt, storage, maintenance, access,
modification, transmission, use or disclosure (a “State Breach”) of Privacy
Restricted Data that is or may be in violation of any State Privacy Laws.
(c)
Notification. CONTRACTOR shall notify the Privacy Official (using the procedures
that apply to Breaches of Unsecured PHI under Section 2.8(c)) of any State
Breaches by or on behalf of CONTRACTOR of Privacy Restricted Data that is or
may be in violation of any State Privacy Laws. In addition, CONTRACTOR shall
also notify the affected Plan participants and beneficiaries (using the procedures
that apply to Breaches of Unsecured PHI under Section 2.8(b)) of any State
Breaches by or on behalf of CONTRACTOR of Privacy Restricted Data that is in
violation of any State Privacy Laws and any state or local governmental agencies,
authorities or other entities, but only to the extent required by such State Privacy
Laws.
(d)
HIPAA Coordination. The parties acknowledge that in certain situations the
provisions of both Section 2.8 and this Section 8.8 shall apply. If both Sections 2.8
and 8.8 apply in a given situation, CONTRACTOR shall comply with both Sections
2.8 and 8.8 to the extent applicable.
Obligation of Plan and CONTRACTOR. To the extent that CONTRACTOR carries out the HIPAA
obligations of the Plan (including the obligations set forth in Section 2.8 and Article 3), CONTRACTOR shall
comply with the applicable requirements of HIPAA as they apply to the Plan in the performance of such
obligations on behalf of the Plan.