NATIVE HEALTH 23_26 CONTRACT 8.15.23_V2 (2).PDF

Maricopa County — Formal (2023-09-13)

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CONTRACT FOR SERVICES 
MARICOPA COUNTY  
by and through the 
DEPARTMENT OF PUBLIC HEALTH 
4041 N. Central Avenue, #1400, Phoenix, Arizona 85012 
AND 
NATIVE HEALTH 
4041 N. Central Ave, Phoenix, Arizona 85012 
1. 
Contract No:   
________ 
 
2.        Contract Type: Service           ____________ 
     
3. 
Contract Amount: $_39,000______ 
4.        Purpose: Community Health Needs Assessment   
5. 
Start Date:  July 1, 2023_________            6.        Expiration Date:  June 30, 2026_____________    
_____________________________________________________________________________________________       
 
This Contract for Services (“Contract”)  is entered into by and between Native Health referred to as “Native Health” and Maricopa 
County, by and through its Department of Public Health referred to as the “County” or “Contractor.” Native Health and the County 
are collectively referred to as the “Parties” and individually as a “Party.”  Contractor, for and in consideration of the covenants and 
conditions set forth, shall provide and perform the services as set forth below.  All rights and obligations of the Parties shall be 
governed by the terms of this Contract, its exhibits, attachments, and appendices, including any subcontracts or Contracts as set 
forth herein and in: 
Section I 
- 
General Provisions 
 
Section III 
- 
Compensation  
Section II 
- 
Scope of Work  
 
Section IV 
- 
Business Associate Agreement 
This Contract contains all the terms and conditions agreed to by the Parties.  No other understanding, oral or otherwise, regarding 
the subject matter of this Contract shall be deemed to exist or to bind the Parties.  Nothing in this Contract shall be construed as 
consent to any lawsuit or waiver of any defense in a lawsuit brought against the County or Native Health in any state or federal 
court. 
Legal Notice under this Contract shall be given by personal delivery or by registered or certified mail, postage prepaid, return 
receipt requested, to the addresses set forth below and shall be effective upon receipt by the Party to whom addressed unless 
otherwise indicated in the notice. 
Notice to: Native Health  
 
 
 
 
Phone: (602) 279-5262 
Address:  4041 North Central Avenue, Phoenix, Arizona 85012 
 
Notice to Department: MCDPH Grants/Contract Unit 
 
Phone: (602) 372-0674  
  
Address: 4041 North Central Avenue, Suite #1400, Phoenix, Arizona 85012 
                                                  
 
IN WITNESS WHEREOF, the Parties enter into this Contract: 
 
NATIVE HEALTH  
 
MARICOPA COUNTY DEPT OF PUBLIC HEALTH 
 
 
Signature 
 
 
 
Signature 
 
 
Name 
 
 
 
Name 
 
 
Title 
 
 
 
Title 
 
Chairman, Board of Supervisors 
 
Date 
 
 
 
Date 
 
 
 
 
 
 
Aug 16, 2023
Walter Murillo
CEO

ATTEST: 
Signature 
 
 
 
 
 
 
ATTEST: 
Signature 
 
 
 
 
 
 
 
 
 
Date 
 
 
 
 
Date 
Clerk of the Board 
          
 
APPROVED AS TO FORM: 
 
 
 
Signature 
 
 
Signature 
 
Date 
 
Date 
Deputy Attorney for Maricopa County

SECTION I                  
GENERAL PROVISIONS 
 
 
1. 
EFFECT 
 
To the extent the Scope of Work conflicts with the General Provisions the Scope of Work 
shall control. 
 
2. 
DEFINITIONS 
 
As used throughout this Contract, the following terms shall have the following meanings: 
 
 
A. 
Contract means this document and all exhibits, attachments, appendices, and 
amendments to this Contract. 
 
 
B. 
County means Maricopa County, Arizona. 
     
C. 
Department means the Maricopa County Department of Public Health (MCDPH). 
 
 
D. 
Director means the Director of the Department. 
 
 
E. 
Funding Source means any federal, state, or private agency funding source that 
may impose conditions on the funding that will be passed on to the County. 
 
 
F. 
Designated Record Set means a group of records maintained by or for a covered 
entity that comprises medical and billing records about individuals maintained by 
or for a covered health care provider; enrollment, payment, claim adjudication, and 
case or medical management record systems maintained by or for a health plan, 
and other records that are used in whole or in part, by or for the covered entity to 
make decisions about individuals. 
 
 
G. 
Healthcare Partner means a person or health care facility licensed, certified, or 
otherwise authorized or permitted by law to administer health care in the ordinary 
course of business or practice of a profession. This includes Federally Qualified 
Healthcare Centers (FQHC) or FQHC look-alike. 
 
3. 
GENERAL REQUIREMENTS 
 
 
A. 
The terms of this Contract shall be construed in accordance with Arizona law.  Any 
lawsuit arising out of this Contract shall be brought in the appropriate court in 
Maricopa County, Arizona. 
 
 
B. 
The County shall, without limitation, obtain and maintain all licenses, permits, and 
authority necessary to do business, render services, and perform work under this 
Contract. 
 
 
C. 
The County is an independent Contractor in the performance of work and the 
provision of services under this Contract and is not to be considered an officer, 
employee, or agent of Native Health. 
 
4. 
AMENDMENTS 
 
All amendments to this Contract shall be in writing and signed by the Parties.

SECTION I                  
GENERAL PROVISIONS 
 
 
5. 
RETENTION OF RECORDS, AUDITS, AND DISALLOWANCES 
 
 
A. 
This provision applies to all financial and programmatic records, supporting 
documents, statistical records, and other records of the County, which are 
reasonably considered as relevant to this Contract. 
 
B. 
The County shall retain all financial books, records, and other documents relevant 
to this Contract for five years after final payment or until after the resolution of any 
audit questions, which could take more than five years, whichever is longer. The 
County, federal, or state auditors, and any other persons duly authorized by the 
County, shall have full access to, and the right to examine, copy, and make use of 
any and all such materials. 
 
 
C. 
The County shall reimburse Native Health for any payments made under this 
Contract that are disallowed by a federal, state, or Maricopa County audit in the 
amount of the disallowance. 
 
6. 
ASSIGNMENT / SUBCONTRACTING 
 
No rights, liability, obligations, or duties under this Contract may be assigned, delegated, 
or subcontracted by the County or Native Health without the prior written approval of the 
other Party. Any attempt to assign any portion of this Contract without the written consent 
of the other Party shall constitute a breach of this Contract. Any assignment shall not alter 
the assigner’s responsibility to assure that all the provisions under this Contract are fulfilled 
by its assignee. All terms and conditions in this Contract shall be included in any 
assignment. 
 
7. 
TERMINATION 
 
 
A. 
The County or Native Health may terminate this Contract at any time with at least 
30 days prior written notice to the other Party.  Such notice shall be given by 
electronic notice, personal delivery or by Registered or Certified Mail, postage 
prepaid and return receipt requested. 
 
 
B. 
This Contract may be terminated by mutual written agreement of the Parties 
specifying the termination date. 
 
 
C. 
If not terminated by one of the methods stated above, this Contract shall terminate 
on the expiration date of this Contract as stated on the Cover Page. 
 
D. 
If either Party defaults under this Contract and the default continues for more than  
10 days after the effective date of the other Party’s written notice stating the 
specific nature of the default, then the noticing Party may treat the default as a 
breach of this Contract.  Upon a breach, the aggrieved Party may exercise any 
remedy available under the law, including the termination of this Contract. Upon a 
breach, the aggrieved Party may exercise any remedy available under the law, 
including the termination of this Contract. If more than one activity is funded by this 
Contract the County may terminate any part of the Work Statement obligations 
without impairing the remaining obligations. 
 
E. 
This contract is subject to cancellation pursuant to A.R.S. § 38-511.

SECTION I                  
GENERAL PROVISIONS 
 
 
F. 
If Native Health terminates this Contract prior to the expiration date, Native Health 
will remain responsible for payment to County for all work and services performed 
through the date of termination and for reimbursement to County of all non-
cancellable commitments incurred in the performance of the work or service.  
 
G. 
Upon termination or expiration, the property purchased in furtherance of this 
Contract will remain the property of the purchasing Party, unless expressly 
specified other.  
 
8. 
SEVERABILITY 
 
If a court finds that any provision of this Contract is invalid, all the remaining provisions 
shall remain in full force and effect. 
 
9. 
STRICT COMPLIANCE 
 
The waiver of a breach may only be made by a writing signed by the waiving Party and 
will not constitute a waiver of any other or subsequent breach to affect in any way the 
effectiveness or enforceability of the provision in question. 
 
10. 
NON-LIABILITY 
 
Neither Party or their officers and employees shall be liable for any act or omission by the 
other Party or any subcontractor, employee, officer, agent, or representative. 
 
11. 
COVENANT AGAINST CONTINGENT FEES 
 
Each warrant that no person or selling agency has been employed or retained to solicit or 
secure this Contract upon an agreement or understanding for a commission, percentage, 
brokerage, or contingent fee.   
Either Party may terminate this Contract without liability for breach of this warranty. 
 
12. 
SAFEGUARDING CLIENT INFORMATION 
 
The use or disclosure by any Party of any information concerning an eligible person served 
under this Contract is directly limited to the performance of this Contract.  
  
13. 
RIGHTS IN DATA 
 
The Parties shall have the use of data and reports resulting from this Contract without cost 
or other restriction, except as may otherwise be provided herein or by law or applicable 
regulation.  Each Party shall supply to the other Party, upon request, any available 
information known to the supplying Party that is relevant to this Contract and to the 
performance hereunder. 
 
14. 
NON-DISCRIMINATION 
 
The Parties, in connection with any service or other activity under this Contract, shall not 
in any way discriminate against any person on the grounds of race, color, religion, sex, 
national origin, age, or disability.  The County shall include a clause to this effect in all 
Subcontracts inuring to the benefit of the County or Native Health.

SECTION I                  
GENERAL PROVISIONS 
 
 
15. 
EQUAL EMPLOYMENT OPPORTUNITY 
 
The Parties shall not discriminate against any employee or applicant for employment 
because of race, color, religion, sex, pregnancy, childbirth, or medical conditions related 
to pregnancy or childbirth, political affiliation or religious affiliation or ideas, culture, creed, 
social origin or condition, genetic information, sexual orientation, gender identity or 
expression, national origin, ancestry, age, disability, military service or veteran status, or 
marital status.  The Parties shall take affirmative action to ensure that applicants are 
employed and that employees are treated during employment without regard to their race, 
color, religion, sex, pregnancy, childbirth or medical conditions related to pregnancy or 
childbirth, political affiliation or religious affiliation or ideas, culture, creed, social origin or 
condition, genetic information, sexual orientation, gender identity or expression, national 
origin, ancestry, age, disability, military service or veteran status, or marital status.  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.  The 
Parties shall, to the extent such provisions apply, comply with Titles VI and VII of the Civil 
Rights Act of 1964, as amended (42 U.S.C. §§ 2000a, et seq.); the Rehabilitation Act of 
1973, as amended (29 U.S.C. §§ 701, et seq.); the Age Discrimination in Employment Act 
of 1967, as amended (29 U.S.C. §§ 621, et seq.); the Immigration Reform and Control Act 
of 1986 (Pub. L. No. 99-603) (“IRCA”); and Arizona Executive Order 2009-09, as amended 
by Executive Order 2003-01, which mandates that all persons shall have equal access to 
employment opportunities.  The Parties shall also comply with all applicable provisions of 
the Americans with Disabilities Act of 1990 (42 U.S.C. §§ 12101, et seq.). 
 
16. 
RIGHT TO EXTEND CONTRACT 
 
Subject to the availability of funds and acceptable County performance, based upon 
mutual agreement by Native Health and the County, the Contract may be extended for 1 
additional month, not to exceed a total extended term of eight (8) months, except that the 
cost will be subject to renegotiation.   
 
17. 
CERTIFICATION REGARDING DEBARMENT AND SUSPENSION 
 
A. 
The undersigned (an authorized official signing for the County) certifies to the best 
of his or her knowledge and belief, that the County, defined as the primary 
participant in accordance with 2 CFR Part 180, and its principals and 
subcontractors, if any: 
 
1)   
are not presently debarred, suspended, proposed for debarment, declared 
ineligible, or voluntarily excluded from covered transactions by any federal 
department or agency; 
 
2)   
have not, within the 3-year period preceding this Contract, been convicted 
of or had a civil judgment rendered against them for the commission of 
fraud or a criminal offense in connection with obtaining, attempting to 
obtain, or performing a public (federal, state, or local) transaction or 
contract under a public transaction; or violated any Federal or State 
antitrust statutes; or committed embezzlement, theft, forgery, bribery, 
falsification or destruction of records, making false statements, or receiving 
stolen property;

SECTION I                  
GENERAL PROVISIONS 
 
 
3)  
are not presently indicted or otherwise criminally or civilly charged by a 
government entity (Federal, State, or local) with the commission of any of 
the offenses enumerated in paragraph (2) of this certification; and 
 
4)   
have not, within the 3-year period preceding this Contract, had one or more 
public transactions (Federal, State, or local) terminated for cause or default. 
 
B.   
If the County is not able to provide this certification, an explanation as to why shall 
be attached to this Contract. 
 
C.   
The County shall include, without modification, this clause in all lower tier covered 
transactions (i.e., transactions with subcontractors) and in all solicitations for lower 
tier covered transactions related to this Contract. 
 
18. 
E-VERIFICATION OF EMPLOYEES 
  
The County warrants that it is following A.R.S. § 41-4401 and further acknowledges: 
 
A. 
That the County and its subcontractors, if any, warrant their compliance with all 
federal immigration laws and regulations that relate to their employees and their 
compliance with A.R.S. § 23-214, subsection A:  after December 31, 2007, every 
employer, after hiring an employee, shall verify the employment eligibility of the 
employee through the verify program and shall keep a record of the verification for 
the duration of the employee's employment or at least three years, whichever is 
longer. 
 
B. 
That a breach of a warranty under subsection A above shall be deemed a material 
breach of this Contract that entitles Native Health to, among other things, terminate 
this Contract without liability. 
 
C. 
The papers of and employee who works on this Contract may be inspected by the 
appropriate authorities to ensure compliance with the warranty provided under that 
subsection A above, and that the County shall make all papers and employment 
records of said employee(s) available during normal working hours in order to 
facilitate such an inspection. 
 
D. 
That nothing herein shall make the County or any subcontractor an agent or 
employee of Native Health. 
 
19. 
WRITTEN CERTIFICATION PURSUANT TO A.R.S. § 35-393.01 
 
 
If Native Health engages in for-profit activity and has 10 or more employees, and if this 
agreement has a value of $100,000 or more, Native Health 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. 
 
20. 
UNIFORM ADMINISTRATIVE REQUIREMENTS 
 
By entering this Contract, the County 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.

SECTION I                  
GENERAL PROVISIONS 
 
 
21. 
WRITTEN CERTIFICATION PURSUANT TO A.R.S. § 35-394.   
 
Native Health warrants and certifies that it does not currently, and agrees for the 
duration of the Agreement, that it will not use:  
 
1. The forced labor of ethnic Uyghurs in the People’s Republic of China. 
2. Any goods or services produced by the forced labor of ethnic Uyghurs in the 
People’s Republic of China. 
3. Any contractors, subcontractors or suppliers that use the forced labor or any 
goods or services produced by the forced labor of ethnic Uyghurs in the 
People’s Republic of China. If Native Health becomes aware during the term 
of this Agreement that the Contractor is not in compliance with this 
paragraph, Native Health shall notify the County within five business days 
after becoming aware of the noncompliance. If the Native Health fails to 
provide a written certification to the County that the Native Health has 
remedied the noncompliance within 180 days after notifying the County of its 
noncompliance, the agreement terminates, except that if the agreement 
termination date occurs before the end of the 180-day period, the agreement 
terminates on the agreement termination date. 
 
22. 
DISPUTE RESOLUTION 
 
The Parties shall meet and confer to resolve any dispute that arises out of this Contract.  
In the event that such informal efforts to resolve the dispute are unsuccessful in 90 days, 
the Parties shall resolve the dispute by arbitration pursuant to A.R.S. § 12-1518 and § 12-
3001, et seq.  
 
23. 
CHANGES 
 
A. The Director may, at any time, by written order and with prior written consent of 
Native Health, make changes within the scope of this Contract in any one or more of 
the following areas: 
 
1) Scope of Work activities reflecting changes in the scope of services, Funding 
Source, or County regulations, policies, or requirements. 
 
2) Administrative requirements, such as changes in reporting periods, frequency 
of reports, or report formats required by funding source, or County 
regulations, policies, or requirements. 
 
3) Contractor reimbursement schedules and program budgets 
  
B. The Director shall not increase or decrease the maximum reimbursable amount to be 
paid the Contractor without an official amendment to this Contract.  Additionally, the 
Director shall not direct substantive changes in services to be rendered by the 
Contractor. 
 
C. Any dispute or disagreement caused by such written order shall constitute a 
"Dispute" within the meaning of the Disputes clause of this Contract and shall be 
administered accordingly.

SECTION I                  
GENERAL PROVISIONS 
 
 
24. 
SPECIAL REQUIREMENTS 
 
A. 
The County shall use written subcontracts, consultant agreements and Business 
Associate Agreements that conform to federal and state laws and regulations, and 
to the requirements of this Contract appropriate to the service or activity covered 
by the subcontract.  These provisions apply with equal force to the subcontract as 
if the subcontractor were the County referenced herein.  The County is responsible 
for performing under this Contract whether or not Subcontractors are used.  The 
County shall submit a copy of each Subcontract to Native Health within 15 days of 
its effective date. 
 
B. 
The County shall include in any subcontracts a provision to the effect that the 
subcontractor agrees that Native Health shall have access to the subcontractor’s 
facilities and the right to examine any books, documents, and records of the 
subcontractor, involving transactions related to the subcontract and that such 
books, documents, and records shall not be disposed of except as provided herein. 
 
25. 
INDEMNITY AND INSURANCE:  
 
The Parties agree that both are Self-Insured entities.  
 
Each party (as "Indemnitor"), to the fullest extent permitted by law, agrees to indemnify, 
defend, and hold harmless the other party (as "Indemnitee") from and against any and 
all claims, losses, liability, costs, or expenses (including reasonable attorney's fees) 
(hereinafter collectively referred to as "claims") arising out of the negligent performance 
of this agreement, but only to the extent that such claims are caused by the act, 
omission, negligence, misconduct, or other fault of the Indemnitor, its officers, officials, 
agents, employees, or volunteers.  
 
26. 
LAWS, RULES, AND REGULATIONS 
 
Native Health and the County understand and agree that this Contract is subject to all 
applicable State and Federal laws, rules, and regulations. 
 
27.  
ADVERTISEMENTS 
 
Except as specifically permitted in this Contract, the County shall not use the names or 
trademarks of Native Health or of any of Native Health’s affiliated entities in any 
advertising, publicity, endorsement, or promotion unless Native Health has provided prior 
written consent for the particular use contemplated.  All requests for approval pursuant to 
this Section must be submitted to Native Health, at least 5 business days prior to the date 
on which a response is needed.  The terms of this section survive the termination, 
expiration, non-renewal, or rescission of this Contract.

SECTION II                                                                                          SCOPE OF WORK     
10 
 
1.  
BACKGROUND  
  
 
Per the compliance requirements of the Health Resources & Services Administration (HRSA), all 
Federally Qualified Healthcare Centers (FQHC) must conduct an annual review of the boundaries 
of its service areas, including the identification of the medically underserved population(s) within 
that service area. In addition, a community needs assessment will identify the unmet need for 
health services in the service area and/or proposed service area of the center based on the 
population served. Maricopa County Department of Public Health (MCDPH) and the Maricopa 
County Synapse coalition, a coalition of non-profit and federally qualified health care partners, will 
work collaboratively to implement a comprehensive assessment of health needs of residents in 
Maricopa County. 
 
2.  
GOALS 
 
MCDPH is committed to ensuring a comprehensive representation of Maricopa County residents. 
Our goals align with Healthy People 2030 and Public Health 3.0 which is guided by addressing 
social determinants of health, and increasing capacity building and community collaboration.  
o Attain high-quality, longer lives free of preventable disease, disability, injury, and 
premature death.* 
o Eliminate health disparities, achieve health equity, and attain health literacy to improve the 
health and well-being of all.*  
o Create social and physical environments that promote attaining the full potential for health 
and well-being for all.* 
o Promote quality of life, healthy development, and healthy behaviors across all life stages.* 
o Engage leadership, key constituents, and the public across multiple sectors to take action 
and design policies that improve the health and well-being of all.* 
 
*Healthy People 2030 Overarching Goals 
 
Data Collection and Assessments Methodology 
 
MCDPH uses the Mobilizing for Action through Planning and Partnerships (MAPP), which is a 
community-driven strategic planning process for improving community health. The MAPP 
framework helps communities apply strategic thinking to prioritize public health issues and identify 
resources to address them. MAPP is an interactive process that can improve the efficiency, 
effectiveness, and ultimately the performance for local public health and healthcare systems 
(MAPP, NACCHO.org). For more information visit: https://www.naccho.org/programs/public-
health-infrastructure/performance-improvement/community-health-assessment/mapp  
 
The County conducts the following assessments in alignment with MAPP 2.0: Community Partner 
Assessment, Community Status Assessment, and the Community Context Assessment. These 
assessments are completed through conducting key informant interviews, focus groups, and 
surveys to provide extensive qualitative and quantitative data collection. The County also 
analyzes data sets per Primary Service Area (“PSA”) and conducts comparisons. These 
assessments and analysis are then incorporated with extensive quantitative data sets such as: 
  
o Hospital Discharge Data from ADHS 
o Birth/Death from Vital Records 
o CDC’s Behavioral Risk Factor Surveillance System 
o CDC’s Youth Behavioral Risk Surveillance System 
o Arizona Youth Survey 
o National Cancer Institute-Cancer Registry 
o Healthy People 2023 and other sources that address priority.

SECTION II                  
            SCOPE OF WORK 
 
 
3. 
SERVICE GOALS: 
 
  
Service/ 
Deliverable 
County agrees to: 
Native Health agrees to: 
Synapse 
Membership     
1. Administer and convene meetings of the 
Community Health Needs Assessment 
Partners Synapse Coalition either virtually or 
in-person at minimum 8 times per year, and 
to convene joint meetings of the Synapse and 
Health Improvement Partnership of Maricopa 
County (HIPMC) at minimum 2 times per 
year.  
2. Provide Synapse members with calendar 
invites, meeting reminders and minutes, and 
access to a shared folder of meeting 
materials, recordings, and action items. 
3. Provide Synapse members with at 
minimum two county points of contact and 
provide partner with any changes to assigned 
staff and/or contact information within 4 
weeks of changes. 
1. Assign and allow at minimum 2 and at 
maximum 5 employee of Native Health to 
actively participate on the Synapse coalition as a 
representative of Native Health to make and/or 
influence decisions on the development and 
implementation of the CHNA process. For 
decisions requiring consensus, Native Health will 
have one vote. 
2. Provide representation at Synapse meetings 
to ensure influence on the development of CHNA 
and Synapse work.  
3. Review and update assigned staff contact 
information annually and provide county with any 
changes to assigned staff and/or contact 
information within 4 weeks of changes. 
Partner-
Specific 
CHNA and 
Prioritization 
Strategy 
 
1. Meet with Native Health individually within 
first 6 months of contract cycle to develop a 
workplan timeline for all deliverables that 
aligns with Native Health needs and county 
capacity. 
2. Develop a plan for health issue 
prioritization, stakeholder/committee 
engagement, and report format development 
tailored to the healthcare partner. 
3. Maintain reliable communication via virtual 
meetings, emails, and phone calls as needed 
based on the phase of the workplan. County 
will provide reminders about meetings and 
workplan timelines. 
4. Develop meeting agendas and provide 
meeting minutes and timeline updates 
following all virtual meetings. 
5. Set up a process for shared documentation 
according to partner's technology 
permissions, such as Dropbox, SharePoint, 
Trello, etc.  
 
 
 
 
1a. Meet with county within first 6 months of 
contract cycle to develop a workplan timeline for 
all deliverables that aligns with Native Health 
needs and county capacity. 
1b. At the beginning of workplan timeline 
development, provide county with organization-
specific timelines and requirements including 
external CHNA submission deadlines, internal 
board/committee timelines, deliverable 
requirements specific to Native Health, and any 
necessary approval processes. 
2. Develop a plan for health issue prioritization, 
stakeholder/committee engagement, and report 
format development tailored to Native Health’s 
needs.  
3. Maintain reliable communication via virtual 
meetings, emails, and phone calls as needed 
based on the phase of the workplan. Lack of 
prompt communication from Native Health may 
result in delays to workplan timelines. County is 
not responsible for making up time lost due to 
delayed communication by Native Health but will 
work with the partner to modify the timeline 
accordingly. 
4. Review meeting agendas, meeting minutes, 
updated timeline and provide additions, 
corrections, or feedback 
5. Verify Native Health requirements for shared 
documentation and work with county to set up 
sharing platform such as Dropbox, SharePoint, 
Trello, etc.

SECTION II                  
            SCOPE OF WORK 
 
 
Ad-hoc Epi 
time 
 
1. Provide prioritized epidemiology and data 
analysis assistance for non-CHNA related 
requests, up to 15 hours of epi staff time per 
year. Requests beyond 15 hours will be 
reviewed to determine if an additional fee will 
be charged.  
1. Provide requests through public data request 
portal at https://phdra.maricopa.gov/ at minimum 
two weeks in advance of requested deadline. 
Coordinated 
CHNA 
Development 
 
1. Once per cycle, coordinate development of 
CHNA tools and measures including the 
community health survey, focus groups, and 
key informant interviews with the guidance of 
the Synapse coalition. County will work to the 
best of their ability to align most updated 
CHNA data collection and analysis to include 
in partner’s deliverables.  
1. Provide timely feedback and direction on 
CHNA tools in line with deadlines established by 
county team, either via participation in Synapse 
meetings or via written response within three 
weeks of request.  
Coordinated 
CHNA Data 
Collection 
 
1. Facilitate data collection of CHNA surveys, 
focus groups, and key informant interviews 
based on strategic sampling goals and a 
targeted regional approach.  
2. Cover the costs of survey development 
and translation, outreach and promotional 
materials, communications, internal staff and 
contracted community outreach partners, and 
data entry using Synapse Fee Fund budget 
and other county budget sources.  
1a. Promote the CHNA survey, focus groups, 
and key informant interviews within Native 
Health according to organization's policies. This 
may include sharing the survey to staff, clients, 
and community networks via emails, social 
media, physical materials, and tabling or 
attending events.  
1b. Help identify non-traditional opportunities to 
promote the CHNA survey in the community 
through marketing strategies and public events. 
2. One month prior to the launch of the CHNA 
survey, provide county with a brief written 
description of their intended CHNA survey 
promotional strategy and identify opportunities 
where county can support. 
CHNA Data 
Reporting 
 
1. Provide Synapse partners with CHNA 
survey analysis with measures analyzed by 
county, by region, and for demographic data 
including race/ethnicity, gender, and age.  
2. Provide reports of qualitative focus group 
and key informant interview data, either 
produced in-house or via contracted partner.  
3. Provide up to 20 non-published additional 
qualitative quotes from qualitative dataset to 
support data presentations or reports.  
1. Provide at minimum 2 weeks’ notice for 
additional qualitative quote requests. 
PSA Data 
Analysis 
 
1. Provide the following health indicator data 
(detailed below), according to Native Health’s 
selection for the following PSAs: 
 
i. Native Health Combined PSA 
ii. Native Health Central 
iii. Native Health Mesa 
iv. Native Health West 
 
2. Provide a draft of analysis within 60 days 
of Native Health indicator selection 
3. Provide a final analysis within 30 days of 
Native Health feedback 
1. Within first 6 months of contract cycle, meet 
with county to develop a workplan timeline for 
CHNA analysis, prioritization, and reporting that 
that aligns with Native Health needs and county 
capacity. 
2. 90 days before draft analysis is due, provide 
zip codes for Primary Service Areas (PSA) of 
analysis. Zip codes may be modified up until 
indicator request is submitted (60 days before 
draft analysis is due).  
3. 60 days before draft indicator analysis is due, 
provide county staff with list of indicator request

SECTION II                  
            SCOPE OF WORK 
 
 
Data: Common health indicator report basic 
age-adjusted rates for listed PSAs by the 
following subgroups: overall population, 
gender, race/ethnicity, and age. The 
geography will also include overall Maricopa 
county-level rates for each indicator, as well 
as a summary of county resident 
demographics. Rates include inpatient 
hospitalizations, emergency department 
visits, and deaths. 
Format: Excel workbook including tabs with 
the following information: overall rates per 
indicator, individual tabs for each health 
indicator with rates by subgroup and PSA (if 
FQHC), screenshots from mapping tools, and 
demographics of the PSA, etc. Due to the 
size of the workbook, the data will be sent via 
agreed-upon sharing format. 
Source: The most recently available data 
from Arizona Department of Health Services 
Hospital Discharge Data and Vital Statistics, 
Behavioral Risk Factor Surveillance System, 
Youth Risk Behavioral Survey, PolicyMap, 
Census.gov, and other sources as available. 
Note: each data source has a different lag 
period of when it becomes available, which 
may limit the recency of data provided. 
Census-released population data is needed 
to calculate rates, which may delay analysis 
of any recent data received.  
from the “Common health indicator list.”  
4. Within 30 days of draft indicator analysis 
submission, provide feedback and request for 
any additional analyses. 
5. Provide at minimum 2 weeks’ notice for any 
additional requests or data modifications.  
Facilitated 
Prioritization 
 
1. Co-design a facilitation strategy for Native 
Health prioritization sessions and 
presentations to gather feedback and receive 
approval from necessary committees. 
2. Develop a slide deck including up to 35 
slides of data analysis as well as additional 
slides containing background information, 
polling questions, etc. Iterations of slide 
decks throughout the prioritization process 
may involve updating or modifying the 
content or layout of the data analysis slides. 
3. Prepare interactive virtual and/or physical 
materials to generate participant feedback 
and polling.  
4. Provide up to 15 cumulative hours of 
presentation time to boards/committees in a 
virtual or in-person format. Presentation time 
beyond 15 hours may be provided for an 
additional fee.  
1. Co-design a facilitation strategy for Native 
Health prioritization sessions and presentations 
to gather feedback and receive approval from 
necessary committees. 
2. Provide direction and feedback to county 
regarding presentation content and materials. 
3a. Convene, register, and host presentations 
whether in-person or virtual. 
3b. Schedule presentations requiring county staff 
participation at least 4 weeks in advance to 
ensure staff availability. 
3c. Provide any refreshments or materials used 
during in-person meetings (e.g., poster boards, 
printed materials, etc.). 
CHNA Report 
 
1a. Produce one final HRSA-compliant 
Community Health Needs Assessment 
report1 following template and deadline 
determined by Native Health and county for 
each of the following PSAs:  
 
1. Within first 6 months of contract cycle, provide 
county with CHNA submission deadlines 
including internal board/committee approval and 
final HRSA deadline.

SECTION II                  
            SCOPE OF WORK 
 
 
i. Native Health Combined PSA 
ii. Native Health Mesa 
 
1b. Include 2-3 page executive summaries 
embedded in the report for each of the 
following PSAs: 
 
i. Native Health Central 
ii. Native Health Mesa 
iii. Native Health West 
 
2. Include relevant, high-level disparities and 
key findings from CHNA Data Reporting, PSA 
Data Analysis, and Facilitated Prioritization.   
3. Provide at least one draft with up to four 
drafts of the report to Native Health for review 
and approval prior to final draft.  
4. Collaborate with 
marketing/communications team to develop 
final report/executive summary design as 
requested by Native Health and provided in 
Word and PDF.  
1According to HRSA posted requirements 
https://bphc.hrsa.gov/compliance/compliance-
manual/chapter3 
2. At the beginning of the report/executive 
summary development process, involve and 
define roles of relevant Native Health staff such 
as program managers, compliance officers, 
marketing staff, etc. 
3. Provide County with CHNA report template or 
description of report component format/content 
requirements/images, branding guidelines as 
specified by Native Health system office.  
4. Complete designated sections of CHNA report 
specific to Native Health background. 
5. Provide feedback within two weeks of report 
draft submissions or according to agreed-upon 
timeline.  
6. If desired, produce final report formats beyond 
Word or PDF (e.g., dashboard, webpage 
integration, etc.) 
7. Include Maricopa County Public Health logo in 
final published report and acknowledge support 
of MCDPH CHNA Team.

SECTION III                                                                                           COMPENSATION 
15 
 
1. 
COMPENSATION 
 
A. Subject to the availability of funds, Native Health shall pay the County for the 
services described herein for a sum not to exceed the Contract Amount listed on the 
cover page of this Contract in equal yearly installments of $13,000 over the three-
year term of this Contract.  
 
 
B. Native Health shall pay the County an amount not to exceed (NTE) $39,000 for the 
life of this Contract. Partners can add additional services during the contract cycle. 
Any additional service that is added, the partner will retroactively pay for that service 
for the duration of the contract. Please refer to price sheet for additional services.  
 
 
  
YR 1 
YR 2 
YR 3 
Yearly Base Amount (includes one PSA analysis) 
$12,000 
$12,000 
$12,000 
Yearly Amount per Additional Report (x1) 
$1,000 
$1,000 
$1,000 
Total Yearly Amount 
$13,000 
$13,000 
$13,000 
 
 
2. 
METHOD OF PAYMENT 
 
 
A. Invoice with net 45 terms. 
 
B. Invoices shall be submitted to: 
  
 
Amanda Watch: awatch@nachci.com 
Francie Spencer: fspencer@nachci.com  
 
 
3. 
NOTICE 
 
Any notice given under this Contract shall be sent to the attention of the 
following: 
 
 
Maricopa County 
Department of Public Health,  
Office of Community Empowerment 
Native Health 
 
4041 N. Central Avenue 
4041 N. Central Avenue 
Suite #600 
Phoenix, AZ 85012 
Phoenix, AZ 85012 
 
 
Maricopa County  
Department of Public Health 
Grants and Contracts Unit 
 
4041 N. Central Ave #1400 
 
Phoenix, AZ 85012

SECTION IV                                                    BUSINESS ASSOCIATION AGREEMENT 
16 
 
BUSINESS ASSOCIATE AGREEMENT 
 
This Business Associate Agreement (“BAA”) sets out the responsibilities and obligations of 
Maricopa County Department of Public Health ("Associate") as a Business Associate (as defined at 45 
C.F.R.§ 160.103) of Native Health (“NATIVE HEALTH”) pursuant to the agreement between Associate and 
NATIVE HEALTH dated ___________________, as well as all future agreements entered into by the 
Parties (collectively, the “Agreement”).  Associate and Native Health (individually a "Party" and collectively 
the "Parties") agree to the terms and conditions of this BAA in order to comply with the use and disclosure 
of Protected Health Information (“PHI”) (as defined at 45 C.F.R.§ 160.103) provisions of the Standards for 
Privacy of Individually Identifiable Health Information, at 45 C.F.R. Parts 160 and 164, Subparts A and E, 
as amended from time to time (the “Privacy Rule”); the Security Standards for the Protection of Electronic 
PHI, 45 C.F.R. Parts 160 and 164, Subparts A and C (the "Security Rule"); and the standards for Notification 
in the Case of Breach of Unsecured PHI, 45 C.F.R. Part 164, Subpart D (the "Breach Notification Rule") 
(collectively, the “HIPAA Rules”).  Unless otherwise provided herein, all capitalized terms in this BAA will 
have the same meaning as provided under the HIPAA Rules and HITECH (as defined below).  Associate 
and Native Health will comply with the terms of this BAA for the duration of the Agreement and for such 
other continuing periods as provided in this BAA. This BAA shall supersede any and all prior business 
associate agreements entered into between the Parties. 
 
1. USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION. 
 
a. Performance of Services.  Associate will use and disclose PHI only for those purposes necessary 
to perform its duties, obligations, and functions under the Agreement, or as otherwise expressly 
permitted or required by this BAA or as Required by Law.  Associate will not use or further disclose 
any PHI in violation of this BAA or in a manner that, if done by Native Health, would violate the 
Privacy Rule. 
 
b. Limited Data Sets.  Associate will limit any uses, disclosures, or requests of PHI to a Limited Data 
Set, as defined in 45 C.F.R. § 164.514(e)(2), or if needed by Associate to the minimum necessary 
PHI required to accomplish the intended purpose of the use, disclosure, or request, as defined by 
the Privacy Rule, pursuant to the Health Information Technology for Economic and Clinical Health 
Act (“HITECH”), and any regulations or guidance promulgated thereunder by the Secretary.  For 
any disclosures of PHI pursuant to this BAA, the Party disclosing the PHI shall determine what 
constitutes the minimum necessary to accomplish the intended purpose of the disclosure. 
 
c. Data Aggregation.  Associate may use PHI to perform data aggregation services as permitted by 
45 C.F.R. § 164.504(e)(2)(i)(B). 
 
d. Associate’s Management and Administration.  Associate may use or disclose PHI for the 
necessary management and administration of Associate, or to carry out the legal responsibilities of 
Associate, provided that if Associate makes a disclosure of PHI: 
 
i. The disclosure is Required by Law; or 
 
ii. Associate first secures written assurances from the receiving party that the 
receiving party will: (i) hold the PHI confidentially; (ii) use or disclose the PHI only 
as required by law or for the purposes for which it was disclosed to the recipient; 
and (iii) notify the Associate of any breaches in the confidentiality of the PHI. 
 
Notwithstanding the foregoing, the Parties explicitly agree that unless the de-identification 
requirements in Section 1(e) of this BAA are met, Associate’s use of PHI in demonstrating its 
services or product to an outside third party is strictly prohibited by this BAA. 
 
e. De-Identification.  Associate may de-identify the PHI, provided that such de-identification is in 
accordance with 45 C.F.R. § 164.514(b)92) and such resulting de-identified information is only

SECTION IV                                                    BUSINESS ASSOCIATION AGREEMENT 
17 
 
used or disclosed for Associate’s internal business purposes.  Associate may not commercialize or 
sell the de-identified information to a third party. 
 
f. 
Prohibition on Off-Shoring PHI.  Associate agrees that no PHI may be created, received, 
maintained, accessed, or transmitted outside of the United States of America, which shall be 
construed as one of the fifty United States or one of the United States territories (i.e., American 
Samoa, Guam, Northern Mariana Islands, Puerto Rico, and Virgin Islands). 
 
2. 
SAFEGUARDS FOR PROTECTED HEALTH INFORMATION.  Associate will implement 
appropriate safeguards to prevent any use or disclosure of PHI not otherwise permitted in this BAA.  
Associate also will implement administrative, physical, and technical safeguards to protect the 
confidentiality, integrity, and availability of the electronic PHI, if any, that Associate creates, 
receives, maintains, or transmits on behalf of Native Health.  Associate will also comply with the 
applicable requirements of Subpart C of Part 164 of the Security Rule in the same manner such 
provisions apply to Native Health. 
 
3. 
REPORTS OF IMPERMISSIBLE USE OR DISCLOSURE. 
 
a. Notification of an Impermissible Use or Disclosure of PHI.  Associate will report to Native Health 
any use or disclosure of PHI not permitted by this BAA, including any Breach of Unsecured PHI, 
as soon as reasonably practicable but in all events, within five (5) business days of its discovery. 
 
b. Notification of Security Incidents.  Associate also will report to Native Health any Security 
Incident of which it becomes aware within five (5) business days of its discovery.  Notwithstanding 
the foregoing, Associate and Native Health acknowledge the ongoing existence and occurrence of 
attempted but unsuccessful Security Incidents that are trivial in nature, such as pings and port 
scans, and Native Health acknowledges and agrees no additional notification to Native Health of 
such unsuccessful Security Incidents is required.  However, to the extent that Associate becomes 
aware of an unusually high number or pattern of unsuccessful Security Incidents due to the 
repeated acts of a single party, Associate shall notify Native Health of these attempts and provide 
the name, if available, of said party.  At the request of Native Health, Associate shall use its best 
efforts to identify the date of the Security Incident, Associate’s response to the Security Incident 
and the identification of the party responsible for causing the Security Incident, if known. 
 
c. Content of Notifications.  Associate's notices provided under this Section 3 will include, to the 
extent possible, the identification of each Individual whose PHI has been, or is reasonably believed 
by Associate to have been, accessed, acquired, used, or disclosed during or as a result of the 
impermissible use or disclosure of PHI, or a Security Incident (“Security Event”).  Associate shall 
also provide Native Health with at least the following information: a description of the Security 
Event, including the date of the Security Event and date of discovery, if known; a description of the 
types of PHI involved in the Security Event; any steps Individuals should take to protect themselves 
from potential harm as a result of the Security Event; and any other information requested by Native 
Health related to the Security Event.  Associate shall supplement such notice with further 
information as it becomes available, even if such information becomes available after Individuals 
have been notified of the Security Event. 
 
d. Cooperation by Associate.  Associate agrees to cooperate with Native Health in the investigation 
of a Security Event and understands and agrees that Native Health in its sole discretion will 
determine whether or not a Security Event is a Breach and/or triggers notification obligations. 
 
e. Obligation to Provide Notifications.  In the event that Associate, or its Workforce members or 
Subcontractors cause a Security Event, or a Security Event occurs while PHI is in Associate’s 
possession or is being transmitted by Associate, Associate agrees that Native Health may, in its 
sole discretion, require Associate to provide all notifications that 
Native Health is required to make pursuant to the Breach Notification Rule and any other applicable 
laws.  Native Health shall have the right to review, direct, and approve or reject the contents or 
manner of such notifications.

SECTION IV                                                        BUSINESS ASSOCIATE AGREEMENT 
 
 
 
f. 
Cost Reimbursement and Indemnification.  Associate also agrees to indemnify and reimburse 
Native Health for any costs incurred in investigating, mitigating, and otherwise responding to a 
Security Event caused by Associate or its Workforce or Subcontractors, or a Security Event occurs 
while PHI is in Associate’s possession or is being transmitted by Associate, including costs related 
to providing legally required notifications, as well as credit monitoring services for at least one (1) 
year to the extent the Security Event involved social security numbers or financial account 
information. 
 
4. 
SUBCONTRACTORS.  In accordance with 45 C.F.R. §§ 164.308(b)(2) and 164.502(e)(1)(ii), if 
Associate provides PHI to a Subcontractor, Associate shall ensure that the Subcontractor agrees 
in writing to substantially the same, but at least as stringent and protective as to Native Health and 
the PHI, as the restrictions and conditions that apply in this BAA to Associate with respect to such 
information, including the safeguards required by Section 2.  Associate shall maintain a list of its 
Subcontractors and will provide Native Health with a copy of such list upon reasonable request. 
 
5. 
OBLIGATIONS REGARDING ASSOCIATE PERSONNEL.  Associate will appropriately inform 
and train all of its Workforce members (“Associate Personnel”), whose services may be used to 
satisfy Associate’s obligations under the Agreement and this BAA of such Associate Personnel’s 
HIPAA Rule and HITECH obligations so as to enable Associate to comply with the terms of this 
BAA.  Associate represents and warrants that the Associate Personnel are under legal obligation 
to Associate, by contract or otherwise, sufficient to enable Associate to fully comply with the 
provisions of this BAA. 
 
6. 
ACCESS TO PHI. 
 
a. Native Health Access.  Within five (5) business days of a request by Native Health for access to 
PHI held by Associate in a Designated Record Set, Associate will make the requested PHI available 
to Native Health, in the time, manner, and format requested by Native Health, including 
electronically if Associate maintains the PHI electronically and the requested form and format is 
readily producible, or, if not, in a readable electronic form and format as agreed to by Native Health 
and the Individual.  Any fee that Associate may charge for providing the access required hereunder 
must be reasonable, cost-based, and determined in accordance with 45 C.F.R. § 164.524(c)(4). 
 
b. Individual Access.  If an Individual requests access to PHI directly from Associate, Associate will 
notify the Individual that it will forward the request to NATIVE HEALTH.  Within five (5) business 
days of the request, Associate will forward such request in writing to Native Health.  Native Health 
will be responsible for making all determinations regarding the grant or denial of an Individual’s 
request for PHI and Associate will make no such determinations.  Only Native Health will release 
PHI to the Individual pursuant to such a request. 
 
7. 
AMENDMENT OF PHI.  Within five (5) business days of receiving a request from Native Health to 
amend an Individual’s PHI held by Associate in a Designated Record Set, Associate will provide 
such information to Native Health for amendment.  If Native Health request includes specific 
information to be included in the PHI as an amendment, Associate will incorporate such amendment 
within five (5) business days of receipt of Native Health request.  Associate will forward to Native 
Health within five (5) business days any requests by Individuals to Associate to amend PHI within 
its or Native Health possession. Native Health will be responsible for making all determinations 
regarding amendments to PHI, and Associate will make no such determinations. 
 
8.       ACCOUNTING OF DISCLOSURES; REQUESTS FOR DISCLOSURE. 
 
a. Disclosure Records.  Associate agrees to document such disclosures of PHI and information 
related to such disclosures as would be required for Native Health to respond to a request by an 
Individual for an accounting of disclosures of PHI in accordance with 45 C.F.R. § 164.528.  As of 
the compliance date set forth in the regulations promulgated under HITECH or as otherwise 
determined by the Secretary, in addition to the accounting of disclosure obligations required under

SECTION IV                                                        BUSINESS ASSOCIATE AGREEMENT 
 
 
45 C.F.R. § 164.528, Associate shall account for all disclosures of PHI made through an Electronic 
Health Record in accordance with all applicable regulations. 
 
b. Data Regarding Disclosures.  For each disclosure for which Associate must maintain 
documentation under Section 8(a), Associate will record and maintain the following information: 
 
▪ 
The date of disclosure.  
▪ 
The name of the entity or person who received the PHI, and the address of such 
entity or person, if known.  
▪ 
A description of the PHI disclosed; and  
▪ 
A brief statement of the purpose of the disclosure. 
 
c. Individual Request for Disclosure Records.  Within five (5) business days of receipt of a notice 
from Native Health to Associate of an Individual’s request for an accounting of disclosures, 
Associate will provide Native Health with the record of disclosures requested in the notice. 
 
d. Individual Request to Associate.  If an Individual requests an accounting of disclosures directly 
from Associate, Associate will notify the Individual that he or she will receive such accounting from 
Native Health.  Associate will forward the request to Native Health within five (5) business days of 
Associate’s receipt of the request and will make its records of disclosures available to Native Health 
as otherwise provided in this Section.  Native Health will be responsible for preparation and delivery 
of the records of disclosure to the Individual.  Associate will not provide an accounting of its 
disclosures directly to the Individual. 
 
e. Survival of Obligations.  Associate’s obligations related to maintaining a disclosure record and 
providing the disclosure record to Native Health as required by this Section 8 shall survive for six 
(6) years from the effective date of the relevant Agreement, Associate shall provide Native Health 
with its disclosure record which reflects disclosures made by Associate over the six (6) years 
immediately preceding the date of termination. 
 
9. 
REQUESTS FOR RESTRICTIONS.  If Native Health advises Associate of any changes in, or 
restrictions to the permitted use or disclosure of PHI provided to Associate, Associate will restrict 
use or disclosure of PHI consistent with Native Health instructions.  If Associate receives a request 
to restrict the disclosure of PHI directly from an Individual, Associate shall promptly notify Native 
Health of such request, and Native Health shall be responsible for making the determination as to 
whether Associate shall comply with the Individual's request. 
 
10. 
DELEGATION OF OBLIGATIONS.  To the extent Associate is clearly required by the terms of the 
Agreement to carry out Native Health obligations under the Privacy Rule, Associate shall comply 
with the requirements of the Privacy Rule that apply to Native Health in the performance of such 
delegated obligations. 
 
11. 
MITIGATION PROCEDURES.  Associate will mitigate, to the maximum extent practicable, any 
harmful effect that is known to Associate arising from its, its Workforce’s, or its Subcontractors’ Use 
or Disclosure of PHI in a manner that violates this BAA. 
 
12. 
INDEMNIFICATION.  The following indemnification provisions shall apply to this BAA and shall
survive the termination of the Agreement or this BAA: 
 
a. To the fullest extent permitted by law, Associate, its successors, assigns and guarantors, shall pay, 
defend, indemnify and hold harmless Native Health, its agents, representatives, officers, directors, 
officials and employees from and against all allegations, demands, proceedings, investigations or 
audits by state or federal government agencies, suits, actions, claims, damages, liability, penalties, 
losses, expenses, including but not limited to, attorney fees, defense costs, court costs, the cost of 
appellate proceedings, and the costs of responding to and defending against an investigation or 
audit, and all claim adjusting and handling expenses, related to, arising from or out of or resulting 
from any actions, acts, errors, mistakes or omissions caused in whole or part by Associate relating

SECTION IV                                                        BUSINESS ASSOCIATE AGREEMENT 
 
 
to work or services in the performance of this BAA, including but not limited to, any Subcontractor, 
or Associate’s or Subcontractor’s Workforce, regardless of whether or not caused in part by the 
active or passive negligence of a party indemnified hereunder including Native Health, its agents, 
representatives, officers, directors, officials and employees. 
 
b. If any claim, action or proceeding is brought against Native Health by reason of any event that is 
the subject of this BAA and or described herein, upon demand made by Native Health, Associate, 
at its sole cost and expense, shall pay, resist or defend such claim or action on behalf of Native 
Health by an attorney hired by Associate, or if covered by insurance, Associate’s insurer, all of 
which must be approved by Native Health, which approval shall not be unreasonably withheld or 
delayed.  Native Health shall cooperate with all reasonable efforts in the handling and defense of 
such claim.  Included in the foregoing, Native Health may engage its own attorney to defend or 
assist in its defense.  Any settlement of claims shall fully release and discharge the indemnified 
parties from any further liability for those claims.  The release and discharge shall be in writing and 
shall be subject to approval by Native Health, which approval shall not be unreasonably withheld 
or delayed.  If Associate neglects or refuses to defend Native Health as provided by this BAA, any 
recovery or judgment Native Health for a claim covered under this BAA shall conclusively establish 
Associate’s liability to Native Health in connection with such recovery, fine, penalty, or judgment.  
Further, if Native Health desires to settle such dispute Native Health shall be entitled to settle such 
dispute in good faith and Associate shall be liable for the amount of such settlements.  Regardless 
of settlement, fine, penalty, or judgment, Associate shall be liable for all expenses connected to the 
defense, including reasonable attorney fees, and other investigative and claims adjusting 
expenses. 
 
c. Any limitations of liability contained in the Agreement shall not apply to the indemnification 
requirements of this Section. 
 
d. In addition to the indemnification obligations set forth herein, Associate shall make itself and any 
Subcontractors or Workforce members assisting Associate in the performance of its obligations 
under the Agreement or this BAA available to Native Health, at no cost to Native Health, to testify 
as witnesses, or otherwise, in the event of litigation or administrative proceedings being 
commenced against Native Health, its directors, officers or employees based upon a claim of 
violation of HIPAA, the HITECH Act, the HIPAA Rules, or other laws related to security and privacy 
by Associate or its Subcontractors or Workforce members. 
 
e. This Section shall survive termination of this BAA. 
 
13. 
RESPONSIBILITIES UPON TERMINATION. 
 
a. Return of PHI, Destruction.  Within fifteen (15) days of termination of this BAA, Associate will 
return to Native Health all PHI received from Native Health or created or received by Associate on 
behalf of Native Health which Associate maintains in any form or format (including copies thereof), 
and Associate will not maintain or keep in any form or format any portion of the PHI.  Alternatively, 
Associate may, upon Native Health written consent, destroy all such PHI and provide written 
documentation of such destruction to Associate.  The requirement to return or destroy such PHI 
will apply to all Subcontractors of Associate.  Associate will be responsible for recovering any PHI 
from such Subcontractors.  If Associate cannot obtain the PHI from any Subcontractor, Associate 
will so notify NATIVE HEALTH and will require that such Subcontractor directly return PHI to Native 
Health or otherwise destroy such PHI, subject to the terms of this Section. 
 
b. Return or Destruction of PHI Infeasible.  If Associate believes that returning or destroying PHI 
in its or its Subcontractors' possession at the termination of this BAA is infeasible, it will provide 
written notice to Native Health within five (5) business days of the effective date of termination of 
this BAA.  Such notice will set forth the circumstances that Associate believes makes the return or 
destruction of PHI infeasible and the alternative measures that Associate recommends for assuring 
the continued confidentiality and security of the PHI.  Native Health promptly will notify Associate 
of whether it agrees that the return or destruction of PHI is infeasible.  If Native Health agrees that

SECTION IV                                                        BUSINESS ASSOCIATE AGREEMENT 
 
 
return or destruction of PHI is infeasible, Associate agrees to extend all protections, limitations, and 
restrictions of this BAA to the PHI retained after termination of this BAA and to limit further uses or 
disclosures to those purposes that make the return or destruction of the PHI infeasible.  Any such 
extended protections, limitations and restrictions will apply to any Subcontractors of Associate for 
whom return, or destruction of PHI is determined by Native Health to be infeasible.  If Native Health 
does not agree that the return or destruction of PHI from Associate or its Subcontractors is 
infeasible, Native Health will provide Associate with written notice of its decision, and Associate 
and its Subcontractors will proceed with the return or destruction of the PHI pursuant to the terms 
of this Section within fifteen (15) days of the date of Native Health notice. 
 
14. 
TERMINATION.  Native Health and Associate may immediately terminate this BAA upon written 
notice to the other Party if Native Health or Associate determines in its discretion that the other 
Party has breached a material term of this BAA.  Alternatively, the non-breaching Party may elect 
to provide the breaching Party with thirty (30) days’ advance written notice of the breaching Party's 
breach of any term or condition of this BAA and afford the breaching Party the opportunity to cure 
the breach to the satisfaction of the non-breaching Party within twenty (20) days of such notice.  If 
the breaching Party fails to timely cure the breach, as determined by the non-Breaching Party, the 
BAA will terminate this BAA as provided in the non-breaching Party's notice. This BAA will 
automatically terminate upon expiration or termination of the last effective Agreement between the 
Parties unless the Parties explicitly agree in writing to extend the term of this BAA beyond the 
expiration or termination of the last effective Agreement. 
 
15. 
ASSOCIATE BOOKS AND RECORDS. 
 
a. Native Health Access.  Following a Security Event, or for purposes of Native Health responding 
to a government inquiry or judicial or administrative process, Associate will, within five (5) business 
days of Native Health written request, make available during normal business hours at Associate’s 
offices, all records, books, agreements, policies, and procedures relating to the use or disclosure 
of PHI for the purpose of allowing Native Health to determine Associate’s compliance with the 
Agreement and this BAA. 
 
b. Government Access.  Associate will make its internal practices, books and records on the use 
and disclosure of PHI available to the Secretary to the extent required for determining compliance 
with the Privacy Rule.  Notwithstanding this provision, no attorney-client, accountant-client, or other 
legal privilege will be deemed waived by Associate or Native Health as a result of this Section.  
Associate shall also make its policies and procedures, and documentation required by the Security 
Rule relating to the safeguards in Section 2, available to the Secretary for purposes of determining 
Native Health and Associate’s compliance with the Security Rule. 
 
16. 
NOTICES.
a. Any notices required under this BAA will be sent to the Parties at the following address by first class 
mail, fax, or hand delivery: 
 
NATIVE HEALTH 
MARICOPA COUNTY DEPARTMENT OF 
PUBLIC HEALTH 
 
4041 N. Central Avenue 
4041 N. Central Avenue, Suite 1400 
Phoenix, AZ 85012 
Phoenix, AZ 85012 
Fax: 602-279-5390 
Fax: 602-605-6885 
Attn: Francie Spencer 
Attn: Annie Daymude 
 
 
b. Any notice, report or other communication required under this BAA shall be in writing and shall be 
delivered personally, telegraphed, emailed, sent by facsimile transmission, or sent by U.S. mail.

SECTION IV                                                        BUSINESS ASSOCIATE AGREEMENT 
 
 
17. 
MISCELLANEOUS. 
 
a. Relationship of Parties.  In the performance of the work, duties and obligations described in this 
BAA or the Agreement, the Parties acknowledge and agree that each Party is at all times acting 
and performing as an independent contractor and at no time shall the relationship between the 
Parties be construed as a partnership, joint venture, employment, principal / agent relationship, or 
master / servant relationship. 
 
b. Regulatory References.  A reference in this BAA to a section in the HIPAA Rules means the 
section as in effect or as amended and for which compliance is required. 
 
c. Amendment.  No change, amendment, or modification of this BAA shall be valid unless set forth 
in writing and agreed to by both Parties.  Notwithstanding the foregoing, the Parties acknowledge 
that state and federal laws relating to electronic data security and privacy are rapidly evolving and 
that amendment of this BAA may be required to ensure compliance with such developments.  The 
Parties specifically agree to take such action as may be necessary from time to time for the Parties 
to comply with the requirements of the HIPAA Rules and HITECH.  Native Health shall provide 
written notice to Associate to the extent that any final regulation or amendment to the HIPAA Rules 
promulgated by the Secretary requires an amendment to this BAA.  The Parties agree to negotiate 
an amendment to this BAA in good faith; however, either Party may terminate this BAA upon ninety 
(90) days written notice to the other Party if the Parties are unable to reach an agreement. 
 
d. Interpretation.  Any ambiguity in this BAA shall be resolved to permit Native Health and Associate 
to comply with the HIPAA Rules and HITECH.  The provisions of this BAA shall prevail over any 
provisions in the Agreement that may conflict or appear inconsistent with any provision in this BAA, 
provided that any provision in the Agreement that is more stringent or protective of PHI than the 
terms of this BAA shall govern. 
 
e. 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.

23 
 
IN WITNESS WHEREOF, each Party has caused this BAA to be executed by its duly authorized 
representative. 
 
 
IN WITNESS WHEREOF, the parties agree to enter into this contract:  
 
 
FOR AND ON BEHALF OF 
 
NATIVE HEALTH 
MARICOPA COUNTY 
 
 
 
 
 
By:  
  
By:                                                                        
Chairman, Board of Supervisors 
 
 
 
Printed name:___________________ 
Date 
 
 
ATTEST: 
Title:___________________________ 
 
 
 
 
 
 
 
 
 
Date: __________________________ 
Clerk of the Board 
 
 
 
 
 
Date 
 
 
 
APPROVED AS TO FORM: 
 
 
 
 
 
 Attorney for Maricopa County  
 
 
 
 
 
Date 
 
 
 
 
CEO
Aug 16, 2023
Walter Murillo