Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutC11-025 Community Health Services Agreement r ,
AGREEMENT BETWEEN EAGLE COUNTY
AND COMMUNITY HEALTH SERVICES
FOR THE PROVISION OF PRENATAL HEALTH CARE SERVICES
This Agreement ( "Agreement ") dated as of this 1- day W 1 -1 , 2011, is
between the County of Eagle, State of Colorado, a body corporate an politic, by and through
its Board of County Commissioners ( "County "), with a mailing address of 500 Broadway,
Post Office Box 850, Eagle, CO 81631 and Community Health Services, Inc., a private non-
profit Colorado corporation with a mailing address of 0405 Castle Creek Road, Suite 6,
Aspen, CO 81611 ( "Contractor ").
WITNESSETH:
1 Whereas, the County, through its Department of Public Health, works to promote the health,
safety and welfare of County residents of all ages; and
Whereas, among the services County assures, in order to promote such health, safety and
welfare are prenatal health care services; and
1
Whereas, the use of outside providers of such services enhances the ability of the County to
promote such health, safety and welfare; and
1
Whereas, Contractor is a provider of such a service and wishes to contract with County.
Now, therefore, in consideration of the foregoing premises and the following promises,
County and Contractor enter into this Agreement.
I: SCOPE
A. Contractor shall provide timely prenatal health -care services, in accordance with
current ACOG medical standards, to low- income Eagle County residents from the Roaring
Fork Valley, with incomes at or below 185% of the federal poverty level who have been
referred to Contractor by County and agree to receive services from Contractor ( "Clients ").
These dollars shall be used solely to defray the cost of Contractor's provision of prenatal
services for to those Clients. County is responsible for the eligibility of each Client for
services, initializing the Medicaid application enrollment, and for maintaining files regarding
eligibility under the scope of this agreement. Contractor shall provide services for 70 Clients,
who are currently pregnant and have been referred by the County under this Agreement.
Contractor shall submit quarterly reports with numbers served and demographics (See
Section VLF below), in addition to quarterly invoices for payment.
II: TERM
This Agreement shall commence on January 1, 2011, and shall terminate on December 31,
2011.
III: COMPENSATION
1
OA I 02 �
A. During the term of this Agreement, Eagle County will pay to Contractor $550 for
each Client served by Contractor. County will reimburse Contractor on a quarterly basis for
Clients served during the previous quarter upon receipt of properly submitted invoices by
Contractor. The Contractor shall utilize these funds to offset the costs of the prenatal care
and care coordination services provided by the Contractor. Contractor shall be reimbursed
for services provided to Clients only after they have been deemed eligible by County.
County will not reimburse Contractor for services provided to Contractor' s patients before
they are deemed eligible Clients by County. The total cost of this Agreement shall not
exceed $38,500, absent an amendment to this agreement signed by both parties.
B. For reimbursement Contractor must submit invoices by the fifth business day of each
quarter. Invoices shall include a description of services performed for each Client during the
previous quarter. If County is not satisfied with the completeness of a submitted invoice,
County may request Contractor to either revise the invoice or provide additional information.
Fees will be paid within thirty (30) days of receipt of a proper and accurate invoice from
Contractor for Contractor's Services. Billings for services provided through December 31,
2011 must be submitted by January 10, 2012, in order to be eligible for reimbursement.
All invoices must be mailed or delivered in- person to the following address to ensure
proper payment. Invoices sent by fax or email will not be accepted.
Eagle County Public Health
550 Broadway
P.O. Box 660
Eagle, CO 81631
C. If, prior to payment of compensation, but after submission to County of a request
therefore by Contractor, County reasonably determines that payment as requested would be
improper because the services were not performed as prescribed by the provisions of this
Agreement, the County shall have no obligation to make such payment. If, at any time after
or during the Term or after termination of this Agreement as hereinafter provided or
expiration of this Agreement, County reasonably determines that any payment theretofore
paid by County to Contractor was improper because the services for which payment was
made were not performed as prescribed by the provisions of this Agreement, then upon
written notice of such determination and request for reimbursement from County, Contractor
shall forthwith return such payment to County. Upon termination of this Agreement as
hereinafter provided or expiration of the Term, any unexpended funds advanced by County to
Contractor shall forthwith be returned to County.
IV: PROHIBITIONS ON PUBLIC CONTRACT FOR SERVICES
If Contractor has any employees or subcontractors, Contractor shall comply with C.R.S. § 8-
17.5 -101, et seq., regarding Illegal Aliens — Public Contracts for Services, and this Contract.
By execution of this Contract, Contractor certifies that it does not knowingly employ or
contract with an illegal alien who will perform under this Contract and that Contractor will
participate in the E- verify Program or other Department of Labor and Employment program
2
•
( "Department Program ") in order to confirm the eligibility of all employees who are newly
hired for employment to perform work under this Contract.
A. Contractor shall not:
(i) Knowingly employ or contract with an illegal alien to perform work
under this contract for services; or
(ii) Enter into a contract with a subcontractor that fails to certify to the
Contractor that the subcontractor shall not knowingly employ or
contract with an illegal alien to perform work under the public contract
for services.
B. Contractor has confirmed the employment eligibility of all employees who are
newly hired for employment to perform work under this Contract through
participation in the E- verify Program or Department Program, as administered
by the United States Department of Homeland Security. Information on
Y P Y
applying for the E- verify program can be found at:
http:// www .dhs.gov /xprevprot/programs /gc 1185221678150. shtm
C. The Contractor shall not use either the E- verify program or other Department
Program procedures to undertake pre - employment screening of job applicants
while the public contract for services is being performed.
D. If the Contractor obtains actual knowledge that a subcontractor performing
work under the public contract for services knowingly employs or contracts
with an illegal alien, the Contractor shall be required to:
(i) Notify the subcontractor and the County within three days that the
Contractor has actual knowledge that the subcontractor is employing
or contracting with an illegal alien; and
(ii) Terminate the subcontract with the subcontractor if within three days
of receiving the notice required pursuant to subparagraph (i) of the
paragraph (D) the subcontractor does not stop employing or
contracting with the illegal alien; except that the Contractor shall not
terminate the contract with the subcontractor if during such three days
the subcontractor provides information to establish that the
subcontractor has not knowingly employed or contracted with an
illegal alien.
E. The Contractor shall comply with any reasonable request by the Department
of Labor and Employment made in the course of an investigation that the
department is undertaking pursuant to its authority established in C.R.S. § 8-
17.5- 102(5).
F. If a Contractor violates these prohibitions, the County may terminate the
3
contract for a breach of the contract. If the contract is so terminated
specifically for a breach of this provision of this Contract, the Contractor shall
be liable for actual and consequential damages to the County as required by
law.
G. The County will notify the office of the Colorado Secretary of State if
Contractor violates this provision of this Contract and the County terminates
the Contract for such breach.
V. TERMINATION
County may terminate this Agreement at any time and for any reason or no reason upon
written notice to Contractor specifying the date of termination, which date shall be not less
than ten (10) days from the date of the notice. In the event Contractor files for bankruptcy or
is declared bankrupt or dissolves, County may declare in writing that this Agreement is
terminated, and all rights of Contractor and obligations of County, except for payment of
accrued but unpaid fees and expenses, shall terminate immediately.
VI. CONTRACTOR'S DUTIES
A. All funds received by Contractor under this Agreement shall be or have been expended
solely for the purpose for which granted, and any funds not so expended, including funds lost
or diverted for other purposes, shall be returned to County.
B. Contractor shall maintain, for a minimum of 3 years, adequate financial and
programmatic records for reporting to County on performance of its responsibilities
hereunder. Contractor shall be subject to financial audit by federal, state or county auditors
or their designees. Contractor authorizes County to perform audits or to make inspections
during normal business hours, upon 48 hours notice to Contractor, for the purpose of
evaluating performance under this Agreement. Contractor shall cooperate fully with
authorized Public Health representatives in the observation and evaluation of the program
and records. Contractor shall have the right to dispute any claims of misuse of funds and seek
an amicable resolution with County.
C. Contractor shall comply with all applicable federal, state and local rules, regulations and
laws governing services of the kind provided by Contractor under this Agreement.
D. Contractor shall assure that the service described herein is provided to the County at a cost
not greater than that charged to other persons in the same community.
E. Contractor shall safeguard information and confidentiality of all clients in accordance
with rules of Eagle County Public Health, and the Health Information Privacy and
Accountability Act.
F. Contractor shall provide the County with a quarterly report of services that includes:
• Name of client
4
• Client's date of birth
• Date of first service
• Due date
• Week of pregnancy at first visit as Client
VII. NOTICE
Any notice required under this Agreement shall be given in writing b - registered or certified
Y q g g g Y g
mail; return requested t uested which shall be addressed as follows:
q
COUNTY: CONTRACTOR:
Eagle County Public Health Director Contact: Liz Stark
PO Box 660 Community Health Services, Inc.
Eagle, CO 81631 0405 Castle Creek Road, Suite 6
(970) 328 -8819 Aspen, Colorado 81611
Notice shall be deemed given three (3) days after the date of deposit in a regular depository
of the United States Postal Service.
VIII. ASSIGNMENT
Contractor shall not assign any of its rights or duties under this Agreement to a third party
without the prior written consent of County. County shall terminate this Agreement in the
event of any assignment without its prior written consent of County.
IX. MODIFICATION
Any revision, amendment or modification of this Agreement shall be valid only if in writing
and signed by all parties.
X. INSURANCE
Insurance Type Coverage Minimums
• Workers' Compensation Statutory
• Employers Liability, including $500,000
Occupational Disease
• Comprehensive General Liability, including $600,000 per occurrence or as specified
in
Broad Form Property Damage the Colorado Governmental Immunity
Act, whichever is greater
• Professional Liability Insurance $500,000 per occurrence
Contractor shall purchase and maintain such insurance as required above and shall provide
certificates of insurance in a form acceptable to County upon execution of this Agreement.
XI. MISCELLANEOUS
5
A. The relationship of Contractor to County is that of independent contractor. No agent,
employee or volunteer of Contractor shall be deemed to be an agent, employee or volunteer
of County.
B. In the event of litigation in connection with this Agreement, the prevailing party shall be
entitled to recover all reasonable costs incurred, including attorney fees, costs, staff time and
other claim related expense.
C. Invalidity or unenforceability of any provision of this Agreement shall not affect the other
provisions hereof, and this Agreement shall be construed as if such invalid or unenforceable
provision was omitted.
D. Contractor shall indemnify and hold harmless County, its Board of Commissioners, and
the individual members thereof, its agencies, departments, officers, agents, employees,
servants and its successors from any and all demands, losses, liabilities, claims or judgments,
together with all costs and expenses incident thereto which may accrue against, be charged to
or be recoverable from County, its Board of Commissioners, and the individual members
thereof, its agencies, departments, officers, agents, employees, servants and its successors, as
a result of the acts or omissions of Contractor, its employees or agents, in or in part pursuant
to this Agreement or arising directly or indirectly out of Contractor's exercise of its
privileges or performance of its obligations under this Agreement.
E. Contractor shall comply at all times and in all respects with all applicable federal, state
and local laws, resolutions, and codes.
F. Notwithstanding anything to the contrary contained in this Agreement, County shall have
no obligations under this Agreement after, nor shall any payments be made to Contractor in
respect of any period after, December 31st of the calendar year of the Term of this
Agreement, without an appropriation therefore by County in accordance with a budget
adopted by the Board of County Commissioners in compliance with the provisions of Article
25, Title 30 of the Colorado Revised Statutes, the Local Government Budget Law (C.R.S. §§
29 -1 -101 et seq.) and the TABOR Amendment (Colorado Constitution, Article X, Sec. 20).
G. This Agreement shall be governed by the laws of the State of Colorado. Jurisdiction and
venue for any suit, right or cause of action arising under, or in connection with this
Agreement shall be exclusive in Eagle County, Colorado.
H. This Agreement supersedes all previous communications, negotiations and/or agreements
between the respective parties hereto, either verbal or written, and the same not expressly
contained herein are hereby withdrawn and annulled. This is an integrated agreement and
there are no representations about any of the subject matter hereof except as expressly set
forth in this Agreement.
I. This Agreement does not, and shall not be deemed or construed to, confer upon or grant to
any third party or parties any right to claim damages or to bring any suit, action or other
6
proceeding against either Contractor or County because of any breach hereof or because of
any of the terms, covenants, agreements and conditions herein.
J. Contractor certifies that it has read the Agreement, understands each and every term and
the requirements set forth herein, and agrees to comply with the same.
In Witness Whereof, County and Contractor have executed this Agreement in triplicate on
the date set forth above. Two counterparts have been delivered to County and one to
Contractor.
COUNTY OF EAGLE, STATE OF COLORADO,
BY AND THROUGH ITS BOARD OF COUNTY
COMM _ . • NERS
..di L ,
By: INN
• � � ! , Cha n - 0 4 -(
CI, ATTEST: Gtx •
, i/ '
7.• ;,'. 4 1 ,4 .- ilk ''
Te . � C m onton f
Clerk to the Board of County Co n *o
Community Ialth ices
By: ,- '
Print Name: L1 z cr ` .d IC RiJ
Title: (AA (+0
c s1Q,cacia j
STATE OF
)SS.
COUNTY OF R\AA M`.- )
The oregoing instrument was acknowledged before me by �t , this - 2iay
11
of i! �
1� . I° 2.9.1t>' -' - y p
r , A I • 1 w �,•••• •*• 1
• , , _. A A ir � V a) ommission expires. l—)
Notary Public SUSAN • I f
i s : M ARKNOOD I
4 % •. .• r
t‘
x o f .
...-
%
EXHIBIT B
PROOF OF INSURANCE
(Certificate of insurance to be inserted as Exhibit B)
8
Print Date: 0 3/2 0/1 0
HEALTHCARE PROVIDERS
CNA SERVICE ORGANIZATION
PURCHASING GROUP
CERTIFICATE OF INSURANCE
OCCURRENCE POLICY FORM
EMEIVEZEMIZZEINERMEMOIDEBEEINIBMIAMESMISIZEIMEMINIMINIERIN
018098 970 HPG 02 6 5 8 5 0 8 7 9 from:12:01 AM Standard Time on: 04/29/10
to 12:01 AM Standard Time on: 04 29 11
IMMIMEMMEMIZEMENIESEMINIMMINEMENEMMEMEECIMENSISIGNIMINSumm
Community Health Services, Inc . Nurses Service Organization
405 Castle Creek Rd Ste 6 159 East County Line Road
Aspen, CO 8 1 6 1 1-3 1 2 5 Hatboro, PA 19040-1218
Medical Specialty: Code: linaTalina
Nurse Practitioner Firm 80965 American Casualty Company of Reading, Pennsylvania
333 S. Wabash Avenue, Chicago, IL 60604
A. PROFESSIONAL LIABILITY
Professional Liability (PL) $ 1,000,000 each claim $ 6,000,000 aggregate
Good Samaritan Liability included above numpassammessamm
Personarinjury Liability included above REENNWERWIMEME&CA
Mal I IITIIII IIIIu ded above IIIIIIIII1I
B. COVERAGE EXTENSIONS:
License Protection $ 25,000 ier froceeding $ 25,000 aggregate
Defendant Expense Benefit t: $ 25,000 aggregate
Deposition Representation liywyggimpaggitemstirm $ 10,000 aggregate
Assault $ 25,000 per incident $ 25,000 aggregate
Medical Payments $ 25,000 ser ierson $ 100 000 aggregate
First Aid 4 '41EfaiilkalVA,::., - 41TEME4:1 $ 10 , 0 00 aggregate
Damage to Property of Others $ 10,000 per incident $ 10,000 aggregate
C. WORKPLACE LIABILITY Coverage part C. Workplace Liability does not apply if Coverage part D. General Liability is made part of this policy.
Workplace Liability included in A. PL limit shown above
Fire & Water Legal Liability included in A. PL limit shown above subject to $150,000 sub-limit
Personal Liability ! A..°V4,0111061S:464.:4kdt*,:4: n°n e
D. GENERAL LIABILITY Coverage part a General Liability does not apply if Coverage part C. Workplace Liability is made part of this policy.
General Liability (GL) none none
- Hife - d Auto & Non OwnedAuto none OW.,1, V:Z.I.C10.3a2Li:gail it
Fire & Water Legal Liability none none
Personal Liability IMMIWIPZ M .4,611c none
Total: $ 3, 750. 0 0 QUESTIONS? CALL: 1-888-288-3534
EEMMISMEEMEMOMEMBENRIMINMENNO81188MMINNNVOMMIONIMEMBEIGNIMINSE
G-121500-D G-121503-C G-121501-C G-145184-A
G-147292-A GSL13424 GSL13425 G-123846-0O5 GSL3886
GSL3908
Master Policy # 188711433
Keep this document in a safe place. 11 and proof of payment are ovidence of your insurance coverage.
1 Pelf=C I CI)r 4 4 - 4/ A 7/Ai
Chairman of the Board Secretary
G-141241-A (07/2001) Coverage Change Date: Endorsement Change Date:
• ACORD CERTIFICATE OF LIABILITY INSURANCE UO22 T
05-28-2010
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
HUB INTERNATIONAL SW AGCY LTD /PHS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
344858 P: (866)467 - 8730 F: (877)905 - 0457 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PO BOX 33015
SAN ANTONIO TX 78265 INSURERS AFFORDING COVERAGE
INSURED INSURER A: Hartford Casualty Ins Co
INSURER B:
COMMUNITY HEALTH SERVICES INSURER C:
0405 CASTLE CREEK RD. STE 6 INSURER D:
ASPEN CO 81611 INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
/NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
LTR DATE IMM /DD /YY) DATE (MM /DD /YY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
A COMMERCIAL GENERAL LIABILITY 34 SBA PA6 3 6 0 04/23/10 0 4/ 2 3/ 11 FIRE DAMAGE (Any one fire) $300,000 _
CLAIMS MADE I X 1 OCCUR MED EXP (Any one person) $10,000 _
X General Liab PERSONAL & ADV INJURY s1,000,000
GENERAL AGGREGATE _ $2,000,00 0
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $2,000,000
7 POLICY JEo X LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
A ANY AUTO 34 SBA PA6360 04/23/10 04/23/11 (Ea accident)
ALL OWNED AUTOS
BODILY INJURY
SCHEDULED AUTOS (Per person)
X HIRED AUTOS
BODILY INJURY $
X NON -OWNED AUTOS (Per accident)
PROPERTY DAMAGE 3
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT $ _
ANY AUTO
OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY
EACH OCCURRENCE _ $
OCCUR CLAIMS MADE AGGREGATE $
DEDUCTIBLE
_ 3 _
RETENTION $ S
WORKERS COMPENSATION AND WC STATU- OTH-
EMPLOYERS' LIABILITY
TORY LIMITS ER
E.L. EACH ACCIDENT S
E.L. DISEASE - EA EMPLOYEE $
E.L. DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPEC /AL PROVISIONS
Those usual to the Insured's Operations. Colorado Department of Public Health
and Environment is listed as additional insured per the Business Liability
Coverage Form SS0008.
CERTIFICATE HOLDER X ADDITIONAL INSURED; INSURER LETTER: A CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
Colorado Department of Public Health 30 DAYS WRITTEN NOTICE (10 DAYS FOR NON- PAYMENT) TO THE CERTIFICATE
and Environment HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO
4300 CHERRY CREEK DR S OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
DENVER, CO 80248
AUTHORIZE REPRESENTATIVE
ACORD 25 -S (7/97) o
ACORD CORPORATION 1988
PINNACOL D7501 E enver, Lowry Blvd
Denr, CO 80230 -7006
ASSURANCE Phone: (303) 361 -4000 / (800) 873 -7242
Fax: (303) 361 -5000 / (888) 329 -2251
www.pinnacol.com
POLICY INFORMATION PAGE
Policy #: 2190342
Policy Type: ADVANCE
ITEM 1. INSURED:
COMMUNITY HEALTH SERVICES, INC.
COMMUNITY HEALTH SERVICES, INC.
%SERVICES, INC
0405 CASTLE CREEK RD #6
ASPEN CO 81611
PP /.00
ITEM 2. POLICY PERIOD: FROM 04/01/2010 TO 0 1 1
12:01 A.M. MOUNTAIN STANDARD TIME
ITEM 3. A. Workers' Compensation Insurance: Part One of the policy applies to the workers' compensation law of the
states listed here:
COLORADO
B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3 A. The
limits of our liability under part two are:
BODILY INJURY BY ACCIDENT $100,000 EACH ACCIDENT
BODILY INJURY BY DISEASE $100,000 EACH EMPLOYEE
BODILY INJURY BY DISEASE $500,000 POLICY LIMIT
C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here:
NONE
(Please contact Pinnacol Assurance for information on coverage outside the state of Colorado)
D. This policy includes the attached endorsements and schedules:
511 Other State Endorsement
CATO9 Catastrophe (Other than Certified Acts of Terrorism)
TER09 Terrorism Risk Insurance Program Reauthorization Act
ITEM 4. We will determine the premium for this policy by our manuals of rules, classifications, rates and rating plans.
All information required below is subject to verification and change by audit. The statements of estimated
advanced premium are also a part of this policy.
Pinnacol Assurance * 7501 E Lowry Blvd * Denver, CO 80230
Page 2 of 6 UB408 -
04/01/201 0 18.56:07 2190342 P4ALL