HomeMy WebLinkAboutPR 17306: NURSE-FAMILY PARTNERSHIP AGREEMENT Memorandum
City of Port Arthur, Texas
Health Department
TO: Floyd T. Johnson, City Manager
FROM: Yoshi D. Alexander, MBA -HCM, Health Director
DATE: September 25, 2012
SUBJECT: Proposed Resolution No. 17306
Approval to Renew the Implementation Agreement between the Nurse - Family
Partnership, A Non -Profit Corporation, and the City of Port Arthur
RECOMMENDATION
It is recommended that the City Council approve P.R. No. 17306, approving a three (3) year
renewal of the Implementation Agreement between the Nurse - Family Partnership, A Colorado
Non - profit Corporation, and the City of Port Arthur for an estimated amount of $15,973 for FY
2013; $15,493 for FY 2014; and $15,493 for FY 2015 in addition to fees for education, training,
and materials for new Nurse - Family Partnership staff.
BACKGROUND
The State of Texas, by and through the Texas Health and Human Services Commission (HHSC)
approved a grant proposal to the City of Port Arthur to support the establishment and operation
of local Nurse - Family Partnership (NFP) program to provide educational, health, guidance, and
other resources for low- income, Medicaid eligible, first -time pregnant women during pregnancy,
and during the first two years of their infant's life through visits by highly trained registered
nurses. Approval of this Implementation Agreement for three years will allow the Nurse - Family
Partnership Corporation to guide and support the City of Port Arthur's program continued
implementation process and also provides for education, training, and materials for new staff.
BUDGETARY AND FISCAL EFFECT
The Nurse - Family Partnership Corporation will be paid through grant funds awarded from the
HHSC for an estimated amount of $20,561 for FY 2013; $20,561 for FY 2014; and $20,561 for
FY 2015 in addition to fees for education, training, and materials for new Nurse - Family
Partnership staff.
STAFFING EFFECT
Approval of this Agreement will allow for training of new NFP staff.
SUMMARY
It is recommended that the City Council approve P.R. No. 17306, approving a three (3) year
renewal of the Implementation Agreement between the Nurse - Family Partnership, A Colorado
Non -profit Corporation, and the City of Port Arthur for an estimated amount of $15,973 for FY
2013; $15,493 for FY 2014; and $15,493 for FY 2015 in addition to fees for education, training,
and materials for new Nurse - Family Partnership staff.
P. R. NO. 17306
9/25/12 -yda
RESOLUTION NO.
A RESOLUTION TO APPROVE THE NURSE - FAMILY PARTNERSHIP
IMPLEMENTATION AGREEMENT BETWEEN THE CITY OF PORT
ARTHUR AND NURSE - FAMILY PARTNERSHIP, A COLORADO NON-
PROFIT CORPORATION, FOR AN ESTIMATED AMOUNT OF $15,973
FOR FY 2013; $15,493 FOR FY 2014; AND $15,493 FOR FY 2015 IN
ADDITION TO FEES FOR NURSE - FAMILY PARTNERSHIP STAFF
TRAINING
WHEREAS, the State of Texas, by and through the Texas Health and Human Services
Commission (HHSC) has awarded a contract to the City of Port Arthur to implement a local
Nurse- Family Partnership (NFP) program to provide educational, health, guidance, and other
resources for low- income, first -time pregnant women during pregnancy, and during the first two
years of their infant's life through visits by highly trained registered nurses; and,
WHEREAS, this City of Port Arthur's Nurse - Family Partnership Program has been in
effect for four (4) years; and,
WHEREAS, the Nurse - Family Partnership, a Colorado Non - Profit Corporation, entered
into contract with the City of Port Arthur to guide and support the City of Port Arthur's program
implementation process, per Resolution No. 08 -326 dated July 29, 2008, and Amendment
Number 1 per Resolution No. 09 -318 dated July 28, 2009; and Resolution No. 11 -055 dated
February 22, 2011; and,
WHEREAS, the Nurse - Family Partnership, a Colorado Non -Profit Corporation wishes
to extend the existing Implementation Agreement for an additional three (3) years for an
estimated amount of $15,973 for FY 2013; $15,493 for FY 2014; and $15,493 for FY 2015 in
addition to fees for education , training, and materials for new Nurse - Family Partnership staff.
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P.R. NO. 17306
Page 2
NOW THEREFORE BE IT RESOLVED BY THE CITY COUNCIL OF THE
CITY OF PORT ARTHUR:
Section 1. That, the facts and opinions in the preamble are true and correct.
Section 2. That, the City Council of the City of Port Arthur hereby approves the
Nurse - Family Partnership Implementation Agreement between the City of Port Arthur and the
Nurse - Family Partnership, a Colorado non - profit Corporation, for three (3) years for an
estimated amount of $15,973 for FY 2013; $15,493 for FY 2014; and $15,493 for FY 2015 in
addition to fees for education, training, and materials for new Nurse - Family Partnership staff.
Section 3. That, the City Council deems it is in the best interest of the City to approve
and authorize the City Manager and the Director of the City's Health Department to execute the
Nurse - Family Partnership Implementation Agreement between the City of Port Arthur, TX and
Nurse- Family Partnership, a Colorado non - profit corporation as delineated in Exhibit "A ".
Section 4. That, a copy of the caption of this Resolution be spread upon the Minutes of
the City Council.
READ, ADOPTED, AND APPROVED, this day of October 2012
A.D., at a Regular Meeting of the City Council of the City of Port Arthur, Texas by the
following Vote:
AYES: Mayor:
Council members:
P. R. NO. 17306
Page 3
NOES:
Mayor
ATTEST:
Sherri Bellard, City Secretary
APPROVED AS TO FORM:
Vale s Ti eno, C ty Att r y
a be -
APPROVED FOR ADMINISTRATION:
Floyd T. Johnson, City Manager Yoshi D. Alexander, MBA -HCM
Director of Health Services
APPROVED FOR AVAILABILITY OF FUNDS:
OdeLtelSit
Deborah Echols, CPA, Director of Finance
{
EXHIBIT "A"
f
NURSE - FAMILY PARTNERSHIP IMPLEMENTATION AGREEMENT
This Agreement ( "Agreement "), for the period September 1, 2012, through August 31, 2015, is
by and between the City of Port Arthur ( "Agency ") and Nurse - Family Partnership, a Colorado
nonprofit corporation ( "NFP ") (together, the "Parties ").
RECITALS:
A. The Parties understand and agree that the Nurse - Family Partnership® Program (the
"Program ") is an evidence -based program developed on the basis of randomized controlled
trial research to yield certain benefits for low- income, first -time mothers and their children
( "Program Benefits ").
B. The Parties understand and agree that Program Benefits can be described generally as
helping low- income, first -time mothers develop behaviors that enable them to have healthier
pregnancies, be better parents, have emotionally and physically healthier children, and
attain greater economic self- sufficiency.
C. The Parties understand and agree that Program implementation by Agency must be based
upon key parameters ( "Model Elements ") identified through research and refined based
upon the Program's experience since 1997 and attached to this Agreement as Exhibit A,
Nurse - Family Partnership Model Elements.
D. Agency desires and intends to implement the Program to serve low- income, first -time
mothers in the geographic area it serves and to be known to the public as Nurse - Family
Partnership.
E. NFP desires and intends to guide and support the Program implementation process in order
to help Agency obtain Program Benefits for the mothers and children that Agency serves.
F. Accordingly, the Parties wish to enter into this Agreement in order to memorialize the
mechanisms and means by which Agency shall implement the Program and NFP shall
support such implementation. The Parties intend to remain in a contractual relationship for
the period described in Section V herein and thereafter, so long as funding is available to
both of the Parties for this purpose.
AGREEMENT:
In consideration of the foregoing recitals, which are incorporated herein, and for other good and
valuable consideration, the receipt and adequacy of which are hereby acknowledged, the
Parties agree as follows:
I. DEFINITIONS.
A. Agreement- Specific Definitions. In addition to terms defined above and elsewhere in this
Agreement, the following terms shall have the meanings set forth below:
1. "ETOTM" means the Efforts to Outcomes TM software system that NFP makes
available to Agency, into which designated, NFP- approved Agency personnel enter
data collected about Clients and the Program, and from which the Parties can obtain
reports to help manage and evaluate program implementation and results.
2. "ETO Website" means the Internet URL through which designated, NFP- approved
Agency personnel can access the ETO to enter data and obtain certain reports and
other services. ETO software is secured against unauthorized use by VeriSign®
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128 -bit Security Encryption, the industry standard in Internet site protection.
Authorized access to the ETO Website can only be provided by NFP
3. "Administrator" means a person with fiscal and quality oversight, operational
coordination responsibilities, and /or evaluation responsibility for the Program's
management.
4. "Client" means a low- income, first -time mother who is enrolled in the Program
implemented by Agency.
5. "Effective Date" means the date first noted above and upon which this Agreement
becomes effective.
6. "Fidelity to the Model" means implementing the Program in a manner consistent with
the Model Elements and therefore maximizing the likelihood of achieving results
comparable to those measured in research.
7. "Visit -to -Visit Guidelines®" means a written guide or guides for how a Nurse Home
Visitor schedules and conducts visits with Clients during their participation in the
Program.
8. "Location" means the work address of a Program Supervisor.
9. "Program Supervisor" means a person who supervises up to eight Nurse Home
Visitors who implement the Program on behalf of Agency.
10. "Research" means any activity, including program evaluation and /or quality
improvement activities, (i) that would, according to Federal regulations, require
review by an Institutional Review Board ( "IRB "), or (ii) that could be expected to yield
generalizable knowledge that could be shared publicly with the professional,
academic, and /or lay communities.
11. "Team" means a half- to full -time Program Supervisor and up to eight (8) Nurse
Home Visitors who report to the Program Supervisor.
B. "Proprietary Property" means all of (i) the Program, including facilitators and handouts,
(ii) the Model Elements, (iii) the name "Nurse- Family Partnership" and the acronym
"NFP" when used in connection with the NFP Logo and the goodwill associated
therewith, (iv) all NFP Community Website and ETO website content, and (v) the
copyrighted materials and other materials used in the Program as of the date hereof that
would be designated as protectable intellectual property under applicable law, including,
but not limited to, all modifications, additions, updates, and derivative works thereof and
all of the rights of NFP and its licensors associated with this property. Proprietary
Property shall also include, individually and collectively, all ideas, concepts, designs,
methods, inventions, modifications, improvements, new uses, and discoveries which are
conceived and /or made in the performance of the responsibilities stated under this
Agreement by one or more of Agency, NFP, or its licensors, whether or not they are
incorporated into the Program or the Proprietary Property. NFP and its licensors reserve
the right to modify the Proprietary Property from time to time in accordance with the
data, research, and current modalities of delivery of the Program and for any other
reason NFP or its licensors, in their sole and absolute discretion, deem appropriate.
NFP will provide Agency with reasonable notice of those modifications. NFP and its
licensors shall retain ownership and all rights to all Proprietary Property, whether
modified or not by Agency.
C. General Application. Unless a clear contrary intention appears, words used with initial -
capitalized letters shall have the meanings set forth in this Agreement, and (i) the
singular includes the plural and vice versa, (ii) reference to any document means such
document as amended from time to time, (iii) "include" or "including" means including
without limiting the generality of any description preceding such term, and (iv) the term
"or" is not exclusive.
II. NFP OBLIGATIONS
PortArthur _TX_NFPAgrmt_Exp20150831 Page 2 of 20
A. NFP grants to Agency a non - exclusive limited right and license to use the Proprietary
Property for the purpose of carrying out Agency's obligations under this Agreement in
the geographic area within which Agency Nurse Home Visitors serve Clients. NFP
reserves the right to modify the Proprietary Property from time to time in accordance with
the data, research, and current modalities of delivery of the Program. NFP will provide
reasonable notice of those modifications as set forth in the Implementation Agreement.
NFP shall retain ownership and all of the rights to any Proprietary Property, whether
modified or not by any Agency. In any event, all software and ETO Website content,
excluding Agency's and other agencies' data, shall remain the sole property of NFP.
B. NFP will provide support to help Agency implement the Program as described in Exhibit
B, Nurse - Family Partnership Support for an Agency.
C. NFP shall submit invoices to Agency for services provided to Agency, listing a date of
provision, a description of each such service, and amounts based upon the fee schedule
provided in Exhibit C, Fees for Nurse - Family Partnership Services.
D. NFP may, from time to time, request that Agency collect additional data and /or
participate in Research initiated by NFP and intended to improve the NFP model or
implementation of the model. NFP may provide the public with information about
Agency's NFP - related Research, publications, and presentations.
E. NFP, independently or jointly with Agency, may publish or present NFP - related
information or Program results in research reports, books, book chapters, peer- reviewed
journal articles, and at academic or professional conferences, always giving due credit to
the Parties involved and recognizing the rights of the individuals doing the work.
F. NFP understands that pursuant to this Agreement, NFP and its employees may have
access to patients' Protected Health Information ( "PHI ") and Agency's business
information. NFP acknowledges that this information has a high level of confidentiality,
and NFP and its employees agree to keep all information made available to its
employees confidential and not to disclose this information. NFP will instruct its
employees /staff /affiliates to follow Agency's policies regarding patient and business
confidentiality. Further, NFP acknowledges that Agency is bound by law to have written
agreements with its business partners who may have access to patient information
requiring compliance with the Health Insurance Portability and Accountability Act of 1996
(HIPAA) and the rules and regulations promulgated thereunder. Accordingly, NFP
warrants and represents that NFP is in compliance with HIPAA and all relevant federal
statutes, rules, regulations, and applicable interpretive rulings promulgated under
HIPAA, or will become compliant to regulations and requirements effective at future
dates according to the applicable timetables. Exhibit D, HIPAA Business Associate
Addendum, is hereby incorporated in this Agreement. Failure by NFP to comply with
this provision and the provisions of Exhibit D, HIPAA Business Associate Addendum,
shall result in immediate and automatic termination of this Agreement without penalty or
cost to Agency. NFP will cooperate with any Agency program(s) instituted in the future
to bring Agency into compliance with HIPAA.
III. AGENCY OBLIGATIONS
A. Agency will make best efforts to implement the Program with Fidelity to the Model and
will undertake the steps described in Exhibit E, Agency Responsibilities, in order to do
SO.
PortArthur _TX_NFPAgrmt_Exp20150831 Page 3 of 20
B. Agency will take all appropriate steps to maintain client confidentiality and obtain any
necessary written client consents for data analysis or disclosure of protected health
information, in accordance with applicable federal and state laws, including, but not
limited to, authorizations, data use agreements, business associate agreements, as
necessary.
C. Agency assumes responsibility for knowledge of and compliance with the State Nurse
Practice Act of its state, state laws, regulations, and licensing requirements pertaining to
nursing practice and state laws and regulations pertaining to mandatory reporting.
D. Agency will ensure that nurses whom it employs to implement that Program are able to
provide care to clients in a manner consistent with the NFP Visit -to -Visit Guidelines.
E. When requested by NFP, Agency will make reasonable efforts to collect additional data
and /or participate in Research intended to improve the NFP model or implementation of
the model.
F. In order to avoid becoming involved in Research that conflicts with implementing the
Program with Fidelity to the Model, Agency will request NFP's permission prior to
participating in any Research that is (1) initiated by a party other than NFP and (2) that
involves Program staff or explicitly targets the families that are enrolled in the Program.
NFP will review and approve or disapprove Agency's request for participation in such
Research on a timely basis and will not unreasonably withhold such approval.
G. Agency will inform NFP of Agency proposals to publish or present NFP - related
information in research reports, books, book chapters, peer- reviewed journal articles,
and at academic or professional conferences. Results of the Program herein outlined
may be published by Agency, or jointly by Agency and NFP, always giving due credit to
the Parties involved and recognizing the rights of the individuals doing the work.
H. Agency is authorized to reproduce certain published materials specified below and used
in the implementation of the Program so long as (1) this Agreement is in effect, (2)
Agency uses the reproductions solely for Program implementation, and (3) Agency does
not sell or otherwise distribute the reproductions to any third party not involved in
Agency's implementation of the Program.
1. The published materials covered by this authorization are delivered to Nurse Home
Visitors as part of the Nurse - Family Partnership Home Visitor education materials in
sets referred to as follows:
a) Pregnancy Facilitators and Handouts
b) Infancy Facilitators and Handouts
c) Toddler Facilitators and Handouts
2. The handouts bear notices indicating copyright by any of the following:
a) University of Colorado
b) University of Colorado Health Sciences Center
c) University of Colorado at Denver and Health Sciences Center
d) Nurse - Family Partnership
3. NFP has the right to grant permission to reproduce materials specified above and
that bear the University copyright notice under the terms of a Memorandum of
Understanding ( "MOU ") dated March 31, 2003, between the University of Colorado
Health Sciences Center, now known as University of Colorado at Denver and Health
Sciences Center, and NFP. The MOU gives NFP an exclusive, perpetual, royalty -
PortArthur_TX_NFPAgrmt_Exp20150831 Page 4 of 20
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free right and license to use copyrighted materials and other materials used in the
Program for the purpose of implementing the Program to serve low- income, first -time
mothers and their families.
4. The corresponding Spanish - language versions of these materials are also covered
by this authorization.
5. Agency may not authorize any other entity to reproduce the materials without prior
written permission from NFP.
I. Agency understands and agrees that all Proprietary Property is owned exclusively by
NFP and its licensors, including all intellectual property rights therein. Agency shall use
the Proprietary Property solely for the purpose of carrying out Agency's obligations
under this Agreement and shall not modify any Proprietary Property without the prior
express written permission of NFP. Agency shall protect all Proprietary Property that
belongs to NFP or its licensors. Agency shall not duplicate and shall prohibit distribution
of or access to Visit -to -Visit Guidelines and the ETO to any individual or organization not
party to the implementation, administration, and operation of the Program, except as
authorized by this Agreement. Agency shall not change or alter the ETO software, and
shall allow only trained, NFP- authorized users to access the ETO Website. If a person
leaves Agency's employ, Agency shall retrieve all Proprietary Property that the person
may have in his or her possession.
IV. FEES AND PAYMENT
A. Fees associated with NFP services in support of an implementing agency are as follows:
1. Initial Education Services. NFP provides initial Nurse - Family Partnership education
for nurse home visitors, Program Supervisors, and Agency Administrators. This fee
applies once for each individual nurse home visitor, nurse supervisor, and
administrator at an agency. Fees are due upon completion of the face -to -face
session.
a) Nurse Home Visitor Initial Education Tuition. Education for nurse home visitors
(NHV) consists of one face -to -face education unit supported by distance
education components. All Program Supervisors who have never taken NHV
Education or who completed it more than two years prior to being promoted to
Supervisor are required to attend NHV Education as well as Supervisor
Education.
b) Supervisor Initial Education Tuition. For Program Supervisors, education
consists of Nurse Home Visitor Initial Education plus two face -to -face education
units supported by distance education components and nurse consultation.
c) Annual Supervisor Education. Program Supervisors are required to attend a
three day face -to -face session held annually in Denver. There is no tuition or
registration fee.
d) Agency Administrator Orientation Tuition. A two day face -to -face session in
Denver, required for new administrators and recommended for experienced
administrators.
e) Nurse - Family Partnership Education Materials Fee. Contributes toward the cost
of the following materials :
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PortArthur _TX_NFPAgrmt_Exp20150831 Pa g
(1) Nurse - Family Partnership Orientation Materials
(2) Set of Prenatal, Infancy and Toddler Guidelines
(3) A series of additional nursing practice and program management resources
tied to implementation of Nurse - Family Partnership.
2. Implementation Support Services. Fees are due on the Effective Date and each
anniversary thereof and are based on the number of Program Supervisor Positions
(the greater of (1) the number of individuals with supervisory responsibility at the
agency or (2) the number of supervisor FTEs that are required to be implementing
the model with fidelity (at least one per eight nurse home visitors). Fees are as
follows:
a) Program Support. Fees are per Program Supervisor Position per year and
contribute to covering costs associated with the following:
(1) Data system (ETO) operation and use, Program Quality System, and
Reporting.
(2) Ongoing Nurse - Family Partnership nurse home visitor, supervisor, and
administrator education; resource library; conference calls; web forums;
Nurse - Family Partnership Community resources; and updating of Nurse -
Family Partnership Education and Visit -to -Visit Guidelines and supporting
materials.
(3) Marketing and Communications consultation and support, including
marketing and community outreach materials (brochures, posters, Client
Referral Kits (with wallet cards, counter display, posters, and other program
information); health fair bags, and nurse recruitment packets. The agency,
however, is responsible for printing, stamping or affixing labels with their local
contact information to the majority of these materials. Client Referral Kits are
customized /printed at no additional charge to the agency. Also provided are
the NFP marketing and communications resources and guidance and a copy
of the NFP Public Awareness Video, as well as updates and regular monthly
communications from the NFP National Service Office.
(4) Policy and Government Affairs, including advocacy and educational work at
federal and state levels.
b) Nurse Consultation. The fee is per Program Supervisor Position per year. The
full fee is charged for the first Program Supervisor Position at a geographic
location and a reduced fee is charged for each additional Program Supervisor
Position at that same location. The fees contribute to covering costs associated
with a Nurse - Family Partnership Nurse Consultant providing the following
support to Program Supervisors:
(1) Helping each Program Supervisor develop an annual plan for
implementation.
(2) Monitoring reports based on each Program Supervisor and her /his team's
activity and performance.
(3) Ongoing email support for each Program Supervisor and periodic regular
calls with each Program Supervisor.
(4) Periodic visits to each Program Supervisor with potential travel with each
Program Supervisor and /or selected nurse home visitors.
(5) Clinical and supervisory coaching and consultation with each Program
Supervisor.
c) Program Supervisor Expansion or Replacement Fee. A one -time fixed fee is
charged for extra support when a new Program Supervisor Position is added or a
vacant position is filled.
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B. The amount payable under this Agreement shall include the following:
1. Fees for the initial NFP education of Program Supervisors and Nurse Home Visitors,
if any, plus $7,046 per Program Supervisor Position for Program Support, $8,447 per
first Program Supervisor Position at each geographic location, and $5,068 per
additional Program Supervisor Position at each geographic location, for the period
from September 1, 2012, through August 31, 2013.
2. Fees for the initial NFP education of Program Supervisors and Nurse Home Visitors,
if any, plus $7,046 per Program Supervisor Position for Program Support, $8,447 per
first Program Supervisor Position at each geographic location, and $5,068 per
additional Program Supervisor Position at each geographic location, for the period
from September 1, 2013, through August 31, 2014.
3. Fees for the initial NFP education of Program Supervisors and Nurse Home Visitors,
if any, plus $7,046 per Program Supervisor Position for Program Support, $8,447 per
first Program Supervisor at each geographic location, and $5,068 per additional
Program Supervisor Position at each geographic location, for the period from
September 1, 2014, through August 31, 2015.
C. Prices are subject to change in accordance with Section IV E below.
D. All fees are based upon NFP's standard terms of invoicing and payment, as follows:
1. Education Fees are invoiced when individuals attend in- person education sessions.
No special reporting or documentation is provided with the invoice(s).
2. Program Support and Nurse Consultation Fees are invoiced on the Effective Date
and each anniversary thereof to cover each ensuing year and are due in 30 days.
No special reporting or documentation is provided with the invoice(s).
3. Program Supervisor Expansion or Replacement Fees are invoiced when the new
supervisor is hired. No special reporting or documentation is provided with the
invoice(s).
E. NFP shall invoice for services provided to Agency based upon the fee schedule set forth
in Exhibit C, Fees for Nurse - Family Partnership Services. NFP reserves the right to
change the fees set forth in Exhibit C during the term of this Agreement but not more
often than annually. NFP will notify Agency at least one year prior to any such change
becoming effective.
F. Invoices will be sent to:
City of Port Arthur
ATTN: Health Department
449 Austin Avenue
Port Arthur, TX 77640
G. Agency will send payments, identifying the NFP invoice, within 30 days of invoice to:
Nurse - Family Partnership
Attention: Finance Department
1900 Grant Street, Suite 400
Denver, CO 80203
V. TERM AND DEFAULT
A. Term of Agreement. This Agreement shall remain in full force and effect through August
31, 2015, unless it is terminated by mutual agreement of the Parties or as otherwise
provided below.
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B. Term Extension. Upon September 1, 2015, and each anniversary of that date, this
Agreement shall automatically extend for an additional year unless either party has
provided not less than sixty (60) days' notice to the other of its intention to terminate the
Agreement on the upcoming anniversary date.
C. Early Termination. The Parties agree that they intend to and will engage in mutual
efforts to keep this Agreement in force. Recognizing, however, that circumstances
beyond the control of the Parties may compel one Party to desire termination before
completion of the term or an extension thereof, either Agency or NFP may terminate this
Agreement at any time by giving the other party written notice of not less than sixty (60)
days.
D. Default. A party shall be in default under this Agreement if a party (i) breaches a
material provision of this Agreement, which breach is not cured to the non - breaching
party's reasonable satisfaction within thirty (30) days of written notice given to the
breaching party by the non - breaching party or (ii) the bankruptcy of a party.
E. Remedies upon Default. The Parties shall use commercially reasonable efforts to take
steps necessary to cause the breaching party to cure the applicable default. If such
default is not cured to the reasonable satisfaction of the other party, and both of the
Parties do not agree to terminate this Agreement, the Parties shall proceed in
accordance with the dispute resolution process set forth in Section VI.
F. Effect of Termination.
1. If this Agreement is terminated by notice of one party to the other, Agency will pay
NFP for all work performed up to the date of termination and all non - cancelable
obligations incurred in accordance with this Agreement. Payment shall be due within
thirty (30) days of termination.
2. If this Agreement is terminated through the dispute resolution process, the rights and
obligations of each of the Parties upon termination shall be spelled out in the dispute
resolution process.
3. Upon termination of this Agreement, regardless of the timing, cause, or mechanism
of such termination:
a) Agency will no longer have access to ETO or the ETO Website;
b) All software and ETO Website content, excluding data which has been collected
by Agency in the course of implementing the Program, shall remain the sole
property of NFP;
c) NFP may retain a record of all data which has been collected by Agency in the
course of implementing the Program and may use that data and reports derived
from it to evaluate the overall progress in national replication of the Program;
d) Agency and NFP will continue to comply with all relevant state, federal laws and
all other provisions of this Agreement with respect to maintaining Client
confidentiality;
e) All materials in Agency's possession that utilize the Nurse - Family Partnership
logo, tag line, or other protected marks must be returned to NFP or destroyed;
f) All copies of Proprietary Property that have been provided to Agency by NFP or
that have come into Agency's possession from other sources must be returned to
NFP or destroyed; and
g) Agency will cease to implement the Program and will cease to represent that it is
implementing the Program.
VI. DISPUTE RESOLUTION. If a dispute arises relating to this Agreement, the Parties shall
attempt to resolve that dispute at the lowest possible level. If the dispute cannot be resolved
PortArthur _TX_NFPAgrmt_Exp20150831 Page 8 of 20
at that level, the dispute shall be elevated to the Director, Program Development, of NFP
and the Program Supervisor. If these persons cannot resolve the dispute, it shall be
elevated to the next organizational level of NFP and Agency. If the dispute is not resolved
through the foregoing process within a reasonable period of time, not to exceed any period
of time that could reasonably be deemed to have a detrimental impact on the
implementation of the Program by Agency, either party may initiate dispute resolution
through any avenue permitted in law or in equity.
VII. LIABILITY.
A. Each party hereto agrees to be responsible and assume liability for its own wrongful or
negligent acts or omissions, or those of its officers, agents, or employees to the full
extent allowed by law.
B. No liability hereunder shall result to a party by reason of delay in performance caused by
force majeure, that is, circumstances beyond the reasonable control of the party.
VIII. ASSIGNMENT; SUBCONTRACTING. Except as provided herein, this Agreement, and
the rights and obligations hereunder, is not assignable or transferable by either party without
the prior written consent of the other party. Without limiting the previous sentence, Agency
shall not have the right to engage or utilize the services of any subcontractor to perform any
of Agency's services hereunder without the prior written consent of NFP.
IX. MISCELLANEOUS PROVISIONS.
A. Consents. Whenever a Party's consent or approval is required under this Agreement,
such consent or approval shall not be unreasonably withheld. If consent or approval is
required by an employee of a Party, the Party who employs such employee shall cause
the employee to give or withhold such consent or approval in accordance with this
Paragraph. If no response is received by the requesting Party within ten business days
after delivery of the applicable request, consent shall be deemed given.
B. Notices. All notices and other communications that are required or permitted to be given
to the Parties under this Agreement shall be sufficient in all respects if given in writing
and delivered by overnight courier or certified mail, postage prepaid, return receipt
requested, to the receiving party at the following address:
For NFP:
Original to: With a copy to:
Nurse - Family Partnership Nurse - Family Partnership
1900 Grant Street, Suite400 1900 Grant Street, Suite400
Denver, CO 80203 Denver, CO 80203
Attention: Chief Executive Officer Attention: Legal Affairs Manager
Telephone: 303 - 327 -4274 Telephone: 303 - 327 -4271
Facsimile: 303 - 327 -4260 Facsimile: 303 - 327 -4260
Email: Email:
Tom. Jenkins @NurseFamilyPartnership.org Elizabeth. Jasper @NurseFamilyPartnership.org
PortArthur _TX_NFPAgrmt_Exp20150831 Page 9 of 20
For Agency:
Original to: With a copy to:
City of Port Arthur Health Department City of Port Arthur
449 Austin Avenue 449 Austin Avenue
Port Arthur, TX 77640 Port Arthur, TX 77640
Attention: Judith Smith, BSN, RN Attention: Cyndi Zoch
Telephone: 409 983 -8862 Telephone: 409 983 -8886
Facsimile: 409 984 -9093 Facsimile: 409 983 -1097
Email: Judith @portartur.net Email: Cyndi(a�portarthur.net
or to such other address as such party may have given to the other by notice pursuant to
this Paragraph. Notice shall be deemed given on the delivery or refusal date, as
specified on the return receipt in the case of certified mail or on the tracking report in the
case of overnight courier.
C. Binding Upon Successors and Assigns. This Agreement, and all covenants, terms,
provisions, and agreements contained herein, shall be binding upon and shall inure to
the benefit of the Parties' respective successors and permitted assigns.
D. Waivers. No covenant, term, or condition, or the breach thereof, shall be deemed
waived, except by written consent of the party against whom the waiver is claimed; and
any waiver of the breach of any covenant, term, or condition shall not be deemed to be a
waiver of any preceding or succeeding breach of the same or any other covenant, term,
or condition.
E. Responsibility for Debts and Obligations. Neither party shall be responsible either
directly or indirectly for any of the debts or obligations of the other party except as
provided under this Agreement.
F. No Third Party Beneficiary. This Agreement does not create any third party beneficiary
rights in any person or entity.
G. Authority to Contract. The undersigned individuals represent that they are fully
authorized to execute this Agreement on behalf of the respective Parties and make all
representations, warranties, and covenants set forth herein. The Parties represent and
warrant that the execution, delivery, and performance of this Agreement have been duly
authorized by all necessary corporate actions of the Parties and do not violate any laws
or any provisions of any agreement to which the Parties are bound.
H. No Joint Venture. Nothing contained in this Agreement shall be deemed or construed as
creating a joint venture or partnership among the Parties. No party shall have the power
to control the activities or operations of another party and their status is, and at all times
shall continue to be, that of independent contractors with respect to each other. No
party shall hold itself out as having authority or relationship in contravention of this
Paragraph.
I. Attorneys' Fees. If a party shall commence any action or proceeding against another
party in order to enforce the provisions of this Agreement, or to recover damages as a
result of the alleged breach of any of the provisions of this Agreement, the prevailing
party shall be entitled to recover all reasonable costs in connection therewith, including
reasonable attorneys' fees.
PortArthur _TX_NFPAgrmt_Exp20150831 Page 10 of 20
J. Further Assurances. The Parties shall cooperate fully with each other and execute such
further instruments, documents, and agreements, and shall give such further written
assurances, as may be reasonably requested by another party to better evidence and
reflect the transactions described herein and contemplated hereby, and to carry into
effect the intent and purposes of this Agreement.
K. Entire Agreement. This Agreement (together with Exhibits hereto, which are hereby
incorporated by this reference) constitutes the entire agreement between the Parties
relating to the subject matter hereof and supersedes all prior or contemporaneous
agreements, whether written or oral, among themselves or their agents and representa-
tives relating to the subject hereof. This Agreement may be altered, amended, or
revoked only by an instrument in writing signed by all the Parties hereto.
L. Severability. If any term or provision of this Agreement shall, to any extent, be
determined to be invalid or unenforceable by a court or body of competent jurisdiction,
the remainder of this Agreement shall not be affected thereby, and each term and
provision of this Agreement shall be valid and enforceable to the fullest extent permitted
by law.
M. Applicable Law. This Agreement shall be governed by and construed according to the
internal laws of the State of Colorado. By execution of this Agreement, each party
submits and irrevocably waives any objection to in personam jurisdiction in the State of
Colorado and the forum and convenience of the state and federal courts thereof.
N. Survival. The terms and conditions of this Agreement shall survive the expiration or
termination of this Agreement to the full extent necessary for their enforcement and for
the protection of the party in whose favor they operate.
O. Counterparts and Facsimile Signatures. This Agreement may be executed in two or
more counterparts, each of which shall be deemed an original and all of which, taken
together, shall constitute one agreement. A facsimile signature to this Agreement shall
be deemed an original and binding upon the party against whom enforcement is sought.
IN WITNESS WHEREOF, the Parties hereto have caused this Agreement to be executed as of
the date set forth herein by their duly authorized representatives.
For NFP: For Agency:
Nurse - Family Partnership City of Port Arthur
By: By:
Wallace P. Dunlap, Chief Planning & Floyd T. Johnson, City Manager
Administrative Officer
Date: Date:
Federal EIN: 20- 0234163
PortArthur _TX_NFPAgrmt_Exp20150831 Page 11 of 20
EXHIBIT A. NURSE - FAMILY PARTNERSHIP MODEL ELEMENTS
When the Program is implemented in accordance with these Model Elements, the Parties can
reasonably have a high level of confidence that results will be comparable to those measured in
research. Conversely, if implementation does not incorporate these Model Elements, results
may be different from research results.
Element 1 Client participates voluntarily in the Nurse - Family Partnership program.
Element 2 Client is a first -time mother.
Element 3 Client meets low- income criteria at intake.
Element 4 Client is enrolled in the program early in her pregnancy and receives her first home
visit by no later than the end of the 28 week of pregnancy.
Element 5 Client is visited one to one, one Nurse Home Visitor to one first -time mother/ family.
Element 6 Client is visited in her home.
Element 7 Client is visited throughout her pregnancy and the first two years of her child's life in
accordance with the current Nurse - Family Partnership Guidelines.
Element 8 Nurse Home Visitors and Nursing Supervisors are registered professional nurses
with a minimum of a Baccalaureate degree in nursing.
Element 9 Nurse Home Visitors and Nursing Supervisors complete educational sessions
required by NFP NSO and deliver the intervention with fidelity to the NFP Model.
Element 10 Nurse Home Visitors, using professional knowledge, judgment, and skill, apply
the Nurse - Family Partnership Visit -to -Visit Guidelines individualizing them to the strengths and
challenges of each family and apportioning time across defined program domains.
Element 11 Nurse Home Visitors apply the theoretical frameworks that underpin the program,
emphasizing Self- Efficacy, Human Ecology, and Attachment theories, through current clinical
methods
Element 12 A full time Nurse Home Visitor carries a case load of no more than 25 active
clients.
Element 13 A full -time Nursing Supervisor provides supervision to no more than 8 individual
Nurse Home Visitors
Element 14 Nursing Supervisors provide Nurse Home Visitors clinical supervision with
reflection, demonstrate integration of the theories, and facilitate professional development
essential to the Nurse Home Visitor role through specific supervisory activities including 1:1
clinical supervision, case conferences, team meetings and field supervision.
Element 15 Nurse Home Visitor and Supervisors collect data as specified by the NFP NSO
and use NFP Reports to guide their practice, assess and guide program implementation, inform
clinical supervision, enhance program quality, and demonstrate program fidelity.
PortArthur _TX_NFPAgrmt_Exp20150831 Page 12 of 20
Element 16 Nurse - Family Partnership Implementing Agency is located in and operated by an
organization known in the community for being a successful provider of prevention services to
low- income families.
Element 17 Nurse - Family Partnership Implementing Agency convenes a long -term
Community Advisory Board that meets at least quarterly to promote a community support
system to the program and to promote program quality and sustainability.
Element 18 Adequate support and structure shall be in place to support Nurse Home Visitors
and Nursing Supervisors to implement the program and to assure that data is accurately
entered into the data base in a timely manner.
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EXHIBIT B. NURSE - FAMILY PARTNERSHIP SUPPORT FOR AN AGENCY
To help Agency implement the Program with Fidelity to the Model, NFP provides the following
support to Agency:
I. NFP provides support to help Agency prepare to implement the Program including:
A. Materials to help Agency:
1. Maintain Agency's work space;
2. Maintain telecommunications and computer capabilities;
3. Recruit, hire, and retain Program Supervisors, Nurse Home Visitors, and
administrative support staff;
4. Maintain and improve a network of sources who may refer low- income, first -time
mothers to Agency;
5. Facilitate enrollment of Clients;
6. Maintain and improve a network of social services that can provide support to
Agency's Clients;
7. Work with media;
8. Inform the community and build support for Agency, the Program, and Program
Benefits;
9. Establish and maintain strong, stable, and sustainable funding for Agency
operations.
B. An ETO users' manual, which provides instructions describing what data must be
collected for ETO by Agency staff, how that data must be entered into ETO, and how
reports can be obtained. NFP may modify the ETO users' manual from time to time and
will provide Agency with updated versions on a timely basis.
C. Access to an Internet -based discussion forum with other entities that are implementing
the Program.
D. A visit to Agency by a member of NFP staff to offer direct consultation on Program
implementation.
II. NFP provides ongoing support to Agency via telephone and email during Program
implementation and operation, including:
A. Consultation with respect to topics such as human resources, developing community
support, keeping interested constituencies informed about progress and results,
planning and implementing expansion, and sustaining and increasing funding;
B. Clinical consultation for Program Supervisors and Nurse Home Visitors;
C. Consultation regarding data collection, entry, management, and interpretation.
D. On -site consultation as is mutually deemed necessary and appropriate.
III. NFP provides a description of education programs, both required and optional, and a
schedule of upcoming education events and locations. NFP may modify the specific names,
descriptions, and content of education programs, as well as their schedule and locations
from time to time and will inform Agency of such modifications on a timely basis.
IV. NFP provides education to Program Supervisors and Nurse Home Visitors at dates and
locations to be determined by NFP. Education will cover the following topics:
A. The Program, Program Benefits, and Model Elements;
B. Use of ETO, including data collection, entry, management, and interpretation;
C. Implementation of the Program using the NFP Visit -to -Visit Guidelines and associated
tools and materials;
D. Knowledge and skills needed by the NFP Program Supervisor; and
E. Other aspects of the Program that NFP believes are warranted for successful Program
implementation by the staff at Agency.
PortArthur _TX_NFPAgrmt_Exp20150831 Page 14 of 20
V. NFP provides Visit -to -Visit Guidelines and other materials to help Program Supervisors and
Nurse Home Visitors implement the Program with Fidelity to the Model Elements. NFP may
modify the Visit -to -Visit Guidelines from time to time and will provide Agency with updated
versions on a timely basis.
VI. NFP provides support for Agency's use of ETO, including:
A. Monitoring the Agency's data collection and entry activity and quality and providing
feedback to Agency as appropriate;
B. Maintaining and supporting ETO software;
C. Upgrading ETO software when deemed necessary by NFP; and
D. Technical assistance via telephone or e-mail to support Agency's use of ETO.
VII. NFP provides implementation reports and evaluation reports at such times as NFP deems
commercially reasonable and necessary to meet the needs of Agency and entities to which
Agency may be obligated to provide such information. Subject to applicable federal and
state laws, if any, such reports cover:
A. Agency activity. Reports designed primarily for Program Supervisors and Nurse Home
Visitors to help them manage Nurse Home Visitor activity.
B. Quality improvement. Reports aimed to help Agency improve Fidelity to the Model
including reports designed (i) to assist Program Supervisors and Nurse Home Visitors
identify and prioritize actions for improving Program outcomes, and (ii) to help NFP staff
assess how Agencies are performing with respect to Fidelity to the Model.
C. Program outcomes. Reports designed to help Program Supervisors and funding
decision makers assess the effectiveness of the Program as applied to Agency's
particular circumstances.
D. These reports are available on a pre- defined schedule or from the ETO Website on
demand. NFP may modify the Program Reports from time to time.
VIII. NFP will provide art work and color and usage guidelines to help Agency develop and
produce communications materials that properly use the NFP trademark, logo, tag lines, and
other copyrighted or otherwise protected language, images, and materials controlled by
NFP.
IX. From time to time, NFP may engage either internal or external auditors to evaluate the
performance of the Agency. Agency will cooperate fully with any quality audit that is
undertaken by or on behalf of NFP.
PortArthur _TX_NFPAgrmt_Exp20150831 Page 15 of 20
1
EXHIBIT C. FEES FOR NURSE - FAMILY PARTNERSHIP SERVICES
NFP fees for services provided under this Agreement will be as follows, subject to change in
accordance with Section IV E:
Initial NFP Education Fee (Invoiced upon completion of the face -to -face session)
Price Effective Date End Date Unit Price Unit of Measure
9/1/2012 8/31/2013 $4,069.00 One time per NHV or Supervisor
9/1/2013 8/31/2014 $4,069.00
9/1/2014 8/31/2015 $4,069.00 _
Initial NFP Program Su ervisor Education Fee (Invoiced upon completion of the first face -to -face session)
Price Effective Date End Date Unit Price Unit of Measure
9/1/2012 8/31/2013 $734.00 One time per Supervisor
9/1/2013 8/31/2014 $734.00
9/1/2014 8/31/2015 $734.00
NFP Agency Administrator Education Fee (Invoiced upon completion of the first face -to -face session)
Price Effective Date End Date Unit Price Unit of Measure
9/1/2012 8/31/2013 $480.00 One time per Administrator
9/1 /2013 8/31 /2014 $480.00
9/1 /2014 8/31 /2015 $480.00
Initial NFP Educational Materials Fee (Invoiced u on completion of the face -to -face NHV Education session)
Price Effective Date End Date Unit Price Unit of Measure
9/1/2012 8/31/2013 $517.00 One time per NHV Trainee
9/1/2013 8/31/2014 $517.00
9/1/2014_ 8/31/2015 $517.00
Annual Program Support Fee (Invoiced annually on the Price Effective Date
Price Effective Date End Date Unit Price Unit of Measure
9/1/2012 8/31/2013 $7,046.00 Per Program Supervisor Position
9/1/2013 8/31/2014 $7,046.00 per Year
9/1/2014 8/31/2015 $7,046.00
Annual Nurse Consultation Fee for Each First Program Supervisor at a Location
(Invoiced annually on the Price Effective Date)
Price Effective Date End Date Unit Price Unit of Measure
9/1/2012 8/31/2013 $8,447.00 Per Program Supervisor Position
9/1/2013 8/31/2014 $8,447.00 per Year
9/1/2014 8/31/2015 $8,447.00
Annual Nurse Consultation Fee for Each Additional Program Supervisor at a Location
(Invoiced annually on the Price Effective Date)
Price Effective Date End Date Unit Price Unit of Measure
9/1/2012 8/31/2013 $5,068.00 Per Program Supervisor Position
9/1/2013 8/31/2014 $5,068.00 per Year
9/1/2014 8/31/2015 $5,068.00
Program Supervisor Ex ansion or Replacement Fee (Invoiced at the time of hire)
Price Effective Date End Date Unit Price Unit of Measure
9/1/2012 8/31/2013 $2,764.00 One time per Expansion or Replacement
9/1/2013 8/31/2014 $2,764.00 Program Supervisor
9/1/2014 8/31/2015 $2,764.00 per Year
I
PortArthur _TX_NFPAgrmt_Exp20150831 Page 16 of 20
1
EXHIBIT D. HIPAA BUSINESS ASSOCIATE ADDENDUM
I. The U.S Department of Health and Human Services has issued final regulations, pursuant
to the Health Insurance Portability and Accountability Act of 1996 ( "HIPAA "), governing the
privacy of individually identifiable health information. See 45 CFR Parts 160 and 164 (the
"HIPAA Privacy Rule "). The Agency, as a "Covered Entity" as defined by HIPAA, is a
provider of health care, a health plan, or otherwise has possession, custody, or control of
health care information or records.
II. "Protected health information" ( "PHI ") means individually identifiable health information
including all information, data, documentation and records, including but not limited to
demographic, medical, and financial information that relates to the past, present, or future
physical or mental health or condition on an individual; the provision of health care to an
individual or payment for health care provided to an individual; and that identifies the
individual or which Agency believes could be used to identify the individual.
A. "Electronic protected health information" means PHI that is transmitted by electronic
media or maintained in electronic media.
B. "Security incident" means the attempted or successful unauthorized access, use,
disclosure, modification, or destruction of information or interference with system
operations in an information system.
III. NFP is considered a Business Associate of Agency, as NFP either: (A) performs certain
functions on behalf of or for Agency that may involve the use or disclosure of protected
individually identifiable health information by Agency to NFP, or the creation or receipt of
PHI by NFP on behalf of Agency; or (B) provides legal, actuarial, accounting, consulting,
data aggregation, management, administrative, accreditation, financial or social services for
Agency involving the disclosure of PHI.
IV. NFP agrees that all PHI obtained as a result of this Agreement shall be kept confidential by
NFP, its agents, employees, successors and assigns as required by HIPAA law and
regulations and by this Agreement and addendum.
V. NFP agrees to use or disclose PHI solely (A) for meeting its obligations under this
Agreement, or (B) as required by law, rule or regulation or as otherwise permitted under this
Agreement of the HIPAA Privacy Rule.
VI. The parties acknowledge that data that may be (but is not with certainty) PHI is collected
during the term of this Agreement for NFP's reporting and evaluation of (a) Agency's
implementation of the Program, (b) comparison of Agency's implementation of the Program
with implementation by other entities, and (c) regional and national patterns and trends in
Program implementation. Returning this data is not feasible. Therefore, NFP shall extend
the protections of this Agreement to such data and /or PHI and limit further uses and
disclosures of such data and /or PHI to those set out in this agreement for so long as NFP
maintains such data and /or PHI. If it becomes necessary for NFP to use the data and /or
PHI in any manner other than what is contemplated in this Agreement, NFP agrees to
consult with and obtain the permission of the Agency.
VII. In the course of providing the services to Agency under the terms of this agreement, NFP
will be enabling the Prevention Research Center for Family and Child Health ( "PRC "), an
organization which is part of the University of Colorado at Denver and Health Sciences
Center, to access data that may be PHI for the purposes of research, analysis, and
reporting. NFP will ensure that PRC and its employees and NFP's agents, employees,
subcontractors or others to whom it provides PHI received by or created by NFP on behalf of
Agency agree to the same restrictions and conditions that apply to NFP with respect to such
information. NFP also agrees to take all reasonable steps to ensure that its employees',
agents', or subcontractors' actions or omissions do not cause NFP to breach the terms of
this Addendum. NFP will use all appropriate safeguards to prevent the use or disclosure of
PHI other than pursuant to the terms and conditions of this Agreement and Addendum.
PortArthur _TX_NFPAgrmt_Exp20150831 Page 17 of 20
VIII. NFP shall, within three (3) days of becoming aware of any use or disclosure of PHI,
other than as permitted by this contract and Addendum, report such disclosure in writing to
Agency.
IX. NFP shall make available such information in its possession which is required for Agency to
provide an accounting of disclosures in accordance with 45 CFR 164.528. In the event that
a request for accounting is made directly to NFP, NFP shall forward such request to Agency
within two (2) days of such receipt. NFP shall implement an appropriate record keeping
process to enable it to comply with the requirements of this provision. NFP shall maintain
data on all disclosures of PHI for which accounting is required by 45 CFR 164.528 for at
least six (6) years after the date of the last such disclosure.
X. NFP shall make PHI available to Agency upon request in accordance with 45 CFR 164.524.
XI. NFP shall make PHI available to Agency upon request for amendment and shall incorporate
any amendments to PHI in accordance with 45 CFR 164.526.
XII. NFP shall make its internal practices, books, and records relating to the use and disclosure
of PHI received from or created or received by NFP on behalf of Agency available to the
Secretary of the U.S. DHHS for purposes of determining Agency's compliance with the
HIPAA Privacy Rule.
XIII. Compliance with Security Regulations: In addition to the other provisions of this
Addendum, if NFP creates, receives, maintains, or transmits electronic PHI on Agency's
behalf, NFP shall:
A. Implement administrative, physical, and technical safeguards that reasonably and
appropriately protect the confidentiality, integrity, and availability of the electronic
protected health information that it creates, receives, maintains, or transmits on behalf of
Agency;
B. Ensure that any agent, including a subcontractor, to whom it provides such information
agrees to implement reasonable and appropriate safeguards to protect it; and
C. Report to Agency any security incident of which it becomes aware.
XIV. NFP agrees to indemnify and hold Agency harmless from and against all liability and
costs, including attorneys' fees, created by a breach of this Addendum by NFP, its agents,
employees, or subcontractors, without regard to any limitation or exclusion of damages
provision otherwise set forth in the Agreement.
XV.Notwithstanding any other provision of the Agreement, Agency shall have the right to
terminate the Agreement immediately if Agency determines that NFP has violated any
material term of this Exhibit D.
PortArthur _TX_NFPAgrmt_Exp20150831 Page 18 of 20
EXHIBIT E. AGENCY RESPONSIBILITIES
To ensure that the Nurse - Family Partnership Program is implemented with Fidelity to the
Model, Agency will undertake the following actions during initial implementation and ongoing
operation:
I. Agency will:
A. Maintain an appropriate work space for staff who are to implement the Program;
B. Maintain appropriate telecommunications and computer capabilities for staff;
C. Recruit, hire, and retain Program Supervisors, Nurse Home Visitors, and
administrative support staff;
D. Maintain and improve a network of referral sources who may refer low- income, first -
time mothers to Agency;
E. Enroll clients that meet the criteria specified in the Model Elements.
F. Maintain and improve a network of social services that can provide support to
Agency's Clients;
G. Work with media to ensure timely and accurate communication to the public about
the Program and its implementation by Agency;
H. Inform the community and build support for Agency, the Program, and Program
Benefits;
I. Establish and maintain strong, stable, and sustainable funding for Agency
operations.
J. Utilize NFP's Internet -based discussion forum to share learning with other entities
that are implementing the Program.
II. Agency will keep NFP informed of implementation issues that arise.
III. Agency will ensure that all Program Supervisors, nurses, and administrative staff attend,
participate in, and /or complete education programs required by NFP, do so on a timely
basis, and, upon completion, demonstrate a level of competence deemed satisfactory by
NFP.
IV. Agency will ensure that no Nurse Home Visitor is assigned a case load or makes a
Client visit (except in the company of an NFP- educated Nurse Home Visitor) until after
she /he has completed education on the Program, Program Benefits, Model Elements, use of
the ETO, and implementation of the Program for mothers who are pregnant.
V. Agency will implement the Program in accordance with Visit -to -Visit Guidelines
including:
A. Ensure enrollment of 23 to 25 first -time mothers per full -time Nurse Home Visitor
within nine months of beginning implementation and make best efforts to maintain that level
of enrollment on an ongoing basis;
B. Ensure that each full -time Nurse Home Visitor carries a caseload of not more than 25
active families;
C. Maintain the established visit schedule; and
D. Ensure that the essential Program content as described in the Visit -to -Visit
Guidelines is covered with Clients by Nurse Home Visitors.
VI. Agency will ensure the availability of appropriate, fully functioning computer systems and
software at Agency for use of ETO and for communication with NFP by email.
VI I. Agency will ensure that Program Supervisors and Nurse Home Visitors (a) collect
required data on client visits and enter it in ETO completely and accurately within one week
of each client visit and (b) enter any other data for ETO completely and accurately on or
PortArthur _TX_NFPAgrmt_Exp20150831 Page 19 of 20
before the last day of each calendar month, taking all appropriate steps to maintain client
confidentiality and obtain any necessary written permissions or agreements for data analysis
or disclosure of protected health information, in accordance with HIPAA (Health Insurance
Portability and Accountability Act of 1996) regulations, including, but not limited to,
authorizations, data use agreements, business associate agreements, as necessary.
Failure of Agency to comply with any applicable provision of HIPAA will constitute a breach
of this Agreement.
VIII. Agency will ensure that Program Supervisors:
A. Aim to develop a supportive relationship with the Nurse Home Visitors she /he
supervises;
B. Meet one -on -one with each Nurse Home Visitor at least weekly to provide clinical
supervision using reflection, preferably in person but by telephone where travel constraints
limit nurse or Program Supervisor mobility;
C. Run activity reports and quality improvement reports from the ETO Website on a
timely basis (typically monthly); use such reports to assess areas where systems,
organizational, or operational changes are needed in order to enhance the overall quality of
program operations; and develop and implement action plans based on such assessments.
IX. Agency will develop a Community Advisory Board with diverse representation (for
example, health, mental health, education, criminal justice, youth, business, social services,
faith -based leaders, other prominent community organization leaders) to ensure broad -
based community support for Agency's implementation of the Program.
X. NFP will periodically assess the extent to which Agency is implementing the Program
with Fidelity to the Model. When such assessment indicates opportunities for Agency to
improve its results by strengthening Fidelity to the Model, NFP staff will meet with Agency
supervision and mutually develop a plan to do so.
PortArthur _TX_NFPAgrmt_Exp20150831 Page 20 of 20