HomeMy WebLinkAbout21-Parks & Recreations
ORIGINAL
CITY OF SAN BERNARDINO - REQUEST FOR COUNCIL ACTION
Date: July 21,2005
Subject: RESOLUTION OF THE MAYOR
AND COMMON COUNCIL OF THE CITY OF
SAN BERNARDINO AUTHORIZING THE
MA YOR 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.
From: Lemuel Randolph, Director
Dept: Parks, Rec. & Community
Services Department
MICC Meeting Date: August 15, 2005
Synopsis of Previous Council Action:
The Mayor and Common Council approved resolutions since 1997 for this project with the last
approval being on 09/09/04, Resolution 2004-276.
Recommended Motion:
Adopt Resolution
./
J /,
'-. ;/ // .//I":l
~ ~.;/'ilt~/
sfgnature
/'
Contact person: Teresa Martin
Phone: 5032
Supporting data attached: Staff report Reso Agmnt
Ward: N/A
FUNDING REQUIREMENTS:
Amount:$45,OOO
Source: (Acct. No.) 123-551-xxxx
(Acct. Description) Mentorinq Focus Grant-
(State Funds)
Finance:
Council Notes: /{M. ~D0{,-J,&f
Agenda Item No. -dJ--
t/S/b5'
CITY OF SAN BERNARDINO - REQUEST FOR COUNCIL ACTION
Staff Report
Subject:
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.
Background:
The Mentoring Program was established in April of 1992 as a project of the Mayor's Youth Task
Force. The initial funding came from the City and the San Bernardino City Unified School District
as a partnership to provide both mentoring and the Late Night Hoops Program.
The City of San Bernardino Mentoring Program became a collaborative partner with the San
Bernardino County Public Health Department in applying and receiving a FOCUS Community
Challenge Grant through the State of California Department of Health Services and has had a
partnership for eight years. This amendment extends this collaborative contract for the July 1, 2005 -
June 30, 2006 fiscal year.
The Parks, Recreation and Community Services Department Mentoring Program will continue as a
collaborative partner in the planning and implementation of the Department of Public Health
FOCUS Project to support youth, families, and prevent teen pregnancy. The program will serve at-
risk youth by providing one-on-one mentoring while meeting the State of California Governor's
Quality Assurance Standards, which are the standards established by the Governor's Mentoring
Partnership Program. The program will support relationships formed between mentors and mentees,
recruit mentors for youth newly referred to the mentoring program, and provide outreach services to
the families.
Mentees are referred to the program from San Bernardino Unified School District. The Mentor
Coordinator works directly with school counselors and other officials to create a positive
environment for Mentee/Mentor experiences. The program has 25 mentors matched with 25
mentees. The program includes monthly mentor support meetings that provide training, information,
and referrals to the Public Health Case Managers and/or other Health Agencies, as needed.
Additionally, workshops will be held for parents of mentees to provide guidance on teen pregnancy
prevention strategies and warning signs.
Documentation will be provided, as required, for 25 matches (25 mentor/mentees), parent
involvement, and sign-in sheets for different activities. The Scope of Work for the Mentoring
Program includes recruitment, training and monitoring, administration, reporting, fundraising, and
monthly advisory committee meetings. Additional activities will include job shadowing, family
picnics, Recognition Program and a family Christmas Party.
Financial Impact:
This contract does not require general funds; however, $14,800 was allocated in the 05/06 budget to
provide administrative support, funding for conferences, and program events. The FOCUS Project
will provide $45,000 for FY2005/06 in accordance with the attached budget for the Mentor
Coordinator's salary, fringe benefits, travel and per diem. The $15,000 match is in-kind services
(volunteers and donations).
Recommendation:
Adopt Resolution.
i
41
I
I
;1
Uj
I
,~ 1 ,
L I i
! i
" i i
I! I
! I
811
" 1
Uj i
'If'!j
> U I
I
;1 I
I
I
I
L; I
J4
, ~
~ r.
.LI
1 '-; I I I
...,
1? III
:d , /1/
,
I
'w I //1
';;)1'
2511 // /
II
'1
271 ' /1/
')Q.
"-01,
I
II
I
11
RESOLUTION NO.
~o)fY
"
.!.
3
RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY
OF SAN BERt'\TARDINO 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.
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 mentoring services
for the period of July I, 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 \vithin one hundred twenty (120) days
of the passage of this resolution.
III
,.
1/
/ / /
.f
I
YCD.2I I
g fS';66T
G I
71
8/
f:j I
'I
101
I
j] i i
1 ~ .
i
I
13 J
I
11 I
'-'~ I
i
< r. I
.,~ I
VI
I
I
.: -; i
. f I
J C I
i
.,n! I
j \.;' j
,vII!
/. I'
::1/
'~I'III 2005.
:QII
2311
, .
241 Approyed as to
'};I
_IV I Form and legal content:
I
,.,.., J
:~~o
JAMES F. PENMAN,
27 I City Attorney
'1
28 '\ .~ ~
By: ',r: j-1'--l.,_' / I (.n--l..~~~.
. I
')
1
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 MENTORI~G SERVICES FOR THE
PERIOD OF JULY 1,2005 THROUGH JUNE 30, 2006.
4!
I
;)
2
~)
I HEREBY CERTIFY that the foregoing Resolution was duly adopted by the Mayor
and Common Council of the City of San Bernardino at a
Yote. to wit:
i
I
I
. 2005, by the following I
I
ABSENT I
I
I
I
I
I
I
I
I
I
I
I
I
meeting thereof. held on the
day of
Council Members:
AYES
NAYS
ABSTAIN
ESTRADA
LONGYILLE
MCGINNIS
DERRY
KELLEY
JOHNSON
MCCAMr-.lACK
Rachel G. Clark. City Clerk
The foregoing resolution is hereby approved this
day of
Judith Valles, Mayor
City of San Bernardino
County of San Bernardino
FAS
STANDARD CONTRACT
FOR COUNTY USE ONL Y
ORIGINAL
New Vendor Code Depl. Contract Number
I--
X Change SC A
I-- SANBERN772 PHL 02-1166 A-3
Cancel
!,--ounty Department Depl. Orgn. Contractor's License No.
Department of Public Health PHL
i"ounty Department Contract Representative Telephone Total Contract Amount
~anessa Long 388-5740 $180,000
Contract [Jpe
i = Revenue 00 Encumbered 0 Unencumbered Other'
Ilf not encumbered or revenue contract type, provide reason:
I Commodity Code Contract Start Date Contract End Date Original Amount Amendment
Amount
Auq 1, 2002 June 30, 2006 $45,000 $45,000
Fund Depl. Organization Appr. Obj/Rev Source GRC/PROJ/JOB No. Amount
AM PHL 3305 200 2445 93470 $45,000
I
Fund Depl. Organization Appr. Obj/Rev Source GRC/PROJ/JOB No. Amount
, ,
Fund Depl. Organization Appr. Obj/Rev Source GRC/PROJ/JOB No. Amount
, ,
Project Name Estimated Payment Total by Fiscal Year
PALS FY Amount 110 FY Amount I/O
FOCUS Project - -
-
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
ne
IJlty of San Bernardino
Address
547 North Sierra Way
San Bernardino, CA 92410
Telephone
(909) 384-5233
Federal 10 No. or Social Security No.
hereinafter called the
Contractor
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
Paraqraph 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 Responsibilities
. -aqraph A is amended to read, "Provide services as set forth in Attachment A - Workplan, which is attached
. eto 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,"
Paae 1 of 4
Section III: Contractor General Responsibilities
Paraqraph N, "Disclosure of Information Relevant to Client Safety," Item 2, is amended to read, "The
tractor shall immediately notify the Department of Public Health concerning the arrest and/or conviction,
.' Jther than minor traffic offenses, of any paid employee, agent, consultant, intern, or volunteer staff, when
sLlch information becomes known to the Contractor,"
ParaGraph U, "Civil RiGhts Compliance," 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,"
ParaGraph 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,
~ :;tion V: Fiscal Provisions
r-'araqraph 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 performance 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."
ParaGraph B, Reportinq 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."
ParaGraph 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
Section VIII: Contract Term
term is amended to read, "This Contract is effective as of August 1, 2002, and is being extended from its
;nded expiration date of June 30, 2005 to expire on June 30, 2006, but may be terminated earlier in
"ccordance with provisions of Section IX, "Early Termination."
Section X: General Provisions
Paraqraph A, County contact information, is amended to read,
"COUNTY:
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
Paraqraph A is amended to read, "The 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:
'."orkplan: Add Attachment A, titled "Workplan FY 2005-2006."
.-TACHMENT B:
Proqram Budqet: Add Attachment B, titled "2005-2006 Program Budget."
ATTACHMENT C:
Business Associate Aqreement: Add Attachment C, titled "Business Associate Agreement."
All other terms and conditions of the Contract shall remain in full force and effect.
Page 3 of 4
JNTY OF SAN BERNARDINO
~
Bill Postmus, Chairman, Board of Supervisors
Dated
City of San Bernardino
(Print or type name of corporation, company, contractor, etc.)
By ~
(Authorized signature - sign in blue ink)
Name
(Print or type name of person signing contract)
SIGNED AND CERTIFIED THAT A COpy OF THIS
DOCUMENT HAS BEEN DELIVERED TO THE
CHAIRMAN OF THE BOARD
Clerk of the Board of Supervisors
of the County of San Bernardino.
By
Title
(Print or Type)
Dated
Address 547 North Sierra Way
Deputy
San Bernardino, CA 92410
Approved as to Legal Form
Presented to BOS for Signature
Reviewed by Contract Compliance
~
Charles Larkin, County Counsel
~
Lori Ciabattini, HSS Contracts Unit
~
James A. Felten, PubliC Health Director
Date
Date
Auditor/Controller-Recorder
Use Onl
o Contract Database
Input Oat
Date
Approved as to Form
and Legal Content:
JAMES F. PENMAN, City Attorney
By: f-'hU'- -::;. . ~?~
('
Page 4 of 4
Attachment A Page I of
Community Challenge Grant Program FOCUS Project
Work Plan FY 2005-06
Agency: San Bernardino County - Department of Public Health Agreement Number: 02-1166 A-3
Subcontractor: City of San Bernardino Parks and Recreation
: GOAL: To com lete all CCG administrative re uirements
t.jective Number: N/A (Pg 1) ActivitiesfTasks Needed to Complete This Objective
,. '.,.' ,- '. . . ",'~. i-' ".'< , .,: . . - . . .'. ' : - -, - ..
Submit quarterly reports per requested format to the lead
Agency by the 10'h of the month following the end of each
Ouarter.
Strategy:
I Administrative Objective
Sub-Strategy:
Population targeted with this
strategy<-::~':,:/':}::i'{'\' .:Jt.' .
o Females 0 Males 0 Both
2. Submit prospective program activity calendars to lead agency
on a quarterly basis.
01,02,
03,04
3. Revise and resubmit Update Report and/or Mid-year and
Finals Progress Report as directed by lead agency.
(Revisions will only be required for Reports that are
incomplete or unsatisfactory).
01,02,
03,04
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 requirements/timelines, 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'h of the
following month.
7. Collect at least 20 % of total grant amount in in-kind 01-4
community match (non-governmental) 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)
Process & Outcomes
Sites of Service:
1.
2.
3.
4.
5.
Is curriculum used?
I 0 No 0 Yes
; Title:
Strategy part of Statewide.::;';:'
E ..4'1~'t' ,,,,,,'C'?'~;:'f[i;1'!'?t4:tr';;;: t......j/,;:":.~
va ua Ion :"""_~,:,,",J.>"=.,..,,..,, ,pA .".....
.-..Of',;," :.;'.j.<t'~-r:-~ - ,~~.;i',-'1'i.>.t~<"':'P ':.-ot:'.>i.:tr.......-.,'..><:...;.~,,-...' - ~ -;,. ~-I
o No Yes
DociiiilehJat!on:iJ,,: Eval uiltio n:
...... . ..: . -',. ."';'" .. ..... - '- ~
_~::~~~)~~;::':;~:g~#&~~rFj;.b
Documentation/Method s
Report Administrative Objective progress and challenges in Update Report, and Mid Year & Final Progress Reports in Overall
Project Narrative section.
Community Challenge Grant Program FOCUS Project
Workplan FY 2005.2006
AUdcnrnem A t"'d\oje L. O'
Agreement Number: 02-1166 A-3
:~ -- ~ -
I'.' .
. . ~,..--"
~".'--- .':;.-; . '''~..;-.
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,
DPH staff
10
12
8
90
-, tCompleters(tolalj1l.irnber of.'
"Wlrtic'p~~"'~ccfrrf;jefi'nrail~,;~;
;''':-if'..~tt....,~._".,~ ',;;~~?;.,;~:~~
.sesslons ,<. -"'f"'~""'"
..lscuri"icLJ lun(jjsed?2J\,~e:-:;';~";'::;{i~i1:!;~>
[8J No 0 Yes
Title:
Strategy part 'of.sta~ewjde '~~""f,j!,:?.,:.
Eva'4:~~.~~jr.~~~2~~~ljt.;~;3'~i1!~}k:';~'
[8J No 0 Yes
l?%~~!!J~~~9~~~!~~]~.Q~j,"':E;:.' ;!,~~{:'i'~:'>'<i':',;.)..if,,'\7Sii{~~c~':7Si",~' ". .
Process & Outcomes:
In a post survey, 80% 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
I d) Resolve to spend time with adolescents in their family
"ocumentation/M ethods:
1, Local Evaluation - Individual Participant Assessments - Post Survey
2. Attendance Logs
.;"::',s!t~!>, !?.l~Elryjce
1. City of San Bernardino Mentoring Program
-. '- "";~:;.>..
- '" ".-:-
-' _::.~;.; :}L :::~~~~~j~~~.:;':':',\~f?~~!:i ~t
Community Challenge Grant Program FOCUS Project
Workplan FY 2005-2006
Attachment A I-'age jot
-
..
'-'.~ >'--"';:;;'..~;
Agreement Number: 02-1166 A-3
'1
Subcontract:
2. Screen volunteer mentors.
3. Accept referrals for youth mentees from
collaborative partners.
4. Provide training for mentors.
5. At least 20 mentors will participate in Train the Trainer
for Youth-Serving Personnel to include orientation to
FOCUS Project. adolescent sexuality, community
resources, FPACT, and asset building.
6. Match at least 25 mentors with mentees.
7. Provide monthly support meetings for mentors.
6
13
6
8. Maintain documentation of mentor/mentee contact
hours and activities.
9. Mentors and mentees will complete the
relationship goals contract to establish 3 general
life goals to work on together for the year. Completed
contracts submitted to lead agency.
10. Mentees complete pre-survey; submit to lead agency.
11. Plan arts activities for youth mentees with Arts Council
Coordinator and participants.
60
12. Mentors and mentees will complete the post goals
contract report and submit to lead agency.
13. After at least six months of mentor/mentee contact,
mentees complete post survey and submit to lead
agency.
14. Review data analysis with evaluator and make
changes to improve program effectiveness.
-r..
Mentoring
Coordinator (MC)
01-3
MC
01-3
MC
01-4
MC
01-3
MC
MC
01-3
MC
01-4
MC, Evaluator
01-4 MC
Project Coordinator,
MC, Evaluator
01-3
01-3 MC
01-4 MC
04
MC
04
MC
04 MC
'I urn ,'used? At,. :~51:,:~t::.~~:1~:~:~~tiiiLtI~~f:~rL:~fr~~~Lt.!~' 'of '~~~~j_~~&j{~t~.:'~3r.:.i~iJi~1f:;'.!J.\~ru~~i;~:~
~ No 0 Yes 1. eit
Docuinentation'ar'id .Eva.lliation.C':!~c
Process & Outcomes:
1. In a post survey, relative to the contract/pre-survey, 80% 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/M ethods:
1. Local Evaluation: Post Goal Assessment of all Participants
2. Attendance Logs/Mentees
3. Enrollment Rosters
ATTACHMENT 8
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
$
732
SUNCONTRACTS
$
OTHER COSTS
TOTAL OTHER COSTS
$
INDIRECT COSTS
$
TOTAL PROJECT COSTS
$
45,000
MATCH
15,000
ATTACHMENT C
BUSINESS ASSOCIATE AGREEMENT
::xcept-as otherwise provided in this Agreement, CONTRACTOR, hereinafter referred to as BUSINESS
c\.SSOCIA TE, 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 et seq., and its implementing regulations, including but not limited to, 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 minimum Protected Health Information
necessary to perform or fulfill a specific function required or permitted hereunder.
B. B'usiness As'sociate shall implement administrative, physical, and 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, recei~es, 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 by this Agreement and/or any security incident with
respect to electronic Protected Health Information of which it becomes aware.
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 4
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 of 45 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 internal practices, books, and records, including policies
and procedures and Protected 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
C,overed Enyty or t~e Secretary, for purposes of the Secretary determining Covered
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.
Page 2 of 4
ATTACHMENT C
K. Upon termination of this Agreement, Business Associate shall return all
Protected Health Information required to be retained and return or destroy
all other Protected Health Information received from the Covered Entity, or
created or received by the Business Associate or its subcontractors,
employees or agents on behalf of the Covered Entity. In the event the
Business Associate determines that returning the 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 this 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.
II.. Speci~ic Use a.nd Disclosure Provisions.
A. Except as otherwise limited in this Agreement, Business Associate may use
Protected Health Information for the proper management and administration
of the Business Associate or to carry out the legal responsibilities of the
Business Associate.
B. Except as otherwise limited in this Agreement, Business Associate may
disclose Protected Health Information for the proper management and
administration of the Business Associate, provided that disclosures are
Required By Law, or Business Associate obtains reasonable assurances
from the person to whom the information is disclosed that it will remain
confidential and used or further disclosed only as Required By Law or for
the purpose for which it was disclosed to the person, and the person notifies
the Business Associate of any instances of which it is aware in which the
confidentiality of the information has been breached.
Page 3 of 4
ATTACHMENT C
C. Except as otherwise limited 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. BusiIless 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. Obligations of Covered Entity.
A. Covered Entity shall notify Business Associate of any limitation(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~vocatiol'1 of, permission by Individual to use or disclose Protected 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 Business Associate's use or disclosure of Protected
Health Information.
IV. General Provisions.
A.Remedies. Business Associate agrees that Covered Entity shall be entitled to
seek immediate injunctive relief as well as to exercise all other rights and
remedies which Covered Entity may have at law or in equity in the event of
an unauthorized use or disclosure of Protected Health Information by
Business Associate or any agent or subcontractor of Business Associate
that received Protected Health Information from Business Associate.
Page 4 of 4
ATTACHMENT C
B. Ownership. 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. Requlatorv 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. Interpretation. Any ambiguity in this Agreement shall be resolved to permit
Covered Entity to comply with the Privacy and Security Rules.
Page 5 of 4