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HomeMy WebLinkAbout20051718.tiff RESOLUTION RE: APPROVE CONTRACT FOR THE EARLY AND PERIODIC SCREENING, DIAGNOSIS AND TREATMENT PROGRAM AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with a Contract for the Early and Periodic Screening, Diagnosis and Treatment Program between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Public Health and Environment, and the Colorado Department of Public Health and Environment, commencing July 1, 2005, and ending June 30, 2006, with further terms and conditions being as stated in said contract, and WHEREAS, after review,the Board deems it advisable to approve said contract, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County,Colorado,that the Contract for the Early and Periodic Screening, Diagnosis and Treatment Program between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Public Health and Environment, and the Colorado Department of Public Health and Environment be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said contract. The above and foregoing Resolution was,on motion duly made and seconded, adopted by ing vote on the 13th day of June, A.D., 2005. it . t ` #� BOARD OF COUNTY COMMISSIONERS 1, a•• .=; /M ��//®/q� WELD COUNTY, COLORADO 18,1 \!. S� ���� / /M�`�-".vi( 11 Nr. • / William H. Jer , Chair !t,- �i ty Clerk to the Board ��� ile, Pr -Tem BY: ff l��j�R"''—t—� Deputy Clerk to the Board 7 Davi . ong APP D AST • Rob . Masde ount A orney GI nn Vaa Date of signature: 6 — c —6z5-- 2005-1718 HL0032 Memorandum TO: William H. Jerke, Chair Board of County Commissioners ' C FROM: Mark E. Wallace, MD, MPH, Director Department of Public Health and Environment COLORADO V'IN DATE: June 9,2005 V ^ , 4Ajta"S SUBJECT: Contract for the EPSDT Program Enclosed for Board review and approval is a contract between the Weld County Board of Commissioners and the State of Colorado, Department of Health Care Policy and Financing (HCPF) for the Early and Periodic Screening, Diagnosis, and Treatments Services (EPSDT) Program. Funding from this contract will be used to provide case management, outreach, and support services for children ages birth to 21 who are on Medicaid in the northeast region of Colorado. Emphasis is on educating families about age appropriate well child services and helping them utilize these services which are available in our community. For these activities, Weld County will be reimbursed a sum not to exceed $123,317 for the time period July 1, 2005 through June 30, 2006 I recommend your approval of this contract. Enclosure CLIN o6 UHA coos 1 Health Care Policy and Financing Agency Number: UHA Contract Routing # 2106-0119 CONTRACT THIS CONTRACT, made this first day of May 2005, by and between the State of Colorado, for the use and benefit of the Department of Health Care Policy and Financing, 1570 Grant Street, Denver, Colorado 80203, hereinafter referred to as the Department, and Board of County Commissioners of Weld County, located at 1555 North 17th Avenue, Greeley, Colorado, 80631, hereinafter referred to as the Contractor. WHEREAS, authority exists in the law and funds have been budgeted, appropriated and otherwise made available and a sufficient unencumbered balance thereof remains available for payment in the Colorado Financial Reporting Systems (COFRS) Fund Number 100, Appropriation Code Number 169 and Encumbrance Number 5e Emig a i O 6- O 1 19 ; WHEREAS, required approval, clearance and coordination has been accomplished from and with appropriate agencies; and WHEREAS, the Contractor's offer was selected in accordance with state law; NOW THEREFORE, subject to the terms, conditions, provisions and limitations contained in this contract, the Department and the Contractor agree as follows: I. DEFINITIONS "Early and Periodic Screening, Diagnosis and Treatment" (EPSDT) means those services which make up Medicaid's comprehensive and preventative child health program for individuals 20 years and under and on Medicaid. "EPSDT Case Management" means an activity that assists individuals eligible for service in gaining and coordinating access to necessary care and services appropriate to the needs of an individual. "EPSDT Outreach" means methods to inform or persuade recipients or potential recipients to enter into care. "Managed Care Organization" means an entity contracting with the Department that provides, delivers, arranges for, pays for or reimburses the costs of health care services through the child's use of health care providers managed by, owned by, under contract with or employed by the entity. "Primary Care Physician" (PCP) means a health care professional, licensed to practice medicine (e.g., a Doctor of Medicine or Doctor of Osteopathic Medicine) or a facility with a licensed physician on staff. 1+�5-/7/� II. SCOPE OF WORK The Contractor shall provide the services listed at 42 U.S.C. Sections 1396a(a)(43) and 1396d(a)(4)(B), specifically helping Medicaid recipients and their parents or guardians to effectively use these resources. The scope of work for this contract cycle shall include the following: A. The Contractor is required to serve Weld, Logan, Yuma, Washington, Morgan Phillips and Sedgwick Counties. B. Outreach to Target Client Populations. "Client Outreach" is the EPSDT Outreach and Case Management service provided by the EPSDT Outreach and Case Manager that complements the health care services provided by the Medicaid provider. The health care services are aimed at the promotion of health, the prevention and treatment of disease and improved access to health care services. The EPSDT Outreach and Case Management service shall include, but is not limited to, an in-depth explanation of EPSDT benefits available, promoting the client's responsibility to maintain the linkage between the child/youth and the PCP, promoting collaborative activities with other child-related health and social services agencies and resources within each county and referring clients to those agencies and resources. The Contractor shall: 1. Contact newly eligible pregnant women and the parent or guardian of children and youth within 60 days of eligibility notification to ensure notification of EPSDT services and benefits. Cases with no Medicaid services/screens in the EPSDT data tracking system shall be prioritized. The contact shall include, but is not limited to: a. Providing an in-depth explanation of EPSDT benefits and the importance of preventive care and regular medical visits including face-to-face or telephone contacts. b. Assisting parents or guardians with locating a PCP, Obstetrician/ Gynecologist (OB/GYN) or specialty provider within the available managed care or fee-for-service options. c. Providing the phone number for the Colorado Medicaid Enrollment Broker to the parents or guardians of children who wish to enroll in a managed care option. d. Informing parents or guardians of the need to arrange Medicaid care and services with private primary insurance(if enrolled). e. Assisting parents or guardians with locating community services and benefits including, but not limited to, providing information on Health Care Program for Children with Special Needs (HCP), Part C, Women Infant and Children program (WIC), Community Center Boards (CCB), Child Find, Part B, School Based Health Centers, Prenatal Plus and Nurse Page 2 of 21 Home Visitor/Nurse Family Partnership. f. Offering immediate assistance to the parent or guardian in reporting the birth of a newborn to the county technician or other agency responsible for state ID assignment should the newborn not yet be reported, utilizing the Add-A—Baby or similar reporting procedure. g. Assisting with referrals to other services and benefits that may or may not be covered by Medicaid. h. Providing information to the parent or guardian that will facilitate overcoming barriers that may impede the client's access to EPSDT services. i. Referring a parent or guardian needing referrals for orthodontic assessment and treatment for their child to the Orthodontic Benefits Coordinator at the Department unless otherwise noted. j. Assisting parent or guardian in obtaining appointments with proper Medicaid providers to bring the child up to date with the American Academy of Pediatrics recommended periodicity schedules. k. Facilitating the completion of the child's immunization records between the PCP and the parent. 2. Provide continued client follow-up if the client was not using an appropriate provider at the time the initial Outreach was completed or follow-up shall continue until a pregnant client is in a Medical Home, which includes OB services or an OB/GYN provider. "Medical Home" means an approach to health care that originates in a primary health care setting, which is family centered. It is not just a building, house or hospital, but a team approach to providing health care. A partnership develops between the family and the primary health care practitioner. Together they access all medical and non-medical services needed by the child and family to achieve maximum potential. 3. Send a letter to the client's last known address if the initial attempt to make the contact was unsuccessful. Page 3 of 21 C. Outreach to Medicaid Providers. "Provider Outreach" means the responsibility of the Contractor and the EPSDT Outreach and Case Manager to work with local Medicaid providers. This process shall include, but is not limited to, identifying providers in a local county or adjacent client accessible counties, who will deliver medical screening, diagnostic and treatment services, dental, mental health, vision, hearing or other services to the Medicaid-enrolled client, explaining to the providers the nature and importance of the EPSDT benefits including the PCP referral requirement and acting as a resource to providers who have identified families in need of assistance with EPSDT Case Management services including community referrals. The Contractor shall: 1. Meet face to face with 50% of the currently available Medicaid providers or office staff in the contract service area to provide information on covered mental health providers, information on EPSDT benefits and available services. Explain what the ESPDT Outreach coordinators can offer providers if the provider refers clients to the EPSDT Outreach office. 2. Make community provider and Medicaid resource information such as Affiliated Computer Systems (ACS) Provider Bulletins and Medicaid program updates available to the provider in written or electronic form. 3. Maintain lists of current managed care and fee for service Medicaid providers who are accepting new clients, including office hours and ages accepted to ensure current and proper referrals. 4. Offer assistance to the provider or clinic with EPSDT Medicaid eligible clients who have excessive missed appointments or need assistance in scheduling appointments. D. Outreach to Community Resource Providers. "Community Outreach" means the Contractor and the EPSDT Outreach and Case Manager will work with local community resource providers who may provide services or programs which are not covered by Medicaid but which may be necessary to the health and well-being of the family. The Contractor shall: 1. Ensure the accuracy of information regarding community resource programs and services by contacting all local community resource providers yearly. 2. Ensure appropriate client referrals by tracking basic program eligibility program guidelines, program rules and regulations. 3. Maintain a written list of covered and noncovered services that shall be made available to community partners, providers, child protection, public health, schools and any other interested party. E. Utilization of Reporting/Tracking System The Contractor shall utilize the data tracking system provided by the Department. The Contractor shall use the tracking system to report electronically to the Department by the Page 4 of 21 tenth of each contract month and semiannually, no later than January 15, 2006 and no later than July 15, 2006 as final reporting documentation. Reports shall include the following information: 1. All contacts with client, provider and community populations. 2. All requests for assistance from community partners and providers to the EPSDT Outreach program as well as all community referrals given to clients and providers. F. Subcontracting of EPSDT Inform Requirements Contractors may subcontract with other departments or agencies to provide EPSDT Outreach to eligible clients. Those agencies wishing to do so shall submit a plan to the Department which describes the relationship with the subcontractors who will be completing the scope of work requirements. The plan shall include training provided, including samples of tools used and agreed upon expectations of the role the subcontractor will provide in regards to the inform process and format in which the subcontractor will communicate client contact information with EPSDT Outreach Contractors. The subcontracted agency will provide client contact information to EPSDT Outreach Contractors to allow for the tracking system data entry of contacts and referrals. G. Provider Changes The Contractor shall notify the Department of all provider changes within ten days of contact with the provider. H. Department Approval of Materials The Contractor shall obtain Department approval on all locally produced publications, letters, brochures or other types of marketing or outreach materials for the EPSDT Outreach and Case Management program before distribution. Required Trainings The Contractor shall require local EPSDT Outreach coordinators and/or supervisors to attend, in person or by phone, at least six of eleven monthly EPSDT Outreach training sessions by the Department. J. Personnel Changes The Contractor shall be required to immediately notify the Department of any personnel changes in EPSDT Outreach staff. K. Additional Requirements The Contractor shall be required to complete and return additional program information requested by the Department. Page 5 of 21 III. GENERAL PROVISIONS A. Order of Precedence The provisions of this contract shall govern the relationship of the Department and the Contractor. In the event of conflicts or inconsistencies between this contract and its exhibits or attachments, such conflicts or inconsistencies shall be resolved by reference to the document in the following order of priority: 1. Colorado Special Provisions, pages 20 and 21. 2. HIPAA Business Associate Addendum. 3. Contract, pages 1 to 19. B. Performance Period The contract shall be effective upon approval by the State Controller, or designee, or on July 1, 2005, whichever is later. The contract performance contemplated herein shall commence as soon as practicable after the effective date of this contract and shall be undertaken and performed in the sequence and manner set forth in the scope of work and extend through June 30, 2006. The Contractor understands and agrees that the Department shall not be liable for payment of work or services or for costs or expenses incurred by this Contractor prior to the proper execution and State Controller approval of this contract. C. Compensation/Maximum Payable 1. Payment is contingent upon funds being appropriated by the General Assembly, budgeted and otherwise made available. Payment pursuant to this contract will be made as earned, in whole or in part, from available Department funds encumbered in an amount not to exceed $123,317.00 for the purchase of the within-described services. The liability of the State, at any time, for such payments shall be limited to the amount remaining of such encumbered funds. 2. Financial obligations of the State of Colorado payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted, and otherwise made available. D. Billing/Payment Procedure The Department shall pay reasonable, allocable, allowable direct costs of performance. Unless otherwise provided, and where appropriate: 1. The Department shall establish billing procedures and pay the Contractor the reasonable, allocable, and allowable direct costs for work performed and accepted under this contract, based on the submission of monthly statements in the format prescribed by the Department. A sample invoice is incorporated herein by reference and attached hereto as Exhibit A. All invoices shall reference the Page 6 of 21 related Contract by its contract routing number, which shall appear on the first page of each document. All invoices shall be based upon the costs of the work and services performed during the term of this contract and shall be supplemented or accompanied by supporting data and subcontractor invoices, if any, covering the work shown on the invoice. To be considered for payment, billings for payment pursuant to this contract must be received within 60 days after the period for which payment is being requested and final billings on this contract must be received by the Department within 60 days after the end of the contract term. 2. Incorrect payments to the Contractor due to omission, error, fraud, or defalcation shall be recovered from the Contractor by deduction from subsequent payment under this contract or other contracts between the Department and the Contractor, or by the Department as a debt due to the Department. The Contractor shall submit requests for reimbursement monthly on the format attached as Exhibit A. The State procurement rules governing allowability and allocability of cost shall govern. The Department reserves the right to audit the Contractor's books and records for a period of three years after contract expiration or termination in order to validate the allowability of costs paid under this contract, and any costs not allowable under the State Procurement Rules shall be reimbursed by the Contractor, or offset against current obligations due by the Department to the Contractor, at the State's elections. E. Health Insurance Portability& Accountability Act of 1996 ("HIPAA"). Federal law and regulations goveming the privacy of certain health information requires a "Business Associate Contract" between the Department and the Contractor. 45 C.F.R. Section 164.504(e). Attached and incorporated herein by reference and agreed to by the parties is a HIPAA Business Associate Addendum for HIPAA compliance. Terms of the Addendum shall be considered binding upon execution of this contract and shall remain in effect during the term of the contract including any extensions. F. Legal Authority The Contractor warrants that it possesses the legal authority to enter into this contract and that it has taken all actions required by its procedures, by-laws, and/or applicable laws to exercise that authority, and to lawfully authorize its undersigned signatory to execute this contract and to bind the Contractor to its terms. The person(s) executing this contract on behalf of the Contractor warrant(s) that such person(s) have full authorization to execute this contract. G. Work Product Ownership The Department shall have all ownership rights, not superseded by other licensing restrictions, in all materials, programs, procedures, etc., designed, purchased, or developed by the Contractor and funded by the Department. The Contractor shall use Contract funds to develop all materials, programs, products, procedures, etc., and such data and software as described in 1. through 6., below, in order to make systems portable Page 7of21 to the Department. Department funding used in the development of these materials, programs, procedures, etc. shall be documented by the Contractor. The Department shall have all ownership rights in data and software, or modifications thereof, and associated documentation and procedures designed and developed to produce any systems, programs reports and documentation, whether provided to Contractor by the Department, developed by the Contractor or its subcontractor and funded by the Department in the performance of this Contract. The Department reserves, on behalf of itself and its Contractors, a royalty-free, non-exclusive and irrevocable license to produce, publish or otherwise use such software, modifications, documentation, and procedures. Such data and software includes, but is not limited to: 1. All computer software and programs, which have been designed, developed, provided to Department or acquired by the Contractor, including all object codes, which are used in performance of this Contract; 2. All internal system software and programs developed by the Contractor or subcontractor, including all source codes, which result from the performance of this Contract; excluding commercial software packages purchased under their own license; 3. All necessary data files; 4. User and operation manuals and other documentation; 5. System and program documentation in the form specified by the Department; and 6. Training materials for Department staff, agents, or designated representatives in the operation and maintenance of this software. H. Inspection and Acceptance The Department reserves the right to inspect services provided under this contract at all reasonable times and places during the term of the contract. "Services" as used in this clause include services performed or tangible material produced or delivered in the performance of services. If any of the services do not conform with contract requirements, the Department may require the Contractor to perform the services again in conformity with contract requirements, with no additional payment. When defects in the quality or quantity of service cannot be corrected by reperfomiance, the Department may (I) require the Contractor to take necessary action to ensure that the future performance conforms to contract requirements and (2) equitably reduce the payment due the Contractor to reflect the reduced value of the services performed. These remedies in no way limit the remedies available to the Department in the termination provisions of this contract, or remedies otherwise available at law. Page 8 of21 Remedies In addition to any other remedies provided for in this contract, and without limiting its remedies otherwise available at law, the Department may exercise the following remedial actions if the Contractor substantially fails to satisfy or perform the duties and obligations in this contract. Substantial failure to satisfy the duties and obligations shall be defined to mean significant insufficient, incorrect or improper performance, activities, or inaction by the Contractor. These remedial actions are as follows: 1. Suspend Contractor's performance pending necessary corrective action as specified by the Department without Contractor's entitlement to adjustment in price/cost or schedule; and/or 2. Withhold payment to Contractor until the necessary services or corrections in performance are satisfactorily completed; and/or 3. Request the removal from work on the contract of employees or agents of the Contractor whom the Department justifies as being incompetent, careless, insubordinate, unsuitable, or otherwise unacceptable, or whose continued employment on the contract the Department deems to be contrary to the public interest or not in the best interest of the Department; and/or 4. Deny payment for those services or obligations which have not been performed and which, due to circumstances caused by Contractor, cannot be performed, or if performed would be of no value to the Department. Denial of the amount of payment must be reasonably related to the value of work or performance lost to the Department. 5. Terminate the contract for default. The above remedies are cumulative and the Department, in its sole discretion, may exercise any or all of them individually or simultaneously. J. Termination for Convenience The Department may terminate this contract at any time the Department determines that the purposes of the distribution of Department moneys under the contract would no longer be served by completion of the project. The Department shall effect such termination by giving written notice of termination to the Contractor and specifying the effective date thereof, at least twenty (20) days before the effective date of such termination. In that event, all finished or unfinished documents, data, studies, surveys, drawings, maps, models, photographs, and reports or other material prepared by the Contractor under this contract shall, at the option of the Department, become its property, and the Contractor shall be entitled to receive just and equitable compensation for any satisfactory services and supplies delivered. Page 9 of 21 If the contract is terminated by the Department as provided herein, the Contractor will be paid an amount which bears the same ratio to the total compensation as the services satisfactorily performed bear to the total services of the Contractor covered by this contract, less payments of compensation previously made, provided, however, that if less than sixty percent (60%) of the services covered by this contract have been performed upon the effective date of such termination, the Contractor shall be reimbursed (in addition to the above payment) for that portion of the actual out-of-pocket expenses (not otherwise reimbursed under this contract) incurred by the Contractor during the contract period which are directly attributable to the uncompleted portion of the services covered by this contract. In no event shall reimbursement under this clause exceed the contract amount. If this contract is terminated for cause, or due to the fault of the Contractor, the Termination for Default/Cause provision shall apply. K. Termination for Default/Cause If, through any cause, the Contractor shall fail to fulfill, in a timely and proper manner, its obligations under this contract, or if the Contractor shall violate any of the covenants, agreements, or stipulations of this contract, the Department shall thereupon have the right to terminate this contract for cause by giving written notice to the Contractor of its intent to terminate and at least ten (10) days opportunity to cure the default or show cause why termination is otherwise not appropriate. In the event of termination, all finished or unfinished documents, data, studies, surveys, drawings, maps, models, photographs, and reports or other material prepared by the Contractor under this contract shall, at the option of the Department, become its property, and the Contractor shall be entitled to receive just and equitable compensation for any services and supplies delivered and accepted. The Contractor shall be obligated to return any payment advanced under the provisions of this contract. Notwithstanding the above, the Contractor shall not be relieved of liability to the Department for any damages sustained by the Department by virtue of any breach of the contract by the Contractor, and the Department may withhold any payment to the Contractor for the purposes of mitigating its damages until such time as the exact amount of damages due to the Department from the Contractor is determined. If after such termination it is determined, for any reason, that the Contractor was not in default, or that the Contractor's action/inaction was excusable, such termination shall be treated as a termination for convenience, and the rights and obligations of the parties shall be the same as if the contract had been terminated for convenience, as described herein. L. Insurance 1. The Contractor shall obtain, and maintain at all times during the term of this agreement, insurance in the following kinds and amounts: a. Workers' Compensation Insurance as required by state statute, and Employer's Liability Insurance covering all of contractor's employees acting within the course and scope of their employment. Page 10 of 21 b. Commercial General Liability Insurance written on ISO occurrence form CG 00 01 10/93 or equivalent, covering premises operations, fire damage, independent contractors, products and completed operations, blanket contractual liability, personal injury, and advertising liability with minimum limits as follows: 1) $1,000,000 each occurrence; 2) $1,000,000 general aggregate; 3) $1,000,000 products and completed operations aggregate; and 4) $50,000 any one fire. If any aggregate limit is reduced below $1,000,000 because of claims made or paid, the contractor shall immediately obtain additional insurance to restore the full aggregate limit and furnish to the State a certificate or other document satisfactory to the State showing compliance with this provision. c. Automobile Liability Insurance covering any auto (including owned, hired and non-owned autos) with a minimum limit as follows: $1,000,000 each accident combined single limit. 2. The State of Colorado shall be named as additional insured on the Commercial General Liability and Automobile Liability Insurance policies (leases and construction contracts will require the additional insured coverage for completed operations on endorsements CG 2010 11/85, CG 2037, or equivalent). Coverage required of the contract will be primary over any insurance or self-insurance program carried by the State of Colorado. 3. The Insurance shall include provisions preventing cancellation or non-renewal without at least 45 days prior notice to the State by certified mail. 4. The contractor will require all insurance policies in any way related to the contract and secured and maintained by the contractor to include clauses stating that each carrier will waive all rights of recovery, under subrogation or otherwise, against the State of Colorado, its agencies, institutions, organizations, officers, agents, employees and volunteers. 5. All policies evidencing the insurance coverages required hereunder shall be issued by insurance companies satisfactory to the State. 6. The contractor shall provide certificates showing insurance coverage required by this contract to the State within 7 business days of the effective date of the contract, but in no event later than the commencement of the services or delivery of the goods under the contract. No later than 15 days prior to the expiration date Page 11 of 21 of any such coverage, the contractor shall deliver the State certificates of insurance evidencing renewals thereof At any time during the term of this contract, the State may request in writing, and the contractor shall thereupon within 10 days supply to the State, evidence satisfactory to the State of compliance with the provisions of this section. 7. Notwithstanding subsection A of this section, if the contractor is a "public entity" within the meaning of the Colorado Governmental Immunity Act Section 24-10- 101, et seq., C.R.S. (2004) ("Act'), the contractor shall at all times during the term of this contract maintain only such liability insurance, by commercial policy or self-insurance, as is necessary to meet its liabilities under the Act. Upon request by the State, the contractor shall show proof of such insurance satisfactory to the State. M. Representatives and Notice 1. Representatives. For the purpose of this contract, the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing new or substitute representatives: For the Department: Phyllis Gervais-Voss Acute Care Benefits Section Manager Name Title For the Contractor: Judy Nero Business Manager Name Title 2. Authority. With respect to the representative of the Department, such individual shall have the authority to inspect and reject services, approve invoices for payment, and act otherwise for the Department, except with respect to the execution of formal amendments to or termination of this agreement pursuant to paragraphs J and K. 3. Notices. All notices required to be given by the parties hereunder shall be hand delivered or given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing substitute addresses or persons to whom such notices shall be sent. For the Department: Individual's Name: Phyllis Gervais-Voss Department and Division: Department of Health Care Policy and Financing Health Benefits Division Address: 1570 Grant Street Page 12 of 21 Denver, Colorado 80203 For the Contractor: Individual's Name: Judy Nero Company Name: Board of County Commissioners of Weld County Address: 1555 North 17th Avenue Greeley, Colorado 80631 N. Assignment and Successors The Contractor agrees not to assign rights or delegate duties under this contract [or subcontract any part of the performance required under the contract] without the express, written consent of the Department which shall not be unreasonably withheld. Except as herein otherwise provided, this agreement shall inure to the benefit of, and be binding upon, the parties hereto and their respective successors and assigns. This provision shall not be construed to prohibit assignments of the right to payment to the extent permitted by Section 4-9-318, CRS, provided that written notice of assignment adequate to identify the rights assigned is received by the controller for the agency, department, or institution executing this contract. Such assignment shall not be deemed valid until receipt by such controller-- as distinguished from the State Controller-- and the Contractor assumes the risk that such written notice of assignment is received by the controller for the agency, department, or institution involved. O. Force Majeure Neither the Contractor nor the Department shall be liable to the other for any delay in, or failure of performance of, any covenant or promise contained in this contract, nor shall any delay or failure constitute default or give rise to any liability for damages if, and only to the extent that, such delay or failure is caused by "force majeure." As used in this contract"force majeure"means acts of God; acts of the public enemy; acts of the state and any governmental entity in its sovereign or contractual capacity; fires; floods; epidemics; quarantine restrictions; strikes or other labor disputes; freight embargoes; or unusually severe weather. P. Third Party Beneficiaries It is expressly understood and agreed that the enforcement of the terms and conditions of this contract and all rights of action relating to such enforcement, shall be strictly reserved to the Department and the named Contractor. Nothing contained in this agreement shall give or allow any claim or right of action whatsoever by any other third person. It is the express intention of the Department and the Contractor that any such person or entity, other than the Department or the Contractor, receiving services or benefits under this agreement shall be deemed an incidental beneficiary only. Page 13 of 21 Q. Governmental Immunity Notwithstanding any other provision of this contract to the contrary, no term or condition of this contract shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protection, or other provisions of the Colorado Governmental Immunity Act, Section 24-10-101, et seq., CRS, as now or hereafter amended. The parties understand and agree that liability for claims for injuries to persons or property arising out of negligence of the State of Colorado, its departments, institutions, agencies, boards, officials and employees is controlled and limited by the provisions of Section 24-10-101, et seq., CRS, as now or hereafter amended and the risk management statutes, Section 24-30-1501, et seq., CRS, as now or hereafter amended. Any liability of the Department created under any other provision of this contract, whether or not incorporated herein by reference, shall be controlled by, limited to, and otherwise modified so as to conform with the above cited laws. R. Severability To the extent that this contract may be executed and performance of the obligations of the parties may be accomplished within the intent of the contract, the terms of this contract are severable, and should any term or provision hereof be declared invalid or become inoperative for any reason, such invalidity or failure shall not affect the validity of any other term or provision hereof. S. Waiver The waiver of any breach of a term, provision, or requirement of this contract shall not be construed or deemed as waiver of any subsequent breach of such term, provision, or requirement, or of any other term, provision, or requirement. T. Entire Understanding This contract is intended as the complete integration of all understandings between the parties. No prior or contemporaneous addition, deletion, or other amendment hereto shall have any force or affect whatsoever, unless embodied herein in writing. No subsequent novation, renewal, addition, deletion, or other amendment hereto shall have any force or effect unless embodied in a writing executed and approved pursuant to the State Fiscal Rules. U. Survival of Certain Contract Terms Notwithstanding anything herein to the contrary, the parties understand and agree that all terms and conditions of this contract and the exhibits and attachments hereto which may require continued performance, compliance, or effect beyond the termination date of the contract shall survive such termination date and shall be enforceable by the Department as provided herein in the event of such failure to perform or comply by the Contractor. Page 14 of 21 V. Modification and Amendment This contract is subject to such modifications as may be required by changes in federal or state law, or their implementing regulations. Any such required modification shall automatically be incorporated into and be part of this contract on the effective date of such change as if fully set forth herein. Except as provided above, no modification of this contract shall be effective unless agreed to in writing by both parties in an amendment to this contract that is properly executed and approved in accordance with applicable law. W. Reporting Unless otherwise provided, in service contracts having a performance term longer than three (3) months, the Contractor shall submit, on a quarterly basis, a written program report specifying progress made for each activity identified in the Contractor's duties and obligations, regarding the performance of the contract. Such written analysis shall be in accordance with the procedures developed and prescribed by the Department. The preparation of reports in a timely manner shall be the responsibility of the Contractor and failure to comply may result in delay of payment of funds and/or termination of the contract. Required reports shall be submitted to the Department not later than the end of each calendar quarter, or at such time as otherwise specified. X. Confidentiality of Records The Contractor shall protect the confidentiality of all records and other materials containing personally identifying information that are maintained in accordance with the contract. Except as provided by law, no information in possession of the Contractor about any individual constituent shall be disclosed in a form including identifying information without the prior written consent of the person in interest, a minor's parent, or guardian. The Contractor shall have written policies governing access to, duplication and dissemination of, all such information. The Contractor shall advise its employees, agents and subcontractors, if any, that they are subject to these confidentiality requirements. The Contractor shall provide its employees, agents and subcontractors, if any, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. No confidentiality requirements contained in this contract shall negate or supercede the provisions of the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA). Y. Compliance With Applicable Law The Contractor shall at all times during the execution of this contract strictly adhere to, and comply with, all applicable federal and state laws, and their implementing regulations, as they currently exist and may hereafter be amended,which are incorporated herein by this reference as terms and conditions of this contract. The Contractor shall also require compliance with these statutes and regulations in subcontracts and subgrants permitted under this contract. The federal laws and regulations include: Age Discrimination Act of 1975 42 U.S.C. Sections 6101, et seq. Page 15 of 21 Age Discrimination in Employment Act of 1967 29 U.S.C. 621-634 Americans with Disabilities Act of 1990 (ADA) 42 U.S.C. 12101, et seq. Equal Pay Act of 1963 29 U.S.C. 206(d) Immigration Reform and Control Act of 1986 8 U.S.C. 1324b Section 504 of the Rehabilitation Act of 1973 29 U.S.C. 794 Title VI of the Civil Rights Act of 1964 42 U.S.C. 2000d Title VII of the Civil Rights Act of 1964 42 U.S.C. 2000e Title DC of the Education Amendment of 1972 20 U.S.C. 1681, et seq. Section 24-34-302, et seq., Colorado Revised Statutes 1997, as amended The Contractor also shall comply with any and all laws and regulations prohibiting discrimination in the specific program(s) which is/are the subject of this contract. In consideration of and for the purpose of obtaining any and all federal and/or state financial assistance, the Contractor makes the following assurances, upon which the Department relies. 1. The Contractor will not discriminate against any person on the basis of race, color, national origin, age, sex, religion and handicap, including Acquired Immune Deficiency Syndrome (AIDS) or AIDS-related conditions, in performance of work under this contract. 2. At all times during the performance of this contract, no qualified individual with a disability shall, by reason of such disability, be excluded from participation in, or denied benefits of the service, programs, or activities performed by the Contractor, or be subjected to any discrimination by the Contractor. The Contractor shall take all necessary affirmative steps, as required by 45 CFR 92.36(e) and (Colorado Executive Order, Procurement Rules), to assure that small and minority businesses and women's business enterprises are used, when possible, as sources of supplies, equipment, construction, and services purchased under this contract. Z. Licenses, Permits, and Responsibilities Contractor certifies that, at the time of entering into this contract, it has currently in effect all necessary licenses, certifications, approvals, insurance, permits, etc. required to properly perform the services and/or deliver the supplies covered by this contract. The Contractor warrants that it will maintain all necessary licenses, certifications, approvals, insurance, permits, etc. required to properly perform this contract, without reimbursement Page 16 of 21 by the Department or other adjustment in contract price. Additionally, all employees of the Contractor performing services under this contract shall hold the required licenses or certification, if any, to perform their responsibilities. The Contractor further certifies that, if it is a foreign corporation or other entity, it currently has obtained and shall maintain any applicable certificate of authority to do business in the State of Colorado and has designated a registered agent in Colorado to accept service of process. Any revocation, withdrawal or non-renewal of necessary licenses, certifications, approvals, insurance, permits, etc. required for the Contractor to properly perform this contract, shall be grounds for termination of this contract by the Department for default. AA. Litigation Reporting Unless otherwise provided, the Contractor shall promptly notify the Department in the event that the Contractor learns of any actual litigation in which it is a party defendant. The Contractor, within ten (10) days after being served with a summons, complaint, or other pleading in a case which involves services provided under this contract and which has been filed in any federal or state court or administrative agency, shall deliver copies of such document to the representative designated in this contract, or in absence of such designation, to the chief executive officer of the department, agency, or institution executing this contract on behalf of the Department. BB. Venue The parties agree that venue for any action related to performance of this contract shall be in the City and County of Denver, Colorado. CC. Federal Funding This contract is subject to and contingent upon the continuing availability of federal funds for the purposes hereof. DD. Maintenance of Records The Contractor shall maintain a complete file of all records, documents, communications, and other written materials which pertain to the operation of programs or the delivery of services under this contract, and shall maintain such records for a period of three (3) years after the date of termination of this contract or final payment hereunder, whichever is later, or for such further period as may be necessary to resolve any matters which may be pending, or until an audit has been completed with the following qualification: If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the three (3) year period, or if audit findings have not been resolved after a three (3) year period, the materials shall be retained until the resolution of the audit findings. All such records, documents, communications and other materials shall be the property of the Department, and shall be maintained by the Contractor in a central location and the Contractor shall be custodian on behalf of the Department. Page 17 of 21 EE. Audit, Inspection of Records, and Monitoring The Contractor shall permit the state, federal government, or any other duly authorized agent of a governmental agency to audit, inspect, examine, excerpt, copy and/or transcribe Contractor's records during the term of this contract and for a period of three (3) years following termination of this contract or final payment hereunder, whichever is later, to assure compliance with the terms hereof, or to evaluate the Contractor's performance hereunder. The Contractor shall also permit these same described entities to monitor all activities conducted by the Contractor pursuant to the terms of this contract. As the monitoring agency may in its sole discretion deem necessary or appropriate, such monitoring may consist of internal evaluation procedures, examination of program data, special analyses, on-site checking, formal audit examinations, or any other reasonable procedure. All such monitoring shall be performed in a manner that will not unduly interfere with contract work. FF. Federal Audit Provisions The Office of Management and Budget (OMB) Circular No. A-133 Audits of States, Local Governments, and Non-Profit Organizations defines audit requirements under the Single Audit Act of 1996 (Public Law 104-156). All state and local governments and non-profit organizations expending $300,000 or more from all sources (direct or from pass-through entities) are required to comply with the provisions of Circular No. A-I33. The Circular also requires pass-through entities to monitor the activities of subrecipients and ensure that subrecipients meet the audit requirements. To identify its pass-through responsibilities, the State of Colorado requires all subrecipients to notify the Department when expected or actual expenditures of federal assistance from all sources equal or exceed $300,000. GG. Conflict of Interest 1. During the term of this contract, the Contractor shall not engage in any business or personal activities or practices or maintain any relationships which conflict in any way with the Contractor fully performing his/her obligations under this contract. 2. Additionally, the Contractor acknowledges that, in governmental contracting, even the appearance of a conflict of interest is harmful to the interests of the Department. Thus, the Contractor agrees to refrain from any practices, activities or relationships which could reasonably be considered to be in conflict with the Contractor's fully performing his/her obligations to the Department under the terms of this contract,without the prior written approval of the Department. 3. In the event that the Contractor is uncertain whether the appearance of a conflict of interest may reasonably exist, the Contractor shall submit to the Department a full disclosure statement setting forth the relevant details for the Department's consideration and direction. Failure to promptly submit a disclosure statement or Page 18 of 21 to follow the Department's direction in regard to the apparent conflict shall be grounds for termination of the contract. 4. The Contractor (and subcontractors or subgrantees permitted under the terms of this contract) shall maintain a written code of standards governing the performance of its employees engaged in the award and administration of contracts. No employee, officer or agent of the Contractor, subcontractor, or subgrantee shall participate in the selection, or in the award or administration of a contract or subcontract supported by federal funds if a conflict of interest, real or apparent, would be involved. Such a conflict would arise when: a. The employee, officer or agent; b. Any member of the employee's immediate family; c. The employee's partner; or d. An organization which employs, or is about to employ, any of the above, has a financial or other interest in the firm selected for award. The Contractor's, subcontractor's, or subgrantee's officers, employees, or agents will neither solicit nor accept gratuities, favors, or anything of monetary value from Contractors, potential Contractors, or parties to sub- agreements HH. Holdover Provision In the event the Department desires to continue the services and a replacement contract has not been fully executed by the end date of this contract, the Department, upon written notice to the Contractor, may unilaterally extend this contract for a period of up to two (2) months. The contract shall be extended under the same terms and conditions as the original contract, including, but not limited to prices, rates and service delivery requirements. However, this extension shall terminate at the end of the two month period or when the replacement contract is signed by the State Controller or an authorized delegate. Page 19 of 21 SPECIAL PROVISIONS (For Use Only with Inter-Governmental Contracts) 1. CONTROLLER'S APPROVAL. CRS 24-30-202(1) This contact shall not be deemed valid until it has been approved by the Controller of the State of Colorado or such assistant as he may designate. 2. FUND AVAILABILITY. CRS 24-30-202(5.5) Financial obligations of the State of Colorado payable after the current fiscal year are contingent upon funds for that purpose being appropriated,budgeted,and otherwise made available. 3. INDEMNIFICATION. To the extent authorized by law, the Contractor shall indemnify, save, and hold harmless the State against any and all claims, damages, liability and court awards including costs, expenses, and attorney fees incurred as a result of any act or omission by the Contractor,or its employees,agents,subcontractors,or assignees pursuant to the terms of this contract. No term or condition of this contract shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protection, or other provisions for the parties, of the Colorado Governmental Immunity Act, CRS 24-10-101 et seq. or the Federal Tort Claims Act,28 U.S.C.2671 et seq. as applicable,as now or hereafter amended. 4. INDEPENDENT CONTRACTOR. 4 CCR 801-2 THE CONTRACTOR SHALL PERFORM ITS DUTIES HEREUNDER AS AN INDEPENDENT CONTRACTOR AND NOT AS AN EMPLOYEE. NEITHER THE CONTRACTOR NOR ANY AGENT OR EMPLOYEE OF THE CONTRACTOR SHALL BE OR SHALL BE DEEMED TO BE AN AGENT OR EMPLOYEE OF THE STATE. CONTRACTOR SHALL PAY WHEN DUE ALL REQUIRED EMPLOYMENT TAXES AND INCOME TAX AND LOCAL HEAD TAX ON ANY MONIES PAID BY THE STATE PURSUANT TO THIS CONTRACT. CONTRACTOR ACKNOWLEDGES THAT THE CONTRACTOR AND ITS EMPLOYEES ARE NOT ENTITLED-TO UNEMPLOYMENT INSURANCE BENEFITS UNLESS THE CONTRACTOR OR THIRD PARTY PROVIDES SUCH COVERAGE AND THAT THE STATE DOES NOT PAY FOR OR OTHERWISE PROVIDE SUCH COVERAGE. CONTRACTOR SHALL HAVE NO AUTHORIZATION, EXPRESS OR IMPLIED,TO BIND THE STATE TO ANY AGREEMENTS,LIABILITY,OR UNDERSTANDING EXCEPT AS EXPRESSLY SET FORTH HEREIN. CONTRACTOR SHALL PROVIDE AND KEEP IN FORCE WORKERS' COMPENSATION (AND PROVIDE PROOF OF SUCH INSURANCE WHEN REQUESTED BY THE STATE) AND UNEMPLOYMENT COMPENSATION INSURANCE IN THE AMOUNTS REQUIRED BY LAW, AND SHALL BE SOLELY RESPONSIBLE FOR THE ACTS OF THE CONTRACTOR,ITS EMPLOYEES AND AGENTS. 5. NON-DISCRIMINATION. The Contractor agrees to comply with the letter and the spirit of all applicable state and federal laws respecting discrimination and unfair employment practices. 6. CHOICE OF LAW. The laws of the State of Colorado and rules and regulations issued pursuant thereto shall be applied in the interpretation, execution,and enforcement of this contract. Any provision of this contract,whether or not incorporated herein by reference, which provides for arbitration by any extra-judicial body or person or which is otherwise in conflict with said laws, rules, and regulations shall be considered null and void. Nothing contained in any provision incorporated herein by reference which purports to negate this or any other special provision in whole or in part shall be valid or enforceable or available in any action at law whether by way of complaint, defense, or otherwise. Any provision rendered null and void by the operation of this provision will not invalidate the remainder of this contract to the extent that the contract is capable of execution. At all times during the performance of this contract, the Contractor shall strictly adhere to all applicable federal and state laws,rules,and regulations that have been or may hereafter be established. 7. SOFTWARE PIRACY PROHIBITION. Governor's Executive Order D 002 00 No State or other public funds payable under this Contract shall be used for the acquisition, operation or maintenance of computer software in violation of United States copyright laws or applicable licensing restrictions. The Contractor hereby certifies that,for the term of this contract and any extensions,the Contractor has in place appropriate systems and controls to prevent such improper use of public funds. If the State determines that the Contractor is in violation of this paragraph,the State may exercise any remedy available at law or equity or under this contract, including, without limitation, immediate termination of the contract and any remedy consistent with United States copyright laws or applicable licensing restrictions. 8. EMPLOYEE FINANCIAL INTEREST. CRS 24-18-201 &CRS 24-50-507 The signatories aver that to their knowledge, no employee of the State of Colorado has any personal or beneficial interest whatsoever in the service or property described herein. Page 20 of 21 SPECIAL PROVISIONS THE PARTIES HERETO HAVE EXECUTED THIS CONTRACT CONTRACTOR: STATE OF •l LO'.- BILL OWENS, (S OR Board of County Commissioners of Weld County Legal Name of Contracting Entity en Rei - o , cuti e irector Department of Health Care Policy and Financing 84-6000-813 Social Security Number or FEIN // LEGAL REVIEW: Signature of Author Yed Officer John W.S ers,Attorney Gen al By kakk William H. Jerke, Chair Print Name&Title of Authorized Officer JUN 1 3 2005 CORPORATIONS: ���1 �VV I . ≥ (A corporate attestation is required) yt.,y/,/f' �/ ,./ 1861 4-4-14/911 Attest(Seal)By —s • ;�..y, .• - • API corporate seal here,if available) Deputy Clerk to the Board J0NI ALL CONTRACTS MUST BE APPROVED BY THE STATE CONTROLLER CRS 24-30-202 requires that the State Controller approve all state contracts. This contract is not valid until the State Controller, or such assistant as he may delegate, has signed it. The contractor is not authorized to begin performance until the contract is signed and dated below. If performance begins prior to the date below,the State of Colorado may not be obligated to pay for the goods and/or services provided. STATE CONTROLLER: Leslie M.Shenefelt Date 13 U I WELD COUNTY DEPARTMENT OF P IC HEALTH AN ENVIRONME BY: Mark E. Wallace, MD, MPH-Direct Page 21 of 21 d -/7/8 HIPAA BUSINESS ASSOCIATE ADDENDUM This Business Associate Addendum ("Addendum") is a part of the Contract dated May 1, 2005 between the Department of Health Care Policy and Financing and Board of County Commissioners of Weld County, contract number 2106-0119. For purposes of this Addendum, the State is referred to as "Covered Entity" or "CE" and the Contractor is referred to as "Associate". Unless the context clearly requires a distinction between the Contract document and this Addendum, all references herein to "the Contract" or "this Contract" include this Addendum. RECITALS A. CE wishes to disclose certain information to Associate pursuant to the terms of the Contract, some of which may constitute Protected Health Information ("PHI") (defined below). B. CE and Associate intend to protect the privacy and provide for the security of PHI disclosed to Associate pursuant to this Contract in compliance with the Health Insurance Portability and Accountability Act of 1996, 42 U.S.C. § 1320d— 1320d-8 ("HIPAA") and its implementing regulations promulgated by the U.S. Department of Health and Human Services, 45 C.F.R. Parts 160 and 164 (the "Privacy Rule") and other applicable laws, as amended. C. As part of the HIPAA regulations, the Privacy Rule requires CE to enter into a contract containing specific requirements with Associate prior to the disclosure of PHI, as set forth in, but not limited to, Title 45, Sections 160.103, 164.502(e) and 164.504(e) of the Code of Federal Regulations ("C.F.R.") and contained in this Addendum. The parties agree as follows: A. Definitions. 1. Except as otherwise defined herein, capitalized terms in this Addendum shall have the definitions set forth in the HIPAA Privacy Rule at 45 C.F.R. Parts 160 and 164, as amended. In the event of any conflict between the mandatory provisions of the Privacy Rule and the provisions of this Contract, the Privacy Rule shall control. Where the provisions of this Contract differ from those mandated by the Privacy Rule, but are nonetheless permitted by the Privacy Rule, the provisions of this Contract shall control. 2. "Protected Health Information" or "PHI" means any information, whether oral or recorded in any form or medium: (i) that relates to the past, present or future physical or mental condition of an individual; the provision of health care to an individual; or the past, present or future payment for the provision of health care to an individual; and (ii) that identifies the individual or with respect to which there is a reasonable basis to believe the information can be used to identify the Page 1 of 10 Colorado Model BA Provision and Addendum For New or Amended Contracts Rev. 10/03 individual, and shall have the meaning given to such term under the Privacy Rule, including, but not limited to, 45 C.F.R. Section 164.501. 3. "Protected Information" shall mean PHI provided by CE to Associate or created or received by Associate on CE's behalf. To the extent Associate is a covered entity under HIPAA and creates or obtains its own PHI for treatment, payment and health care operations, Protected Information under this Contract does not include any PHI created or obtained by Associate as a covered entity and Associate shall follow its own policies and procedures for accounting, access and amendment of Associate's PHI. B. Obligations of Associate. 1. Permitted Uses. Associate shall not use Protected Information except for the purpose of performing Associate's obligations under this Contract and as permitted under this Addendum. Further, Associate shall not use Protected Information in any manner that would constitute a violation of the Privacy Rule if so used by CE, except that Associate may use Protected Information: (i) for the proper management and administration of Associate; (ii) to carry out the legal responsibilities of Associate; or (iii) for Data Aggregation purposes for the Health Care Operations of CE. Additional provisions, if any, governing permitted uses of Protected Information are set forth in Attachment A to this Addendum. 2. Permitted Disclosures. Associate shall not disclose Protected Information in any manner that would constitute a violation of the Privacy Rule if disclosed by CE, except that Associate may disclose Protected Information: (i) in a manner permitted pursuant to this Contract; (ii) for the proper management and administration of Associate; (iii) as required by law; (iv) for Data Aggregation purposes for the Health Care Operations of CE; or (v) to report violations of law to appropriate federal or state authorities, consistent with 45 C.F.R. Section 164.502(j)(1). To the extent that Associate discloses Protected Information to a third party, Associate must obtain, prior to making any such disclosure: (i) reasonable assurances from such third party that such Protected Information will be held confidential as provided pursuant to this Addendum and only disclosed as required by law or for the purposes for which it was disclosed to such third party; and (ii) an agreement from such third party to notify Associate within two business days of any breaches of confidentiality of the Protected Information, to the extent it has obtained knowledge of such breach. Additional provisions, if any, governing permitted disclosures of Protected Information are set forth in Attachment A. 3. Appropriate Safeguards. Associate shall implement appropriate safeguards as are necessary to prevent the use or disclosure of Protected Information other than as permitted by this Contract. Associate shall maintain a comprehensive written information privacy and security program that includes administrative, technical Page 2 of 10 Colorado Model BA Provision and Addendum For New or Amended Contracts Rev. 10/03 and physical safeguards appropriate to the size and complexity of the Associate's operations and the nature and scope of its activities. 4. Reporting of Improper Use or Disclosure. Associate shall report to CE in writing any use or disclosure of Protected Information other than as provided for by this Contract within five (5) business days of becoming aware of such use or disclosure. 5. Associate's Agents. If Associate uses one or more subcontractors or agents to provide services under the Contract, and such subcontractors or agents receive or have access to Protected Information, each subcontractor or agent shall sign an agreement with Associate containing substantially the same provisions as this Addendum and further identifying CE as a third party beneficiary with rights of enforcement and indemnification from such subcontractors or agents in the event of any violation of such subcontractor or agent agreement. Associate shall implement and maintain sanctions against agents and subcontractors that violate such restrictions and conditions and shall mitigate the effects of any such violation. 6. Access to Protected Information. Associate shall make Protected Information maintained by Associate or its agents or subcontractors in Designated Record Sets available to CE for inspection and copying within ten (10) business days of a request by CE to enable CE to fulfill its obligations to permit individual access to PHI under the Privacy Rule, including, but not limited to, 45 C.F.R. Section 164.524. 7. Amendment of PHI. Within ten business (10) days of receipt of a request from CE for an amendment of Protected Information or a record about an individual contained in a Designated Record Set, Associate or its agents or subcontractors shall make such Protected Information available to CE for amendment and incorporate any such amendment to enable CE to fulfill its obligations with respect to requests by individuals to amend their PHI under the Privacy Rule, including, but not limited to, 45 C.F.R. Section 164.526. If any individual requests an amendment of Protected Information directly from Associate or its agents or subcontractors, Associate must notify CE in writing within five (5) business days of receipt of the request. Any denial of amendment of Protected Information maintained by Associate or its agents or subcontractors shall be the responsibility of CE. 8. Accounting Rights. Within ten (10) business days of notice by CE of a request for an accounting of disclosures of Protected Information, Associate and its agents or subcontractors shall make available to CE the information required to provide an accounting of disclosures to enable CE to fulfill its obligations under the Privacy Rule, including, but not limited to, 45 C.F.R. Section 164.528. As set forth in, and as limited by, 45 C.F.R. Section 164.528, Associate shall not provide an accounting to CE of disclosures: (i) to carry out treatment, payment or health Page 3 of 10 Colorado Model BA Provision and Addendum For New or Amended Contracts Rev. 10/03 care operations, as set forth in 45 C.F.R. Section 164.506; (ii) to individuals of Protected Information about them as set forth in 45 C.F.R. Section 164.502; (iii) pursuant to an authorization as provided in 45 C.F.R. Section 164.508; (iv) to persons involved in the individual's care or other notification purposes as set forth in 45 C.F.R. Section 164.510; (v) for national security or intelligence purposes as set forth in 45 C.F.R. Section 164.512(k)(2); (vi) to correctional institutions or law enforcement officials as set forth in 45 C.F.R. Section 164.512(k)(5); (vii) incident to a use or disclosure otherwise permitted by the Privacy Rule; (viii) as part of a limited data set under 45 C.F.R. Section 164.514(e); or (ix) disclosures prior to April 14, 2003. Associate agrees to implement a process that allows for an accounting to be collected and maintained by Associate and its agents or subcontractors for at least six (6) years prior to the request, but not before the compliance date of the Privacy Rule. At a minimum, such information shall include: (i) the date of disclosure; (ii) the name of the entity or person who received Protected Information and, if known, the address of the entity or person; (iii) a brief description of Protected Information disclosed; and (iv) a brief statement of purpose of the disclosure that reasonably informs the individual of the basis for the disclosure, or a copy of the individual's authorization, or a copy of the written request for disclosure. In the event that the request for an accounting is delivered directly to Associate or its agents or subcontractors, Associate shall within five (5) business days of the receipt of the request forward it to CE in writing. It shall be CE's responsibility to prepare and deliver any such accounting requested. Associate shall not disclose any Protected Information except as set forth in Section 2(b)of this Addendum. 9. Governmental Access to Records. Associate shall make its internal practices, books and records relating to the use and disclosure of Protected Information available to the Secretary of the U.S. Department of Health and Human Services (the "Secretary"), in a time and manner designated by the Secretary, for purposes of determining CE's compliance with the Privacy Rule. Associate shall provide to CE a copy of any Protected Information that Associate provides to the Secretary concurrently with providing such Protected Information to the Secretary. 10. Minimum Necessary. Associate (and its agents or subcontractors) shall only request, use and disclose the minimum amount of Protected Information necessary to accomplish the purpose of the request, use or disclosure, in accordance with the Minimum Necessary requirements of the Privacy Rule including, but not limited to 45 C.F.R. Sections 164.502(b) and 164.514(d). 11. Data Ownership. Associate acknowledges that Associate has no ownership rights with respect to the Protected Information. 12. Retention of Protected Information. Except upon termination of the Contract as provided in Section 4(d) of this Addendum, Associate and its subcontractors or agents shall retain all Protected Information throughout the term of this Contract Page 4 of 10 Colorado Model BA Provision and Addendum For New or Amended Contracts Rev. 10/03 and shall continue to maintain the information required under Section 2(h) of this Addendum for a period of six (6) years. 13. Associate's Insurance. Associate shall maintain casualty and liability insurance to cover loss of PHI data and claims based upon alleged violations of privacy rights through improper use or disclosure of PHI. All such policies shall meet or exceed the minimum insurance requirements of the Contract (e.g., occurrence basis, combined single dollar limits, annual aggregate dollar limits, additional insured status and notice of cancellation). 14. Notification of Breach. During the term of this Contract, Associate shall notify CE within two business days of any suspected or actual breach of security, intrusion or unauthorized use or disclosure of PHI and/or any actual or suspected use or disclosure of data in violation of any applicable federal or state laws or regulations. Associate shall take (i) prompt corrective action to cure any such deficiencies and (ii) any action pertaining to such unauthorized disclosure required by applicable federal and state laws and regulations. 15. Audits, Inspection and Enforcement. Within ten (10) business days of a written request by CE, Associate and its agents or subcontractors shall allow CE to conduct a reasonable inspection of the facilities, systems, books, records, agreements, policies and procedures relating to the use or disclosure of Protected Information pursuant to this Addendum for the purpose of determining whether Associate has complied with this Addendum; provided, however, that: (i) Associate and CE shall mutually agree in advance upon the scope, timing and location of such an inspection; (ii) CE shall protect the confidentiality of all confidential and proprietary information of Associate to which CE has access during the course of such inspection; and (iii) CE shall execute a nondisclosure agreement, upon terms mutually agreed upon by the parties, if requested by Associate. The fact that CE inspects, or fails to inspect, or has the right to inspect, Associate's facilities, systems, books, records, agreements, policies and procedures does not relieve Associate of its responsibility to comply with this Addendum, nor does CE's (i) failure to detect or (ii) detection, but failure to notify Associate or require Associate's remediation of any unsatisfactory practices, constitute acceptance of such practice or a waiver of CE's enforcement rights under the Contract. 16. Safeguards During Transmission. Associate shall be responsible for using appropriate safeguards to maintain and ensure the confidentiality, privacy and security of Protected Information transmitted to CE pursuant to the Contract, in accordance with the standards and requirements of the Privacy Rule, until such Protected Information is received by CE, and in accordance with any specifications set forth in Attachment A. 17. Restrictions and Confidential Communications. Within ten (10) business days of notice by CE of a restriction upon uses or disclosures or request for confidential Page 5 of 10 Colorado Model BA Provision and Addendum For New or Amended Contracts Rev. 10/03 communications pursuant to 45 C.F.R. 164.522, Associate will restrict the use or disclosure of an individual's Protected Information, provided Associate has agreed to such a restriction. Associate will not respond directly to an individual's requests to restrict the use or disclosure of Protected Information or to send all communication of Protect Information to an alternate address. Associate will refer such requests to the CE so that the CE can coordinate and prepare a timely response to the requesting individual and provide direction to Associate. C. Obligations of CE. 1. Safeguards During Transmission. CE shall be responsible for using appropriate safeguards to maintain and ensure the confidentiality, privacy and security of PHI transmitted to Associate pursuant to this Contract, in accordance with the standards and requirements of the Privacy Rule, until such PHI is received by Associate, and in accordance with any specifications set forth in Attachment A. 2. Notice of Changes. CE shall provide Associate with a copy of its notice of privacy practices produced in accordance with 45 C.F.R. Section 164.520, as well as any subsequent changes or limitation(s) to such notice, to the extent such changes or limitations may effect Associate's use or disclosure of Protected Information. CE shall provide Associate with any changes in, or revocation of, permission to use or disclose Protected Information, to the extent it may affect Associate's permitted or required uses or disclosures. To the extent that it may affect Associate's permitted use or disclosure of PHI, CE shall notify Associate of any restriction on the use or disclosure of Protected Information that CE has agreed to in accordance with 45 C.F.R. Section 164.522. CE may effectuate any and all such notices of non-private information via posting on CE's web site. Associate shall review CE's designated web site for notice of changes to CE's HIPAA privacy policies and practices on the last day of each calendar quarter. D. Termination. 1. Material Breach. In addition to any other provisions in the Contract regarding breach, a breach by Associate of any provision of this Addendum, as determined by CE, shall constitute a material breach of this Contract and shall provide grounds for immediate termination of this Contract by CE pursuant to the provisions of the Contract covering termination for cause, if any. If the Contract contains no express provisions regarding termination for cause, the following terms and conditions shall apply: a. Default. If Associate refuses or fails to timely perform any of the provisions of this Contract, CE may notify Associate in writing of the non- performance, and if not promptly corrected within the time specified, CE may terminate this Contract. Associate shall continue performance of this Contract to the extent it is not terminated and shall be liable for excess costs incurred in procuring similar goods or services elsewhere. Page 6 of 10 Colorado Model BA Provision and Addendum For New or Amended Contracts Rev. 10/03 b. Associate's Duties. Notwithstanding termination of this Contract, and subject to any directions from CE, Associate shall take timely, reasonable and necessary action to protect and preserve property in the possession of Associate in which CE has an interest. c. Compensation. Payment for completed supplies delivered and accepted by CE shall be at the Contract price. In the event of a material breach under paragraph 4a, CE may withhold amounts due Associate as CE deems necessary to protect CE against loss from third party claims of improper use or disclosure and to reimburse CE for the excess costs incurred in procuring similar goods and services elsewhere. d. Erroneous Termination for Default. If after such termination it is determined, for any reason, that Associate was not in default, or that Associate's action/inaction was excusable, such termination shall be treated as a termination for convenience, and the rights and obligations of the parties shall be the same as if this Contract had been terminated for convenience, as described in this Contract. 2. Reasonable Steps to Cure Breach. If CE knows of a pattern of activity or practice of Associate that constitutes a material breach or violation of the Associate's obligations under the provisions of this Addendum or another arrangement and does not terminate this Contract pursuant to Section 4(a), then CE shall take reasonable steps to cure such breach or end such violation, as applicable. If CE's efforts to cure such breach or end such violation are unsuccessful, CE shall either (i) terminate the Contract, if feasible or (ii) if termination of this Contract is not feasible, CE shall report Associate's breach or violation to the Secretary of the Department of Health and Human Services. 3. Judicial or Administrative Proceedings. Either party may terminate the Contract, effective immediately, if(i) the other party is named as a defendant in a criminal proceeding for a violation of HIPAA, the HIPAA Regulations or other security or privacy laws or (ii) a finding or stipulation that the other party has violated any standard or requirement of HIPAA, the HIPAA Regulations or other security or privacy laws is made in any administrative or civil proceeding in which the party has been joined. 4. Effect of Termination. a. Except as provided in paragraph (2) of this subsection, upon termination of this Contract, for any reason, Associate shall return or destroy all Protected Information that Associate or its agents or subcontractors still maintain in any form, and shall retain no copies of such Protected Information. If Associate elects to destroy the PHI, Associate shall certify in writing to CE that such PHI has been destroyed. b. If Associate believes that returning or destroying the Protected Page 7 of 10 Colorado Model BA Provision and Addendum For New or Amended Contracts Rev. 10/03 Information is not feasible, Associate shall promptly provide CE notice of the conditions making return or destruction infeasible. Upon mutual agreement of CE and Associate that return or destruction of Protected Information is infeasible, Associate shall continue to extend the protections of Sections 2(a), 2(b), 2(c), 2(d) and 2(e) of this Addendum to such information, and shall limit further use of such PHI to those purposes that make the return or destruction of such PHI infeasible. E. Injunctive Relief. CE shall have the right to injunctive and other equitable and legal relief against Associate or any of its subcontractors or agents in the event of any use or disclosure of Protected Information in violation of this Contract or applicable law. F. No Waiver of Immunity. No term or condition of this Contract shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protection, or other provisions of the Colorado Governmental Immunity Act, CRS 24-10- 101 et seq. or the Federal Tort Claims Act, 28 U.S.C. 2671 et seq. as applicable, as now in effect or hereafter amended. G. Limitation of Liability. Any limitation of Associate's liability in the Contract shall be inapplicable to the terms and conditions of this Addendum. H. Disclaimer. CE makes no warranty or representation that compliance by Associate with this Contract, HIPAA or the HIPAA Regulations will be adequate or satisfactory for Associate's own purposes. Associate is solely responsible for all decisions made by Associate regarding the safeguarding of PHI. Certification. To the extent that CE determines an examination is necessary in order to comply with CE's legal obligations pursuant to HIPAA relating to certification of its security practices, CE or its authorized agents or contractors, may, at CE's expense, examine Associate's facilities, systems, procedures and records as may be necessary for such agents or contractors to certify to CE the extent to which Associate's security safeguards comply with HIPAA, the HIPAA Regulations or this Addendum. J. Amendment. 1. Amendment to Comply with Law. The parties acknowledge that state and federal laws relating to data security and privacy are rapidly evolving and that amendment of this Addendum may be required to provide for procedures to ensure compliance with such developments. The parties specifically agree to take such action as is necessary to implement the standards and requirements of HIPAA, the Privacy Rule, the Final HIPAA Security regulations at 68 Fed. Reg. 8334 (February 20, 2003), 45 C.F.R. § 164.314 and other applicable laws relating to the security or privacy of PHI. The parties understand and agree that CE must receive satisfactory written assurance from Associate that Associate will adequately safeguard all Protected Information. Upon the request of either party, the other party agrees to promptly enter into negotiations concerning the terms of an amendment to this Addendum embodying written assurances consistent with Page 8 of 10 Colorado Model BA Provision and Addendum For New or Amended Contracts Rev. 10/03 the standards and requirements of HIPAA, the Privacy Rule or other applicable laws. CE may terminate this Contract upon thirty (30) days written notice in the event (i) Associate does not promptly enter into negotiations to amend this Contract when requested by CE pursuant to this Section or (ii) Associate does not enter into an amendment to this Contract providing assurances regarding the safeguarding of PHI that CE, in its sole discretion, deems sufficient to satisfy the standards and requirements of HIPAA and the Privacy Rule. 2. Amendment of Attachment A. Attachment A may be modified or amended by mutual agreement of the parties in writing from time to time without formal amendment of this Addendum. K. Assistance in Litigation or Administrative Proceeding . Associate shall make itself, and any subcontractors, employees or agents assisting Associate in the performance of its obligations under the Contract, available to CE, at no cost to CE up to a maximum of 30 hours, to testify as witnesses, or otherwise, in the event of litigation or administrative proceedings being commenced against CE, its directors, officers or employees based upon a claimed violation of HIPAA, the Privacy Rule or other laws relating to security and privacy or PHI, except where Associate or its subcontractor, employee or agent is a named adverse party. L. No Third Party Beneficiaries. Nothing express or implied in this Contract is intended to confer, nor shall anything herein confer, upon any person other than CE, Associate and their respective successors or assigns, any rights, remedies, obligations or liabilities whatsoever. M. Interpretation and Order of Precedence. The provisions of this Addendum shall prevail over any provisions in the Contract that may conflict or appear inconsistent with any provision in this Addendum. Together, the Contract and this Addendum shall be interpreted as broadly as necessary to implement and comply with HIPAA and the Privacy Rule. The parties agree that any ambiguity in this Contract shall be resolved in favor of a meaning that complies and is consistent with HIPAA and the Privacy Rule. This Contract supersedes and replaces any previous separately executed HIPAA addendum between the parties. 1. Survival of Certain Contract Terms. Notwithstanding anything herein to the contrary, Associate's obligations under Section 4(d) ("Effect of Termination") and Section 12 ("No Third Party Beneficiaries") shall survive termination of this Contract and shall be enforceable by CE as provided herein in the event of such failure to perform or comply by the Associate. This Addendum shall remain in effect during the term of the Contract including any extensions. 2. Representatives and Notice. a. Representatives. For the purpose of the Contract, the individuals identified elsewhere in this Contract shall be the representatives of the respective parties. If no representatives are identified in the Contract, the Page 9 of 10 Colorado Model BA Provision and Addendum For New or Amended Contracts Rev. 10/03 individuals listed below are hereby designated as the parties' respective representatives for purposes of this Contract. Either party may from time to time designate in writing new or substitute representatives. b. Notices. All required notices shall be in writing and shall be hand delivered or given by certified or registered mail to the representatives at the addresses set forth below. State/Covered Entity Representative: Name: Phyllis Gervais-Voss Title: Acute Care Benefits Section Manager Department and Division: Department of Health Care Policy and Financing Health Benefits Division Address: 1570 Grant Street Denver, Colorado 80203 Contractor/Business Associate Representative: Name: Judy Nero Title: Business Manager Department and Division: Board of County Commissioners of Weld County Address: 1555 North 17th Avenue Greeley,Colorado 80631 Page 10 of 10 Colorado Model BA Provision and Addendum For New or Amended Contracts Rev. 10/03 ATTACHMENT A This Attachment sets forth additional terms to the HIPAA Business Associate Addendum, which is part of the Contract dated May 1, 2005, between the Department of Health Care Policy and Financing and Board of County Commissioners of Weld County, contract number 2106-0119 ("Contract") and is effective as of July 1, 2005 (the "Attachment Effective Date"). This Attachment may be amended from time to time as provided in Section 10(b) of the Addendum. 1. Additional Permitted Uses. In addition to those purposes set forth in Section 2(a) of the Addendum, Associate may use Protected Information as follows: No additional permitted uses. 2. Additional Permitted Disclosures. In addition to those purposes set forth in Section 2(b) of the Addendum, Associate may disclose Protected Information as follows: No additional permitted disclosures. 3. Subcontractor(s). The parties acknowledge that the following subcontractors or agents of Associate shall receive Protected Information in the course of assisting Associate in the performance of its obligations under this Contract: None. 4. Receipt. Associate's receipt of Protected Information pursuant to this Contract shall be deemed to occur as follows, and Associate's obligations under the Addendum shall commence with respect to such PHI upon such receipt: Upon receipt of PHI from the Department. 5. Additional Restrictions on Use of Data. CE is a Business Associate of certain other Covered Entities and, pursuant to such obligations of CE, Associate shall comply with the following restrictions on the use and disclosure of Protected Information: No additional restrictions on use of data. 6. Additional Terms. [This section may include specifications for disclosure format, method of transmission, use of an intermediary, use of digital signatures or PKI, authentication, additional security of privacy specifications, de-identification or re- identification of data and other additional terms] 0 0 0 0 q 0 0 0 0 0 0 O O O N O C. Li W J > Z m m N N Q F L 0 Z c LL 0 O in Q ." a g E o E d pp N 0 W 0 0 0 0 0 0 0 € o H 0 0 0 0 O O a i z o Cu O I CL 73 U F w O O E z z z y o °' W 0 u } 0_ E E X W ce U LL O ai 2 ai W E co OX coQ F LL O_ LL 0 U- OH w o` E U E 0 O E ro h O J L a E 'm C N N d O ¢ cZ To m Z JO 0 co ry a Z 01 m LL co d o 06 3 u a 8 c CO o o 10 N J ~ O 0 H 0 u co E Z W rt U' m t°1. 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