ORDER NO. 19754
APPROVAL OF A MANDATED PROVIDER AGREEMENT BETWEEN
ALL PHYSICIANS (MEDICAL DOCTORS) ON STAFF AT
SID PETERSON MEMORIAL HOSPITAL AND KERR COUNTY, TEXAS
FROM SEPTEMBER 1, 1990 THROUGH AUGUST 31, 1991
Dn this the 23rd day of August 1990, upon motion made by
Commissioner Morgan, seconded by Commissioner Ray, the Court
unanimously approved by a vote of three a Mandated Provider
Agreement, by and between all Physicians (medical doctors) on
staff at the Sid Peterson Memorial Hospital, acting by and
through their duly authorized Chief of Staff, W. C.
O'Donnell, Jr. , M. D. , and Kerr County, Texas, acting by and
through its duly authorized County Judge, Danny R. Edwards,
as authorized by the Commissioners' Court of Kerr County,
Texas, for Indigent Health Care, as required by the Indigent
Health Care and Treatment Act, to provide certain Physician
services for its eligible residents.
AGRSSMENT
(PHYSICIAN - SID PBTSRSON HOSPITAL)
This Mandated Provider Agreement is entered into on the
_lst_____.__ day of _September____, 1990, by and between all
Physicians (medical dor.t.ors) on staff at SID PETERSON
MEMORIAL HOSPITAL as of August _31___, .]_990, art i.ng by and
through their duly authorized Chief of Staff, W. C.
O'Donnell, Jr, (hereinafter. called "Physi_cian, whether one or
more), and KFRR COI.TNTY, TEXAS, arti.ng by and through its duly
author. i.zed COiJNTY ,?trDGF., DANNY R. EDWA.RDS, as authorized by
the Commissioners' Court of Kerr. County, Texas (hereinafter
r.,al.led "County").
WITNFSSETE~
WfiFRFA5, County is regu.i.red by the Indigent Hea:Lth Care
and Treatment Ar.t {hereinafter cal ].eci "Art") to provide
certain physician services for its e]_igible residents;
WHFREA.S, County desires to insure that County's el.igibl.e
residents receive those mandatory physician services required
by the Ar_.t.;
WHEREAS, Physician agrees to provide, or to arrange the
provi_si.ons of, those mandatory physic. ian services required by
the Art far County's el.igibl.e r.esident.s;
NOW, THEREFORE, in consi.deratian of the mutual r.ovenants
herein .rani-wined County hereby designates anct Physi.r.ian
PAGE 1
hereby agrees to he a Mandated Provi.dc~r for mandatary
physir,i.an services required by the Art or the Art's
regulations t.o he provided to County's el_i.gible residents and
the parties agree as follows
7.. DFFTNITIONS
A11 terms shall he as defined by the Ar.t and by the
TEXAS DEPARTMENT OF HUMAN SERVICES, (hereinafter called
"Department.") t.o the extent. of the departments rights,
responsi.hi.liti.es and powers under the Act.
2. MANDATRD PROVIDER
Physician shall. be a mandated provider of the mandatory
physician services f.or County's eligible residents, as
defined by the Act.. Physician repre:;ent.s that Physician
is duly licensed as a Medical Doctor under the Laws of
the State, of. Texas and i.s certifi.ed for the Medicare
program by the Fiealt.h Care Financing Administration.
[Inle~~s otherwise agreed upon, Physi r.ian shall deliver,
or arrange to be del.ve.red, physician services that are
ronsi.der.ecl mandatory services pursuant. to the Ar.t or. as
defined by the Department, Such services shal]_ be
provided to el.ig:i.ble residents of County who do not
rPSi.dP within an area that. a publir_ physician or
physir.:i.an distri.r.t has a legal obl.i.gation to serve.
County shall require it.s eligible residents t.o obtain
mandatory phys~i.r_ian services from rontr.dcti.ng physir.ians
PAGE 2
except in emerc7enr.y si.t~.zat i one;, or. why n mP~jir.al.ly
inaPPrapr.iate.
3, CO?JNTY' S FINANCIAL O13I,IGATIC?NS
County shall. reimhurCe Physician far rhysi.ai.an service:,
Provided i:o eligible residents. County will re.i.mburse
Phy,~,ici.a.n for a1.1. norm~~l anck. reasan~~hle r.harges far
mandated servi_r_.es up to the maximum amount of services
and rei_rnr~ursPment allowed under the Ar,t . County i s not
7 i.:~k?l.e far r.emhursement of services whir.h exr.Peri the
maxim~.zm. per Y>atient limits esj-,-~hl.i.,heti by the Art. If
Physician transfers F;ligi_hl.e residents of County to a
nonr.r~,ni-7°~,rti ncj phyr i.r. i.an far phyC _i r i an servir..pr whi r.h
Phy~; i. r;_i.an i_s unable to Provirke, (='aunty is ahligat.ed to
reimY::u.r~;e the recP-ivinq physician :~t. the r.ec-P-ivinq
physir.ians Payment rate, h~.at not to exr..eed the maximum
Paymr'nt. af. re i.ml^>ur^ement all.awet3 ~.Inder t.hP Art ar
e.st~hlished by the DePar.tment, All transfers wi)_1 he
made t.o cantrar.t:ing Physir;ian~; i.f passi_bl.c~. Per poi-lent
expenditure limits as estak~l.i_shec] by the Art apply to
sur.h serv.i.re^ del-ivere~k by the rf.reaving physi.ri.an.
PAGE 3
4. NOTICE
County shal_1 have the duty and responsibility to give
all. notir_PS conr_erni.ng the availability of mandatory
physici.:~n services from Hospital.
S. DFTFRMINA.TION_OF._EL~IGIBILITY
Caunt.y shall be responsibl_P for determining whether an
applicant is eligible for fi.nanr.i.al assistance defined
by the Act and shall provide eligible residents with
documents anct/or ca.r. ds whir.h ident i.fy persons as
eL.i_aible residents.
In thF~ rase of_ a patient who may bP eli.ghl.P reeking
nonemergency services, Physician shall. not provide such
nonemf:r.c{enry serv~.r..es until. County has determined
el_i_gibi.l_ity of the patient, has notified Physician of
the el.:ig-i_bi.l.ity der..i.sion and has approved in wr. icing
provision of_ the nonemergency services. County must.
determine el i.cJi.bility for nonemergenry ser.vi.r.,es within
fourteen (14) days from the date County receives a
completed appl.icat.ion.
Fl.i.gi.bi l i.t.y requirements and this contr.art may be
modi.fi.nd at. any time by County to rafler_t any statutory
rhancJes in County's indigent care obl.i.gati.ons.
RPSidenry disputes shall. he resolved by the Department..
6. NOTTFICA.TION OF PROVISION OF SERVICES
Phy.,ic-i.an may deliver emnrgenry services to eli.gi.bl.e
PAGE 4
r.esi.dent.^ of County without abtaini.ng County approval.
Physi.r,ian must rer,eive written approval. from County
before providing nanPmergenry service^.
7. RFIMBURSFMF;NT PR.Or,FDURE;5
Physi.r.:ian rhal.l present charges for physi.r.ian services
provided to eligible patients to Caunt.y monthly. Co~.znty
shall reimburse Physician within thr.ity {30) days of
presentation of t.hP r.harges at the payment rate
determined by the Department.
A11. payment disputes are to be submitted far binding
rPSC~l.uti_on to a panelr,onsisting of a Hospital medic;al
staff member wha did not attend the patient, Hasp.ital's
administrator, one Haspit~il Eloard of Tr. tzstee member,
County ~?udge, and ane County ('.ammi_ssianPr.
In the r..ase of. emergency physician services rendered to
a patient. wha is dPtermi.ned in Section 5 not to be
el.:igi.ble f.or fi.nanr,i.al arsi.stanr..P, Physi.r.i.an shall. he
financially responsible f_or the services rendered to
si~r,h patient . Phys ir. i.an r. eser. ves the right to pursue
any reasonable rol.lert.ian effort against such patients.
Physir,ian shall. have the right. to b:i.ll el.i.gi.ble patients
far non-covered charges whether the charges are for
P.XC.lUded services ar beratlse the charges are not payable
by County due to provisions of the Art or payment
pal.iries and rates established by the Department.
PAGE 5
8. TFiIRD FARTY PAYERS
Physician will notify County i.f any eligible residents
have arcess to any other'sour.ces of payment for the
eligible services provided, but County shall be
responsible for the payment of such eligible services
as prov_ideci for herein. Physi.c,i.an shall. notify County
of t.hP amounts received from third party payors and
reimr>tarse County for servi.res and amounts covered under
this Agreement,
9. RF..CORL?fi
Physician wi.l1 provide County ar.r,ess to a1.1. f.inanr,ial
rer..ords necPSSar.y to document the Physician's provision
of sPrvir,es. Such ar.,ress shall. bP du r. i.ng normal.
business hours of the Physician and shall bP preceded
by notir.e from County. Sur..h notice shall be rer.ei.ved by
Fhysi_cian Z4 hours in advance of such examination.
County shall hold a.l.l medir.al rer_or.ds in strir,t.
r_onfic]ence so as not to violate the physician/patient
relationship.
County sha1.1. obtain a signed authorized medi.ral. consent
form from the patient, authorizing the release of
his/her medical. records and provide the same to the
Physician prior to rer,.Pivi.ng any medica]_ records.
1.0. TERM AND RENFWAT~ TF..RMS
The term of this Agreement shall be from September 1.,
.1.990 through August 31., 1991. This Agreement may be
PAGE 6
renewed for additional one {1) year terms by written
agreement of the parties at least. thirty (30) days prior
t.o the expiration of the original or any renewal. term.
County shall. reimburse Physir.ian ar,r.ording to the
provisions of_ t.hi_s Agreement for any eligi_b1e patient
who continues to rer,eive el.igi.ble physiri.an servi.r.es
past the expiration of this Agreement.
11. TFRMTNATION AND RIGHT TO CiJRE
Ei.thFr party may terminate this Agreement upon br.ear,h of
this Agreement with thirty (30) clays prior written
notice, prov:i.eied the breaching party has been notified
thirty {30) days prior. t.o the termination notice and
efforts to resolve the matter t.o the terminating party's
satisfa.r_t.ion are unsuccessful. Upon termination as
prOVldP.d for herein, neither. of the parties shall. have
any further duty or obligation to the other except for
i.ndebtednPSS due at the t:i.me of termination anci
indemnification of the other party.
12. HOLD HARMhFS~
Each party agrees to i.ndemnif.y and hold harmless the
other. party and its employees against. and from all_
claims and actions brought by third p~irties against the
other party on account of willful, intentional,
negl.i.gent or illegalr,onduct, omissions or bad faith of
the party, its agents or employees, Physir.ian shall
retain so 1.e authority and respansibili.ty for the
servir,es rendered to eligible patients of County.
PAGE 7
1.3. ASSIGNMENT
Neither party sha1.1. assign this Agreement except with
the prior written consent of the other party, except as
provided in section 5 hereof.
14. HEADINGS
Section headings are for convenienr.e of reference only
and shall not be usecl to r,onst.rue the meaning of.' any
provision to this Agreement.
]. ; , CO[JNTERPARTS
This Agreement may be executed in any number of
counterparts, each of which shall be an original, and
al.l of which shal.l_ together r_.onstit.ute one agreement.
16. OBLIGATIONS AS CONDITION
All obligations of each party t.o this Agreement are
r_ondit.ions to further performance of the other party's
continued performance of i.ts obligations under the
Agreement.
17. EXCL~[JSIVE_RICHTS
Only the parties t.o this Agreement have the exclusive
right to bring suit to enforr_e this Agreement and no
other parties may bring suits as a third party
benefir_iary, or otherwise, to enforce the Agreement..
18. SEVFRANCF
Should any part. of this Agreement be invalid or
unenforceable, sur.;h inval.idit.y or unenforr.eabi.lity shall
PAGE 8
not affect. the validity and enforceability of the
remai.ni.ng portions.
19 . I~AW
This Agreement shall be construed i.n acror. danr.e with the
laws of the State of Texas.
20. AMENDMHNT
This Agreement may not be modified exr_,ept in wr.it:ing
P,xP..GlltP,d by both parties to this Agreement .
21. NOTICE
Any notir.es, demands or communications required,
permitted or desired to be given hereunder. Shall. be
deemed effectively given when personal..ly delivered or.
mailed by prepaid rert-ified mail, return receipt
reque:>t.ed, addressed as follows:
Kerr County ,Judge Chief of Staff
Kerr County Courthouse S.d Peterson Memorial.
700 Main Hospital
Ker.rvi_lle, TFrxas 78028 7.10 Water Street
Kerrville, Texas 78028
or. sur.h othf:r address and to the attent.i.on of such other
person(s) or off_icer.(s) as Dither party may designate by
written notice.
2?... FORCF MAJEURE
NP i.t.hPr Party shall he liable nor deemed to be in
default for. any delay or failure of performance under
this Agreement or. other i.nt.err.uption from Acts of. God,
civil or military author. i.ty, arts of public. enemy, war,
PAC;F 9
acr.,ident.s, fares, explosions, eart.hguakes, f:Loods,
fai.l.urP of tran:~r)ortation, strikes, or other work
inter.rupt..ions by either Party's employees or agents, or
any similar or di.ssi.mi.l.ar cause beyond the reasonable
r_ontrol of either Party. Either party in sur_h event may
terminate this Agreement.
73 . RFLATInNSHT_P___C~F .PARTIES.
None of. the provisions of this Agreement are intended to
create nor shall be deemed r,onstrued to create any
relationship between County and Physi.r,ian other. than
that of independent entities r_ontr.acting with ear_h other
hereunder solely f_or the purpose of. effecting the
provisions of this Agreement. Neither the parties
her'et0, or any of their resper.t.ive off:ir,e r. s, di.rertors
or P,ICIpLoyP,P.s shall he r_onstrued t.o be the agent,
employee or representative of the other party.
24. ENTIRE AGREEMENT
This Agreement supersedes all prior agreements between
the parties with respect to the subjec;t matter hereof.
Thi., Agreement. i.s subject to all areas controlled by the
Indigent Health Care and Treatment. Act, as it. may be
amended, and by the Texas Department of Human Ser_vicPs
and other applicable local., state and federal laws,
rules or regulations.
PAGE ].0
TN WTTNF.SS WEiEREOF, the Part.i_es have caused this
Agreement. to hP execut.ed by their respective duly authorized
representatives as of_ the day and year first above written.
Chief of Staff.
SID PFTFRSON MEMORIAL HOSPITAL KF.RR CO[iNTY, TF_.X S
y ~ -------\-~----------------. -------._~.____ Y .- --------- ---~ - ---- -
W. C. O'Donnell, ~7r. Dann R. Edwards
Chief of Staff Ker. r County ,judge
PAGE 1].
• PLEASE Fl-RNISH ONF ORIGINA AND SEyEN COPIES OF THIS REOUESTAND D UM NTS
j0 BE REVIEWED BY 1HE COl1RT_
MADE BY: Gordon NY~rgan OFFICE• Commissioner Precinct #1
MEETING DATE: August 23, 1990 TIME PREFERRED:
SUBJECT: (PLEASE BE SPECIFIC): _Approve Mandated Provider Agent with Ph,~ G; ~; any
on Staff at Sid Peterson Memorial Hospital
ESTIMATED LENGTH ~ PRESENTATION:
IF PERSONNEL MATTER -NAME OF EMPLOYEE:
NAME OF PERSON ADDRESSING THE COURT: cordon MorcLan
Ttme for submttttng this request for Court to assure that the matter is posted In
accordance with Article 6252-17 is as follows:
• Meettngs held on' second Monday: t 2:0o P. M. previous Wednesday
• Meetings held on Thursdays: 5:00 P. M. previous Thursday.
• If preferable. Agenda Requests may be made on office stationery w[th the above
information attached
THIS REG?UEST RECEIVED BY: -~~ ~ '
THiS REQUEST RECEIVED ON: ~'~` ~ `%~ ~, ~~~~~~~ LEI III
Att Agenda Requests wilt be screened by the County Judge's Office to determine tf
adequate information has been prepared for the Court's formal consideration and action at
time of Court meetings. Your cooperation will be appreciated and contribute towards
your request being addressed. at the earliest opportunity.