IN WITNESS WHEREOF, the parties hereto, by their duly authorized representatives, have affixed their hands. | |
COUNTY OF SAN MATEO | |
By: | |
Richard S. Gordon, President Board of Supervisors, San Mateo County | |
Date: | |
ATTEST: | |
By: | |
Clerk of Said Board | |
PHARMERICA | |
Contractor’s Signature | |
Date: | |
Long Form Agreement/Business Associate v 6/24/04 |
Exhibit “A” | ||||
In consideration of the payments set forth in Exhibit “B”, Contractor shall provide the following services: | ||||
A. |
Contractor shall provide the following pharmacy services including medications and IV therapy services to San Mateo Medical Center (SMMC) Long Term Care and Burlingame Long Term Care (BLTC): | |||
1. |
Contractor agrees to promptly deliver to County any prescription and nonprescription drugs and supplies within reasonable times and without unreasonable delay, except for circumstances and conditions beyond its control which shall expressly include, but not be limited to, out of stock situations. If for any reasons Contractor is unable to deliver requested item(s) within a reasonable time, Contractor shall promptly notify County of its inability to deliver, and shall, subsequently, secure an alternative source of supply. If an order is missed by Contractor and not sent on the appropriate day with the routine deliveries, then the medication will automatically be considered STAT or sent accordingly the next day. | |||
2. |
Contractor agrees to provide continuous products and services Monday through Friday during normal business hours and shall, in addition, provide emergency service twenty-four (24) hours per day, seven (7) days a week throughout the calendar year. An emergency shall be defined as the lack of availability for administration of any drug ordered by a physician, regardless of reason. Drugs ordered STAT by the physician that are not available in the facility emergency drug supply shall be available and administered within one (1) hours during normal pharmacy hours. For those hours during which the pharmacy is closed, drugs ordered STAT within two (2) hours. Drug orders shall be available on the same day ordered unless the drug would not normally be started until the next day. Antibiotics will be delivered within four (4) hours if not available in Emergency Drug Supply. | |||
3. |
Contractor agrees to bill each patient individually or in the case of a Medi-Cal Assistance Recipient to the appropriate state agency in conformity with the usual and customary method of billing. | |||
4. |
Contractor will provide to County all forms it deems necessary for the proper execution of the drug delivery system. Said forms include, but shall not be limited to, drug order and reorder forms, delivery receipt forms, and communication orders. | |||
5. |
All deliveries, by whatever means, shall be at the expense of Contractor. Routine deliveries will be completed within thirty (30) minutes of agreed upon delivery times which are 3:00 p.m. and 8:00 p.m. for San Mateo County Long Term Care and Burlingame Long Term Care Services, except for circumstances beyond Contractor's control. | |||
6. |
All telephone calls to Contractor from County, or from County to Contractor shall be made by the most expedient and least expensive method. All long distance toll charges resulting from said telephone calls shall be the responsibility of Contractor. | |||
7. |
Contractor will, as necessary, make available to County certain materials and equipment which may include, but shall not be limited to, reference books, films, slides, manuals, audio-visual equipment and training aids. Contractor shall also insure that drug distribution carts are available for use on a continual basis. It is understood and agreed to by County that such materials shall at all times remain the property of Contractor and upon demand shall be returned to Contractor in their original condition subject to normal wear and tear. However, in the event of termination of this Agreement, County shall be responsible for purchasing the drug distribution carts at their then remaining value. | |||
8. |
Contractor shall provide County with an appropriate number of Emergency Medication Kits and use the policy which shall conform to all State Board of Pharmacy and Board of Health rules and regulations. It is understood by both parties that said kit and its contents shall remain at the property of Contractor in the event of termination of this contract. It is further understood and agreed upon by both parties that use of an item from this kit shall be pursuant only to a drug order by a licensed physician. County agrees to promptly report the usage of any item from this kit and to facilitate the billing for said items to the appropriate patient. In the event that County fails to report such usage, the cost of replenishing the kit to the approved list of contents shall be borne by County. | |||
9. |
Applicable Standards. The services performed by Contractor shall conform to the standards of the Joint Commission on Accreditation of Hospitals and Health Organizations (Long Term Care Section); the Department of Health and Human Services; and all other State and Federal Agencies including, but not limited to, the State board of Health; State Board of Pharmacy; and the Department of Health Services. | |||
Contractor shall obtain and maintain all necessary local, State, and Federal licenses and permits required for the operation of Contractor consistent with the above standards. Contractor agrees that its pharmacists shall be registered and qualified to practice as Long Term Care facility pharmacists. Quality Assurance monitoring will be provided separately through an independent contract. | ||||
10. |
SMMC retains professional and administrative responsibility for the services rendered, however, in no circumstance shall SMMC be liable for the acts or omissions of Contractor and Contractor is bound in full by the indemnification/hold harmless language of this Agreement. | |||
B. |
Contractor will provide the following consulting services: | |||
1. |
Review the drug regimen of each patient at the skilled level of care in SMMC Long Term Care 1AB and BLTC at least once each month and report in writing any irregularity to San Mateo Medical Center’s Administrator, Medical Director, Director of Nursing Services, and where appropriate, the individual patient's physician. | |||
2. |
Serve on SMMC Long Term Care Quality Improvement Committee at SMMC 1 AB and BLTC. | |||
3. |
Submit, at least quarterly, a written report to SMMC Long Term Care Quality Improvement Committee on the status of SMMC Long Term Care 1AB and BLTC pharmaceutical service and staff performance. Such report shall include, but not be limited to: | |||
a. |
A review and assessment of compliance with any plan of action previously adopted by SMMC Long Term Care 1AB and BLTC quality Improvement Committee. | |||
b. |
A review and ongoing assessment of compliance with all federal, state, or local laws, regulations or rules and all of San Mateo Long Term Care 1AB and BLTC pharmaceutically-related policies and procedures including, for example, that drugs are dispensed and labeled in compliance with federal and state laws, and provided on a prompt and timely basis. | |||
c. |
Recommendations, if any, for improving the delivery of pharmaceutical services with the goal of correcting or preventing instances of noncompliance and enhancing the level of patient care in SMMC Long Term Care 1AB and BLTC facility. | |||
4. |
Prepare and maintain SMMC Long Term Care 1AB and BLTC Pharmacy Policy and Procedure Manual. | |||
5. |
Assist SMMC Long Term Care 1AB and BLTC staff in the accounting, destruction, and reconciliation of unused controlled substances as prescribed by law, rule, or regulation. | |||
6. |
Assist SMMC Long Term Care 1AB and BLTC administrative staff in establishing and implementing policies and procedures for the safe and effective distribution, control, and use of drugs. | |||
7. |
Consult with the Medical Director and any attending physicians regarding the use of formulary drugs as requested by the Facility Administrator. | |||
8. |
Participate as needed in SMMC Long Term Care 1AB’s facility inservice training program for the licensed nursing staff. | |||
9. |
Meet all other responsibilities required of a consultant pharmacist as set forth in federal, state, or local laws, regulations, or rules as enacted or as may be enacted or amended. | |||
10. |
Contractor agrees that the following additional services will be provided to SMMC Long Term Care 1AB and BLTC. These services include: | |||
a. |
A FAX system for convenient ordering. | |||
b. |
Pharmacist consulting services. | |||
c. |
Nurse consulting services in medication distribution and other incidental consulting. | |||
d. |
Continuing education services. | |||
e. |
Access to a toll-free hotline for dietary, medical records, clinical, Medicare, regulatory and reimbursement questions. | |||
11. |
Contractor shall apprise SMMC of recommendations, plans for implementation and continuing assessment through dated and signed reports which shall be retained by SMMC for follow-up action and evaluation of performance. | |||
C. |
SMMC Long Term Care 1AB and BLTC Administrator shall designate the employee(s) responsible for implementing the services contemplated in this Agreement and who shall act as coordinator(s) with Contractor. | |||
Exhibit “B” | ||||
A. |
In consideration of the services provided by Contractor in Exhibit “A”, County shall pay Contractor based on the following fee schedule: | |||
1. |
County shall pay Contractor for pharmaceuticals provided to patients covered by Medicare at rates established for Medi-Cal patients. | |||
2. |
County agrees to notify Contractor as to the status of each patient regarding source of reimbursement for prescription drugs and supplies and in case of a Medi-Cal patient, shall provide to Contractor, an appropriate Medi-Cal ID card or P.O.E. sticker on a prompt and timely basis so as to avoid delays in pharmacy billings. County also agrees that it shall notify Contractor as to changes in status or source of reimbursement on a prompt and timely basis. County shall give Contractor reasonable access to all patient records, facilities, and supplies necessary for the performance of its duties, herein, and Contractor agrees that it will furnish to County upon request all reciprocal information relating to the drugs and supplies furnished to County or patients therein. | |||
3. |
In all instances where County processes billing and remittance on behalf of Contractor, County agrees to promptly process said claims received from Contractor and to remit the same to Contractor within sixty (60) days' of receipt of Contractor's statement without regard to collectability. Any unpaid monies greater than 60 days shall bear interest of 10% per annum. | |||
4. |
In the event of any dispute arising from any claim or bill submitted by Contractor, Contractor shall have access to all reasonable and necessary documents and records that would in the discretion of Contractor tend to sustain its claim. Further, where County is an intermediary in the processing of said claim, County shall promptly furnish to Contractor any information regarding the status of the claim and shall grant to any fiscal agency involved the right to discuss status of the claim with Contractor. | |||
5. |
County shall pay for any drugs, supplies, or ancillary equipment purchased on its own account and shall remit payment on same promptly according to the terms extended by Contractor upon receipt of bill from Contractor. The purpose of said drugs, supplies, and equipment is not required by this contract. This amount shall not exceed the limits as set forth in paragraph 2, of this Agreement. | |||
6. |
County may at its option purchase from Contractor and Contractor agrees to sell to County all stock supplies whose use may not be attributed to a single patient. | |||
7. |
In the event of the referral of a Medi-Cal pending patient, the County shall have four (4) months to provide proof of eligibility. After this time, Contractor shall bill the patient or Conservator. | |||
8. |
Maximum amount for pharmacy services shall not exceed ONE MILLION SIX HUNDRED FORTY-TWO THOUSAND DOLLARS ($1,642,000) | |||
B. |
For providing consulting services, Contractor shall be paid based on the following: | |||
1. |
Contractor will be compensated by County for consultant pharmacy services rendered from the first day of a calendar month to the last day of that calendar month ("Billing Period") according to invoices submitted by Contractor to County. Contractor shall be compensated at a rate of THREE DOLLARS AND FIFTY CENTS ($3.50) per bed per month, based upon invoices submitted for the applicable Billing Period. | |||
2. |
The maximum amount for Consulting services will not exceed FIFTY THOUSAND DOLLARS ($50,000). County shall have the right to withhold payment if County determines that the quantity or quality of work performed is unacceptable. | |||
C. |
The term of this agreement is July 1, 2005 to June 30, 2008. Maximum payment for services provided under this agreement the three-year term will not exceed ONE MILLION SIX HUNDRED NINETY-TWO THOUSAND DOLLARS ($1,692,000). | |||