AGREEMENT BETWEEN
THE COUNTY OF SANTA CLARA AND THE CITY OF SAN JOSE FOR
SEXUAL ASSAULT FORENSIC EXAM (“SAFE”) SERVICES
This Sexual Assault Forensic Exam (“SAFE”) Services Agreement (“Agreement”) is made and entered into as of July 1, 2022 (“Effective Date”), by and between the County of Santa Clara, a political subdivision of the State of California, on behalf of the Santa Clara Valley Medical Center (“SCVMC”), and the City of San José, a municipal corporation, on behalf of the San José Police Department (“Payer”), to provide SAFE Services to patients referred to this program (“Patient)” by SJPD.
This Agreement is as follows:
1. SCVMC agrees to provide SAFE Services to individuals who request a medical evidentiary examination defined in ATTACHMENT A. SCVMC will accept patients referred by Payer in accordance with SCVMC’s policies. This Agreement is not exclusive, and Payer will not be obligated to refer any minimum number of patients to SCVMC by reason of this Agreement.
2. TERM: The term of this Agreement is from the Effective Date to June 30, 2023, inclusive, unless terminated earlier pursuant to Section 15 (“Initial Term”). (a) Retroactive Services: SCVMC provided services before the Effective Date in anticipation of the Agreement’s execution. Payer accepts and approves the services provided before the Effective Date; Payer will compensate SCVMC for those services in accordance with the terms of this Agreement. However, in no event will Payer compensate SCVMC for services performed before July 1, 2022. (b) Optional Term: After the Initial Term, Payer reserves the right, at its sole discretion, to extend the term of this Agreement for up to four (4) additional one- year terms (“Option Terms”) up through June 30, 2027.
i. Notice: Payer shall provide SCVMC with no less than thirty (30) calendar days’ prior written notice of its intention to exercise its option to extend the term of this Agreement. See ATTACHMENT C for Notice of Exercise of Option to Extend Agreement Form.
ii. Appropriation of Funds Contingency: Payer’s funding of this Agreement shall be on a fiscal year basis (July 1 to June 30) and is subject to annual appropriations. SCVMC acknowledges that the Payer, a municipal corporation, is precluded by the California State Constitution and other laws from entering into obligations that financially bind future governing bodies, and that, therefore, nothing in this Agreement shall constitute an obligation of future legislative bodies of the Payer to appropriate funds for
DRAFT--Contact the Office of the City Clerk at (408) 535-1260 or [email protected] for final document.
purposes of this Agreement. Accordingly, the parties agree that any Option Term(s) is contingent upon the appropriation of funds by the Payer. This Agreement will terminate immediately if funds necessary to continue the Agreement are not appropriated. Despite the foregoing, the Payer shall pay SCVMC for any services performed in accordance with Agreement up to the date of termination.
3. COMPENSATION: Payer will pay SCVMC up to Six Hundred Forty-Eight Thousand Three Hundred Fifty Dollars ($648,350) per each annual term, for a maximum total compensation not to exceed Three Million Two Hundred Forty-One Thousand Seven Hundred Fifty Dollars ($3,241,750) for the Initial Term and Option Terms, for providing the services set forth herein. Payer and SCVMC shall amend the agreement to increase the total compensation if services provided by SCVMC exceed the total annual compensation. SAFE services and rates are listed in ATTACHMENT A. The laboratory fees are listed in ATTACHMENT B.
4. RESPONSE CHARGE: If a SAFE examiner is called to respond for a SAFE exam and that exam is canceled for any reason, such as the victim refusing the exam or SJPD cancelling the exam, an HC SART LEVEL I/CONSULTATION charge, as described in ATTACHMENT A, will be assessed and will be due and payable by Payer.
5. SCVMC will bill Payer within 180 days of service in accordance with its customary billing practices for services rendered under this Agreement. Payer will make payment on billings within 60 days of the receipt of each statement.
6. SCVMC agrees to provide Payer access to the state-mandated reporting California Office of Emergency Services Medical Evidentiary Examination Forms, or their successors, as permitted by law.
7. INDEMNIFICATION AND INSURANCE:
A. Indemnification: In lieu of and notwithstanding the pro rata risk allocation, which might otherwise be imposed between the parties pursuant to Government Code Section 895.6, or any other statute, regulation or rule that may otherwise affect the terms of this Agreement, the parties agree that all losses or liabilities incurred by a party shall not be shared pro rata but, instead, SCVMC and Payer agree that, pursuant to Government Code Section 895.4, each of the parties hereto shall fully indemnify and hold each of the other parties, their officers, board members, employees, and agents, harmless from any claim, expense or cost, damage or liability imposed for injury (as defined in Government Code Section 810.8) occurring by reason of the negligent acts or omissions or willful misconduct of the indemnifying party, its officers, employees or agents, under or in connection with or arising out of any work, authority or jurisdiction delegated to such party under this Agreement. No party, nor any officer, board member, employee or agent thereof shall be responsible for any damage or liability occurring by reason of the negligent acts or omissions or willful misconduct of the other parties hereto, their officers, board members, employees, or
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agents, under or in connection with or arising out of any work authority or jurisdiction delegated to such other parties under this Agreement.
B. Insurance: SCVMC shall comply with the insurance requirements set forth in ATTACHMENT D for the Agreement term. SCVMC must submit to the Payer’s designated risk manager ("Risk Manager"), for the Risk Manager’s written approval, all documents demonstrating compliance with the requirements of ATTACHMENT D. The Risk Manager may amend or waive, in writing, any of the requirements contained in ATTACHMENT D.
8. Throughout the term of this Agreement, SCVMC and Payer respectively will meet all licensure and regulatory requirements necessary for it to carry out the activities described in this Agreement, and otherwise comply with all applicable laws, ordinances, codes, and regulations in the performance of the Agreement.
9. SCVMC or any agent thereof will not bill or collect any amounts from Patients for SAFE Services. Other medical services provided to Patient may be the financial responsibility of Patient or Patient’s health insurance. Such services will be billed as appropriate to Patient or Patient’s insurance payer.
10. Payer and its employees, agents, and subcontractors, shall comply with the County’s No- Smoking Policy, as set forth in the Board of Supervisors Policy Manual section 3.47 (as amended from time to time), which prohibits smoking: (1) at the Santa Clara Valley Medical Center Campus and all County-owned and operated health facilities, (2) within 30 feet surrounding County-owned buildings and leased buildings where the County is the sole occupant, and (3) in all County vehicles.
11. Compliance with Non-Discrimination and Equal Opportunity Laws: Payer shall comply with all applicable Laws concerning nondiscrimination and equal opportunity in employment and contracting, including but not limited to the following: Santa Clara County’s policies on nondiscrimination and equal opportunity; Title VII of the Civil Rights Act of 1964 as amended; Americans with Disabilities Act of 1990; the Age Discrimination in Employment Act of 1967; the Rehabilitation Act of 1973 (Sections 503 and 504); the Equal Pay Act of 1963; California Fair Employment and Housing Act (Gov. Code § 12900 et seq.); California Labor Code sections 1101, 1102, and 1197.5; and the Genetic Information Nondiscrimination Act of 2008. In addition to the foregoing, Payer shall not discriminate against any subcontractor, employee, or applicant for employment because of age, race, color, national origin, ancestry, religion, sex, gender identity, gender expression, sexual orientation, mental disability, physical disability, medical condition, political belief, organizational affiliation, or marital status in the recruitment, selection for training (including but not limited to apprenticeship), hiring, employment, assignment, promotion, layoff, rates of pay or other forms of compensation. Nor shall Payer discriminate in the provision of services provided under this contract because of age, race, color, national origin, ancestry, religion, sex, gender identity, gender expression, sexual orientation, mental disability, physical disability, medical
DRAFT--Contact the Office of the City Clerk at (408) 535-1260 or [email protected] for final document.
condition, political activities or affiliations as outlined in California Labor Code Section 1101, organizational affiliations, or marital status.
12. Compliance with Wage and Hour Laws: Payer shall comply with all applicable wage and hour Laws, which may include but are not limited to, the Federal Fair Labor Standards Act, the California Labor Code, and, if applicable, any local minimum wage, prevailing wage, or living wage Laws. Payer agrees to comply with the County’s Contracting Principles set forth in the Board Policy Manual. The Contracting Principles require, among other things, that Payer be a fiscally responsible entity and treat its employees fairly. Payer is also required to (1) comply with all applicable federal, state and local rules, regulations and laws; (2) maintain financial records, and make those records available upon request; (3) provide to the County copies of any financial audits that have been completed during the term of the contract; and (4) upon the County's request, provide the County reasonable access, through representatives of the Payer, to facilities, financial and employee records that are related to the purpose of the contract, except where prohibited by federal or state laws, regulations or rules.
13. The County is a public agency subject to the disclosure requirements of the California Public Records Act (“CPRA”). If Payer’s proprietary information is contained in documents submitted to County, and Payer claims that such information falls within one or more CPRA exemptions, Payer must clearly mark such information “CONFIDENTIAL AND PROPRIETARY,” and identify the specific lines containing the information. In the event of a request for such information, the County will make its best efforts to provide notice to Payer prior to such disclosure. If Payer contends that any documents are exempt from the CPRA and wishes to prevent disclosure, it is required to obtain a protective order, injunctive relief, or other appropriate remedies from a court of law in Santa Clara County before the County’s deadline for responding to the CPRA request. If Payer fails to obtain such a remedy within County’s deadline for responding to the CPRA request, County may disclose the requested information. Payer further agrees that it shall defend, indemnify, and hold County harmless against any claim, action, or litigation (including but not limited to all judgments, costs, fees, and attorney’s fees) that may result from the denial by County of a CPRA request for information arising from any representation, or any action (or inaction), by the Payer.
14. AMENDMENT: This Agreement may be modified only by a written amendment executed by the parties.
(a) In the event SCVMC increases the exam rates in ATTACHMENT A and ATTACHMENT B, SCVMC shall provide Payer a written notice at least 30 days prior to implementation of the increased exam rates to initiate an amendment, and if accepted, Payer shall include the new rates under the same terms and conditions of the Agreement through a written amendment executed by both parties.
15. TERMINATION: The Agreement can be terminated by either party upon 30 days’ written notice. In the event that this Agreement is terminated, and a Patient or Patients are referred to SCVMC prior to termination, SCVMC will complete the SAFE services for such Patients and
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Payer will pay for the completed services at the rate set forth herein.
16. NOTICE:
(a) Manner of Giving Notice: All notices and other communications required by this Agreement must be in writing, and must be made via e-mail, personal service and United States mail, postage prepaid.
(b) When Effective: A notice or other communication that is e-mailed is effective when sent provided the sender receives an acknowledgement from the intended recipient (e.g. return receipt, return e-mail, or other written acknowledgement). A notice or other communication that is personally served is effective when personally delivered. A notice or other communication that is mailed is effective 3 calendar days after deposit in the United States mail.
(c) To Whom Given: All notices and other communications between the parties regarding the Agreement must be given to the individuals identified below using the appropriate contact information for giving notice:
To the Payer: City of San José
San José Police Department
Attn: Chief of Police
201 W. Mission Street
San Jose, CA 95110
(408) 277-4212
[email protected]
To the SCVMC: County of Santa Clara
Santa Clara Valley Medical Center
Attn: Paul E. Lorenz
751 South Bascom Avenue
San Jose, CA 95128
408-885-4012
[email protected]
17. The parties agree that the law governing this Agreement shall be that of the State of California. In the event that suit, be brought by either party to this Agreement, the parties agree that venue shall be exclusively vested in the state courts of the County of Santa Clara.
18. CONFIDENTIALITY: During the performance of this Agreement, the parties may have access to the identity and information relating to a Patient’s personal and private information.
Parties agree to treat all such information as confidential and must use all necessary care to maintain such information in confidence and for use only for the purposes contemplated in this Agreement. Parties must not release any of the aforementioned information to any entity or party other than Payer’s or SCVMC’s staff, nor discuss such information with any other party other than Payer’s or SCVMC’s staff, without the express written consent of the appropriate Payer or SCVMC manager or as the Payer or SCVMC may be required by law to
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disclose. In the event that Payer or SCVMC receives a subpoena, court order, or other legal document requiring release of the information, or is informed that such a document is being requested, Payer or SCVMC must immediately give notice to the appropriate Payer or SCVMC manager in order to permit the Payer or SCVMC to seek a protective order or other similar order.
19. This Agreement contains all of the agreements, representations and understandings of the parties and supersedes and replaces any previous understandings, commitments or agreements, whether oral or written. This Agreement may only be modified by a written amendment duly executed by the parties to this Agreement.
20. This Agreement may be executed by the parties in separate counterparts, each of which when so executed and delivered shall be an original, but all such counterparts shall together constitute one and the same instrument.
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DRAFT--Contact the Office of the City Clerk at (408) 535-1260 or [email protected] for final document.
21. Unless otherwise prohibited by law, the parties agree that an electronic copy of a signed contract, or an electronically signed contract, has the same force and legal effect as a contract executed with an original ink signature. The term "electronic copy of a signed contract" refers to transmission by facsimile, electronic mail, or other electronic means of a copy of an original signed contract in a portable document format. The term "electronically signed contract" means a contract that is executed by applying an electronic signature using industry accepted technology.
INTENDING TO BE BOUND HEREBY, the parties have caused their authorized representatives to execute this Agreement as set forth below:
County of Santa Clara on behalf of
Santa Clara Valley Medical Center
Agreement Accepted:
“Payer”
City of San José
Paul Lorenz Date Sarah Zarate Date
Chief Executive Officer Director, Office of the City Manager
Approved: Approved as to form:
Vinod Sharma Date Carl B. Mitchell Date
Chief Financial Officer Senior Deputy City Attorney
Rene Santiago Date
Deputy County Executive
Approved as to form and legality:
Deputy County Counsel Date
DRAFT--Contact the Office of the City Clerk at (408) 535-1260 or [email protected] for final document.
ATTACHMENT A
County of Santa Clara, on behalf of Santa Clara Valley Medical Center Sexual Assault Forensic Exam Program – Procedure Price List FY 2023 Rates, effective July 1, 2022
*Laboratory fees reflect testing related to the forensic exam such as chemistry, immunology, and bacteriology. Detailed laboratory fees are in Attachment B. **Sexual assault forensic exam (SAFE) and medical evidentiary exam are the same exam. ***Standard SAFE exam is considered routine medical evidentiary exam and the patient reports to law enforcement
Billing
Category
[2440]
Procedure
Master #
[100]
Procedure Name
[2]
Description
New FY
2023 Price*
SART 45000147 HC SART LEVEL
I/CONSULTATION
SAFE examiner responds at
police request for SAFE**
exam, and the exam does not
happen, either because of patient
decision or police decision
$460.00 +
Lab Fees
SART 45000146 HC SART LEVEL
II/ROUTINE
Standard*** SAFE exam done by
SAFE examiner at request of law
enforcement or patient
$1,429.00 +
Lab Fees
SART 45000148 HC SART LEVEL
III/EXTENSIVE
Standard*** SAFE exam done
under difficult circumstance (i.e.,
in ED, ICU, OR) or the case was
unusually difficult and extensive
due to injuries or patient state.
$2,119.00 +
Lab Fees
SART 45000145 HC SART LEVEL
V/VAWA
Non-Investigative Report (NIR)
is standard SAFE exam, but the
patient chooses not to report to
Law Enforcement, in accordance
with Violence Against Women
Act (VAWA)
$1,429.00 +
Lab Fees
SART 51000869 NON-ACUTE
EXAM
SAFE exam for minors only, who
report a history (delayed
disclosure) of sexual abuse after
the acute time period as follows:
0-11 years > 72 hours
12-17 years > 10 days
$1,429.00 +
Lab Fees
SART 51000578
HC SART
FOLLOW UP
EXAM
If injuries are extensive or
inconclusive, a follow up exam
may be conducted to obtain
interval images and assessment
$256.00 +
Lab Fees
DRAFT--Contact the Office of the City Clerk at (408) 535-1260 or [email protected] for final document.
ATTACHMENT B
County of Santa Clara, on behalf of Santa Clara Valley Medical Center Lab Fee Schedule
SAFE Services provided for shall be reimbursed by Payer in accordance with the fee schedule set forth below. Any test not listed below shall be reimbursed at 100% of the current year Medicare allowed rate for such test.
ADULT/ADOLESCENT LAB CHARGES
ID NUMBER
Current
Procedure
Terminology
DESCRIPTION COST
30100539 84703 HC PREGNANCY, SERUM $46.00
30600053 87340 HBsAg $64.00
30600300 87389 HC HIV-1 AND HIV-2 ANTIBODIES, P24 ANTIGEN $149.00 30200112 86705 ANTI-HBc (IGM) $72.00
30200443 86780 HC SYPHILIS EIA AB $82.00
30200153 86593 HC RPR, QUANTITATIVE $27.00
30100328 80076 HC LIVER FUNCTION PANEL $215.00
30100276 82565 HC CREATININE $32.00
Glomerular Filtration Rate (No Charge, reported with HC Creatinine) $0.00
30000182 87517 HBV DNA PCR (Reflex) $265.00
DRAFT--Contact the Office of the City Clerk at (408) 535-1260 or [email protected] for final document.
ATTACHMENT C
Notice of Exercise of Option to Extend Agreement
AGREEMENT
TITLE:
DATE:
NAME:
ADDRESS:
EMAIL:
DATE OF OPTION:
Pursuant to Section 2(b)(i) of the Agreement referenced above, Payer hereby exercises its option to extend the term under the following provisions:
OPTION NO.
NEW OPTION TERM
Begin date:
End date:
MAXIMUM COMPENSATION for New Option Term: $
For the option term exercised by this Notice, City of San José shall pay County of Santa Clara, Santa Clara Valley Medical Center (“SCVMC”) an amount not to exceed the amount set forth above for SCVMC’s services and reimbursable expenses, if any. The undersigned signing on behalf of the City of San José hereby certifies that an unexpended appropriation is available for the term exercised by this Notice, and that funds are available as of the date of this signature.
CITY OF SAN JOSE
a municipal corporation
By________________________________
Name:
Title:
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ATTACHMENT D
Insurance Requirements
SCVMC, at SCVMC's sole cost and expense, shall procure and maintain for the duration of this AGREEMENT insurance against claims for injuries to persons or damages to property which may arise from, or in connection with, the performance of the services hereunder by SCVMC, its agents, representatives, employees or subcontractors. Payer acknowledges that SCVMC may self-insure all or part of its obligation.
A. Minimum Scope of Insurance
Coverage shall be at least as broad as:
1. The coverage provided by Insurance Services Office Commercial General Liability coverage (“occurrence”) Form Number CG 0001; and
2. The coverage provided by Insurance Services Office Form Number CA 0001 covering Automobile Liability. Coverage shall be included for all owned, non-owned and hired automobiles; and
3. Workers' Compensation insurance as required by the California Labor Code and Employers Liability insurance; and
4. Professional Liability Medical Malpractice insurance for all medical services rendered.
There shall be no endorsement reducing the scope of coverage required above unless approved by the Payer’s Risk Manager.
B. Minimum Limits of Insurance
SCVMC shall maintain limits no less than:
1. Commercial General Liability: $1,000,000 per occurrence for bodily injury, personal injury and property damage. If Commercial Liability Insurance or other form with a general aggregate limit is used, either the general aggregate limit shall apply separately to this project/location or the general aggregate limit shall be twice the required occurrence limit; and
2. Automobile Liability: $1,000,000 combined single limit per accident for bodily injury and property damage; and
3. Workers' Compensation and Employers Liability: Workers' Compensation limits as required by the California Labor Code and Employers Liability limits of $1,000,000 per accident; and
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4. Professional Liability Medical Malpractice: $1,000,000 per claim and $1,000,000 aggregate.
Any limits requirement may be met with any combination of primary and excess coverage so long as the excess coverage is written on a "follow form" or umbrella basis.
C. Deductibles and Self-Insured Retentions
Any deductibles or self-insured retentions must be declared to, and approved by Payer's Risk Manager.
D. Other Insurance Provisions
The policies are to contain, or be endorsed to contain, the following provisions:
1. Commercial General Liability and Automobile Liability Coverages
a. The City of San Jose, its officers, employees and agents are to be covered as additional insureds as respects: Liability arising out of activities performed by or on behalf of, SCVMC; products and completed operations of SCVMC; premises owned, leased or used by SCVMC; and automobiles owned, leased, hired or borrowed by SCVMC. The coverage shall contain no special limitations on the scope of protection afforded to Payer, its officers, employees, and agents.
b. SCVMC's insurance coverage shall be primary insurance as respects Payer, its officers, employees, and agents. Any insurance or self-insurance maintained by Payer, its officers, employees, or agents shall be excess of SCVMC's insurance and shall not contribute with it.
c. Any failure to comply with reporting provisions of the policies by SCVMC shall not affect coverage provided Payer, its officers, employees, or agents.
d. Coverage shall state that SCVMC’s insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the limits of the insurer’s liability.
e. Coverage shall contain a waiver of subrogation in favor of the Payer, its officers, employees, and agents.
2. Workers’ Compensation and Employers’ Liability
Coverage shall contain waiver of subrogation in favor of the City of San Jose, its officers, employees, and agents.
3. Claims Made Coverages
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If coverage is obtained on a “claims made” policy form, the retroactive date shall precede the date services were initiated with the Payer and the coverage shall be maintained for a period of three (3) years after termination of services under this Agreement.
4. All Coverages
Each insurance policy required by this AGREEMENT shall be endorsed to state that coverage shall not be suspended, voided, cancelled, or reduced in limits except after thirty (30) days' prior written notice has been given to Payer, except that ten (10) days’ prior written notice shall apply in the event of cancellation for nonpayment of premium.
E. Acceptability of Insurers
Insurance is to be placed with insurers acceptable to Payer's Risk Manager.
F. Verification of Coverage
SCVMC shall furnish Payer with certificates of insurance and endorsements or a self-insurance letter affecting coverage required by this AGREEMENT. The certificates and endorsements or self- insurance letter for each insurance policy are to be signed by a person authorized by that insurer to bind coverage on its behalf.
Proof of insurance shall be emailed in pdf format to: [email protected]:
Certificate Holder
City of San Jose—Finance
Risk Management & Insurance
200 East Santa Clara Street, 14th Floor Tower
San Jose, CA 95113-1905
G. Subcontractors
SCVMC shall include all subcontractors as insureds under its policies or shall obtain separate certificates and endorsements for each subcontractor.
DRAFT--Contact the Office of the City Clerk at (408) 535-1260 or [email protected] for final document.