.. r
-.,,
~i('='f~<=:i'~~;... t:if I:a h~il'=iii+L:F-i i E:1i I-'%~'l.r'.' i1!Lf~ F-1i=+fa:t~!'~it~.i'~I i
_..
)'~h. , IT - '; _~ ~ 1..) I 1 _. ; r.. I .'-~1.1!'! i-ii__1', _11 ~ 1 i-„_.. : It..~ _., ~ , :-i;__ r-li aJ..J I . _~ f : L... L;Y i I
,~
..... _
:' h? kJ iY" c. c. , ! I ` i*1 ! _`~ i::. i'~' :. y 1 ~_~ -_! 1 1 F-. f't to L. k.. f 1 F•!I I- i l~;! i_f~• ~ __ . Y 1. ' ~) ~_
~~
;..., ., -
.._ _:, .I. .: t". i~, .. i,._LIi t_, c~. '~.~ 11. °i i_: :.'i;. of L~. iy ....i .k I(, 1f._ ,.I_ ~. .. i_ i
~. {.i (n rn 7. Si 1. Ca r'I P. '. I" C! ?. ,:' ; ; c:+. Ir C=+ q [. ~_i (:_ :~~ i.i C~ E• t:~ Ci + ~ I_ Ci In m i ~ s, :1. C, :- G• r t_ ~ ,~, t-, _ E •.' y s_ 1"; C~
c...::,,_:„I: unanimously approved by a vote of 4-0-0, ,_; ._:._:+~;~:_;:al_~_:ta
I-' f' l) ': 'I. C: t i' 111:j i ` t? ' ;il ,:' f'. k: y I: ': a_t ri f~{ C:a 'r? 1! I~`2 `_' ~i1 7l ~_ i 1 (? __ .C t:~ F-' :? '~ :' 1^ 1 U it I T ~ ~ 3 ITI t ~ i 7. r=..i
i• ,_ ~_ ,. I k-1 C! y ct l r c:. _ ': 'r' G tt (.., f l : %: c> _] Ll , c+. ~_t'k• ~ I ti r ' 1 'i:: N ;:~
,....
;~.+.. Iii l.:, 1 t~ I_ r ;: 1, _! Y y h- ., t.l. ;-i;:a..l ~ .~ , , _..YI .._ :.._ I-, _ ., +_li`~ . ~ : ._ .. _., _. _.,C .4 I ~
i
k:; '; ::. r. _; 1.: ..I i,... lJ L.t C -'t ;. T: ~:. t ~
_ I ~ , _ _ ci I_I. i ',' c. I_t'k I"i C; i„ ].: r~ v ~: ca I_I. ~'s t: 'y L.t ~ r rl c• 4 lfa „ _.. ._ . tt ..
- 9
.., t- .... .. . . .... .... ~ ~ .
,_, _., c:+. _I. •_ ~ V r .~ L ct ~_l L. ~' L: i°~ ~_~ 1.,+.1 Iii l;l . Ci I
- _ _. ~ - F 1
. - --
i -I ,~ t t' L-, (.?.'r ' r ;~'~ n Cj (- i'' ~ l F f0 t3 °1 'k' 1-i t'.^'~= e i, ~_+ {:) t^ ;-! V ;. ~ ~ t? _ . ~ ' i,; :.~. 7. I l 7. ~"' C: _. I_ :L t_' s : I::
n ... ._ ... 1 .. .... .~ ._ .
r ~. f I !_ t.! i, t i [! ca. ). Ei r'I . In t:+. rl G; . I. Ca i''' : r'I ~! _: E! ? E1 1. ~ r! ; \% .. (:. E':' :.. I` . ,' .. _ t. 1 _~ ~ ,
+ + ~ ~" r ~. 4. A 4 + _
I t_• .~ 1 '.~ i i'i i.... o
11GRBglY1BNT
(SID PETERSON 1+~8MORIAL HOSPITAL)
This Mandated Provider Agreement is entered into on the
lst day of September 1991, by and between SID
PETERSON MEMORIAL HOSPITAL acting by and through it's duly
authorized administrator, F. W. HALL, Jr. (hereinafter
called "Hospital"), and KERR COUNTY, TEXAS, acting by and
through its duly authorized COUNTY JUDGE, W. G. STACY, as
authorized by the Commissioners' Court of Kerr County, Texas
(hereinafter called "County").
WITNESSETH
WHEREAS, County is required by the Indigent Health Care
and Treatment Act (hereinafter called "Act") to provide
certain inpatient and outpatient mandatory hospital services
for its eligible residents;
WHEREAS, County desires to insure that County's
eligible residents receive those inpatient and outpatient
mandatory hospital services required by the Act;
WHEREAS, Hospital agrees to provide, or to arrange the
provisions of, those inpatient and outpatient mandatory
hospital services required by the Act for County's eligible
residents;
NOW, THEREFORE, in consideration of the mutual
covenants herein contained, County hereby designates and
Hospital hereby agrees to be a Mandated Provider for
inpatient and outpatient mandatory hospital services
required by the Act or the Act's regulations to be provided
to County's eligible residents and the parties agree as
follows:
1. DEFINITIONS
All terms shall be as defined in the Act and by the
TEXAS DEPARTMENT OF HUMAN SERVICES, (hereinafter called
"Department") to the extent of the departments rights,
responsibilities and powers under the Act.
2. MANDATED PROVIDER
Hospital shall be a mandated provider of the inpatient
and outpatient mandatory hospital services for County's
eligible program by the Health Care Financing
Administration. Unless otherwise agreed upon, Hospital shall
deliver, or arrange to be delivered, those inpatient and
outpatient hospital services, ordered by a physician, that
are considered mandatory services pursuant to the Act or as
defined by the Department. Such inpatient and outpatient
services shall be provided to eligible residents of County
who do not reside within an area that a public hospital or
Page 1
hospital district has a legal obligation to serve. County
shall require its eligible residents to obtain inpatient and
outpatient mandatory hospital services from Hospital except
in emergency situations, when medically inappropriate, or
when the service is not available through Hospital.
County shall have the right to require nonmandated hospital
providers, who deliver or will deliver inpatient or
outpatient mandatory hospital services to a patient who is
or may be an eligible resident to transfer the patient to
Hospital unless it is medically inappropriate to do sa.
3. COUNTY'S FINANCIAL OBLIGATIONS
County shall reimburse Hospital for inpatient and
outpatient mandatory hospital services provided to eligible
residents. County is obligated to reimburse Hospital for all
normal and reasonable charges of Hospital up to the maximum
amount of reimbursement allowed under the Act. County is not
liable for reimbursement of services which exceed the
maximum per patient limits established by the Act. County
shall notify Hospital before the date on which County
anticipates it will spend ten percent (10~) of the general
revenue levy for that fiscal year. If Hospital transfers
eligible residents of County for inpatient and outpatient
mandatory hospital services which Hospital is unable to
provide, County is obligated to reimburse the receiving
hospital at the receiving hospital's payment rate, but not
to exceed the maximum payment of reimbursement allowed under
the Act or established by the Department. Per patient
expenditure limits as established by the Act apply to such
services delivered by the receiving hospital.
4. NOTICE
County shall have the duty and responsibility to post
all notices concerning the availability of inpatient and
outpatient mandatory hospital services from Hospital.
5. DETERMINATION OF ELIGIBILITY
County shall be responsible for determining whether an
applicant is eligible for financial assistance defined by
the Act and shall provide eligible residents with documents
and/or cards which identify persons as eligible residents.
In the case of a patient who may be eligible seeking non-
emergency services, Hospital shall not provide such non-
emergency services until County has determined eligibility
of the patient, has notified Hospital of the eligibility
decision and has approved in writing provision of the non-
emergency services. County must determine eligibility for
non-emergency services within fourteen (14) days from the
date County receives a completed application.
County shall provide Hospital with current eligibility forms
and procedures for distribution to applicants.
Page 2
Eligibility requirements and this contract may be modified
at any time by County to reflect any statutory changes in
County's indigent care obligations. Residency disputes shall
be resolved by the Department.
6. NOTIFICATION OF PROVISION OF SERVICES
Hospital may deliver emergency services to eligible
residents of County without obtaining County approval.
Hospital must receive written approval from County before
providing non-emergency services.
7. REIMBURSEMENT PROCEDURES
Hospital shall present full charges for inpatient and
outpatient mandatory hospital services provided to eligible
patients to County monthly for patients discharged during
the previous thirty (30) days. County shall reimburse
Hospital within thirty (30) days of presentation of the
charges at the payment rate for inpatient and outpatient
care as determined by the Department. All payment disputes
are to be submitted far binding resolution to a panel
consisting of a Hospital medical staff member who did not
attend the patient, Hospital's administrator, one Hospital
Board of Director member, County Judge, and one County
Commissioner.
In the case of emergency hospital services rendered to a
patient who is determined in Section 5 not to be eligible
for financial assistance, Hospital shall be financially
responsible for the services rendered to such patient.
Hospital reserves the right to pursue any reasonable
collection effort against such patients.
Hospital shall waive all deposit requirements far eligible
patients, except to the extent such deposits are required
for usual and customary Hospital policies as security for a
person's non-covered charges. Hospital shall have the right
to bill eligible patients for non-covered charges whether
the charges are for excluded services or because the charges
are not payable by County due to provisions of the Act or
payment policies and rates established by the Department.
8. THZRD PARTY PAYORS
Hospital will notify County if any eligible residents have
access to any other sources of payment for the eligible
services provided, but County shall be responsible for the
payment of such eligible services as provided for herein.
Hospital shall notify Gounty of the amounts received from
third party payors and reimburse County for services and
amounts covered under this Agreement.
9. RECORDS
Hospital will provide County access to all financial records
necessary to document the Hospital's provision of services.
Page 3
Such access shall be during normal business hours of the
Hospital and shall be preceded by notice from County. Such
notice shall be received by Hospital twenty four (24) hours
in advance of such examination.
County shall hold all medical records in strict confidence
so as not to violate the physician/patient relationship.
County shall obtain a signed authorized medical consent form
from the patient, authorizing the release of his/her medical
records and provide the same to the Hospital prior to
receiving any medical records.
10. TERM AND RENEWAL TERMS
The term of this Agreement shall be from September 1. 1991
through August 31, 1992. This Agreement may be renewed for
additional one (1) year terms by written agreement of the
parties at least thirty (30) days prior to the expiration of
the original or any renewal term. County shall reimburse
Hospital according to the provisions of this Agreement for
any eligible patient who continues to be hospitalized past
the expiration of this Agreement.
11. TERMINATION AND RIGHT TO CURB
Tither party may terminate this Agreement upon breach
of this Agreement with thirty (30) days prior written
notice, provided the breaching party has been notified
thirty (30) days prior to the termination notice and efforts
to resolve the matter to the terminating party's
satisfaction are unsuccessful. Upon termination as provided
for herein, neither of the parties shall have any further
duty or obligation to the other except for indebtedness due
at the time of termination and indemnification of the other
party.
12. HOLD HARMLESS
Sach party agrees to indemnify and hold harmless the
other party and its employees against and from all claims
and actions brought by third parties against the other party
on account of willful, intentional, negligent or illegal
conduct, omissions or bad faith of the party, its agents or
employees. Hospital and its medical staff shall retain sole
authority and responsibility for the treatment of eligible
patients of County.
13. ASSIGNMENT
Neither party shall assign this Agreement except with
the prior written consent of the other party.
14. HEADINGS
Section headings are for convenience of reference only
and shall not be used to construe the meaning of any
provision to this Agreement.
Page 4
15. COUNTERPARTS
This Agreement may be executed in any number of
counterparts, each of which shall be an original, and all of
which shall together constitute one agreement.
16. OBLIGATIONS AS CONDITION
All obligations of each party to this Agreement are
conditions to further performance of the other party's
continued performance of its obligations under the
Agreement.
17. EXCLUSIVE RIGHTS
Only the parties to this Agreement have the exclusive
right to bring suit to enforce this Agreement and no other
parties may bring suits as a third party beneficiary, or
otherwise, to enforce the Agreement.
18. SEVERANCE
Should any part of this Agreement be invalid or
unenforceable, such invalidity or unenforceability shall not
affect the validity and enforceability of the remaining
portions.
19. LAW
This Agreement shall be construed in accordance with
the laws of the State of Texas.
20. AMENDMENT
This Agreement may not be modified except in writing
executed by both parties to this Agreement.
21. NOTICE
Any notices, demands or communications required,
permitted or desired to be given hereunder shall be deemed
effectively given when personally delivered or mailed by
prepaid certified mail, return receipt requested, addressed
as follows:
Kerr County Judge Administrator
Kerr County Courthouse Sid Peterson Memorial Hospital
700 Main 710 Water Street
Kerrville, Texas 78028 Kerrville, Texas 78028
or such other address and to the attention of such other
person(s) or officer(s) as either party may designate by
written notice.
22. FORCE MAJEURE
Neither Party shall be liable
default for any delay or failure of
Agreement or other interruption from
military authority. acts of public
fires, explosions, earthquakes,
transportation, strikes, or other
nor deemed to be in
performance under this
Acts of God, civil or
enemy, war, accidents,
floods, failure of
work interruptions by
Page 5
either Party's employees or agents, or any similar or
dissimilar cause beyond the reasonable control of either
Party. Either party in such event may terminate this
Agreement.
23. RELATIONSHIP OF PARTIES
None of the provisions of this Agreement are intended
to create nor shall be deemed construed to create any
relationship between County and Hospital other than that of
independent entities contracting with each other hereunder
solely for the purpose of effecting the provisions of this
Agreement. Neither the parties hereto, or any of their
respective officers, directors or employees shall be
construed to 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 subject matter hereof. This
Agreement is 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 Services and other applicable
local, state and federal laws, rules or regulations.
IN WITNESS WHEREOF, the Parties have caused this
Agreement to be executed by their respective duly authorized
representatives as of the day and year first above written.
SID PETERSON MEMORIAL HOSPITAL
BY:
F. W. Hall, Jr.
Administrator
KERR COUNTY, TEXAS
s
W. G. Stacy
Kerr County Judge
Page 6
COMMISSIONERS' COURT AGENDA REQUEST
~UlS
PLEASE FURNISH ONE ORIGINAL AND FIVE COPIES OF THIS REQUEST AND
DOCUMENTS TO BE REVIEWED 8Y THE COURT
MADE BY: w_~:_ sra~,
MEETING DATE: Aiigi,sr 1 2 _ 1 A91
OFFICE: cat„ y .T„a~
TIME PREFERRED:
SUBJECT: (PLEASE BE SPECIFIC) Annroval of Mandated Provider Agreements
with Sid Peterson Memorial Hospital and Physicians required by the Indigent Health
Care and Treatment Act.
EXECUTIVE SESSION REQUESTED: YES _NO x
PLEASE STATE REASON FOR EXECUTIVE SESSION
ESTIMATED LENGTH OF PRESENTATION: 5 mint es
PERSONNEL MATTER - NAME OF EMPLOYEE:
NAME OF PERSON ADDRESSING THE COURT: COUritV Jtd _e
Time for submitting this request for Court to assure that the matter is posted in accordance
with Article 6252-17 is as follows;
~ Meetings held on second Monday: 12:00 P.M. previous Wednesday
~ Meetings held on Thursdays: 5:00 P.M. previous Thursday
THIS REDDEST RECEIVED BY: g/s/ 1
THIS REQUEST RECEIVED ON : is ~ 11:20 am
All Agenda Requests will be screened by the County Judge's Office to determine if
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. See Agenda Request
Guidelines.
ORDER N0. 20369
APPROVAL OF A MANDATED PROVIDER
AGREEMQVT BETWEEN SID PEZT;RSON
MEMORIAL HOSPITAL AND I~RR
COUNTY FROM SF;PTF',MF'RRR 1,1991
THROUGH AUGUST 31, 1991
August 12, 1991
Vol S, Page 360