HomeMy WebLinkAboutCORRECTIONAL MANAGED CARE 1TABLE OF CONTENTS ~i'~ w~ ' ,
~FE~NCED CONTACT PROVISIONg ................................................................................. 1
I. ~TE~ATION OF T~8 ........................................................................................ 2
II. CO.IDEntITY ..................................................................................................... 2
III. DELEGATION ~ ASSIG~ENT ........................................................................... 2
IV. E~E~I~ ~ ~VE~ ~PORT ................................................................ 3
V. FACILIT~S, PA~ENTS A~ SERVICES .............................................................. 3
VI. ~E~ICATION ~ ~8~C~ ................................................................... 3
~I. ~8PECTION8 ~ A~ITS ...................................................................................... 4
VIII. [ICENS~ ~ [a~ ..................................................................................................... 5
IX. BASEL~ OBLIGATION ............................................................................................ 5
X. NO~ISC~ATION ................................................................................................... 5
XI. NOTICES ........................................................................................................................ 8
XII. SEVE~ILITY ............................................................................................................ 8
~II. STATUS OF CONT~CTOR ....................................................................................... 9
~V. TE~ .............................................................................................................................. 9
XV. TE~ATION ............................................................................................................. 9
XVI. TH~ P~TY BE~FICI~Y ................................................................................. 10
~II. WA~ER OF DEFA~T ............................................................................................. 10
E~BIT a ................................................................................................................................ 12
I. PAYMENTS ................................................................................................................. 12
II. DEF~TIONS .............................................................................................................. ] 2
III. SERVICe8 .................................................................................................................... 14
IV. ~DITION~ ~QU~MENTS .............................................................................. 16
INSURANCE ON FILE
WORK MAY PROCEED
UNTIL INSURANCE EXPIRE~J
..~1/~1,~2o (2 ....
CLERK 0[: CO'UNGIL
OATE: /.~/~/q ,~
AGREEMENT FOR THE PROVISION OF
INMATE MEDICAL SERVICES
BETWEEN
CITY OF SANTA ANA
CORRECTIONAL MANAGED CARE MEDICAL CORPORATION
THIS AGREEMENT, is entered into this 1st day of September 1998, which date is
enumerated for purposes of reference only, by and between the CITY OF SANTA ANA, a
charter city and municipal corporation duly organized and existing under the constitution and
laws of the State of California (CITY), and CORRECTIONAL MANAGED CARE MEDICAL
CORPORATION (CONTRACTOR).
WITNESSETH:
WHEREAS, CITY wishes to contract with CONTRACTOR for the provision of the
Inmate Medical Services described herein; and
WHEREAS, CONTRACTOR is agreeable to the rendering of such services on the
terms and conditions hereinatter set forth; and
NOW, THEREFORE, IT IS MUTUALLY AGREED AS FOLLOWS:
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Page 1 of 20
REFERENCED CONTRACT PROVISIONS
Term:
September 1, 1998 through August 31, 2001
"Period One" means the period September 1, 1998 through August 31, 1999
"Period Two" means the period September 1, 1999 through August 31, 2000
"Period Three" means the period September 1, 2000 through August 31, 2001
Maximum Obligation:
Period One Baseline Obligation
Period Two Baseline Obligation
Period Three Baseline Obligation
TOTAL BASELINE OBLIGATION:
Basis for Payment:
Net Thirty (30) Days
$546,232.00
$546,232.O0
$1,638,696.00
Notices to CITY and CONTRACTOR:
CITY:
City of Santa Ana
Santa Aha Jail
62 Civic Center Plaza
Santa Ana, CA 92702
CONTRACTOR:
Correctional Managed Care Medical Corporation
12862 Garden Grove Blvd, Suite 280
Garden Grove, CA 92843
Attention: RhobertaPaz, Director of Operations
CONTRACTOR'S Insurance Coverage:
Workers' Compensation and Employer's Liability
Professional Liability
Comprehensive General Liability Insurance )
Comprehensive Automobile Liability Insurance,)
covering the owned, non-owned and hired )
automobile hazards)
Statutory
$5,000,000
$2,000,000
Combined Single
Limit
Reimbursement Method: One-twelfth of total annual per diem, monthly
43 I. ALTERATION OF TERMS
44 This Agreement, together with Request for Proposal by CITY, Proposal by CONTRACTOR
45 and Exhibit A attached are incorporated herein by reference and fully express all understandings
46 of CITY and CONTRACTOR with respect to the subject matter of this Agreement, and shall
47 constitute the total Agreement between the parties for these purPoses. No addition to, or
48 alteration of, the terms of this Agreement, whether written or verbal, shall be valid unless made
49 in writing and formally approved and executed by both parties.
50 II. CONFIDENTIALITY
51 A. CONTRACTOR shall mainta'm the confidentiality of all records, including billings
52 and any audio and/or video recordings, in accordance with all applicable State and Federal codes
53 and regulations, as they now exist or may hereal~er be amended or changed. CONTRACTOR
54 agrees that all inmates served pursuant to this Agreement are patients of the City of Santa Ana's
55 Medical Services systmn and therefore, to the extent permitted under applicable law or
56 regulation, CONTRACTOR shall exchange information regarding specific patients with CITY.
57 B. Prior to providing any services pursuant to this Agreement, all employees,
58 subcontractors, and volunteer staff or interns of CONTRACTOR shall agree, in writing, with
59 CONTRACTOR to maintain the confidentiality of any and all information and records which
60 may be obtained in the course of providing such services. The agreement shall specify that it is
61 effective irrespective of all subsequent terminations of CONTRACTOR'S employees,
62 subcontractors, and volunteers or interns.
63 C. All Confidential Information furnished by CONTRACTOR to CITY hereunder will be
64 kept confidential by CITY and shall not, without the pr/or written consent of CONTRACTOR,
65 be disclosed by CITY, or by its representatives, contractors, or employees in any manner
66 whatsoever, in whole or in part, and shall not be used by CITY or its representatives, contractors,
67 or employees who need to know the Confidential Information.
68 III. DELEGATION AND ASSIGNMENT
69 A. CONTRACTOR may not delegate the obligations hereunder, either in whole or in
70 part, without prior written consent of CITY; however, obligations undertaken by
71 CONTRACTOR pursuant to this Agreement may be carried out by subcontracts, provided such
72 subcontracts are approved in writing by CITY, meet the requirements of this Agreement as they
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73 relate to the service or activity under subcontract, and include any provisions that CITY may
74 reasonably require. No subcontract shall terminate or alter the responsibilities of
75 CONTRACTOR to CITY pursuant to this Agreement.
76 B. CONTRACTOR may not assign the rights hereunder, either in whole or in part,
77 without the prior written consent of CITY.
78 IV. EXPENDITURE AND REVENUE REPORT
79 No later than sixty (60) days following Period One, Period Two, and Period Three of this
80 Agreement, CONTRACTOR shall submit to CITY, for informational purposes only, an
81 Expenditure and Revenue Report for that period. Such report shall be prepared in accordance
82 with the format that is provided by CITY.
83 V. FACILITIES. PAYMENTS AND SERVICES
84 CITY shall compensate CONTRACTOR, and CONTRACTOR agrees to provide the
85 services, staffing, any equipment and supplies, and reports in accordance with Exhibit A to this
86 Agreement. CONTRACTOR shall operate continuously throughout the term of this Agreement
87 with at least the required number and type of staff which meet applicable CITY, State and
88 Federal requirements, and which are necessary for the provision of the services hereunder.
89 VI. INDEMNIFICATION AND INSURANCE
90 A. Each party hereto shall indemnify and hold harmless the other party and its directors,
91 officers, employees, representatives and agents, including any subsidiaries providing the services
92 hereunder, from and against any claim, liability, loss or cost and shall defend any action,
93 proceeding or claim against the indemnified party or its directors, officers, employees,
94 representatives or agents, including any subsidiaries providing services hereunder, arising out of
95 or connected with any act or omission of the indemnifying party under this Agreement or any of
96 its directors, officers, employees, representatives or agents, including any subsidiaries providing
97 services hereunder, or the conditions of property used in the performance of this Agreement.
98 B. CITY warrants that it is self-insured or maintains policies of insurance placed with
99 reputable insurance companies licensed to do business in the State of California which insure the
100 perils of bodily injury, professional liability and property damage.
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101 C. Without limiting CONTRACTOR'S indemnification, CONTRACTOR shall maintain
102 in force at all times during the term of this Agreement a policy or policies of insurance, or a Self
103 Insurance Program acceptable to CITY, as specified on Page 1 of this Agreement.
104 D. Any person providing Physician Services pursuant to this Agreement shall maintain
105 Professional Liability insurance against medical malpractice with an insured limit of not less
106 than $1,000,000 per occurrence and $3,000,000, in the aggregate, per year.
107 E. Certificates of Insurance evidencing the above coverage's and clauses shall be given to
108 CITY as referenced on Page 1 of the Agreement. Such insurance shall: (1) Name the City of
109 Santa Ana, its officers, agents, employees and representatives as additional insureds; (2) Be
110 primary with respect to insurance or self insurance programs maintained by the CITY; (3)
111 Contain standard separation of insured provisions; and (4) Give to the CITY prompt and timely
112 notice of claim made or suit instituted arising out of the contractor's operations hereunder.
VII, INSPECTIONS AND AUDITS
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115 A. CITY, any authorized representative of CITY, any authorized representative of the
116 State of California, the Secretary of the United States Department of Health and Human
117 Services, the Comptroller General of the United States, or any of their authorized representatives,
118 shall have access to any books, documents, and records, including but not limited to, medical and
119 client records, of CONTRACTOR which such persons deem pertinent to this Agreement, for the
120 purpose of conducting an audit, evaluation, examination, or making transcripts during the
121 periods of retention set forth in the Records paragraph of Exhibit A to this Agreement. Such
122 persons may at all reasonable times, inspect or otherwise evaluate the services provided pursuant
123 to this Agreement, and the premises in which they are provided.
124 B. CONTRACTOR shall actively participate and cooperate with any person specified in
125 subparagraph A. above in any evaluation or monitoring of the services provided pursuant to this
126 Agreement, and shall provide the above-mentioned persons adequate office space to conduct
127 such evaluation or monitoring.
128 C. Following an audit report, in the event of non-compliance with applicable laws and
129 regulations governing funds provided through this Agreement, CITY may terminate this
130 Agreement as provided for in the Termination paragraph or direct CONTRACTOR to
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131 immediately implement appropriate corrective action. A plan of correction shall be submitted to
132 CITY in writing within thirty (30) days after receiving notice from CITY.
133 D. Within fourteen (14) days of receipt by CONTRACTOR, CONTRACTOR shall
134 forward to CITY a copy of any audit report. Such audit shall include, but not be limited to,
135 management, financial, programmatic or any other type of audit of CONTRACTOR'S
136 operations, whether or not the cost of such operation or audit is reimbursed, in whole, or in part
137 through this Agreement.
138 VIII. LICENSE AND LAW
139 A. CONTRACTOR and all of its employees and subcontractors providing services
140 pursuant to this Agreement shall, throughout the term of this Agreement, maintain all necessary
141 licenses, permits, approvals, c~-fificates, waivers and exemptions required by the laws and
142 regulations of the United States, the State of California, CITY and any other applicable
143 governmental agencies necessary for the provision of the services hereunder. CONTRACTOR
144 shall notify CITY immediately in writing of its inability to obtain or maintain, such permits,
145 licenses, approvals, certificates, waivers and exemptions irrespective of the pendency of any
146 appeal. The refusal of any such application, irrespective of appeal shall also require written
147 notification to CITY. Said inability may be cause for termination of this Agreement.
148 B. CONTRACTOR, all of its employees and subcontractors providing services pursuant
149 to this Agreement, shall be further subject to and comply with all applicable governmental laws,
150 regulations, and requirements as they exist now or may be hereafter amended.
151 C. CONTRACTOR warrants that all CONTRACTOR physicians providing services
152 under this Agreement are and will continue to be as long as this Agreement remains in effect, the
153 holders of currently valid unrestricted licenses to practice medicine in the State of California.
154 IX. BASELINE OBLIGATION
155 The Baseline Obligations of CITY for services provided pursuant to this Agreement are as
156 specified on Page 3 of this Agreement.
157 X. NONDISCRIMINATION
158 A. Employment - Affirmative Action shall be taken to ensure that applicants are
159 employed, and that employees are treated during employment without regard to their ethnic
160 group identification, race, religion, ancestry, color, creed, sex, marital status, national origin, age,
161 sexual preference, medical condition, or physical or mental disability. Such affirmative action
162 shall include, but not be limited to the following: employment, upgrading, demotion or transfer;
163 recruitment or recruitment advertising; layoff or termination; rate of pay or other forms of
164 compensation; and selection for training, including apprenticeship.
165 There shall be posted in conspicuous places, notices available to employees and applicants for
166 employment available fi.om CITY and/or the United States Equal Employment Opportunity
167 Commission setting forth the provisions of the Equal Opportunity Clause.
168 1. All solicitations or advertisements for employees placed by or on behalf of
169 CONTRACTOR shall state that all qualified applicants will receive consideration for
170 employment without regard to ethnic group identification, race, religion, ancestry, color, creed,
171 sex, marital status, national origin, age (over 40), sexual preference, medical condition, or
172 physical or mental disability.
173 2. Each labor union or representative of workers with which CONTRACTOR has a
174 collective bargaining agreement or other contract or understanding must post a notice advising
175 the labor union or workers' representative of CONTRACTOR'S equal opportunity obligations,
176 and shall post copies of the notice in conspicuous places available to employees and applicants
177 for employment.
178 3. In the event of non-compliance with this paragraph or as otherwise provided by
179 State and Federal law, all or part of this Agreement may be terminated or suspended, and
180 CONTRACTOR may be ineligible for further contracts.
181 B. Services, Benefits, and Facilities - CONTRACTOR shall not discriminate in the
182 provision of services, the allocation of benefits, or the accommodation in facilities on the basis of
183 ethnic group identification, race, color, religion, ancestry, creed, sex, national origin, marital
184 status, age, sexual preference, medical condition, or physical or mental disability in accordance
185 with Title IX of the Education Amendments of 1972; Title VI of the Civil Rights Act of 1964 (42
186 U.S.C. §200-d); the Age Discrimination Act of 1975 (42 U.S.C. §6101); Article 9.5, Chapter 1,
187 Part 1, Division 2, Title 2, (Section 11135, et, seq.) of the California Government Code; and Title
188 9, Chapter 4, Subchapter 6 (Section 10800, et seq.) of the California Code of Regulations, and all
189 other pertinent rules and regulations promulgated pursuant thereto, and as otherwise provided by
190 law and regulation, as all may now exist or be hereafter amended or changed.
191 1. For the purpose of this subparagraph B., "discrimination" means denying a client
192 or potential client any service, benefit, or accommodation that would be provided to another and
193 includes, but is not limited to, the following:
194 a) Denying a client any service or benefit or availability of a facility.
195 b) Providing any service or benefit to a client which is different or is
196 provided in a different manner or at a different time fi.om that provided to other clients.
197 c) Restricting a client in any way in the enjoyment of any advantage or
198 privilege enjoyed by others receiving any service or benefit.
199 d) Treating a client differently fi.om others in satisfying any admission
200 requirement or condition, or eligibility requirement or condition, which individuals must meet in
201 order to be provided any service or benefit.
202 e) Assignment of terms or places for the provision of services on the basis of
203 ethnic group identification, race, religion, ancestry, color, creed, sex, marital status, national
204 origin, age, sexual preference, medical condition, or physical or mental disability of the clients to
205 be served.
206 2. Compla'mt Process - All complaints alleging discrimination in the delivery of
207 services because of ethnic group identification, race, religion, ancestry, creed, color, sex, marital
208 status, national origin, age, sexual preference, medical condition, or physical or mental disability
209 may be resolved by the State through the State of California's Affirmative Action Complaint
210 Process.
211 C. Persons with Disabilities - CONTRACTOR agrees to comply with the provisions of
212 Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794 et seq., as implemented in Title 45
213 CFR, Section 84.1 et. seq.), pertaining to the prohibition of discrimination against qualified
214 persons with disabilities in all programs or activities, and the Americans with Disabilities Act of
215 1990 (42 U.S.C. 12101 et. seq.) as they exist now or may be hereafter amended together with
216 succeeding legislation.
217 D. Retaliation - Neither CONTRACTOR, nor its employees or agents shall intimidate,
218 coeme or take adverse action against any person for the purpose of interfering with rights
219 secured by Federal or State laws, or because such person has filed a complaint, certified, assisted
220 or otherwise participated in an investigation, proceeding, hearing or any other activity
221 undertaken to enforce rights secured by Federal or State law.
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223 A. Unless otherwise specified, ail notices, claims, correspondence, reports and/or
224 statements authorized or required by this Agreement shall be effective when written and
225 deposited in the United States mail, first class postage prepaid and addressed as specified on
226 Page 3 of this Agreement.
227 B. Termination Notices shall be effective when written and deposited in the United States
228 Mail, certified, return receipt requested, and addressed as specified on Page 3 of this Agreement.
229 C. NOTIFICATION OF DEATH - Upon becoming aware of the death of any person
230 receiving services hereunder, CONTRACTOR shall immediately, in person or by telephone,
231 notify the on-premises Jail Administrator &/or Designee, the Orange County Coroner, and the
232 Orange County District Attorney. In addition, CONTRACTOR shall, within sixteen (16) hours
233 after such death, deliver in person or by facsimile machine, a Written Notification of Death to the
234 above persons. The telephone report and Written Notification of Death shall contain the name of
235 the deceased, the date and time of death, the nature and circumstances of death, and the name(s)
236 of CONTRACTOR'S officers or employees with knowledge of this matter. Upon request, and to
237 the extent allowable by law, CONTRACTOR shall provide the Coroner, District Attorney, Jail
238 Administrator &/or Designee with a complete copy of the deceased patient's medical record.
239 D. NOTIFICATION OF SPECIAL INCIDENTS - Immediately upon becoming aware of
240 any occurrence of a serious nature which may expose either party to liability or disrupt the
241 services hereunder, CONTRACTOR shall verbally notify the on-premises Jail Administrator
242 &/or Designee. Such occurrences may include but are not limited to accidents, injuries, or acts of
243 negligence, or any incident or cimumstance which adversely impacts the capacity of
244 CONTRACTOR to provide the services hereunder. Such verbal notification shall be followed,
245 within twenty-four (24) hours, by written notification to CITY, the Jail Administrator &/or
246 Designee.
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249 If a court of competent jurisdiction declares any provision of this Agreement or application
250 thereof to any person or circumstances to be invalid or if any provision of this Agreement
251 contravenes any Federal, State, or locai statute, ordinance, or regulation, the remaining
252 provisions of this Agreement or the application thereof shall remain valid, and the remaining
253 provisions of this Agreement shall remain in full force and effect, and to that extent the
254 provisions of this Agreement are severable.
255 XIII. STATUS OF CONTRACTOR
256 CONTRACTOR is, and shall at all times be deemed to be, an independent contractor, wholly
257 responsible for the manner in which it performs the services hereunder. CONTRACTOR is
258 entirely responsible for compensating staff and consultants employed by CONTRACTOR. This
259 Agreement shall not be construed as creating the relationship of employer and employee, or
260 principal and agent, between CITY and CONTRACTOR or any of CONTRACTOR'S agents,
261 employees or subcontractors. CONTRACTOR assumes exclusive responsibility for acts of its
262 employees, agents, or subcontractors as they relate to the services provided during the course and
263 scope of their employment. CONTRACTOR'S employees, agents, or subcontractors shall not be
264 entitled to any rights or privileges of CITY employees, nor be considered in any manner to be
265 City employees.
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267 The term of this Agreement shall commence and terminate as specified on Page 1 of this
268 Agreement, unless otherwise sooner terminated as provided herein; provided, however,
269 CONTRACTOR shall be obligated to perform such duties as would normally extend beyond this
270 term including, but not limited to, obligations with respect to indemnification, audits, reporting,
271 and accounting.
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273 A. CITY may terminate this Agreement, without cause, by giving ninety (90) days written
274 notification to CONTRACTOR.
275 B. CONTRACTOR may terminate this Agreement with or without cause by giving ninety
276 (90) days written notice.
277 C. After receiving any Notice of Termination, CONTRACTOR shall continue to provide
278 services and cooperate with CITY staff until the date of termination in a manner which is
279 consistent with recognized standards of quality patient care and prudent business practice, and
280 obtain immediate clarification from CITY of any unsettled issues of contract performance during
281 the remaining contract term.
282 D. The fights and remedies of CITY provided in this Termination paragraph shall not be
283 exclusive, and are in addition to any other fights and remedies provided by law or this
284 Agreement.
285 E. CITY may terminate this Agreement immediately, upon written notice, on the
286 occurrence of any of the following events:
287 1. The loss by CONTRACTOR of legal capacity.
288 2. Cessation of Services.
289 3. Delegation or Assignment of CONTRACTOR'S services operation without
290 written approval by CITY.
291 4. The neglect by any physician or licensed person employed by CONTRACTOR of
292 any duty required pursuant to this Agreement.
293 5. The loss of accreditation or any license required by the Licenses and Law
294 paragraph of this Agreement.
295 6. The continued incapacity of any physician or licensed person to perform duties
296 required pursuant to this Agreement.
297 7. Unethical conduct or malpractice by any physician or licensed person providing
298 services pursuant to this Agreement; provided, however, CITY may waive this option if
299 CONTRACTOR removes such physician or licensed person from serving of persons treated
300 pursuant to this Agreement.
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302 XVI. THIRD PARTY BENEFICIARy
303 Neither party hereto intends that this Agreement shall create fights hereunder in third parties,
304 including but not limited to any subcontractors or any clients provided services hereunder.
305 XVII. WAIVER OF DEFAULT
306 Waiver of any default by CONTRACTOR shall not be considered a waiver of any
307 subsequent default. Waiver of any breach by CONTRACTOR of any provision of this
308 Agreement shall not be considered a waiver of any subsequent breach. Waiver of any default or
309 any breach by CONTRACTOR shall not be considered a modification of the terms of this
310 Agreement.
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1N WITNESS WHEREOF, the parties have executed this Agreement, in the County of
Orange, State of California.
ATTEST:
ft/'ardce C. Guy / ,/~'
~' Clerk of the Council t /
CITY OF SANTA ANA
A municipal corporation of the
State of California
Y
APPROVED AS TO FORM:
33 lo~ Joseph W. Fletcher
City Attorney
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APPROVED AS TO CONTENT:
City Manager
RECOMMENDED FOR APPROVAL:
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350(x%
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352 ,~~-
353 Paul M. Walters
354 Chief of Police
CONTRACTOR:
Correctional Managed Care Medical
Corporation
.~.hoberta Paz
Director of Operations
Tax Identification Number
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EXHIBIT A
TO
AGREEMENT FOR INMATE MEDICAL SERVICES
PAYMENTS, DEFINITIONS, SERVICES, AND
ADDITIONAL REQUIREMENTS
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362 A. For services provided hereunder, CITY shall pay CONTRACTOR one-twelfth (1/12)
363 of total annual per diem monthly, upon receipt of CONTRACTOR'S invoice on a form approved
364 or supplied by CITY and provide such information as is required by CITY; provided, however,
365 the total of all payments for each Period do not exceed CITY'S Baseline Obligation for the
366 Period. CITY shall pay CONTRACTOR one-tweffih (1/12) of the total price for the DENTAL
367 UNIT, monthly, over the first year of the contract.
368 B. Payments will be made by CITY within Thirty (30) days after receipt of a correctly
369 completed invoice form.
370 C. CITY shall not reimburse CONTRACTOR for services provided beyond the
371 expiration and/or termination of this Agreement, except as may otherwise be provided under this
372 Agreement, or specifically agreed upon in a subsequent Agreement.
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375 A. The parties agree to the following terms and definitions, and to those terms and
376 definitions which, for convenience, are set forth elsewhere in this Agreement.
377 1. "Health Authority" means Correctional Managed Care Medical Corporation's
378 Medical Director.
379 2. "Responsible Physician and Health Care Professional" means any physician,
380 nurse, or other person or class of persons designated by CONTRACTOR to perform treatment
381 authorization functions specified in this Agreement.
382 3. "Custodial Patient" means any of the following:
383 a) A City of Santa Ana Jail inmate referred to CONTRACTOR for treatment
384 by the Santa gna Jail Sick-Call Protocol.
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385 b) A person brought to CONTRACTOR for treatment by the City of Santa
386 Ana's Jail on behalf of outside "Owning Agencies", i.e., U.S. Marshall Service, INS, etc..
387 c) A minor, brought to CONTRACTOR for treatment, who is under the care
388 and custody of the City of Santa Ana's Jail.
389 d) Emergency health care needs will be provided by CONTRACTOR until
390 CITY contracted Paramedics arrive. Emergency treatment for facility personnel who are injured
391 or become ill while on the job and emergency first medical care will be provided to any visitor of
392 the Jail Facility.
393 4. "Emergency" means the sudden and unexpected onset of a symptom, illness, or
394 injury which, in the judgment of a physician, requires immediate diagnosis and/or treatment in
395 order to alleviate or attempt to prevent severe pain, permanent disability, serious medical
396 complications or loss of life.
397 5. "Fiscal Year" means the period from July 1st, through the following June 30th
398 and may be abbreviated "FY".
399 6. "Health Care Services" means any treatment, or referral for supportive services,
400 including any Physician Services, which are determined by CONTRACTOR to be medically
401 necessary to protect life or prevent significant disability, and to treat diseases, illnesses or
402 injuries in order to prevent a serious deterioration of health.
403 7. "Inpatient" means a Custodial Patient referred by CONTRACTOR, for admission
404 for the purpose of receiving Health Care Services, with the expectation of remaining hospitalized
405 at least overnight and will be the responsibility of the City of Santa Ana or the outside "Owning
406 Agencies, i.e., U.S. Marshall Service, INS, etc..
407 8. "Physician Services" means Health Care Services provided by the responsible
408 physician, acting within the scope of their license.
409 9. "Usual and Customary Charge" or "Charge" means the amount which
410 CONTRACTOR normally or usually charges the majority of its patients for a specified type of
411 service, including the types of Health Care Services provided hereunder. CONTRACTOR'S
412 Usual and Customary Charges shall be subject to review by CITY to determine that they
413 conform to Usual and Customary charges made by other providers.
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A. At the Santa Aha City Jail, CONTRACTOR shall provide Health Care Services
including Physician Services requested or required for Custodial Patients by CITY or any other
person authorized in accordance with this Agreement. Baseline services to be provided by
CONTRACTOR shall include the following:
1. Physician Services, nursing, dental clinics, psychiatric clinics, laboratory services,
sick call, intake triage and on-site emergency.
2. ' ' - CONTRACTOR will provide medical services, other
than physician services, 7 days a week 24 hours a day. Registered Nurse, 1000 to 2200.
Licensed Vocational Nurse, 2 shifts 7 days a week fi.om 0700 to 1900 and 1900 to 0700. Nurse
Practitioner, Monday, Tuesday, Wednesday, Friday, 1700 through 2200 and Saturdays, 0800 to
1200. Medical records clerk will be available Monday through Friday 0830 to 1700.
3. Twenty-four (24) Hour On-Call Physician Coverage - Physician will be available
24 hours a day, seven days a week. He will respond to pages within 30 minutes and arrive
within 2 hours of notification to respond. He will be available via telephone to consult with the
medical and facility staff.
4. l~ltl~r~:a~g~ - CONTRACTOR will partner with Western Medical Center
Laboratory Services (VENDOR) or such other Laboratory as necessary. VENDOR will provide
all lab services including pick up and will deliver "STAT" results within 2 hours via FAX or
telephone with FAX follow-up. VENDOR will provide a Phlebotomist on an as needed basis.
5. Fourteen (14) Day Physicals - CONTRACTOR will perform full physicals on
inmates with a length of stay 14 days and greater including TB skin testing after a four (4) day
length of stay.
6. Over the Counter Medications - CONTRACTOR will provide over the counter
medications for inmate minor medical needs. CONTRACTOR will identify and maintain
appropriate levels.
7. ~ - CONTRACTOR will provide First Aid Kits to all of the housing
units as well as the exam rooms and kitchen areas. CONTRACTOR will be responsible for
inventory and re-stocking of all First Aid Kits.
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8. ~ - CONTRACTOR will be responsible to perform dental clinics
once a week. Dentist and dental assistant will perform this service on-site.
9. psychiatry_ Clinics - CONTRACTOR will be responsible to perform psychiatry
clinics twice a month. Psychiatrist will perform this service on-site.
10. City Responsible Medical Services - CITY will be responsible for all medical
services that are rendered outside the Jail. This includes but is not limited to Hospital in-patient
services, Hospital emergency services, Hospital out-patient services, Specialty physician out-
patient consultations and treatments, ancillary and diagnostic testing.
11. Charged Back Medical Services - CONTRACTOR will be responsible to arrange
and pay for on-site mobile x-ray, Ophthalmology, OB/Gyn, and dental repair services.
CONTRACTOR will invoice CITY, monthly, for services rendered in that month.
B. CONTRACTOR shall recruit, screen, qualify, orient, provide, manage, compensate,
and evaluate all physicians required to provide any Health Care Services which may be requested
and authorized pursuant to this Agreement. Physicians shall write legibly in patient charts,
orders, etc.
C. CONTRACTOR shall provide staff located within the Santa Ana Jail whose duties
include, but are not limited to, the following, in accordance with Section III.A.2 above.
1. Appointments based on sick-call activity.
2. Receiving and routing of treatment authorizations.
3. Establishing, providing, and maintaining medical records.
4. Receiving and forwarding telephonic and written communications between
physician and medical staff and Jail personnel.
5. Requesting lab services ordered by Responsible physician, and routing of results
to appropriate medical staff.
D. CONTRACTOR shall pay parking for all administrative and medical staff.
E. CONTRACTOR shall provide appropriate medical equipment and furniture, where
needed, for Two (2) exam rooms. As specified in Exhibit B.
F. CONTRACTOR shall provide appropriate dental equipment and furniture, where
needed, for 4th floor exam room. As specified in Exhibit C.
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475 IV. ADDITIONAL REOUIREMENTS
476 A. CONTRACTOR shall provide those medical reports required by CITY for Custodial
477 Patients provided services pursuant to this Agreement. At a minimum, CONTRACTOR shall
478 provide a written Medical Service Activity Report for services provided hereunder. The report
479 shall include, but not be limited to, Date of Service, Booking Number, Name of Inmate,
480 Attending nurse or physician, Brief description of problem, Brief description of disposition and
481 Amount billed to the City of Santa Ana. Medical Service Activity Report will be submitted to
482 CITY daily.
483 B. UTILIZATOIN REVIEW/QUALITY ASSURANCE-
484 1. CONTRACTOR shall maintain a Utilization Review (U.R.) program and a
485 Quality Assurance (Q.A.) program for the review of all services provided pursuant to this
486 Agreement. Subject to all confidentiality laws, and upon request, CONTRACTOR shall provide
487 CITY with a written copy of its Q.A. and U.R. procedures together with such periodic statistical
488 reports, encounter data and other information which may result from Q.A. and U.R. activities for
489 Custodial Patients. The extent and format of such information shall be determined, in writing, by
490 CITY. Such programs shall meet the requirements of all appropriate Federal and State Laws and
491 regulations.
492 2. "Responsible Physician" means the physician who provides On-Site Medical
493 Services to Custodial Patients at the Santa gna Jail. CONTRACTOR'S designee, Director of
494 Operations or Designee, shall develop written U.R. and Q.A. procedures. CONTRACTOR'S
495 Utilization Review personnel shall perform concurrent U.R. inconjunction with the Responsible
496 Physician and provide periodic reports to CONTRACTOR'S Health Authority.
497 3. "Health Authority" means CONTRACTOR'S Medical Director. The Health
498 Authority will assume responsibility for the reviewing, approving, and implementing of medical
499 policies and procedures. The Health Authority and CONTRACTOR'S Director of Operations
500 will work closely with CITY to insure appropriateness and adequacy of inmate health care.
501 4. For cases in which CITY and CONTRACTOR, disagree regarding the level,
502 appropriateness, or quality of care including the need for Inpatient or Outpatient Care, the
503 CONTRACTOR'S Responsible Physician, the CONTRACTOR'S Nurse Practitioner, the
504 CONTRACTOR'S Director of Operations, and the CITY'S Jail Administrator will meet and
505 attempt to resolve the disagreement. If the disagreement is not thereby resolved within thirty
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506 (30) days, then the CONTRACTOR'S Responsible Physician, and the CITY'S Jail
507 Administrator shall meet with the CONTRACTOR'S Health Authority and attempt to obtain
508 agreement. If agreement is not obtained within thirty (30) days after such meeting, such dispute
509 shall be submitted to binding arbitration, conducted according to the rules of the American
510 Arbitration Association, but not necessarily by said Association. The arbitrator shall be a person
511 mutually agreed upon by the parties. If the parties cannot agree upon an arbitrator, then either
512 party may bring an action in the appropriate court to have the dispute resolved. If an arbitrator is
513 agreed upon by the parties, all parties shall contribute equally to the arbitrator's fees and other
514 costs of the proceedings, and shall bear their own attorney's fees. Said arbitration shall be the
515 sole remedy for disputes arising from disputes under this subparagraph, provided, however, if the
516 arbitrator falls to render a decision within thirty (30) days after the matter is submitted to
517 him/her, then either party hereto may bring an action de novo in the appropriate court to have the
518 dispute resolved.
519 C. CONTRACTOR shall provide access by CITY to any medical records of Custodial
520 Patients in accordance with all applicable laws and regulations as they now exist or may
521 hereafter be changed.
522 F. CONTRACTOR'S Responsible Physician and Director of Operations shall be
523 available to meet on a regular basis with the representative of the Santa Ana Jail. Such persons,
524 acting for the respective parties, shall have the authority to resolve U.R., Q.A., or other issues
525 related to the treatment of Custodial Patients.
526 G. CONTRACTOR shall provide CITY with the name, specialty, board status,
527 professional license number, DEA number, and office phone number of each physician providing
528 services hereunder.
529 H. CONTRACTOR'S off-site Administrative &/or Medical staff and visitors shall follow
530 procedures established by the Santa Ana Jail who are responsible for security and access to the
531 Jail.
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532
533
534
535
536
537
538
539
540
541
542
543
544
545
546
547
548
549
550
551
552
553
554
555
556
EXHIBIT B
TO
AGREEMENT FOR INMATE MEDICAL SERVICES
EQU1MENT REQUIREMENTS
CONTRACTOR agrees to provide appropriate medical equipment for two exam
rooms as follows:
1. Two (2) Examination Tables
2. Two (2) Table-Mayo
3. Two (2) Swivel Head Examining Lamps
4. Two (2) Physician's Scale
5. Four (4) Tyco's Pocket Aneroid
6. Two (2) Revolving Stools
7. Five (5) Emergency Resuscitators - Mouth to Mask
8. Five (5) Anaphylaxis Kits
9. Five (5) First Aid Kits #50
10. Three (3) Kappa 100 Otoscope/Ophthalmoscope Sets
11. Four (4) Thermometer - Two (2) Filac F-1500 Electronic and Two (2) First Temp Genius
12. Four (4) Adscope 655
13. Three (3) Instrument Trays with Covers
14. Two (2) sets of Sundry Jars
15. Three (3) Step-on Cans
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557
558
559
560
561
562
563
564
565
566
567
568
569
570
571
572
573
EXHIBIT C
TO
AGREEMENT FOR INMATE DENTAL SERVICE
EQUIPMENT REQULREMENTS
CONTRACTOR agrees to provide appropriate dental equipment for 1 dental exam
room as follows:
2.
3.
4.
5.
6.
7.
8.
Dental Works Pro Cart II
Trophy Irix 70C X-Ray
Belmont Bel-20 Duration w/o Slings, Cobalt Blue
Chair Adaptor for Light with Light Post 48"
Belmont X-Calibur Blu Unit Mount Light
Crown Seating Elite Doctors C50D Stool, Cobalt Blue
Crown Seating Elite Assistants C50A Stool, Cobalt Blue
Rinn 67-6000 Universal Viewer
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574
575
576
577
578
579
58O
581
582
583
584
EXHIBIT D
TO
AGREEMENT FOR INMATE MEDICAL SERVICES
COST SCHEDULE FOR CHARGEBACK SERVICES
K. COST SCHEDULE FOR CHARGEBACK SERVICES
1. Denture, partial plate and bridge repair $200 Ea
2. X Ray services $48/58 Ea
3. Opthamology Services $130 Ea
4. OB/GYN Services $130 Ea
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