Loading...
HomeMy WebLinkAboutContract 53582 DocuSign Envelope ID: 17DE1D40-53EO-4A8C-831A-740470EOB9CF 4 CSC No. 53582 FEg 2 2 c� NSeccRjhAGREEMENT TO PROVIDE SEXUAL ASSAULT NURSE EXAMINATION SERVICES O This Agreement to Provide Sexual Assault Nurse Examination Services ("Agreement") is made and entered into effective the Effective Date (see Section ILA below) by and between the Tarrant County Hospital District d/b/a JPS Health Network("TCHD"),a unit of local government, and more specifically a county hospital district, created and operating under Chapter 281 of the Texas Health and Safety Code and the City of Fort Worth ("City"), a Texas home rule municipal corporation. RECITALS WHEREAS, TCHD, in furtherance of its statutory obligations to provide health care services to the indigent and needy residents of Tarrant County, Texas, owns and operates a fully accredited, integrated health care delivery system providing health care services throughout, and serving the residents of, Tarrant County, Texas; and WHEREAS, The City requires specialized sexual assault examination services including full sexual assault examination of adolescent and adult victims of sexual assault(the"Services")by a Sexual Assault Nurse Examiner("SANE") for use in the investigation and prosecution of sexual assault offenses;and WHEREAS, as used herein a SANE is defined as a registered nurse who has received specialized training, as set forth by the Texas Attorney General's Office of Sexual Assault Prevention and Crisis Services,to perform full sexual assault examinations and partial sexual assault examinations and evaluations,which training includes,but is not limited to,the use of sexual assault examination kits, and the documentation required for each type of examination performed; and WHEREAS, TCHD has agreed to (i) provide the facilities necessary to perform the Services ("Facility" or "Facilities") and (ii) maintain employment of qualified SANE personnel with the necessary training and expertise to perform the Services; NOW, THEREFORE, in consideration of the mutual covenants contained herein, the parties agree as follows: I. SERVICES TO BE PERFORMED. A. Upon request from the City and authorization from law enforcement, TCHD will provide the Services which shall include the following: 1. A full forensic sexual assault examination ("Forensic Examination") using a sexual assault examination kit("SAE Kit"), for the purposes of gathering biological and trace evidence from acute sexual assault victims against whom a sexual assault has occurred within 120 hours prior to the victim presenting to TCHD(or longer if requested by law enforcement). The Forensic Examination may include the use of High Definition ("HD") photography and presentation of any documentation obtained by use of HD photography, including any written interview documents, graphs, charts or opinions, L%Ii. ,qEC0RD s ETARY DocuSign Envelope ID: 17DE1D40-53E04A8C-831A-740470EOB9CF — --- — and the packaged evidence included inside the SAE Kit. The Forensic Examination may also include, at the direction of law enforcement, testing for sexually transmitted diseases and the laboratory results of such testing. 2. For adolescent victims of sexual assault a Forensic Examination shall always be conducted regardless of when the sexual assault occurred. 3. The SANE's performance of a Forensic Examination shall be provided without cost to the victim,provided however that other necessary medical treatment,if any,which may not be covered though the victim's treatment may be reimbursed by other sources such as Crime Victims Compensation funding. 4. The Services shall be provided and be available at one or more Facilities*24 hours a day, seven days a week throughout the Term(defined below)hereof. 5. The Services shall be provided to the victim regardless of whether the victim names the abuser or cooperates with any investigation arising out of the sexual assault. 6. An advocate from the local Crisis Center will be offered and available to aid the victim of the sexual assault. 7. If a sexual assault results in the pregnancy of a victim, the victim shall receive timely and comprehensive information about and timely access to all lawful pregnancy-related medical services. 8. The Services shall comply with TCHD's confidentiality policies, and with the requirements of the Health Insurance Portability and Accountability Act ("HIPAA") and the Health Information Technology for Economic and Clinical Health Act of 2009 ("HITECH Act"), as more fully set forth herein in Section MR 9. The City shall retrieve the completed SAE Kit from TCHD in compliance with all applicable timeframes or deadlines required by applicable state law or regulation, as the same may be amended from time to time. R. MISCELLANEOUS A. Term and Termination 1. Term. The Term of this Agreement shall be for a period of five (5) year(s), commencing on October 1,2019 ("Effective Date")and terminating on September 30, 2024. 2. Termination. Either party may terminate this Agreement for any reason upon the provision of sixty(60) days prior written notice to the other party. DocuSign Envelope ID: 17DE1D40-53EO-4A8C-831A-740470EOB9CF --- B. Amendment. No supplement, modification or amendment of any term, provision, or condition of this Agreement shall be binding or enforceable on either party hereto unless in writing signed by both parties. C. Invoice for Services. TCHD's invoice for provision of the Services shall be submitted to the City for examinations conducted prior to September 1, 2019 and to the Texas Attorney General's office for examinations conducted on or after September 1, 2019, in the manner prescribed by state law and applicable regulations, as the same may be promulgated and/or amended from time to time. D. Compensation. For invoices submitted to the City , the City shall pay TCHD an amount not to exceed One Hundred and Fifty Thousand Dollars and 00/100 ($150,000.00) per year in accordance with the provisions of this Agreement and the Charge Sheet attached as Schedule"A,"which is incorporated for all purposes herein. TCHD shall not perform any additional services for the City not specified by this Agreement unless the City requests and approves in writing the additional costs for such services. The City shall not be liable for any additional expenses of TCHD not specified by this Agreement unless the City first approves such expenses in writing. There is no guarantee expressed or implied as to the minimum quantity of work that the City is obligated to provide or the minimum compensation to be paid under this Agreement. TCHD shall provide monthly invoices to the City. Invoices shall contain a detailed breakdown to include: date of service, patient name, and type of services performed including employees name and title. Payment for services rendered shall be due within thirty (30) days if the uncontested performance of the particular services so ordered and receipt by City of TCHD's invoice for payment of same. In the event of a disputed or contested billing, only that portion so contested may be withheld from payment, and the undisputed portion will be paid. No interest will accrue on any contested portion of the billing until mutually resolved. City will exercise reasonableness in contesting any billing or portion thereof. E. Assignment. No party to this Agreement may assign its rights under this Agreement without the prior written consent of the other party. F. Governing Law; Jurisdiction. THE AGREEMENT BETWEEN THE PARTIES REGARDING THE SUBJECT MATTER HEREOF SHALL BE GOVERNED BY AND INTERPRETED IN ACCORDANCE WITH THE LAWS OF THE STATE OF TEXAS, USA, WITHOUT REFERENCE TO ITS LAWS RELATING TO CONFLICTS OF LAW. Any legal action arising out of or relating to the subject matter hereof shall be brought only in the state or federal courts located in Tarrant County, Texas, and the parties irrevocably consent to the jurisdiction and venue of such courts. DocuSign Envelope ID: 17DE1 D40-53EO-4A8C-831A-740470EOB9CF ---- -- - G. Relationship of the Parties. None of the provisions of this Agreement are intended to create, and none shall be deemed or construed to create, any relationship between the parties,other than that of independent contractors. This Agreement shall not create the relationship of employer-employee,agency,partnership,or joint venture. Neither party shall have the right or power in any manner to unilaterally obligate the other to any third party, whether or not related to the purpose of this Agreement. H. Notices, Notices pursuant to this Agreement must be in writing to be effective. Notices shall be delivered as follows: a. For TCHD: Robert Earley,President and CEO Tarrant County Hospital District d/b/a JPS Health Network 1500 South Main Street Fort Worth,Texas 76104 With a copy to: Neal Adams General Counsel Adams,Lynch&Loftin,P.C. 3950 Hwy 360 Grapevine, Texas 76051 b. For City: City of Fort Worth Attn: Assistant City Manager 200 Texas Street Fort Worth, TX 76102-6314 Facsimile: (817) 392-8654 With copy to Fort Worth City Attorney's Office at same address I. SeverabWty. Should any part, term, or provision of this Agreement be declared to be invalid, void, or unenforceable, all remaining parts, terms, and provisions hereof shall remain in full force and effect,and shall in no way be invalidated,impaired,or affected thereby. J. Entire Agreement. This Agreement contains the entire agreement between the parties relating to the rights herein granted and the obligations herein assumed,and supersedes all prior written or oral agreements or communications between the parties. J. Electronic Signatures; Facsimile and Scanned Copies; Duplicate Originals; Counterparts; Admissibility of Copies. Each Party agrees that: (i) any electronic signature (if any), whether digital or encrypted, to this Agreement made by any Party is intended to authenticate this Agreement and shall have the samc force and effect as an original manual signature; and (ii) any signature to this Agreement by any Party DocuSign Envelope ID: 17DE1D40-53EO-4A8C-831A-740470EOB9CF - -- -- ------------ — transmitted by facsimile or by electronic mail shall be valid and effective to bind that Party so signing with the same force and effect as .an original manual signature. Delivery of a copy of this Agreement or any other document contemplated hereby bearing an original or electronic signature by facsimile transmission (whether directly from one facsimile device to another by means of a dial-up connection or whether mediated by the worldwide web),by electronic mail in portable document format(.pd fl form, or by any other electronic means intended to preserve the original graphic and pictorial appearance of a document, will have the same effect as physical delivery of the paper document bearing an original or electronic signature. This Agreement may be executed in multiple duplicate originals and all such duplicate originals shall be deemed to constitute one and the same instrument. This Agreement may be executed in counterparts,each of which shall be deemed to be an original,but all of which,taken together, shall be deemed to constitute a single instrument. The Parties warrant and represent that a true and correct copy of the original of this Agreement shall be admissible in a court of law in lieu of the original Agreement for all purposes of enforcement hereof. K. Binding Agreement. The parties hereto warrant and represent that upon execution hereof, this Agreement shall be a legal,valid and binding obligation on them and shall be enforceable against them in accordance with its terms. The individuals signing this Agreement warrant and represent that they are duly authorized to sign this Agreement on behalf of the parties hereto. L. Budgetary Limitations. The parties acknowledge and agree that both parties are governmental entities and, as such, are subject to an annual budgetary processes and the limitations and restrictions of fiscal funding. Notwithstanding any other provision herein, if and to the extent the obligations of this Agreement, either in its initial Term or in any automatically or otherwise renewed Term, should continue over into TCHD's or City's subsequent fiscal years following that fiscal year when this Agreement was executed and funds are not appropriated or budgeted for this Agreement and completion of the Term in question, TCHD or City may terminate this Agreement. M. Right to Audit. TCHD agrees that City shall, until the expiration of three (3) years after final payment under the Agreement, have access to and the right to examine any directly pertinent books, documents, papers and records of TCHD involving transactions relating to the Agreement.TCHD agrees that City shall have access during normal working hours to all necessary TCHD facilities and shall be provided adequate and appropriate workspace in order to conduct audits in compliance with the provisions of this section. City shall give TCHD reasonable advance notice of intended audits. Agreement without penalty and shall have no further obligation or liabilities hereunder. [Signature page follows] DocuSign Envelope ID: 17DE1D40-53EO-4A8C-831A-740470EOB9CF - - --- Consented to and Agreed as of the Effective Date. TARRANT COUNTY HOSPITAL DISTRICT d/b/a JPS Health Network 1500 S.Main Street Fort Worth,TX 76104 By: Ra(di>X f 4t!j Name:Robert Earley Title: President and CEO Date: February 26, 2020 1 9:30 AM CST CITY: City of Fort Worth Contract Compliance Manager: By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract,including ensuring all performance By: Jesus J.Chapa(Jan 29,2020) and reporting requirements, Name: Jesus J. Chapa Title: Assistant City Manager J=�6� Date: By: Sasha Kane(Jan 23,2020) Name: Sasha Kane Approval Recommended: Title: Sr.Contract Compliance Specialist Approved as to Form and Legality: Edwin Kraus By: Edwin Kraus(Jan 27,2020) `� Name: Edwin Kraus �,.� .. � " t Title: Chief of Police e y: Matt Murray(Jan 29,20201 ame: Matthew A.Murray Attest: _ � itle: Assistant City Attorney ;contract Authoriz do forRonald P. C�onza/es ';""' ti " , " M&C: 19-0229 I D/1S IC lq By: for Ronald P.Gonzales(Jan 29,2020) Name: Mary J.Kayser Title: City Secretary OFFICIAL RECORD CITY SECRETARY FT. WORTH,TX DocuSign Envelope ID: 17DE1D40-53EO-4A8C-831A-740470EOB9CF Schedule A Charge Sheet for Sexual Assault Examination DocuSign Envelope ID: 17DE1D40-53EO-4A8C-831A-740470EOB9CF Standard Costs Associated with Examination (Dates of crime on or after 7115/16) Maximum aggregate amount of reimbursement:$1000 Possible Code/s Description Limit Notes 99283- Sexual Assault $233.00 Examiner fee for an exam performed by a physician, 99285, Exam licensed nurse practitioner,sexual assault examiner, or sexual assault nurse examiner. 57452- . This fee covers the basic patient evaluation,however 57420 additional examinations may be required based on the findings and history,such as an anogenital assessment or anoscopy, may be submitted for reimbursement. • Sexual assault examiners and sexual assault nurse examiners(SANE)may submit a standard billing form with a descriptive itemized statement. Possible Code/s Description Limit Notes 99211 Place of service $125.00 This includes exams conducted in any healthcare setting fee for exam in other than a hospital(non-facility setting). non-facility setting FAC Place of service $350.00 • This includes exams conducted at a hospital(facility fee for exam in a setting). R-450 or R- facility setting • A hospital includes a general or special hospital 760 licensed under the Texas Health and Safety Code, Chapter 241. 0 Charges for hospitals must be on a UB-04,including an itemized statement. Revenue code R-450 or R-760 might be used in conjunction with this fee. E�t� e5 Possible Cade/s Description Limit Notes 99170 Anogenital Exam $150.00 Anogenital exam using magnification(magnification *99199— includes colposcope,SDFI,or other medically accepted requires magnification for anogenital assessment. Itemization or a description of services billed 56820 Exam of Vulva $150.00 Exam of the vulva using magnification(magnification with includes colposcope,SDFI,or other medically accepted Magnification magnification for assessment). 46600 Anoscopy $71.00 Examination by physician,sexual assault nurse examiner, or sexual assault examiner where an anoscopy is performed. Revised July 21,2016 DocuSign Envelope ID: 17DE1D40-53EO-4A8C-831A-740470EOB9CF Standard Costs Associated with Examination (Dates of crime on or after 7/15/16) Maximum aggregate amount of reimbursement:$1000 Sexual AssatiltKit Possible Code/s Description Limit Notes 99070/Kit Sexual Assault kit $50.00 This may be used in addition to supplies-digital photography charged under 99070 or other supplies charged under 99070. 'Laboratory (Maximum reimbursement for all lab fees:$250.00) Possible Code/s Description Limit Notes CPT code Pathology and $250.00 o Requires a detailed or itemized description with a range Laboratory breakdown of charges. 80047 Procedures 0 Maximum reimbursement for all lab fees:$250.00. 89398 • Laboratory procedures including,but not limited to: ■ Pregnancy test ■ Urine analysis ■ Drug or alcohol screen ■ STD Testing ■ Venipuncture ■ Handling/conveyance of the specimen Additional Charges Possible Code/s Description Limit Notes 99499 Additional $106.00/ • Requires Documentation of Procedure. Evaluation Hour • This includes additional time needed after the start of Management the exam. • Examples:language barrier,extensive exam,trauma, waiting for law enforcement arrival to pick up evidence. 99070 Supplies: Digital $100.00 e Requires a detailed or itemized description. Photography 0Use of digital photography during examination. • This includes setup and take down of equipment, burning of CDs,and other activities. • This may be used in addition to the kit under 99070/Kit or other supplies charged under 99070. 99070 Supplies $100.00 e Requires a detailed or itemized description. • Extensive laboratory procedures that require excess supplies and materials require Documentation of Procedure and will be reimbursed up to a maximum amount of$100.00 for the supplies and materials. • This may be used in addition to the kit under 99070/Kit or supplies-digital photography charged under 99070. 99050 After Hours $39.00 This includes weekends,holidays,or exams conducted between lOpm-8am. Revised July 21,2016 City of Fort Worth, Texas Mayor and Council Communication DATE: 10/15/19 M&C FILE NUMBER: M&C 19-0229 LOG NAME: 3535JPSSANE19 SUBJECT Authorize Execution of Agreement for Sexual Assault Medical Examination Services with the Tarrant County Hospital District d/b/a JPS Health Network to be Reimbursed by the Texas Crime Victims'Compensation Fund in an Amount Not to Exceed$150,000.00 Per Year and Adopt Appropriation Ordinance(ALL COUNCIL DISTRICTS) RECOMMENDATION: It is recommended that the City Council: 1.Authorize execution of an Agreement for sexual assault medical examination services with the Tarrant County Hospital Distract d/b/a JPS Health Network; 2.Authorize the Agreement to begin October 1,2019 and expire September 30,2020; 3.Authorize the Agreement to be renewed for up to four successive one-year periods;and 4.Adopt the attached appropriation ordinance increasing appropriations in the General Fund, in an amount up to$150,000.00, pending receipt of reimbursement funds. DISCUSSION: Sexual assault medical examinations have been conducted at John Peter Smith Hospital(JPS),a division of the Tarrant County Hospital District, for more than 30 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.The Attorney General's Office of the State of Texas establishes victim eligibility and allowable reimbursable expenses and will reimburse the City up to$1,000.00 per case. The Police Department will use the Agreement to provide professional examinations for an estimated 240 sexual assault cases for Fiscal Year 2020.The charges for emergency room,tests performed and a hospital fee will be billed to the Police Department at a cost not to exceed $1,000.00 per case as allowable and reimbursable expenses by the State of Texas Crime Victims'Compensation Program. RENEWAL OPTIONS:This Agreement may be renewed for up to four additional one year periods at the City's option at a cost of up to $100,000.00 per renewal period. This action 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. A Form 1295 is not required because:This contract will be with a governmental entity,state agency or public institution of higher education:JPS Health Network FISCAL INFORMATION/CERTIFICATION: The Director of Finance certifies that upon approval of the above recommendations and execution of the Agreement,funds will be available in the current operating budget,as appropriated,of the General Fund.The Police Department is responsible for the collection and deposit of funds due to the City. Submitted for City Manager's Office by- Jay Chapa 5804 Originating Business Unit Head: Ed Kraus 4231 Additional Information Contact: Sasha Kane 4547