HomeMy WebLinkAboutContract 31752 05-04-05PO4 : 49 RCVU
CITY SECRETARY
CONTRACT NO_
AGREEMENT BETWEEN TARRANT COUNTY HOSPITAL DISTRICT
AND
FORT WORTH POLICE DEPARTMENT
WHEREAS, the Tarrant County Hospital District d/b/a JPS Health Network
("the District") provides certain health care services in Tarrant County Texas;
and
WHEREAS FORT WORTH POLICE DEPARTMENT ("Contractor")
desires to obtain sexual assault examinations in connection with the
investigation or prosecution of an alleged sexual assault:
SECTION I: DISTRICT OBLIGATIONS ARE TO:
1. Provide Sexual Assault examination and forensics collection
2. Obtain consents for examination and treatment.
SECTION II: CONTRACTOR OBLIGATIONS ARE TO:
1. To authorize the examination.
2. Pay the fees for services rendered by the T.C.H.D. within thirty (30) days
of billing date.
SECTION III: FEES FOR SERVICE
1. The fee for sexual assault examination and forensics collection shall be
assessed to the Contractor according to the guidelines set forth in the Crime
Victim's Compensation Program administered by the Office of the Attorney
General, State of Texas.
2. Make checks payable to: JPS Health Network
P.O. Box 916046
Fort Worth, Texas 76191-6046
Attention: Cashier
Generic Sexual Assault Exam Agreement Pagel
SECTION IV: NOTIFICATION
Whenever this Agreement requires or permits any consent, approval, notice,
request, proposal or demand from one party to another, the consent, approval,
notice, request, proposal or demand must be in writing to be effective and shall
be delivered to the party intended to receive it at the address shown below:
If intended for the CONTRACTOR, to: FORT WORTH POLICE
DEPARTMENT
350 W Belknap
Fort Worth, Texas 76102
817.877.8202
If intended for the HOSPITAL, to: Director of Emergency Department
1500 South Main Street
Fort Worth, Texas 76104
(817) 927-1100
SECTION V: TERM OF AGREEMENT:
1. The term of this Agreement shall be from OCTOBER 1, 2004 to
SEPTEMBER 30, 2005.
2. At the expiration of said term, all obligations of the parties hereunder shall
cease.
3. Within thirty days of receiving invoice from District, Contractor shall remit
to the District all fees for services rendered under this contract.
3 Nothing herein shall prevent the parties at any time from entering into
further written agreements or written amendments hereto as may be
mutually acceptable to both parties. This agreement represents the entire
agreement between the parties and supercedes any prior written or oral
agreement and may only be amended in writing signed by both hospital
and contractor.
4 This Agreement, or any portion thereof shall not be assignable without
express, written consent of both parties.
5. Either party may terminate this agreement without cause at any time on
thirty (30) days written notice.
Other Provisions
1. Venue - This Agreement shall be interpreted under the laws of the State of
Texas. The venue for any lawsuit or other judicial or administrative proceeding
Generic Sexual Assault Exam Agreement Page 2
arising out of this Agreement will be the Fort Worth Division of the Northern
District of Texas if the lawsuit or other proceeding arises in Federal Court or
Tarrant County, Texas if the matter arises in State Court.
2. Relationship of the Parties - Nothing contained herein or any document
executed in connection herewith shall be deemed or construed by the
Parties hereto, nor by any third party, as creating the relationship of
principal and agent, partnership, joint enterprise, common enterprise, joint
venture, joint owners, or joint tenants between the Parties. The Parties
hereby declare and acknowledge that the relationship existing is one of
independent contractor.
3. CONTRACTOR ("Business Associate"), its officers, employees and
representatives and the Tarrant County Hospital District ("Covered Entity")
acknowledge that Covered Entity is a covered entity as that term is
defined in the Health Insurance Portability and Accountability Act of 1996
(42 U.S.C. 1320d) ("HIPAX). The parties acknowledge that federal
regulations relating to the confidentiality of individually identifiable health
information require covered entities to comply with the "Privacy Standards"
adopted by the United States Department of Health and Human Services,
as they may be amended from time to time, 65 Fed. Reg. 82462-82829
(Dec. 28, 2000) ("Privacy Standards"). The Privacy Standards require a
covered entity to ensure that business associates who receive confidential
information in the course of providing services on behalf of a covered
entity comply with certain obligations regarding the confidentiality of health
information. Accordingly, the parties hereto agree to enter into a business
associate agreement that meets the requirements of the Privacy
Standards on or before the implementation date of the Privacy Standards,
April 14, 2003, or as that date may be amended from time to time. In the
event that the parties are not able to reach agreement regarding a
business associate agreement, this agreement may be terminated at the
option of the Tarrant County Hospital District on the HIPAA
Implementation Date.
4. CONTRACTOR SHALL DEFEND AND HOLD HARMLESS AND
INDEMNIFY THE DISTRICT, ITS OFFICERS AND EMPLOYEES FROM
ANY LIABILITY AND COSTS INCURRED AS THE RESULT OF ANY
UNLAWFUL USE OR DISCLOSURE OF SAID RECORDS AND
INFORMATION, OR ANY FAILURE TO COMPLY WITH THIS
PARAGRAPH BY THE CONTRACTOR, ITS OFFICERS AND
EMPLOYEES FROM ANY LIABILITY AND COSTS INCURRED AS 'rHE
RESULT OF ANY UNLAWFUL USE OR DISCLOSURE OF SAID
RECORDS AND INFORMATION,OR ANY FAILURE TO COMPLY WITH
THIS PARAGRAPH BY THE CONTRACTOR, ITS OFFICERS,
EMPLOYEES AND REPRESENTATIVES,
Generic Sexual Assault Exam Agreement Page 3
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Genetic Sexual Assault Exam Agreement Page 4
F-o r.
79
JPS HEALTH NETWORK
1500 South Main Street
Ft. Worth, Texas 76104
Date
Fort Worth Police Department
350 W Belknap
Fort Worth, Texas 76102
Attention: Accounts Payable
To Whom It May Concern.-
This
oncern:This claim is in reference to sexual assault examination charges. The officer's
name, badge number, case number and the date of service are listed on the
attached statement. The amount due is $ for the services rendered.
Please include the patient number (located in the top left-hand comer of the
itemized statement) for each claim.
Please mail the payment to: JPS HEAL TH NETWORK
P.O. Box 916046
Ft. Worth, Texas 76191-6046
817-920-6701
Attention: Cashier
Thank you,
Marilyn K- Franklin
Billing Coordinator
817-920-6701
Generic Sexual Assault Exam Agreement Page 5
City of Fort Worth, Texas
Mayor and Council Communication
COUNCIL ACTION: Approved on 11/4/2003
DATE: Tuesday, November 04, 2003
LOG NAME: 35HOSPITAL REFERENCE NO.: C-19845
SUBJECT:
Rape Examination Services Agreement with Tarrant County Hospital District for the Police
Department
RECOMMENDATION:
It is recommended that the City Council:
1. Authorize payment for hospital services rendered by the Tarrant County Hospital District at John Peter
Smith Hospital during FY2002-2003 for an amount not to exceed $125,000; and
2. Authorize an agreement for professional rape examination services for the Police Department with the
Tarrant County Hospital District at John Peter Smith Hospital: and
3. Authorize this agreement to begin October 1, 2003, and expire September 30, 2004, with up to four
successive one-year terms at the City's option.
DISCUSSION:
Rape examinations have been conducted at John Peter Smith Hospital (JPS), a division of the Tarrant
County Hospital District, for the past 23 years. In 1978, a cooperative effort between JPS, the Tarrant
County District Attorney's Office, and the Fort Worth Police Department was established in an attempt to
provide a more complete and uniform collection of evidence, thus benefiting the criminal investigation
procedure.
Prior to FY2002-2003, physician and hospital fees were billed to the District Attorney's Office, and rape
exam fees were billed to the Fort Worth Police Department with a per exam fee of $100. The annual cost to
the Police Department, at that time, was approximately $25,000, which was reimbursed by the
state. Beginning in FY2002-2003, JPS began billing the Police Department for the rape exam at an
increased rate ($195-233), and also the associated hospital fees ($250-400). However, due to a
miscommunication, the Police Department only processed the rape exam payments at the new rate. As a
result, the invoices for the hospital fees have not been paid, but the City has received reimbursement from
the state for the services. To correct this, JPS is reviewing each invoice to ensure that the charges do not
exceed the amount that is reimbursable, and will be resubmitting the invoices to the City.
This Mayor and Council Communication (M&C) will authorize the payment of these past invoices, and
resolve the fact that the City has received greater reimbursement from the state than has actually been paid
out. For FY2002-2003, total expenditures are estimated at $66,000 after the unpaid invoices are resolved;
however, this M&C will authorize payments up to $125,000 in the event that the revised invoices have a
higher than anticipated total. The state reimburses 100% of the cost through the Victims Compensation
Fund.
The Police Department will use the new agreement to provide professional examinations for an estimated
Logname: 35HOSPITAL Page 1 of 2
500 sexual assault cases during Fiscal Year 2003-2004. The charges for emergency room, tests
performed, and a hospital fee will be billed to the Police Department at a cost not to exceed $583 per case.
M/WBE - A waiver of the goal for M/WBE subcontracting requirements was requested by the department
and approved by the M/WBE Office because the purchase of services is from sources where subcontracting
or supplier opportunities are negligible.
RENEWAL OPTIONS - This agreement may be renewed for up to four successive one year terms at the
City's option. Renewal may be effected by notice in writing by the City Manager or his designated
representative to the contractor within 30 days of the expiration of the prior term and does not require
specific City Council approval, provided that the City Council has appropriated sufficient funds to satisfy the
City's obligations during the renewal term.
FISCAL INFORMATION/CERTIFICATION:
The Finance Director certifies that funds are available, as appropriated, of the General Fund. The Police
Department is responsible for the collection of revenue due to the City.
TO Fund/Account/Centers FROM Fund/Account/Centers
GG01 451130 0356103 0.00 GG01 539120 0356103 $0.00
Submitted for City Manager's Office by: Joe Paniagua ()
Originating Department Head: Ralph Mendoza (4-8386)
Additional Information Contact: Susan Alanis (4-8262)
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