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HomeMy WebLinkAbout20240426.tiffRESOLUTION RE: APPROVE LABORATORY SERVICES AGREEMENT AND AUTHORIZE CHAIR TO SIGN - DENVER HEALTH AND HOSPITAL AUTHORITY 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 Laboratory Services Agreement between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Coroner's Office, and the Denver Health and Hospital Authority, commencing upon full execution of signatures, with further terms and conditions being as stated in said agreement, and WHEREAS, after review, the Board deems it advisable to approve said agreement, 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 Laboratory Services Agreement between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Coroner's Office, and the Denver Health and Hospital Authority, be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said agreement. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 21st day of February, A.D., 2024. BOARD OF COUNTY COMMISSIONERS ATTEST: V.dtks) , i,..; Weld County Clerk to the Board APP Deputy Clerk to the Board VED County Attorney Date of signature: 1, „ ORM: WELD COUNTY, COLO Kevin EXCUSED Perry L. B fck, Pro-Tem Mike Freeman Scott K. James Saine cc: Co (HS) 03 /IS /24 2024-0426 CO0003 BOARD OF COUNTY COMMISSIONERS PASS -AROUND REVIEW PASS -AROUND TITLE: Laboratory Services agreement for Coroner and Denver Health DEPARTMENT: Coroner DATE: Feb 8, 2024 PERSON REQUESTING: Michael Burson Brief description of the problem/Issue: We are setting up laboratory services with Denver Heath and just need this agreement signed. What options exist for the Board? Decline signing agreement Consequences: The coroner will not be able to perform our duties as we need a lab to perform certain tests. Our previous lab has stopped accepting postmortem samples. Impacts: Certain types of cases will not be examined properly and thus impact determination of cause and manner of death. This will impact families and health entities that track such statistics. Cost (Current Fiscal Year/Ongoing or Subsequent Fiscal Years: This is not a new cost although the fees with Denver Health are significantly less than our previous labs (Mckee and LabCorp). These services have been accounted for in our Medical Services budget line. Recommendation: Please sign the agreement. Although we have not been impacted by not having these services in place (-3 weeks), it is imperative that we get them up and running as soon as possible. Thank you. Support Recommendation Schedule Place on BOCC Agenda Work Session Other/Comments: Perry L. Buck, Pro -Tern Mike Freeman Scott K. James Kevin D. Ross, Chair Lori Saine rf- Via twit V►a final 2024-0426 Uzi Ccco3 Karla Ford From: Sent: To: Subject: Scott James Thursday, February 8, 2024 12:06 PM Karla Ford Re: Please Reply - "11120 - Weld County Coroner_DHHA_LaboratorySvcsAgmtt_Final 02082024j1k_LS.pdf" Importance: High Approve - thanks! Scott K. James Weld County Commissioner, District 2 1150 O Street, P.O. Box 758, Greeley, Colorado 80632 970.336.7204 (Office) 970.381.7496 (Cell) Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. On Feb 8, 2024, at 11:30 AM, Karla Ford <kford@weld.gov>wrote: Please advise if you support recommendation and to have department place on the agenda. Karla Ford — Office Manager, Board of Weld County Commissioners 1150 O Street, P.Q. Box 758, Greeley, Colorado 80632 :: 970.336-7204 :: kford@weldgov.com:: www.weldgov.com **Please note my working hours are Monday -Thursday 7:00a.m.-5:00p.m.** Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. 1 Karla Ford From: Sent: To: Subject: yes Lori Saine Thursday, February 8, 2024 5:41 PM Karla Ford RE: Please Reply - PA 11120 - Weld County Coroner_DHHA_LaboratorySvcsAgmtt_Final Lori Saine Weld County Commissioner, District 3 1150 O Street PO Box 758 Greeley CO 80632 Phone: 970-400-4205 Fax: 970-336-7233 Email: Isaine@weldgov.com Website: www.co.weld.co.us In God We Trust Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. Original Message From: Karla Ford <kford@weld.gov> Sent: Thursday, February 8, 2024 11:32 AM To: Kevin Ross <kross@weld.gov>; Lori Saine <Isaine@weld.gov> Subject: Please Reply - PA 11120 - Weld County Coroner_DHHA_LaboratorySvcsAgmtt_Final Importance: High Please advise if you support recommendation and to have department place on the agenda. Karla FordE Office Manager, Board of Weld County Commissioners 1150 O Street, P.O. Box 758, Greeley, Colorado 80632 :: 970.336-7204 :: kford@weldgov.com:: www.weldgov.com :: **Please note my working hours are Monday -Thursday 7:00a.m.-5:00p.m.** Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise 1 LABORATORY SERVICES AGREEMENT THIS LABORATORY SERVICES AGREEMENT ("Agreement") is made and entered into as of the date of the last signature of the Parties hereto ("Effective Date"), by and between DENVER HEALTH AND HOSPITAL AUTHORITY, a body corporate and political subdivision of the State of Colorado, with offices located at 777 Bannock St., Denver, Colorado 80204, hereinafter referred to as "DHHA," and Weld County Coroner's Office, with offices located at 1121 M Street, Greeley, CO 80631. Each may be referred to as a "Party" and collectively the "Parties". RECITALS: WHEREAS, DHHA is the owner and operator of Denver Health Medical Center, in Denver, CO, which is an acute care hospital and provides inpatient, outpatient, and specialty medical and ancillary services; and WHEREAS, DHHA is a duly licensed and qualified provider of, but not limited to, ancillary and diagnostic laboratory services, to include specialized laboratory expertise services and is capable of providing such services for Weld County Coroner's Office; and WHEREAS, Weld County Coroner's Office desires to secure the services of DHHA to provide diagnostic laboratory services for death investigations/inquests of Weld County Coroner's Office; and WHEREAS, DHHA is willing to assist Weld County Coroner's Office by providing such services during the term of this Agreement. NOW, THEREFORE, in consideration of the premises and the mutual covenants and agreements set forth herein, the parties agree as follows: I. FORM OF AGREEMENT. This Agreement shall consist of the terms and conditions stated in the following numbered paragraphs and Addenda. No other documentation related to this Agreement or generated as a result of this Agreement shall form a part of this Agreement unless it is expressly referenced and incorporated herein. II. DENVER HEALTH AND HOSPITAL AUTHORITY REPRESENTATIVE. The Chief Executive Officer ("CEO") is the official Representative of DHHA and directs all services under this Agreement. Communication between DHHA and Weld County Coroner's Office shall be directed through the CEO or their designee and Weld County Coroner's Office representative. III. SERVICES TO BE PERFORMED. DHHA shall provide Weld County Coroner's Office with reference laboratory services for diagnostic testing of certain laboratory tests for which Weld County Coroner's Office does not have testing capacity ("Services"). The parties shall work together to communicate the Services that will be available to Weld County Coroner's Office under the terms of this Agreement. These Services shall be further defined in Exhibit A 2020-2022 Outreach Fee Schedule attached hereto and incorporated into this Agreement. DHHA represents that all Services shall be performed in accordance with best practice industry standards and in compliance with this Agreement including Exhibits, and all applicable federal, state and local laws and regulations and accreditation requirements. The parties agree that they shall work together in good faith to mutually agree on the operational details and scheduling for all Services to be provided hereunder. All Services will be provided consistent with appropriate quality of care and the standard of care for the community. IV. QUALIFICATIONS. Each qualified provider performing laboratory procedure Services for Weld County Coroner's Office under this Agreement shall at all times meet all of the following qualifications: A. Hold at all times a current, valid, and unrestricted license to practice his or her profession in the State of Colorado; B. Be at all times qualified and eligible to provide services to beneficiaries as a participating physician under all federally funded healthcare programs, including without limitation, the Medicare and Medicaid programs; and C. Not be, and at no time have been, excluded from participation in any federally funded healthcare program, including without limitation, Medicare, or Medicaid. D. Maintain a valid licensure by the Drug Enforcement Agency. V. PAYMENT. DHHA and Weld County Coroner's Office agree to accept and pay for the Services of DHHA as detailed in the 2020-2022 Outreach Fee Schedule in Exhibit A, attached hereto and made a part of this Agreement. All invoices to Weld County Coroner's Office shall contain the name of the provider, the date(s) of service, and the type of service provided. All invoices shall be submitted to the following address: 1121 M St. Greeley, CO 80631 . Invoices shall be due and payable within thirty (30) days of receipt. All payments by Weld County Coroner's Office to DHHA pursuant to this Agreement shall be delivered to the address as set forth in the invoice. VI. TERM; TERMINATION. The term of this Agreement shall commence on the Effective Date of this Agreement and shall continue for a one (1) year period from the Effective Date. Thereafter, this Agreement shall renew automatically for successive twelve-month periods, except that this Agreement or the attached Exhibit A shall be subject to modification by mutual agreement of the parties. Notwithstanding anything herein to the contrary, this Agreement may be terminated by either party at any time as follows: A. With cause by either party upon the default by the other party of any term, covenant, or condition of this Agreement, where such default continues for a period of fifteen (15) business days after the defaulting party receives written notice thereof from the other party 2 specifying the existence of such default; or B. Without cause by either party upon at least sixty (60) days prior written notice to the other party, in which case the Agreement shall terminate on the future date specified in such notice; or C. Immediately upon either party's loss of license, accreditation, or certification or exclusion or suspension from participation in federal healthcare programs and business; or D. Should Weld County Coroner's Office not receive yearly appropriation/budgeting for extension or renewal. Any such termination shall in no way prejudice the payments due for services rendered, nor Weld County Coroner's Office right to services prior to the end of the period of notice. If DHHA's services are terminated, postponed or revised, DHHA shall be paid for that work satisfactorily completed up and to the terminate date indicated in the notice of termination. If this Agreement is terminated, all attached Exhibits shall automatically be deemed terminated as of the date of the Agreement termination. VII. USE OF NAME; MARKETING. Neither party shall use the name, symbol, or image of the other party in any publicity, advertising, or news release without the prior written approval of the other party. Any marketing or promotional materials referencing the other party or promoting these Services shall be formally approved by both parties prior to dissemination. Each party is free to disclose the other's name as required by applicable law or regulation or other applicable provisions of this Agreement. VIII. NO REQUIREMENTS OR INDUCEMENT TO REFER. The terms and conditions of this Agreement represent the result of arms -length negotiations between unaffiliated parties. The Parties acknowledge and agree that such Services do not involve the counseling or promotion of a business arrangement or other activity that violates any federal, state or local law, and the aggregate services to be provided under this Agreement do not and will not exceed those that are reasonably necessary to accomplish the commercially reasonable business purposes and the legitimate medical purposes of this arrangement. The parties understand and agree that the purpose of this Agreement is not to seek or induce the improper referral of patients and that there is no requirement under this Agreement or any other agreement or arrangement between the parties to require either party to refer its patients to the other for products or services. The parties acknowledge and agree that no payment under this Agreement is in return for the prohibited referral of patients or for the purchasing, leasing, or ordering of any products or supplies from the other party. Each party represents that it has not engaged in, and during the term of this Agreement agrees not to engage in, any activities prohibited under the federal anti -kickback statutes (42 U.S.C. Sections 1320a-7, 1320a -7a, and 1320-7b), the regulations promulgated pursuant to such federal statutes, related state and local statutes and regulations, and rules of professional conduct. 3 IX. NON-EXCLUSIVE AGREEMENT. This Agreement is not exclusive. Accordingly, either party shall have the right to enter into one or more agreements relating to the same or similar matters as are covered by this Agreement and execution by either party of such agreements shall not constitute a breach of this Agreement. X. NO THIRD PARTY BENEFICIARIES. It is expressly understood and agreed that enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement shall be strictly reserved to the parties and nothing contained in this Agreement shall give or allow any such claim or right of action by any other entity or third person. It is the express intention of the parties that any person other than a party to this Agreement receiving services or benefits under this Agreement shall be deemed to be an incidental beneficiary only. XI. NO DISCRIMINATION IN EMPLOYMENT. In connection with the performance of work under this Agreement, the parties agree not to refuse to hire, discharge, promote or demote, or to discriminate in matters of compensation against any person otherwise qualified, solely because of race, color, religion, national origin, gender, age, military status, sexual orientation, gender identity, marital status, or physical or mental disability; and further agree to insert the foregoing provision in all subcontracts hereunder. XII. NO WAIVER OF RIGHTS. No assent expressed or implied, to any breach of any one or more covenants, provisions, or conditions of the Agreement shall be construed as a waiver of any succeeding or other breach. XIII. ASSIGNMENT OR SUBCONTRACTING. Weld County Coroner's Office and DHHA agree not to assign, pledge, transfer, or subcontract their duties and rights in this Agreement, in whole or in part without first obtaining the written consent of the other party. Any attempt by Weld County Coroner's Office or DHHA to assign, transfer, or subcontract their rights hereunder without such prior written consent of the other party, shall at the option of the non -defaulting party automatically terminate this Agreement and all rights of the defaulting party. Such consent may be granted or denied at the sole and absolute discretion of the representative of Weld County Coroner's Office if DHHA is seeking consent or by the CEO if Weld County Coroner's Office is seeking such consent. XIV. STATUS OF DHHA. It is understood and agreed by and between the parties that the status of DHHA shall be that of independent contractor and it is not intended, nor shall it be construed, that DHHA or its officers, agents, subcontractors or employees under the contract are employees or officers of Weld County Coroner's Office. DHHA UNDERSTANDS THAT IT AND ITS EMPLOYEES ARE NOT ENTITLED TO UNEMPLOYMENT INSURANCE BENEFITS, WORKERS' COMPENSATION BENEFITS OR FRINGE BENEFITS FROM WELDCOUNTY CORONER'S OFFICE. SUCH BENEFITS MAY BE PROVIDED BY DHHA OR SOME OTHER ENTITY. DHHA MAY BE OBLIGATED TO PAY FEDERAL, STATE AND LOCAL TAXES ON ANY MONIES PAID PURSUANT TO THIS CONTRACT RELATIONSHIP. 4 XV. OWNERSHIP, CUSTODY AND ACCESS TO RECORDS. It is understood and agreed that all Weld County Coroner's Office patient charts, medical files and other records prepared or utilized by DHHA in the course of performing its services under this Agreement, other than DHHA's billing and time records, are the property of Weld County Coroner's Office and shall remain in the custody and control of Weld County Coroner's Office provided however, that DHHA and its Service providers shall have full access to such records through the term of this Agreement for the purpose of performing its Services hereunder and thereafter, shall continue to have access for the purpose of defending a professional liability action or any audit or claim by an insurer, governmental agency or other party. DHHA's billing and time records related to services provided to Weld County Coroner's Office under this Agreement shall be retained for not less than three (3) years and shall be available to Weld County Coroner's Office auditors for inspection and verification. In the event that a party desires to obtain a third -party audit of the financial records, at its own cost, related to this Agreement, the requesting party shall provide ten (10) days prior written notice to the other party of its intent to audit all such records. The results of any such audit shall be disclosed to the audited party. XVI. VENUE, GOVERNING LAW. This Agreement shall be construed and enforced in accordance with the laws of the State of Colorado without regard to the choice of law thereof. Venue for any legal action relating to this Agreement shall lie in Denver, Colorado courts. XVII. LIABILITY. Each party agrees to be responsible for any and all negligent or wrongful acts or omissions of its officers, employees, and agents arising out of this Agreement. XVIII. HEALTH CARE PROFESSIONAL LIABILITY INSURANCE COVERAGE. DHHA represents that it self -insures for professional liability insurance for itself and for its public employees who provide health care services pursuant to the Colorado Governmental Immunity Act C.R.S. §24-10-101, et seq. DHHA agrees that its self-insurance program shall provide coverage in accordance with the limits of the Colorado Governmental Immunity Act. Pursuant to the Colorado Governmental Immunity Act, DHHA agrees to be responsible for damages resulting from injuries sustained from an act or omission of a public employee occurring during the performance of the employee's duties and within the scope of his/her employment, unless sovereign immunity bars the action against DHHA. XIX. MEDICARE CLAUSE. DHHA agrees to allow the Secretary of the Department of Health and Human Services and the Comptroller General or their duly authorized representatives, access upon request to this Agreement and to the books, documents and records of DHHA that are necessary to verify the nature and extent of costs of services furnished under this Agreement. DHHA also agrees that if it carries out any duties of the Agreement through a subcontract, with a value or cost of Ten Thousand Dollars ($10,000.00) or more over a twelve month period with a related organization, the subcontract must contain a clause to the effect that the related organization must make available, upon written request, to the Secretary, or upon request to the Comptroller General, or their duly authorized representatives, the subcontract and the books, documents and records of the related organization that are necessary to verify the nature and extent of the costs. Such access shall be allowed until the expiration of four (4) years after the services are furnished under this Agreement. 5 XX. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT. Each party shall comply with all state and federal laws regarding the confidentiality of patient information and records. Specifically, but not by way of limitation, Weld County Coroner's Office and DHHA will comply with all applicable rules, regulations and standards pertaining to the confidentiality of protected health care information ("PHI") under the Health Insurance Portability and Accountability Act of 1996 ("HIPAA"). The parties may receive or create from or on behalf of each other certain health or medical information PHI as defined in 45 C.F.R. Section 164.501) in connection with the performance of services under this Agreement. Use or disclosure of this PHI is subject to protection under state and federal law, including HIPAA and regulations promulgated there under by the U.S. Department of Health and Human Services ("Regulations"). The parties specifically agree that they will take such action as is necessary, including amending this Agreement, to implement in a timely manner the requirements of HIPAA, the Regulations, and other applicable laws relating to the security and confidentiality of PHI. Exception: Parties specifically agree that HIPAA applies to "covered entities" as defined by the HHS. Covered entities include: 1) health plans, 2) health care clearinghouses (such as billing services), and 3) health care providers that electronically transmit PHI; and that medical examiners and coroner offices are not covered entities pursuant to 45 C.F.R. § 160.102 -Applicability, and 45 C.F.R. § 160.103 — Definition, Covered Entity. As such, with coroner or medical examiner investigations/inquests concerning a "decedant", HIPPA requirements would not be applicable to this Agreement for DHHA provision of Laboratory Services to Weld County Coroner's Office. XXI. JOINT COMMISSION. DHHA shall provide services, as defined in this Agreement, within the scope of current Joint Commission standards. DHHA represents that it is aware of and in compliance with Joint Commission standards applicable to the services to be provided by DHHA under this Agreement. DHHA agrees that all services shall be performed in a manner consistent with Weld County Coroner's Office policies and procedures and applicable professional standards. DHHA shall provide fully qualified, trained, licensed and competent persons who shall provide services safely and effectively. DHHA shall maintain evidence for every person providing services hereunder of professional licensure and current clinical competence, which shall be provided to Weld County Coroner's Office upon request. XXII. DEBARMENT. Each party hereby represents that neither it nor its directors, officers, or employees are currently excluded, debarred, proposed for debarment, or otherwise ineligible to participate in federal health care programs or in federal procurement or non -procurement programs; nor have they been convicted of a criminal offense related to the provision of health care items or services. Each party further agrees to notify the other party within three (3) days should it or any of its directors, officers, or employees become a debarred person during the term of this Agreement. XXIII. CONFIDENTIALITY. DHHA acknowledges that in order to perform under this Agreement, either Party may provide or receive certain confidential information identified by the disclosing Party to the receiving Party as confidential. Parties acknowledge that the restrictions contained in this section are reasonable and necessary for the protection of the legitimate interests of each Party. Parties acknowledges that, in providing services and materials to the other Party in 6 connection with this Agreement, Parties will be exposed to certain confidential information owned and/or developed by the other Party. Such information shall be considered Confidential Information. This Agreement imposes no obligation upon a Party who receives Confidential Information where such Confidential Information: (i) is in the Party's (the "Recipient") possession before receipt from the other Party (the "Discloser"); (ii) is or becomes a matter of public knowledge through no fault of the Recipient; (iii) is rightfully received by the Recipient from a third party without a duty of confidentiality; (iv) is independently developed by the Recipient; (v) is disclosed by the Recipient under operation of law provided the Recipient gives the Discloser prompt notice of the requirement to disclose and the opportunity to contest such disclosure; or (vi) is disclosed by the Recipient with the Discloser's prior written approval. The Receiving Party shall ensure that each of its employees, officers, directors, or agents who has access to Confidential Information disclosed under this Agreement is informed of its proprietary and confidential nature and is required to abide by the terms of this Agreement. The Receiving Party shall take security precautions equal to or greater than the security precautions the Receiving Party employs to protect its own highly confidential information, but in any event not less than reasonable security precautions, to protect from disclosure and to keep confidential the Confidential Information of the Disclosing Party. The Receiving Party shall promptly notify the Disclosing Party of any disclosure of such Confidential Information in violation of this Agreement or of any subpoena or other legal process requiring production or disclosure of said Confidential Information, and in any event, such notice shall occur in advance of any production of Confidential Information. Additionally, production of any Confidential Information pursuant to an order, subpoena or legal proceeding shall not cause Confidential Information to lose its confidential status and Recipient shall continue to take all reasonable and necessary steps to protect its confidentiality during such use, to the extent possible. All Confidential Information disclosed under this Agreement shall be and remain the property of the Disclosing Party and nothing contained in this Agreement shall be construed as granting or conferring any rights to such Confidential Information to the other Party. Each Party shall use Confidential Information only for the Purpose. The Receiving Party shall honor any request from the Disclosing Party to promptly return or destroy all copies of Confidential Information disclosed under this Agreement and all notes related to such Confidential Information. The Parties agree that the Disclosing Party will suffer irreparable injury if its Confidential Information is made public, released to a third party, or otherwise used or disclosed in breach of this Agreement and that the disclosing Party shall be entitled to obtain injunctive relief against a threatened breach or continuation of any such breach and other relief as allowed under law. XXIV. NON -DISCLOSURE. Both parties agree that now and fora period of five (5) years following termination of this Agreement: (i) they will hold the other's Confidential Information in confidence, and will not, without the other's written consent, disclose any portion thereof to any third party; (ii) they will restrict dissemination of the other's Confidential Information within its organization to those persons who have a need to know such information in order to perform under this agreement; (iii) they will take such actions as are necessary, including appropriate agreement with or instructions to its employees, to enable it to perform its obligations hereunder, and for no other purpose; and (iv) any Confidential Information disclosed by one party to the other or its employees prior to the date of the agreement shall be subject to this Agreement. 7 XXV. PARAGRAPH HEADINGS. The captions and headings set forth herein are for convenience of reference only, and shall not be construed so as to define or limit the terms and provisions hereof. XXVI. EXECUTION OF AGREEMENT. This Agreement is expressly subject to, and shall not be or become effective or binding on any party hereto until it has been fully executed by all parties hereto. This Agreement shall be binding on all parties, their successors and assigns. XXVII. FORCE MAJEURE. Neither party shall be liable for failure to perform solely caused by unforeseeable Force Majeure circumstances beyond their control ("Force Majeure") including strikes, riots, floods, fires, explosions, acts of nature, acts of government, or labor disturbances. The party experiencing the Force Majeure circumstances must notify the other party of the delay as soon as reasonably possible and cooperate in minimizing the impact of such Force Majeure. XXVIII. NOTICES. Notices concerning termination of this Agreement, notice of alleged or actual violation of the terms or provision of this Agreement, and other notices shall be provided to the parties at the following addresses: If to DHHA: Denver Health and Hospital Authority Office of General Counsel 660 Bannock Street, 5th Floor, Mail Code 1919 Denver, Colorado 80204 If to Weld County Coroner's Office: Weld County Coroner's Office 1121 M Street Greeley, CO 80631 Said notice shall be delivered personally during normal business hours to the appropriate office, above, or by prepaid U.S. mail. Mailed notice shall be deemed effective three (3) days after deposit with the U.S. Postal Service. The parties may from time -to -time designate substitute addresses or persons where and to whom such notices are to be mailed or delivered but such substitutions shall not be effective until actual receipt of written notification. XXIX. COUNTERPARTS OF AGREEMENT. This Agreement may be executed in multiple, identical counterparts, each of which shall be deemed to be an original, and all of which, taken together, shall constitute one and the same instrument. Signatures to this Agreement transmitted by facsimile transmission, by electronic mail in "portable document format" (".pdf') form, or by any other electronic means intended to preserve the original graphic and pictorial appearance of the Agreement, shall have the same effect as physical delivery of the paper Agreement bearing the original signature. 8 DocuSign Envelope ID: 421B5971-7462-4AA7-83DC-4ED96AC8C822 XXX. ENTIRE AGREEMENT: AMENDMENT. This Agreement reflects the entire Agreement of the parties with respect to the subject matter hereof and supersedes all prior oral or written statements, understandings, or correspondence, if any, with respect thereto. This Agreement may be amended only by one or more mutually agreed upon amending agreements in the form of an amendment, executed in the same manner as this Agreement IN WITNESS WHEREOF, the parties have caused this Agreement to be executed as of the day and year first above written. DENVER HEALTH AND HOSPITAL AUTHORITY Tax ID No. 84-1343242 e-DocuSigned by: YtI��A.U/ By Chief Operating Officer Contract # 11120 ATTEST. dall4- ;‘A Weld �ou�n Clerk to the B BY Kris Gaw BOARD OF COUNTY COMMISSIONERS WELD CO ' `. COLO'� 7C__-- O Kevin D. Ross, Chair FEB 2 12024 9 ,.goa 0/-02.. EXHIBIT A SUBMITTED TO WELD COUNTY CORONER UNDER SEPARATE DOCUMENT 10 Denver Health Medical Center Department of Pathology Laboratory Services 2020-2022 Outreach Fee Schedule Exhibit A CP Lab Tests **CP Lab Fee Maximum Turnaround Times ACETAMINOPHEN $ 114.43 60 minutes ALANINE AMINO TRANSFERASE (ALT) $ 5.30 60 minutes ALBUMIN $ 4.95 60 minutes ALKALINE PHOSPHATASE $ 5.18 60 minutes AFP $ 16.77 24-48 hours AMMONIA $ 14.57 60 minutes AMYLASE $ 6.48 60 minutes ANA SCREEN $ 12.09 48-72 hours ASPARTATE AMINOTRANSFERASE -AST $ 5.18 60 minutes AUTOMATED CBC $ 6.47 60 minutes AUTOMATED CBC w/ DIFF $ 7.77 60 minutes AUTOMTD RETICULOCYTE CNT $ 7.77 60 minutes BASIC METABOLIC PANEL $ 8.46 60 minutes BILIRUBIN DIRECT $ 5.02 60 minutes BILIRUBIN TOTAL $ 5.02 60 minutes B -Type NATURIURETIC PEPTIDE - BNP $ 39.26 60 minutes Blood Gas - Venous $ 26.07 60 minutes Blood Gas - Arterial $ 26.07 60 minutes Blood Culture Multiplex PCR 35.09 x20 = $701.80 4 hour BLOOD/URIC ACID $ 4.52 60 minutes BODY FLUID PH $ 3.58 60 minutes BODY FLUID CELL COUNT $ 4.72 60 minutes C3 $ 12.00 60 minutes C4 $ 12.00 60 minutes CA 125 $ 20.81 24 hours CA 153 $ 20.81 24 hours CD4 $ 26.78 24 hours CALCIUM $ 1.16 60 minutes CALCIUM; IONIZED $ 13.68 60 minutes CARBAMAZEPINE TOTAL $ 14.57 60 minutes CARBON DIOXIDE - CO2 $ 4.88 60 minutes CARBON MONOXIDE $ 12.32 60 minutes CBC w/Manual Differential $ 7.77 6 hours CCP ANTIBODY $ 12.95 48-72 hours CD3/CD4/CD8 $ 84.68 24-48 hours CEA $ 18.96 60 minutes CERULOPLASMIN $ 10.74 60 minutes CHG DECALCIFY TISSUE $ 12.23 6 hours CHG SURG PATH, LEVEL V $ 82.47 6 hours CHLORIDE $ 4.60 60 minutes CHOLESTEROL $ 4.35 60 minutes CK (CPK) $ 6.51 60 minutes COMPREHEN METABOLIC PANEL $ 10.56 60 minutes Page 1 of 9 Denver Health Medical Center Department of Pathology Laboratory Services 2020-2022 Outreach Fee Schedule Exhibit A CORTISOL $ 16.30 60 minutes C -REACTIVE PROTEIN $ 5.18 24 hours C-DIFFICILE TOXIN Rapid test $ 23.96 1-4 hours (daily 7am-11pm) C-Difficile Toxin by PCR $ 37.27 24-48 hours CREATININE $ 5.12 60 minutes CREATININE CLEARANCE TEST $ 9.46 60 minutes CULTURE AEROBIC ID $ 12.89 Prelim report 2-5 days CULTURE ANAEROBE ID $ 17.55 Prelim report 2-5 days CULTURE BACTERIA OTHER $ 9.47 Prelim report 2-5 days CULTURE BLOOD FOR BACTERIA $ 10.32 Prelim report 2-5 days CULTURE BONE $ 18.77 6 hours CULTURE CSF $ 15.30 Prelim report 2-5 days CULTURE FLUID $ 15.30 Prelim report 2-5 days CULTURE FUNGI ID YEAST (FUNC) $ 8.41 Prelim report 2-5 days CULTURE FUNGUS ID & Mold $ 27.14 Prelim report 2-5 days CULTURE GENITAL $ 8.62 Prelim report 2-5 days CULTURE HERPES HSV $ 26.07 Prelim report 2-5 days CULTURE MRSA $ 6.63 Prelim report 2-5 days CULTURE RESPIRATORY $ 8.62 Prelim report 2-5 days CULTURE SCREEN ONLY $ 8.62 Prelim report 2-5 days CULTURE STREP B $ 6.63 Prelim report 2-5 days CULTURE STOOL $ 9.44 Prelim report 2-5 days CULTURE TISSUE $ 14.50 Prelim report 2-5 days CULTURE URINE $ 8.07 Prelim report 2-5 days CULTURE WOUND $ 8.62 Prelim report 2-5 days CHLAMYDIA/GONORRHEA PCR (CT/NG) $ 70.18 24-48 hours Cryptococcal Antigen, CSF $ 16.07 24-48 hours D-DIMER $ 9.72 6 hours DIGOXIN $ 13.28 60 minutes DRUG ABUSE PANEL 6 $ 62.14 60 minutes E TEST $ 4.75 6 hours ELECTROLYTE PANEL $ 7.01 60 minutes ESTRADIOL $ 27.94 60 minutes ETOH Ethyl Alcohol $ 114.43 60 minutes FACTOR 2 PROTHROMBIN $ 65.69 24-48 hours FACTOR 5 LEIDEN $ 73.37 24-48 hours FECAL FAT $ 5.10 60 minutes FERRITIN $ 13.63 60 minutes FIBRINOGEN $ 9.72 60 minutes FOLIC ACID - FOLATE $ 14.70 60 minutes FOLIC ACID RBC $ 17.65 24-48 hours FREE THYROXINE (FT4) $ 9.02 60 minutes FLURSV PCR $ 142.63 24 hours FLU Rapid $ 16.55 60 minutes Page 2 of 9 Denver Health Medical Center Department of Pathology Laboratory Services 2020-2022 Outreach Fee Schedule Exhibit A FSH $ 18.58 60 minutes GENTAMICIN $ 16.38 60 minutes GI - PCR Panel $ 416.78 1-4 hours (daily lam-11pm) GGT $ 7.20 60 minutes GLUCOSE BLOOD QUANT $ 3.93 60 minutes GLUCOSE OTHER FLUID $ 3.93 60 minutes GLUCOSE TEST $ 12.87 60 minutes GLYCOSYLATED HEMOGLOBIN (HBA1c) $ 9.71 60 minutes GRAM NEGATIVE COMBO SUSCEPTIBILITY $ 8.65 6 hours GRAM POSITIVE COMBO SUSCEPTIBILITY $ 8.65 6 hours GRAM POSITIVE SUSCEPTIBILITY $ 8.65 6 hours SMEAR GRAM STAIN $ 4.27 60 minutes HAPTOGLOBIN QUAN $ 12.58 60 minutes HCG Urine Qualitative $ 8.61 60 minutes HCG Serum Qualitative $ 7.52 24 hours HCG Serum Quant $ 15.05 24 hours HDL $ 8.19 60 minutes HELICOBACTER PYLORI IgG $ 16.85 24-48 hours HEMATOCRIT $ 2.37 60 minutes HEMAGLOBIN $ 2.37 60 minutes HbA1c $ 9.71 60 minutes HEPATIC FUNCTION PANEL $ 8.17 60 minutes HEPATITIS A IgM $ 11.26 24-48 hours HEPATITIS A Total $ 12.39 24-48 hours HEPATITIS B SURFACE ABY $ 10.74 24-48 hours HEPATITIS B SURFACE AG El $ 10.33 24-48 hours HEPATITIS B Core IGM $ 11.77 24-48 hours HEPATITIS B Core Total $ 12.05 24-48 hours HEPATITIS C AB TEST $ 11.77 24-48 hours HEPATITIS C RNA Viral Load $ 42.84 24-48 hours HEPARIN ASSAY-unfractionated $ 18.37 60 minutes HEPARIN ASSAY -low molecular weight $ 13.09 60 minutes HIV -1 DNA Viral Load $ 85.10 24-48 hours HIV 1/2/O 4th generation $ 24.08 24 hours HIV RAPID TEST $ 8.89 60 minutes HPV by PCR $ 35.09 24-48 hours HSV by PCR $ 35.09 36 hours IgA $ 9.30 60 minutes IgG $ 9.30 60 minutes IgM $ 9.30 60 minutes IMMUNFIX E-PHORSIS/URINE/ $ 29.35 48-72 hours IMMUNOFIX E-PHORESIS SERU $ 22.34 48-72 hours IRON $ 6.47 60 minutes IRON BINDING TEST $ 8.74 60 minutes Page 3 of 9 Denver Health Medical Center Department of Pathology Laboratory Services 2020-2022 Outreach Fee Schedule Exhibit A KIRBY BAUER $ 7.48 6 hours LACTATE (LD) (LDH) ENZYME $ 6.04 60 minutes LACTIC ACID $ 11.57 60 minutes LH $ 18.52 60 minutes LIPASE $ 6.89 60 minutes LIPID PANEL $ 13.39 60 minutes LITHIUM $ 6.61 60 minutes MAGNESIUM $ 6.70 60 minutes MICROALBUMIN $ 5.78 60 minutes MICRO/AGAR DILUT-PER PLT $ 4.75 60 minutes MICROBE SUSCEPT Disk $ 8.65 24-48 hours MICROSCOPIC EXAM OF URINE $ 3.05 60 minutes Mycobateria MTB by PCR $ 41.68 24-48 hours MYCOBACTERIA CULTURE & Smear $ 22.87 24-48 hours NASAL SMEAR FOR EOSINOPHI $ 5.79 60 minutes OCCULT BLOOD $ 4.38 60 minutes OSMOLALITY Serum $ 6.61 60 minutes OSMOLALITY Urine $ 6.82 60 minutes OVA AND PARASITES SMEARS $ 26.88 24-48 hours PARATHYROID HORMONE - PTH $ 41.28 24-48 hours PERTUSSIS PCR $ 35.09 24-48 hours PHENYTOIN TOTAL $ 13.25 60 minutes PHOSPHORUS $ 4.74 60 minutes POTASSIUM $ 4.76 60 minutes PREALBUMIN $ 14.59 60 minutes PROLACTIN $ 19.38 60 minutes PROCALCITONIN (PCT) $ 27.22 60 minutes PROTEIN E-PHORESIS SERUM $ 10.74 24-48 hours PROTEIN E-PHORESIS/URINE/ $ 17.83 24-48 hours PROTEIN OTHER $ 3.67 60 minutes PROTEIN TOTAL SERUM $ 3.67 60 minutes PROTHROMBIN TIME (PT)/INR $ 4.29 60 minutes PTT (THROMBOPLASTIN TIME) $ 6.01 60 minutes PSA TOTAL $ 18.39 60 minutes Quantiferon Plus $ 61.98 3-5 days RAPID STREP ONLY $ 16.53 60 minutes RENAL FUNCTION PANEL $ 8.68 60 minutes RESPIRATORY PCR Panel (Multiplex) $ 522.05 1-4 days (daily 7am-11pm) RBC SED RATE AUTOMATED $ 2.70 60 minutes RHEUMATOID FACTOR QUANT $ 5.67 60 minutes RUBELLA ANTIBODY $ 14.39 60 minutes SALICYLATE $ 114.43 60 minutes SARS-COV2 BY PCR $ 51.00 48 Hours Scabies Prep $ 4.27 24-48 hours Page 4 of 9 Denver Health Medical Center Department of Pathology Laboratory Services 2020-2022 Outreach Fee Schedule Exhibit A SEROLOGIC AGGLUTINATION $ 5.18 24-48 hours SODIUM $ 4.81 60 minutes RPR Syphillis $ 4.27 24-48 hours SYNERGY QUAD $ 8.65 6 hours SYPHILLIS -Treponema $ 13.24 24-48 hours TESTOSTERONE $ 25.81 24-48 hours THYROID STIM HORMON - TSH $ 16.80 60 minutes THEOPHYLLINE $ 14.14 60 minutes TOTAL TESTOSTERONE $ 25.81 60 minutes Toxoplasma IgG $ 14.39 24-48 hours Toxoplasma IgM $ 14.41 24-48 hours TRANSFERRIN $ 12.76 60 minutes TRIGLYCERIDES $ 5.74 60 minutes TRIIODOTHYRONINE (T3) $ 14.18 24-48 hours TROPONIN QUANT $ 12.47 60 minutes UREA NITROGEN $ 5.56 60 minutes URIC ACID $ 4.52 60 minutes URINALYSIS AUTO W/ Reflex to Scope $ 2.25 60 minutes URINALYSIS AUTO W/SCOPE $ 3.05 60 minutes URINE ALBUMIN $ 7.78 60 minutes URINE AMYLASE $ 6.48 60 minutes URINE BARBITUATES $ 114.43 60 minutes URINE BENZODIAZEPINES $ 114.43 60 minutes URINE CALCIUM $ 6.48 60 minutes URINE CHLORIDE $ 5.75 60 minutes URINE COCAINE $ 62.14 60 minutes URINE CREATININE $ 5.18 60 minutes URINE ETOH $ 62.14 60 minutes URINE GLUCOSE $ 3.93 60 minutes URINE LSD $ 62.14 60 minutes URINE MICROALBUMIN $ 5.78 60 minutes URINE OSMOLALITY $ 6.82 60 minutes URINE OXYCODONE $ 62.14 60 minutes URINE PHENCYCLIDINE $ 114.43 60 minutes URINE PHOSPHORUS $ 5.78 60 minutes URINE POTASSIUM $ 4.73 60 minutes URINE PROTEIN $ 3.67 60 minutes URINE SODIUM $ 5.06 60 minutes URINE THC $ 62.14 60 minutes URINE/UREA-N $ 5.56 60 minutes URINE URIC ACID $ 5.08 60 minutes VANCOMYCIN $ 13.54 60 minutes VALPROIC ACID $ 13.54 60 minutes Venipuncture $ 12.90 N/A Page 5 of 9 Denver Health Medical Center Department of Pathology Laboratory Services 2020-2022 Outreach Fee Schedule Exhibit A Vitamin D 25 -OH 29.60 60 minutes VITAMIN B-12 $ 15.08 60 minutes Type & Screen $ 15.75 60 minutes Prenatal Type & Screen 15.75 60 minutes DAT 57.47 60 minutes Antibody ID Screen 113.51 60 minutes Antibody Titer 14.95 60 minutes AP Lab Tests AP Lab Fee Slide & Block $ 9.03/block & slide AFP 70.00 ALK 70.00 bcl-2 70.00 bcl-6 70.00 BerEp4 (Epithelial Specific Antigen) 70.00 b-HCG 70.00 BOB -1 $ 70.00 Breast Cocktail 70.00 BRST-2 70.00 C4d (Cell Marque) 70.00 Calcitonin 70.00 Calponin 70.00 Calretinin $ 70.00 CD1a 70.00 CD3 70.00 CD4 $ 70.00 CD5 $ 70.00 CD7 70.00 CD8 70.00 CD10 $ 70.00 CD15 $ 70.00 CD19 $ 70.00 CD2O 70.00 CD21 Cell Marque 70.00 CD23 70.00 CD30 70.00 CD31 70.00 CD34 70.00 CD43 70.00 CD44 Cell Marque $ 70.00 CD45 1 $ 70.00 CD56 I $ 70.00 CD57 1 $ 70.00 CD61 70.00 Page 6 of 9 Denver Health Medical Center Department of Pathology Laboratory Services 2020-2022 Outreach Fee Schedule Exhibit A CD68 $ 70.00 CD79a $ 70.00 CD99 $ 70.00 CD117 117 $ 70.00 CD138 $ 70.00 CDX2 $ 70.00 CEA(m) $ 70.00 CEA(p) $ 70.00 Chromo $ 70.00 CK5/6 (Cell Marque) $ 70.00 CK7 $ 70.00 CK8/18 (CAM 5.2) $ 70.00 CK19 $ 70.00 CK2O $ 70.00 CMV $ 70.00 Cyclin D1 $ 70.00 D2-40 Biocare $ 70.00 Desmin $ 70.00 EBER $ 70.00 E-Cadherin $ 70.00 EGFr Dako $ 70.00 EMA $ 70.00 ER $ 70.00 Factor 13 70.00 Galectin 3 70.00 GFAP $ 70.00 Glypican 3 CellMarque $ 70.00 HepPar 1 $ 70.00 Her2Neu $ 160.00 HHVS CM $ 70.00 H M B45 $ 70.00 H M W-cyto $ 70.00 H. pylori Biocare $ 70.00 HSV 1&2 $ 70.00 IgA Cell Marque $ 70.00 Inhibin $ 70.00 Kappa 70.00 Kappa Probe $ 70.00 Lambda $ 70.00 Lambda Probe $ 70.00 Melan A 70.00 M I B-1 70.00 MLH1 $ 70.00 MSA $ 70.00 Page 7 of 9 Denver Health Medical Center Department of Pathology Laboratory Services 2020-2022 Outreach Fee Schedule Exhibit A MSH2 $ 70.00 MSH6 Cell marque 70.00 MUC6 Cell Marque 70.00 MPO 70.00 Myogenin 70.00 Myosin Heavy Chain 70.00 Napsin A Cell Marque 70.00 Neurofilament 70.00 NSE 70.00 OCT2 70.00 OCT3/4 70.00 p16 70.00 p53 70.00 p57 CM 70.00 p63 Biocare 70.00 PAX -5 70.00 PAX -8 Cell Marque 70.00 Pan-cyto $ 70.00 PIN 4 Cocktail Biocare 70.00 PMS2 Cell Marque 70.00 FLAP 70.00 PR 70.00 PSA 70.00 PSAP 70.00 PSMA 70.00 RCC 70.00 5-100 70.00 SALL4 Biocare 70.00 SMA 70.00 SOX -2 70.00 SV40T Cell Marque 70.00 Synaptophysin 70.00 Tdt 70.00 Thyroglobulin 70.00 TTF-1 70.00 Tyrosinase 70.00 Uroplakin 70.00 Varicella Zoster 70.00 Vimentin 70.00 Von Willebrand Factor (Factor *) 70.00 WT -1 70.00 Reference Lab Testing* Page 8 of 9 Denver Health Medical Center Department of Pathology Laboratory Services 2020-2022 Outreach Fee Schedule Exhibit A * Reference Laboratory Test charges passed onto customer with a $10.00 handling fee applied per test. **CP Lab Fees are based on the 2020 Medicare Reimbursement Rate. Page 9 of 9 LABORATORY SERVICES AGREEMENT - DENVER HEALTH AND HOSPITAL AUTHORITY APPROVED AS TO SUBSTANCE: ��ia4I lac ew, NZ7 Department Head, or Elected Official APPROVED AS TO FUNDING: 4bimat Chief Financial Officer, or Controller APPROVED AS TO FORM: County Attorney Hello