97-248�F,�� q�t - a�18'
_., ,:- . ;.
RESOLUTION
�.Il�iT PAUL, 1�IINNESOTA
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Refened To
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WHEREAS, the City of Saint Paul supports early intervention for newiy diagnosed HIV
positive persons; and
WHEREAS, the City will administer Ryan White Early Intervention Program to be
targeted to low-income, uninsured, and underinsured persons; and
WHEREAS, the City will receive funding for this activity from a contract with
Hennepin County Community Health Department who is coordinating the spending of
Ryan White CARE Act Funds in Minnesota; and
WHEREAS, a copy of the contract which is to be kept on record and on fi{e i� the
Department of Finance and Management Services; and
THEREFORE, BE IT RESOLVED, ihat the proper City Officials are hereby authorized
and directed to execute an agreement with the Hennepin County Community Health
Department.
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Requested by Department of:
Saint Paul Public Health
By: �it�tC�
Adopted by C,6u�i1: Date�
Adoption� erh'f� b Coum
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By: ;
Approved by Ma • Date
BY� `' +._-- //1/�
Form� prove by ' At
B � 2 �.2 0 — ��
Approved by Mayor for Submission to Council
By: �rti. �
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Public Heal c � ziisi9� GREEN SHEET N_ 3 3 9 8 9 _
COMACT PEflSON 8 PHONE � INRIAVOATE
EPNiTMEM DIflECTOH "� � CITY CAUNGI
Ydeal Hol[an 292-7713 ^u�" [�.eft'rarroFwEV �cmc�aK
MUST BE ON fAUNCIL AGENDA BY (DATE) � aFOR ���� DIqECTO � FlN. & MGT. SERVICES DIR.
QRDEF � MAYOR (OR ASSISiANf� O
TOTAL # OF SIGNATURE PAGES 1 (CLIP ALL LOCATIONS FOR SIGNATURE)
ncnounEauesrm:
Council Resolution to authorize City signatures on a contract be[ween the City of Saint Paul,
acting through its Saint Paul Public Health and Iiennepin County through the Hennepin County
Gommunity Health Department.
RECOMMENOA7iONS= appwa (A) a Reject (R} pEpSONAL SERViCE CONTRACTS NUST ANSW ER THE FOILOWING QUESTONS:
_ PLANNING COMMISSION _ ClY0. SERVICE COMM4SSION 1. Has this persoMfirm ever worked under a corrtract for lliis departmenK -
_ a8 GoMMmEe _ YES 'NO �
_�� 2. Has this perwnlfirm ever been a city emptoyee?
— YES NO
_ DISTAIGT CAUR7 _ 3. Oces this petsunNirtn possess a skill not narmall
Y Possessed DY atry a�rce�t city amplqrae?
SUPPORTS WHIGH COUNCIL OBJECTIVE7 YES NO
Explain a11 yes answers on separate sheet anG atteeh to green sheet ,
INITIATING PROH�EM, ISSUE. OPPORTUNITY iWho, Whai, When. Where, Why):
This is a continuation of the Ryan White Early Intervention Activities which has been
previously funded by the Minneapolis Department of Health. The Hennep-in Caunty Community
Health Department has assumed fiscal responsibility. Newly diagnosed HIV positive persons
many times are low-income, uninsured, and underinsured. The new availability of HIV related
drug therapy puts new emphasis on medical intervention as early as poseible.
ADVANTAGESIFAPPROVED: .
' Saint Paul will receive funding/reimbursement for the services provided to this project.
' The project will continue to be a state-wide model based on the experience of Saint Paul
Public Health on this project in previous years.
' Early intervention will assist persons to know the available HIV related resources,
particularly medical intervention.
DISADVANTAGESIFAPPROVED. ' � r .. + ;�{> .
NONE �ouncii Research Center �°
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Ts-.,n r n 'eG`� ��ffi���h�'��
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�AAYOR'� (J�PIG'E
�ES 20 1997
DISADVANTAGES IF NOT APPROVED:
' Funding will not be obtained for our role in this project.
' Possibility of loss of exgerienced staff and deterioration of the pro,J"ect.
' Loss of ineaningful information to HIV infected persons.
TOTAL AMOUNT OF THANSACTION $ 3� OOO COST/REVENUE BUDGETEp (CIRCLE ONE) YES NO
FUNDItdGSOURCE HeriReplri CO. CoIDtIIUAlty H831tY1 Dept. ACTIYITYNUMBER 33243
FINANCIAL INFORMATION: (EXPLAIN)
Hennepin Counry Community Health Depar6nent
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AA Code: M13
ContractNo. A11237
Federal Tax ID Na
Vendor No
AIAS/I3IV SERVICES AGREEMENT
THIS AGREEMENf made and entered into by and between the County of Hennepin, State of
Minnesota, hereinafter referred to as the "County", tt�rough the Hennepin Connty Community Health
Deparknent, 525 Portland Avenue, Minneapolis, Minnesota 55415, hereinafter refeired to as the
"Department", and the City of St. Paul through its Public Health Department, hereinafter refesed to as
the "Provider."
TERM. AND COST OF THE AGREEMENT
A. The term of this Agreement shall be from 7anuary 1,1997, xhrou�h-May 2, 1997.
B. Total cash paysnents to the Provider for AIDS1f3N related services shall not exceed the lesser
of $3,000, or actual allowable expenses.
2. PAYMENT FOR CONTRACTED SERVICES
A. The Provider agrees to make expenditures of county-provided payments for the purpose of
providing the services as described in fi�ibit A and within the line item budget contained in
Exhibit B and to reimburse to the County any and all County payments in excess of actual
allowable expenses within 120 days of Che expirarion date of this Agreement or 120 days after
cancellation of this Agreement.
B. Payment for services shall be made directly to the Provider after complefion of the services
upon the presentation of a claim in the manner provided by law goveming the County's
payznent of claims and/or invoices. Upon final execution of this agreement, the provider
agency may request an advance equal to the first month's award based on a proration of the
contract amount. The Provider shaA submit monthly invoices for services rendered on forms
which will be fumished by the County. {See Exhibit C) Payment shall be made within 35 days
from receipt of the invoice. Invoices will be due: February 15, 1997 for services provided
during the period 3anuary 1, 1997 - January 31, 1997; March 15, 1997 for services pxovided
during the period February 1, 1997 - February 28, 1497; April I5, 1947 for services provided
during the period March 1, 1997 - Mazch 31, 1997; and May 15, 1997 for services provided
during the period April l, 1997 - May 2, 1997. The final payment will be made after
reconciliation of final expenses and the previous payments including the initial advance.
Payments shall be made in the manner provided by law for payment of c]aims against the
County.
C. The Provider agrees that every reasonable effort will be made to collect from third-party
payment sources andlor govemment agencies, which are either authorized or under legal
obtigarion to make such payments.
Hennepin County Communiry Health Deparhneni
3. CONTRACTED SBRVSCES
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A. AIDSIHIV related services shall be provided by Ciry of St. Paul Public Aealth at offices
located at 555 Cedar Street, St. Paul, Minnesota.
B. Provider shall provide services to idenrified targeted populations as described in E�ibit A.
Participants must be at or below 300 percent of the federal poverty level, as outlined below:
Family Size Annual Income
1 $ 23,220
2 31,080
3 38,940
4 46,800
5 54,660
6 62,520
7 70,380
8 78,240
For family units with more than eight members, add $2,620 for each
additional member.
C. Provider shall provide documented reports on services provided and clients served as
requested.
D. Provider agrees fo provide equal access to services, and shall not deny services based on
inability to pay.
4. CONDTTIONS OF THE PARTIES' OBLIGATIONS
The Provider shall comply with each of the following pmvisions:
A. The Maltreatment of Minors Reporting Act, Minnesota Statutes Section 626.556 and all rules
promulgated by the Minnesota Department of Human Services implementing such Act now in
force or hereafter adopted.
B. The Vulnerable Adults Reporting Act, Minnesota Statutes, Section 626.557, and all rules
promulgated by the Minnesota Department of Human Services implemenring such Act now in
force or hereafter adopted.
5. l�UDITS REPORTS MONITORING PROCEAURES RECORDS AND EVALUATION
The Provider shall:
A. Shall provide the Department with a quarterly narrative report on services provided in the
format delineated in fixhibit D. A narrative report will be due May 15, 1997 for services
provided during the period January 1, 1997 - Mazch 31, 1997. A quarterly narrative report on
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Hennepin County Community Health Aepartment
services provided during the period of April l, 1997 - May 2, 1997, will be due August I5,
1997, and will also include services provided during the period of April 1, 1997 through June
30, 1997 as outlined in subsequent contracts. In addition, the provider shall collect and report
anonymous client level data on al] individuals receiving HIV/AIDS services through this
agreement to the Minnesota Deparhnent of Health as highlighted in Eachibit D.
B. Shall maintain in each client record verificafion of FiIV status. Client records will be available
for review during site visits conducted by the contract manager. One site visit will be
conducted during the contract period.
C. Shall include, at a minimum, the following language in its client consent forms:
"The Hennepin County Community Health Department funds this program and requires some
personal informarion be collected and reported periodically for the following purQoses:
• To identify the services persons with HN disease need and use.
• To identify barriers to receiving those services.
• To evaluate future funding needs
We are not required to send your name or any other identifying information to the Hennepin
County Community Health Department as a condition of funding."
D. Maintain a bookkeeping system which sufficiently and properly reflects all direct and indirect
costs of any nature expended in the performance of this Agreement.
E. Maintain all financial books and records for at least 5 years for audit purposes; provided that, if
the Department fiunishes written notice during this period requesring retention of records to
allow complerion of an andirop [ne Deparhnent or its ultimate sources of funds, the Provider
shall retain records for the period requested.
F. Particapate in evaluarion of Provider services, through the following activities:
The Pxovider shall develop a plan incorporafing community and client input into
the evaluation of the delivery of services, to be submitted to the Department by
March 31, 1997.
The Provider will consult at least once a quarter with the Deparhnent on the
development and content of all program services and products and the status of
program implementation.
The Department shall conduct an on-site program visit at least once during the
contract period. This ��sit shall be for the purposes of assessing compliance
with contractual obligations, assessing program effectiveness and providing
technical assistance.
The Provider agrees that the County, the State Auditor, or IegislaYive authority, or any of their duly
authorized representatives at any time during normal business hours, and as often as they may
reasonably deem necessarv, shall have access to and the right to examine, audit, excerpt, and
h-anscribe any books, documents, papers, records, etc., and accounting procedures and practices of
the Providez which aze relevant to this Agreement.
6. SPECIAL DUTIES
The Provider shall attend all trainings and meetings required by the Deparhnent.
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Hennepin Counry Community Health Deparhnrnt
7. STANDARDS AND LICENSES
A. During the term of this Agreement, the Provider shall comply with all applicable standazds
required by the Minnesota Deparhnent of Aealth and shall maintain appropriate license and
certification requirements. Failure to maintain such standazds may be cause for cancellation of
this Agreement. In addirion, the Provider shall comply with any other standards or criteria
established by the Depaztment to assure quality of service.
B. The Provider shall remain in compliance with all other applicable federal, state, or local laws
and regulations pertaining to the pezformance of this Agreement.
8. DATA PRIVACY
All data collected, created, received, maintained, or disseminated for any purposes by the activities
of the Provider in the performance of this Agreement is govemed by the Minnesota Government
Data Practices Act, Minnesota Statutes, Chapter 13, and all other statutory provisions governing
data privacy, Minnesota Rules implemenring such Act now in force or hereafter adopted, as well
as Federal regulations on data privacy.
9. NON DISCRIMINATION - AFFIIZMATNE ACTION
A. In accordance with Hennepin County's policies against discrimination, no person shall be
excluded from full employment rights, denied access to, or participation in, or the benefits of
any program, service or acrivity, or subjected to harassment on the grounds of race, color,
creed, religiasr, sge; se�-�isability, marital status, sexual orientation, public assistance status,
or national origin; and no person who is protected by applicable Federal or State laws, rules, or
regularions against discrimination shall be otherwise subjected to discrimination.
B. If this Agreement is for a sum of over $50,000 or is one of several contracts with said Provider
within a 12-month period totaling more than $50,�00 or is amended to exceed $SQ,OQ� and
1) A written governmental jurisdiction plan exemption is granted by the Director of the
County's Affirmative Action Programs Department (Director), it is agreed that Hennepin
County's Appendix Z forms and is a part of this Agreement; or
2) A written exemprion is not granted or is withdrawn by said Director, then it is agreed
that Hennepin County's Appendix Y forms and is a part of this Agreement as though
fully set forth herein.
3) Provider will fisnish all information and reports required by the Hennepin County
Affirmative Action Policy.
4) Provider shall adopt and comply with Hennepin County's Equal Employment
Opportunity/Affirmative Action Policies, with regard to employment and contracting. If
at any time during the contract period, the basis of an approved exemption should
change, Provider shall inform the Director in writing within ten (10) calendar days from
the date of said change.
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Hennepin County Gommunity Health Departmeni
C. Where applicable, no qualified handicapped person as defined by United States Department of
Health and Human Services Regulations Title 45, Part 84.3 (j) (k) which implements Section
504 of the Rehabilitation Act of 1973, 29 USC 704 under Executive Order ATO. 11914 (4 FR
17871, April 28, 1976):
1) Shall be denied access to or opportunity to participate in or receive benefits from any
service offered by the Provider under the provisions of this Agreement, nor
2) Shall any qualified handicapped person be subject to discrimination in employment
under any program or activity related in the services fiunished by the Provider.
3) Where applicable, no qualified individual with a disability as defined by the Americans
with Disabilities Act of 1990, Public Law 101-336, Title I, Section 101(8) shall be
discrimanated against by the denial of full and equal enjoyment of the services and
facilities, privileges, advantages, or accommodations furnished by the Provider as a
private enfity operating a service as a puhlic accommodation pursuant to the provisions
of Tifle III of the Americans with Disabilities Act, Secrion 301(7).
D. Provider agrees to adhere to the County's Acquired Immune Deficiency Syndrome (AIDS)
Policy which provides that no employee, applicant or client shall be subjected to testing,
removed from normal and customary status, or deprived of any rights, privileges or freedoms
because of his or her AIDS status except for clearly stated, specific, and compelling medical
and/or public health reasons. Provider shall establish the necessary policies conceming AIDS
to assure that County clients in contracted programs and provider's employees in County
contraefed preg�ams are afforded the same h with regazd to AIDS as persons direct]y
employed or served by the County.
E. If during the term of this Agreement or any extension thereof it is discovered that the Provider
is not in complianee with the applicable regulations or if the Provider engages in any
discriminatory practices, the Department shall cancel this Agreement in accoxdance with
Paragraph 14 hereof.
10. INDEMNIFICATION AND INSTJRANCE
A. Indemnification:
The Provider agrees to defend, indemnify, and hold haxmless the County, its elected officials,
officers, agents, volunteers, and employees from any liability, claims, causes of acfion,
judgments, damages, losses, costs, or expenses, including reasonable attomeys fees, resulting
directly or indirectly from an act or omission of the Provider, its subcontractors, anyone
directly or indirectly employed by them, or anyone for whose acts or omissions they may be
liable in the performance of the services required by this Agreement, and against all loss by
reason of the failure of the Provider to perform fully, in any respect, all obligations under this
Agreement. The forgoing indemnificarion is at all times subject to limits in Minnesota Statute
466 as to the provider.
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Hennepin County Communiry Health Deparhnent
B. Insurance:
The Provider is self-insured.
The Provider shall require that each independent professionaUcontractor rendering counseling
and/or health care services on a regular basis fo recipients under this Agreement fumish to the
Provider proof of Professional Liability insurance as follows:
Professional Liability - Errors and Omissions:
Per Claim
Aggregate
�:
Professional Liability - Medical A�7alpracfice:
Per Occurrence
Aggregate
I 1. INDEPENDENT PROVIDER
$1,000,000
$1,000,000
$1,000,000
$1,000,000
It is agreed that nothing herein contained is intended or should be conshued in any manner as
creating or establishing the relationship of co-partners between the parties hereto or as constituting
the Provider as the agent, representative, or employee of the County for any purpose or in any
manner whatsoever. The Provider is to be and shall remain an independent provider with respect
to all services performed under this Agreement. The Provider represents that it has, or will secure
at its own expense, all personnel required in performing services under this Agreement. Any and
all personnel of Provider or other persons, while engaged in the performance of any work or
services required by Provider under this Agreement, shall have no contractual relationship with the
County and shall not be considered employees of the County, and any and all claims that may or
might arise under the Minnesota Economic Security Act or the Workers Compensation Act of the
State of Minnesota on behalf of said personnel or other persons while so engaged, and any and all
claims whatsoever on behalf of any such person or personnel arising out of employment or alleged
employment including, without limitation, claims of discrimination against the Provider, its
officers, agents, providers, or employees shall in no way be the responsibility of the County; and
Provlder shall defend, indemnify, and hold the Counry, its commissioners, offacers, agents, and
employees harmless from any and all such claims irrespecrive of any determinarion of any
pertinent tribunal, agency, board, commission, or court. Such personnel or other persons shall not
requize nor be entitled to any compensation, rights, or benefits of any kind whatsoever from the
County, including, without limitation, tenure rights, medical and hospital care, vacation leave,
Workers' Compensation, IZe-employment Insurance, disability, severance pay, and PERA.
12. SUBCONTRACTII�IG AND A5SIGNMENTS
The Provider shall neither enter into subcontracts for performance of any of the services
contemplated under this Agreement, nor assign this Agreement, without the prior written approval
of the Department and subject to such conditions and provisions as the Department may deem
necessary. The Provider shall be responsible for the performance of all subcontractors.
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He�nepin County Communiry Health Departrnent
13. DEFAULT
A. Unless the Provider's default is excused undez the provisions of this Agreement, the Provider
after receipt of notice by the Deparlment of any of the following conditions or other
circumstances warranfing cancellarion of this A�-eement, shall have ten (10) days (or such
longer period as the Deparlment may authorize in writing) after receipt of the notice from the
Department to cure the specified failure:
1) If the Provider fails to provide services called for by this Agreement within the time
specified herein or any extension thereof; or
2) If the Provider is in such fmancial condifion so a to endanger the performance of this
Agreement; or
3) If the Provider fails to perfarm any of the other provisions of this Agreement, or so fails
to prosecute the work as to endanger perfozmance of this Agreement in accordance with
its terms; or
4) If it is discovered that material misrepresentations were made by the Provider as to
conditions relied upon by the Deparhnent, which are purported to exist according to the
terms of this Agreement and all exhibits and documents attached hereto and incorporated
by reference.
If the Pravider fails to cure the specified condition after notice within the prescribed period of
time, the Departmer.±:na3t, ��pon writter. notce, i*.r±nediately cancel the whole or part of this
Agreement.
Notwithstanding the above, Provider shall not be relieved of liability to the County for
damages sustained by the County by virtue of any breach of this Agreement by Provider, and
the County may withhold any payments to the Provider for the purpose of set-off until such
time as the exact amount of damages due the County is determined.
B. The rights and remedies of the County and the Deparhnent provided in this clause shall not be
exclusive and aze in addition to any other rights and remedies provided by ]aw or equity.
The County's failwe to insist upon strict performance of any covenant, agreement, or
stipularion of this Agreement or to exercise any right herein contained shall not be a waiver or
relinquishment of such covenant, agreement, stipularion, or right, unless the County consents
thereto in writing. Any such written consent shall not constitute a waiver or relinquishment of
the future of such covenant, agreement, stipulation, or right.
14. NOTICES
Any notice or demand which may or must be given or made by a party hereto, under the terms of
this Agreement or any statute or ordinance, shall be in writing and shall be sent registered or
certified mail to the other party addressed as follows:
Hennepin County Community Heakh Depariment
Provider
Mary Sonnen, Director, HIV/AIDS Programs
City of St. Paul Public Health
555 Cedar Street
St. Paul, Mumesota 55101
(612)292-7711
County
Jeff Spartz
Heimepin County Administrator
A-2303 Goveminent Center
Minneapolis, MN 55487
(612)348-7574
Department
Hennepin County Community Health Department
c10 Mark Lee
525 Portland Avenue South
Minneapolis, MN 55415
(612)348-4092
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Any party znay designate a different addressee or address at any time by giving written notice
delivered by certified mail.
15. CANCELLATION
Either party may cancel this Agreement with or without cause upon 30 days written norice
delivered by certified mail.
After receipt of a notice of cancellarion, and except as otherwise directed, the Provider shall:
A. Discontinue provision of services under this Agreement on the date, and to the extent
specified, in the notice of cancellation;
B. Cancel all orders and subcontracts to the extent that they relate to the performance of services
canceled by the notice of cancellation;
C. Settle all outstanding liabilities and all claims arising out of such cancellation of orders and
subcontracts, with the approval or ratificarion to the extent that may be required, which
approval or ratificarion shall be final for all the purposes of this clause;
D. Complete performance of such services as shall not have been canceled by the notice of
cancellation; and
Hennepin Counry Community Health Department
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E. Maintain all records relating to performance of the canceled portion of the Agreement as may
be required by the Department.
16. SEVERABILITY
In the event any provision of this Agreement shall be held invalid or unenforceable by any court of
competent jurisdicrion, such holding shall not invalidate or render unenforceable any other
provision hereof.
17. CONTRACT ADMTNISTRATION
In order to coordinate the services of the Provider with the activities of the Community Health
Department so as to accomplish the purposes of this contract, 7ennifer Thompson shall manage
this contract on behalf of the County and shall serve as a liaison between the County and the
Provider.
18. MERGER AI3D MODIFICATION
A. It is understood and agreed that the entire Agreement between the parties is contained herein
and that this Agreement supersedes all oral agreement and negotiations between the parties
relating to the subjecf matter hereo£ AIl items refened to in this Agreement are incorporated
or attached and are deemed to be part of this Agreement.
B. Any material alterarions, variations, modifications, or waivers of provisions of this Agreement
shall be va�id when they have been reduced to writing as an amendment to this Agreement
signed by the parties hereto.
C. Any policy changes by the Provider embodying client populations, client services, service
locarions or hours, must be approved by the Department and shall be valid only when
incorporated as an amendment to this Agreement and signed by the parties hereto.
19. FAIR HEARING AND GRIEVANCE PROCEDURE
The Provider shall establish a procedure through which recipients may assert grievances
concerning the operation of the service programs. The Provider shall advise service recipients of
this procedure. The Provider will make available to the Department a copy of the Provider's
existing grievance procedure. Any changes in the grievance procedure shall be forwarded to the
Deparhnent within 30 days of the change
20. PAPER RECYCLING
The County encourages the Provider to develop and implement an office paper and newsprint
recycling program.
In contracts over $250,OOQ the Provider aa ees to establish an office paper and newsprint
recycling program. The Provider shall provide a written plan to the County upon request, which
shall include a description of the program, the program administrator, list of collectibles and
procedures utilized for recycling, as wel] as an annual summary report.
a� -a�t�
Hennepin County Communiry Nealth Department
The Provider, having signed this Agreement, and the Hennepin County Board of Commissioners, having
duly approved this Agreement on January 1, 1997, and pursuant to such approval and the proper Counry
official having signed this contract, the parties hereto agree to be bound by the provisions herein set
forth.
Approved as to form and execution.
COUNT'Y OF HENI3EPIN,
STATE OF MINNESOTA
Assistant County Attomey
Date'
CITY OF SAINT PAUL
APPROVED AS TO FORM:
Assistant City Attorney
Date:
Chair of Its County Boazd
Acting County Administrator
ATTEST:
Deputy/Clerk of the County Board ,
CITY OF ST. PAUL PUBLIC HEALTFI
Director, Saint Paul Public
Title� Health
Name:
Director, Finance and
Tit1e: Management Services
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Hennepin Counry Communiry Health Deparhnent
STATE OF MINNESOTA )
COUN'I'Y OF HENNEPIN )
) ss.
On this day of , 19_, before me appeared
to me personally Imown, who stated ihat he/she is the
of
the corporarion described
in and who executed the foregoing insh�ument; and that said instrument was executed on behalf of said
coxporation by authority of its Board/Governing Body; and he/she aclmowledged said instrument to be
the free act and deed of said coiporation.
Notary Public
My Commission Expires
11
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Hennepin County Community Health Deparhnent
AIDS/HIV SERVICES AGREEMENT
EXHIBIT A
[.YK�l�s�l���l�il [�
Agency: City of St. Paul, St. Paul Public Aealth, Room 111 Clinic
Program: Early Intervention Services
Funding Period: 7anuary 1, 1997 - May 2, 1997
Program Summary: St. Paul Public Health, Room 1 I 1 Clinic will provide early intervention services to
primarily newly diagnosed individuals living with HIV disease, include, but not limited to: physician
services, nursing services, laboratory testing, and referral to other appropriate services.
Target Population: Low income (at or below 300% of federal poverty level) individuals living with
HIV disease in the 13 county Eligible Metropolitan Area.*
GOAL 1: Improve the health and well-being of individuals newly diagnosed with HIV through the
provision of early intervention services, including, but not limited to: physician services, nursing
services, laboratory testing, and referral to other appropriate services.
Ohjective l.a.: Provide at least 15 eazly intervention service visits to iQ eligible individuals living
with HN disease.
Outcome/Service Measure: Number of clients served.
Number of early intervention service visits.
*Thirteen county Eligible Metropolitan Area includes: Anoka, Carver, Chisago, Dakota, Hennepin,
Isanti, Ramsey, Scott, Sherburne, Washington, and Wright Counties in Minnesota and Pierce and St.
Croix Counties in Wisconsin.
Modificalions to Exhibit A allowed tl�rough writien request and prior approval af contract manager.
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HennepSn County Community Health DepartmenT
AIDS/HIV SERVICES AGREEMENT
EXFIIBIT B
PROGRAM BUDGET
Agency: City of St. Paul, St. Paul Public Health, Room I11
Program: Eazly 3ntervention Services
Funding Period: January 1, 1997 - May 2, 1997
Budgef Category CAR� ACT TITLE I Funded
Pmgram Budget Amount
a. Personnel $ 800
b. Fringes @ 20% of personnel $ 160
c. Travel $ 0
d. Equipment $ 0
e. Supplies $ 0
f. Contractual: Physician Services $ 1,500
g. Other: Laboratory Costs $ 540
h. Total Direct Charges $ 3,000
i. Indirect Charges $ 0
j_ TOTAL $ 3,000
Modif cations within each category of the above line item budget of less than 10 percent of any
line item are permitted without prior approval by the County, so long as notification of such
modzfzcations is given to zhe County.
Hennepin Counry Communiry Health Deparhnent
AIDS/HIV SERVICES AGREEMENT
EXHIBIT C
IiW OICE
Agency: City of St. Paul Public Health, Room 111 Clinic
Program: Eazly Intervention Services
Funding Period: January 1, 1997 - May 2, 1997
° -a� �
Bxpenditure Cateeory Amount
a.
b.
c.
d.
e.
f.
g•
h.
i.
J•
Personnel
Fringes
Travel
Equipment
Supplies
Contractual
Other
Total Direct Charges
Indirect Charges
TOTAL REIMBURSEMENT REQUBSTED:
I, on behalf of hereby
state that the above request for reimbursement represents an accurate accounring of expenditures for the
services provided pursuant to an agreement with Hennepin County Community Health Deparhnent.
Date:
Title:
Please send completed invoice to:
Jennifer Thompson, Contract Manager
Hennepin County Community Health Department
525 Portland Avenue South, Level 3
Minneapolis, MN 55415
QLIESTIONS about compJeting this invoice? CaIl7ennifer Thompson at (612) 348-5964.
9�-��lY
Hennepin County Community Health Department � --"
AIDSlIiIV SERVICES AGREEMENT
EXHIBIT D
DATA REPORTII�G FORMAT
I. iVARRATIVE REPORT
Please submit a quarterly narrarive report as pursuant to the signed services agreement which addresses
the following areas:
a. $riefly describe at least two case studies that typify the services being provided (i-2
paragraphs per case study).
b. If the agency has not perfornted the activities nor provided the services required according to
the scope of service for the quarter, please explain.
c. Report any administrative issues (i.e. problems with data collection, intemal evaluation
activities, staffing changes or problems, budgefing, etc.) that occurred during the quarter.
d. Describe any client service needs identified during the quarter that remain unmet.
e. List any trainings andtor workshops staff attended.
£ Report the total number of clients serviced durin�the quarter. Also, report the number of
clients not served, and the reasons the agency was unable to serve the clients.
Each narrative report should clearly list the name and address of the agency, name of program (if
applicable), reporting period, and the name and phone number of a contact person.
Reports should be submitted to:
Jennifer Thompson, Contract Manager
Hennepin County Community Health Department
525 Portland Avenue South, Leve13
Minneapolis, MN 55415
II. DATA COLLECTION
Funded agencies are required to complete an IIIV Services Client-Level Reporting System (CLRS) form
for each client served by the contract and a financial worksheet on the utilization of resources. (See
sample CLRS form attached, the financial worksheet will be presented at a training session.) The CLRS
forms are bubble sheets requesting basic demographic information about each client. CLRS forms and
the financial worksheet will be coliected by the 1�innesota Bepartment of Health as the coordinating
agency for the federal Annual Administrative Report. Providers will receive additional informarion and
training regarding data collection requirements. Providers are required to attend all trainings related to
data collection and reporting.
QUESTIOIVS about reporting? Call Jennifer Thompson, Hennepin County Community Health
Department at (612) 348-5964.
�F,�� q�t - a�18'
_., ,:- . ;.
RESOLUTION
�.Il�iT PAUL, 1�IINNESOTA
t:�r-•�:r;
Refened To
Committee: Date
u'J
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2
3
4
5
6
7
$
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
WHEREAS, the City of Saint Paul supports early intervention for newiy diagnosed HIV
positive persons; and
WHEREAS, the City will administer Ryan White Early Intervention Program to be
targeted to low-income, uninsured, and underinsured persons; and
WHEREAS, the City will receive funding for this activity from a contract with
Hennepin County Community Health Department who is coordinating the spending of
Ryan White CARE Act Funds in Minnesota; and
WHEREAS, a copy of the contract which is to be kept on record and on fi{e i� the
Department of Finance and Management Services; and
THEREFORE, BE IT RESOLVED, ihat the proper City Officials are hereby authorized
and directed to execute an agreement with the Hennepin County Community Health
Department.
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Bostrom
Harris
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Absent
Requested by Department of:
Saint Paul Public Health
By: �it�tC�
Adopted by C,6u�i1: Date�
Adoption� erh'f� b Coum
i
By: ;
Approved by Ma • Date
BY� `' +._-- //1/�
Form� prove by ' At
B � 2 �.2 0 — ��
Approved by Mayor for Submission to Council
By: �rti. �
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a�, -a�t�
Public Heal c � ziisi9� GREEN SHEET N_ 3 3 9 8 9 _
COMACT PEflSON 8 PHONE � INRIAVOATE
EPNiTMEM DIflECTOH "� � CITY CAUNGI
Ydeal Hol[an 292-7713 ^u�" [�.eft'rarroFwEV �cmc�aK
MUST BE ON fAUNCIL AGENDA BY (DATE) � aFOR ���� DIqECTO � FlN. & MGT. SERVICES DIR.
QRDEF � MAYOR (OR ASSISiANf� O
TOTAL # OF SIGNATURE PAGES 1 (CLIP ALL LOCATIONS FOR SIGNATURE)
ncnounEauesrm:
Council Resolution to authorize City signatures on a contract be[ween the City of Saint Paul,
acting through its Saint Paul Public Health and Iiennepin County through the Hennepin County
Gommunity Health Department.
RECOMMENOA7iONS= appwa (A) a Reject (R} pEpSONAL SERViCE CONTRACTS NUST ANSW ER THE FOILOWING QUESTONS:
_ PLANNING COMMISSION _ ClY0. SERVICE COMM4SSION 1. Has this persoMfirm ever worked under a corrtract for lliis departmenK -
_ a8 GoMMmEe _ YES 'NO �
_�� 2. Has this perwnlfirm ever been a city emptoyee?
— YES NO
_ DISTAIGT CAUR7 _ 3. Oces this petsunNirtn possess a skill not narmall
Y Possessed DY atry a�rce�t city amplqrae?
SUPPORTS WHIGH COUNCIL OBJECTIVE7 YES NO
Explain a11 yes answers on separate sheet anG atteeh to green sheet ,
INITIATING PROH�EM, ISSUE. OPPORTUNITY iWho, Whai, When. Where, Why):
This is a continuation of the Ryan White Early Intervention Activities which has been
previously funded by the Minneapolis Department of Health. The Hennep-in Caunty Community
Health Department has assumed fiscal responsibility. Newly diagnosed HIV positive persons
many times are low-income, uninsured, and underinsured. The new availability of HIV related
drug therapy puts new emphasis on medical intervention as early as poseible.
ADVANTAGESIFAPPROVED: .
' Saint Paul will receive funding/reimbursement for the services provided to this project.
' The project will continue to be a state-wide model based on the experience of Saint Paul
Public Health on this project in previous years.
' Early intervention will assist persons to know the available HIV related resources,
particularly medical intervention.
DISADVANTAGESIFAPPROVED. ' � r .. + ;�{> .
NONE �ouncii Research Center �°
�EB �'� 199T
Ts-.,n r n 'eG`� ��ffi���h�'��
- �...,_. ,
�AAYOR'� (J�PIG'E
�ES 20 1997
DISADVANTAGES IF NOT APPROVED:
' Funding will not be obtained for our role in this project.
' Possibility of loss of exgerienced staff and deterioration of the pro,J"ect.
' Loss of ineaningful information to HIV infected persons.
TOTAL AMOUNT OF THANSACTION $ 3� OOO COST/REVENUE BUDGETEp (CIRCLE ONE) YES NO
FUNDItdGSOURCE HeriReplri CO. CoIDtIIUAlty H831tY1 Dept. ACTIYITYNUMBER 33243
FINANCIAL INFORMATION: (EXPLAIN)
Hennepin Counry Community Health Depar6nent
a� -i� �'
AA Code: M13
ContractNo. A11237
Federal Tax ID Na
Vendor No
AIAS/I3IV SERVICES AGREEMENT
THIS AGREEMENf made and entered into by and between the County of Hennepin, State of
Minnesota, hereinafter referred to as the "County", tt�rough the Hennepin Connty Community Health
Deparknent, 525 Portland Avenue, Minneapolis, Minnesota 55415, hereinafter refeired to as the
"Department", and the City of St. Paul through its Public Health Department, hereinafter refesed to as
the "Provider."
TERM. AND COST OF THE AGREEMENT
A. The term of this Agreement shall be from 7anuary 1,1997, xhrou�h-May 2, 1997.
B. Total cash paysnents to the Provider for AIDS1f3N related services shall not exceed the lesser
of $3,000, or actual allowable expenses.
2. PAYMENT FOR CONTRACTED SERVICES
A. The Provider agrees to make expenditures of county-provided payments for the purpose of
providing the services as described in fi�ibit A and within the line item budget contained in
Exhibit B and to reimburse to the County any and all County payments in excess of actual
allowable expenses within 120 days of Che expirarion date of this Agreement or 120 days after
cancellation of this Agreement.
B. Payment for services shall be made directly to the Provider after complefion of the services
upon the presentation of a claim in the manner provided by law goveming the County's
payznent of claims and/or invoices. Upon final execution of this agreement, the provider
agency may request an advance equal to the first month's award based on a proration of the
contract amount. The Provider shaA submit monthly invoices for services rendered on forms
which will be fumished by the County. {See Exhibit C) Payment shall be made within 35 days
from receipt of the invoice. Invoices will be due: February 15, 1997 for services provided
during the period 3anuary 1, 1997 - January 31, 1997; March 15, 1997 for services pxovided
during the period February 1, 1997 - February 28, 1497; April I5, 1947 for services provided
during the period March 1, 1997 - Mazch 31, 1997; and May 15, 1997 for services provided
during the period April l, 1997 - May 2, 1997. The final payment will be made after
reconciliation of final expenses and the previous payments including the initial advance.
Payments shall be made in the manner provided by law for payment of c]aims against the
County.
C. The Provider agrees that every reasonable effort will be made to collect from third-party
payment sources andlor govemment agencies, which are either authorized or under legal
obtigarion to make such payments.
Hennepin County Communiry Health Deparhneni
3. CONTRACTED SBRVSCES
q�, •av�
A. AIDSIHIV related services shall be provided by Ciry of St. Paul Public Aealth at offices
located at 555 Cedar Street, St. Paul, Minnesota.
B. Provider shall provide services to idenrified targeted populations as described in E�ibit A.
Participants must be at or below 300 percent of the federal poverty level, as outlined below:
Family Size Annual Income
1 $ 23,220
2 31,080
3 38,940
4 46,800
5 54,660
6 62,520
7 70,380
8 78,240
For family units with more than eight members, add $2,620 for each
additional member.
C. Provider shall provide documented reports on services provided and clients served as
requested.
D. Provider agrees fo provide equal access to services, and shall not deny services based on
inability to pay.
4. CONDTTIONS OF THE PARTIES' OBLIGATIONS
The Provider shall comply with each of the following pmvisions:
A. The Maltreatment of Minors Reporting Act, Minnesota Statutes Section 626.556 and all rules
promulgated by the Minnesota Department of Human Services implementing such Act now in
force or hereafter adopted.
B. The Vulnerable Adults Reporting Act, Minnesota Statutes, Section 626.557, and all rules
promulgated by the Minnesota Department of Human Services implemenring such Act now in
force or hereafter adopted.
5. l�UDITS REPORTS MONITORING PROCEAURES RECORDS AND EVALUATION
The Provider shall:
A. Shall provide the Department with a quarterly narrative report on services provided in the
format delineated in fixhibit D. A narrative report will be due May 15, 1997 for services
provided during the period January 1, 1997 - Mazch 31, 1997. A quarterly narrative report on
9� -ay�
Hennepin County Community Health Aepartment
services provided during the period of April l, 1997 - May 2, 1997, will be due August I5,
1997, and will also include services provided during the period of April 1, 1997 through June
30, 1997 as outlined in subsequent contracts. In addition, the provider shall collect and report
anonymous client level data on al] individuals receiving HIV/AIDS services through this
agreement to the Minnesota Deparhnent of Health as highlighted in Eachibit D.
B. Shall maintain in each client record verificafion of FiIV status. Client records will be available
for review during site visits conducted by the contract manager. One site visit will be
conducted during the contract period.
C. Shall include, at a minimum, the following language in its client consent forms:
"The Hennepin County Community Health Department funds this program and requires some
personal informarion be collected and reported periodically for the following purQoses:
• To identify the services persons with HN disease need and use.
• To identify barriers to receiving those services.
• To evaluate future funding needs
We are not required to send your name or any other identifying information to the Hennepin
County Community Health Department as a condition of funding."
D. Maintain a bookkeeping system which sufficiently and properly reflects all direct and indirect
costs of any nature expended in the performance of this Agreement.
E. Maintain all financial books and records for at least 5 years for audit purposes; provided that, if
the Department fiunishes written notice during this period requesring retention of records to
allow complerion of an andirop [ne Deparhnent or its ultimate sources of funds, the Provider
shall retain records for the period requested.
F. Particapate in evaluarion of Provider services, through the following activities:
The Pxovider shall develop a plan incorporafing community and client input into
the evaluation of the delivery of services, to be submitted to the Department by
March 31, 1997.
The Provider will consult at least once a quarter with the Deparhnent on the
development and content of all program services and products and the status of
program implementation.
The Department shall conduct an on-site program visit at least once during the
contract period. This ��sit shall be for the purposes of assessing compliance
with contractual obligations, assessing program effectiveness and providing
technical assistance.
The Provider agrees that the County, the State Auditor, or IegislaYive authority, or any of their duly
authorized representatives at any time during normal business hours, and as often as they may
reasonably deem necessarv, shall have access to and the right to examine, audit, excerpt, and
h-anscribe any books, documents, papers, records, etc., and accounting procedures and practices of
the Providez which aze relevant to this Agreement.
6. SPECIAL DUTIES
The Provider shall attend all trainings and meetings required by the Deparhnent.
�1- ay �
Hennepin Counry Community Health Deparhnrnt
7. STANDARDS AND LICENSES
A. During the term of this Agreement, the Provider shall comply with all applicable standazds
required by the Minnesota Deparhnent of Aealth and shall maintain appropriate license and
certification requirements. Failure to maintain such standazds may be cause for cancellation of
this Agreement. In addirion, the Provider shall comply with any other standards or criteria
established by the Depaztment to assure quality of service.
B. The Provider shall remain in compliance with all other applicable federal, state, or local laws
and regulations pertaining to the pezformance of this Agreement.
8. DATA PRIVACY
All data collected, created, received, maintained, or disseminated for any purposes by the activities
of the Provider in the performance of this Agreement is govemed by the Minnesota Government
Data Practices Act, Minnesota Statutes, Chapter 13, and all other statutory provisions governing
data privacy, Minnesota Rules implemenring such Act now in force or hereafter adopted, as well
as Federal regulations on data privacy.
9. NON DISCRIMINATION - AFFIIZMATNE ACTION
A. In accordance with Hennepin County's policies against discrimination, no person shall be
excluded from full employment rights, denied access to, or participation in, or the benefits of
any program, service or acrivity, or subjected to harassment on the grounds of race, color,
creed, religiasr, sge; se�-�isability, marital status, sexual orientation, public assistance status,
or national origin; and no person who is protected by applicable Federal or State laws, rules, or
regularions against discrimination shall be otherwise subjected to discrimination.
B. If this Agreement is for a sum of over $50,000 or is one of several contracts with said Provider
within a 12-month period totaling more than $50,�00 or is amended to exceed $SQ,OQ� and
1) A written governmental jurisdiction plan exemption is granted by the Director of the
County's Affirmative Action Programs Department (Director), it is agreed that Hennepin
County's Appendix Z forms and is a part of this Agreement; or
2) A written exemprion is not granted or is withdrawn by said Director, then it is agreed
that Hennepin County's Appendix Y forms and is a part of this Agreement as though
fully set forth herein.
3) Provider will fisnish all information and reports required by the Hennepin County
Affirmative Action Policy.
4) Provider shall adopt and comply with Hennepin County's Equal Employment
Opportunity/Affirmative Action Policies, with regard to employment and contracting. If
at any time during the contract period, the basis of an approved exemption should
change, Provider shall inform the Director in writing within ten (10) calendar days from
the date of said change.
�
°l'1-a�t
Hennepin County Gommunity Health Departmeni
C. Where applicable, no qualified handicapped person as defined by United States Department of
Health and Human Services Regulations Title 45, Part 84.3 (j) (k) which implements Section
504 of the Rehabilitation Act of 1973, 29 USC 704 under Executive Order ATO. 11914 (4 FR
17871, April 28, 1976):
1) Shall be denied access to or opportunity to participate in or receive benefits from any
service offered by the Provider under the provisions of this Agreement, nor
2) Shall any qualified handicapped person be subject to discrimination in employment
under any program or activity related in the services fiunished by the Provider.
3) Where applicable, no qualified individual with a disability as defined by the Americans
with Disabilities Act of 1990, Public Law 101-336, Title I, Section 101(8) shall be
discrimanated against by the denial of full and equal enjoyment of the services and
facilities, privileges, advantages, or accommodations furnished by the Provider as a
private enfity operating a service as a puhlic accommodation pursuant to the provisions
of Tifle III of the Americans with Disabilities Act, Secrion 301(7).
D. Provider agrees to adhere to the County's Acquired Immune Deficiency Syndrome (AIDS)
Policy which provides that no employee, applicant or client shall be subjected to testing,
removed from normal and customary status, or deprived of any rights, privileges or freedoms
because of his or her AIDS status except for clearly stated, specific, and compelling medical
and/or public health reasons. Provider shall establish the necessary policies conceming AIDS
to assure that County clients in contracted programs and provider's employees in County
contraefed preg�ams are afforded the same h with regazd to AIDS as persons direct]y
employed or served by the County.
E. If during the term of this Agreement or any extension thereof it is discovered that the Provider
is not in complianee with the applicable regulations or if the Provider engages in any
discriminatory practices, the Department shall cancel this Agreement in accoxdance with
Paragraph 14 hereof.
10. INDEMNIFICATION AND INSTJRANCE
A. Indemnification:
The Provider agrees to defend, indemnify, and hold haxmless the County, its elected officials,
officers, agents, volunteers, and employees from any liability, claims, causes of acfion,
judgments, damages, losses, costs, or expenses, including reasonable attomeys fees, resulting
directly or indirectly from an act or omission of the Provider, its subcontractors, anyone
directly or indirectly employed by them, or anyone for whose acts or omissions they may be
liable in the performance of the services required by this Agreement, and against all loss by
reason of the failure of the Provider to perform fully, in any respect, all obligations under this
Agreement. The forgoing indemnificarion is at all times subject to limits in Minnesota Statute
466 as to the provider.
q� •a�
Hennepin County Communiry Health Deparhnent
B. Insurance:
The Provider is self-insured.
The Provider shall require that each independent professionaUcontractor rendering counseling
and/or health care services on a regular basis fo recipients under this Agreement fumish to the
Provider proof of Professional Liability insurance as follows:
Professional Liability - Errors and Omissions:
Per Claim
Aggregate
�:
Professional Liability - Medical A�7alpracfice:
Per Occurrence
Aggregate
I 1. INDEPENDENT PROVIDER
$1,000,000
$1,000,000
$1,000,000
$1,000,000
It is agreed that nothing herein contained is intended or should be conshued in any manner as
creating or establishing the relationship of co-partners between the parties hereto or as constituting
the Provider as the agent, representative, or employee of the County for any purpose or in any
manner whatsoever. The Provider is to be and shall remain an independent provider with respect
to all services performed under this Agreement. The Provider represents that it has, or will secure
at its own expense, all personnel required in performing services under this Agreement. Any and
all personnel of Provider or other persons, while engaged in the performance of any work or
services required by Provider under this Agreement, shall have no contractual relationship with the
County and shall not be considered employees of the County, and any and all claims that may or
might arise under the Minnesota Economic Security Act or the Workers Compensation Act of the
State of Minnesota on behalf of said personnel or other persons while so engaged, and any and all
claims whatsoever on behalf of any such person or personnel arising out of employment or alleged
employment including, without limitation, claims of discrimination against the Provider, its
officers, agents, providers, or employees shall in no way be the responsibility of the County; and
Provlder shall defend, indemnify, and hold the Counry, its commissioners, offacers, agents, and
employees harmless from any and all such claims irrespecrive of any determinarion of any
pertinent tribunal, agency, board, commission, or court. Such personnel or other persons shall not
requize nor be entitled to any compensation, rights, or benefits of any kind whatsoever from the
County, including, without limitation, tenure rights, medical and hospital care, vacation leave,
Workers' Compensation, IZe-employment Insurance, disability, severance pay, and PERA.
12. SUBCONTRACTII�IG AND A5SIGNMENTS
The Provider shall neither enter into subcontracts for performance of any of the services
contemplated under this Agreement, nor assign this Agreement, without the prior written approval
of the Department and subject to such conditions and provisions as the Department may deem
necessary. The Provider shall be responsible for the performance of all subcontractors.
6
q�-a�a�
He�nepin County Communiry Health Departrnent
13. DEFAULT
A. Unless the Provider's default is excused undez the provisions of this Agreement, the Provider
after receipt of notice by the Deparlment of any of the following conditions or other
circumstances warranfing cancellarion of this A�-eement, shall have ten (10) days (or such
longer period as the Deparlment may authorize in writing) after receipt of the notice from the
Department to cure the specified failure:
1) If the Provider fails to provide services called for by this Agreement within the time
specified herein or any extension thereof; or
2) If the Provider is in such fmancial condifion so a to endanger the performance of this
Agreement; or
3) If the Provider fails to perfarm any of the other provisions of this Agreement, or so fails
to prosecute the work as to endanger perfozmance of this Agreement in accordance with
its terms; or
4) If it is discovered that material misrepresentations were made by the Provider as to
conditions relied upon by the Deparhnent, which are purported to exist according to the
terms of this Agreement and all exhibits and documents attached hereto and incorporated
by reference.
If the Pravider fails to cure the specified condition after notice within the prescribed period of
time, the Departmer.±:na3t, ��pon writter. notce, i*.r±nediately cancel the whole or part of this
Agreement.
Notwithstanding the above, Provider shall not be relieved of liability to the County for
damages sustained by the County by virtue of any breach of this Agreement by Provider, and
the County may withhold any payments to the Provider for the purpose of set-off until such
time as the exact amount of damages due the County is determined.
B. The rights and remedies of the County and the Deparhnent provided in this clause shall not be
exclusive and aze in addition to any other rights and remedies provided by ]aw or equity.
The County's failwe to insist upon strict performance of any covenant, agreement, or
stipularion of this Agreement or to exercise any right herein contained shall not be a waiver or
relinquishment of such covenant, agreement, stipularion, or right, unless the County consents
thereto in writing. Any such written consent shall not constitute a waiver or relinquishment of
the future of such covenant, agreement, stipulation, or right.
14. NOTICES
Any notice or demand which may or must be given or made by a party hereto, under the terms of
this Agreement or any statute or ordinance, shall be in writing and shall be sent registered or
certified mail to the other party addressed as follows:
Hennepin County Community Heakh Depariment
Provider
Mary Sonnen, Director, HIV/AIDS Programs
City of St. Paul Public Health
555 Cedar Street
St. Paul, Mumesota 55101
(612)292-7711
County
Jeff Spartz
Heimepin County Administrator
A-2303 Goveminent Center
Minneapolis, MN 55487
(612)348-7574
Department
Hennepin County Community Health Department
c10 Mark Lee
525 Portland Avenue South
Minneapolis, MN 55415
(612)348-4092
�l'1- �y�
Any party znay designate a different addressee or address at any time by giving written notice
delivered by certified mail.
15. CANCELLATION
Either party may cancel this Agreement with or without cause upon 30 days written norice
delivered by certified mail.
After receipt of a notice of cancellarion, and except as otherwise directed, the Provider shall:
A. Discontinue provision of services under this Agreement on the date, and to the extent
specified, in the notice of cancellation;
B. Cancel all orders and subcontracts to the extent that they relate to the performance of services
canceled by the notice of cancellation;
C. Settle all outstanding liabilities and all claims arising out of such cancellation of orders and
subcontracts, with the approval or ratificarion to the extent that may be required, which
approval or ratificarion shall be final for all the purposes of this clause;
D. Complete performance of such services as shall not have been canceled by the notice of
cancellation; and
Hennepin Counry Community Health Department
q� •a4�'
E. Maintain all records relating to performance of the canceled portion of the Agreement as may
be required by the Department.
16. SEVERABILITY
In the event any provision of this Agreement shall be held invalid or unenforceable by any court of
competent jurisdicrion, such holding shall not invalidate or render unenforceable any other
provision hereof.
17. CONTRACT ADMTNISTRATION
In order to coordinate the services of the Provider with the activities of the Community Health
Department so as to accomplish the purposes of this contract, 7ennifer Thompson shall manage
this contract on behalf of the County and shall serve as a liaison between the County and the
Provider.
18. MERGER AI3D MODIFICATION
A. It is understood and agreed that the entire Agreement between the parties is contained herein
and that this Agreement supersedes all oral agreement and negotiations between the parties
relating to the subjecf matter hereo£ AIl items refened to in this Agreement are incorporated
or attached and are deemed to be part of this Agreement.
B. Any material alterarions, variations, modifications, or waivers of provisions of this Agreement
shall be va�id when they have been reduced to writing as an amendment to this Agreement
signed by the parties hereto.
C. Any policy changes by the Provider embodying client populations, client services, service
locarions or hours, must be approved by the Department and shall be valid only when
incorporated as an amendment to this Agreement and signed by the parties hereto.
19. FAIR HEARING AND GRIEVANCE PROCEDURE
The Provider shall establish a procedure through which recipients may assert grievances
concerning the operation of the service programs. The Provider shall advise service recipients of
this procedure. The Provider will make available to the Department a copy of the Provider's
existing grievance procedure. Any changes in the grievance procedure shall be forwarded to the
Deparhnent within 30 days of the change
20. PAPER RECYCLING
The County encourages the Provider to develop and implement an office paper and newsprint
recycling program.
In contracts over $250,OOQ the Provider aa ees to establish an office paper and newsprint
recycling program. The Provider shall provide a written plan to the County upon request, which
shall include a description of the program, the program administrator, list of collectibles and
procedures utilized for recycling, as wel] as an annual summary report.
a� -a�t�
Hennepin County Communiry Nealth Department
The Provider, having signed this Agreement, and the Hennepin County Board of Commissioners, having
duly approved this Agreement on January 1, 1997, and pursuant to such approval and the proper Counry
official having signed this contract, the parties hereto agree to be bound by the provisions herein set
forth.
Approved as to form and execution.
COUNT'Y OF HENI3EPIN,
STATE OF MINNESOTA
Assistant County Attomey
Date'
CITY OF SAINT PAUL
APPROVED AS TO FORM:
Assistant City Attorney
Date:
Chair of Its County Boazd
Acting County Administrator
ATTEST:
Deputy/Clerk of the County Board ,
CITY OF ST. PAUL PUBLIC HEALTFI
Director, Saint Paul Public
Title� Health
Name:
Director, Finance and
Tit1e: Management Services
10
q�-ayd
Hennepin Counry Communiry Health Deparhnent
STATE OF MINNESOTA )
COUN'I'Y OF HENNEPIN )
) ss.
On this day of , 19_, before me appeared
to me personally Imown, who stated ihat he/she is the
of
the corporarion described
in and who executed the foregoing insh�ument; and that said instrument was executed on behalf of said
coxporation by authority of its Board/Governing Body; and he/she aclmowledged said instrument to be
the free act and deed of said coiporation.
Notary Public
My Commission Expires
11
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Hennepin County Community Health Deparhnent
AIDS/HIV SERVICES AGREEMENT
EXHIBIT A
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Agency: City of St. Paul, St. Paul Public Aealth, Room 111 Clinic
Program: Early Intervention Services
Funding Period: 7anuary 1, 1997 - May 2, 1997
Program Summary: St. Paul Public Health, Room 1 I 1 Clinic will provide early intervention services to
primarily newly diagnosed individuals living with HIV disease, include, but not limited to: physician
services, nursing services, laboratory testing, and referral to other appropriate services.
Target Population: Low income (at or below 300% of federal poverty level) individuals living with
HIV disease in the 13 county Eligible Metropolitan Area.*
GOAL 1: Improve the health and well-being of individuals newly diagnosed with HIV through the
provision of early intervention services, including, but not limited to: physician services, nursing
services, laboratory testing, and referral to other appropriate services.
Ohjective l.a.: Provide at least 15 eazly intervention service visits to iQ eligible individuals living
with HN disease.
Outcome/Service Measure: Number of clients served.
Number of early intervention service visits.
*Thirteen county Eligible Metropolitan Area includes: Anoka, Carver, Chisago, Dakota, Hennepin,
Isanti, Ramsey, Scott, Sherburne, Washington, and Wright Counties in Minnesota and Pierce and St.
Croix Counties in Wisconsin.
Modificalions to Exhibit A allowed tl�rough writien request and prior approval af contract manager.
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HennepSn County Community Health DepartmenT
AIDS/HIV SERVICES AGREEMENT
EXFIIBIT B
PROGRAM BUDGET
Agency: City of St. Paul, St. Paul Public Health, Room I11
Program: Eazly 3ntervention Services
Funding Period: January 1, 1997 - May 2, 1997
Budgef Category CAR� ACT TITLE I Funded
Pmgram Budget Amount
a. Personnel $ 800
b. Fringes @ 20% of personnel $ 160
c. Travel $ 0
d. Equipment $ 0
e. Supplies $ 0
f. Contractual: Physician Services $ 1,500
g. Other: Laboratory Costs $ 540
h. Total Direct Charges $ 3,000
i. Indirect Charges $ 0
j_ TOTAL $ 3,000
Modif cations within each category of the above line item budget of less than 10 percent of any
line item are permitted without prior approval by the County, so long as notification of such
modzfzcations is given to zhe County.
Hennepin Counry Communiry Health Deparhnent
AIDS/HIV SERVICES AGREEMENT
EXHIBIT C
IiW OICE
Agency: City of St. Paul Public Health, Room 111 Clinic
Program: Eazly Intervention Services
Funding Period: January 1, 1997 - May 2, 1997
° -a� �
Bxpenditure Cateeory Amount
a.
b.
c.
d.
e.
f.
g•
h.
i.
J•
Personnel
Fringes
Travel
Equipment
Supplies
Contractual
Other
Total Direct Charges
Indirect Charges
TOTAL REIMBURSEMENT REQUBSTED:
I, on behalf of hereby
state that the above request for reimbursement represents an accurate accounring of expenditures for the
services provided pursuant to an agreement with Hennepin County Community Health Deparhnent.
Date:
Title:
Please send completed invoice to:
Jennifer Thompson, Contract Manager
Hennepin County Community Health Department
525 Portland Avenue South, Level 3
Minneapolis, MN 55415
QLIESTIONS about compJeting this invoice? CaIl7ennifer Thompson at (612) 348-5964.
9�-��lY
Hennepin County Community Health Department � --"
AIDSlIiIV SERVICES AGREEMENT
EXHIBIT D
DATA REPORTII�G FORMAT
I. iVARRATIVE REPORT
Please submit a quarterly narrarive report as pursuant to the signed services agreement which addresses
the following areas:
a. $riefly describe at least two case studies that typify the services being provided (i-2
paragraphs per case study).
b. If the agency has not perfornted the activities nor provided the services required according to
the scope of service for the quarter, please explain.
c. Report any administrative issues (i.e. problems with data collection, intemal evaluation
activities, staffing changes or problems, budgefing, etc.) that occurred during the quarter.
d. Describe any client service needs identified during the quarter that remain unmet.
e. List any trainings andtor workshops staff attended.
£ Report the total number of clients serviced durin�the quarter. Also, report the number of
clients not served, and the reasons the agency was unable to serve the clients.
Each narrative report should clearly list the name and address of the agency, name of program (if
applicable), reporting period, and the name and phone number of a contact person.
Reports should be submitted to:
Jennifer Thompson, Contract Manager
Hennepin County Community Health Department
525 Portland Avenue South, Leve13
Minneapolis, MN 55415
II. DATA COLLECTION
Funded agencies are required to complete an IIIV Services Client-Level Reporting System (CLRS) form
for each client served by the contract and a financial worksheet on the utilization of resources. (See
sample CLRS form attached, the financial worksheet will be presented at a training session.) The CLRS
forms are bubble sheets requesting basic demographic information about each client. CLRS forms and
the financial worksheet will be coliected by the 1�innesota Bepartment of Health as the coordinating
agency for the federal Annual Administrative Report. Providers will receive additional informarion and
training regarding data collection requirements. Providers are required to attend all trainings related to
data collection and reporting.
QUESTIOIVS about reporting? Call Jennifer Thompson, Hennepin County Community Health
Department at (612) 348-5964.
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RESOLUTION
�.Il�iT PAUL, 1�IINNESOTA
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Refened To
Committee: Date
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WHEREAS, the City of Saint Paul supports early intervention for newiy diagnosed HIV
positive persons; and
WHEREAS, the City will administer Ryan White Early Intervention Program to be
targeted to low-income, uninsured, and underinsured persons; and
WHEREAS, the City will receive funding for this activity from a contract with
Hennepin County Community Health Department who is coordinating the spending of
Ryan White CARE Act Funds in Minnesota; and
WHEREAS, a copy of the contract which is to be kept on record and on fi{e i� the
Department of Finance and Management Services; and
THEREFORE, BE IT RESOLVED, ihat the proper City Officials are hereby authorized
and directed to execute an agreement with the Hennepin County Community Health
Department.
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Requested by Department of:
Saint Paul Public Health
By: �it�tC�
Adopted by C,6u�i1: Date�
Adoption� erh'f� b Coum
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By: ;
Approved by Ma • Date
BY� `' +._-- //1/�
Form� prove by ' At
B � 2 �.2 0 — ��
Approved by Mayor for Submission to Council
By: �rti. �
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Public Heal c � ziisi9� GREEN SHEET N_ 3 3 9 8 9 _
COMACT PEflSON 8 PHONE � INRIAVOATE
EPNiTMEM DIflECTOH "� � CITY CAUNGI
Ydeal Hol[an 292-7713 ^u�" [�.eft'rarroFwEV �cmc�aK
MUST BE ON fAUNCIL AGENDA BY (DATE) � aFOR ���� DIqECTO � FlN. & MGT. SERVICES DIR.
QRDEF � MAYOR (OR ASSISiANf� O
TOTAL # OF SIGNATURE PAGES 1 (CLIP ALL LOCATIONS FOR SIGNATURE)
ncnounEauesrm:
Council Resolution to authorize City signatures on a contract be[ween the City of Saint Paul,
acting through its Saint Paul Public Health and Iiennepin County through the Hennepin County
Gommunity Health Department.
RECOMMENOA7iONS= appwa (A) a Reject (R} pEpSONAL SERViCE CONTRACTS NUST ANSW ER THE FOILOWING QUESTONS:
_ PLANNING COMMISSION _ ClY0. SERVICE COMM4SSION 1. Has this persoMfirm ever worked under a corrtract for lliis departmenK -
_ a8 GoMMmEe _ YES 'NO �
_�� 2. Has this perwnlfirm ever been a city emptoyee?
— YES NO
_ DISTAIGT CAUR7 _ 3. Oces this petsunNirtn possess a skill not narmall
Y Possessed DY atry a�rce�t city amplqrae?
SUPPORTS WHIGH COUNCIL OBJECTIVE7 YES NO
Explain a11 yes answers on separate sheet anG atteeh to green sheet ,
INITIATING PROH�EM, ISSUE. OPPORTUNITY iWho, Whai, When. Where, Why):
This is a continuation of the Ryan White Early Intervention Activities which has been
previously funded by the Minneapolis Department of Health. The Hennep-in Caunty Community
Health Department has assumed fiscal responsibility. Newly diagnosed HIV positive persons
many times are low-income, uninsured, and underinsured. The new availability of HIV related
drug therapy puts new emphasis on medical intervention as early as poseible.
ADVANTAGESIFAPPROVED: .
' Saint Paul will receive funding/reimbursement for the services provided to this project.
' The project will continue to be a state-wide model based on the experience of Saint Paul
Public Health on this project in previous years.
' Early intervention will assist persons to know the available HIV related resources,
particularly medical intervention.
DISADVANTAGESIFAPPROVED. ' � r .. + ;�{> .
NONE �ouncii Research Center �°
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�AAYOR'� (J�PIG'E
�ES 20 1997
DISADVANTAGES IF NOT APPROVED:
' Funding will not be obtained for our role in this project.
' Possibility of loss of exgerienced staff and deterioration of the pro,J"ect.
' Loss of ineaningful information to HIV infected persons.
TOTAL AMOUNT OF THANSACTION $ 3� OOO COST/REVENUE BUDGETEp (CIRCLE ONE) YES NO
FUNDItdGSOURCE HeriReplri CO. CoIDtIIUAlty H831tY1 Dept. ACTIYITYNUMBER 33243
FINANCIAL INFORMATION: (EXPLAIN)
Hennepin Counry Community Health Depar6nent
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AA Code: M13
ContractNo. A11237
Federal Tax ID Na
Vendor No
AIAS/I3IV SERVICES AGREEMENT
THIS AGREEMENf made and entered into by and between the County of Hennepin, State of
Minnesota, hereinafter referred to as the "County", tt�rough the Hennepin Connty Community Health
Deparknent, 525 Portland Avenue, Minneapolis, Minnesota 55415, hereinafter refeired to as the
"Department", and the City of St. Paul through its Public Health Department, hereinafter refesed to as
the "Provider."
TERM. AND COST OF THE AGREEMENT
A. The term of this Agreement shall be from 7anuary 1,1997, xhrou�h-May 2, 1997.
B. Total cash paysnents to the Provider for AIDS1f3N related services shall not exceed the lesser
of $3,000, or actual allowable expenses.
2. PAYMENT FOR CONTRACTED SERVICES
A. The Provider agrees to make expenditures of county-provided payments for the purpose of
providing the services as described in fi�ibit A and within the line item budget contained in
Exhibit B and to reimburse to the County any and all County payments in excess of actual
allowable expenses within 120 days of Che expirarion date of this Agreement or 120 days after
cancellation of this Agreement.
B. Payment for services shall be made directly to the Provider after complefion of the services
upon the presentation of a claim in the manner provided by law goveming the County's
payznent of claims and/or invoices. Upon final execution of this agreement, the provider
agency may request an advance equal to the first month's award based on a proration of the
contract amount. The Provider shaA submit monthly invoices for services rendered on forms
which will be fumished by the County. {See Exhibit C) Payment shall be made within 35 days
from receipt of the invoice. Invoices will be due: February 15, 1997 for services provided
during the period 3anuary 1, 1997 - January 31, 1997; March 15, 1997 for services pxovided
during the period February 1, 1997 - February 28, 1497; April I5, 1947 for services provided
during the period March 1, 1997 - Mazch 31, 1997; and May 15, 1997 for services provided
during the period April l, 1997 - May 2, 1997. The final payment will be made after
reconciliation of final expenses and the previous payments including the initial advance.
Payments shall be made in the manner provided by law for payment of c]aims against the
County.
C. The Provider agrees that every reasonable effort will be made to collect from third-party
payment sources andlor govemment agencies, which are either authorized or under legal
obtigarion to make such payments.
Hennepin County Communiry Health Deparhneni
3. CONTRACTED SBRVSCES
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A. AIDSIHIV related services shall be provided by Ciry of St. Paul Public Aealth at offices
located at 555 Cedar Street, St. Paul, Minnesota.
B. Provider shall provide services to idenrified targeted populations as described in E�ibit A.
Participants must be at or below 300 percent of the federal poverty level, as outlined below:
Family Size Annual Income
1 $ 23,220
2 31,080
3 38,940
4 46,800
5 54,660
6 62,520
7 70,380
8 78,240
For family units with more than eight members, add $2,620 for each
additional member.
C. Provider shall provide documented reports on services provided and clients served as
requested.
D. Provider agrees fo provide equal access to services, and shall not deny services based on
inability to pay.
4. CONDTTIONS OF THE PARTIES' OBLIGATIONS
The Provider shall comply with each of the following pmvisions:
A. The Maltreatment of Minors Reporting Act, Minnesota Statutes Section 626.556 and all rules
promulgated by the Minnesota Department of Human Services implementing such Act now in
force or hereafter adopted.
B. The Vulnerable Adults Reporting Act, Minnesota Statutes, Section 626.557, and all rules
promulgated by the Minnesota Department of Human Services implemenring such Act now in
force or hereafter adopted.
5. l�UDITS REPORTS MONITORING PROCEAURES RECORDS AND EVALUATION
The Provider shall:
A. Shall provide the Department with a quarterly narrative report on services provided in the
format delineated in fixhibit D. A narrative report will be due May 15, 1997 for services
provided during the period January 1, 1997 - Mazch 31, 1997. A quarterly narrative report on
9� -ay�
Hennepin County Community Health Aepartment
services provided during the period of April l, 1997 - May 2, 1997, will be due August I5,
1997, and will also include services provided during the period of April 1, 1997 through June
30, 1997 as outlined in subsequent contracts. In addition, the provider shall collect and report
anonymous client level data on al] individuals receiving HIV/AIDS services through this
agreement to the Minnesota Deparhnent of Health as highlighted in Eachibit D.
B. Shall maintain in each client record verificafion of FiIV status. Client records will be available
for review during site visits conducted by the contract manager. One site visit will be
conducted during the contract period.
C. Shall include, at a minimum, the following language in its client consent forms:
"The Hennepin County Community Health Department funds this program and requires some
personal informarion be collected and reported periodically for the following purQoses:
• To identify the services persons with HN disease need and use.
• To identify barriers to receiving those services.
• To evaluate future funding needs
We are not required to send your name or any other identifying information to the Hennepin
County Community Health Department as a condition of funding."
D. Maintain a bookkeeping system which sufficiently and properly reflects all direct and indirect
costs of any nature expended in the performance of this Agreement.
E. Maintain all financial books and records for at least 5 years for audit purposes; provided that, if
the Department fiunishes written notice during this period requesring retention of records to
allow complerion of an andirop [ne Deparhnent or its ultimate sources of funds, the Provider
shall retain records for the period requested.
F. Particapate in evaluarion of Provider services, through the following activities:
The Pxovider shall develop a plan incorporafing community and client input into
the evaluation of the delivery of services, to be submitted to the Department by
March 31, 1997.
The Provider will consult at least once a quarter with the Deparhnent on the
development and content of all program services and products and the status of
program implementation.
The Department shall conduct an on-site program visit at least once during the
contract period. This ��sit shall be for the purposes of assessing compliance
with contractual obligations, assessing program effectiveness and providing
technical assistance.
The Provider agrees that the County, the State Auditor, or IegislaYive authority, or any of their duly
authorized representatives at any time during normal business hours, and as often as they may
reasonably deem necessarv, shall have access to and the right to examine, audit, excerpt, and
h-anscribe any books, documents, papers, records, etc., and accounting procedures and practices of
the Providez which aze relevant to this Agreement.
6. SPECIAL DUTIES
The Provider shall attend all trainings and meetings required by the Deparhnent.
�1- ay �
Hennepin Counry Community Health Deparhnrnt
7. STANDARDS AND LICENSES
A. During the term of this Agreement, the Provider shall comply with all applicable standazds
required by the Minnesota Deparhnent of Aealth and shall maintain appropriate license and
certification requirements. Failure to maintain such standazds may be cause for cancellation of
this Agreement. In addirion, the Provider shall comply with any other standards or criteria
established by the Depaztment to assure quality of service.
B. The Provider shall remain in compliance with all other applicable federal, state, or local laws
and regulations pertaining to the pezformance of this Agreement.
8. DATA PRIVACY
All data collected, created, received, maintained, or disseminated for any purposes by the activities
of the Provider in the performance of this Agreement is govemed by the Minnesota Government
Data Practices Act, Minnesota Statutes, Chapter 13, and all other statutory provisions governing
data privacy, Minnesota Rules implemenring such Act now in force or hereafter adopted, as well
as Federal regulations on data privacy.
9. NON DISCRIMINATION - AFFIIZMATNE ACTION
A. In accordance with Hennepin County's policies against discrimination, no person shall be
excluded from full employment rights, denied access to, or participation in, or the benefits of
any program, service or acrivity, or subjected to harassment on the grounds of race, color,
creed, religiasr, sge; se�-�isability, marital status, sexual orientation, public assistance status,
or national origin; and no person who is protected by applicable Federal or State laws, rules, or
regularions against discrimination shall be otherwise subjected to discrimination.
B. If this Agreement is for a sum of over $50,000 or is one of several contracts with said Provider
within a 12-month period totaling more than $50,�00 or is amended to exceed $SQ,OQ� and
1) A written governmental jurisdiction plan exemption is granted by the Director of the
County's Affirmative Action Programs Department (Director), it is agreed that Hennepin
County's Appendix Z forms and is a part of this Agreement; or
2) A written exemprion is not granted or is withdrawn by said Director, then it is agreed
that Hennepin County's Appendix Y forms and is a part of this Agreement as though
fully set forth herein.
3) Provider will fisnish all information and reports required by the Hennepin County
Affirmative Action Policy.
4) Provider shall adopt and comply with Hennepin County's Equal Employment
Opportunity/Affirmative Action Policies, with regard to employment and contracting. If
at any time during the contract period, the basis of an approved exemption should
change, Provider shall inform the Director in writing within ten (10) calendar days from
the date of said change.
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Hennepin County Gommunity Health Departmeni
C. Where applicable, no qualified handicapped person as defined by United States Department of
Health and Human Services Regulations Title 45, Part 84.3 (j) (k) which implements Section
504 of the Rehabilitation Act of 1973, 29 USC 704 under Executive Order ATO. 11914 (4 FR
17871, April 28, 1976):
1) Shall be denied access to or opportunity to participate in or receive benefits from any
service offered by the Provider under the provisions of this Agreement, nor
2) Shall any qualified handicapped person be subject to discrimination in employment
under any program or activity related in the services fiunished by the Provider.
3) Where applicable, no qualified individual with a disability as defined by the Americans
with Disabilities Act of 1990, Public Law 101-336, Title I, Section 101(8) shall be
discrimanated against by the denial of full and equal enjoyment of the services and
facilities, privileges, advantages, or accommodations furnished by the Provider as a
private enfity operating a service as a puhlic accommodation pursuant to the provisions
of Tifle III of the Americans with Disabilities Act, Secrion 301(7).
D. Provider agrees to adhere to the County's Acquired Immune Deficiency Syndrome (AIDS)
Policy which provides that no employee, applicant or client shall be subjected to testing,
removed from normal and customary status, or deprived of any rights, privileges or freedoms
because of his or her AIDS status except for clearly stated, specific, and compelling medical
and/or public health reasons. Provider shall establish the necessary policies conceming AIDS
to assure that County clients in contracted programs and provider's employees in County
contraefed preg�ams are afforded the same h with regazd to AIDS as persons direct]y
employed or served by the County.
E. If during the term of this Agreement or any extension thereof it is discovered that the Provider
is not in complianee with the applicable regulations or if the Provider engages in any
discriminatory practices, the Department shall cancel this Agreement in accoxdance with
Paragraph 14 hereof.
10. INDEMNIFICATION AND INSTJRANCE
A. Indemnification:
The Provider agrees to defend, indemnify, and hold haxmless the County, its elected officials,
officers, agents, volunteers, and employees from any liability, claims, causes of acfion,
judgments, damages, losses, costs, or expenses, including reasonable attomeys fees, resulting
directly or indirectly from an act or omission of the Provider, its subcontractors, anyone
directly or indirectly employed by them, or anyone for whose acts or omissions they may be
liable in the performance of the services required by this Agreement, and against all loss by
reason of the failure of the Provider to perform fully, in any respect, all obligations under this
Agreement. The forgoing indemnificarion is at all times subject to limits in Minnesota Statute
466 as to the provider.
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Hennepin County Communiry Health Deparhnent
B. Insurance:
The Provider is self-insured.
The Provider shall require that each independent professionaUcontractor rendering counseling
and/or health care services on a regular basis fo recipients under this Agreement fumish to the
Provider proof of Professional Liability insurance as follows:
Professional Liability - Errors and Omissions:
Per Claim
Aggregate
�:
Professional Liability - Medical A�7alpracfice:
Per Occurrence
Aggregate
I 1. INDEPENDENT PROVIDER
$1,000,000
$1,000,000
$1,000,000
$1,000,000
It is agreed that nothing herein contained is intended or should be conshued in any manner as
creating or establishing the relationship of co-partners between the parties hereto or as constituting
the Provider as the agent, representative, or employee of the County for any purpose or in any
manner whatsoever. The Provider is to be and shall remain an independent provider with respect
to all services performed under this Agreement. The Provider represents that it has, or will secure
at its own expense, all personnel required in performing services under this Agreement. Any and
all personnel of Provider or other persons, while engaged in the performance of any work or
services required by Provider under this Agreement, shall have no contractual relationship with the
County and shall not be considered employees of the County, and any and all claims that may or
might arise under the Minnesota Economic Security Act or the Workers Compensation Act of the
State of Minnesota on behalf of said personnel or other persons while so engaged, and any and all
claims whatsoever on behalf of any such person or personnel arising out of employment or alleged
employment including, without limitation, claims of discrimination against the Provider, its
officers, agents, providers, or employees shall in no way be the responsibility of the County; and
Provlder shall defend, indemnify, and hold the Counry, its commissioners, offacers, agents, and
employees harmless from any and all such claims irrespecrive of any determinarion of any
pertinent tribunal, agency, board, commission, or court. Such personnel or other persons shall not
requize nor be entitled to any compensation, rights, or benefits of any kind whatsoever from the
County, including, without limitation, tenure rights, medical and hospital care, vacation leave,
Workers' Compensation, IZe-employment Insurance, disability, severance pay, and PERA.
12. SUBCONTRACTII�IG AND A5SIGNMENTS
The Provider shall neither enter into subcontracts for performance of any of the services
contemplated under this Agreement, nor assign this Agreement, without the prior written approval
of the Department and subject to such conditions and provisions as the Department may deem
necessary. The Provider shall be responsible for the performance of all subcontractors.
6
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He�nepin County Communiry Health Departrnent
13. DEFAULT
A. Unless the Provider's default is excused undez the provisions of this Agreement, the Provider
after receipt of notice by the Deparlment of any of the following conditions or other
circumstances warranfing cancellarion of this A�-eement, shall have ten (10) days (or such
longer period as the Deparlment may authorize in writing) after receipt of the notice from the
Department to cure the specified failure:
1) If the Provider fails to provide services called for by this Agreement within the time
specified herein or any extension thereof; or
2) If the Provider is in such fmancial condifion so a to endanger the performance of this
Agreement; or
3) If the Provider fails to perfarm any of the other provisions of this Agreement, or so fails
to prosecute the work as to endanger perfozmance of this Agreement in accordance with
its terms; or
4) If it is discovered that material misrepresentations were made by the Provider as to
conditions relied upon by the Deparhnent, which are purported to exist according to the
terms of this Agreement and all exhibits and documents attached hereto and incorporated
by reference.
If the Pravider fails to cure the specified condition after notice within the prescribed period of
time, the Departmer.±:na3t, ��pon writter. notce, i*.r±nediately cancel the whole or part of this
Agreement.
Notwithstanding the above, Provider shall not be relieved of liability to the County for
damages sustained by the County by virtue of any breach of this Agreement by Provider, and
the County may withhold any payments to the Provider for the purpose of set-off until such
time as the exact amount of damages due the County is determined.
B. The rights and remedies of the County and the Deparhnent provided in this clause shall not be
exclusive and aze in addition to any other rights and remedies provided by ]aw or equity.
The County's failwe to insist upon strict performance of any covenant, agreement, or
stipularion of this Agreement or to exercise any right herein contained shall not be a waiver or
relinquishment of such covenant, agreement, stipularion, or right, unless the County consents
thereto in writing. Any such written consent shall not constitute a waiver or relinquishment of
the future of such covenant, agreement, stipulation, or right.
14. NOTICES
Any notice or demand which may or must be given or made by a party hereto, under the terms of
this Agreement or any statute or ordinance, shall be in writing and shall be sent registered or
certified mail to the other party addressed as follows:
Hennepin County Community Heakh Depariment
Provider
Mary Sonnen, Director, HIV/AIDS Programs
City of St. Paul Public Health
555 Cedar Street
St. Paul, Mumesota 55101
(612)292-7711
County
Jeff Spartz
Heimepin County Administrator
A-2303 Goveminent Center
Minneapolis, MN 55487
(612)348-7574
Department
Hennepin County Community Health Department
c10 Mark Lee
525 Portland Avenue South
Minneapolis, MN 55415
(612)348-4092
�l'1- �y�
Any party znay designate a different addressee or address at any time by giving written notice
delivered by certified mail.
15. CANCELLATION
Either party may cancel this Agreement with or without cause upon 30 days written norice
delivered by certified mail.
After receipt of a notice of cancellarion, and except as otherwise directed, the Provider shall:
A. Discontinue provision of services under this Agreement on the date, and to the extent
specified, in the notice of cancellation;
B. Cancel all orders and subcontracts to the extent that they relate to the performance of services
canceled by the notice of cancellation;
C. Settle all outstanding liabilities and all claims arising out of such cancellation of orders and
subcontracts, with the approval or ratificarion to the extent that may be required, which
approval or ratificarion shall be final for all the purposes of this clause;
D. Complete performance of such services as shall not have been canceled by the notice of
cancellation; and
Hennepin Counry Community Health Department
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E. Maintain all records relating to performance of the canceled portion of the Agreement as may
be required by the Department.
16. SEVERABILITY
In the event any provision of this Agreement shall be held invalid or unenforceable by any court of
competent jurisdicrion, such holding shall not invalidate or render unenforceable any other
provision hereof.
17. CONTRACT ADMTNISTRATION
In order to coordinate the services of the Provider with the activities of the Community Health
Department so as to accomplish the purposes of this contract, 7ennifer Thompson shall manage
this contract on behalf of the County and shall serve as a liaison between the County and the
Provider.
18. MERGER AI3D MODIFICATION
A. It is understood and agreed that the entire Agreement between the parties is contained herein
and that this Agreement supersedes all oral agreement and negotiations between the parties
relating to the subjecf matter hereo£ AIl items refened to in this Agreement are incorporated
or attached and are deemed to be part of this Agreement.
B. Any material alterarions, variations, modifications, or waivers of provisions of this Agreement
shall be va�id when they have been reduced to writing as an amendment to this Agreement
signed by the parties hereto.
C. Any policy changes by the Provider embodying client populations, client services, service
locarions or hours, must be approved by the Department and shall be valid only when
incorporated as an amendment to this Agreement and signed by the parties hereto.
19. FAIR HEARING AND GRIEVANCE PROCEDURE
The Provider shall establish a procedure through which recipients may assert grievances
concerning the operation of the service programs. The Provider shall advise service recipients of
this procedure. The Provider will make available to the Department a copy of the Provider's
existing grievance procedure. Any changes in the grievance procedure shall be forwarded to the
Deparhnent within 30 days of the change
20. PAPER RECYCLING
The County encourages the Provider to develop and implement an office paper and newsprint
recycling program.
In contracts over $250,OOQ the Provider aa ees to establish an office paper and newsprint
recycling program. The Provider shall provide a written plan to the County upon request, which
shall include a description of the program, the program administrator, list of collectibles and
procedures utilized for recycling, as wel] as an annual summary report.
a� -a�t�
Hennepin County Communiry Nealth Department
The Provider, having signed this Agreement, and the Hennepin County Board of Commissioners, having
duly approved this Agreement on January 1, 1997, and pursuant to such approval and the proper Counry
official having signed this contract, the parties hereto agree to be bound by the provisions herein set
forth.
Approved as to form and execution.
COUNT'Y OF HENI3EPIN,
STATE OF MINNESOTA
Assistant County Attomey
Date'
CITY OF SAINT PAUL
APPROVED AS TO FORM:
Assistant City Attorney
Date:
Chair of Its County Boazd
Acting County Administrator
ATTEST:
Deputy/Clerk of the County Board ,
CITY OF ST. PAUL PUBLIC HEALTFI
Director, Saint Paul Public
Title� Health
Name:
Director, Finance and
Tit1e: Management Services
10
q�-ayd
Hennepin Counry Communiry Health Deparhnent
STATE OF MINNESOTA )
COUN'I'Y OF HENNEPIN )
) ss.
On this day of , 19_, before me appeared
to me personally Imown, who stated ihat he/she is the
of
the corporarion described
in and who executed the foregoing insh�ument; and that said instrument was executed on behalf of said
coxporation by authority of its Board/Governing Body; and he/she aclmowledged said instrument to be
the free act and deed of said coiporation.
Notary Public
My Commission Expires
11
�f � -�4d
Hennepin County Community Health Deparhnent
AIDS/HIV SERVICES AGREEMENT
EXHIBIT A
[.YK�l�s�l���l�il [�
Agency: City of St. Paul, St. Paul Public Aealth, Room 111 Clinic
Program: Early Intervention Services
Funding Period: 7anuary 1, 1997 - May 2, 1997
Program Summary: St. Paul Public Health, Room 1 I 1 Clinic will provide early intervention services to
primarily newly diagnosed individuals living with HIV disease, include, but not limited to: physician
services, nursing services, laboratory testing, and referral to other appropriate services.
Target Population: Low income (at or below 300% of federal poverty level) individuals living with
HIV disease in the 13 county Eligible Metropolitan Area.*
GOAL 1: Improve the health and well-being of individuals newly diagnosed with HIV through the
provision of early intervention services, including, but not limited to: physician services, nursing
services, laboratory testing, and referral to other appropriate services.
Ohjective l.a.: Provide at least 15 eazly intervention service visits to iQ eligible individuals living
with HN disease.
Outcome/Service Measure: Number of clients served.
Number of early intervention service visits.
*Thirteen county Eligible Metropolitan Area includes: Anoka, Carver, Chisago, Dakota, Hennepin,
Isanti, Ramsey, Scott, Sherburne, Washington, and Wright Counties in Minnesota and Pierce and St.
Croix Counties in Wisconsin.
Modificalions to Exhibit A allowed tl�rough writien request and prior approval af contract manager.
a� -a��
HennepSn County Community Health DepartmenT
AIDS/HIV SERVICES AGREEMENT
EXFIIBIT B
PROGRAM BUDGET
Agency: City of St. Paul, St. Paul Public Health, Room I11
Program: Eazly 3ntervention Services
Funding Period: January 1, 1997 - May 2, 1997
Budgef Category CAR� ACT TITLE I Funded
Pmgram Budget Amount
a. Personnel $ 800
b. Fringes @ 20% of personnel $ 160
c. Travel $ 0
d. Equipment $ 0
e. Supplies $ 0
f. Contractual: Physician Services $ 1,500
g. Other: Laboratory Costs $ 540
h. Total Direct Charges $ 3,000
i. Indirect Charges $ 0
j_ TOTAL $ 3,000
Modif cations within each category of the above line item budget of less than 10 percent of any
line item are permitted without prior approval by the County, so long as notification of such
modzfzcations is given to zhe County.
Hennepin Counry Communiry Health Deparhnent
AIDS/HIV SERVICES AGREEMENT
EXHIBIT C
IiW OICE
Agency: City of St. Paul Public Health, Room 111 Clinic
Program: Eazly Intervention Services
Funding Period: January 1, 1997 - May 2, 1997
° -a� �
Bxpenditure Cateeory Amount
a.
b.
c.
d.
e.
f.
g•
h.
i.
J•
Personnel
Fringes
Travel
Equipment
Supplies
Contractual
Other
Total Direct Charges
Indirect Charges
TOTAL REIMBURSEMENT REQUBSTED:
I, on behalf of hereby
state that the above request for reimbursement represents an accurate accounring of expenditures for the
services provided pursuant to an agreement with Hennepin County Community Health Deparhnent.
Date:
Title:
Please send completed invoice to:
Jennifer Thompson, Contract Manager
Hennepin County Community Health Department
525 Portland Avenue South, Level 3
Minneapolis, MN 55415
QLIESTIONS about compJeting this invoice? CaIl7ennifer Thompson at (612) 348-5964.
9�-��lY
Hennepin County Community Health Department � --"
AIDSlIiIV SERVICES AGREEMENT
EXHIBIT D
DATA REPORTII�G FORMAT
I. iVARRATIVE REPORT
Please submit a quarterly narrarive report as pursuant to the signed services agreement which addresses
the following areas:
a. $riefly describe at least two case studies that typify the services being provided (i-2
paragraphs per case study).
b. If the agency has not perfornted the activities nor provided the services required according to
the scope of service for the quarter, please explain.
c. Report any administrative issues (i.e. problems with data collection, intemal evaluation
activities, staffing changes or problems, budgefing, etc.) that occurred during the quarter.
d. Describe any client service needs identified during the quarter that remain unmet.
e. List any trainings andtor workshops staff attended.
£ Report the total number of clients serviced durin�the quarter. Also, report the number of
clients not served, and the reasons the agency was unable to serve the clients.
Each narrative report should clearly list the name and address of the agency, name of program (if
applicable), reporting period, and the name and phone number of a contact person.
Reports should be submitted to:
Jennifer Thompson, Contract Manager
Hennepin County Community Health Department
525 Portland Avenue South, Leve13
Minneapolis, MN 55415
II. DATA COLLECTION
Funded agencies are required to complete an IIIV Services Client-Level Reporting System (CLRS) form
for each client served by the contract and a financial worksheet on the utilization of resources. (See
sample CLRS form attached, the financial worksheet will be presented at a training session.) The CLRS
forms are bubble sheets requesting basic demographic information about each client. CLRS forms and
the financial worksheet will be coliected by the 1�innesota Bepartment of Health as the coordinating
agency for the federal Annual Administrative Report. Providers will receive additional informarion and
training regarding data collection requirements. Providers are required to attend all trainings related to
data collection and reporting.
QUESTIOIVS about reporting? Call Jennifer Thompson, Hennepin County Community Health
Department at (612) 348-5964.