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HomeMy WebLinkAboutContract 63547MONO =099 CA W CITY OF FORT WORTH AGREEMENT FOR MOBILE INTEGRATED HEALTH SERVICES This Agreement for Mobile Integrated Health Services ("Agreement") is made between the City of Fort Worth ("Fort Worth"), a home -rule municipal corporation organized under the laws of the state of Texas, and Recovery Resource Council, a Domestic Nonprofit Corporation ("Facility"). Fort Worth and Facility are each a "Party" and collectively the "Parties" to this Agreement. WHEREAS, Fort Worth, by and through the Fort Worth Fire Department, provides regulated prehospital emergency medical services ("EMS") and emergency ambulance transportation ("EMS System") to the public within its jurisdiction and of those jurisdictions who have executed an EMS Interlocal Agreement with Fort Worth; WHEREAS, as the licensed EMS Provider of Fort Worth's EMS System, Fort Worth also provides mobile integrated health services ("MIH") to enrolled clients; WHEREAS, MIH includes non-exclusive services that are designed to enhance, coordinate, effectively manage, and integrate out of hospital care, to improve outcomes, enhance the client's experience of care, and improve the efficiency and effectiveness of healthcare services provided to enrolled clients; and WHEREAS, the purpose of this Agreement is to state the terms and conditions under which Fort Worth will provide MIH services to Facility and Facility's patients who elect to enroll in Fort Worth's MIH program; NOW THEREFORE, known by all these present, Fort Worth and Facility, acting herein by the through their duly authorized representatives, agree to the following terms: I. SCOPE OF SERVICES 1.1 Fort Worth will provide enrolled patients of Facility with the services described in Paragraph 1 of Exhibit "A" attached hereto and incorporated herein by this reference (the "MIH Services") 1.2 Facility will provide Fort Worth with the services, and perform the obligations, described in Paragraph 2 of Exhibit "A" attached hereto and incorporated herein by this reference. II. TERM 2.1 This Agreement will be effective upon execution by Fort Worth's Assistant City Manager and will expire on September 30 of the next fiscal year of Fort Worth, unless terminated earlier in accordance with the terms and conditions of this Agreement. This Agreement may be renewed by the written, mutual, agreement of the Parties for an unlimited number of one-year renewals, each a "Renewal Term." MIH Services Agreement Page 1 of II IV. TERMINATION 4.1 Convenience. Either Fort Worth or Facility may terminate this Agreement at any time and for any reason by providing the other party with 30 days written notice of termination. 4.2 Breach. If either party commits a material breach of this Agreement, including but not limited to the Facility failing to pay to Fort Worth any amount due hereunder, the non -breaching Party must give written notice to the breaching party that describes the breach in reasonable detail. The breaching party must cure the breach ten (10) calendar days after receipt of notice from the non -breaching party, or other time frame as agreed by the parties. If the breaching party fails to cure the breach within the stated period, the non -breaching party may, in its sole discretion, and without prejudice to any other right under this Agreement, law, or equity, immediately terminate this Agreement by giving written notice to the breaching party. 4.3 Duties and Obligations of the Parties. In the event that this Agreement is terminated prior to the Expiration Date, Facility shall pay Fort Worth for services actually rendered up to the effective date of termination and Fort Worth shall continue to provide the Facility with services requested by the Facility and in accordance with this Agreement up to the effective date of termination. Upon termination of this Agreement for any reason, Facility shall provide Fort Worth with copies of all completed or partially completed documents prepared under this Agreement. In the event Facility has received access to Fort Worth information or data as a requirement to perform services hereunder, Facility shall return all Fort Worth provided data to Fort Worth in a machine-readable format or other format deemed acceptable to Fort Worth. V. REQUIRED DOCUMENTATION 5.1 To facilitate Fort Worth's provision of the MIH Services, upon request by Fort Worth, Facility shall provide Fort Worth with all documentation reasonably required by Fort Worth in connection with the MIH Services as soon as reasonably possible. Further, Facility shall maintain such documentation for the longer of six (6) years after termination of this Agreement, or the period required by applicable state law. 5.2 Fort Worth will provide patient care reports for enrolled Facility patients that receive MIH Services electronically using Fort Worth's ePCR system, as may be required. Contemporaneously with the execution of this Agreement, Facility agrees to execute a Business Associate Agreement with Fort Worth on the template provided by Fort Worth. VI. HIPAA 6.1 It is the intent of the parties to comply fully with the Health Insurance Portability and Accountability Act, Texas Health and Safety Code Chapter 181, and implementing regulations issued pursuant thereto (collectively "HIPAA" herein). The parties agree that protected health information (hereinafter referred to as "Protected Health Information" or "PHI") is subject to protection under HIPAA, and it is the intent of the parties to be in full compliance with, state and federal law, including applicable provisions of HIPAA, the Health Information Technology for MIH Services Agreement Page 2 of 11 Economic and Clinical Health Act ("HITECH") its related regulations, and all applicable state privacy and security laws related to access of PHI by the Parties. To the extent that the services performed under this Agreement are determined to be performing a transaction subject to HIPAA or the HITECH Act, the Business Associate Agreement shall control. 6.2 Each party shall implement and maintain such safeguards as are necessary to ensure that the PHI is not used or disclosed except as is provided in this Agreement and any referenced documents, including the Business Associate Agreement. VII. RECORDS 7.1 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, Fort Worth 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 Fort Worth under this Agreement. 7.2 Facility shall retain all documents produced because of services provided hereunder for a period of three (3) years (hereafter referred to as "retention period") from the date of termination of the Agreement. If, at the end of the retention period, there is litigation or other questions arising from, involving, or concerning this documentation or the services provided hereunder, Facility shall retain the records until the resolution of such litigation or other such questions. Facility agrees that Fort Worth shall have access to and the right to examine at reasonable times any directly pertinent books, documents, papers and records of Facility involving transactions relating to this Agreement at no additional cost to Fort Worth. Facility agrees that Fort Worth shall have access during normal working hours to all necessary Facility property and shall be provided with adequate and appropriate workspace in order to conduct audits in compliance with the provisions of this section. Fort Worth shall give Facility not less than 10 days' written notice of any intended audits. VIII. INDEMNIFICATION 8.1 Facility covenants and agrees to FULLY INDEMNIFY, DEFEND and HOLD HARMLESS, Fort Worth and the elected officials, employees, officers, directors, volunteers and representatives of Fort Worth, individually and collectively, from and against any and all costs, claims, liens, damages, losses, expenses, fees, fines, penalties, proceedings, actions, demands, causes of action, liability and suits of any kind and nature, including but not limited to, personal or bodily injury, death and property damage, made upon Fort Worth directly or indirectly arising out of, resulting from or related to Facility's activities under this Agreement, including any acts or omissions of Facility, any agent, officer, director, representative, employee, consultant or subcontractor of Facility, and their respective officers, agents employees, directors and representatives while in the exercise of the rights or performance of the duties under this Agreement. The indemnity provided for in this paragraph shall not apply to any liability resulting from the sole negligence of Fort Worth, its officers or employees, in instances where such negligence causes personal injury, death, MIH Services Agreement Page 3 of 11 or property damage. IN THE EVENT FACILITY AND FORT WORTH ARE FOUND JOINTLY LIABLE BY A COURT OF COMPETENT JURISDICTION, LIABILITY SHALL BE APPORTIONED COMPARATIVELY IN ACCORDANCE WITH THE LAWS FOR THE STATE OF TEXAS, WITHOUT, HOWEVER, WAIVING ANY GOVERNMENTAL IMMUNITY AVAILABLE TO FORT WORTH UNDER TEXAS LAW AND WITHOUT WAIVING ANY DEFENSES OF THE PARTIES UNDER TEXAS LAW. 8.2 The provisions of this indemnity section are solely for the benefit of the parties hereto and not intended to create or grant any rights, contractual or otherwise, to any other person or entity. Facility shall advise Fort Worth in writing within 24 hours of any claim or demand against Fort Worth or Facility known to Facility related to or arising out of Facility's activities under this Agreement and shall see to the investigation and defense of such claim or demand at Facility's cost. Fort Worth shall have the right, at its option and at its own expense, to participate in such defense without relieving Facility of any of its obligations under this paragraph. IX. NOTICE 9.1 Notices. Notices required pursuant to the provisions of this Agreement shall be conclusively determined to have been delivered when (1) hand -delivered to the other party, its agents, employees, servants or representatives; or (2) received by the other party by United States Mail, registered, return receipt requested, addressed as follows: TO FORT WORTH: City of Fort Worth Attn: Assistant City Manager 100 Fort Worth Trail Fort Worth TX 76102 With Copy to the City Attorney at same address TO FACILITY: Recovery Resource Council Attn: Eric Niedermayer, CEO 403 N. Sylvania Ave, Fort Worth, TX 76111 X. INSURANCE Facility must provide Fort Worth with certificate(s) of insurance documenting policies of the following types and minimum coverage limits that are to be in effect prior to commencement of any MIH Services pursuant to this Agreement: 10.1 Coverage and Limits (a) Commercial General Liability: $1,000,000 - Each Occurrence $2,000,000 — Aggregate MIH Services Agreement Page 4 of 11 (b) Automobile Liability: $1,000,000 - Each occurrence on a combined single limit basis Coverage will be on any vehicle used by Facility, or its employees, agents, or representatives while providing Services under this Agreement. "Any vehicle" will be any vehicle owned, hired and non -owned. (b) Worker's Compensation: Statutory limits according to the Texas Workers' Compensation Act or any other state workers' compensation laws where the Services are being performed Employers' liability $100,000 - Bodily Injury by accident; each accident/occurrence $100,000 - Bodily Injury by disease; each employee $500,000 - Bodily Injury by disease; policy limit (c) Professional Liability (Errors & Omissions): $1,000,000 - Each Claim Limit $1,000,000 - Aggregate Limit Professional Liability coverage may be provided through an endorsement of the Commercial General Liability (CGL) policy, or a separate policy specific to Professional E&O. Either is acceptable if coverage meets all other requirements. Coverage must be claims -made and maintained for the duration of the contractual agreement and for two (2) years following completion of services provided. An annual certificate of insurance must be submitted to Fort Worth to evidence coverage. 10.2 General Requirements (a) The commercial general liability and automobile liability policies must name Fort Worth as an additional insured thereon, as its interests may appear. The term Fort Worth includes its employees, officers, officials, agents, and volunteers in respect to the contracted services. (b) The workers' compensation policy must include a Waiver of Subrogation (Right of Recovery) in favor of Fort Worth. (c) A minimum of Thirty (30) days' notice of cancellation or reduction in limits of coverage must be provided to Fort Worth. Ten (10) days' notice will be acceptable in the event of non-payment of premium. Notice must be sent to Fort Worth in accordance with the notice provision of this Agreement. MIH Services Agreement Page 5 of 11 (d) The insurers for all policies must be licensed and/or approved to do business in the State of Texas. All insurers must have a minimum rating of A- VII in the current A.M. Best Key Rating Guide or have reasonably equivalent financial strength and solvency to the satisfaction of Risk Management. If the rating is below that required, written approval of Risk Management is required. (e) Any failure on the part of Fort Worth to request required insurance documentation will not constitute a waiver of the insurance requirement. (f) Certificates of Insurance evidencing that Facility has obtained all required insurance will be delivered to Fort Worth prior to Fort Worth proceeding with any MIH Services pursuant to this Agreement. XI. GENERAL PROVISIONS 11.1 Governmental Powers. It is understood and agreed that by execution of this Agreement, Fort Worth does not waive or surrender any of its governmental powers or immunities. 11.2 No Waiver. The failure of Fort Worth or Facility to insist upon the performance of any term or provision of this Agreement or to exercise any right granted herein shall not constitute a waiver of Fort Worth's or Facility's respective right to insist upon appropriate performance or to assert any such right on any future occasion. 11.3 Governing Law and Venue. This Agreement shall be construed in accordance with the laws of the State of Texas. If any action, whether real or asserted, at law or in equity, is brought on the basis of this Agreement, venue for such action shall lie in state courts located in Tarrant County, Texas or the United States District Court for the Northern District of Texas, Fort Worth Division. 11.4 Severabilitv_ . If any provision of this Agreement is held to be invalid, illegal or unenforceable, the validity, legality and enforceability of the remaining provisions shall not in any way be affected or impaired. 11.5 Force Maieure. Fort Worth and Facility shall exercise their best efforts to meet their respective duties and obligations as set forth in this Agreement, but shall not be held liable for any delay or omission in performance due to force majeure or other causes beyond their reasonable control, including, but not limited to, compliance with any government law, ordinance or regulation, acts of God, acts of the public enemy, fires, strikes, lockouts, natural disasters, wars, riots, epidemics or pandemics, material or labor restrictions by any governmental authority, transportation problems, restraints or prohibitions by any court, board, department, commission, or agency of the United States or of any States, civil disturbances, other national or regional emergencies, and/or any other similar cause not enumerated herein but which is beyond the reasonable control of the Party whose performance is affected (collectively "Force Majeure Event"). The performance of any such obligation is suspended during the period of, and only to the extent of, such prevention or hindrance, provided the affected Party provides notice of the Force Majeure Event, and an explanation as to how it hinders the party's performance, as soon as MIH Services Agreement Page 6 of 11 reasonably possible, as determined in the Fort Worth's discretion, after the occurrence of the Force Majeure Event. The form of notice required by this section shall be the same as section 13 above. 11.6 Headings Not Controlling. Headings and titles used in this Agreement are for reference purposes only and shall not be deemed a part of this Agreement. 11.7 Review of Counsel. The parties acknowledge that each party and its counsel have reviewed this Agreement and that the normal rules of construction to the effect that any ambiguities are to be resolved against the drafting party shall not be employed in the interpretation of this Agreement or exhibits hereto. 11.8 Amendments. No amendment of this Agreement shall be binding upon a party hereto unless such amendment is set forth in a written instrument and duly executed by an authorized representative of each party. 11.9 Entiretv of Agreement. This Agreement, including any exhibits attached hereto and any documents incorporated herein by reference, contains the entire understanding and agreement between Fort Worth and Facility, their assigns and successors in interest, as to the matters contained herein. Any prior or contemporaneous oral or written agreement is hereby declared null and void to the extent in conflict with any provision of this Agreement. 11.10 Counterparts. This Agreement may be executed in one or more counterparts and each counterpart shall, for all purposes, be deemed an original, but all such counterparts shall together constitute one and the same instrument. An executed Agreement, modification, amendment, or separate signature page shall constitute a duplicate if it is transmitted through electronic means, such as fax or e-mail, and reflects the signing of the document by any party. Duplicates are valid and binding even if an original paper document bearing each party's original signature is not delivered. 11.11 Signature Authority. The person signing this agreement hereby warrants that he/she has the legal authority to execute this agreement on behalf of the respective party, and that such binding authority has been granted by proper order, resolution, ordinance or other authorization of the entity. Each party is fully entitled to rely on these warranties and representations in entering into this Agreement or any amendment hereto. 11.12 Electronic Signatures. This Agreement maybe executed by electronic signature, which will be considered as an original signature for all purposes and have the same force and effect as an original signature. For these purposes, "electronic signature" means electronically scanned and transmitted versions (e.g. via pdf file or facsimile transmission) of an original signature, or signatures electronically inserted via software such as Adobe Sign. [Signature Page Follows] MIH Services Agreement Page 7 of 11 ACCEPTED AND AGREED: FORT WORTH: lit'q'in By: William hnson (Jun 26, 202517:32 CDT) Name: William Johnson Title: Assistant City Manager Date: 06/26/2025 APPROVAL RECOMMENDED: By: James Davis (Jun 26, 2025 14:28 CDT) Name: Jim Davis Title: Fire Chief Date: ATTEST: By: Name: Jannette Goodall Title: City Secretary Date: FACILITY: By: 6� Name: Eric Niedermayer Title: CEO Date: 6/26/2025 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: 4�1 Name: Brenda Ray Title: Purchasing Manager Date: APPROVED AS TO FORM AND LEG By: Name: Taylor Paris Title: Assistant City Attorney Date: CONTRACT AUTHORIZATION: M&C: 25-0531 6.10.25 Type text MIH Services Agreement Page 8 of 11 EXHIBIT "A" — STATEMENT OF WORK Introduction The goal of this project is to support Recovery Resource Council with an EMS program to prevent overdose in the Tarrant County region. Recovery Resource Council and the Fort Worth Fire Department must incorporate four key strategies: 1) Provide overdose reversal education or make referral to opioid reversal medication sources. 2) Provide referral sources for US Food and Drug Administration (FDA) approved medications used to treat opioid disorder and link participants to ongoing care sources. 3) Provide Recovery Support Peer services. 4) Provide community pre -hospital health care provider follow-up and support. The Overdose Response Team ("ORT") (Recovery Resource Council and the Fort Worth Fire Department) must provide one or more of the above activities to 225 individuals annually. The Fort Worth Fire Department is required to address the following implementation strategies: a. Deliverable #1. EMS Community Paramedicine Follow-up and Support Patients identified as being at risk for opioid and/or stimulant overdose or opioid and/or stimulant use disorder must receive follow-up and support by Paramedics and EMT's to address any co-occurring opioid and/or stimulant use disorder and related healthcare issues. Paramedics or EMT's must be available to provide overdose care supportive consultation for participants for a minimum of eight (8) consecutive days after identification or until time of participant enrollment. b. A follow-up includes making contact with the patient and providing any of the following: health and wellness screening and/or assessment, referral to services, listening to patient concerns and answering questions. c. Develop and submit monthly "Patient Engagement and Retention" Report. The Fort Worth Fire Department will utilize one specially trained Fort Worth Fire Department Paramedic or EMT who will work as a part of a 2-person team (Paramedic/EMT and a Peer Services Specialist employed by Recovery Resource Council) to engage clients from previous interactions, referrals from law enforcement, 911 dispatch, Recovery Resource Council, or other stakeholders and community sources and provide education and assess the client's willingness to engage in recovery and the status of current withdrawal symptoms. Fort Worth Fire Department Personnel will work 2 days a week for (8) hour shifts on this two - person team. Hours will be collaboratively determined with the Recovery Resource Council and adjusted as necessary in order to facilitate visits with patients that may not be available at certain times. This may include weekends as needed. One Fort Worth Fire Department Personnel and one Peer Services Specialist (2 persons) will be present for every attempted visit due to the history and nature of the EMS calls that the patient has been involved in and in order to ensure and provide appropriate resources. MIH Services Agreement Page 9 of 11 At the beginning of each shift, the Fort Worth Fire Department Personnel will pull the records from the previous days' 911 responses to opiate overdoses or other possible opiate misuse responses. Fort Worth Fire Department Personnel will not be attempting visits to anyone that has or is known to have a violent history or that the crew feels will be a substantial safety concern. All visits will be documented in an effort to track data. Data will be submitted to Recovery Resource Council monthly and will include: 1. Number of participants that received EMS responses for opioid withdrawal symptoms in the last 24 hours. 2. Number of participants that Fort Worth Fire Department Personnel attempted visits with. ` 3. Number of participants that Fort Worth Fire Department Personnel successfully completed visits with. ` 4. Document patient history of Opiate dependence with noted current presence of withdrawal symptoms with abstinence of use of opiates and any other substances 5. Clinical Opiate Withdrawal Scale (COWS) 6. Number of opioids overdose kit issued, if issued. 7. Number of participants successfully engaged with Recovery Resource Council Peer Recovery Coaches and/or a treatment center Program Goals The goal of this program is to make contact with participants within 48- 72 hours of overdose in an attempt to establish them with a Peer Services Specialist and connect them to services to support treatment and recovery from opioid use disorder. Including but not limited to recovery outpatient program at a partnering treatment center, support groups, and/or Medication Assisted Treatment programs. Visit Details Visits are subject to change at the sole discretion of the Fort Worth Fire Department Personnel, scene safety and the cooperation of the patient and/or participants' family: Working from referral sources previously mentioned, initial visits should be made within 72 hours of overdose at address listed for patient. If and when the patient is located, and if the patient consents, they will be provided the option by Fort Worth Fire Department Personnel, to engage with a Peer Support Specialist who will encourage patient in further discussion regarding available resources. There are several goals of this program (which are listed below) and individuals will be able to/ready to meet these goals at different times. Fort Worth Fire Department will make every attempt to meet these goals with each individual that they are able to get to consent from. Attempted contacts may include phone calls or in person visits. Goals of the Program: MIH Services Agreement Page 10 of 11 • Make successful contact with the individual and obtain consent to participate in the medication assisted treatment program. • Obtain a focused medical history, basic physical examination and assessment of current withdrawal symptoms using the Clinical Opiate Withdrawal Scale (COWS) tool • Connect the individual with a Recovery Coach from Recovery Resource Council Connect the individual with continued treatment from a partnering treatment facility Exclusion Criteria/ NA MIH Services Agreement Page 11 of 11 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: