HomeMy WebLinkAboutWashington State Association of Local Health Officials (WSALPHO) - 011419WASHINGTON STATE ASSOCIATION OF LOCAL PUBLIC HEALTH OFFICIALS —
JEFFERSON COUNTY PUBLIC HEALTH
AGREEMENT
This AGREEMENT formalizes the understanding between the Washington State Association of
Local Public Health Officials (WSALPHO) and Jefferson County Public Health regarding the
operation of Medicaid Administrative Claiming (MAC) in Washington State.
ARTICLE I
PURPOSE
The purpose of this AGREEMENT is to facilitate the operation of a statewide Random Moment
Time Survey (RMTS) that complies with the requirements of the LHJs' Cost Allocation Plan
approved by the Centers for Medicare and Medicaid Services (CMS), and the MAC contract
between HCA and each participating LHJ. The Agreement will also assist in oversight activities
of the Health Care Authority (HCA) working with the LHJ MAC Steering Committee to provide
coordination and program compliance among participating LHJs.
ARTICLE II
DEFINITIONS
Authorized Representative: The person or persons authorized by the LHJ and WSALPHO to
coordinate activities under this AGREEMENT (the MAC Coordinator) will be the Point of
Contact for response to monitoring activities. Contact information for the LHJ and WSALPHO
Representative, or the person who will connect the caller to the Authorized Representative, is
found in Article III of this AGREEMENT.
Business Associate: As defined in 45 CFR, Part 160.103, otherwise known as HIPAA, and
includes any entity that performs or assists in performing a function or activity involving the
uses/disclosures of individually identifiable Health Information or involving any other function
or activity regulated by HIPAA; or provides legal, accounting, actuarial, consulting, data
aggregation, management, accreditation, or financial service where the services involve
individually identifiable Health Information.
Business Days and Hours: Shall mean Monday through Friday, 8:00 a.m. to 5:00 p.m., Pacific
Time, except for holidays observed by the State of Washington.
Centers for Medicare and Medicaid Services (CMS): A federal agency within the Department of
Health and Human Services responsible for the administration and oversight of the Title XIX
Medicaid Administrative Claiming program.
Consortium: LHJs are grouped into consortia based on similar duties staff perform,
organizational structure, types of programs, scope of work, or regional working relationships and
participate in a common Random Moment Time Survey (RMTS) together in order to achieve the
level of statistical validity in the RMTS required by CMS. Each consortium composed of more
than one LHJ will identify a member LHJ to act as the Lead Agency for the consortium and
serve on the statewide LHJ Steering Committee. Each LHJ that is the sole entity in a
consortium, such as Public Health — Seattle & King County, will identify a single person to
represent it on the Steering Committee.
Cost Allocation Plan: A federally -approved plan describing the methodology and procedures for
claiming federal reimbursement for activities that are necessary for the efficient administration of
the State Medicaid Plan.
Health Care Authority (HCA): The State agency responsible for administration and oversight of
the Medicaid Administrative Claiming program in Washington State.
HIPAA Rules: "HIPAA Rules" shall mean the Privacy, Security, Breach Notification, and
Enforcement Rules at 45 CFR Part 160 and 164.
Local Health Jurisdiction (LHJ): A signatory health department, health district, or county within
the State of Washington that operates a public health department or division within its county
government pursuant to authority granted under Chapters 70.05, 70.08, 70.46 RCW or other
applicable law.
LHJ MAC Contract: The legal agreement between HCA and the LHJ for participation in the
MAC program. The contract lays out the responsibilities of each party for ensuring program
compliance.
LHJ MAC Steering Committee: The LHJ MAC Steering Committee (Steering Committee)
functions as an advisory board working under the direction of WSALPHO leadership. The
Steering Committee provides broad oversight of the LHJ MAC program in Washington State and
acts as a point of contact for HCA staff.
Medicaid Administrative Claiming (MAC): Title XIX of the Social Security Act (the Act)
authorizes payments to states for expenditures necessary for the administration of the State
Medicaid Plan.
Proportional Share: The percentage paid by each LHJ to WSALPHO for the costs of the
WSALPHO Contractor and WSALPHO's administrative fee is based on the proportional share
of the total federal reimbursement paid to all LHJs for MAC activities for the most recent four
quarters for which there is complete data.
Protected Health Information: Shall have the same meaning as those terms in the HIPAA Rules.
Random Moment Time Study: A web -based system operated by WSALPHO's Contractor that
captures the activities that can be reimbursed under Medicaid Administrative Claiming via a
CMS -approved time survey methodology.
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Washington State Association of Local Public Health Officials: WSALPHO is a 501(c)3 private,
non-profit organization operating on behalf of Local Health Jurisdictions to advance the interests
of local public health in Washington State.
WSALPHO Contractor: Vendor contracted through WSALPHO to operate an RMTS and
claiming system [including offset, indirect rate, and Medicaid Eligibility Rate (MER)for the
MAC program that is compliant with the currently approved LHJ Cost Allocation Plan and to
provide consultation and technical assistance to the Steering Committee and LHJs, as directed by
the Steering Committee.
ARTICLE III
AUTHORIZED REPRESENTATIVES
JEFFERSON COUNTY PUBLIC HEALTH WSALPHO
Vicki Kirkpatrick Jaime Bodden
Director Managing Director
615 Sheridan Street 206 10th Street Port Townsend, WA
98368 Olympia, WA 98501
ARTICLE IV
RESPONSIBILITIES OF LOCAL HEALTH JURISDICTIONS
Local Health Jurisdictions participating in the Medicaid Administrative Claiming program will:
• Participate in the MAC claiming program through an inter -local AGREEMENT between the
LHJ and HCA, and participate in an RMTS operated by the WSALPHO Contractor.
• Participate in peer review or other quality assurance activities to ensure the program's
compliance with all federal regulations and federal and state published guidance.
• Name an employee to act as the MAC Coordinator who will oversee MAC activities at the
LHJ and monitor their compliance with federal and state regulations and published guidance,
including the RMTS and the development and updating of all non -fiscal documents required
for the MAC audit file.
• Name an employee to act as the MAC fiscal coordinator, who will oversee the development
of the quarterly MAC invoice, certify its accuracy, and maintain the fiscal sections of the
MAC audit file.
• The LHJ MAC Coordinator or designee will attend WSALPHO-sponsored trainings as
scheduled.
• The LHJ fiscal coordinator will attend WSALPHO-sponsored fiscal trainings as scheduled.
• The LHJ MAC coordinator will participate in regularly -scheduled Coordinator conference
calls convened by WSALPHO.
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ARTICLE V
RESPONSIBILITIES OF WSALPHO
WSALPHO will:
Procure a contractor to operate an RMTS and claiming system that complies with the most
current federally -approved Cost Allocation Plan.
Provide assurance that this AGREEMENT, once executed by the parties, is and remains a
Public Record subject to the provision of Ch. 42.56 RCW, the Public Records Act.
In conjunction with LHJ Steering Committee, will provide coordination and leadership of the
LHJ MAC program in Washington State to ensure quality assurance and consistency state-
wide.
ARTICLE VI
RESPONSIBILITIES OF MAC CONTRACTOR
The MAC Contractor will operate a MAC RMTS and claiming system for participating LHJs in
Washington State in accordance with a federally -approved cost allocation plan. The MAC
contractor will also provide consultation and technical assistance, as directed by the Steering
Committee.
The MAC Contractor will submit a proposed work plan that includes proposed tasks, staffing,
timeline, and associated costs to WSALPHO no later than November 15 of the preceding year
for review and approval by WSALPHO and the LHJ MAC Steering Committee, which will be
incorporated annually as an amendment to this AGREEMENT.
ARTICLE VII
INVOICE AND PAYMENT
The Contractor submits a quarterly invoice of actual costs to WSALPHO no later than 60 days
following the end of a calendar quarter to the designee of the LHJ Steering Committee who will
review calculations and approve proposed work for payment. Following approval for payment,
WSALPHO will invoice Public Health Seattle King County and Tacoma Pierce County Health
Department quarterly with the remaining participating LHJs invoiced their proportional share
semi-annually in January and August (for the prior six months), The invoice will link billed
tasks to the annual work plan. The budgeted annual costs for Contractor's services,
WSALPHO's administrative fee, and the LHJ's proportionate share are incorporated by
reference as Contractor Costs and LHJ Proportional Share for calendar year 2019 (Attachment
A).
WSALPHO receives a five percent fee based on the Contractor's budget to administer the MAC
program and coordinate the work of the LHJ MAC Steering Committee. WSALPHO will
reconcile this fee to the Contractor's actual cost and credit each LHJ its proportional share of any
overpayment. This adjustment will be applied to the LHJ's succeeding year invoice.
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ARTICLE VIII
HIPAA - PROTECTED HEALTH INFORMATION
WSALPHO acknowledges that that the work under this AGREEMENT may require compliance
with "The Health Insurance Portability and Accountability Act of 1996" commonly known as
HIPAA. WSALPHO shall not use protected health information in any manner that would
constitute a violation of HIPAA and any regulations enacted pursuant to its provisions and
Washington State privacy laws and further agrees not to use or disclose Protected Health
Information other than as permitted or required by the AGREEMENT or as required by law.
Contractor agrees to implement physical, electronic, and managerial safeguards to prevent
unauthorized access to Protected Health Information.
WSALPHO Contractors that may use the LHJ Protected Health Information in the course of their
work are considered to be a Business Associate of WSALPHO and the LHJ.
The LHJ reserves the right to monitor, audit, or investigate the use of Protected Health
Information collected, used, or acquired by Contractor through this AGREEMENT.
The obligations set forth in this Section shall survive completion, cancellation, expiration, or
termination of this AGREEMENT.
ARTICLE IX
INDEMNIFICATION
Each party shall indemnify, defend and hold harmless, each other, its officers, agents and
employees, from and against any and all claims, lawsuits, demands for money damages, losses or
liability, or any portion thereof, including attorney's fees and costs, arising from the negligent
acts or omissions of the parties, its employees, or representatives.
ARTICLE X
RIGHTS IN DATA
Records and other documents in any medium, furnished by one party to this AGREEMENT to
the other party, will remain the property of the furnishing party, unless otherwise agreed. The
receiving party will not disclose or make available this material to any third parties without first
giving notice to the furnishing party and giving it a reasonable opportunity to respond. Each
party will utilize reasonable security procedures and protections to assure that records and
documents provided by the other party are not erroneously disclosed to third parties.
ARTICLE XI
RECORDS, DOCUMENTS, AND REPORTS
WSALPHO and its Contractor shall maintain books, records, documents, magnetic media,
receipts, invoices and other evidence relating to this AGREEMENT and the performance of the
services rendered, along with accounting procedures and practices, all of which sufficiently and
properly reflect all direct and indirect costs of any nature expended in the performance of this
AGREEMENT. At no additional cost, these records, including materials generated under this
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AGREEMENT, shall be subject at all reasonable times to inspection, review, or audit by the
LHJ. Records shall be retained for a period of six (6) years after the date of final payment.
If any litigation, claim or audit is started before the expiration of the six (6) year period, the
records shall be retained until all litigation, claims, or audit findings involving the records have
been resolved.
ARTICLE XII
TERM AND TERMINATION
This AGREEMENT is effective January 1, 2019, and will terminate 12/31/2019. Either LHJ or
WSALPHO may terminate this AGREEMENT for convenience with written notification to all of
the other signatories to the AGREEMENT no less than ninety (90) calendar days prior to the
beginning of a calendar quarter. The AGREEMENT may be extended for two-year periods with
the written consent of WSALPHO and the MAC Steering Committee.
ARTICLE XIII
AMENDMENTS
Modifications to this AGREEMENT must be in writing and will become effective upon the
approval of the modification by WSALPHO and LHJ.
ARTICLE XIV
INDEPENDENT CAPACITY
The employees or agents of WSALPHO or LHJ who are engaged in the performance of this
AGREEMENT shall continue to be employees or agents of that party and shall not be considered
for any purpose to be employees or agents of any other party to this AGREEMENT.
ARTICLE XV
SEVERABILITY
If any provision of this AGREEMENT or any document incorporated by reference shall be held
invalid, such invalidity shall not affect the other provisions of this AGREEMENT which can be
given effect without the invalid provision, if such remainder conforms to the requirements of
applicable law and the fundamental purpose of this AGREEMENT, and to this end the
provisions of this AGREEMENT are declared to be severable.
ARTICLE XVI
NO THIRD PARTY BENEFICIARIES
This AGREEMENT is entered into solely for the mutual benefit of the parties to this
AGREEMENT. This AGREEMENT is not entered into with the intent that it shall benefit any
other person and no other such person shall be entitled to be treated as a third -party beneficiary
of this AGREEMENT.
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ARTICLE XVII
DISPUTE RESOLUTION
If a dispute between any parties to this AGREEMENT arises out of or related to this
AGREEMENT, or the breach thereof, and if the dispute cannot be settled through direct
discussions, the parties agree to first endeavor to settle the dispute in an amicable manner by
mediation. Thereafter, any unresolved controversy or claim arising out of or related to this
AGREEMENT, or breach thereof, may be settled in a court having jurisdiction thereof. The
parties may seek to resolve disputes pursuant to mediation or arbitration, but are not required to
do so.
ARTICLE XVIII
NOTICES
Whenever this AGREEMENT provides for notice to be provided by one party to another, such
notice shall be in writing and directed to the Authorized Representatives identified in Article III.
ARTICLE XIX
SURVIVORSHIP
The following clauses survive the termination of this AGREEMENT:
VIII Confidential Information
IX. Immunity, Indemnification, and Limitations
XIV. Severability
XV. No Third Party Beneficiaries
XVI. Dispute Resolution
ARTICLE XX
INSURANCE
WSALPHO shall ensure that any Contractor shall provide insurance coverage as set out in this
section. The intent of the required insurance is to protect WSALPHO should there be any claims,
suits, actions, costs, damages or expenses arising from any negligent or intentional act or
omission of the Contractor or subcontractor, or agents of either, while performing under the
terms of this AGREEMENT.
The Contractor shall provide insurance coverage that shall be maintained in full force and effect
during the term of this AGREEMENT, as follows:
Commercial General Liability Insurance Policy: Provide a Commercial General Liability
Insurance Policy, including contractual liability, in adequate quantity to protect against legal
liability arising out of contract activity but no less than $1,000,000 per occurrence.
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Professional Liability Insurance: Provide a Professional Liability Insurance policy, including
contractual liability, in adequate quantity to protect against legal liability, but no less than
$1,000,000 per claim.
ARTICLE XXI
TERM
The AGREEMENT shall be effective January 1, 2019, and end December 31, 2019.
ARTICLE XXII
OTHER OR PRIOR AGREEMENTS
If WSALPHO and LHJ have a prior written AGREEMENT that relates to the subject matter of
this AGREEMENT, namely, MAC claiming, then, at such time that WSALPHO and said LHJ
both execute this AGREEMENT, such prior written AGREEMENT between them shall become
null and void and of no further force and effect.
ARTICLE XXIII
GOVERNING LAW
This AGREEMENT shall be interpreted, construed and enforced in accordance with the laws of
the State of Washington.
IN WITNESS WHEREOF, this AGREEMENT has been executed and approved and is effective
and operative by WSALPHO and LHJ as herein provided.
JEFFERSON COUNTY PUBLIC HEALTH
By:
Vicki Kirkpat ick, irector
Date: %
BOARD OF COUNTY COMMISSIONERS
WSALPHO
By:
J e Bodden, Managing Director
Date:
JEFFERSON C NTY, WASHINGTON
ATTEST-
By:�u �4��"�
, Chair Carolyn 6allaway, Deputy CLdrk of the Board
Date: APPROVED A TO F M:
V"• P. � Z
Philip Hunsucker, Chief Civil D6puKPrdsecuting Atty.
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APPENDIX B
BUSINESS ASSOCIATE AGREEMENT
This Agreement ("Agreement") is made and entered into this 1 st day of _January,
2019, by and between Jefferson County Public Health ("Covered Entity"), whose business
address is 615 Sheridan Street, Port Townsend, WA 98368, and Washington State Associate of
Local Public Health Officials (WSALPHO)_ ("Business Associate"), whose business address
is 206 10'h Ave. SE., Olympia, WA 98501-1311.
WHEREAS, Business Associate is in the business of providing oversight activities of the Health
Care Authority (HCA) working with the Local Health Jurisdiction (LHJ) Medicaid
Administrative Claiming (MAC) Steering Committee to provide coordination and program
compliance among participating LHJs ("Offering"); and
WHEREAS, Covered Entity wishes to engage, or has engaged, Business Associate in connection
with said Offering,
NOW, THEREFORE, in consideration of the premises and mutual promises herein contained, it
is agreed as follows:
1. Definitions. Terms used, but not otherwise defined in this Agreement, shall have the same
meaning as those terms in the Privacy Rule, Security Rule, and HITECH Act.
a. Agent. "Agent" shall have the meaning as determined in accordance with the federal
common law of agency.
b. Breach. "Breach" shall have the same meaning as the term "breach" in 45 CFR
§ 164.402.
c. Business Associate. 'Business Associate" shall mean WSALPHO.
d. Covered Entity. "Covered Entity" shall mean [Local Health Jurisdiction].
e. Data Aggregation. "Data Aggregation" shall have the same meaning as the term "data
aggregation" in 45 CFR § 164.501.
f. Designated Record Set. "Designated Record Set" shall have the same meaning as the
term "designated record set" in 45 CFR § 164.501.
g. Disclosure. "Disclosure" and "Disclose" shall have the same meaning as the term
"Disclosure" in 45 CFR § 160.103.
h. Electronic Health Record. "Electronic Health Record" shall have the same meaning as
the term in Section 13400 of the HITECH Act.
i. Health Care Operations. "Health Care Operations" shall have the same meaning as the
term "health care operations" in 45 CFR § 164.501.
j. HIPAA Rules. "HIPAA Rules" shall mean the Privacy, Security, Breach Notification,
and Enforcement Rules at 45 CFR Part 160 and Part 164.
k. HITECH Act. "HITECH Act" shall mean The Health Information Technology for
Economic and Clinical Health Act, part of the American Recovery and Reinvestment Act of
2009 ("ARRA" or "Stimulus Package"), specifically DIVISION A: TITLE XIII Subtitle D—
Privacy, and its corresponding regulations as enacted under the authority of the Act.
1. Individual. "Individual" shall have the same meaning as the term "individual" in 45 CFR
§ 160.103 and shall include a person who qualifies as a personal representative in accordance
with 45 CFR § 164.502(g).
m. Minimum Necessary. "Minimum Necessary" shall mean the Privacy Rule Standards
found at §164.502(b) and §164.514(d)(1).
n. Privacy Rule. "Privacy Rule" shall mean the Standards for Privacy of Individually
Identifiable Health Information at 45 CFR Part 160 and Part 164, Subparts A and E.
o. Protected Health Information. "Protected Health Information" shall have the same
meaning as the term "protected health information" in 45 CFR § 160.103, limited to the
information created, received, maintained or transmitted by Business Associate on behalf of
Covered Entity.
p. Required By Law. "Required By Law" shall have the same meaning as the term
"required by law" in 45 CFR § 164.103.
q. Secretary. "Secretary" shall mean the Secretary of the Department of Health and Human
Services or his or her designee.
r. Security Incident. "Security Incident" shall have the same meaning as the term
"Security Incident" in in 45 CFR § 164.304.
s. Security Rule. "Security Rule" shall mean the Standards for Security of Electronic
Protected Health Information at 45 C.F.R. parts § 160 and § 164, Subparts A and C.
t. Subcontractor. "Subcontractor" shall mean a person or entity "that creates, receives,
maintains, or transmits protected health information on behalf of a business associate" and
who is now considered a business associate, as the latter term is defined in in in 45 CFR
§160.103.
u. Subject Matter. "Subject Matter" shall mean compliance with the HIPAA Rules and
with the HITECH Act.
2
fi 4
v. Unsecured Protected Health Information. "Unsecured Protected Health Information"
shall have the same meaning as the term "unsecured protected health information" in 45 CFR
§ 164.402.
w. Use. "Use" shall have the same meaning as the term "Use" in 45 CFR § 164.103.
2. Obligations and Activities of Business Associate.
a. Business Associate agrees to not Use or Disclose Protected Health Information other than
as permitted or required by this Agreement or as Required By Law.
b. Business Associate agrees to use appropriate safeguards to prevent Use or Disclosure of
Protected Health Information other than as provided for by this Agreement. Business
Associate further agrees to implement administrative, physical and technical safeguards that
reasonably and appropriately protect the confidentiality, integrity and availability of any
electronic Protected Health Information, as provided for in the Security Rule and as
mandated by Section 13401 of the HITECH Act.
c. Business Associate agrees to 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. Business Associate
further agrees to report to Covered Entity any Use or Disclosure of Protected Health
Information not provided for by this Agreement of which it becomes aware, and in a manner
as prescribed herein.
d. Business Associate agrees to report to Covered Entity any Security Incident, including all
data Breaches or compromises, whether internal or external, related to Protected Health
Information, whether the Protected Health Information is secured or unsecured, of which
Business Associate becomes aware.
e. If the Breach, as discussed in paragraph 2(d), pertains to Unsecured Protected Health
Information, then Business Associate agrees to report any such data Breach to Covered
Entity within ten (10) business days of discovery of said Breach; all other compromises, or
attempted compromises, of Protected Health Information shall be reported to Covered Entity
within twenty (20) business days of discovery. Business Associate further agrees, consistent
with Section 13402 of the HITECH Act, to provide Covered Entity with information
necessary for Covered Entity to meet the requirements of said section, and in a manner and
format to be specified by Covered Entity.
f. If Business Associate is an Agent of Covered Entity, then Business Associate agrees that
any Breach of Unsecured Protected Health Information shall be reported to Covered Entity
immediately after the Business Associate becomes aware of said Breach, and under no
circumstances later than one (1) business day thereafter. Business Associate further agrees
that any compromise, or attempted compromise, of Protected Health Information, other than
a Breach of Unsecured Protected Health Information as specified in 2(e) of this Agreement,
3
shall be reported to Covered Entity within ten (10) business days of discovering said
compromise, or attempted compromise.
g. Business Associate agrees to ensure that any Subcontractor, to whom Business Associate
provides Protected Health Information, agrees to the same restrictions and conditions that
apply through this Agreement to Business Associate with respect to such information.
Business Associate further agrees that restrictions and conditions analogous to those
contained herein shall be imposed on said Subcontractors via a written agreement that
complies with all the requirements specified in § 164.504(e)(2), and that Business Associate
shall only provide said Subcontractors Protected Health Information consistent with Section
13405(b) of the HITECH Act. Further, Business Associate agrees to provide copies of said
written agreements to Covered Entity within ten (10) business days of a Covered Entity's
request for same.
h. Business Associate agrees to provide access, at the request of Covered Entity and during
normal business hours, to Protected Health Information in a Designated Record Set to
Covered Entity or, as directed by Covered Entity, to an Individual, in order to meet Covered
Entity's requirements under 45 CFR § 164.524, provided that Covered Entity delivers to
Business Associate a written notice at least three (3) business days in advance of requesting
such access. Business Associate further agrees, in the case where Business Associate controls
access to Protected Health Information in an Electronic Health Record, or controls access to
Protected Health Information stored electronically in any format, to provide similar access in
order for Covered Entity to meet its requirements the HIPAA Rules and under Section
13405(c) of the HITECH Act. These provisions do not apply if Business Associate and its
employees or Subcontractors have no Protected Health Information in a Designated Record
Set of Covered Entity.
i. Business Associate agrees to make any amendment(s) to Protected Health Information in
a Designated Record Set that Covered Entity directs or agrees to pursuant to 45 CFR
§ 164.526, at the request of Covered Entity or an Individual. This provision does not apply if
Business Associate and its employees or Subcontractors have no Protected Health
Information from a Designated Record Set of Covered Entity.
j. Unless otherwise protected or prohibited from discovery or disclosure by law, Business
Associate agrees to make internal practices, books, and records, including policies and
procedures (collectively "Compliance Information"), relating to the Use or Disclosure of
Protected Health Information and the protection of same, available to the Covered Entity or
to the Secretary for purposes of the Secretary determining Covered Entity's compliance with
the HIPAA Rules and the HITECH Act. Business Associate further agrees, at the request of
Covered Entity, to provide Covered Entity with demonstrable evidence that its Compliance
Information ensures Business Associate's compliance with this Agreement over time.
Business Associate shall have a reasonable time within which to comply with requests for
such access and/or demonstrable evidence, consistent with this Agreement. In no case shall
access, or demonstrable evidence, be required in less than five (5) business days after
Business Associate's receipt of such request, unless otherwise designated by the Secretary.
4
C
k. Business Associate agrees to maintain necessary and sufficient documentation of
Disclosures of Protected Health Information as would be required for Covered Entity to
respond to a request by an Individual for an accounting of such Disclosures, in accordance
with 45 CFR § 164.528.
1. On request of Covered Entity, Business Associate agrees to provide to Covered Entity
documentation made in accordance with this Agreement to permit Covered Entity to respond
to a request by an Individual for an accounting of disclosures of Protected Health Information
in accordance with 45 C.F.R. §164.528. Business Associate shall provide said documentation
in a manner and format to be specified by Covered Entity. Business Associate shall have a
reasonable time within which to comply with such a request from Covered Entity and in no
case shall Business Associate be required to provide such documentation in less than three
(3) business days after Business Associate's receipt of such request.
m. Except as provided for in this Agreement, in the event Business Associate receives an
access, amendment, accounting of disclosure, or other similar request directly from an
Individual, Business Associate shall redirect the Individual to the Covered Entity.
n. To the extent that Business Associate carries out one or more of Covered Entity's
obligations under the HIPAA Rules, the Business Associate must comply with all
requirements of the HIPAA Rules that would be applicable to the Covered Entity.
o. A Business Associate must honor all restrictions consistent with 45 C.F.R. § 164.522 that
the Covered Entity or the Individual makes the Business Associate aware of, including the
Individual's right to restrict certain disclosures of protected health information to a health
plan where the individual pays out of pocket in full for the healthcare item or service, in
accordance with HITECH Act Section 13405(a).
3. Permitted Uses and Disclosures by Business Associate.
a. Except as otherwise limited by this Agreement, Business Associate may make any Uses
and Disclosures of Protected Health Information necessary to perform its services to Covered
Entity and otherwise meet its obligations under this Agreement, if such Use or Disclosure
would not violate the Privacy Rule, or the privacy provisions of the HITECH Act, if done by
Covered Entity. All other Uses or Disclosures by Business Associate not authorized by this
Agreement, or by specific instruction of Covered Entity, are prohibited.
b. 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.
c. 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
5
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.
d. Except as otherwise limited in this Agreement, Business Associate may Use Protected
Health Information to provide Data Aggregation services to Covered Entity as permitted by
45 CFR § 164.504(e)(2)(i)(B). Business Associate agrees that such Data Aggregation services
shall be provided to Covered Entity only wherein said services pertain to Health Care
Operations. Business Associate further agrees that said services shall not be provided in a
manner that would result in Disclosure of Protected Health Information to another covered
entity who was not the originator and/or lawful possessor of said Protected Health
Information. Further, Business Associate agrees that any such wrongful Disclosure of
Protected Health Information is a direct violation of this Agreement and shall be reported to
Covered Entity immediately after the Business Associate becomes aware of said Disclosure
and, under no circumstances, later than three (3) business days thereafter.
e. Business Associate may Use Protected Health Information to report violations of law to
appropriate Federal and State authorities, consistent with §164.5020)(1).
f. Business Associate shall make Uses, Disclosures, and requests for Protected Health
Information consistent with the Minimum Necessary principle as defined herein.
4. Obligations and Activities of Covered Entity.
a. Covered Entity shall notify Business Associate of the provisions and any limitation(s) in
its notice of privacy practices of Covered Entity in accordance with 45 CFR § 164.520, to the
extent that such provisions and limitation(s) may affect Business Associate's Use or
Disclosure of Protected Health Information.
b. Covered Entity shall notify Business Associate of any changes in, or revocation of,
permission by an Individual to use or disclose Protected Health Information, to the extent
that the changes or revocation 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, and also notify Business Associate regarding restrictions that must be
honored under section 13405(a) of the HITECH Act, to the extent that such restrictions may
affect Business Associate's Use or Disclosure of Protected Health Information.
d. Covered Entity shall notify Business Associate of any modifications to accounting
disclosures of Protected Health Information under 45 CFR § 164.528, made applicable under
Section 13405(c) of the HITECH Act, to the extent that such restrictions may affect
Business Associate's use or disclosure of Protected Health Information.
L
e. Covered Entity shall provide Business Associate, within thirty (30) business days of
Covered Entity executing this Agreement, a description and/or specification regarding the
manner and format in which Business Associate shall provide information to Covered Entity,
wherein such information is required to be provided to Covered Entity as agreed to by
Business Associate in paragraph 2(e) of this Agreement. Covered Entity reserves the right to
modify the manner and format in which said information is provided to Covered Entity, as
long as the requested modification is reasonably required by Covered Entity to comply with
the HIPAA Rules or the HITECH Act, and Business Associate is provided sixty (60)
business days notice before the requested modification takes effect.
f. Covered Entity shall provide Business Associate, within thirty (30) business days of
Covered Entity executing this Agreement, a description and/or specification regarding the
manner and format in which Business Associate shall provide information to Covered Entity,
wherein such information is required to be provided to Covered Entity as agreed to by
Business Associate in paragraph 2(1) of this Agreement. Covered Entity reserves the right to
modify the manner and format in which said information is provided to Covered Entity, as
long as the requested modification is reasonably required by Covered Entity to comply with
the HIPAA Rules or the HITECH Act, and Business Associate is provided sixty (60)
business days notice before the requested modification takes effect.
g. Covered Entity shall not require Business Associate to Use or Disclose Protected Health
Information in any manner that would not be permissible under the HIPAA Rules if done by
the Covered Entity.
5. Term and Termination.
a. Term. The Term of this Agreement shall be effective as of January 1, 2019`, and shall
terminate when all of the Protected Health Information provided by Covered Entity to
Business Associate, or created or received by Business Associate on behalf of Covered
Entity, is destroyed or returned to Covered Entity, or, if it is infeasible to return or destroy
Protected Health Information, protections are extended to such information, in accordance
with the termination provisions in this Agreement.
b. Termination for Cause by Covered Entity. Upon Covered Entity's knowledge of a
material breach of this Agreement by Business Associate, Covered Entity shall give Business
Associate written notice of such breach and provide reasonable opportunity for Business
Associate to cure the breach or end the violation. Covered Entity may terminate this
Agreement, and Business Associate agrees to such termination, if Business Associate has
breached a material term of this Agreement and does not cure the breach or cure is not
possible. If neither termination nor cure is feasible, Covered Entity shall report the violation
to the Secretary.
c. Termination for Cause by Business Associate. Upon Business Associate's knowledge of a
material breach of this Agreement by Covered Entity, Business Associate shall give Covered
7
Entity written notice of such breach and provide reasonable opportunity for Covered Entity
to cure the breach or end the violation. Business Associate may terminate this Agreement,
and Covered Entity agrees to such termination, if Covered Entity has breached a material
term of this Agreement and does not cure the breach or cure is not possible. If neither
termination nor cure is feasible, Business Associate shall report the violation to the Secretary.
d. Effect of Termination.
1. Except as provided in paragraph (2) of this section, upon termination of this
Agreement for any reason, Business Associate shall return or destroy all Protected
Health Information received from, or created or received by Business Associate on behalf
of Covered Entity. This provision shall also apply to Protected Health Information that is
in the possession of Subcontractors of Business Associate. Business Associate shall retain
no copies of the Protected Health Information.
2. In the event that Business Associate determines that returning or destroying the
Protected Health Information is infeasible, Business Associate shall provide to Covered
Entity, within ten (10) business days, notification of the conditions that make return or
destruction infeasible. Upon such determination, Business Associate shall extend the
protections of this Agreement to such Protected Health Information and limit further uses
and disclosures of such Protected Health Information to those purposes that make the
return or destruction infeasible, for so long as Business Associate maintains such
Protected Health Information.
6. Entire Agreement.
a. This Agreement supersedes all other prior and contemporaneous written and oral
agreements and understandings between Covered Entity and Business Associate regarding
this Subject Matter. It contains the entire Agreement between the parties.
b. This Agreement may be modified only by a signed written agreement between Covered
Entity and Business Associate.
c. All other agreements entered into between Covered Entity and Business Associate, not
related to this Subject Matter, remain in full force and effect.
7. Governing Law.
a. This Agreement and the rights of the parties shall be governed by and construed in
accordance with Federal law as it pertains to the Subject Matter and shall be governed by and
construed in accordance with the laws of the State of Washington as it pertains to contract
formation and interpretation, without giving effect to its conflict of laws. The parties agree
that any appropriate state court sitting in Benton County, Washington or any Federal Court
sitting in the Eastern District of Washington shall have exclusive jurisdiction of any case or
controversy arising under or in connection with this Agreement and shall be a proper forum
in which to adjudicate such case or controversy.
E:3
b. Each parry irrevocably consents to the jurisdiction of such courts, and irrevocably waives,
to the fullest extent permitted by law, the defense of an inconvenient forum to the
maintenance of such suit, action, or proceeding in any such court and further waives the right
to object, with respect to such suit, action, or proceeding, that such court does not have
jurisdiction over such party.
8. Miscellaneous.
a. Regulatory References. A reference in this Agreement to a section in the Privacy Rule,
Security Rule, or HITECH Act means the section as in effect or as amended.
b. 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 and Business Associate to
comply with the requirements of the Privacy Rule, Security Rule, the Health Insurance
Portability and Accountability Act of 1996 (Pub. L. No. 104-191), and the HITECH Act, and
its corresponding regulations.
c. Survival. The respective rights and obligations of Business Associate under Section 5(d)
of this Agreement shall survive the termination of this Agreement.
d. Interpretation. Any ambiguity in this Agreement shall be resolved to permit Covered
Entity and Business Associate to comply with the Privacy Rule, Security Rule, the Health
Insurance Portability and Accountability Act of 1996 (Pub. L. No. 104-191), and the
HITECH Act, and its corresponding regulations.
e. Severability. If any provision or provisions of this Agreement is/are determined by a
court of competent jurisdiction to be unlawful, void, or unenforceable, this Agreement shall
not be unlawful, void or unenforceable thereby, but shall continue in effect and be enforced
as though such provision or provisions were omitted.
9. Counterparts.
This Agreement may be executed in any number of counterparts, each of which shall be deemed
an original, but all of which together shall constitute one original Agreement. Facsimile or
electronically authenticated signatures shall be accepted and enforceable in lieu of original
signatures.
APPROVED AND ACCEPTED BY:
Business Associate:
Washington State Association of Local Public Health Officials
Ja'r�iie Bodden
Managing Director
Phone: (360) 753-1886
Covered Entity:
JEFFERSON COUNTY PUBLIC HEALTH
. arl
Vicki Kirkpatrick
Director
Phone: (360) 385-9408
BOARD OF COUNTY COMMISSIONERS
JEFFERSON UNTY, WASHINGTON
By:
Chair
Date: Z/ Y % �z
10
l-2 t
Date
/'� K )/
Date
ATTEST:, r
Carolyn dallaway, Deputy CIA( of the Board
APPROVED AS TO FO M:
4PC� z //r// 90
Philip Hun cker, Chief Civil ffuVProefecuting Atty.
�e�e�tson
Public He9alt
615 Sheridan Street
Port Townsend, WA 98368
www.JeffersonCountyPublicHealth.org
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Vicki Kirkpatrick, Director
DATE: �jm, )� , W)%
Consent Agenda
December 17, 2018
SUBJECT: Agenda Item — Agreement between Washington State Association of
Local Public Health Officials (WSALPHO) and Jefferson County Public
Health (LHJ) regarding Medicaid Administrative Claiming (MAC);
January 1, 2019 — December 31, 2019; not to exceed $38,248.
STATEMENT OF ISSUE:
Jefferson County Public Health requests Board approval of the agreement between WSALPHO and LHJ
regarding the operation of Medicaid Administrative Claiming in Washington State; January 1, 2019 —
December 31, 2019; not to exceed $38,248.
ANALYSIS/ STRATEGIC GOALS/PRO'S and CON'S:
This agreement is to continue to use WSALPHO, through Jefferson County Public Health's Washington State
Health Care Authority (HCA) Medicaid Administrative Claiming contract, to administer the Random Moment
Time Surveys (RMTS) and provide coordination and leadership to ensure state-wide consistency that is
compliant with the federally approved Cost Allocation Plan.
FISCAL IMPACT/COST BENEFIT ANALYSIS:
This is an ongoing agreement that is funded by revenues received through Medicaid Administrative
Claiming and reflected yearly in the Budget directed to Community Health programs.
RECOMMENDATION:
JCPH management request approval of the agreement between WSALPHO and LHJ regarding the operation
of Medicaid Administrative Claiming in Washington State; January 1, 2019 — December 31, 2019; not to
exceed $38,248.
REVIEWED BY:
/J
Phfflp Morley,',Co, ty Administrator Date
Community Health Environmental Public Health
Developmental Disabilities 360-385-9444
360-385-9400 (f) 360-379-4487
360-385-9401 (f) Always working for a safer and healthier community
�- 001
615 Sheridan Street
Port Townsend, WA 98368
www.JeffeR, u ty E I'cHealth.org
Ely,
�1� N-18-40 L
� � � �
CONTRACT REVIEW FORM DEC
YE S
CONTRACT WITH: Washington State Assoc. of Local Public H6sdommtsft
CONTRACT FOR: Medicaid Administrative Claiming TERM: January 1, 2019 — December 31, 2019
COUNTY DEPARTMENT: Jefferson County Public Health
For More Information Contact: Vicki Kirkpatrick
Contact Phone #: X408
RETURN TO: Jenny Matter RETURN BY: ASAP
AMOUNT: Not to exceed $38,248
Revenue:
Expenditure:
Matching Funds Required:
Source(s) of Matching Funds:
Step 1: REVIEW BY RIS
Review riewei
Date Re
k APPROVED FORM
Comments:
PROCESS: ❑ Exempt from Bid Process
❑ Consultant Selection Process
❑ Cooperative Purchase
❑ Competitive Sealed Bid
❑ Small Work Roster
❑ Vendor List Bid
❑ RFP or RFQ
✓ Other: Continuation of
services
12-13(l�S
rned for revision (See Comments)
;APPROVED
p REVIEW BY PRO UTING T O EY
Review by:• C.
Date Reviewed:
AS TO FORM LB 'Rfaturned for revision (See Comments)
Comments:
(This form to stay with contract throughout the contract review process)
Community Health Environmental Public Health
Developmental Disabilities 360-385-9444
360-385-9400 (f) 360-379-4487
360-385-9401 (f) Always working for a safer and healthier community