HomeMy WebLinkAbout20050266.tiff RESOLUTION
RE: APPROVE PURCHASE OF SERVICES AGREEMENT FOR MIGRANT HEAD START
HEALTH SERVICES AND HEALTH INSURANCE PORTABILITY AND
ACCOUNTABILITY ACT (HIPAA) BUSINESS ASSOCIATE ADDENDUM AND
AUTHORIZE CHAIR TO SIGN - ST. MARY'S FAMILY PRACTICE RESIDENCY
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 Purchase of Services Agreement for
Migrant Head Start Health Services and Health Insurance Portability and Accountability Act(HIPAA)
Business Associate Addendum between the County of Weld,State of Colorado,by and through the
Board of County Commissioners of Weld County,on behalf of the Department of Human Services,
Family Educational Network of Weld County, and St. Mary's Family Practice Residency,
commencing February 1, 2005, and ending November 30, 2005,with terms and conditions being
as stated in said agreement and addendum, and
WHEREAS, after review, the Board deems it advisable to approve said agreement and
addendum, 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 Purchase of Services Agreement for Migrant Head Start Health Services
and Health Insurance Portability and Accountability Act(HI PAA) Business Associate Addendum
between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Department of Human Services, Family
Educational Network of Weld County,and St. Mary's Family Practice Residency,be,and hereby is,
approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said agreement and addendum.
2005-0266
HR0076
: } a aa-oY-ds
HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) BUSINESS
ASSOCIATE ADDENDUM
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 19th day of January, A.D., 2005.
BOARD OF COUNTY COMMISSIONERS
E act i,,/ /� WELD COUNTY, COLORADO
�. � )
( sbi �'�:-,r �1
^;i.��J•'.'s William H. J ke, Chair
a��i!•�*c-o �ilerk to the Board
M. eile, Pro-Tom
!eputy Clerk t• e board
Da 'd E. Long
APP' . E► A
Rob, D. Masden
yA GT��
�u ty Attorney 41�,�^
Date of signature: TTS,
Glenn Vaad C—
2005-0266
HR0076
MEMORANDUM
rThft 44446 DATE: January 10, 2005
\(#9
WI`PITO: Board of County Commissioners
O FROM: Walt Speckman, Executive Director` `,)
COLORADO SUBJECT: Purchase of Services Agreement between FENWC and
St. Mary's Family Practice Residency also included is the HIPAA
Business Associate Addendum
Presented for approval before the Weld County Board of County Commissioners is a Purchase of
Services Agreement between FENWC and St. Mary's Family Practice Residency hereinafter
referred to as Health Center.
The Health Center agrees to provide all physical examinations and update immunizations,
hematocrit, blood pressure, hearing, vision, and height/weight necessary for any Migrant Head
Start child.
FENWC agrees to reimburse the Health Center at the rate of$30.00 per encounter, for health
services not to exceed 500 for a total reimbursement not to exceed $15,000.00. Children must
have a written referral to receive services above and beyond Physical Examinations.
Also attached to this Agreement is the HIPAA Business Associate Addendum. The purpose of
this Addendum is to satisfy certain standards and requirements of HPAA and the HIPAA
Regulations, including, but not limited to, Title 45,Sections 164.504(e) and 164.314 of the Code
of Federal Regulations (CFR), as the same may be amended from time to time.
The term of this Agreement is from February 1, 2005 through September 30, 2005 with the
option to extend to November 30, 2005.
If you have any questions please contact Janet Flaugher, Director, @ 353-3800, ext. 3340.
2005-0266
PURCHASE OF SERVICES AGREEMENT
THIS AGREEMENT, made and entered into this day of January, 2005 by and 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 Division of Human Resources' Family Educational Network of Weld County
hereinafter referred to as "FENWC" and St. Mary's Family Practice Residency, hereinafter referred to as
"Health Center."
WITNESSETH
WHEREAS, FENWC is required to provide medical/dental services according to the Head Start
Performance Standards 45CFR 1304-1, 3,4, & 5.
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as
follows:
1. The Health Center shall provide the health services for the Migrant Head Start eligible children.
Services and appropriate documentation will be complete by the end of the program year.
a. The Health Center will schedule appointments for referred children, for preventive health
care, i.e., physical examinations and immunizations.
The Health Center will see ill children at the clinic, as needed and assess children who
may be in need of medical services.
b. FENWC will provide transportation for children and families to make appointments as
necessary.
2. The Health Center agrees to provide all physical examinations and update immunizations,
hematocrit, blood pressure, hearing , vision, and height and weight necessary for any Migrant
Head Start child.
3. FENWC agrees to reimburse the Health Center at the rate of$30.00 per encounter, for health
services not to exceed 500. for a total reimbursement not to exceed $15,000.00. Children must
have a written referral to receive services above and beyond Physical Examinations.
Prescriptions will not be covered in the above cited rate.
4. FENWC will not be charged for those children covered by Medicaid or private insurance.
Medicaid numbers shall be provided at the time of the appointment and the Health Center shall
send the billing to the appropriate agency.
5. The Health Center will submit itemized bills according to child and service to:
Family Educational Network of Weld County
Migrant Head Start Program
attn: Health Specialist
PO Box 1805
Greeley, CO 80632
6. This Agreement may be modified upon the written consent of both parties.
7. Services provided by the Health Center that are not reimbursed by FENWC will be designated as
a non-federal match/in-Kind contribution to the FENWC Program on behalf of the Health Center.
Non-Federal Match/In-Kind Contributions must be submitted with the bills.
8. The Health Center and FENWC mutually agree that this Agreement may be canceled by either
party after a thirty(30) day written notice. This Agreement will be terminated immediately in the
event funding for the Head Start Program is stopped.
9. The term of this Agreement is from February 1, 2005 through September 30, 2005 with the option
to extend to November 30, 2005.
10. The Health Center assures that it carries adequate liability and malpractice insurance.
11. Assurances:
a. The Health Center agrees that it is an independent contractor and that its officers,
employees, and clients do not become employees of Weld County, and therefore are not
entitled to any employee benefits as Weld County employees, as a result of the execution
of this Agreement.
b. FENWC, the Weld County Board of Commissioners, its officers and employees, shall not
be held liable for injuries or damages caused by any negligent acts or omissions of the
Health Center, its employees, volunteers, or agents while performing this Agreement.
The Health Center, its officers and employees, shall not be held liable for injuries or
damages caused by any negligent acts or omissions of FENWC, its employees,
volunteers, or agents while performing functions as described in this Agreement. The
Health Center shall provide adequate liability and worker's compensation insurance for all
of its employees, volunteers agents engaged in the performance of this Agreement, as
required by the Colorado Worker's Compensation Act. Likewise, FENWC, by and
through the Board of Weld County Commissioners, shall provide adequate liability and
workers'compensation insurance for all employees of FENWC engaged in the
performance of this Agreement.
c. No officer, member, or employee of Weld County and no member of their governing
bodies shall have any pecuniary interest, direct or indirect, in the approved Agreement or
the proceeds thereof.
d. The Health Center understands that monitoring and evaluation of the performance of this
Agreement shall be conducted by the Weld County Division of Human Resources and the
results provided to the Weld County Board of Commissioners.
e. The Health Center and FENWC assure compliance with Title VI of the Civil Rights Act of
1986, and that no person shall, on the grounds of race, creed, color, sex, handicap, or
national origin be excluded from participation in, be denied the benefits of, or be
otherwise subjected to discrimination under the approved Agreement.
IN WITNESS WHEREOF, the parties hereunto have caused this Agreement to be duly executed
as of the day and year first herein above set forth.
WELD COUNTY BOARD OF ST. MARY'S FAMILY PRACTICE
COUNTY COMMISSIONERS RESI E
William H. Jerke, Chairperson Robert Ladenburge , O
JAN 1 9 2005Oat
WELD COUNTY DIVISION
OF HUMANS RVICES
/ sts.
Wa J. peckman, Executive Director
.0 Ell, idiAL
1861
O i";'% I/to, a B. "d
ATTESTING TO BOARD OF COUNTY
COMMISSIONER SIGNATURES ONLY
ST. MARY'S HOSPITAL AND MEDICAL CENTER, INC.
HIPAA BUSINESS ASSOCIATE ADDENDUM
This HIPAA Business Associate Addendum ("Addendum") supplements and is
made part of the Purchase of Services Agreement ("Agreement") dated
20 between St. Mary's Hospital and Medical Center, Inc., (hereinafter "Covered
Entity") and County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County on behalf of the Weld Counmty Division of Human
Resources' Familly Educational Network of Weld County (hereinafter "FENWC"), and is
effective as of April 14, 2003.
It is the intent of the Covered Entity and the Business Associate to protect the
privacy and provide for the security of Protected Health Information ("PHI") disclosed to
the Business Associate pursuant to the Agreement in compliance with the Health
Insurance Portability and Accountability Act of 1996 ("HIPAA") and privacy and security
regulations published by the U.S. Department of Health and Human Services ("DHHS")
contained at 45 CFR Parts 160 and 164 which may be periodically revised or amended
(the "HIPAA Regulations") and other applicable laws. The purpose of this Addendum is
to satisfy certain standards and requirements of HIPAA and the HIPAA Regulations,
including, but not limited to, Title 45, Sections 164.504(e) and 164.314 of the Code of
Federal Regulations ("CFR"), as the same may be amended from time to time.
In consideration of the mutual promises below and the exchange of information
pursuant to the Agreement, the parties agree as follows:
1. Definitions.
a. "Protected Health Information" or "PHI", as defined in HIPAA and the
HIPAA Regulations, means information that is received by Business
Associate from or on behalf of the Covered Entity, or is created by
Business Associate, or is made accessible to Business Associate by the
Covered Entity and is information about an individual, 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 pro-
vision 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 infor-
mation can be used to identify the individual.
b. "Disclose", "Disclosed" and "Disclosure" mean, with respect to PHI, the
release, transfer, provision of access to, or divulging in any other manner
of PHI outside Business Associate's internal operations or to other than
its employees.
HIPAA BA Addendum.January 2004
Page 1 of 7
c. "Use" (in both its verb and noun forms) or "Uses" mean, with respect to
PHI, the sharing, employment, application, utilization, examination or
analysis of such PHI within Business Associate's internal operations.
2. Obligations of Business Associate.
a. Use of Protected Health Information. Business Associate's use of PHI
shall be limited to only those purposes that are necessary to perform its obligations
under the Agreement. Business Associate shall not and shall ensure that its directors,
officers, employees contractors and agents, do not use PHI received from the Covered
Entity in any manner that would constitute a violation of the HIPAA Regulations if used
by the Covered Entity, except that Business Associate may use PHI in its possession
(i) for Business Associate's proper management and administrative services, or (ii) to
carry out the legal responsibilities of Business Associate.
b. Disclosure of Protected Health Information. Business Associate's
disclosure of PHI shall be limited to only those purposes that are necessary to perform
its obligations under the Agreement. Business Associate shall not and shall ensure that
its directors, officers, employees, contractors and agents do not disclose PHI received
from the Covered Entity in any manner that would constitute a violation of the HIPAA
Regulations if disclosed by the Covered Entity, except that Business Associate may
disclose PHI in its possession in a manner permitted pursuant to this Addendum or as
required by law. To the extent Business Associate discloses PHI to a third party,
Business Associate must obtain, prior to making any such disclosure (a) reasonable
assurances from such third party that such PHI 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 (b) an agreement from such third
party to immediately notify Business Associate of any breaches of the confidentiality of
the PHI, to the extent it has obtained knowledge of such breach. Business Associate
shall disclose PHI only to those third party subcontractors and agents that may be
assisting the Business Associate in carrying out its Business Associate functions under
the Agreement, as identified on Exhibit A attached hereto and incorporated herein by
reference.
c. Safeguards Against Misuse of Protected Health Information. Business
Associate agrees that it will implement all appropriate safeguards to prevent the use or
disclosure of PHI other than pursuant to the terms and conditions of this Addendum.
d. Reporting of Disclosures of Protected Health Information. Business
Associate shall, within three (3) business days of becoming aware of a disclosure of
PHI in violation of this Addendum by Business Associate, its officers, directors,
employees, contractors or agents or by a third party to which Business Associate
disclosed PHI pursuant to subparagraph (b) of this Section, report any such disclosure
to the Covered Entity. Business Associate agrees to have procedures in place for
mitigating, to the maximum extent practicable, any damaging effect from the use or
disclosure of PHI in a manner contrary to this Addendum or the HIPAA Regulations.
HIPAA BA Addendum.January 2004
Page 2 of 7
e. Agreements by Third Parties. Business Associate shall enter into an
agreement with any agent or subcontractor that will have access to PHI that is received
from, or created or received by Business Associate on behalf of the Covered Entity, as
identified on Exhibit A, pursuant to which such agent or subcontractor agrees to be
bound by the same restrictions, terms and conditions that apply to Business Associate
pursuant to this Addendum with respect to such PHI.
f. Access to Information. Within ten (10) business days of a request by the
Covered Entity, Business Associate agrees to comply with Covered Entity's request to
accommodate an individual's access to his/her PHI. In the event an individual contacts
Business Associate directly about access to PHI, Business Associate shall within three
(3) business days forward such request to the Covered Entity. Any denials of access to
the PHI requested shall be the responsibility of the Covered Entity.
g. Availability of Protected Health Information for Amendment. Within ten
(10) business days of receipt of a request from the Covered Entity for the amendment
of an individual's PHI, Business Associate shall promptly incorporate any such amend-
ments into the PHI. In the event an individual contacts Business Associate directly
about making amendments to PHI, Business Associate will not make any amendments
to the individual's PHI but shall forward such request to the Covered Entity within three
(3) business days of such contact. Any denials of requested amendment to PHI shall
be the responsibility of the Covered Entity.
h. Accounting of Disclosures. Business Associate hereby agrees to maintain
a record of disclosures of PHI for a retention period of six (6) years. Business
Associate agrees to make information regarding disclosures of PHI regarding an
individual available to the Covered Entity within ten (10) business days of a request by
the Covered Entity. At a minimum, Business Associate shall provide the Covered Entity
with the following information: (i) the date of the disclosure, (ii) the name of the entity or
person who received the PHI, and if known, the address of such entity or person, (iii) a
brief description of the PHI disclosed, (iv) a brief statement of the purpose of such
disclosure which includes an explanation of the basis for such disclosure, and (v) the
names of all individuals whose PHI was disclosed. In the event the request for an
accounting is delivered directly to Business Associate, Business Associate shall within
three (3) business days forward such request to the Covered Entity. It shall be the
Covered Entity's responsibility to prepare and deliver any such accounting requested.
Business Associate hereby agrees to implement an appropriate recordkeeping process
to enable it to comply with the requirements of this Section.
Availability of Books and Records. Business Associate hereby agrees to
make its internal practices, books and records relating to the use and disclosure of PHI
received from, or created or received by Business Associate on behalf of the Covered
Entity available to the Covered Entity, or to the Secretary of DHHS or designee, for
purposes of determining the Covered Entity's and Business Associate's compliance
with HIPAA and the HIPAA Regulations.
HIPAA BA AddendumJanuary 2004
Page 3 of 7
j. Responsibilities Upon Termination of Agreement. Upon the termination of
the Agreement for any reason, Business Associate shall return or destroy all PHI and
will retain no copies of such information. If such return or destruction of PHI is not
feasible as approved by the Covered Entity, Business Associate agrees that the
provisions of this Addendum are extended beyond termination to the PHI, and Business
Associate shall limit all further uses and disclosures to those purposes that make the
return or destruction of the PHI infeasible.
k. Requirements of Security Regulations. Business Associate agrees that it
will —
(i) implement administrative, physical, and technical safeguards that
reasonably and appropriately protect the confidentiality, integrity, and availability
of the electronic PHI ("EPHI") that it creates, receives, maintains, or transmits on
behalf of the Covered Entity as required by the HIPAA Security Regulations;
(ii) ensure that any agent, including a subcontractor, to whom it
provides such EPHI agrees to implement reasonable and appropriate safeguards
to protect it; and
(iii) report to the Covered Entity any security incident of which it
becomes aware.
3. Obligations of Covered Entity.
a. Notification Requirements. With regard to the use and/or disclosure of PHI by
the Business Associate, the Covered Entity hereby agrees to inform the Business
Associate of any changes in, withdrawal of, or restrictions upon any consent or
authorization provided to the Covered Entity pursuant to the HIPAA Regulations.
b. Safeguards. The Covered Entity shall be responsible for using appropriate
safeguards to maintain and ensure the confidentiality, privacy and security of PHI
transmitted to Business Associate pursuant to the Agreement, in accordance with the
HIPAA Regulations, until Business Associate receives such PHI.
4. Term and Termination.
a. Term. This Addendum shall become effective as of April 14, 2003 and
shall continue in effect until the underlying Agreement is terminated. In addition, certain
requirements at Section 2j of this Addendum shall survive termination.
b. Material Breach. In addition to and notwithstanding the termination
provisions set forth in the Agreement, a breach by Business Associate of any provision
of this Addendum, as determined by Covered Entity, shall constitute a material breach
HIPAA BA Addendum.January 2004
Page 4 of 7
of the Agreement and shall provide grounds for [immediate] termination of the
Agreement [in accordance with the terms of the Agreement].
c. Reasonable Steps to Cure Breach. If the Covered Entity knows of a
pattern of activity or practice of Business Associate that constitutes a material breach or
violation of the Business Associate's obligations under the provisions of this Addendum
or another arrangement and does not terminate the Agreement pursuant to subpara-
graph (a) of this Section, then the Business Associate, upon receipt of notice from the
Covered Entity, shall have ten (10) days in which to take reasonable steps to cure such
breach or end such violation, as applicable. If the Business Associate's efforts to cure
such breach or end such violation are unsuccessful, the Covered Entity shall either
(i) terminate the Agreement, if feasible or (ii) if termination of the Agreement is not
feasible, the Covered Entity shall report Business Associate's breach or violation to the
Secretary of DHHS.
d. Judicial or Administrative Proceedings. Either party may terminate the
Agreement, effective immediately, if (i) the other party is convicted in a criminal
proceeding for a violation of HIPAA or (ii) a finding or stipulation that the other party has
violated any standard or requirement of HIPAA or other security or privacy laws is made
in any administrative or civil proceeding in which the party has been joined.
5. No Third Party Beneficiaries. Nothing expressed or implied in the Agreement
or this Addendum is intended to confer, nor shall anything herein confer, upon any
person other than the parties hereto and their respective successors or assigns, any
rights, remedies, obligations, or liabilities whatsoever.
6. Incorporation of Addendum.
The signing of this Addendum by the authorized agents of the parties shall incorporate
this Addendum into the original Agreement between the parties. It is further intended
that in the event of any inconsistency between the Agreement and its other attachments
and this Addendum, that the terms of this Addendum be construed as final and binding.
All other terms and provisions of the Agreement remain unchanged and in full
force and effect.
COVERED ENTITY:
St. Mary's Hospital and Medical Center, Inc. / . . .•. .•.•.•• .
• •
By " { lr/ / DATE: �pGJrckt "
NAME: Robert W. Ladenburger
TITLE: President and CEO
HIPAA BA Addendum.January 2004
Page 5 of 7
BUSINESS ASSOCIATE:
weld County. Colorado [BA Name]
chairman, Boar of County��issioners ,�� _
�� DATE: JAN 1 9 ?pp5
ATTEST: �� �`
ti:4)
: �S�'�
WELD COUNTY CLERK T' TH BOARD mi
HIPAA BA Addendum.January 2004
Page 6 of 7
EXHIBIT A
TO
HIPAA BUSINESS ASSOCIATE ADDENDUM
THIRD PARTY SUBCONTRACTORS OR AGENTS
OF BUSINESS ASSOCIATE
HIPAA BA Addendum.January 2004
Page 7 of 7
Hello