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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
MAYO CLINIC
13500 E. Shea Blvd., Scottsdale, Arizona 85259
1. Contract No: 2: Contract Type: Service
3. Contract Amount: $46,800 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 Mayo Clinic Arizona dba Mayo Clinic referred to as
“Mayo Clinic” and Maricopa County, by and through its Department of Public Health referred to as the “County.” Mayo Clinic
and the County are collectively referred to herein as the “Parties” and individually as a “Party.” The contractor, in consideration
of the covenants and conditions set forth herein, 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 amendments as set forth herein and in:
Section | - 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 the Contractor in any state or federal
court.
Legal Notice under this Agreement 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:_ Mayo Clinic Phone.
Address: 13400 E. Shea Blvd. Scottsdale, AZ 85259
Notice to: MCDPH Grants/Contract Unit Phone: (602) 372-0674
Address: 4041 North Central Avenue, Suite #1400, Phoenix, Arizona 85012
IN WITNESS WHEREOF, the Parties enter this Contract:
MAYO CLINIC. MARICOPA COUNTY DEPT OF PUBLIC HEALTH
. Marion K. Kelly .
Signature — Gerionk Kelly dulr, 2023 12:107OT) Signature
Name Marion K. Kelly Name
Title Director, Community Engagement Title Chairman, Board of Supervisors
Date Jul 27, 2023 Date
ATTEST: ATTEST:
Signature Signature
Office of the Clerk of the Board
Date
APPROVED AS TO FORM:
Signature Signature
Attorney for Maricopa County
Date Date
SECTION | 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.
G, Department means the Maricopa County Department of Public Health (MCDPH).
D. Director means the Director of the Department.
E. Eunding Source 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.
3. GENERAL REQUIREMENTS
A. The terms of this Contract shall be governed by 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, and shall comply with all laws regarding Unemployment Insurance,
Disability Insurance, and Workers’ Compensation.
Cc. 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 Mayo Clinic.
4. AMENDMENTS
All amendments to this Contract shall be in writing and signed by the Parties.
SECTION |
GENERAL PROVISIONS
5. ASSIGNMENT / SUBCONTRACTING
No rights, liability, obligations, or duties under this Contract may be assigned,
delegated, or subcontracted by the County or Mayo Clinic 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.
6. 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
considered as relevant to this Contract.
The County shall retain all financial books, records, and other documents relevant
to this Contract for six 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
such materials.
The County shall, upon written demand, therefore, reimburse Mayo Clinic for any
payments made under this Contract that are disallowed by a Federal, State, or
Maricopa County audit in the amount of the disallowance, as well as all expenses,
court costs, and attorney fees Mayo Clinic incurs in connection with any legal action
relating to such disallowance.
If, at any time, Mayo Clinic determines that a cost for which payment has been made
is a disallowed cost Mayo Clinic shall notify the County in writing of the disallowance
and the required course of action, which may be, at the option of Mayo Clinic, either
to adjust any future claim submitted by the County by the amount of the
disallowance or to require repayment of the disallowed amount by the County
within thirty (30) business days of such notice.
7. TERMINATION
A.
The County or Mayo Clinic may terminate this Contract at any time with at least
thirty (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.
This Contract may be terminated by mutual written agreement of the Parties
specifying the termination date therein.
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 ten
days after the effective date of the other Party’s written notice stating the specific
SECTION | GENERAL PROVISIONS
10.
11.
12.
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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. 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. If more than one activity is funded by this Agreement 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.
F. If Contractor terminates this Contract prior to the expiration date, Contractor 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 services.
Upon termination or expiration, the property purchased in furtherance of this Contract will.
remain the property of the purchasing Party, unless expressly specified otherwise.
SEVERABILITY
If a court finds that any provision of this Contract is invalid, all the remaining provisions
shall remain in full force and effect.
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.
NON-LIABILITY
Neither Party, nor their officers and employees, shall be liable for any act or omission by
the other Party or any subcontractor, employee, officer, agent, or representative.
COVENANT AGAINST CONTINGENT FEES
Each Party warrants that it has not utilized any person or agency to solicit or secure this
Contract for a commission or contingent fee. Either Party may terminate this Contract
without liability for breach of this warranty.
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.
RIGHTS IN DATA
The Parties may use all data and reports resulting from this Contract without cost or other
SECTION | GENERAL PROVISIONS
14.
15.
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restriction, except as otherwise restricted by this Contract or by law. Each Party shall
supply to the other Party, upon request, any available information known to the supplying
Party that is relevant to this Contract.
NON-DISCRIMINATION
The County, 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 Mayo Clinic.
EQUAL EMPLOYMENT OPPORTUNITY
The County 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 County 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
County 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 County shall also comply with all applicable provisions of
the Americans with Disabilities Act of 1990 (42 U.S.C. §§ 12101, et seq.).
RIGHT TO EXTEND CONTRACT
Subject to the availability of funds and acceptable County performance, based upon
mutual written and signed agreement by Mayo Clinic and the County, the Contract may
be extended for one additional month, not to exceed a total extended term of eight months,
except that the cost will be subject to renegotiation.
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 20 CFR Part 180, and its principals and
subcontractors, if any:
1) are not presently debarred, suspended, proposed for debarment, declared
SECTION |
GENERAL PROVISIONS
ineligible, or voluntarily excluded from covered transactions by any federal
department or agency.
2) have not, within the three-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;
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 three-year period preceding this Contract, had one or
more public transactions (federal, state, or local) terminated for cause or
default.
If the County is not able to provide this certification, an explanation as to why shall
be attached to this Contract.
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 e-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;
That a breach of a warranty under subsection A above shall be deemed a material
breach of this Contract that entitles Mayo Clinic to, among other things, terminate
this Contract without liability.
That Mayo Clinic retains the right to inspect the papers of the County and any
subcontractor employee who works under this Contract to ensure compliance with
the warranty provided under 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.
That nothing herein shall make the County or any subcontractor an agent or
employee of Mayo Clinic.
SECTION | GENERAL PROVISIONS
19.
20.
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WRITTEN CERTIFICATION PURSUANT TO A.R.S. § 35-393.01.
If Mayo Clinic engages in for-profit activity and has 10 or more employees, and if this
Contract has a value of $100,000 or more, Mayo Clinic certifies it is not currently
engaged in, and agrees for the duration of this Contract 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.
UNIFORM ADMINISTRATIVE REQUIREMENTS
By entering this Contract, the County agrees to comply with all applicable provisions of
Title 2, Subtitle A, Chapter Il,PART 200—UNIFORM ADMINISTRATIVE
REQUIREMENTS, COST PRINCIPLES, AND AUDIT REQUIREMENTS FOR FEDERAL
AWARDS contained in Title 2 C.F.R. § 200 et seq.
WRITTEN CERTIFICATION PURSUANT TO A.R.S. § 35-394.
Mayo Clinic warrants and certifies that it does not currently, and agrees for the duration
of the contract, 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 Mayo Clinic becomes aware during the term of this Contract
that the Contractor is not in compliance with this paragraph, Mayo Clinic shall
notify the County within five business days after becoming aware of the
noncompliance. If the Mayo Clinic fails to provide a written certification to the
County that the Mayo Clinic has remedied the noncompliance within 180 days
after notifying the County of its noncompliance, the Contract terminates, except
that if the Contract termination date occurs before the end of the 180-day period,
the agreement terminates on the Contract termination date.
DISPUTE RESOLUTION
If any dispute arises out of this Contract or involves a recipient of services under the terms
of this Contract, the Parties shall meet and confer to resolve the dispute. If 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.
CHANGES
A. The Director may, at any time, by written order and with prior written consent of
Mayo Clinic, make changes within the scope of this Contract in any one or more
of the following areas:
1): Work Statement activities reflecting changes in the scope of services,
SECTION | GENERAL PROVISIONS
24.
25.
26.
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
SPECIAL REQUIREMENTS
A. The County shall use written subcontracts, consultant agreements and/or
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 Subcontractors
are used. The County shall submit a copy of each Subcontract to Mayo Clinic
within fifteen days of its effective date.
B. The County shall include in any subcontracts a provision to the effect that the
subcontractor agrees that Mayo Clinic 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.
INDEMNITY AND INSURANCE:
The parties agree that both are Self-Insured government 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 Contract but only to the extent that such claims which result in vicarious/derivative
liability to the Indemnitee are caused by the act, omission, negligence, misconduct, or
other fault of the Indemnitor, its officers, officials, agents, employees, or volunteers.
LAWS, RULES, AND REGULATIONS
Mayo Clinic and the County understand and agree that this Contract is subject to all
applicable state and federal laws, rules, and regulations.
SECTION | GENERAL PROVISIONS
27.
ADVERTISEMENTS
Use of Mayo Clinic Name: Except as specifically permitted in this Contract, the County
shall not use the names or trademarks of Mayo Clinic Health or of any of Mayo Clinic
affiliated entities in any advertising, publicity, endorsement, or promotion unless Mayo
Clinic has provided prior written consent for the particular use contemplated. All requests
for approval pursuant to this Section must be submitted to Mayo Clinic at least five
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
1. BACKGROUND
The Patient Protection and Affordable Care Act (ACA) has requirements that nonprofit hospitals
must satisfy to maintain their tax-exempt status under section 501(c) (3) of the Internal Revenue
Code. One such requirement added by the ACA, Section 501(r) of the Code, requires nonprofit
hospitals to conduct a Community Health Needs Assessment (CHNA) and adopt implementation
strategies to address the identified needs for the community at least once every three years. As
part of the CHNA, each hospital is required to collect input from the community from individuals
in the community, including public health experts as well as residents, representatives, or leaders
of low-income, minority, and medically underserved populations. 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*; and
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 act and
design policies that improve the health and well-being of all*.
*Healthy People 2030 Overarching Goals
Data Collection and Assessments Methodology
MCDPH uses 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 efficiency,
effectiveness, and 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) and conducts comparisons. These assessments
and analysis are then incorporated with extensive quantitative data sets such as:
Hospital Discharge Data from ADHS
Birth/Death from Vital Records
CDC’s Behavioral Risk Factor Surveillance System
CDC’s Youth Behavioral Risk Surveillance System
Arizona Youth Survey
National Cancer Institute-Cancer Registry
Healthy People 2023 and other sources that address priority.
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SECTION II
SCOPE OF WORK
3. SERVICE GOALS:
Membership 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.
Service/ . a .
Deliverable County agrees to: Mayo Clinic agrees to:
Synapse 1. Administer and convene meetings of the 41. Assign and allow at minimum 2 and at
maximum 5 employee of Mayo Clinic to actively
participate on the Synapse coalition as a
representative of Mayo Clinic to make and/or
influence decisions on the development and
implementation of the CHNA process. For
decisions requiring consensus, Mayo Clinic 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- 1. Meet with Mayo Clinic individually within
Specific the first 6 months of the contract cycle to
CHNA and develop a workplan timeline for all
Prioritization deliverables that aligns with Mayo Clinic
Strategy 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 Mayo Clinic
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 Mayo Clinic, and any
Necessary approval processes.
2. Develop a plan for health issue prioritization,
stakeholder/committee engagement, and report
format development tailored to Mayo Clinic’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 Mayo Clinic may
result in delays to workplan timelines. County is
not responsible for making up time lost due to
delayed communication by Mayo Clinic 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 Mayo Clinic requirements for shared
documentation and work with county to set up
sharing platform such as Dropbox, SharePoint,
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SECTION II SCOPE OF WORK
Trello, etc.
Ad-hoc Epi 1. Provide prioritized epidemiology and data 1. Provide requests through public data request
time analysis assistance for non-CHNA related portal at httos://ohdra.maricopa.gov/ at minimum
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.
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
1. Facilitate data collection of CHNA surveys,
1a. Promote the CHNA survey, focus groups,
selection for the following PSA(s):
Maricopa County
2. Provide a draft of analysis within 60 days
of Mayo Clinic indicator selection
3. Provide a final analysis within 30 days of
Mayo Clinic feedback
Data: Common health indicator report basic
age-adjusted rates for one PSA (individual or
CHNA Data focus groups, and key informant interviews and key informant interviews within Mayo Clinic
Collection based on strategic sampling goals and a according to the organization’s policies. This
targeted regional approach. may include sharing the survey to staff, clients,
and community networks via emails, social
2. Cover the costs of survey development media, physical materials, and tabling or
and translation, outreach and promotional attending events.
materials, communications, internal staff and | 1b. Help identify non-traditional opportunities to
contracted community outreach partners, and | promote the CHNA survey in the community
data entry using Synapse Fee Fund budget through marketing strategies and public events.
and other county budget sources.
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 1. Provide Synapse partners with CHNA 1. Provide at minimum 2 weeks’ notice for
Reporting survey analysis with measures analyzed by additional qualitative quote requests.
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.
PSA Data 1. Provide the following health indicator data 1. Within the first 6 months of contract cycle,
Analysis (detailed below), according to Mayo Clinic’s meet with county to develop a workplan timeline
for CHNA analysis, prioritization, and reporting
that that aligns with Mayo Clinic 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,
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SECTION II SCOPE OF WORK
combined) by the following subgroups: overall | provide county staff with list of indicator request
population, gender, race/ethnicity, and age. from the “Common health indicator list.”
The geography will also include overall
Maricopa county-level rates for each 4. Within 30 days of draft indicator analysis
indicator. Rates include inpatient submission, provide feedback and request for
hospitalizations, emergency department any additional analyses.
visits, and deaths.
5. Provide at minimum 2 weeks’ notice for any
Format: Excel workbook including tabs with | additional requests or data modifications.
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.
Facilitated 1. Co-design a facilitation strategy for Mayo 1. Co-design a facilitation strategy for Mayo
Prioritization Clinic prioritization sessions and Clinic prioritization sessions and presentations to
presentations to gather feedback and receive | gather feedback and receive approval from
approval from necessary committees. necessary committees.
2. Develop a slide deck including up to 35 2. Provide direction and feedback to county
slides of data analysis as well as additional regarding presentation content and materials.
slides containing background information,
polling questions, etc. Iterations of slide 3a. Convene, register, and host presentations
decks throughout the prioritization process whether in-person or virtual.
may involve updating or modifying the 3b. Schedule presentations requiring county staff
content or layout of the data analysis slides. participation at least 4 weeks in advance to
ensure staff availability.
3. Prepare interactive virtual and/or physical 3c. Provide any refreshments or materials used
materials to generate participant feedback during in-person meetings (e.g., poster boards,
and polling. printed materials, etc.).
4. Provide up to 10 cumulative hours of
presentation time to boards/committees in a
virtual or in-person format. Presentation times
beyond 10 hours may be provided for an
additional fee.
CHNA Report | 1. Produce a final IRS-compliant Community 1. Within the first 6 months of the contract cycle,
Health Needs Assessment report’ following
template and deadline determined by Mayo
Clinic and county for the following PSA(s):
Maricopa County
provide county with CHNA submission deadlines
including internal board/committee approval and
final IRS deadline.
2. At the beginning of the report development
process, involve and define roles of relevant
Mayo Clinic staff such as program managers,
14
SECTION II
SCOPE OF WORK
2. Include information 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 Mayo Clinic for review
and approval prior to final draft.
4. Collaborate with
marketing/communications team to develop
final report design as requested by Mayo
Clinic and provided in Word and PDF.
‘According to IRS posted requirements
https:/www.irs.gov/charities-non-
profits/community-health-needs-assessment-
for-charitable-hospital-organizations-section-
5011r3
compliance officers, marketing staff, etc.
3. Provide County with CHNA report template or
description of report component format/content
requirements/images as specified by Mayo Clinic
system office.
4. Complete designated sections of CHNA report
specific to Mayo Clinic background.
5. Provide feedback within two weeks of draft
submissions or according to an 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
43 COMPENSATION
A. Subject to the availability of funds, Mayo Clinic 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 $15,600 over the three-year term
of this Contract.
Mayo Clinic shall pay the County an amount not to exceed (NTE) $46,800 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 the price sheet for additional services.
B.
METHOD OF PAYMENT
A. Invoice with Net 45 terms.
B. Invoices shall be submitted to:
Mayo Clinic info:
kelly. marion@mayo.edu
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
Mayo Clinic
4041 N. Central Avenue
13500 E. Shea Blvd.
Suite #600
Scottsdale, AZ 85259
Phoenix, AZ 85012
Maricopa County
Department of Public Health
Grants and Contracts Unit
4041 N. Central Ave #1400
Phoenix, AZ 85012
SECTION IV BUSINESS ASSOCIATE AGREEMENT
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 Mayo Clinic (‘PARTNER ORGANIZATION”) pursuant to the agreement between
Associate and PARTNER ORGANIZATION dated , as well as all future agreements
entered into by the Parties (collectively, the “Agreement”). Associate and Mayo Clinic (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 Mayo Clinic 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 all
prior business associate agreements entered 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 Mayo Clinic, 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 fulfill 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 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
17
SECTION IV BUSINESS ASSOCIATE AGREEMENT
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 of 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 Mayo Clinic. 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 Mayo Clinic
3. REPORTS OF IMPERMISSIBLE USE OR DISCLOSURE.
a. Notification of an Impermissible Use or Disclosure of PHI. Associate will report to Mayo Clinic
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 Mayo Clinic any Security Incident
of which it becomes aware within five (5) business days of its discovery. Notwithstanding the
foregoing, Associate and Mayo Clinic acknowledge the ongoing existence and occurrence of
attempted but unsuccessful Security Incidents that are trivial in nature, such as pings and port
scans, and Mayo Clinic acknowledges and agrees no additional notification to Mayo Clinic 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 Mayo Clinic of these attempts and provide
the name, if available, of said party. At the request of Mayo Clinic, 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 Mayo Clinic 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 Mayo
Clinic 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 Mayo Clinic in the investigation
of a Security Event and understands and agrees that Mayo Clinic in its sole discretion will
determine whether 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 Mayo Clinic may, in its
sole discretion, require Associate to provide all notifications that Mayo Clinic is required to make
pursuant to the Breach Notification Rule and any other applicable laws. Mayo Clinic shall have
18
SECTION IV BUSINESS ASSOCIATE AGREEMENT
8.
a.
the right to review, direct, and approve or reject the contents or manner of such notifications.
Cost Reimbursement and Indemnification. Associate also agrees to indemnify and reimburse
Mayo Clinic 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.
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 Mayo Clinic 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 Mayo Clinic with a copy of such list upon reasonable request.
OBLIGATIONS REGARDING ASSOCIATE PERSONNEL. Associate will appropriately inform
and train all 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 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.
ACCESS TO PHI.
Mayo Clinic Access. Within five (5) business days of a request by Mayo Clinic for access to PHI
held by Associate in a Designated Record Set, Associate will make the requested PHI available to
Mayo Clinic, in the time, manner, and format requested by Mayo Clinic, 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 Mayo Clinic 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).
Individual Access. If an Individual requests access to PHI directly from Associate, Associate will
notify the Individual that it will forward the request to Mayo Clinic. Within five (5) business days
of the request, Associate will forward such request in writing to Mayo Clinic. Mayo Clinic 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 Mayo Clinic will release PHI to the
Individual pursuant to such a request.
AMENDMENT OF PHI. Within five (5) business days of receiving a request from PARTNER
ORGANIZATION to amend an Individual’s PHI held by Associate in a Designated Record Set,
Associate will provide such information to Mayo Clinic for amendment. If Mayo Clinic’s 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 Mayo Clinic request. Associate will
forward to Mayo Clinic within five (5) business days any requests by Individuals to Associate to
amend PHI within its or PARTNER ORGANIZATION 's possession. Mayo Clinic will be responsible
for making all determinations regarding amendments to PHI, and Associate will make no such
determinations.
ACCOUNTING OF DISCLOSURES; REQUESTS FOR DISCLOSURE.
Disclosure Records. Associate agrees to document such disclosures of PHI and information
related to such disclosures as would be required for Mayo Clinic to respond to a request by an
19
SECTION IV BUSINESS ASSOCIATE AGREEMENT
10.
11.
12.
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
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.
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.
Individual Request for Disclosure Records. Within five (5) business days of receipt of a notice
from PARTNER ORGANIZATION to Associate of an Individual’s request for an accounting of
disclosures, Associate will provide Mayo Clinic with the record of disclosures requested in the
notice.
. 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
PARTNER ORGANIZATION. Associate will forward the request to Mayo Clinic within five (5)
business days of Associate’s receipt of the request and will make its records of disclosures
available to PARTNER ORGANIZATION as otherwise provided in this Section. PARTNER
ORGANIZATION 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.
Survival of Obligations. Associate’s obligations related to maintaining a disclosure record and
providing the disclosure record to Mayo Clinic as required by this Section 8 shall survive for six
(6) years from the effective date of the relevant Agreement, Associate shall provide PARTNER
ORGANIZATION with its disclosure record which reflects disclosures made by Associate over the
six (6) years immediately preceding the date of termination.
REQUESTS FOR RESTRICTIONS. If Mayo Clinic 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 Mayo Clinic instructions. If Associate receives a request
to restrict the disclosure of PHI directly from an Individual, Associate shall promptly notify Mayo
Clinic of such request, and Mayo Clinic shall be responsible for making the determination as to
whether Associate shall Mayo Clinic comply with the Individual's request.
DELEGATION OF OBLIGATIONS. To the extent Associate is clearly required by the terms of the
Agreement to conduct Mayo Clinic obligations under the Privacy Rule, Associate shall comply
with the requirements of the Privacy Rule that apply to Mayo Clinic in the performance of such
delegated obligations.
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.
INDEMNIFICATION. The following indemnification provisions shall apply to this BAA and shall
survive the termination of the Agreement or this BAA:
To the fullest extent permitted by law, Associate, its successors, assigns and guarantors, shall pay,
defend, indemnify and hold harmless Mayo Clinic, its agents, representatives, officers, directors,
20