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HomeMy WebLinkAboutContract 63461CSC No. 63461 MOBILE INTEGRATED HEALTHCARE SERVICES AGREEMENT READMISSION PREVENTION PROGRAM This Agreement for mobile integrated healthcare ("Agreement") is entered into as of the date shown below between Baylor Scott & White All Saints Medical Center ("Facility") and the City of Fort Worth ("Provider"). WHEREAS, Facility provides health care services through an integrated health delivery system that includes in -patient services, as well as a network of facilities located throughout and serving the residents of North Texas; and. WHEREAS, Facility from time to time contracts with other medical service providers to facilitate the programs of Facility; and; WHEREAS, Provider is in the business of providing health services to facilities and individuals, and; WHEREAS, Provider has developed and maintains the expertise and resources necessary to perform and complete the services described herein, and; NOW, THEREFORE, in consideration of the agreements contained herein and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties hereto agree as follows: Article 1 DEFINITIONS 1. "Provider" shall mean the City of Fort Worth. 1.2. "Program" shall mean the organized effort to provide recently discharged Facility patients with a thirty (30) day plan to decrease the likelihood of readmission through the interventions described in Exhibit A ("Readmission Prevention Program"), attached hereto and incorporated by reference. 1.3. Program Fee" shall mean the amount Facility shall pay Provider for each Program Patient enrolled in the Program. 1.4. Program Patient" shall mean Facility patients who are identified by Facility as having preventable hospital readmissions, who fit the Program enrollment guidelines, and who are selected by Facility receive Services from Provider under this agreement. 1.5. "Services" shall mean the health care services provided to Program Patients by Provider under the Program, as more fully described on Exhibit A. OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Article 2 -PROVIDER'S COMMITMENTS. 2.1. Services. Provider shall provide Services to Program Patients as more fully described in Exhibit A. Provider will supply the necessary equipment, supplies and other materials required to perform and deliver the Services to the Program Patients. 2.2. Performance Expectations. Provider shall furnish the Services to Program Patients as set forth in Exhibit B (attached hereto and incorporated herein by reference). 2.3. Qualifications of Personnel. Provider shall use only qualified personnel to perform the Services. Records of the qualifications and certifications of Provider Personnel shall be made available to Facility upon request. 2.4. Data Reporting and -Population Management. For purposes of this Agreement, patient population information shall be shared between Facility and Provider at a minimum of monthly intervals. More frequent information sharing may be required pursuant to the Program Management and Reporting requirements in Article 3 of Exhibit A. Facility shall refer Program Patients referrals to the appropriate patient populations in the Program and shall manage system records for the same. 2.5. Program Patient Care Encounter Documentation. Provider shall track and report all encounters with Program Patients in an Electronic Medical Record ("EMR") with an appropriate level of detail for incorporation in Facility's records. The EMR shall be provided to Facility within one (1) business day of request and shall include all required information. If Facility notifies Provider that the EMR is incomplete or unreadable, the Facility shall notify Provider's Program liaison and Provider shall provide a new EMR with the appropriate level of information or in a readable condition within one (1) business day of such notice. 2.6. Program Patient Data. Both parties agree to share Program Patient data for purposes permitted under the provisions of 45 CFR § 164.506. Both parties shall retain Program records for the time required by law. 2.7. Program Liaisons. Provider and Facility shall each designate Program liaisons who are readily accessible to address concerns. Article 3 PROGRAM FEES AND PAYMENT. 3.1. Fee Structure. The Program Fee is per Patient and covers all Provider visits and contacts with a Program Patient for a defined thirty (30) day period. 3.2. Invoices and Payment. Provider shall invoice Facility on a monthly basis for Program Patients that have completed the thirty (30) day Program no later than the 15th day of the following month. Facility shall make payment of all amounts not subject to a bona fide dispute within thirty (30) days of Facility's receipt of the invoices from Provider. 3.3. Payment Disputes. Facility will notify Provider of any disputed charges within 10 business days from receipt of the invoice. 3.4. Program Fee Amount. Facility will compensate Provider at a rate of Twelve Hundred U.S. Dollars ($1,200.00) for each enrolled Program Patient. Provider may increase the Program Fee by giving sixty (60) days' notice (see Section 5.1.1 below for Facility's right to terminate). No Program Fee shall be due for patients who are referred by Facility but not enrolled by Provider. Article 4 TERM OF AGREEMENT. 4.1. This Agreement shall become effective on the date shown below for an initial one year term and shall automatically renew for two additional one year terms unless terminated by either parry in accordance with Article 5 below. Article 5 TERMINATION. 5.1. Notice. Either party may terminate this Agreement with or without cause by giving sixty (60) days written notice to the other party of the effective date of termination. If Facility gives notice of termination within thirty (30) days of receiving notice of a rate increase by Provider, only thirty (30) days' notice shall be required to effect a termination and the existing rates will remain in effect for the thirty (30) days before termination. 5.2. Breach. Either party may terminate this Agreement in the event of the other party's material breach hereof; provided, however, that termination for breach shall not become effective unless and until the parry in breach has been given written notice of such breach describing the nature of the breach with sufficient specificity to permit its cure, and such party shall have failed to have cured such breach to the reasonable satisfaction of the other within thirty (30) days following said notice. 5.3. Nonpayment. In the event of nonpayment by Facility of any amount due hereunder, Provider may terminate this Agreement on ten (10) days written notice. 5.4. Insolvency. In the event a Party files a voluntary petition in bankruptcy or makes an assignment for the benefit of creditors or otherwise seeks relief from creditors under any federal or state bankruptcy, insolvency, reorganization or moratorium statute, or is the subject of an involuntary petition in bankruptcy which is not dismissed with prejudice within sixty (60) days of its filing, the other party may terminate this Agreement immediately. 5.5. Prior obligations. Termination shall have no effect upon the rights or obligations of the parties arising out of any transactions occurring prior to the effective date of such termination. Article 6 HIPAA PRIVACY RULE. 6.1. Covered Entities. Both parties provide health care services directly to patients and are "covered entities" under the HIPAA Privacy Rule. 45 C.F.R. § 160.103. The HIPAA Privacy Rule expressly permits covered entities to share protected health information ("PHI") for the provision, coordination, and management of health care and for conducting quality assessments and improvement activities. 45 C.F.R. § 164.506(c). Therefore, Facility acknowledges and agrees that it is permitted to disclose PHI to Provider without the need for a business associate agreement, patient authorization, or any other permissions or approval. Article 7 NOTICES. 7.1. Any notice required to be given pursuant to this Agreement shall be in writing and shall be sent by certified mail, registered mail, or hand delivery to the parties at the addresses set forth below: Provider: City of Fort Worth 100 Fort Worth Trail Fort Worth, Texas 76102 Attn: Assistant City Manager w/Copy to City Attorney Facility: Baylor Scott & White All Saints Medical Center 1400 81h Ave Fort Worth, TX 76104 Attn: Charles Williams Article 8 GENERAL PROVISIONS 8.1. Parties Bound. This Agreement shall be binding upon and inure to the benefit of the parties and their respective legal representatives, assigns and successors. 8.2. Legal Construction. In case one or more of the provisions contained in this Agreement shall for any reason be held to be invalid, illegal, or unenforceable in any respect, such invalidity, illegality or unenforceability shall not affect any other provision in this Agreement and this Agreement shall be construed as if such invalid, illegal, or unenforceable provision had never been contained in it. 8.3. Entire Agreement. This Agreement constitutes the entire agreement of the parties on the subject matter and supersedes any prior understanding or written or oral agreements between the parties respecting the subject matter of this Agreement. 8.4. Governing LaNv. This Agreement shall be construed under and in accordance with the laws of the State of Texas, and all obligations of the parties created under this Agreement are performable in Tarrant County, Texas. 8.6. No Assignment. Neither this Agreement nor any duties or obligations under it shall be assignable by either party without the prior written consent of the other party. In the event of an Assignment by either party to which the other party has consented, the assignee or the assignees legal representative shall agree in writing to assume, perform, and be bound by all of the covenants, obligations and agreements contained in this Agreement. 8.7. Amendment. This Agreement may be only amended by a written instrument signed by both parties. 8.8. Medicare Access to Records. To the extent required by Section 1395x(v)(1)(I) of Title 42 of the United States Code, until the expiration of four years after the termination of this Agreement, Provider shall, upon written request, make available to the Secretary of the United States Department of Health and Human Services, or to the Comptroller General of the United States General Accounting Office, or to any of their duly authorized representatives, a copy of this Agreement and such books, documents, and records as are necessary to certify the nature and extent of the costs of the Services provided by Provider under this Agreement. 8.9. Independent Contractor. It is understood and agreed that Provider is engaged by Facility to provide the Services as an independent contractor and that no employee or agent of one party shall be considered an employee or agent of the other party. Neither party has the right to bind the other party to any contract or any other obligations. 8.10. Warranty of Services. Provider represents and warrants that all services provided under this Agreement comply with applicable laws. Provider represents and warrants that (a) Provider is not excluded from any federal health care program, as defined under 42 U.S.C. Section 1320a- 7b(f), for the provision of items or services for which payment may be made under a federal health care program; (b) no basis for exclusion from any health care program exists; (c) Provider has not arranged or contracted (by employment or otherwise) with any employee, contractor, or agent that Provider knows or should know are excluded from participation in any federal health care program; and (d) no final adverse action, as such term is defined under 42 U.S.C. Section 1320a-7e(g), has occurred or is pending or threatened against Provider or its affiliates or to their knowledge against any employee, Provider or agent engaged to provide items or services under this agreement (collectively "Exclusions/Adverse Actions") Provider, during the term of this Agreement, shall notify Facility of any Exclusions/Adverse Actions or any basis therefore within fifteen (15) days of its learning of any such Exclusions/Adverse Actions or any basis therefore. 11. Multiple Counterparts. This Agreement may be executed in multiple counterparts, each of which shall be deemed to be an original for all purposes. EXECUTED to be effective as of July 1, 2025. CITY OF FORT WORTH U By William J hnson (Jun 16, 202515:13 CDT) Printed Name: William Johnson Title: Assistant City Manager Baylor Scott & White All Saints Medical Center By: Oj'� wxw� Printed Name: Charles Williams Title: President West Region & BSW All Saints Medical Center CITY OF FORT WORTH INTERNAL ROUTING PROCESS: Approval Recommended: By: James Davis (Jun 16, 2025 13:30 CDT) Name: Jim Davis Title: Fire Chief Approved as to Form and Legality: B: Y Name: Taylor C. Paris Title: Assistant City Attorney Contract Authorization: M&C:25-05 1 6.10.2025 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 and reporting requirements. By: AW Name: Brenda Ray Title: Purchasing Manager City Secretary: 4 FORr°°o pro Gpdp aa�lv1v^„" dpQn nEXo 56gq By: Name: Jannette S. Goodall Title: City Secretary OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX EXHIBIT "A" READMISSION PREVENTION PROGRAM Article 1 REFERRALS 1.1. Upon obtaining the patient's consent and authorization, referrals into the Readmission Prevention Program will be initiated by Facility utilizing Provider's enrollment process. 1.2. Provider will follow-up on a patient within 24 hours of referral into the Program to do an initial assessment and process enrollment. 1.3. A patient will be counted as enrolled after the initial assessment is complete and patient agrees to participate in the Program. Article 2 Program Requirements 2.1. Program interventions include: 2.1.1. Initial assessment including discharge summary review 2.1.2. PCP/Specialist care coordination approach 2.1.3. Assessment of living environment 2.1.4. Education on disease process 2.1.5. Review and verification of medications 2.1.6. Baseline vital signs and assessment 2.1.7. Delivery and review of patient education and tracking materials 2.1.8. Delivery of non -emergency access phone contact number and instructions for use 2.1.9. Completion of a series of home visits to educate the patient and family on appropriate care management. 2.2. If the patient meets clinical requirements, Provider will coordinate in -home diuresis with the patient's PCP or specialist. 2.3. Provider will provide Program Patients with a twenty-four (24) hours a day, seven (7) days a week, non -emergency number to request mobile healthcare provider support during Program enrollment. 2.4. Term of enrollment will be for the thirty (30) day post -discharge period. 2.5. After enrollment is complete, Provider is responsible for administering and performing the interventions. 2.6. Program medical direction will be the sole responsibility of Provider. 2.7. Facility may audit the Program and review specific interventions at any time for the purposes of validating outcomes and adherence to process. Article 3 PROGRAM MANAGEMENT & REPORTING 3.1. Provider will provide weekly summary reporting of the Program including: 3.1.1. Count of new referrals 3.1.2. Count of patients by Program disposition 3.2. Provider will provide monthly summary & detail reporting of the Program including: 3.2.1. Patient demographics 3.2.2. Current disposition 3.2.3. Number of Visits 3.2.4. Number of Calls 3.2.5. Enrollment date 3.2.6. Last visit date 3.2.7. Expected Program completion date 3.3. Facility will provide detailed level reporting for patients enrolled in Program including: 3.3.1. Patient consent 3.3.2. Patient demographics 3.3.3. Count of ED Visits for each patient, pre and post enrollment 3.3.4. Count of Inpatient Admissions for each patient, pre and post enrollment 3.3.5. Recent discharge instructions and care plans 3.4. Provider will participate in monthly Program review meetings to discuss outcomes of the Program Domain Quality of Care & Patient Safety Experience of Care Metrics Name Q 1: Primary Care Utilization (CORE MEASURE) Q5: Unplanned Acute Care Utilization (e.g., emergency ambulance response, urgent ED visit) U4: Unplanned 30day Facility Readmissions (CORE MEASURE) E l : Patient Satisfaction (CORE MEASURE) EXHIBIT "I3" PERFORMANCE EXPECTATIONS Goal Increase the number of patients utilizing a Primary Care Provider (if none upon enrollment) Minimize rate of patients who require unplanned acute care related to Provider care plan within 24 hours after a Provider intervention. Reduce rate of all -cause unplanned 30-day Facility readmission s by enrolled patients by intervention Optimize patient satisfaction scores by intervention Value I Number of Enrolled Patients with an established PCP relationship upon graduation Number of patients who require unplanned acute care related to Provider care plan within 24 hours after a Provider intervention. Number of actual 30-day readmissions. Value 2 Number of enrolled patients without an established PCP relationship upon enrollment All Provider visits in which a referral to Acute Care was NOT REQUIRED. Number of anticipated 30- day readmissions. Each referred patient is anticipated to have one (1) readmission during the 30day period. Formula Value I Nalue 2 Value 1 /Value 2 Value 1/Value 2 Metric 90% 5% 20% 90% City of Fort Worth, Texas Mayor and Council Communication DATE: 06/10/25 M&C FILE NUMBER: M&C 25-0531 LOG NAME: 36FD EMS MIH PROGRAM SUBJECT (ALL) Authorize Execution of Agreements for the Mobile Integrated Health Program within the City of Fort Worth Fire Department's Emergency Medical Services Operation in Collaboration with Multiple Agencies RECOMMENDATION: It is recommended that the City Council authorize execution of agreements for the Mobile Integrated Health Program within the City of Fort Worth Fire Department's Emergency Medical Services operation, in collaboration with multiple agencies. DISCUSSION: The purpose of this Mayor and Council Communication (M&C) is to authorize execution of agreements with Kindful Health, LLC, Health Masters HomeCare, Inc., Holy Savior Hospice, LLC., Klarus Home Care, LLC, Landmark Health of California, LLC, Texas Health Harris Methodist Hospital Alliance, Cook Children's Health Plan, Holy Hospice & Palliative Care, LLC, Medically Home Group, Inc., Molina Healthcare of Texas, Inc., Silverado Hospice and Supportive Care, and Vitas Healthcare of Texas, L.P. The City of Fort Worth recognizes the growing need for innovative, cost-effective, and community -based healthcare delivery models. The Mobile Integrated Health (MIH) Program represents a proactive approach to addressing non -emergent 911 calls, frequent system users, chronic disease management, behavioral health crises, and social determinants of health by integrating public safety and healthcare resources. Through partnerships with these agencies, the Fort Worth Fire Department seeks to implement and enhance MIH services that: • Reduce non -emergency calls to 911 • Decrease avoidable emergency room visits • Provide targeted care to high -utilizer populations • Offer in -home assessments, telehealth services, and follow-up care • Improve community health outcomes and patient satisfaction • Support continuity of care for patients with chronic or complex needs One critical element of this collaborative approach includes coordination with healthcare facilities to identify and enroll eligible patients in the MIH Program. Facilities will introduce the concept of enrollment to all patients they determine to be eligible, provided those patients reside within the Fort Worth Emergency Medical Services (EMS) System service area. At the request or desire of the patient, the facility will facilitate enrollment into the MIH program. Facilities will notify the City's MIH program of each patient enrolled and provide relevant patient information necessary for continuity of care, data tracking, and program evaluation. Importantly, this program will not require funding from the City of Fort Worth. All services performed under this agreement will be compensated by the participating facilities or organizations. This ensures that MIH resources are sustainably deployed while expanding access to care through strategic partnerships. Programs under this initiative may include, but are not limited to: • Nurse Triage and Alternative Destination Transport • High Utilizer Outreach Programs • Behavioral Health and Crisis Intervention Response • Transitional Care and Chronic Disease Management • Community Paramedicine Programs The execution of agreements with partner agencies is essential to clearly define roles, responsibilities, data -sharing protocols, reimbursement models, and operational procedures. These agreements will serve ALL COUNCIL DISTRICTS. A Form 1295 is not required because: This contract legally does not require City Council approval. FISCAL INFORMATION / CERTIFICATION: The Director of Finance certifies that approval of this recommendation will have no material effect on City funds. Submitted for Citv Manaaer's Office bv: William Johnson Oriainatina Business Unit Head: Jim Davis 6801 Additional Information Contact: