HomeMy WebLinkAbout2005-281
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RESOLUTION NO. 2005-281
RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY
OF SAN BERNARDINO AUTHORIZING THE MAYOR OR HER DESIGNEE TO
EXECUTE AMENDMENT NO.3 TO CONTRACT 02~1l66 WITH THE COUNTY OF
SAN BERNARDINO TO PROVIDE YOUTH MENTORING SERVICES FOR THE
PERIOD OF JULY 1, 2005 THROUGH JUNE 30, 2006.
BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE
CITY OF SAN BERNARDINO AS FOLLOWS:
SECTION 1. The Mayor of the City of San Bernardino or her designee is hereby
authorized and directed to execute on behalf of said City, Amendment No. 3 to Contract 02-
1166 with the County of San Bernardino relating to the provision of youth rnentoring services
for the period of July 1, 2005 through June 30, 2006, a copy of which is attached hereto,
marked Exhibit "A" and incorporated herein by reference as fully as though set forth at length.
SECTION 2. The authorization to execute the above referenced agreement is
rescinded if the parties to the agreement fail to execute it within one hundred twenty (120) days
of the passage of this resolution.
III
III
III
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51
RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY
OF SAN BERNARDINO AUTHORIZING THE MAYOR OR HER DESIGNEE TO
EXECUTE AMENDMENT NO.3 TO CONTRACT 02-1166 WITH THE COUNTY OF
SAN BERNARDINO TO PROVIDE YOUTH MENTORING SERVICES FOR THE
PERIOD OF JULY 1,2005 THROUGH JUNE 30,2006.
I HEREBY CERTIFY that the foregoing Resolution was duly adopted by the Mayor
and Common Council of the City of San Bernardino at a
joint regular
6
7 meeting thereof, held on the 15th
day of
August
, 2005, by the following
8 vote, to wit:
9 Council Members:
AYES
NAYS
ABSTAIN ABSENT
10 ESTRADA
x
11
12
13
14
15
16
LONGVILLE
x
MCGINNIS
x
DERRY
x
KELLEY
x
JOHNSON
x
17 MCCAMMACK
18
19
20
21
22
x
Q~ h. CLvJu
R~el G. Clark, City Clerk
The foregoing resolution is hereby approved this
2005.
August
23
24
25
26
27
28
Wend cCammack, Mayor Pro Tern
City of San Bernardino
Approved as to
Form and legal content:
JAMES F. PENMAN,
City Attorney
By:r '1-. f e-..-...
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200.5-:-281 '
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REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY. CALIFORNIA
AND RECORQ OF ACTION
... . ~.1
September27,2005
FROM: JAMES A. FELTEN, Public Health Director
Department of Public Health
SUBJECT: CONTRACT AMENDMENT WITH CITY OF' SAN BERNARDINO FOR THE
PROVISION OF COMMUNITY-BASED SERVICES TO EDUCATE TEENS ON
RESPONSIBLE SEXUAL BI:HAVlOR
RECOMMENDATION: Approve Amendment No.3 to Contract 02-1166 with the City of San
Bernardino, increasing the total contract amount by $45,000 from $135,000 to $180,000 for the
provision of local community-based services to educate teens on responsible sexual behavior,
and extending the term by one year through June 30; 2006. '
BAC~GROUND INFORMATION: Approval of the contract amendment with the City of San
Bern rdino will extend the contract term by twelve months through June 30, 2006, increase total
fundi g by $45,000, and allow the subcontractor to continue provision of services, activities, and
curriqula to help prevent teen pregnancy through the Community Challenge Grant/FOCUS
Project.
Proiect Summarv
Since 1997, the Families Organized for Community Unification and Success (FOCUS) Project has
been funded by the State Department of Health Services, Office of Community Challenge Grants.
The project goals are to reduce teen and unintended pregnancies, promote responsible parenting,
promote the role' of young men in the prevention of teen pregnancy, stress the. importance of
men's contribution to the well-being of their children, and increase community involvement in
building healthy families by increasing the awareness of the adverse effects of teen and
unintended pregnancies. Underscoring' the importance of collaborative community partnerships,
the project serves adolescents, families, and youth-serving personnel in the cities of San
Bernardino, Colton, Highland, Bloomington, Rialto, Adelanto, Apple Valley,' Barstow, and
Victorville. The Department of Public Health (Department) targets these areaS-classified as "hot
spots" by the State-since they have both a high teen birth rate and concentration of live births.
Additionally, these areas are not currently served by other intervention programs that address the
needs of the same or similar target populations, including Male Involvement Project (MIP),
Information and Education (I & E), and Teen Smart.
Page 1 of 2
cc: DPH-Epperson w/agree.
Contractor w/agree. clo DPH
Auditor-Valdez w/agree.
. IDS w/agreement
Risk Management
Co. Counsel-Larkin
CAO-Kratzke
File w/agreement
Record of Action of the Board of Supervisors
AGREEMENT NO. 02-1166 A-3
APPROVED CALENDAR)
B ORS
C D~O
MOTION' MOVE AYE
4 --s
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ITEM 072
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2005-281
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BOARD OF SUPERVISORS
CONTRACT AMENDMENT WITH THE CITY OF SAN BERNARDINO FOR THE PROVISION OF
COMMUNITY-BASED SERVICES TO MEVENT TEEN PREGNANCY
September 27, 2005
Page2of2 '
On August 16, 2005, the Board of Supervisors approved a five-year extension (through June
2010) to the primary grant agreement with the state for the FOCUS Project. The grant agreement
identifies the Department's two existing subcontractors: Arts Council for San Bernardino County
and City of San Bernardino Parks and Recreation Department. Also on August 16, 2005, the
Board approved a contract amendment with the Arts Council for San Bernardino County. The
contract amendment with the City of San Bernardino was delayed pending approval by the city
council, which occurred on August 15, 2005.
On October 8, 2002, the Board approved a contract with the City of San Bernardino Parks and
Recreation Department. The term of the base contract was August 1, 2002 through June 30,
2003, and the total amount of funding was $45,000. The Department has twice amended the
contract to a total of $135,000 to coincide with extensions to the primary grant agreement with the
State. The current contract expired on June 30, 2005. The subcontractor continues to complete
its scope of work duties in a satisfactory manner. Approval of this item will allow the City of San
, Bernardino Parks and Recreation Department to continue provision of community-based services
designed to increase the knowledge' of responsible reproductive behavior and health related
issues among pre-sexually and sexually active adolescents; will increase the total amount of the
subcontract by $45,000 from $135,000 to $180,000; and will extend the term of the contract by
one year through June 30, 2006.
REVIEW BY OTHERS: This item has been reviewed by County Counsel (Charles Larkin, Deputy
County Counsel, 387-5431) on September 14, 2005. This item has also been reviewed by the
County Administrative Office (Vicki Kratzke, Administrative Analyst, 387-8906) on September 15.
2005.
FINANCIAL IMPACT: Approval of this item imposes no additional local cost on the County. This
item increases the contract with the City of San Bernardino by $45,000, from $135,000 to
$180,000 and extends the period by one year to June 30, 2006. Appropriations and revenue in
the amount of $45,000 for this contract have been included in the Department's FY 2005-06
budget.
SUPERVISORIAL DISTRICT(S): First, Third, and Fifth
PRESENTER: James A. Felten, Public Health Director, (909) 387-9146
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9/27/05 072
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FOR COUNTY USE ONi.. y
Vendor Code Dept.
SANBERN77;" SC PHL A
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200~-281
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nty Department Contract Representative
County of San Bernardino anessa Long
Change
Cancel
nty Department
epartment of Public Health
02-1166 A-3
Dept.
PHL
Orgn.
Contractor's Ucense No.
Telephone
388-5740
Total Contract Amount
$180,000
FAS
Contract J}:Pe
o Revenue [i] Encumbered 0 Unencumbered U Other:
f not encumbered or revenue contract type, prilvide reason:
Commodity Code Contract Start Date Contract End Date Original Amount
STANDARD CONTRACT
Fund
AAA
Dept.
PHL
Au 1 2002
Organization Appr.
3305 200
June 30, 2006 $45,000
Obj/Rev Source GRCIPROJ/JOB No.
2445 93470
Amendment
Amount
$45 000
Amount
$45,000
Fund Dept.
Organization
Appr. ObjlRev Source GRCIPROJ/JOB No. Amount
Fund Dept.
Organization
Appr. Obj/Rev Source GRCIPROJ/JOB No. Amount
PALS
FOCUS Project
FY
Estimated Payment Total by Fiscal Year
Amount lID FY Amount lID
Project Name
THE CONTRACT is entered into in the State of California by and between the County of San Bernardino, Department of
Public Health, hereinafter called the County, and
Name
City of San Bernardino
Address
547 North Sierra Way
hereinafter called the
Contractor
San Bernardino, CA 92410
Telephone
(909) 384-5233
FederallD No. or Social Security No.
IT IS HEREBY AGREED AS FOLLOWS:
AMENDMENT NO.3
It is hereby agreed to amend Contract number 02-1166 as follows:
Section I: Definitions/Abbreviations
Paraaraph C is amended to read, "Department of Public Health - The Department that provides health and
educational services to the residents of San Bernardino County.'
Section II: Contractor Service ResDonslbllitles
Paraaraph A is amended to read, "Provide services as set forth in Attachment A - Workplan, which is attached
hereto and incorporated herein by this reference. Contractor agrees to comply with all terms and conditions
and exhibits of the Department of Public Health grant award from the State of California, Maternal, Child, and
Adolescent Health/Office of Family Planning Branch, Grant Award No. 05-45320."
Page 1 of 4
2005,-281
~eCtloD III: Contractor General ReSDonilbllltle~
P.araaraoh N. "Disclosure of Information Relevant to- Client Safety," Item 2, is amended to read, "The
Contractor shall immediately notify the Department of Public Health conceming the arrest and/or conviction,
for other than minor traffic offenses, of any paid employee, agent, consultant, intern, or volunteer staff, when
such information becomes known to the Contractor."
Paraaraoh U. "Civil Riahts Comoliance." is amended to read, "The Contractor shall develop and maintain
internal policies and procedures to assure compliance with each factor outlined by state regulation. These
policies must be developed into a Civil Rights Plan, which is to be on file with the County Department of Public
Health within thirty (30) days of awarding of the Contract. The Plan must address prohibition of discriminatory
practices, accessibility, language services, staff development and training, dissemination of information,
complaints of discrimination, compliance review, and duties of the Civil Rights Liaison. Upon request, the
County will supply a sample of the Plan format. The Contractor will be monitored by the County for
compliance with provisions of its Civil Rights Plan."
Paraaraoh AA. "HIPAA." is added to read, "Pursuant to the Health Insurance Portability and Accountability Act
- of 1996 (HIPAA), regulations have been promulgated governing the privacy and security of individually
identifiable health information (IIHI) otherwise defined as Protected Health Information (PHI) or electronic
Protected Health Information (ePHI). The HIPAA Privacy and Security Regulations specify requirements with
respect to contracts between an entity covered under the HIPAA Privacy and Security Regulations and its
Business Associates. A Business Associate is defined as a party that performs certain services on behalf of,
or provides certain services for, a Covered Entity and, in conjunction therewith, gains access to IIHI, or PHI or
ePHI. Therefore, in accordance with the HIPAA Privacy and Security Regulations, Contractor shall comply
with the terms and conditions as set forth in the attached Business Associate Agreement, hereby incorporated
by this reference as Attachment C.
Section V: Fiscal Provisions
Paraaraoh A. "Maximum Reimbursement." Item 1, is amended to read, "The maximum amount of
reimbursement under the Contract shall not exceed $180,000 ($45,000 for FY 2002-2003, $45,000 for FY
2003-2004, $45,000 for FY 2004-2005, and $45,000 for FY 2005-2006), and is subject to availability of funds
to the County. The consideration to be paid to the Contractor as provided herein shall be in full payment for all
of the Contractor's services and expenses incurred in the performan~ hereof, including travel and per diem.
Reimbursement of invoices shall be based in items included in Attachment B - Project Budget. All
reimbursement to the Contractor shall be contingent upon the submission by the Contractor, and approval by
the County, of the herein required reports, invoices, and supporting documentation."
ParaaraDh B. ReDortina is amended to read, "The Contractor shall provide progress reports on a quarterly
basis. The content of these reports shall be: a) progress accomplished with regard to the Scope of Work and
Workplan; b) data on client services during the three-month reporting period; and c) other information as
required to meet Program requirements. Report format will be specified by the County and the County
reserves the right to revise report format or require additional reports as required during the Contract period to
meet Program needs. Contractor shall submit progress reports to the County within (15) fifteen calendar days
following the quarter in which the services were provided."
Paraaraoh C. "Invoices." Item 2, is amended to read, "The Contractor shall maintain documentation for all
expenditures claimed for reimbursement from the County under the Contract. The Contractor shall only be
reimbursed for expenses that are substantiated by the supporting documentation submitted. Invoices shall be
submitted to the address below. All other notices shall be mailed to the address as shown in Section X (A).
County of San Bernardino
Department of Public Health
Perinatal and Adolescent Life Section
505 North Arrowhead Avenue, Second Floor
San Bernardino, CA 92415-0048"
Page 2 of 4
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'2005-281
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'Section VIII: Contract Term
The term is amended to read, KThis Contract is effective as of August 1, 2002, and is being extended from its
amended expiration date of June 30, 2005 to expire on June 30, 2006, but may be terminated earlier in
accordance with provisions of Section IX, KEarly Termination."
Section X: General Provisions
ParaaraDh A, County contact information, is amended to read,
KCOUNTY:
County of San Bernardino
Department of Public Health
Perinatal and Adolescent Life Section
Attention: Vanessa Long
505 North Arrowhead Avenue, Second Floor
San Bernardino, CA 92415-0048"
Section XI: Conclusion
Paraaraoh A is amended to read, KThe Contract, consisting of sixteen (16) pages and Attachments A through
C, is the full and complete document describing services to be rendered by the Contractor to the County,
including all covenants, conditions, and benefits."
ATTACHMENT A:
WorkDlan: Add Attachment A, titled KWorkplan FY 2005-2006."
ATTACHMENT B:
Proaram Budaet: Add Attachment B, titled K2005-2006 Program Budget."
ATTACHMENT C:
Business Associate Aareement: Add Attachment C, titled KBusiness Associate Agreement."
All other terms and conditions of the Contract shall remain in full force and effect.
Page 3 of 4
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. 2005...281
C~BERNARDI.NO
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-8i"'PeetmYSi Chairman, Board of Supervisors
PAUL BIANE. Vice
Dated SEP 2 7 2005
-
or, etc.)
Name
(P~~~!:o~~~~ct)
Mayer fro 1em
If -/7, opt or Type)
SIGNED AND CER
DOCU~ENT
CHAIRMAN OF
Title
Dated
~
Address 547 North Sierra Way
San Bernardino, CA 92410
Reviewed by Contract Compliance
Date
~
Lori Ciabaltini, HSS Contracts Unit
Date
Date
Auditor/Controller-Recorder
Use Onl
Approved as to Form
and Legal Content:
JAMES F. PENMAN. City Attorney
BY'd--- - 9./~
Page 4 of 4
. 2005-281 Community Challenge Grant Program FOCUS Project
Work Plan FY 2005-06
. . Agenpy: San Bernardino County - Department of Public Health Agreement Number:
Subcontractor: City of San Bernardino Park$ and Recreation .
'GOAL: To com lete all CCG administrative re ulrements
Attachment A
---~,,~~
~age 1 of3
02-1166 A-3
Strategy:
Administrative Objective
Sub-5trategy:
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1l~,J.UJ~, .v,r~T ~~.1.:.,J ,~'i ~..;.t,,,,,r,:. ,~~, ;<,;1
American Indian
Asian
Black/African American
Latino/His anlc
White
Multiracial/Ethnic
Other
Unknown
Submit quarterly reports per requested format to the lead
Agency by the 10" of the month following the end of each
Ouarter.
2. Submit prospective program activity calendars to lead agency 01,02,
on a quarterly basis. 03,04
3. Revise and resubmit Update"Report and/or Mid-year and 01,02,
Finals Progress Report as directed by lead agency. 03,04
(Revisions will only be required for Reports that are
incomplete or unsatisfactory).
4. Submit monthly and complete invoices to lead agency. 01-4
5. Participate in evaluation activities as directed by the local and
statewide evaluators. Per evaluation requirementsltimefines, 01-4
complete and submit:
. Attendance reports
. Completed evaluation forms
6. Submit program attendance within 10 days of completion of 01-4
programs and mentor-mentee contact hours by the 10" of the
following month.
7. Collect at least 20 % of total grant amount in in-kind 01-4
community match (non-govemmental) and document on
Community Match Record Form in Progress Reports.
8. Attend at least 5 out of 6 Collaborative Meetings (if 01-4
Coordinator is unable to attend, a representative must attend)
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DocumentatlonlMethods,.
ReportAdministrative Objective progress and challenges in Updat!'l Report, and Mid Year & Final Progress Reports in Overall
Project Narrative section.
2005-281
Community Challenge Grant Program FOCUS Project
W~r.kplan FY 2005-2006
I-\UClCllllltlllll-\ ""d~t:1 ~ UI .:
Strategy: Education and Support
for Significant Adults and Other
Care Ivers of Adolescents
Sub-Strategy:
2. Provide at least 3 gO-minute family or parent
activities to include presentations and health fairs
about life healthy life choices for adolescents and
community resources.
Q1-4
Mentoring
Coordinator,
DPHstaff
11 and
12 -14
15 -19
20 - 24
30 25 and older
~~];-h!r~ "ti.1'I:Jt(l- t~t':Jl fi_'rn - ~...>~p~,:
American Indian
Asian
10 Black /African American
12 LatinolHis anic
8 White
MultiraciaVEthnic
Other
Unknown
or
;. ~In<;'}', ',II 'JH~; '! "lltlli'lIlli,\} oil'.J
30 Number of artici ants
3 Number of sessions/
presentations/meetings/activit
ies
90 Length in minutes/each
session
Process & Outcomes:
In a pOstsurVey,8()% of partiCipants In a ninetY minUte session will report:
a) An increase of perceived knowledge of healthy life choices
b) An Increase of perceived knowledge of community resources
c) Report satisfaction with their joint participation with the adolescent at today's activity
d Resolve to s end time with adolescents in their famll
Documentation/Methods:
1. Local Evaluation - Individual Participant Assessments - Post Survey
2. Attendance Logs
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!005-281
Community Challenge Grant ProQram FOCUS Project
Wor.kplan FY 2005.2006
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Strategy: 10. Mentorlng
1
1. Recruit adult mentors via community presentations, 01-3 Mentoring
print and telecast ads, personal contacts. Coordinator (MC)
2. Screen volunteer mentors. 01-3
MC
3. Accept referrals for youth mentees from 01-3
collaborative partners. MC
4. Provide training .for mentors. 01-4
MC
5. At least 20 mentors will participate in Train the Trainer
for Youth-Serving Personnel to include orientation to 01-3 MC
FOCUS Project, adolescent sexuality, community
resources, FPACT, and asset building. MC
6. Match at least 25 mentors with mentees. 01-3 MC
7. Provide monthly support meetings for mentors. 01-4 MC, Evaluator
8. Maintain documentation of mentor/mentee contact
hours and activities. 01-4 MC
9. Mentors and nientees will complete the Project Coordinator,
relationship goals contract to establish 3 general MC, Evaluator
life goals to work on together for the year. Completed
contracts submitted to lead agency. 01-3
10. Mentees complete pre-survey; submit to lead agency. 01-3 MC
11. Plan arts activities for youth mentees with Arts Council
Coordinator and participants. 01-4 MC
12. Mentors and mentees will complete the post goals
contract report and submit to lead agency. 04
MC
13. After at least six months of mentorlmentee contact,
mentees complete post survey and submit to lead 04
agency. MC
14. Review data analysis with evaluator and make
changes to improve program effectiveness. 04 MC
Sub-Strategy; 10A. Formal Mult to
Youth Mentoring
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: Jr.,11 "}" , _
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~,;)'.i:1'l.,'I:J~I;' [",! :':'W,~JO!I!)l!} ,~'
if"Jj~3"Ii1'.-Ii. '~L{.ii,,;; i ;' li:i'7""";1"" ;~--- VI
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American Indian
Asian
6 Black /African American
13 Latino/His anlc
6 White
MultiraciaVEthnic
Other '.
Unknown
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25 Number of artici ants
850 Number of sessions/
presentations/meetings/
activities
60 Length In minutes/each
session
Process & Outcomes:
1. In a post survey, relative to the contractlpre-survey, 8Q% of youth who have had 24 hours of mentoring will indicate progress
relative to their originally agreed upon life goals articulated at pre-Intervention with the mentor.
- ~ 2. ~-In a post survey, mentees who have had 24 hours of mentoring will have higher perceptions of:
, a) mentor support b) self-worth c) general future thinking and life goals
Documentation/Methods:
1. Local Evaluation: Post Goal Assessment of all Participants
2, Attendance LogslMentees
3. Enrollment Rosters
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2005-281
ATTACHMENT B
FOCUS' PROJECT BUDGET
CITY OF SAN BERNARDINO
DEPT. of PARKS, RECREATION, AND COMMUNITY SERVICES
JULY, 1 2005 THROUGH JUNE 30, 2006
PERSONNEL
Mentor Coordinator
40,768
SUBTOTAL PERSONNEL
40,768
FRINGE BENEFITS
3,500
TOTAL PERSONNEL
$
44,268
. TRAVEL AND PER DIEM
or .
SUNCONTRACTS
$
$
732
OTHER COSTS
INDIRECT COSTS
$
$
$
45,000
TOTAL OTHER COSTS
TOTAL PROJECT COSTS
MATCH
15,000
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2005-28.1
ATTACHMENT C
..
BUSINESS ASSOCIATE AGREEMENT
. Except a~ otherwise provided in this 'Agreement, CONTRACTOR, hereinafter referred to as BUSINESS
. ASSOCIATE, may use or disclose Protected Health Information' to perform functions, activities or
services for or on behalf of the COUNTY OF SAN BERNARDINO, hereinafter referred to as the
COVERED ENTITY, as specified in this Agreement and in the attached Contract, provided such use or
disclosure does not violate the Health Insurance Portability and Accountability Act (HIPAA), 42 U.S.C.
, ~
1320d etseq., and its implementing regulations, Including but notlimitedto, 45 Code of Regulations
Parts 160, 162, and 164, hereinafter referred to as the Privacy and Security Rules.
I. Obligations and Activities of Business Associate.
A. Business Associate shall not use or further disclose, Protected Health Information other
than as .permitted or required by this Agreement or as Required" By Law. Business,
Associate shall disclose to its employees, subcontractors,agents, or other third parties,
and request from Covered Entity, only the mil1imum ProteCted ~~ith Information
necessary to perform or fulfill a specific function required or permitted hereunder.
B. B'usiness ASsociate $11all implement administrative, physical, anq technical safeguards to:
1. Prevent use or disclosure of the Protected Health Information other than as provided for by
this Agreement.
2. Reasonably and appropriately protect the confidentiality, Integrity, and availability of the
electronic Protected Health Information that It creates, receives, maintains, or transmits on
behalf of the Covered Entity.
. , ,
C. Business Associate shall mitigate. to the, extent practicable, any harmful effect that Is
known to Business Associate of a use or disclosure of Protected Health Information by
Business Associate In violation of the requirements of this Agreement.
/'
D. Business Associate shall report to Covered Entity any use or disclosure of'the Protected
-- .
Health Information not provided for, b~~this-Agreementand/oranysecurity incident with
'::_:_:_._.:.::..:.~~_:~:..~:~Jesp-.~2t tQ..!lec.!r:QD.!9._Er.C?t~<?~~~J:i~althJ!lf9_f1!1a~i~':l_C?f...:Y.!'~~c.~.it~eC2'!l~~.~~~re~ ... _ .. . ," .'. :.::....: ..:. .::.'
E. Business Associate shall ensure. that any agent, including a subcontractor,. to whom it
provides Protected Health Information received from; or created or received by Business
Associate on behalf of Covered Entity, shall comply with the same restrictions and
. PAGE 1 of 5
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2005-281
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ATTACHMENT C
conditions that apply through this Agreement to Business Associate with respect to such
information.
F. Business Associate shall provide access to Protected Health Information in a Designated
Record Set to Covered Entity or to an Individual, at the request or direction of Covered
Entity and in. the time and manner designated by the Covered Entity, in order to meet the
requirements '0145 CFR 164.524.
G. Business Associate shall make any amendment(s) to Protected Health Information in a.
Designated Record Set that the Covered Entity directs or agrees to pursuant to 45 CFR
164.526, in the time and manner designated by the Covered Entity.'
H. Business Associate shall make intemal practices; books, and records, including policies
and .procedures .andProtected Health Information, relating to the use and disclosure of
. ,
Protected Health Information received from, or created or received by Business Associate
. on behalf of, Covered Entity available to the Covered Entity, and/or to the Secretary for the
U.S. Department of Health and Human Services, in a time and manner designated by the '
Covered' Entity or the Se,cretary, for purposes of the Secretary determining Covered
"r .
Entity's compliance with the Privacy and Security Rules.
I.
Business Associate, shall document such disclosures of Protected Health Information and
information related'to such disclosures as would be required for Covered Entity to respond
to a request by an Individual for an accounting' of disclosures of Protected Health
Information in accordance with 45 CFR 164.528. .
...
J. ' Business Associate shall provide to Covered Entity or an' Individual, in the time and
manner designated by the Covered Entity, information collected in accordance with
provision (i), above, to permit Covered Entity to respond to a request by the Individual for;
an accounting of disclosures of Protected Health InfOrmation in accordance with 45 CFR .
/
164.528.
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2005...28:1. ATTACHMENT C
K.Upon termination of this AgreemEmt, Business Associate shall retum - all
Protected Health Information required to be retained andretum or destroy
all other Protected Health Information received from the Covered Entity, or
created or received by the _ Business Assocl?lte or _ its subcontractors,
employees or agents on behalf of the Covered Entity. In the event the
4 ...
Business . Associate determines that retuming ~he Protected Health
Information is not feasible. the Business Associate. shall provide the
Covered Entity with written notification of the conditions that make return not
. . .
feasible. Business Associate further agrees to extend any and all
protections, limitations, and restrictions contained in trns Agreement, to any
Protected Health Information retained by Business Associate or Its
. subcontractors, employees or agents after the termination' of this
Agreement, and to limit any further uses and/or disclosures to the purposes
.that make the return or destruction of the Protected Health Information
infeasible.
n.. Specific Use and Disclosure Provisions.
..r .
A. Except as otherwise limited In this Agreement. Business Associate may use
Protected Health Information for the proper management and a~ministratlon .
of . the Business Associate or to carry out the legal responsibiHties of the
Business Associate. .' ,
B.
Except as .otherwise I.imit~d in. this Agreement, . BLisiness Associa.te. may.
disclose Protected. Health Information for the proper management and
administration of the Business Associate, provided that disclosures ~re
Required By Law. or Business Associate obtains reasonable assurances ;
from the person to whom the information. is disclosed that it will remai~
confidential and used or further disclQsedonly as Required By Law or for
the purpose for which it was di~~~~sed to the person, and the person notifies
t~:.~~s~~_~~s._ Ass?_~iat~ ?f.~~t I~st~~~~~~:_~~!~~.__i~_i~_ a.~~~~ _i~_~~i~_~t~~._ _..
. .uconfidefjtia.lity-6.f th'e ~info~ati6rihas~eeifbre~c~~a. ~___'H:-_:"______ -~- --.:-- .. u. ...--
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'2005-281
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ATTACHMENT C
C .' Except as otherwise Iilnited In this Agreement, Business Associate may use
Protected Health Information to provide Data Aggregation service to
Covered Entity as permitted by 42 CFR 164.504(e)(2)(i)(B).
D. ' Business Associate may use Protected Health Information to report
~ ~ . . .
violations of law to appropriate Federal and State authorities, consistent
with 42 CFR 164.5020)(1).
III. Obl/gatlonsof Covered Entity.
.'>', " .
. A. Covered 'Entity shall notify Business Associate of any Iimitatiori(s) in its
notice of privacy practices of Covered Entity in accordance with' 45 CFR
., : .164.520, to the extent that such limitation may affect Business Associate's
use or disclosure of Protected Health Information. ' ,
B. Covered Entity shall notify Business Associate of any, changes in, or
r~vocatiol1 of, permission by Individual to use'or disclose Prote~ted Health
Information, to . the extent that such changes may affect Business
Associate's use or disclosure of Protected Health Information.
C. .' ''Covered Entity shall notify Business Associate of any restriction to the use
, or disclosure of Protected Health, Information that, Covered Entity has
agreed to In accordance with 45 CFR, 164.522, to the extent that such,
restriction may affect Busin&ss Associate'& use 01 .di~l.ilJl:iul t:l , ur. PI utt:lcltld
Health Information.
IV. General Provisions.
A.Reriledies.. Business Associate agrees that Covered Entity shall be entitled to
seek immediate injunctive reli~~ "_~. well-as to exercise all other rights and
, . _ u _r~'!l~~ie~_~hic~ Cover~d 'En~tY. r.na~~ave at I~Vi ()r in e,q':lity_i~th~.~~e~t of
. . .'u -- ari--:iiriauth~oiized ' use - ,or'dlscicisure u ot -Protected" H!:ialth- "iriforiTi'atlon' by .' .
Business Associate or any agent or subcontractor of Business Associate
that received Protected Health Information from Business Associate.
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ATTACHMENT C
B.
Ownershio. . The Protected Health Information' shall be and remain the
property of the Covered Entity. Business Associate agrees that it acquires
no title or rights to the Protected Health Information.
C.
Re.aulatorv References. A reference in this Agreement to a section in the
Privacy or Security Rule means the section as in effect or as amended.
D.
Amendment. The Parties, agree to take such action as is necessary to
amend this Agreement from time to time as is necessary for Covered Entity ,
to comply with the requirements of the Privacy and Security Rules and the
Health Insurance Portability and Accountability Act of 1996, Pub. L. No.
104-191.
E.
Interoretation. Any ambiguity in this Agreement shall be resolved to permit
Covered Entity to comply with ,the Privacy and Security Rules. '
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