18-R-37 - Agreement with Southwest Texas Regional Advisory Council STRACWHEREAS, the City of Schertz staff (the "City ") has developed a Mobile Integrated
Healthcare (MIH) service line within the EMS Department to deal with high utilizers of 911
services; and
WHEREAS, MIH staff have been able to expand their services into providing broad
based healthcare services that improve the health and well -being of the citizens within the EMS
service area; and
WHEREAS, large healthcare payers and systems desire to participate in providing MIH
services to their patients across the entire San Antonio region and consider entering into multiple
small contracts for service over burdensome; and
WHEREAS, the Southwest Texas Regional Advisory Council ( STRAC) provides
regional coordination of all aspects of the acute healthcare system and desires to coordinate MIH
services for regional EMS agencies to provide a single point of contact in the region; and
WHEREAS, City staff has determined that STRAC is uniquely qualified to provide such
regional Mobile Integrated Healthcare Service coordination for the City; and
WHEREAS, the City has determined that it is in the best interest to reduce healthcare
cost to its citizens while improving their level of health; and
WHEREAS, the City Council has determined that it is in the best interest of the City to
enter into an agreement with STRAC pursuant to the Mobile Integrated Healthcare Services
Agreement attached hereto as Exhibit A (the "Agreement ").
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF SCHERTZ, TEXAS
THAT:
Section 1. The City Council hereby authorizes the Acting City Manager to enter into
the Agreement with STRAC in substantially the form set forth on Exhibit A.
Section 2. The recitals contained in the preamble hereof are hereby found to be true,
and such recitals are hereby made a part of this Resolution for all purposes and are adopted as a
part of the judgment and findings of the City Council
Section 3. All resolutions, or parts thereof, which are in conflict or inconsistent with
any provision of this Resolution are hereby repealed to the extent of such conflict, and the
provisions of this Resolution shall be and remain controlling as to the matters resolved herein.
Section 4. This Resolution shall be construed and enforced in accordance with the
laws of the State of Texas and the United States of America.
Section 5. If any provision of this Resolution or the application thereof to any person
or circumstance shall be held to be invalid, the remainder of this Resolution and the application
of such provision to other persons and circumstances shall nevertheless be valid, and the City
Council hereby declares that this Resolution would have been enacted without such invalid
provision.
Section 6. It is officially found, determined, and declared that the meeting at which
this Resolution is adopted was open to the public and public notice of the time, place, and subject
matter of the public business to be considered at such meeting, including this Resolution, was
given, all as required by Chapter 551, Texas Government Code, as amended.
Section 7. This Resolution shall be in force and effect from and after its final
passage, and it is so resolved.
PASSED AND ADOPTED, this 3rd day of April, 2018.
CITY OF S_C `W, TEXAS
Carpenter, Mayor
ATTEST:
�;_ "'�' 2�-�
Brenda Dennis, City Secretary
(CITY SEAL)
50077397.1
11 e O
50077397.1 A-1
AGREEMENT PROVISION
C2: c 1
This Agreement for Mobile Integrated Healthcare (MIH) Services (the "Agreement ") is entered in
to as of April 1, 2018, between City of Schertz Emergency Medical Services ( "City of Schertz")
and the Southwest Texas Regional Advisory Council ( "STRAC ").
WHEREAS, the purpose of this Agreement is to state the terms and conditions under which City
of Schertz will provide MIH Services to enrolled patients from an entity that has a current
agreement with STRAC;
WHEREAS, the City of Schertz will work together with STRAC and the entity they are contracted
with to develop treatment protocols and /or patient care plans for enrolled patients within the
area serviced by the City of Schertz for EMS and /or MIH services;
WHEREAS, the City of Schertz will provide personnel that will work to fulfill the program goals as
defined in the agreement between STRAC and they entity requesting MIH services;
WHEREAS, the Parties agree that patient care will be provided in accordance with mutually
agreed upon care plans, and that City of Schertz MIH Providers will have access to any Medical
Director or a Physician identified by STRAC or through the contracted provider that has an MIH
agreement with STRAC to aid in medical decision making for patients enrolled in the program, if
necessary;
NOW, THEREFORE, in consideration of the Agreements contained herein, the Parties hereto
agree as follows:
1. Services Provided.
a. City of Schertz shall provide STRAC with MIH Services in order to complete the
work defined in the contract between STRAC and any other entity requesting MIH
services within areas served by the City of Schertz for EMS and /or MIH as well as
the services described in Section 1 of Appendix A.
b. STRAC shall provide City of Schertz with the services and perform the obligations
described in Section 2 of Appendix "A" attached hereto and incorporated herein
by reference (the "STRAC Services ").
c. Specific program goals and services to be provided will be defined in each
agreement that STRAC executes with any entity requesting MIH services and will
also be defined in a Letter of Engagement from STRAC to the City of Schertz. The
City Manager will decide on participation in each program on a case by case basis.
1
HOSPICE I vl_draft_12 /12/17
2. Fees for Services.
a. As compensation for the City of Schertz Services, STRAC shall compensate City of
Schertz at the times and in the amounts set forth in the contract executed
between STRAC and the entity requesting MIH services. City of Schertz and STRAC
shall have the right to amend the Mobile Integrated Healthcare Fees by mutual
agreement. All fees will also be set forth in the Letter of Engagement that shall be
provided by STRAC to the City of Schertz for program involvement.
3. Required documentation for Services.
a. STRAC shall provide City of Schertz with all documentation reasonably required by
City of Schertz in order to provide services in accordance with Appendix "A ",
Section 2. This information shall be provided to City of Schertz at time of
enrollment so compliant care can be provided by City of Schertz.
4. Payment for the Services.
a. STRAC shall be liable to and shall pay all compensation due in accordance with the
Agreement between STRAC and the entity requesting MIH services. City of Schertz
will submit invoices to STRAC on a monthly basis and STRAC agrees to pay City of
Schertz's invoices in full within thirty (30) days of its receipt of such invoices.
5. Term of the Agreement.
a. Term. The term of this Agreement shall commence on April 1, 2018. City of Schertz
shall have the option in its sole discretion to annually renew this Agreement
automatically on the same terms and conditions.
b. Immediate Termination by STRAC. STRAC may terminate this agreement
immediately upon notice to City of Schertz, in the event of: (a) STRAC or its
subcontractor's violation of any applicable Federal, State or local law, rule or
regulation, including but not limited to, Chapter 775 of the Texas Health and
Safety Code, Chapter 157 of Title 25 of the Texas Administrative Code ( "TAC ") and
any applicable Federal, State or local special or general laws, or administrative
regulations governing the operation of EMS; (b) the revocation or suspension of
any of City of Schertz's licenses, accreditations or certifications; (c) or
determination by STRAC that the health, safety or welfare of any patient may be
in jeopardy if this agreement is not terminated.
c. Termination due to Material Breach. City of Schertz, at anytime by written notice
to STRAC, may declare this Agreement in default and terminate this Agreement.
2 HOSPICE I v1_draft_12 /12/17
STRAC shall have thirty (30) days after receipt of written notice to cure any default
unless such right to cure is waived or cure is deemed impossible. STRAC and or
any payer of a contract of MIH services with STRAC shall be the sole judge of
whether the default has been satisfactorily cured. The events giving rise to
termination under this section include but are not limited to:
(1) failure by STRAC in the performance of any of its obligations hereunder,
including but not limited to, failing to provide services as set forth in
Appendix A; or
(2) expiration or cancellation of any policy of insurance agreed to be
maintained by STRAC.
d. Termination without Cause. Either party signed herein may terminate the
Agreement with 30 days written notice to the other party.
e. Actions After Termination In the event that this Agreement shall be terminated,
any and all fees shall be paid through the effective date of termination including
all monthly fees due for all enrolled patients through the end of the month when
the termination is effective.
6. Education and Training.
a. Each party agrees to provide the -other party with education and training as set
forth in Exhibit "A" attached hereto. In connection with such education and
training, each party agrees to execute or provide the other party with
documentation requested by the other party for purposes of patient privacy.
7. HIPAA.
a. 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 confidential health information (hereinafter referred to as
"Protected Health Information" or "PHI ") is subject to protection under, 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
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 herein are determined to be performing
a transaction subject to HIPAA or HITECH Act, the Business Associate Agreement
3 HOSPICE I vl draft 12/12/17
shall control. Contemporaneously with the execution of this Agreement, the
parties have executed a HIPAA compliant Business Associate Agreement.
b. 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.
8. GENERAL PROVISIONS
a. Corporate Practice of Medicine. Nothing contained herein is intended to (a)
constitute the use of a medical license for the practice of medicine by anyone
other than a licensed physician; (b) enable or assist STRAC or any corporation to
practice medicine when in fact such corporation is not licensed to practice
medicine; or (c) constitute or result in any other act or create any other
arrangements in violation of the Texas Medical Practice Act.
b. Retention of and Access to Records and Reports. City of Schertz agrees to provide
STRAC and federal, state, and local governmental authorities having jurisdiction,
upon request, access to all books, records and other papers (including, but not
limited to, medical and financial records) and information relating to this
Agreement and to those services rendered by City of Schertz pursuant to this
Agreement, and to maintain such books, records, papers and information for the
longer of six (6) years after termination of this Agreement, or the period required
by applicable state law. All requested information shall be supplied within
fourteen (14) business days of the receipt of the request, where practicable.
b. STRAC and its subcontractors shall retain any and all documents produced as a
result of services provided hereunder for a period of four (4) years (hereafter
referred to as a "retention period") from the date of termination of the
Agreement. If, at the end of the retention period, there is litigation or other
questions arisingfrom, involving or concerningthis documentation or the services
provided hereunder, STRAC shall retain the records until the resolution of such
litigation or other such questions. STRAC acknowledges and agrees that City of
Schertz shall have access to any and all such documents at any and all times, as
deemed necessary by City of Schertz, during said retention period. City of Schertz
may, at its election, require STRAC to return the documents to City of Schertz at
STRAC's expense prior to or at the conclusion of the retention period. In such
event, STRAC may retain a copy of the documents at its sole cost and expense.
9. Warranties and Covenants.
STRAC represents and warrants that:
4 HOSPICE I v1_draft_12 /12/17
a. All information, data or reports provided or to be provided to City of Schertz is,
shall be, and shall remain complete and materially accurate as of the date shown
on the information, data, or report to the best of STRAC's knowledge.
b. No litigation or proceedings are presently pending or threatened against STRAC
relating to the Agreement.
c. STRAC has legal authority to enter into this Agreement and to accept payments
hereunder, and has taken all necessary measures to authorize such execution of
contract and acceptance of payments pursuant to the terms and conditions
hereof.
d. STRAC (i) is not currently excluded, debarred, or otherwise ineligible to participate
in Federal health care programs as defined in 42 U.S.C. Section 1320a -7b(f) (the
"Federal health care programs "); (ii) is not convicted of a criminal offense related
to the provision of health care items or services but has not yet been excluded,
debarred, or otherwise declared ineligible to participate in the Federal health care
programs, and (iii) is not under investigation or otherwise aware of any
circumstances which may result in STRAC being excluded from participation in the
Federal health care programs. This shall be an ongoing representation and
warranty during the term of this Agreement, and STRAC shall immediately notify
any entity of which STRAC contracts of any change in the status of the
representation and warranty set forth in this section. Any material breach of this
section shall give City of Schertz the right to terminate this Agreement
immediately for cause.
10. Assignments.
This Agreement is not assignable by either party without the prior written consent of the
other.
11. Waiver of Performance.
No waiver by either party of a breach of any of the terms, conditions, covenants or guarantees
of this Agreement shall be construed or held to be a waiver of any succeeding or preceding
breach of the same or any other term, condition, covenant or guarantee herein contained.
Further, any failure of either party to insist in any one or more cases upon the strict
performance of any of the covenants of this Agreement, or to exercise any option herein
contained, shall in no event be construed as a waiver or relinquishment for the future of such
covenant or option. In fact, no waiver, change, modification or discharge by either Party
hereto of any provision of this Agreement shall be deemed to have been made or shall be
effective unless expressed in writing and signed by the party to be charged.
S HOSPICE I v1_draft_12 /12/17
b. No act or omission of either party shall in any manner impair or prejudice any
right, power, privilege or remedy available to the party hereunder or by law or in
equity, such rights, powers, privileges or remedies to be always specifically
preserved hereby.
c. No representative or agent of the either party may waive the effect of the
provisions of this Section.
12. Legal Construction.
In case any one or more of the provisions in this agreement shall be held to be invalid,
illegal or unenforceable in any respect, such invalidity, illegality, or unenforceability shall
not affect any other provision and this Agreement shall be construed as if such invalid,
illegal, or unenforceable provision had never been contained herein.
13. Choice of Law and Venue.
This Agreement shall be governed by and interpreted in accordance with the laws of the
State of Texas, without giving any effect to any conflict of law's provisions.
14. Confidentiality.
a. The Parties acknowledge that in connection with the services to be performed
under this agreement by STRAC and City of Schertz, either party, may be acquiring
and making use of certain confidential information of the other party which
includes, but is not limited to, management reports, financial statements, internal
memoranda, reports, patient lists, and other materials or records of a proprietary
nature ( "Confidential Information "). Therefore, in order to protect the
Confidential Information, the parties, shall not after the date hereof use the
Confidential Information of the other party except in connection with the
performance of services pursuant to this Agreement, or divulge the Confidential
Information of the other party to any third party, unless the other party consents
in writing to such use or divulgence or disclosure is required by law. In the event
either party receives a request or demand for the disclosure of Confidential
Information of the other party, the party receiving the request or demand shall
immediately provide written notice to the other party of such request or demand,
including a copy of any written element of such request or demand.
b. STRAC and City of Schertz agree to adequately instruct their employees, medical
providers, and all personnel that may provide services pursuant to this Agreement
regardingthe confidentiality and privacy of patients and patients' medical records.
15. Medicare Access to Records.
6 HOSPICE I vl_draft_12 /12/17
a. To the extent required by Section 1395x(v)(1)(1) of Title 42 of the United States
Code, until the expiration of four years of termination of this Agreement, STRAC
and /or City of Schertz shall upon written request, make available to the Secretary
of the US Department of Health and Human Services, or 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 STRAC under this Agreement.
16. Amendment.
a. No amendment, modification, or alteration of the terms hereof shall be binding
unless the same be in writing, be dated subsequent to the date hereof and duly
executed by the parties hereof.
17. Severability.
a. Any provision of this Agreement that is determined invalid or unenforceable will
be ineffective to the extent of such determination without invalidating the
remaining provisions of this Agreement or affecting the validity or enforceability
of such remaining provisions. Furthermore, in lieu of such invalid or unenforceable
provision, there shall be added automatically as a part of this Agreement a
provision as similar in terms to such invalid or unenforceable provision as may be
possible, while also legal, valid and enforceable.
18. Notices
a. 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:
STRAC: Southwest Texas Regional Advisory Council
7500 US Highway 90 West, Suite 200, San Antonio, TX 78227
ATTN: Eric Epley, Executive Director
City of Schertz: City of Schertz
1400 Schertz Parkway
Schertz, TX 78154
19. Entire Agreement.
a. This Agreement constitutes the final and entire agreement between the parties.
No other agreements, oral or otherwise, regarding the subject matter of this
7 HOSPICE I v1_d raft_ 12 /12/17
Agreement shall be deemed to exist or to bind the parties unless same is in writing
dated subsequent to the date hereof and duly executed by the parties.
EXECUTED IN DUPLICATE ORIGINALS ON THE DATE FIRST WRITTEN ABOVE.
8 HOSPICE I vl_draft_12 /12/17
Brian James
City of Schertz, Acting City Manager
Date
9
Southwest Texas Regional
Advisory Council:
Executive Director
Date
Appendix A.
City of Schertz Services
1. City of Schertz agrees to provide to STRAC the following services:
a. Facilitate the enrollment of patients who are receiving care from an entity that has a
current contract with STRAC into the City of Schertz MIH Program.
b. City of Schertz MIH personnel shall make contact with the patient and his /her family
to schedule the required number of visits as outlined in the contract between STRAC
and the entity requesting MIH services.
c. If required in the contract between STRAC and the entity requesting MIH services, the
address and other demographic information for patients shall be logged at the
Provider's Public Safety Answering Point (PSAP) for ready identification in the event
the patient or family accesses 911. This will allow, among other things MIH personnel
to identify calls from a patient's address and facilitate response of an MIH paramedic
to each 911 call from that address.
I. If required in the contract between STRAC and the entity requesting MIH
services and in the event that a 911 call is received by City of Schertz from the
patient's residence that is enrolled in the Program, MIH will be notified and
the nearest appropriate apparatus from the jurisdiction will be dispatched
d. City of Schertz shall keep patient care records for every contact with enrolled patients.
e. City of Schertz shall provide monthly reports on utilization of the MIH Program and
any other requested data as defined in the contract between STRAC and the entity
requesting MIH services on enrolled patients to STRAC.
10 HOSPICE I v1_draft_12 /12/17
Appendix A.
STRAC Services
2. STRAC shall provide the following services to City of Schertz and perform the following
obligations:
a. Cause each entity with which STRAC contracts for MIH services to introduce the
concept of enrollment in the MIH Program to all patients eligible for participation in
the MIH Program.
b. Cause each entity with which STRAC contracts to provide to MIH services to provide
the following information for each such patient:
i. Patient's full name, date of birth, social security number and phone number
ii. Access to all medical records for the patient enrolled in the MIH Program, to
include the out of Hospital DNR.
c. Cause each entity with which STRAC contracts for MIH service to provide STRAC and
City of Schertz with timely information regarding patients who are no longer enrolled
in the MIN Program.
d. Cause each entity with which STRAC contracts for MIH service to provide STRAC
and /or City of Schertz continuing education and training regarding the specific
program defined in the contract.
e. Cause each entity with which STRAC contracts for MIH services to provide STRAC
and /or City of Schertz with access to its Electronic Medical Record System to allow
access to pertinent patient information.
11 HOSPICE I v1_draft_32 /12/17