The URL can be used to link to this page

Browse Search

Home My WebLink About20053713.tiff Health Services Agreement THIS AGREEMENT by and between the Board of County Commissioners of the County of Weld ("BOCC"), on behalf of the Weld County Sheriff's Office ("WCSO"), and CORRECTIONAL HEALTHCARE MANAGEMENT, INC. ("CHM") is entered into as of the 1St day of January, 2006. Whereas, WCSO is charged by law with the responsibility for administering, managing and supervising the health care delivery system of the Weld County North Jail Complex ("Facility") located at 2110 O Street, Greeley, Colorado, and the objective of the WCSO is to provide for the delivery of quality health care to Inmates in accordance with applicable law; and, CHM is in the business of providing correctional health care services and desires to provide such services for WCSO under the terms and conditions hereof; therefore, with the intent to be legally bound, and in consideration of the covenants and promises hereinafter made, the parties hereto agree as follows: I: HEALTH CARE SERVICES 1.1 GENERAL. BOCC hereby engages CHM to provide for the delivery of reasonable and necessary medical, dental, and pharmaceutical care to individuals under the custody and control of WCSO, medically cleared for acceptance, and sentenced to and incarcerated in the Facility ("Inmates"). CHM hereby accepts such engagement according to the terms and provisions hereof. 1.2 SCOPE OF SERVICES. CHM will provide, on a regular basis, professional medical, dental, pharmaceutical, and related health care and administrative services for the Inmates. This program will include a preliminary health evaluation screening of Inmates upon arrival at the Facility, regularly scheduled sick call, nursing coverage, regular physician visits, on-site infirmary care, physical evaluations, hospitalization, medical specialty services, emergency medical care, medical records management, pharmacy services, health education and training, a quality assurance program, an infection control program, administrative support services, and other services, as more specifically described hereinafter. The hours for routine nurse sick call shall be at levels that allow for all inmates needing medical services to be seen within twenty-four (24) hours from the time of the request for such services. If CHM finds that they cannot meet the terms of this Agreement or any part thereof, they shall immediately notify WCSO in writing of the area of non-compliance, so that the problem can be addressed. 1.3 INTAKE SCREENING. CHM will provide documented inmate health screening with health history within 8 hours of facility admission or sooner as may be indicated by the booking risk assessment instrument. At a minimum, the screening will include inquiry into: A. Current illness and health problems including medical, dental, and communicable diseases B. Medications taken and special health requirements 1 of 16 C u se ti At y fl(+& 2005-3713 12-21/4 ' cb5 : i Ak_ C el+n of o3 • C. Use of alcohol and drugs, including the types, methods, amounts, frequency, and date/time of last use and history of problems related to withdrawal D. For women, a history of gynecological problems and pregnancies E. Observations of behavior, including the state of consciousness, mental status, appearance, conduct,tremors and sweating F. Notation of body deformities, trauma markings, ease of movement, bruises and jaundice G. Condition of skin and body orifices, including rashes and infestations, needle marks or other indications of drug abuse. 1.4 INMATE TRUSTEE MEDICAL CLEARANCE. CHM will examine and provide medical clearance for all inmate workers (trustee prisoners), as requested by the Facility staff. The medical clearance process will be completed within forty-eight (48) hours of receiving the list of inmates to be cleared unless laboratory testing necessarily increases the time required. 1.5 COMPREHENSIVE MEDICAL/MENTAL HEALTH CARE. CHM shall identify to WCSO those inmates with medical/mental conditions, which may be worsened as a result of being incarcerated at the Facility or which may require extensive care while incarcerated. After review of the circumstances surrounding the charges, and when security risks are minimal, the WCSO shall make every effort to have those inmates released. 1.6 SPECIALTY SERVICES. CHM will provide for specialty services (e.g. radiology services, laboratory services, etc.) on-site to the extent reasonably possible. To the extent specialty care is required and cannot be rendered on-site, CHM will make appropriate off-site arrangements for the rendering of such care. CHM will make every effort to schedule routine off-site services in a manner convenient for WCSO transportation, and during the normal business hours of Monday through Friday, 8 a.m. to 4 p.m. 1.7 PREGNANT INMATES. CHM will provide health services to any pregnant Inmate in accordance with NCCHC standards, but health care services provided to an infant following birth will not be the responsibility of CHM. 1.8 EMERGENCY SERVICES. CHM will provide for twenty-four (24) hour a day emergency health care services to include on-site emergencies and acute hospital services with one physician or more health care providers. CHM will provide first response emergency medical treatment to Inmates, visitors, and WCSO staff as necessary and appropriate on-site. CHM will provide off-site emergency medical care for Inmates, as required, through arrangements to be determined with local hospitals. Provision of emergency services to staff shall be limited to injuries or short term emergency care received while on duty at the Facility. CHM will provide ambulance services for Inmates for emergency circumstances. Routine transfers will be the responsibility of WCSO in regards to off-site non-emergency medical treatment. 2 of 16 1.9 HOSPITALIZATION SERVICES. CHM will arrange for the admission of any Inmate who, in the opinion of the medical director, requires hospitalization and will bear the costs thereof, limited in the following circumstances and amounts. 1.10 MAXIMUM LIABILITY FOR OFF-SITE MEDICAL SERVICES FOR INMATES AS DESCRIBED BELOW. Any outside medical or other health care services required to treat any Inmate shall be limited in financial responsibility to CHM in the following manner: CHM's maximum liability for actual costs paid associated with outside medical services shall be $75,000.00 per year. Actual costs paid is defined as the net cost actually paid by CHM less any discounts or other considerations negotiated independently between any outside medical service provider and CHM. Any expense incurred or to be incurred for medical and other healthcare services provided offsite (e.g. hospital, specialists, etc.), in excess of$75,000.00 per year will be the responsibility of WCSO. Should the actual costs of outside medical services stay under the $75,000.00 annual capitation, CHM will reimburse WCSO 100% of the difference. CHM will be responsible to insure that the costs of outside medical services are paid in accordance to C.R.S. §17- 26-104(1.3). CHM will provide detailed, individual inmate, itemized billing of all outside expenditures to WCSO on a monthly basis. 1.11 REVIEW OF HOSPITAL AND OFF-SITE SERVICES. CHM will review all invoices for hospital care and other off-site providers. This review will be completed to determine if the Inmate was the financial responsibility of the WCSO and CHM on the date and time services were provided. If not, CHM will assist in routing the invoice to the appropriate agency for payment. 1.12 ASSUMPTION OF FISCAL RESPONSIBILITY FOR INMATE MEDICAL CARE. CHM will begin fiscal responsibility for pre-booking injuries once the Inmate has been medically cleared and accepted into the Facility. 1.13 ELECTIVE MEDICAL CARE. CHM will not be responsible for the provision of elective medical care to Inmates. For purposes of this agreement, elective medical care means medical care which if not provided, would not in the opinion of CHM's Medical Director cause the Inmate's health to deteriorate or cause definite harm to the Inmate's well being. 1.14 TRANSPORTATION SERVICES. To the extent any Inmate, visitor or WCSO staff requires off-site health care treatment (e.g., hospitalization, specialty services, etc) WCSO will provide appropriate routine transportation services, as requested by CHM. CHM will be responsible for ambulance services for Inmates requiring emergency transportation. 1.15 SUPPLIES AND PHARMACUETICALS. CHM will be responsible for all office and medical supplies used in meeting the specifications of this Agreement. All supplies purchased for use in the performance of this Agreement, shall be the property of WCSO and shall remain on-site at the termination of the Agreement. 3of16 CHM will provide a total pharmaceutical system for the Facility. CHM will provide for pharmaceutical services to assure the availability of prescribed medications within eight (8) hours of the order of issue being written. Pharmaceutical services shall be consistent with State and Federal regulations, and must be monitored by a licensed qualified pharmacist. Arrangements will be made with a local pharmacy for back-up and emergency medications. CHM will provide for the purchasing, dispensing, administering and storage of all pharmaceuticals by qualified personnel. CHM will provide for the recording of the administration of medications in a manner and on a form approved by the health care authority to include documentation of the fact that inmates are receiving and ingesting their prescribed medications. Documentation will also be required when an inmate's ordered medication is not administered and the reason given. CHM will be financially responsible for the cost of all drugs with the exception: A) All psychotropic medications. CHM will provide the WCSO with a monthly report of the psychotropic medications prescribed for mental health diagnosis to be reimbursed by WCSO on a monthly basis. B) The cost of AZT or any other AIDS- and/or Hepatitis-related medications and testing will be limited to $5,000.00 per year for the entire inmate population. Should the cost of these medications and testing stay below $5,000.00 per year, CHM will reimburse WCSO 100% of the difference. CHM will pay for one (1) pair of eyeglasses when prescribed and deemed necessary by a physician for minimal function by such inmate. CHM will not be responsible for replacement prosthesis or reading glasses that are willfully destroyed by an inmate. 1.16 COURT ORDERED OR EVIDENTIARY SAMPLES. CHM personnel are prohibited from participating in the collection of forensic information, with the exception of sexual assault and specified court-ordered tests. In the case of sexual assault, CHM personnel may gather evidence for forensic purposes with the written consent of the inmate- victim. Similarly, court-ordered laboratory tests or x-ray procedures may be performed by CHM personnel, if the Inmate has given written consent. 1.17 CONTAMINATED WASTE. CHM will be responsible for the disposal of all general waste, including infectious and hazardous waste. The material will be removed from the Facility and disposed of as regulated by federal, state and local laws. All costs related to the removal and disposal will be at CHM's expense. 1.18 PERMITS AND LICENSES. CHM will ensure that all permits and licenses required by Federal, State and local laws, rules and regulations necessary for the implementation of the work undertaken by CHM pursuant to this Agreement shall be secured and paid for by CHM. Specific licenses, fees, permits and certifications secured and paid for by CHM include, but are not limited to: a. Drug Enforcement Administration License b. CLIA Laboratory License c. State Board of Pharmacy Outlet License 4 of 16 CHM agrees to pay all applicable taxes, including sales and excise taxes, and shall keep current all necessary licenses, permits and certifications necessary to fulfill the terms and conditions of this Agreement. 1.19 COMMUNICATIONS. Provision shall be made for quarterly meetings between the health services and facility administration, including their documentation, to facilitate good communication and rapport between jail staff and health services. The Health Services Administrator is expected to attend monthly jail staff meetings. 1.20 PROVIDER COOPERATION. It is understood that all CHM personnel are required to obtain a security clearance prior to entering any secure area of the Facility. CHM personnel will be required to complete and submit a written application for jail security clearance to the WCSO included with the application will be their full name, date of birth and current home address. The security clearance does not supplant the need for CHM's own internal pre-employment background check. It is understood that no one has a right to receive or maintain a security clearance form the WCSO and that the WCSO may revoke a security clearance with or without cause at any time. Once the security clearance has been revoked, the individual cannot reenter the Facility. 1.21 NORTHERN COLORADO HEALTH ALLIANCE. CHM shall become an active member of the Northern Colorado Health Alliance. The Alliance maintains a shared electronic medical records system that the WCSO is slated for deployment in the first quarter of 2006. CHM will ensure that the medical staff is properly trained in the use of the electronic medical records system at no additional cost to the WCSO. It is understood that all hardware, software, and maintenance related to the Alliance membership will be provided and paid for by WCSO. II: PERSONNEL 2.1 STAFFING. CHM will provide medical, dental, and support personnel necessary for the rendering of health care services to Inmates as contemplated herein. The health care staff will be comprised of 12.55 FTEs as described in the submitted proposal. Said services shall include but not be limited to: Physician services will be sufficient to provide the required needs of the day and assure medical evaluation/follow up within twenty four (24) hours of post nursing triage referral (including weekends and holidays) but no less than 3.5 hours per week per 100 inmates. Up to 50% of physician services may be provided by physician extenders such as Physician's Assistants or Nurse Practitioners. In addition, 24-hour physician on-call services with the availability for consultation and the ability to meet the on-site needs are required. A pager service shall be utilized and specified. Nursing services will be available to provide for the following: A. Respond to booking area within 10 minutes of an officer's request to evaluate the physical condition of a prisoner and determine if the prisoner's health would be compromised if the prisoner were accepted for admission 5 of 16 B. Respond to booking area within 10 minutes of an officer's request to medically assess the prisoner's post-acceptance risk when indicated by a preliminary booking process prisoner risk assessment instrument C. Documenting counts and inventory of prescription medication accepted with inmate at booking or when accepted from other than a pharmacy D. Complete and document participation in suicide staffings during normal business hours and complete and document suicide assessment and suicide staffing after normal business hours E. Complete and document health and mental health histories and risk of suicide for all prisoners in custody within 8 hours of booking F. Maintain an emergency response capability 24 hours daily G. Inmate physicals will be completed within fourteen (14) days after booking H. Inmate worker (trusty prisoner) physicals will be completed within 48 hours of request from Programs staff, weekends included I. Distribution of medications a minimum of two times each day in the housing units. Evening distribution to be complete prior to nightly facility lockdown in each unit. J. Document prior notice to inmate when prescriptions being discontinued or a clinic visit required before being refilled. K. Sick call triage and follow-up on a daily basis to include weekends and holidays. L. Appropriate and timely response to medical needs and emergencies M. Physician support services. Dental services shall at a minimum include: A. Dental sick call services that provide for no more than a ten-day waiting period to be seen. CHM shall provide sufficient clerical staff to support the Agreement. Copies of staffing schedules encompassing all health care staff are to be submitted to the Contract Administrator on the tenth (10th) of each month for the upcoming month. Daily updates shall be submitted if there are changes. 2.2 LICENSURE, CERTIFICATION, AND REGISTRATION OF PERSONNEL. All personnel provided or made available by CHM to render services hereunder will be 6 of 16 licensed, certified or registered, as appropriate, in their respective areas of expertise pursuant to applicable Colorado law and as required by NCCHC guidelines. WCSO shall provide background criminal records checks on all CHM employees upon hire. CHM will promptly notify Weld County in the event of revocation or suspension of employer/employee license or certification. In the event of such revocation or suspension, continuation of purchase of services by Weld County shall be at the discretion of Weld County. 2.3 SATISFACTION WITH HEALTH CARE PERSONNEL. WCSO shall have the right to reject the employment by CHM of any person or firm, and to require the removal of any person or firm employed or engaged by CHM, when it deems such action to be in its best interest and in the best interest of attaining successful implementation of its correctional health care services program. If the WCSO should become dissatisfied with any CHM personnel provided by CHM hereunder, CHM, in recognition of the sensitive nature of correctional services, will, following receipt of written notice from WCSO of dissatisfaction and the reasons therefore, exercise their best efforts to resolve the problem. If the problem is not/cannot be resolved, CHM will remove the individual within a reasonable time frame considering effects on delivery of health care and recruitment/hiring of an acceptable replacement. 2.4 USE OF INMATES IN THE PROVISION OF HEALTH CARE SERVICES. Inmates will not be employed or otherwise engaged by either CHM or WCSO in the direct rendering of any health care services. Inmates may be used in positions not involving the rendering of health care services directly to Inmates as CHM and WCSO may mutually agree. 2.5 SUBCONTRACTING AND DELEGATION. In order to discharge its obligations hereunder, CHM will engage certain health care professionals as independent contractors rather than as employees. CHM shall not engage any professional and or organization who does not themselves meet the standards and professional licensing requirements. As the relationship between CHM and these health care professionals will be that of independent contractor, CHM will not be considered or deemed to be engaged in the practice of medicine or other professions practiced by these professionals, and CHM will not exercise control over the manner or means by which these independent contractors perform their professional duties. 2.6 DISCRIMINATION. CHM will recruit, select, train, promote, transfer, and release its personnel, as contemplated hereunder, without regard to race, color, religion, national origin, handicap, veteran status, age, or gender(except where age, gender or handicap is a bonefide occupational qualification). Further, CHM will administer its other personnel policies such as compensation, benefits, layoffs, return from layoff, company sponsored training, education, and tuition assistance without regard to race, color, religion, national origin, handicap, veteran status, age or sex. 2.7 SOLE PROVIDER. CHM shall be the sole supplier and or coordinator of the medical care delivery system at the Facility. The term "medical care" includes medical, psychiatric, psychological, and dental care. The responsibility of the provider for the 7 of 16 • medical care of an Inmate commences when an Inmate has been medically cleared for acceptance into the facility, after resolution of any injury or illness requiring immediate transportation and treatment at a hospital or similar facility. III: SERVICES TO CORRECTIONAL STAFF 3.1 SERVICES TO CORRECTIONAL STAFF. CHM will provide the following services to correctional staff at the Weld County North Jail Complex: A) Emergency services including first aid, assessment, stabilization and the coordination of transport of any employees or visitors who become ill or injured in the Weld County North Jail Complex. B) CPR and First Aid Training for correctional officers. IV: REPORTS AND RECORDS 4.1 MEDICAL RECORDS. CHM will maintain a medical record for each Inmate who has received health care services. This medical record will be maintained pursuant to applicable law and will be kept separate from the Inmates confinement record. A complete copy of the applicable medical record will be available to accompany an Inmate's confinement record at the request of the WCSO. A summary of significant medical problems will be provided to accompany an Inmate who is transferred to another correctional setting. A complete copy of the applicable medical record will be available to accompany an Inmate who is transferred from the WCSO to another for off- site medical services. Medical records will be kept confidential, and CHM will follow the WCSO's policy with regard to access by Inmates and WCSO staff to medical records, subject to applicable law regarding confidentiality of such records. No information contained in the medical records will be released by CHM except as provided by WCSO policy, by a court order, or otherwise in accordance with applicable law. WCSO owns and retains custody and control of all medical records. Upon termination of this agreement, all medical records will be the property of WCSO. 4.2 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 (HIPAA). It has been determined that the HIPAA policies and regulations, such as privacy notices, do not apply because incarcerated inmates have no right to privacy under HIPAA regulations. Once an inmate is released, however, the inmate's records are covered under HIPAA. CHM acknowledges and agrees to comply with HIPAA regulations and jail policies in the release of medical records for inmates released from custody. 4.3 REGULAR REPORTS BY CHM TO WCSO. CHM will provide daily and monthly reports to WCSO containing an analysis of health care services rendered hereunder and any other reports requested by WCSO, pertaining to the direct delivery of health care services, during the term of this Agreement. The monthly and daily reports shall include, but not be limited to: A. Monthly report: A statistical report with narrative on noteworthy accomplishments or events will be due on the fifth (5th) calendar day of each month to the Contract Administrator that includes, but is not limited to, the following: 8 of 16 • Inmates seen at scheduled clinics • Inmates seen by physician • Inmates seen by dentist • Inmates seen by physician extender(s) • Medial specialty consultation referrals • Off-site hospital admissions • Inmate injuries • Emergency room visits • Intake medical screenings • Trustee physicals • Fourteen (14) day physicals • Labwork • All vacancies by position, number of days vacant and new hires by name B. Daily Report: A daily report of the previous twenty-four (24) hours shall be submitted to the Contract Administrator. Saturday and Sunday reports shall be submitted Monday morning. The daily report must include, but not be limited to, the following data: • Number, name and hours delinquent for eight (8) hour intake screening • Number and name of trustee applicant physicals delinquent after forty-eight(48) hours of referral • Amount and type of prescribed medication accepted from sources other than pharmacy • Number of transfers to off-site hospital emergency departments • Communicable disease reporting • Suicide assessments and/or staffings completed • Inmate injuries • Report of status of inmates in local hospitals • Report of status of inmates held in special jail housing units for medical reasons and basis for continuation • Staffing by position (LPN/RN, etc) and hours worked 4.3 INMATE GRIEVANCES. CHM will ensure that inmate grievances will be monitored to detect areas of concern. Inmate grievances will be documented on a log as to type of complaint and a response shall be prepared within five (5) days of receipt (excluding weekends and holidays), the HSA will review and respond to all inmate grievances. Completed responses will be returned to the inmate through the Contract Administrator. 4.4 INMATE HEALTH INSURANCE. CHM must seek and obtain from any Inmate, information concerning any health insurance the Inmate might have that would cover services rendered by CHM hereunder, and WCSO will cooperate fully with CHM in its efforts to secure this information. 4.5 THIRD PARTY REIMBURSEMENT. In the event that outside health services provided under this Agreement are covered by third party payments, including but not 9 of 16 limited to workers' compensation, insurance companies, and Medicaid/Medicare, and CHM receives reimbursement from such entities, the amount paid to CHM shall be netted against the maximum liability for outside medical services aggregate as specified in the Agreement. If the aggregate is exceeded, CHM shall continue to seek reimbursement from such entities, and such payments shall be paid to WCSO, subject to reasonable administrative fees. WCSO agrees to facilitate this effort and to make available to CHM necessary records and information for processing such claims. 4.6 INMATE INFORMATION. In order to assist CHM in providing the best possible health care services to Inmates, WCSO will provide CHM with information pertaining to Inmates that CHM identifies as reasonable and necessary for CHM to adequately perform its obligations hereunder. 4.7 CHM RECORDS AVAILABLE TO WCSO. CHM will make available to WCSO, at the request of the WCSO, all records, documents, and other papers relating to the direct delivery of health care services to Inmates. 4.8 WCSO'S RECORDS AVAILABLE TO CHM WITH LIMITATIONS ON DISCLOSURE. During the term of this agreement and for a reasonable time thereafter, WCSO will provide CHM at CHM's request, WCSO records relating to the provision of health care services to Inmates during the term of this agreement as may be requested by CHM or as are pertinent to the investigation or defense of any claim related to CHM's conduct. WCSO will make available to CHM such records as are maintained by WCSO, hospitals, and other outside health care providers involved in the care or treatment of Inmates (to the extent WCSO has any control of those records) as CHM may reasonably request consistent with applicable law; provided however, that any such information released by WCSO to CHM that WCSO considers confidential, by CHM and will not, except as may be required by law, be distributed to any third party without prior written approval by WCSO. 4.9 RETENTION OF RECORDS. CHM agrees to retain all books, records and other documents relevant to this Agreement for a ten (10) year period from the end of the year that services were provided, and any longer period which may be required to complete any audit and resolve any pending audit findings. CHM agrees to make these documents available to State and Federal personnel and other persons authorized by Weld County. If CHM ceases to operate as a business during the above 10-year period, the records will be furnished to Weld County for storage purposes. 4.10 POLICIES AND PROCEDURES. CHM will create and provide a written manual of standardized policies and defined procedures, approved by the Health Care Authority and the WCSO. Said policies and procedures must be reviewed at least annually and revised as necessary under the direction of the Health Care Authority and with the approval of the WCSO. V: SECURITY 5.1 GENERAL. CHM and WCSO understand that adequate security services are necessary for the safety of the agents, employees, and subcontractors of CHM, as wells as for the security of Inmates and WCSO staff. WCSO will determine the necessity of security services sufficient to enable CHM and its personnel to safely provide the health care 10 of 16 services called for hereunder and will provide the same. CHM shall not be liable for failure to provide services due to security personnel being unavailable to CHM staff. 5.2 TRANSPORTATION OFF-SITE. WCSO will provide security as necessary and appropriate in connection with the transportation of any Inmate between the WCSO and any other location for off-site services as contemplated herein. CHM will make every effort to schedule routine off-site services in a manner convenient for WCSO transportation, and during the normal business hours of Monday through Friday, 8 a.m. to 4 p.m. VI: OFFICE SPACE AND EQUIPMENT 6.1 OFFICE SPACE AND SUPPORT. WCSO agrees to provide CHM with office space, facilities, office furniture and fixtures, utilities (including local telephone service), sufficient to enable CHM to perform its obligations hereunder. CHM will be responsible for all facsimile line charges. 6.2 DELIVERY OF POSSESSION. WCSO will deliver to CHM, on the date of commencement of this agreement, possession and control of all office furniture and fixtures currently in place at the WCSO health care facilities, which will remain the property of the WCSO and BOCC. 6.3 SUPPLIES. CHM warrants and represents that the quality and quantity of supplies provided by CHM during this agreement will be sufficient to enable CHM to perform its obligations hereunder. Supplies are defined as durable and/or consumable items with a unit cost of less than $500. All supplies purchased for use in the performance of the Agreement, shall be the property of WCSO and shall remain on-site at the termination of the Agreement. 6.4 EQUIPMENT. CHM may use all equipment owned by WCSO in conjunction with that furnished. Basic office furniture to include desks, chairs and file cabinets current in place will be available for CHM's use. Office equipment purchased or leased by CHM will belong to CHM upon completion of Agreement. The Weld County North Jail Complex shall be responsible for the following: A) Voice telephone and long distance telephone charges necessary for CHM to provide services within the scope of this Agreement. The County will provide and pay for a language line interpreting service when required. B) All maintenance of all medical and office equipment supplied and owned by the County for use by CHM. The County shall be responsible for replacement should such equipment become non-serviceable due to routine use. C) Necessary small and capital medical equipment with a unit cost of $500 or more. CHM and Contract Administrator for WCSO must agree such items of equipment are necessary or desirable for the performance of the Agreement. All such requests must be submitted to the Contract Administrator by June 1 of each year for inclusion in the following budget year appropriation request and are subject to appropriation decisions by the BOCC. D) All computer hardware, software and maintenance necessary to participate as an active member of the Northern Colorado electronic medical records and access the Corrections Management System. 11 of 16 VII: TERM AND TERMINATION OF AGREEMENT 7.1 CONTRACT TERM. This agreement shall be effective on January 1, 2006 at 12:00:00 a.m. MST and end on December 31, 2008 at 11:59:59 p.m. MST with two (2) one-year renewals. The Agreement may be evaluated at any time during this period, at terms and conditions mutually agreeable. The following provisions shall apply: A) Percentage increases in the total cost per year are limited to documented local inflationary medical cost data (current year Consumer Price Index — medical care component within the Midwest Region) and changes in the average daily inmate population at the Weld County North Jail Complex for each and every year the contract exists beginning January 1, 2007. B) Providing satisfactory service is given. C) Providing the BOCC approves funding for the Agreement. 7.2 TERMINATION. This agreement may be terminated in the event of any one of the following: (A) MUTUAL TERMINATION. If either party fails to fulfill its obligation under the Agreement in a timely and proper manner, or if either party violates any material covenant, agreement, or stipulation of the Agreement, the party shall thereupon have the right to terminate the Agreement by giving written notice to the other party of termination which will occur no less than thirty (30) calendar days after the date of notice. The notice shall specify the effective date of the termination, and the reasons therefore, unless the party to whom notice is given cures the breach to the satisfaction of the party giving notice prior to the effective date of termination. Notwithstanding the above, CHM shall not be relieved of liability to WCSO or BOCC for damages sustained by the County by virtue of any breach of the Agreement by CHM and the County may withhold any payments to CHM, in an amount reasonably calculated to equal the estimated damages, for the purpose of setoff until such time as the exact amount of damages to the County from CHM is determined. (B) TERMINATION FOR CONVENIENCE OF THE COUNTY. The County may terminate the Agreement at any time by giving written notice to CHM of termination which will occur no less than sixty (60) calendar days after the date of the notice and specify the effective date thereof. 7.3 RESPONSIBILITY FOR INMATE HEALTH CARE. Upon termination of this agreement, total responsibility for providing health care services to all Inmates, including Inmates receiving health care services at facilities off-site will be transferred from CHM to the WCSO and BOCC. VIII: COMPENSATION 8.1 COMPENSATION. WCSO will pay CHM the sum of$1,093,032.00 for the 12-month term of this Agreement. CHM will bill WCSO the sum of$91,086.00 at the beginning 12 of 16 of each month and such amount shall be submitted to CHM within thirty (30) calendar days. 8.2 PER INMATE PER DAY ESCALATOR/DE-ESCALATOR. At the end of each month, an average daily inmate count shall be calculated and provided to CHM. CHM will bill WCSO $1.29 per inmate per day that the count exceeds 550 inmates. If the average daily inmate count for any given month is less than 425, CHM will refund $1.29 per inmate per day below 425 back to WCSO. 8.3 WCSO EMPLOYEE VACCINATION PROGRAM. Upon request, CHM will provide vaccinations for hepatitis A and B, TB testing, flu shots and other Occupational Health and Safety Administration (OSHA) requirements. WCSO will provide vaccine for all such required services with the exception of the PPD derivative for TB testing. CHM will manage and bear the cost of the annual TB screening for all Weld County North Jail Complex staff. IX: LIABILITY AND RISK MANAGEMENT 9.1 INSURANCE. At all times during the term of this agreement, CHM will maintain general liability and professional liability insurance covering CHM, its employees, its officers, and agents with limits not less than one million dollars ($1,000,000) per occurrence and two million dollars ($2,000,000) in the aggregate annually. Such coverage will also extend to physicians, dentists, and psychiatrists engaged by CHM on an independent contractor basis for the provision of health services hereunder. CHM will also maintain a separate liability policy covering bodily injury, personal injury and property damage in the amount of one million dollars ($1,000,000) combined single limit. Workers' compensation insurance as required by Colorado law will also be in force for the duration of the Agreement. CHM shall provide BOCC with a certificate confirming the existence of such coverage and providing for notice of BOCC of any cancellation of such coverage. 9.2 INDEMINTY. CHM shall be liable and responsible for any and all damages to persons or property caused by or arising out of the actions, obligations, or omissions of CHM, its employees, agents, representatives or other persons acting under CHM's direction or control in performing or failing to perform the Work under this Agreement. CHM will indemnify and hold harmless the County, its elected officials, and its employees, agents, and representatives, from any and all liability, claims, demands, actions, damages, losses,judgments, costs, or expenses, including but not limited to attorney's fees, which may be made or brought or which may result against any indemnified parties as a result or on account of the actions or omissions of CHM, its employees, agents or representatives, or other persons acting under CHM's direction or control. Nothing in this indemnification shall be construed in any way to be a waiver of the County's immunity protection under the Colorado Governmental Immunity Act, C.R.S. §24-10- 101, et seq., as amended. X: MISCELLANEOUS 10.1 INDEPENDENT CONTRACTOR STATUS. BOCC expressly acknowledges that CHM is an independent contractor and nothing in this agreement is intended nor shall be construed to create an agency relationship, an employer/employee relationship, a 13 of 16 joint venture relationship, or any other relationship allowing BOCC to exercise control or direction over the manner or methods by which CHM or its subcontractors perform hereunder, other than as herein provided. CHM employees or agents agree to follow the policies of WCSO, State law and minimum Jail standards, detention facilities and minimum Jail standards, as well as those standards required of NCCHC and ACA accreditation. 10.2 PERFORMANCE BOND. In lieu of a performance bond, CHM will submit to Weld County purchasing proof that a line of credit is available to draw on, should CHM default on its contractual obligations. CHM will forfeit one-twelfth (1/12) of its annual contractual obligation to WCSO to fund transition to another company. The line of credit is to provide proof that CHM has the financial liquidity in the event of a default situation. 10.3 NOTICE. All notices or other communications required or permitted to be given under this agreement shall be in writing and shall be deemed to have been duly given if delivered personally in hand or mailed certified mail, return receipt requested, postage prepaid on the date posted, and addressed to the appropriate party at the following address or such addresses as may be given in writing to the parties: (A) BOCC Weld County Board of County Commissioners 915 Tenth Street, PO Box 758 Greeley, CO 80631 With a copy to WCSO: David Malcom, Commander Weld County Sheriffs Office 2110 "O" Street Greeley, CO 80631 (B) CORRECTIONAL HEALTHCARE MANAGEMENT, INC Correctional Healthcare Management, Inc. Mrs. Cristina Capoot, President& CEO 8484 South Valley Highway Road, Suite 250 Englewood, CO 80112 10.3 GOVERNING LAW. This agreement and the right and obligations of the parties hereto shall be governed by, and construed according to, the laws of the State of Colorado. 10.4 ENTIRE AGREEMENT. This agreement, together with CHM's proposal are hereby incorporated and adopted by reference and attached to hereto constitutes the entire agreement of the parties and is intended as a complete and exclusive Statement of promises, representations, negotiations, discussions, and agreements that have been made in connection with the subject matter hereof. No modification or amendment to this agreement shall be binding upon the parties unless the same is in writing and signed by the respective parties hereto. 14 of 16 10.5 WAIVER OF BREACH. The waiver by either party of a breach or violation of any provision of this agreement shall not operate as, or be construed to be, a waiver of any subsequent breach of this same or other provision hereof. 10.6 ENFORCEMENT. In the event either party incurs legal expenses or costs to enforce the terms of this agreement, the prevailing party in any proceeding hereunder shall be entitled to recover the costs such action so incurred, including, without limitation, reasonable attorney's fees. 10.7 FORCE MAJEURE. CHM shall not be deemed in violation of this agreement if it is prevented from performing any of its obligations hereunder for any reason beyond its control, including Inmate disturbances, lack of adequate security escorts, acts of GOD, civil or military authority, acts of public enemy, war, explosions, earthquakes, floods, or any similar cause beyond the reasonable control of either party. 10.8 SEVERABILITY. In the event of any provision of this agreement is held to been unenforceable for any reason, the unenforceability thereof shall not effect the remainder of the agreement which shall remain in full force and effect and enforceable in accordance with its terms. 10.9 CHANGES WITHIN THE LAW. Notwithstanding anything herein to the contrary, if (i) any applicable law, statute, regulation, ordinance, standard, rule, court order or decree, policy, practice or procedure of any applicable governmental unit, agency or office (including but not limited to the federal, state or local courts, legislative bodies, and agencies, including Weld County Sheriff's Office and/or Weld County, or their respective officers or agents) is adopted, implemented, amended or changed, or if (ii) any standard of care or treatment protocol changes or evolves in any material respect, or if any new medication or therapy is introduced to treat any illness, disease or condition, and if such change, as described in either (i) or (ii), materially increases the cost to CHM of providing healthcare services hereunder; then CHM and the Weld County Sheriffs Office and/or Weld County will meet to negotiate compensation or service requirement changes. The parties agree to meet and negotiate in good faith within thirty (30) days following the giving of notice by one party to the other party of a change (whether such change is anticipated or implemented). If the parties fail to reach agreement regarding compensation or service requirement changes within the foregoing thirty (30) day period, then either the Weld County Sheriffs Office and/or Weld County or CHM may terminate their Agreement with Weld County upon sixty (60) days prior written notice. IN WITNESS WHEREOF, the parties have set their hands and seals hereto as the day and year first above written. 15 of 16 THE BOARD OF COUNTY COMMISSIONERS OF WELD COUNTY, ON BEHALF OF WCSO ATTEST: ,1,>, kJ William H. Jerke DEC 2 8 7005 Chair, Weld County Board of County Commissioners 14‘111/(1 E Clerk to the Board r titf'l UaPtEL k , Pu WV D=fluty Cle to the B.! d _�u.M► APPROVED BY: Co orney, Weld County CORRECTIONAL HEALTHCARE MANAGEMENT, INC. ATTEST: BY: C/ .- � �� Cristina Capoot President & CEO Correctional Healthcare Management, Inc. 16 of 16 cf0©S"r 3 Hello