274374 �NHITE - CITV CLERK � y
PINK - FINANCE TY OF SA I NT PA LT L Council �'�����
GANARV - DEPARTMENT
BLUE - MAYOR File NO.
ouncil Resolution
Presented B e Levi
Referred To Committee: Date
Out of Committee By Date
RESOLVED, That the Council of the City of Saint Paul hereby authorizes and
directs the proper City officials to execute an agreement with the County
of Ramsey and Family Tree, Inc. , whereby the City and County will assist in
its functioning as a neighborhood health center in caring for the medical-health
needs of the citizens of the City and County in the adjacent geographic area;
the City's contribution �or the calendar year 1980 being $50,746 , and said
agreement expiring December 31 , 1980.
Funding Code: 03215
P
COUIVCILMEN Requested by partment of:
Yeas Nays �
—u=�,._ •
"��t In Favor m it S rVic
Le�rine n
h,�i�-��!.,x � , �l�l. '1��.r�.
r.,;.;,_,,�n -- Against BY
s'�,��:�:��^� for Thomas J. Kelley
Tedes:_o `� � ��p�
�n?� '� Form pproved by i t rne
.;a<...
Adopted b � o cil: Date
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Ce �ed P- ed Cour�cil Se etary BY
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tlppr �by 1�lavor. Dat --��� A t�Q(1 Approved by Mayor for Submission to Council
By . - gy t �,��'Z-�c.,cS���2�C�'1./
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AGREEP•1EPdT
�id F�GF:EE��EP1T, Dated thi s day of December 1979 among the
CITY OF SAI"1T PI'�UL, ��ii nnesota, herei nafter cal l ed "Ci ty"; tI�P CQUtJTY OF
RAt;SEY, �tinnesota, hereinafiter called "County"; and Family Tree�Inc. ,
locatea a4 1599 Selby , Saint Paul , t•linnesota, hereinafter
callec! "Grantee"; .
�
lJIT��ESSETH o
In consideration of the services of the Grantee functioning as a neigh-
borhood health center in caring for tl�e medical-health needs of the citizens
of the City and County, the parties f�ereto mutually agree as follows:
1. Th� City and County �lill each give to the Grantee such sum of money
as is set across from the name of each as reflected on the attached Exhibit A
and in the manner set forth herein.
2. Th� sum of money granted by the City and County is for the Grantee's
use during 19�Q. P�o aclditional or future funding or assurances thereof will be
provided ar honored i�nless set forth in an amendment to this Actreement or a
separate agreement approved as the free act of the City and County.
3. The County shall pay to the City its contribution as reflected on ,
Exhibit A in equal installments on January 1 , April 1 , July 1 , and Octaber 1 ,
�sao. � �
�. The .City shall pay to the Grantee its and the County's contribution
in installments as fo7loti•rs: '�
(a) 25! of the total contribution of bo�h the City and County an
or before January 1 , 1980;
(b) 25% of the total contribution of both th� City and County on
or before P,pril 1 , 1980;
(c) 25;� of th4 total contrihution of both the City and County on
or bEfore July 1 , 1980;
� (d) 25°� of the total contributioii of both the City and County on
or before October l , 19�0.
5. The City, acting as the transmittal agent of the contribution of both
the City and County, as set forth in Paragraph 4, shall not be liable to pay
to the Grantee the County's contribution if not received by it from the County
pursuant to Paragraph 3.
6. The Grantee shall on April 20, July 20, October 20, 1980, and January
20, 1931 submit to the City an itemized statement of a]1 Grantee's expenditures,
revenue and report of services on a form or forms to be provided by the City.
The City shall make such reports available to the County u�on receipt. Further,
the Grantee shall preserve all documentation used by�it in complying �aith the
statements and reports required by this p�ragranh and shall be available to the
City and County for its revievi and audit as desired.
7. The Grantee si�all , �1ith apnroval of the City, develop and enforce a
fee schedule for patient charges.
8. The City shall act as the liaison to the Grantee for such day-to-day
administration as nay be needed and shall be resoonsible for:
(a) Reviewing and evaluating the program and fiscal activities of the
Grantee and disseminating reports thereof;
(b) Providirtg technical assistance to the �rantee in developing and
implementing the fee schedule referenced in Paragraph 7;
(c) Coordinating activities common to the Division of Public Health
of the City and/or the Cormnunity Health Services Department of the County
and the :Grantee;
(d) Rendering to the Grantee such other assistance as tvithin the
City's resources;
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9. The Grantee shall ensure that:
(a) Services provided to eligible individuals are furnished without
regard to race, color, creed, sex, age, marital status or family size;
(b) Services are orovided v�ith respect for individual privacy and
dignity; and
(c) Services are �rovided without coercion and shall not be denied
on the basis of refusal to participate in research projects or other
activities of the Grantee, or on the basis of ability to pay.
10. The Grantee shall obtain and keep in force at its own expense during
the term of this Agreement, professional liability insurance in the amount of
Three Nundred Thousand Dollars ($300,OOQ). R certificate evidencing such
insurance as being in force during 1980, and co-insuring the City and County,
shall be furnished to the City Attarney for revie�v and a�proval on or before
January 1 , 1°II0.
11 . The Grantee's organization and activities shall be guided by the
format described in the attached Exhibit Q.
12. The Grantee shall submit to the City a total o�erating budget on
forms provided by the City and an operational plan of its services to be pro-
vided during the term of this A�reement on or before February 15, 1930.
13. The Grantee shall submit to the City a total operating budget on
forms provided by the City and an ooerational plan of its services to be pro-
vided during the calendar year 1�81 on June 1 , 1980.
14. The Grantee shall obtain a financial and program audit for the period
of ti�is Agreement by a certified public accountant. This audit shall certify
to compliance a�ith the terms of this grant and budget develo�ed for this grant
period. The Grantee shall submit a copy of the audit report to the City. The
City shall make said renort available to the County upon receipt.
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15. The Grantee shall make available relevant background and Gualifica-
. tion su�maries of both re�ularly employed and volunteer staff to the City and
County.
1G. The Grantee agrees that deviations of ten percent (1�%) or more,
un�•rards or dot�mi-rar�is, fror� its 1920 agency budget, and/or additions or d�le-
tions from its 192� operational plan as approved by the City and County ��ill
be transnitted to t}�e City and County in a timely fashion and in a manner to
be deterr�ined b� the City's Clinic Coordinator. Such. information shall be
before the fact and shall include pertinent data relative to the planned addi-
tion, deletion, or any other modification of programs and the subsequent pro-
jected budgetary ii�pact for the contract year an� the follo�rring year.
17. Ttie Grantee declares Emily Fuerst� to be the
� �
person responsible for cor�pliance with the terms of the Agreement, and its
Dr. James Barker as the person responsible for its
medical services.
18. The Gity declares its Director of the Deaartment of Community Ser-
vices ar sucti designee as noted in �•�riting by him as the person responsible
for complia�ce with this Agreer�ent.
19. Tiie County declares its Executive Director or such designee as
noted in vrriting by him as the person responsible for compliance with this
Agreement.
20. The Grantee aQrees that at all times under this Agreement, it, and
its employees, agents, and volunteers are independent contractors as to the.
City, and not employees of the City.
21 . The term of this Agrezment shall b� from January 1 , 1930 through
December 31 , ]930.
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IP! I�IITt�JESS l�1HEPE0F, the parti es have set thei r hands as fol l ovis:
A�pro��eJ as to Form COUi�dTY OF RA"1SEY
By
Assistant County Attorney � Board Chairman
Y. .
C
` ay
Aorroved as ta Forr� Executive Director
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Funds are Available
Assistant Ci y Attorne Account Number(s)
° � Amount
GR�►�r'TEE: The Family Tree, Inc. gy
Budgeting and Accounting
gy
Insurance Approval
Its Director
By
Risk Manager
CI7Y OF SAIP�lT PAUL
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Funds are Available .•
Account tJumber 03215
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. By
Director, Denartnent of Finance
t�lanagement Services
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, ; � �. ' �Exhibit B
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. . t,c�l i r;ur, s r,�;��,apo�, . .
" - FOFi 7FIE OPERAT I O�l OF hE I GtIE30RN0��D FIEAI.TH CENTEP.S • � �
STi����,q4D I - O��r,�;1%.1T I Os:.�,L STRUCTU�tE
A. Gcva�nir�g body: -Fhe center operates under �he �i-ec;ior� uf an identifi�bie . .
board ofi direcfiors. _ .
I . This board hold� regularty scheduled and docur.;�nted neetings.
2. tts mee�ings are o?en to the public and are ar�nounced public{}�, � " �
at i east f i ve days pr i or to each regu i ar 1 y schedu i ecf r��ea-f i ng. � .
3. This body has futl legai aufihori-fy and responsibili�y for o��era{ i
. conduct of the center. . �
4. The center is incorporated with ihe assistance of an attorney. �
B. Governing body r.�ake-�p: . . �
I . The board of d i re�tors i s rr:ade up of at teas-t 5 t4 consumers.
2. The board of direci-ors is reflectiva racially, cultura( ly, econonically
• and sexuatfy of the center's neighborhood and/or service popufaiion.
C. Governing body responsibitities: the board of directors is tF�e policy-making .
bady. . - .
.- a.
1 . It adopts effective c( ien-t care policies and by-laws governir�g the
• operatien of the facili-ty in accor�ar,ce with (ecal requirenents and
in conjunction with medical staff. Such policies and by-la�rs are in
� writing and dated, and ihe board of directors e�,sures they are
� . operai-ionat and reviews them at least annually. - �
2. It has a client- review conmittee responsibte for 1-he devetopmeni- of
policies relative to the health care, safety and �ig,h�s of clients.
3. T he yoverning body hires the chief administrative staff person. �
4. I t cons i e�ers and acts or�.budc�ets, contrac�s, a,reer.�s:�ts and ofiher
, o�eration�l r�atters prese�ted to it by its staff. ,
D. Channels of resoonsibility: chann�ls of respcn�i�ility as ��efl as
su�+ervisory relation�hips r�ithin the center are doc�.:�e�ted hy r.;ea�s
of an organizational chart or other suitabie �
, .
1 . Ass i gnmen� of respons i b i 1 i ty znd de I eg�t i or. of �author i ty �r;i th i r. th�
center's or5anization a;e specified in jcb dss:.riptic� o� adminis;r�- �
t i ve,` and profess i ona I personrie 1 .
. ,�����Tw� . _ ...:. ....
T ..
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. ' _. �.�::�inistrative records: administrati �e re=ord; ar.d reFcr�ts are a��intair��
a�o used to guide the oFeration a7d reflect the procress of the center.
1 . kdminis�frative recerds inclure statis�ical d��a or, n��nbers �erved.
2. An annua( report i s comp i led �:h icPi i nc I udes a-t �eas; a sumr�ary o� .
financial operation end of services Yrovided. The report is made
availabte to the public. � �
���'i�;�Rt� I I. - PERSQPJtdEt POLI CI ES . . .
?�rso��ne l po l i c i es and prac i i ces are esfiab F i shed, rev i e:•r�d per i od i ca�t f y and � � �
;�v;szd as necessary. � .
r. Farsonne I po1 i ci es ot the ceni-er are wri�ten ar,d made ava i 1 ab le -Fo a�( I �
center personnel . . � .
�. The cenfier has in effect a viable personnet gr'ievar,ce policy. . .
C. The written personnet policy covers: � . • � �- '
I . Fliring procedure, including an affirmafiive statement of fair � . .
emptoyment in hiring. . . . �
2. Employee probation. . . . :
3. Evaluaiion of job perfornar,ce. . � " ��
�. Salary adjustr^ents � :
� 5. Hotiday, sick leave, annua[ leave and other Eenefii's. � • � -
. E. Terminations - votuntary and invotuntary. � � ' . " � � - •
_ . _:�� c�n�er has a sufficient number ot qualified personne! tQ meet the needs of ctients.
�. S�affing: staffing is adequate to p rovida the services essential to i�nplenent .
��e stai-ed goa I s and ob jecfi i�ves of the center.
1 . A11 members ot the sfiaft are qualified to perform the duties and
� responsibili-ties assigned to them, and meefi such Fe�erat, State .
and local professional requirer�ents as are arolicable. � .
2. If the services of health care students are u�ilized in providing • � •
care, such trainees ��erk under tne direct on-si�e suFervision of � �
appropriately qualified professicnal personnal . � �
�. If paraprofessionals �:ork at the center, their job �escriptions � . _ • • _
(and actual funcfiions) reflect fih2ir trairing a.�� s�ills.
' .�a�.^. Thr-ee � � '
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�s. . " . � . � '
' • 4. Y+r i Ften ',::: de i i�es ex i st, c i t�rg T:�e mi n i r�u�n r�4:�:,ers of personne i
' �eczssary for delivaring services during c2nt�;r s�ssior�s. �
E. Continuing Education: all cen�er personnei - paic z�d volur�tce; - are giv�n
� the opportun i f y to par�i c i pate i n on-go i n� educafi i Una f progr-ar�s re t a i ed ta .
their activities, inciudir.g ori�n�a1i�n, on-the-job �rainir�„ reoular in-�e;vicE
trainin� prograr�s, and participatior� i� v,��rkshops, insjitutes or cor�tir�uing
edu�atio� courses. � �
STA\DAP,� t I l - F I P�A.�JC i f�L h;AtdAGEt'�cNT .
A. Annual budgst: a budge� related to ths centerts objectives is prepared annually.
6. Accounting system and records: an accour,ting systen in maintained that- -
, pro�uces intormation reflecting the fiscal ex�erience and 1-he curren� financia[.
. . pos i ti on of the ceni�er. � . .
� t. The center �mainfiains records a�equaie to meet i�s operating needs �
• and its o6ligations io clients, fihird-party payors and ot�er � � �
. .i nterested parti es. . . _ �
2. Reports ot the center�s current financiat position and other pe r�irent
financial information are sub►�it-ted to fihe govErning bcdy at feast
quarterly. -
3. The center provides for an independent cer-Eified audit or an .
unaudited opinion ot its finarcial operations to be carried ou1-
annua� ly. • -�- . �
C. Irasurance: an insuranCe program that prbvides for adequate cor�preh�nsiv� �
� liability insurance covering center personnel and for pro�eciion of the centerts _
physical and financiat resources is in effecfi. � .
0. The c I i n i c i s i n cor�p 1 i ance rr i th State a�d Federa l taa:s regard i ng f i nanc i e 1 .
reporting. � . . . .
( . Tax return is prepared and subr�itted annually. � - .
2. State and Federal emptoy.ee �vithholding taxes are deposi.ted regularly
within legal limits. ��
3. State and Federa I returns for err�p I�yee rr i thhe I d tar,�s are f i l ed
qua rter l y. •
4. The center meets requ i reme�ts �or S±ate Uner�p Ioyr:e�►t 1 ns��rance for � �
its employees. ' •
5. The center m�els requ i rements Tor ti!orkr��n's Cerper�sat i o� i nsu rance
for its emptoyees. �.
6. The op�ion to join the Fed�ra) Socid( Secu�i�y .pro,ra^� has be�n o`fered
to the er.►ployees (p�rtains fio 501 (c) (3), oraani_ztic�s) .
.. .
' P�'d�lil!^U�� S�a�dards � �
r , .. . .
. : P�ca .Four �
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ST��•.��RD t V - OFtGA�t I ZAT I�r�AL PLAti�d i�1G � .
A. Goals and Objectiv�s: the bo��d of �i�ectors h�s �c:veloped a set of goals
and objecfiives ti•rhich inctudes:
I . The ove�ail philosophy or nission of the ciir�ic. �, � •
2. its projected outcor�es relative to the scope o` health services available . : :
to its ciients. .
3. The cor-�mun i iy (both geograph i c anc� cu Ifiura I) -�o be served. . . -
4. OTher projected ou-tcomes re�erred to or impliEd by the mission statenent �
� sucfi as cost of care, cl ien-t advocacy, etc. . � . � _
B. Progran Ptanning: the board annualty develops policies and objectives based .
on the philosophy and goals of -the center. -
' i . The chief adninisi'rative officer develops an annua! workpfan based ort - _
the priori-ties of the board. �The workplan addresses: ' .
� a. The numbsr of ctients to be served. �
� . b. The scope of services -to be delivered. � � �
�. The effect of the services on fihe cost`of care. . �
. � . .
�. d. ��The nathods of f i nanci ng the .care to be de! i vered. � � : . ' • :
e. The person pow�r necessary to de1iver the services. �
f. The space necessary for delivering fihe se�vices. .� �
� g. The relationship with other providers of care. � � _ :
C. Prograr� Evatuation: the director or chief administrative officer reporfis �.to -fihe
_ governing body annualiy regarding the ef�ectiveness of the prog�ar�. The report -
includes: . • .
1 . Numb�rs of ciients served. �
2. The scope of services delivered at the cent�r. �
3. The average cost of services per ctient visit.
4. The adequacy of the phys.ical space in which services rrare delF.vzred. .
. �
5. The nunbers and co�petercies of the sta`t �•:ho delive:-ed the services. ,
6. Current relationships vrith other provi�ers of care. �
, %�ag��" F i va . . . .
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, -'STA�VCARD V - FI-6Y;i I CAL cP�VI FO���'��vT �
The center site conforms to buildir.g, health and fire rc:�ulatio�s of the city,
county and/or v i I I age ►rhere i n i t i s !oca-ted and cL��;p I i ar�ce i s adec�uGfie ly d�cur,,�nted.
STP.idDARQ 1i I - POL f CY A�10 FRC�tDI;RE .
Policy and .proce�u�e are dsvelop�d for i�ple�en�iF,g i-he stated goals ar,d o�jectives
of the center. .� - � � . _
A. h',anuafs: policy and procedure manuals exist having been developed a:ith the
adv i�s of pro�ess i ona i personne t , adm i n i s�-rat i on and c I i erits and are rev i e�•red .
at least annually and revised as necessary. The manuaf (s) incl�de guide( ines
governing the provision of emsrgar�cy a�d non-znergency care �Fat may be givzn
• at the facilisy, and cover at leasfi The fotlowing: .
I . Protoco{ fcr er�rgency procedurzs �hai- r�ay be perforred in i-he cent�r.
2. Procedures to be� foilowed in referring a ctient zo ano�her facility "
. � tor care not avaitable at the center. . � � � .
3. Protocot regarding contact with cor:�municable disease and procedures
tor i nfec�i on contro t at fihe center. �
4. Pro�oco( for contacting clients when fotlo�r--up visits are necessary.
� . �
B. Convenience/Rccessibility: the center has in effect poticies and procedures
. which assure. that center services are c�fered at -tirres/occasions and in a
manner thafi i s reasonab I y conven i ent fer fhe ra jor i ty of �he c�i er,ts, � _
� � . : . .
I . The avaitability of firansportation and the work/school requirer:,anfis
of clienfis are taken Tnto account. � �
� 2. A schedule showing the days and hou�s when the csnter is open is
posted in a conspicuous place in fihe center an� nade availabte .
� � to poss+ble referral sources. � �
3. If lang�age or cultural barriers exist befi•;aen cer�ter personne( . . �
and a significant nur�ber. ot clients, arrangements should be Made �
for in�erpreters to bz present, rr�ulti-languace signs to be pos-Fed,
or for o�her mechanisms to ensure adequate cor::nunicatio�►.
4. Proced�res are developad to accomriod�te ctients ►•rith physicat handicaps.
C. Appoi ntr��er�t sysi-en: i f the center sees c I i ents by appo i n-�ment, a t i rre-s�ec i f i c
appointmzn� system is establisheu, with adequate tir�a atloti�;ed for sta�f to see .
� nsvr cl ients �as a�el ( as those r!iaking rei-urn visits.
I . Average a:a i t i ng t i r� at fihe center shou I d no'f exceed one hour.
2. To the exte�t possib.le.efforts are r�ade tc enable the ctient
to se2 the same provider on each returr, visit. �
� , •
� �►�;i n+�^Jm S randards � ` ,
, . -�,a�l-' S i•x . . .
� .' ,
. 3. For r:�r�-�errer�encv c�r�a, ct ien-� sho�.:!d 'nave t�c: :�ai�� no long�r -th�n t►•�o `
, h�eks for appoin�tren�hs. .
� D. Continuity of cara: the center adopts a��1 imple^�r.1s r:echanisms i�o ensure
' tne co�ti�uity and availability of care. � � •
I . A rr�chznisn is established for providir.g services to unscheduted .
ciients urg�ntly in need of care. � - _
2. The cl ie�t is informrd a� th? ti►�a of ihe initiat contact �yi-I�h 1-he � �
. ceni-er of the services avai ;ab(e at -the center znd is given ihe �
opportun i ty to p I an for Yrays i n �rh i ch tF►ese serv i ces can be. � � � .
integrated inio his/�ar totaf care. �
3. Off-tiou; nedical coverage is provided by the cenfier or an alfiernative .
tnachanisr.► is _devetoped to ens�re coverage. �
4. A recorded fielephone nassage is utilized leaving instructions for � �
clients catting during timzs when the center is not open. �. . �
5. A procedure exisfis for referring clients �to other facilities for care � '
� not avai labte afi the center and guidel ines cover ai- least -�he fot totying: . �
a. lnforming the client ot aiternative sources of care and sfieps . .
� � -thafi nust be taken fio arrange for the care. � � .
� b. Transfsrring of information regarding the client wii-h �ha - :
� client's authorization to the receiving facifity. � -
c. Transferring of infornation regar ing -the client from the � �
re�eiving facitity to the center �or inclusion in the clienfi's � . .
center records.
E. Clients' Rights/Responsibilities: -the center adopts and makes available -to . . _
ciients written policies regarding the rights/responsibili�ties of clients. - � . �
These policies ensure each client at least that he/she is: = . • �
1 . Fully inforned of these rights and of a{ I rules and regutations �
concerning clienfi cond�ct and �esponsibilities. - �
� 2. tnformed of fihe identity(ies) of the people involved in his/her � �
ca re. If trainees particiPate in the care, he/s�e shal { be so
in�ormed. � �
3. Inforr�ed of the charges for services involved in the care given and �
-thafi fih� chargzs for alI services provided by the, cen±er be avaitabte .
at requast. � �
4. Inforr�ed of the reasons for and nature of al ! ex��ina�ions, -hestine and -
proced�ares that are done. . �
��':i n i�;�m S�f�c�J3�d� ' .
, . °a�e �5even • . ' ,
. . . . , .
5. InformeJ of the nature of his/her c��:di;:c:� �nG of aliern-ji�i��e •
treafrne�ts, if they exists providirg for his par�icipafiion in thc �
planning for care.
6. (r�forried of h i s/her r i�ht to re f��p treatrs�nt recomrr.e�ded ar•�d of , �
. thz possible conseque„ces of that retusal . �
7. [nforr��d and assisted to understanc a�d exerci:e his/her rights . . � �
and may, via an existing m�chanisr�,. voica grievances and recomr�snd . �
changes in policies and service fio cer,ter sfia�f and outside . :
� repres�ntatives of his/her choice. :
8. Assure confie+en�fia! trea-�manfi of his/her disctosures and records,
ar►d�r;�y approve or refuse the release of any informafiion i-o any . �
individual not involved in his/her care at fihe cenfier except as •
� requ i red by 1 aw or fih i rd-Party payr:sent confiract. �
9. T�eated with consideration, respect, and full considerafiion of �
his/her dignity ahd individ�aliiy, including privacy in treatment ' �
and care. . � � . � . -
STAPJDARD V l ( - P•IEO I CAL RECORDS . �
t nd i v i dua� c t i ent recards. and report i ng sysfierrs necessary to ca rry .oufi program �
. evaluation and to maet atl applicabie professionat, administrative, pianning and
tegal requiremen-Fs sha11 be estabiished and r�ainfiained. . .
A. Individual ciient records: a m2dical record is mai�h�ained for every � �
ciient receiving msdical care provided bylthe service.
. I . A sample of inedical records is reviewed periodically by designated •
administrative and/or professional s�aff to deternine the quality
of the records. �
2. Medical records confain atI of the follorring data: .
� a. Personat data incl�ding: � - � �
1 . pa-tient identification
2, r►ame(s} of person(s) io be nofiified in case of er�rger,cy
3. serv i ce reg i strat i o:�,� or other i dent i fy i ng nurrber
4. identification ot ofihar sou�ces of rsdica[ care � .
5. source of referral ' .
6. date of v i s i-ts . �
7, designation of prirary Fhysiciar, or health worker
responsible for clier�t's care. . �
. S h':hrii,y�un Standards � •
.
, . ,;P��� �ight
• ` � � .
b. Clinical data including:
I . clien� t►istory to inc(ude h:stcry of at ;c�rgies �
and previous ilinesses, hospiTalizatio;�s, and . � '
surgeries and medication used. � .
2. physical examination report . , .� _ _
. _. 3. � ctientts current problems � • .
. 4. clinicaf no�es writien by appropriate center - •
personnel . � . - .
5. consulfiation reporfis; if appticable �
6. copy of relevant records of care renc+ered . � �
. - by other providers _ .
c. Diagnostic da-�a including: �
. 1. taborafiory reports '� , ' . . � .
2. radiology reports � . _ .
- 3. oiher reports; as applicable �
� d. Treafinent and instructions, inctuding: -• �
t . cJient ranagem�nt plar.s, inc(uding follo►ti�-up �
� action as indicated `
2. notaTions af prescriptions rrri-Ften
• . 3. setf-care instructions . .
4. inst�uctions regarding return visits � . - � '
5. signed consent .forms; an�. signed re(eases . � �
6. instrucfiions for care given per ►elephore �� � .
B. C�nfidentiality: •the confideniiality of al ! redical records is r�aintained subject
to applicable lar;s and third-party contracts requiring disclosure. �
I . The center safeguards fihe inforr�ataon in the re�cord agains�• loss, •<,
defacer�enfi, '�amperi nC .or unau�hori zed uss. . • •
2. The center�s emptoyees receive instruction concerning the
preservation of the confiCentiality of the ctiEr,��s �:edical records.
3. 1�lritte� informal consent of the cliert shall be required for the �
release of r�edical information. • • " �
`,i�1 fl�i��u�,1 J �cti�uc;� u� . . .
� Pa�?-.�d i ne � . � � .
, , .�
�' �C. •F i;! i ng arici ,r-�tr 3::va t system: t��A�i c�( records are i ndex�:d and f 1 1 e:d i n a .
� � manner �r�i ch fac i I i ta+es ttte acqu i s i t i on o f sta�t i st�i ca I i n tormat i on and " . �
the retriEVal of records for client care ,and prograr.► evalu�iior, purposes. �
STAi•iDr1R� V I l I - LABORf+TG'tZY SEP.V I CES
laboratory servi ces comrr�nsurate �,ith the center's nez�s are provi ded by the cente�
itself, by an ou�tside laboratory which is part of an accredited or certified -
hospital , or by an ouiside independent laboratory r;hich is approved to provide services.
If the ce�ter provides la5oratory services directfy, the folloa:ing criteria are
zPP� icable: � . �
A. Personnel : if fihe cenfier provides more ihan bas.ic taborator}� services,
the laboratory is under the di�ec�ion of - or regutar consultation is
� av i 1 ab t e fror,i - a patho i og i st. ' -
�. Raquests and reporfis: signed reporis of laboratory findings a�-s refiurned .
� promptly to fihe �equesting individual and entered into the client�s
medica � record. . . � - '
� C, Safety: proper safety� precautions are mainfiained aoains� hazards trorr , �
tire, explosions, electricat equipment, volatile chemica(s and f{arimable �
solutions. �
D. Quality control : �
. I . The taboratory ir�ptemanis an internal quality control program covering
at feast the calibration ot equipnent and'validation ot test results.
2._ Laboratory personne� participate in �periodic revie�•�s and updates. of
procedures and equipr�ent. : .
STP,NOARD 1 X - PHAR�•tACEI;i t CA L SERV I CES � .
If pharmaceutica( services are offered directly by the center, they are providzd :
� in accordance rrith acceoted pro`essional principles and a�propria-te Federal ,
Sta�e and local laws and with the follot�in� cri;eria:
A. Personnel : the disFensing ot prescription medications shculd be done �
onty by a licensed pharr:acist opsrating from a pharnacy or by the •
physician in cemptiance �rith Flinnesota Sta�utes which alSov:s supervised
interns or n�rses to disaense clrugs. � �
8. Prescriptions: m�dicat+ons are dispensed only upcn the �•�rit�en order of a . .
ticensed p�actitioner/physician. All redications di�pensed must be pre�er-ly .
(a be t ed vr i th at l east the na^^.� of .the c l i enfi, the narr.e of the prescr i b i r.g
practitioner/Fhysician, the na^�e of the drug, the directions for e,se and
the date the drug is disper.sed.
. . . .. . . .
: .!
� r•� •
1 �-! , , 1 . , . �.,�5.� 1�,�yr/'�
r:as b ��•� �
• ' ;� .
• , , • .
. �
. • ��1 f1 i r"L!;: Stand3rds
Paga Te:� .
C. Patie�t prc±fi le: ir the ce��er fi I Is r�-escr;;,-h�or>; fror.� nor,-center �rac�itior,ers/
Fhys i cans, a med i cat i on Fro�i l e i s rr,a i nta i nec i n fihe pharrrac�/. ,
Q. Contro I I ed substancts: a I I reca�c'-E:eep i�r and secur i ty requ i rer,^.enfis o f the
Drug Enforcer�ent Adr�inistration �ust be conpiied with if con�rolled subsfiances
are to be utitized. . ' �
STF.�dQ�tP,) X - BACh-U? SERV I CFS - �
Provisions are �ade for care not availabfe at the center itself. . �
A. :'irit�en agreements for fihe procure:r.e�t of necessary conse:ltations, special . ,
ssrvices nofi available at the cenfiar, ard in-patiert care are devetoped
with cooperating agencies and instifi utions, p� 'riodically revieti•red, and _ � '
a�proved by the center's governing body, and writte� poiicies and ,
procedures exi st govern i ng the provi s ion of such care. - -. �. . � . . . : . .
� : c3. Tne agre2nants speci fy ths rr;echan i sr► for transfer of necessary records • - .
and information.
. . 1 .
, . �
�_ ,....-.-..m.-„ �.,.... . r
� ' � . �,: � ors 4Z: i3f�.9��
.. , .
> . . R�v. : 9�8�+'7S
E.�,�NATIQN CF Aiy�ZSTRATI�'E OR�, . �� .
1��I�N �tD OI�D NCE.� ++�r ,.� �,
. .rr�r�i r�� i.��rirftlrr �r�w�i�i.ri in��r��� � . . . .
�► � � �: � �'�'� E �
Da�es January 16, 1980 JAN � •?���98C
MA�f.O_�� �-
�o: rsAY03t GL�oRCE LPiTIMER
. ���
FRr Thomas J. Kelley, Director of Department of Con�rrity Services �
�: Contract among The Family Tree, Inc. , the County of Ramsey ar�d the City a�
. Saint Paul
, �
l�GTiO�i RF F.�STED: .
�ri,lrr����u �.r+��rfr.rr��: - � -. . � . - � � . . .
. . .. . .. . . � � � . � . - . � . . . . ` i
. , . . . . . . . . . .. . � . .. . .. : .':Y:
executive approva1 and signature ,
, . . :
, •
L�t'R�OSE AND .RATIQNALE' Ft�R T�IIS ACTION: `
� 11�4����i�� - Y��11��1■ . . . . I� .'`.� � � . : ... � . � �E
�`� The five�ccxnnunity clinics �(Face to Face, Family Tr�e,�Hel=p�ng Ha�rd, Ptorth End .-
� and West 5ide) have recei"ved funding from tk�e Gity a�ci� County sir�e 14?6 to
; support th�ir activities as neighborh�od he$lth centers. this contract conti�ues.
the financial support through 1980. `
`A2'3'A�MENTS: � ' ,'
. Council Resolutiorr �p�
, contract document - ��ti�Ee�copies
aPpeadix A - �h�nr�e�?`� pies . �
apPendix 6 - opies
� �