Business Associate Contract for Nursing Services Parties: This Agreement is entered into between Wasco County, Oregon, a political subdivision of the State of Oregon, represented by the North Central Public Health District, herein referred to as NCPHD and Sherman County Schools, a municipal corporation of the State of Oregon, hereinafter referred to as the SCHOOL. WHEREAS, ORS 190.010 provides that a unit of local government may enter into a written agreement with any other unit or units of local government for the performance of any or all functions and activities that a party to the agreement, its officers or agencies, have authority to perform; and WHEREAS, NCPHD and said SCHOOL have agreed that the NCPHD will provide special nursing services above and beyond the level of services offered to the balance of Wasco and Sherman Counties; NOW, THEREFORE, in consideration of the terms, conditions and covenants herein stated, it is agreed as follows: I. The NCPHD assumes responsibility for and agrees to: a) Provide skilled community nursing services for school age children and their families as outlined in Exhibit A attached hereto and by this reference incorporated herein. b) Invoice SCHOOL annually for school nursing services. II. The SCHOOL agrees: a) To pay NCPHD EIGHT DOLLARS ($8.00) per year for each student enrolled in the school at the end of the first quarter of the school year, as determined by records maintained by the SCHOOL. b) To provide NCPHD with student count, for invoicing purposes, at the end of the first quarter of the school year. III. It is mutually agreed that: a) All personnel provide skilled community nursing services under this agreement shall be NCPHD employees. The NCPHD shall have full responsibility in connection with the direction of all employees assigned duties under the provisions under this agreement. b) Personnel providing skilled community nursing services shall work for the SCHOOL on days which are listed as school days on a Nursing Contract 2012-2013 Page 1
CONFIDENTIALITY: school schedule as adopted by the school board of the school. c) This agreement shall commence on the first day of September, 2012 and terminate on the 30th day of June, 2013. However, either party may terminate this agreement upon thirty (30) days written notice to the other. d) The NCPHD will not provide insurance coverage or defend any action, suit or proceeding arising out of activities in connection with this agreement beyond covering Wasco and Sherman County and its own employees. e) The laws of the State of Oregon shall govern this Agreement. Both parties will comply with all federal, state, county, and local laws, ordinances, and regulations applicable to this agreement. They further agree to comply with Title VI of the Civil Rights Acts of 1964, and with Section V of the Rehabilitation Act of 1973. As a Business Associate of NCPHD, the SCHOOL agrees to not use or disclose any information concerning an NCPHD client for a purpose not directly connected with the administration of its responsibilities under this contract, except on written consent of the NCPHD client, his or her legally responsible parent or guardian, or if appropriate, his or her attorney. Use and Disclosure of Protected Health Information. The SCHOOL may use and disclose Protected Health Information only as required to satisfy its obligations under the Agreement, as permitted herein, but shall not otherwise use or disclose any Protected Health Information. Protected Health Information includes information contained in a student s medical records and billing records. The SCHOOL shall ensure that it will not use or disclose Protected Health Information received from NCPHD in any manner that would constitute a violation of the Health Insurance Privacy and Accountability Act Standards. The SCHOOL acknowledges that, as between the SCHOOL and NCPHD, all Protected Health Information shall be and remain the sole property of the NCPHD. The SCHOOL further represents that, to the extent the SCHOOL requests that NCPHD disclose Protected Health Information, such a request is only for the minimum necessary Protected Health Information for the accomplishment of the contracted purpose. Safeguards Against Misuse of Information. The SCHOOL shall use all appropriate safeguards to prevent the use or disclosure of Protected Health Information. Reporting of Disclosures of Protected Health Information. The SCHOOL shall, as soon as practicable, but in no event later than within two (2) days of becoming aware of any use or disclosure of Protected Health Information in violation of the Agreement by the SCHOOL, report any such disclosure to NCPHD. In such event, the SCHOOL shall, in consultation with NCPHD, mitigate, to the extent practicable, any harmful effect that is known to the SCHOOL of such improper use or disclosure. Nursing Contract 2012-2013 Page 2
Accounting of Disclosures. Within ten (10) days of notice by NCPHD to the SCHOOL that it has received a request for an accounting of disclosures of Protected Health Information (other than disclosures to which an exception to the accounting requirement applies, including, but not limited to, the exceptions for a disclosure that is related to the treatment of the student, the processing of payments related to such treatment, or the health care operations of a NCPHD or its business associate) the SCHOOL shall make available to the NCPHD such information as is in the SCHOOL's possession and is required for the NCPHD to make the accounting required by 45 C.F.R. 164.528. At a minimum, the SCHOOL shall provide NCPHD with the following information: (i) the date of the disclosure, (ii) the name of the entity or person who received the Protected Health Information, and if known, the address of such entity or person, (iii) a brief description of the Protected Health Information disclosed, and (iv) a brief statement of the purpose of such disclosure which includes an explanation of the basis for such disclosure. In the event the request for an accounting is delivered directly to the SCHOOL, the SCHOOL shall within two (2) days forward such request to NCPHD. The SCHOOL shall implement an appropriate record keeping process to enable it to comply with the requirements of this Section. ACCESS TO RECORDS During the term of this contract and for the period of five (5) years after the termination of this contract, the SCHOOL shall make available to the Health Care Financing Administration, the Comptroller General of the United States and their duly authorized representatives, all documents and records necessary to certify the nature and extent of the costs of those services and records relating to the use and disclosure of Protected Health Information received from, or created and received by NCPHD on behalf of NCPHD. Notice of Request for Data. The SCHOOL agrees to notify NCPHD within five (5) business days of the Contractor s receipt of any request or subpoena for Protected Health Information. To the extent that NCPHD decides to assume responsibility for challenging the validity of such request, the SCHOOL shall cooperate fully with NCPHD in such challenge. TERMINATION Termination Upon Breach of Provisions Applicable to Protected Health Information. Any other provision of the Agreement notwithstanding, the Agreement may be terminated by NCPHD upon five (5) days written notice to the SCHOOL in the event that the SCHOOL breaches any provision contained in this contract and such breach is not cured within such five (5) day period; provided, however, that in the event that termination of the contract is not feasible, in NCPHD's sole discretion, the SCHOOL acknowledges and agrees that NCPHD has the right to report the breach to the Secretary, notwithstanding any other provision of this Agreement to the contrary. Return or Destruction of Protected Health Information upon Termination. Upon termination of the Contract, the SCHOOL shall either return or destroy all Protected Health Information received from NCPHD or created or received by the SCHOOL on behalf of NCPHD and which the SCHOOL still maintains in any form. The SCHOOL shall not retain any copies of such Protected Health Information. Notwithstanding the foregoing, to the extent that NCPHD agrees that it is not feasible to return or destroy such Protected Health Information, the terms and provisions of this Addendum shall survive termination of the Agreement and such Protected Health Information shall be used or disclosed solely for such purpose or purposes which prevented the return or destruction of such Protected Health Information. Nursing Contract 2012-2013 Page 3
NCPHD Right of Cure. At the expense of the SCHOOL, NCPHD shall have the right to cure any breach of the SCHOOL's obligations under this Addendum. NCPHD shall give the SCHOOL notice of its election to cure any such breach and the SCHOOL shall cooperate fully in the efforts by NCPHD to cure the SCHOOL s breach. All requests for payment for such services of NCPHD shall be paid within thirty (30) days. AMENDMENT NCPHD and the SCHOOL agree to amend this Addendum to the extent necessary to allow either party to comply with the Privacy Standards, the Standards for Electronic Transactions (45 C.F.R. Parts 160 and 162) and the Security Standards (45 C.F.R. Part 142) (collectively, the "Standards") promulgated or to be promulgated by the Secretary or other regulations or statutes. The SCHOOL agrees that it will fully comply with all such Standards and that it will agree to amend this Addendum to incorporate any material required by the Standards. IN WITNESS WHEREOF, the parties hereto have executed this agreement the day and year set opposite their respective signatures. School Representative Wasco County Commissioner North Central Public Health District Director Approved as to form: County Counsel Nursing Contract 2012-2013 Page 4
Exhibit A The school nurse is an employee of NCPHD and has a current license to practice as a RN in the State of Oregon. Responsibilities include, but are not limited to: a) Reviewing health records and teacher referrals to identify possible student health problems. b) Providing a nursing assessment for selected students; identifying goals for care, formulating a writing protocol; evaluating and revising the plan of care as necessary. c) Participating in case staffings with other school personnel when appropriate. d) Counseling individual students regarding health needs/problems and making appropriate referrals as necessary. e) Working as liaison among the school, community health and welfare agencies and the medical profession. f) Auditing and filing immunization information to assure compliance with the State statutes. g) Inspecting, referring, education, excluding those suspected of having a communicable disease. h) Providing scoliosis screening for grade 7. i) Continuing supervision of students who have positive PPD s, are on prenatal and family planning programs. Nursing Contract 2012-2013 Page 5